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Our health counts powerpoint
 

Our health counts powerpoint

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Summary presentation of the Our Health Counts Urban Aboriginal Health Research Project completed in April 2011 - launched Dec. 2011.

Summary presentation of the Our Health Counts Urban Aboriginal Health Research Project completed in April 2011 - launched Dec. 2011.

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    Our health counts powerpoint Our health counts powerpoint Presentation Transcript

    • Our Health Counts Launched December 2011
    • Unique Partnership
      • Our Health Counts was a collaborative effort by:
      • Ontario Federation of Indian Friendship Centres (OFIFC)
      • Métis Nation of Ontario (MNO)
      • Ontario Native Women’s Association (ONWA)
      • Tungasuvvingat Inuit (TI)
        • Urban First Nations Health - Project Team
          • De dwa da dehs ney.>s Aboriginal Health Access Centre
          • Hamilton Executive Directors Aboriginal Coalition
          • Centre for Research on Inner City Health (CRICH) - Led by Dr. Janet Smylie
          • Multiple funders: OFIFC, MOHLTC, AHTF, CRICH
          • Data linked to Institute for Clinical & Evaluative Sciences
    • Research Findings
      • Historic Study
        • A lack of population-based data for urban Aboriginal people - has led to poor planning & policy neglect
        • Findings confirm community’s belief regarding poor health status
        • Results significantly higher than Stats Canada figures
        • 790 people recruited (554 adults, 236 children)
        • 92% of participants agreed to link to OHIP - access to detailed health information through ICES - first time access
    • Unique Approach
      • Community-based urban setting
      • Participatory research design
        • Multi-sector collaboration
        • Shared decision making
        • Respondent driven sampling
        • Community capacity building
        • Trained First Nations interviewers
      • Reflective of Aboriginal beliefs
        • Concept mapping - health dimensions
        • Holistic - health linked to social determinants
        • Respectful engagement vs rapid response
    • Ways of Knowing
      • Use of ‘concept mapping’
      • Community partners worked with researchers to develop a ‘concept map’ to inform survey design
        • Aligns with traditional Aboriginal tools
        • 102 health ‘concepts’ identified by group
        • Sorted into 10 domains
        • Questionnaire built on community priorities
        • Ensured meaningful info is gathered
        • Assessed both strengths & vulnerabilities
        • Reflects Aboriginal world-view - health & wellbeing is a balance of physical, mental, social & spiritual dimensions
    • Demographics
      • 13, 735 people in Hamilton report Aboriginal ancestry (Census 2006) - likely a significant underestimation
      • First Nation’s people represent 2.8% of Hamilton’s population
      • OHC population much younger than general population
      • 51% report being Registered Indians (Indian Act)
      • 95% most often speak English at home
    • Housing Impacts Health I live entirely off food banks, that’s where nutrition comes in, no choice over food…
      • 90% moved at least once in 5 years - vastly higher than non Natives
      • 50% have moved 3 or more times
      • 13% report being homeless or in ‘transition’
      • 74% live in crowded conditions (using Stats Canada definition)
      • Housing is inadequate and in disrepair
      • 70% people live in poorest neighbourhood in Hamilton (3% general pop.)
      • High mobility tied to a cycle of poverty
      • 63% give up important things - food - to afford housing
      • 22% report they do not have enough to eat
      • Stresses families, health, interferes with employment and education
    • Education/Employment
        • Low levels of formal education:
        • 57% First Nations adults over 18 completed some high school
        • 20% report completing high school
        • 5% completed some/all university
        • Women trend to more education
        • Income & employment:
        • 28% income from wages & salaries, 8% from self-employment
        • 69% provincial/municipal social assistance, 10% EI, 17% Child Tax Benefits,
        • 13% other income sources
        • 18% earn less than $4,999, 22% between $5,000 & $15,000,
        • 15% earn between $15,000 & $20,000
        • Only 22% earn over $20,000 (compared to 57% of Hamilton residents)
        • Only 2% First Nations in highest income quartile
      • First Nation people have less access to the social determinants of health
        • Structural & institutional inequalities can’t be solved at individual level - policy, practice & legal changes needed
        • Striking levels of poverty
        • Housing & food instability
        • Lower levels of education & employment
        • Less access to public transportation - impacts employment/inclusion
        • Poorer health status - more chronic illnesses
        • Racism, social exclusion & discrimination
        • Unequal access to health, supports & services
        • Socio-economic stressors likely to be under reported
      Social Determinants of Health
    • Impact of Colonization
      • Legacy of colonization & residential schools impacts health, wellbeing & family cohesion
        • 6% participants were students at residential schools
        • 40% have family member who were at residential schools
        • 65% felt personal negative impacted,
        • 34% felt negative impact as a family member
        • 40% report child protection was part of their childhood care
        • 35% report their children have been involved with child protection
        • 49% felt this has negatively affected their overall health/wellbeing
