Policy Issue #6:Aboriginal Health   HLTH 405 / Canadian Health Policy               Winter 2012 School of Kinesiology and ...
Aboriginal Health
Today’s LectureAboriginal Health: Social Determinants of Healthand the Import of Ethical Partnerships• An Abbreviated Hist...
What Canadians SeeAttawapiskat CrisisAttawapiskat Response
The Danger of StigmaWe forget about…  o The colonization process (1700-1800s)  o The inauguration of the Indian Reservatio...
Colonization (1700-1800s)  o Royal Proclamation (1763)  o Treaty of Paris (1783)
Indian Reservation System   o War of 1812   o Loyalist Migration (post-1814)   o Resident Schools are established (1830)
Indian Act (1876)What did it say?  o (S.46) Removal of Indians  o (S.86) Enfranchisement  o (S.138) Unlawful for Indian Ag...
Assimilation (1920s)
Residential Schools            Video:Kevin Annetts "Unrepentant‛A Documentary about ResidentialSchool Survivors in Canada
Post-WWII Policies                                       o 1951 – Ceremonial bans are                                     ...
The White Paper (1969)                                                Based on a desire to                                ...
Thoughts?
‚However much good a particular health or socialprogram might do in the narrow sphere itaddresses, it does not shift the o...
Ethical Partnerships
2005 Transformative         Change AccordIts AimStrengthen government-to-governmentrelationship to achieve 3 key objective...
A BlueprintJuly 2005First Nations Leadership Council creates theFN Health Blueprint for British Columbia  o Challenges inc...
Health GapsProvincial Medical Officer of Health: 2001 Report• 49% of young people smoke, more than double provincial avg.•...
Jurisdictional Context• Currently, provincial and federal programs and funding  creates a patchwork of services that are p...
Transformative Change Accord’s          10-Year Action Plan1. Establish effective mental health programs to address   subs...
Transformative Change Accord’s          10-Year Action Plan2. Integrate the ActNow BC Strategy with First Nation health   ...
Transformative Change Accord’s         10-Year Action Plan3. Establish tripartite pilot programs in Northern Health   Auth...
Transformative Change Accord’s          10-Year Action Plan4. Increase the number of trained FN health professionals
Transformative Change Accord’s      10-Year Action Plan  Governance, Relationships and Accountability
Transformative Change Accord –Governance, Relationships and Accountability1. Establish a First Nations Health Council that...
Transformative Change Accord –Governance, Relationships and Accountability4. Create a high-level Health Partners Group (FN...
Transformative Change Accord’s      10-Year Action Plan Health Promotion and Disease/Injury Prevention
Transformative Change Accord –Health Promotion and Disease/Injury Prevention1. Minister of State for ActNow BC will collab...
Transformative Change Accord –Health Promotion and Disease/Injury Prevention4. Match non-FN communities in terms of access...
Transformative Change Accord’s      10-Year Action Plan          Health Services
Transformative Change Accord –                     Health Services1. Build a FN-run acute care hospital centre in Lytton, ...
Transformative Change Accord –                     Health Services5. Develop a Maternity Access Project to train midwives ...
Transformative Change Accord’s      10-Year Action Plan        Performance Tracking
Transformative Change Accord –                   Performance Tracking1. Provincial Health Officer will issue Aboriginal He...
Conclusion
Have a great week!
Week 11 - Aboriginal Health
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  • As many as 100,000 Aboriginals who are alive today have suffered the fate of attending Residential Schools, so the social and health impacts will not cease to be felt overnight. Through ethical partnerships and FN-directed community-building, we can be part of the solution.
