Aboriginal Physician Use in Canada: Location, Orientation and Identity

Abstract

The main objectives of this paper are to compare Aboriginal and Canadian health status and physician use and to identify the factors associated with the use of physician services. Data are drawn from the 1991 Aboriginal Peoples Survey (APS) and the 1991 General Social Survey (GSS), which are weighted random samples of the Aboriginal and total Canadian populations, respectively. The results demonstrate that Aboriginals were much less likely to use physician services, even though Aboriginals rank their health similarly to the total Canadian population. Location becomes an important aspect of both physician use and health status, with Aboriginals residing on-reserve generally having lower levels of self-assessed health and less likely to have seen a physician. While Aboriginals with the poorest health status were more likely to have seen a physician, other factors including education were found to be barriers to use of health care. Aboriginal identity and cultural orientation provided mixed results.

Prevalence and severity of household food insecurity of First Nations people living in an on-reserve, sub-Arctic community within the Mushkegowuk Territory

“…Collecting data with isolated communities is not without merit as each reserve has unique characteristics and many want local information to direct local policies and programmes (43)(44)(45) .…”

Prevalence of systemic lupus erythematosus and systemic sclerosis in the First Nations population of Alberta, Canada

“…Aboriginal peoples in the Northwest Territories have higher use of nursing and social services compared to physician services, reflecting delivery of health services by nonphysicians in remote locations (17). Data based on a wider population from the 1991 Aboriginal Peoples Survey also revealed that Aboriginal peoples, particularly those living on a reserve, were less likely to use physician services compared to the general Canadian population (16). Differential access to medical services would result in fewer rural or First Nations individuals being diagnosed with a SARD, and an underestimate of prevalence based on administrative data sets since no billing claim or hospitalization separation would be generated.…”

“…The influence of demographic factors on SARD prevalence has been previously demonstrated (12)(13)(14)(15). The effect of demographic factors on disease diagnosis and thus prevalence may be particularly amplified in the First Nations population, where differential access to health services has been documented for care in general (16,17), nephrology services (18), and rheumatologist care (3).…”

Prevalence of Chronic Kidney Disease and Survival among Aboriginal People

“…10 Social, personal, and environmental factors all have been identified as potentially contributing to more rapid progression of kidney dysfunction among black individuals, conceivably contributing to their higher rates of ESRD. 17 Similar factors may be present in the Aboriginal population; in particular, decreased access to specialized medical care 18,19 and insufficient or ineffective primary care 20,21 may result in suboptimal use of therapeutic approaches that have been shown to slow the progression of kidney failure. [22][23][24][25][26] Barriers in access to care for patients with CKD are not unique to the Aboriginal population; ethnic minorities with CKD in general are much less likely than white individuals to be referred to a nephrologist.…”