    • Colonization cont.
      • High levels of violence & abuse reported
        • Violence is part of their community - 58%
        • Violence related to crime with neighbourhood - 95%
        • Lateral violence is common amongst First Nations peers - 81%
        • Violence is related to racism & discrimination - 67%
        • Family violence - 60% (mental/emotional abuse 96%, physical 90%, sexual abuse 52% )
        • Women report experiencing more violence than men
    • Chronic Disease & Disability
      • First Nations people carry a greater health burden, at a younger age, & that limits functional activity
      • 16% have diabetes (3 x general pop.)
      • 26% high blood pressure (20% general population)
      • 31% have arthritis (20% general population)
      • 9% Hepatitis C (> 1% within the general population)
      • 36% report their health is ‘fair to poor’
      • 1/2 - 3/4 of adults have limitations due to illness
      • First Nations men feel their health is better than women do
      • 18% of First Nations women feel health is ‘excellent/good’
      • Compared to 61% for women within general population
    • Health Care Access “Our health deserves appropriate and dedicated care”
      • Urgent need for improved health care access
        • 40% rate access to health care as ‘fair to poor’
      • Barriers to care reported:
        • Long waiting lists - 48%
        • Access to transportation - 35%
        • Can’t afford direct costs - 32%
        • Doctors are not available
        • Lack of trust in health care providers - 24%
        • Stigma & discrimination play a contributing role
      • “ We need more Aboriginal people in health care, education, places where people are looking up to other people. More native role models.”
    • Emergency Room Use
      • First Nations more likely to use Emergency Room
        • Using emergency department for acute & non-acute illness
        • 50% report using ER in past year (22% general population)
        • 11% had more than 6 visits (<2% general population)
        • ER use holds for both children and adults
      • Children less likely to be admitted
        • Compared to non native children - lower rates of admission
        • With comparable or more severe symptoms of illness
        • Is there a systemic bias toward admitting non-native children?
    • Challenges & Strengths
      • Main challenges people identified
        • Drugs & alcohol are major concerns - 68%
        • Housing - 61%
        • Crime, poverty & employment - 60%
      • Community strengths
        • Strong family values - 53%
        • Awareness of First Nations culture - 41%
        • Community health programs/ traditional ceremonies - 38%
        • Presence of elders within community - 36%
        • Social connections within the community - 35%
      • Strong sense of identity as First Nations people
        • Over 93% of people feel it is import/very import for their children learn their language & culture
        • 1/3 people report using traditional medicine
        • Hamilton’s First Nations community has remarkable cultural continuity, resilience & hope - despite alarming inequalities
      Reclaiming identity
    • Whole Government Approach
        • Problems facing Urban Aboriginals in Hamilton are complex
          • Solutions require a whole government approach - working collaboratively with First Nations leaders
          • Our Health Data demonstrates increasing disparities in the social determinants of health for urban Aboriginals
          • Needs inter sectorial partnerships to resolve
        • An urban Aboriginal specific, culturally based, community - driven strategy is required
          • Address inequalities in accessing social determinants of health in accordance with human rights legislation (housing, food security)
          • Chronic disease & disability is disproportionally felt. Municipal & provincial governments need to work with Aboriginal community to set priorities, preventative action & health promotion plans
        • Work with Aboriginal community leaders, municipal, provincial & federal governments to...
          • Remove barriers to equitable access to community health care, emergency departments & inpatient hospital services
          • Fund the development & expansion of culturally reflective, community based traditional family treatment centres, mental & maternal health programs & services
            • Build cultural safety & competence skills recognizing Aboriginal world-view & healing practices
            • Promote self-determination in health care delivery, governance, research, planning, development, delivery & evaluation
      Whole government cont...
    • Child Health Approach
      • Support children’s language & cultural programming - include Aboriginal organizations & school boards
      • Eliminate barriers to primary health care, reduce wait lists, target health concerns in culturally sensitive ways
      • Support First Nations families in parenting their children in culturally supportive ways
      • Accord Aboriginal children their human right to live in healthy homes & attend schools/ programs which do not worsen their health
      Our children are our future... a shared commitment to their health & wellbeing is critical
      • ‘ Our Health Counts’ demonstrates research can be successfully done by Aboriginal people for the benefit of their community
      • Fund First Nations led applied service research
      • Planning is best done in respectful partnership
        • Support interagency collaboration & cooperation
        • Work with Aboriginal agencies & organizations to gain knowledge, promote self-determination in planning, design, development & delivery of culturally specific health services programs & policies
      Research & Planning