Recognition of the "preventable, avoidable and unfair" health inequities experienced among First Nations, Inuit and Métis peoples in Canada is growing, and was evident during the recent Canadian Public Health Association (CPHA) Conference celebrating 100 years of public health in Canada. The national event, in Toronto June 13-16, 2010, drew more than 1,500 participants from across the country.
Madeleine Dion Stout, former president of the Aboriginal Nurses Association of Canada and recipient of the 2010 National Aboriginal Achievement Award for Health, said during a plenary session that there is a recent trend among Canadians who are seeking to "understand Aboriginal communities' public health issues... through an Aboriginal lens." Dion Stout applauded the shift from a romanticized view to a more authentic understanding of Aboriginal cultures and traditions as an "essential cornerstone for effective public health process in Aboriginal communities." She was quoted in the CPHA official newsletter, The Daily.
Eight sessions and nearly 40 presentations in the conference program addressed a wide variety of issues related to Aboriginal Health in Canada, from rural and urban Inuit communities preparing for the H1N1 pandemic to strategies for addressing chronic disease, HIV/AIDS, and mental health.
In recognizing a century of public health achievements, the Honourable Monique Bégin, a former federal Health Minister who led the passage and implemention of the Canada Health Act, said there have been "extraordinary strides" in public health in the country, from flouridation and immunization to a general drop in infant deaths. However, she said the "need is still acute in our Aboriginal communities."
Similarly, Canada's Chief Public Health Officer, Dr. David Butler-Jones, applauded advances in such fundamental public health issues as safer, healthier foods and clean water. Nevertheless, he said Canada has seen a number of safe water crises in Battleford, Saskatchewan and Walkerton, Ontario, while "[m]any Aboriginal communities, in particular, cannot count on their water supply."
Canada's "Moral Debt"
Dr. Gilles Paradis, associate professor at the Department of Epidemiology at McGill University and scientific editor of the Canadian Journal of Public Health, said Canada faces the challenge of addressing "unacceptable inequalities" that undermine the social solidarity at the heart of Canadian society. Paradis said in the official CPHA newsletter The Daily that it was "shameful that First Nations are systematically disadvantaged and neglected by public authorities, left to cope with life conditions that other Canadians would never accept."
He said Canada faces a "moral debt" to support economic social and cultural development for Aboriginal communities, "giving them the leverage to expand their own education, health, social services, and infrastructure financing."
Dion Stout highlighted during a plenary session the need for attention to the "living context" of Aboriginal communities for insight on the prevailing health conditions. She noted that:
- infant mortality rates are 20 times higher than in the general population
- type 2 diabetes is three times as prevalent
- suicide rates are five to 11 times higher
- earning ability among adult males is about half the Canadian average
Dion Stout said that policies and programs to address the "shocking health and socio-economic conditions" have "either fallen short of implementation, like the report of the Royal Commission on Aboriginal peoples, or been cancelled before their time, like the Aboriginal Healing Foundation," which is focused on addressing the needs of residential school survivors.
Presentations Address New Approaches to Aboriginal Health
As well as staging a half-day workshop on collaborative approaches to "breaking the interngenerational cycle" of chronic disease and issues rooted in a colonial history, the NCCAH facilitated a session on "Social Determinants of Health from a First Nations, Inuit and Métis Perspective." This event featured presentations on gender and women's health in relation to First Nations communities; early child development from a Métis perspective; and the envrionment and nutrition security from the perspective of the Inuit. In each case, the strengths and challenges of working within a social determinants of health framework were explored.
