Racism and the lack of primary care providers mean off-reserve First Nations, M茅tis and Inuit women and girls have poorer health overall compared to their non-Indigenous counterparts, says a study by the Public Health Agency of Canada.
Compared with non-Indigenous females, those in the three distinct groups reported a higher prevalence of diagnosed chronic diseases and worse mental health, including mood or anxiety disorders, says the study, which noted Canada鈥檚 colonial history of residential schools, forced or coerced sterilization and destruction of traditional lands.
Researchers used data for all females aged 15 to 55 from the annual Canadian Community Health Survey between 2015 and 2020. That amounted to 6,000 people from the three distinct groups and 74,760 non-Indigenous females, all in their reproductive years.
鈥淚ndigenous females waited longer for primary care, more used hospital services for non-urgent care and fewer had consultations with dental professionals,鈥� says the study, published Monday in the Canadian Medical Association Journal.
Lead researcher Sebastian Srugo said that while thousands of women across Canada lack a family doctor, 鈥渢hose conversations are happening much, much more among Indigenous women.鈥�
鈥淓ven when we compare Indigenous women and people assigned female at birth to non-Indigenous counterparts of a similar age, similar education, income and living in the same places, we still have those gaps,鈥� Srugo said.
Women who were pregnant or had just given birth were worse off, and that could affect their children years later, he said.
鈥淭his is about inter-generational impacts of not having access to this care,鈥� Srugo said. 鈥淚t鈥檚 also about a justifiable lack of trust that Indigenous communities have with the health-care system in Canada.鈥�
Primary care providers could support the women in their reproductive decisions and assess them for conditions including heart disease, depression and cancer, he said.
Multiple studies have connected poorer health outcomes for Indigenous females compared to the wider population.
But Srugo said the PHAC study adds to limited research involving First Nations, M茅tis and Inuit, which have diverse cultures, languages and histories but are typically lumped together as Indigenous Peoples.
The study included 2,902 First Nations, 2,345 M茅tis and 742 Inuit women and girls. Researchers also received input from an advisory committee specifically created for the project. Members were from four organizations 鈥� Les Femmes Michif Otipemisiwak (Women of the M茅tis Nation), the Native Women鈥檚 Association of Canada, Pauktuutit Inuit Women of Canada and 2 Spirits in Motion.
While Lee Clark, director of health for the Native Women鈥檚 Association of Canada, lauded federal researchers for partnering with Indigenous organizations, she said their study should not become 鈥渙ne more paper in the pile of evidence鈥� that has made little difference in the lives of women deprived of equitable care.
Researchers themselves cited the challenges in access to care in a 鈥渄isjointed jurisdictional system, resulting in medical relocations for birthing and general health care.鈥�
Clark said she hoped the federal government would use the findings to 鈥渉old provinces accountable鈥� to deliver targeted programs for women whose needs have been sidelined for too long.
Indigenous communities are still deeply affected by the 2020 death of Atikamekw woman Joyce Echaquan in a Quebec hospital, where she filmed staff insulting her as she lay dying, she said.
鈥淭he majority of people I speak with in the community, we have stories of blatant racism,鈥� she said from Gatineau, Que. 鈥淐olonialism isn鈥檛 historic. It鈥檚 ongoing. These harms are continuing and they鈥檙e perpetuated still. Joyce鈥檚 example is just one of the examples that was recorded.鈥�
In a decision earlier this month, anarbitration tribunal ordered the reinstatement of an orderly who was fired by the hospital. An arbitrator wrote that while the employee made inappropriate comments toward Echaquan, she was not responsible for most of the poor treatment the patient received compared to the 鈥渋nsulting, vulgar, racist and rude remarks and behaviour鈥� of a nurse. That nurse was also fired for telling Echaquan that she was stupid and 鈥渂etter off dead.鈥�
Clark also called on federal and provincial governments to work together to incorporate Indigenous practices in health care, including midwifery that uses traditional practices.
鈥淧ockets of this is happening, recently in Nova Scotia. It needs to be everywhere. It needs to be more accepted. The medicalization of birth is just an outright stamp of colonialism.鈥�
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