Creating conditions for Canadian aboriginal health equity: the promise of healthy public policy

Abstract

In the Canadian context, the persistence and growth of Aboriginal health and social inequity signals that we are at a critical public health policy juncture; current policy reflects an historic relationship between Aboriginal people and Canada that fails the contemporary health needs of Canada’s Aboriginal peoples. In this review, we highlight the need for healthy public policy that recognizes and prioritizes the rights of Canada’s Aboriginal people to achieve health equity. Drawing from a structural approach, we examine the historical scope and comprehensive breadth of the Indian Act in shaping modern Aboriginal health and social inequities. Canada’s failure to implement a national public policy for Aboriginal health reflects the proliferation of racism in modern day Canada, and a distinctly lacking political will at the federal level. Despite these structural challenges, there is great promise in community self-determination in health care and the role of community-led research as advocacy for policy reform. In our conclusion, we turn to the Report on the Truth and Reconciliation Commission of Canada (2015) and draw upon the concept of reconciliation as a fundamental precursor for Aboriginal health equity. The burden of systemic change needed to promote healthy public policy cannot be carried by any single group of advocates; it is a shared responsibility that will require the collaboration and integration of various actors and knowledges.

Full Issue

“…Their geography has presented a number of practical limitations to practising TFS in meaningful ways, but so too are they limited by their relative social and cultural exclusion from their home communities. At the root of many of these women's stories of urbanization lie uneasy truths about the politics of identity and Bill C-31, that clause in the Indian Act that has separated women from their communities and children from their families (Bourassa, McKay-McNabb, & Hampton, 2004;Richmond & Cook, 2016). Life history interviews with female Elders representing the same communities in southwestern Ontario further illustrate these intergenerational impacts that have disconnected First Nation women, in particular those living in urban centres, from the land .…”

Measuring What Counts to Advance Indigenous Self-Determination: A Case Study of the Nisg̱a’a Lisims Government’s Quality of Life Framework and Survey

“…Well-Being in the Indigenous Context; the Importance of Participatory Research Indigenous well-being has broadly been described as holistic, multidimensional, and based on community-centred experiences and Indigenous epistemology. It has been associated to individual, systemic, and institutional factors, most notably, colonialism (Greenwood et al 2018;Richmond and Cook 2016). For example, the medicine wheel approach, which is used in the First Nations Holistic Policy and Planning Model, the Integrated Life Course, and Social Determinants Model of Aboriginal Health, exemplifies the concept of Indigenous well-being as a holistic and integrated approach to health.…”

Kijiikwewin aji

“…North America was colonized, gender roles were redefined with the imposition of European laws (Boyer, 2006). The colonial constructs include, but are not limited to: eras of the Indian Act (Richmond & Cook, 2016), child welfare (Blackstock, Trocme & Bennett, 2004), residential schools (Truth and Reconciliation Report, 2015), and the present crisis of missing and murdered Indigenous women and girls (Olsen Harper, 2006).…”