Canada needs a holistic First Nations health strategy

Katz, Alan; Enns, Jennifer; Kinew, Kathi Avery

doi:10.1503/cmaj.170261

Cited by 25 publications

(27 citation statements)

References 3 publications

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“…The drivers for these elevated rates of suicides and suicide attempts among First Nations people have been well documented: poverty, poor housing conditions, scarcity of employment opportunities, and a lack of access to culturally safe health care services (including mental health supports) contribute to poor physical health and an overall outlook of hopelessness. 27,28 The characteristics associated with FASD (impulsivity, tendency for alcohol and other drug abuse, and difficulties maintaining employment and personal relationships) serve to further exacerbate clinical symptoms of individuals with FASD living in conditions of environmental risk. 29,30 The cumulative effect of significant systemic social and cultural disadvantage in combination with FASD results in a group of First Nations youth with FASD who demonstrate high rates of suicide attempts and completion.…”

Section: Discussionmentioning

confidence: 99%

Health, Social, Education, and Justice Outcomes of Manitoba First Nations Children Diagnosed with Fetal Alcohol Spectrum Disorder: A Population-Based Cohort Study of Linked Administrative Data

et al. 2018

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Objective:To examine health services, social services, education, and justice system outcomes among First Nations children and youth with fetal alcohol spectrum disorder (FASD).Methods:In this retrospective cohort study, health and social services, education, and justice data were linked with clinical records on First Nations (FN) individuals aged 1 to 25 and diagnosed with FASD between 1999 and 2010 ( n = 743). We compared the FN FASD group to non-FN individuals with FASD (non-FN FASD; n = 315) and to First Nations individuals (matched on age, sex, and income) not diagnosed with FASD (FN non-FASD; n = 2229). Rates and relative risks (RRs) were calculated using generalized linear models.Results:FN FASD individuals had similar health services use to non-FN FASD individuals but had greater involvement with child welfare (RR, 1.20; 95% confidence interval [CI], 1.02 to 1.41) and the justice system (RR, 1.37; 95% CI, 1.07 to 1.74) and were more likely to be charged with a crime (RR, 1.40; 95% CI, 1.05 to 1.86). There were no suicides/suicide attempts among the non-FN FASD individuals during the study, but the crude rate/100 person-years of suicides among FN FASD individuals (0.22 for females; 1.06 for males) was substantially higher than for FN non-FASD individuals (0.08 for females; 0.32 for males). There were no significant differences between groups in the education outcomes we measured.Conclusions:Young people with FASD are at risk for poor health, education, and social outcomes, but First Nations young people with FASD face comparably higher risks, particularly with child welfare and justice system involvement. The study emphasizes a critical need for appropriate resources for First Nations children with FASD.

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Section: Discussionmentioning

confidence: 99%

Health, Social, Education, and Justice Outcomes of Manitoba First Nations Children Diagnosed with Fetal Alcohol Spectrum Disorder: A Population-Based Cohort Study of Linked Administrative Data

et al. 2018

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“…As argued by MacNeil (2008), “Challenges in defining and reporting suicide in the Aboriginal population cannot be addressed without a cultural understanding [emphasis added] of suicide among Aboriginals in general and specifically across diverse bands” (p. 9). It is also crucial to highlight that the problem is not restricted to mental health: “Large inequities in virtually every measure of health and wellness exist between First Nations and their non-Indigenous counterparts” (Katz, Enns, & Avery Kinew, 2017, p. e1006). Through an ethnographic approach—or indeed through any other appropriate methodology—it would be possible to understand how a violent history of colonialism led to the current health conditions of First Nations people.…”

Section: Critiquing O’byrne’s Erroneous Understanding Of Ethnography mentioning

confidence: 99%

A Critique of O’Byrne’s Understanding of Ethnography and the Politics of Public Health Research

Brisson

2018

Qual Health Res

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Patrick O’Byrne criticizes the use of ethnography in public health research focused on cultural groups. His main argument is that ethnography disciplines marginalized populations that do not respect the imperative of health. In this article, I argue that O’Byrne has an erroneous understanding of ethnography and the politics of scientific research. My main argument is that a methodology itself cannot discipline individuals. I argue that if data are used as a basis to develop problematic public health policies, the issue is the policies themselves and not the methodology used to collect the data. While O’Byrne discourages researchers from conducting health research like ethnography focused on cultural groups, I argue the exact opposite. This has to do with justice and equity for marginalized communities and the obligation to tailor health services for their specific needs, which may not be the same as those of the general population.

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“…This will require skills-based training in intercultural competency, conflict resolution, human rights, and antiracism” ( TRC 2015 ). Although many of these recommendations have previously been made by others ( Browne et al 2016 ; Haggerty et al 2018 ; Katz et al 2017 ; Lavoie 2013 ; Lavoie et al 2007 ), these do not appear to have been heeded considering the continued dismal health indices. The missing link appears to be a stark lack of policy action.…”

Section: Discussionmentioning

confidence: 99%

What Changes Would Manitoba First Nations Like to See in the Primary Healthcare They Receive? A Qualitative Investigation

Kyoon-Achan¹,

Lavoie²,

Kinew

et al. 2019

hcpol

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Background: First Nations (FN) have unique perspectives and experiences of health and healthcare services, which are critical to the provision of effective community-based primary healthcare (CBPHC). Objective: This paper shares FN perspectives on primary healthcare (PHC), taking geographical, cultural and historical realities into account, to elucidate opportunities to improve current healthcare services. Methods: Semi-structured in-depth qualitative interviews were completed with 183 residents of 8 Manitoba FN communities. Grounded theory-guided data analysis was conducted. Results: Improving PHC performance requires delivering timely and holistic healthcare that integrates traditional health knowledge, comprehensive CBPHC increasing services such as healthcare and medical transportation, healthy food as an important preventative measure and a culturally informed workforce backed by local leadership and promoting cultural respect. Conclusion: The relationship between self-determination and health is a critical factor in the implementation of CBPHC. FN must be respected to decide healthcare priorities that reflect the needs and visions of each community.

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Canada needs a holistic First Nations health strategy

Cited by 25 publications

References 3 publications

Health, Social, Education, and Justice Outcomes of Manitoba First Nations Children Diagnosed with Fetal Alcohol Spectrum Disorder: A Population-Based Cohort Study of Linked Administrative Data

Health, Social, Education, and Justice Outcomes of Manitoba First Nations Children Diagnosed with Fetal Alcohol Spectrum Disorder: A Population-Based Cohort Study of Linked Administrative Data

A Critique of O’Byrne’s Understanding of Ethnography and the Politics of Public Health Research

What Changes Would Manitoba First Nations Like to See in the Primary Healthcare They Receive? A Qualitative Investigation

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