Indigenous stories & the social determinants of health
- Max Fineday | January 21, 2016
The Truth and Reconciliation Commission has released its final report. This landmark document demonstrates the myriad ways in which the health and well-being of Indigenous peoples were damaged by Canada's residential school policies.
I was a toddler - I can’t remember exactly what age, only that my booster seat in the back of our family car gave me the perfect vantage point to see everything we were passing by. My mom, a woman with too many degrees to count who is the daughter of proud Norwegian farmers, and my Dad, a nêhiyaw traditional knowledge keeper and (especially by his own account) the funniest man alive, were in the front seat.
I don’t remember their conversation, but I remember the word ‘sad’ being spoken as we passed by a young Indigenous girl, maybe in her mid-teens, waving at us as we drove by. It was winter in Saskatchewan, the kind that will chill you to your bones. I thought, with the naivety of a young boy, that she must be cold, after looking down at my puffy jacket, complete with mittens on strings. I didn’t hesitate to wave back, as we passed her, headed toward our warm, middle-class home on the other side of the river.
By 2050, Indigenous people will make up the majority of Saskatchewan’s population. In other parts of Canada, Indigenous people are the fastest growing community. When I think back to seeing that young girl standing on a street corner in the snow, a girl who could have been my relative, who could have been a classmate of yours, or your children’s, I wonder what kind of future we are making for ourselves leading up to 2050.
That young girl, who is 4.5 times more likely to be murdered or go missing than other Canadian women, represents the fate of too many Indigenous people in Canada. Born into a wealthy nation, yet still suffering from poverty, at worst willfully neglected, at best ignored, so many Indigenous people have so few chances to enjoy all that their home territory has to offer.
I’ve seen it happen, around me in the community, and in my own family. Indigenous people starved for the nourishment that should be the fruit of a respectful treaty relationship. Indigenous people left to sit and wait for the leftovers while Canada continues to eat even when no longer hungry.
Canadians regularly hear about Indigenous peoples on the six o’clock news, about a tragedy in a First Nations community, or a crime committed by an Indigenous person in an urban centre. A typical newscast can include stories about poverty, education, sickness, violence, and discrimination relating to Indigenous peoples all before the first commercial break. But is this where Canada stops listening, after hearing the brief news story? Do they shake their heads or, recognize that ‘something must be done’? Do they simply shrug, and go about their lives, with some prejudice reinforced by what they’ve just heard?
It’s not that Canadians don’t care. I know many would say that they do care about all people, but there has been little action to back that up. I think it is clear that for a long time Canadians didn’t care about the fate of Indigenous people, and maybe still don’t. Perhaps it’s largely because they have been taught that Indigenous people are a problem and because they don’t know, not really, what’s happening to Indigenous peoples behind those brief news stories.
I’m not sure that we’ve admitted to ourselves that we have a real problem – but it’s not “the Indian problem” as it was often phrased in the past. It’s a relationship problem. Indigenous peoples are over-represented in the criminal justice system and under-represented in post-secondary education.
Indigenous women are more likely to be murdered or go missing than other women. Rampant poverty for Indigenous people is a wall that prevents them from reaching their full potential. Indigenous peoples are like the abused partner in a dysfunctional marriage, and Canada refuses to go to counseling.
The result of all of these differences is more sickness and shorter lives for Indigenous people in this country. We suffer from higher infant mortality rates, far higher levels of chronic illnesses like diabetes, heart disease, and HIV/AIDS, and shorter lifespans overall. An Indigenous woman is likely to live 5 years less than the national average, for a man the difference is 9 years.
This isn’t happening because people are First Nations or Métis, it’s entirely dependent on the social, political and historical factors that affect the lives of Indigenous people in Canada. When social factors such as income, education, employment, housing and food security are controlled for, the differences in health outcomes disappear. The reality, however, is that when it comes to these social determinants of health, the deck is stacked against Indigenous people.
The social determinants of health provide a framework that can predict how healthy someone will be in their lifetime based on their living conditions: where they work, live, learn and play. Some of the most compelling reading on the social determinants and the path to a health society is coming from Upstream. My goal in this project is to explore how that idea relates to Indigenous lives, and how it might help us chart a way to a healthier balance and healthier relationships in Canada.
Determinants of Health
1. Income and Income Distribution
3. Unemployment and Job Security
4. Employment and working conditions
5. Early childhood development
6. Food Security
8. Social Inclusion
9. Social Safety Net
10. Health Services
11. Aboriginal Status
When I first heard about the social determinants, and saw the list, I couldn’t help but draw connections to what I’ve seen in my community, in my family, and in neechidom as a whole.
Although Indigenous peoples may not use the same academic language as medical professors in Canadian universities, grassroots Indigenous people and organizations have been advocating for better healthcare, education, training, and living conditions as pieces of solutions that will increase the well-being in Indigenous communities.
The National Indian Brotherhood (now the Assembly of First Nations) was born out of the struggle for Indian Control of Indian Education. All those years ago, leaders realized that the children from their communities would be at a disadvantage, would be less healthy, unless they were given a proper education.
In contemporary times we see Idle No More – the resistance and the resurgence of pride that spread across the country – calling for equitable treatment, respect, and justice for Indigenous peoples. When hundreds of people gather in spaces across Canada to tell the story of young First Nations people walking to Ottawa to demand that a school be built in their community, when people come together with a single voice to insist that children born on reserve should not have to wait in hospital while the provincial and federal governments bicker about who should pay for their home care, they are speaking the language of the social determinants of health.
We know that challenges exist in Indigenous communities across our province, and across our country, but few are talking about real action for meaningful change. Instead of leadership and action, many in government are focused on issues that will win more votes. When was the last time an election was won over issues of treaty adherence, or ending injustice towards Indigenous people.
This article originally appeared on Upstream.