  • Week 11 - Aboriginal Health

    1. 1. Policy Issue #6:Aboriginal Health HLTH 405 / Canadian Health Policy Winter 2012 School of Kinesiology and Health Studies Course Instructor: Alex Mayer, MPA
    2. 2. Aboriginal Health
    3. 3. Today’s LectureAboriginal Health: Social Determinants of Healthand the Import of Ethical Partnerships• An Abbreviated History of Oppression• Turning A Corner o Calder case o Residential Schools Apology• Self-Determination as Cornerstone for Aboriginal Health o Promoting Cultural Competency o Models for Ethical Partnerships o BC’s Transformative Change Accord
    4. 4. What Canadians SeeAttawapiskat CrisisAttawapiskat Response
    5. 5. The Danger of StigmaWe forget about… o The colonization process (1700-1800s) o The inauguration of the Indian Reservation System (1830) o The Indian Act (1867) & Assimilation o Residential Schools & Sexual Sterilization Acts (1920s) o The White Paper (1969)
    6. 6. Colonization (1700-1800s) o Royal Proclamation (1763) o Treaty of Paris (1783)
    7. 7. Indian Reservation System o War of 1812 o Loyalist Migration (post-1814) o Resident Schools are established (1830)
    8. 8. Indian Act (1876)What did it say? o (S.46) Removal of Indians o (S.86) Enfranchisement o (S.138) Unlawful for Indian Agents not to sell land kept ‘in trust’ for Aboriginal peoples o (S.141) Unlawful to raise or accept money to help Aboriginal peoples pursue a legal claim against the Crown
    9. 9. Assimilation (1920s)
    10. 10. Residential Schools Video:Kevin Annetts "Unrepentant‛A Documentary about ResidentialSchool Survivors in Canada
    11. 11. Post-WWII Policies o 1951 – Ceremonial bans are lifted o 1960 – Aboriginal men are eligible to vote o Nevertheless, ‚Sixties Scoop‛ sees upward of 20,000 On-Reserve children adopted into White families, perpetuating the forced assimilation of FNSgt. Thomas George Prince, peoplesmost decorated Aboriginal soldier (WWII)
    12. 12. The White Paper (1969) Based on a desire to promote social equality, and a political ideology bent on removing the special Constitutional status of Quebec and First Nations, for the sake of forming a ‘more perfect union’, Chretien’s WhiteIndian Affairs Minister, Jean Chretien (1973) Paper promotes the extinguishment of treaties.
    13. 13. Thoughts?
    14. 14. ‚However much good a particular health or socialprogram might do in the narrow sphere itaddresses, it does not shift the overall picture ofAboriginal disadvantage – the pattern ofpoverty, powerlessness and despair – thatdetermines health and illness.‛ - Royal Commission on Aboriginal Peoples (1996)
    15. 15. Ethical Partnerships
    16. 16. 2005 Transformative Change AccordIts AimStrengthen government-to-governmentrelationship to achieve 3 key objectives: o Develop a 10-Year Plan to close gaps in education, health, housing and economic opportunities; o Reconcile Aboriginal rights and title with those of the Crown; o Establish a new relationship based on mutual respect and recognition
    17. 17. A BlueprintJuly 2005First Nations Leadership Council creates theFN Health Blueprint for British Columbia o Challenges include… • Expanding health care delivery and access, including dental care • Need for mental health and addictions services • Limited access to women’s health • Clarifying roles and responsibilities between governments and organizations • Developing collaborative working relationships • Monitoring progress
    18. 18. Health GapsProvincial Medical Officer of Health: 2001 Report• 49% of young people smoke, more than double provincial avg.• Aboriginal peoples live 7 years less on avg.• Diabetes is 40% more prevalent than the BC avg.• #1 reason for day surgery for children is dental care; aboriginal children are 4 times more likely to require such care than BC avg.• Higher rates of pneumonia, MVAs, HIV/AIDS, child mortality
    19. 19. Jurisdictional Context• Currently, provincial and federal programs and funding creates a patchwork of services that are prone to gaps, discontinuities and inadequacies in service delivery• Programs developed in silos create duplication and overlap, create different levels of accessibility for services based on different eligibility criteria (e.g. Metis versus First Nations versus non-status FN)• Data-sharing between providers is compromised or non- existent, creating difficulties in assessing overall picture of Aboriginal health in BC
    20. 20. Transformative Change Accord’s 10-Year Action Plan1. Establish effective mental health programs to address substance abuse and youth suicide
    21. 21. Transformative Change Accord’s 10-Year Action Plan2. Integrate the ActNow BC Strategy with First Nation health programs to avoid preventable chronic diseases (e.g. diabetes)
    22. 22. Transformative Change Accord’s 10-Year Action Plan3. Establish tripartite pilot programs in Northern Health Authority and build the Lytton Health Centre to improve acute care and community health services under the direction of First Nations stakeholders
    23. 23. Transformative Change Accord’s 10-Year Action Plan4. Increase the number of trained FN health professionals
    24. 24. Transformative Change Accord’s 10-Year Action Plan Governance, Relationships and Accountability
    25. 25. Transformative Change Accord –Governance, Relationships and Accountability1. Establish a First Nations Health Council that supports FN regional health planning; participates in prov/fed health policy and program planning; and provides leadership in the implementation of a Health Plan2. Hire an Aboriginal physician to work with the Provincial Health Officer on Aboriginal health issues, with a specific responsibility for tracking health progress of Aboriginal people in British Columbia3. Each Health Authority and FN will develop Aboriginal Health Plans and engage in collaborative decision-making
    26. 26. Transformative Change Accord –Governance, Relationships and Accountability4. Create a high-level Health Partners Group (FNHC, prov and fed govt, colleges and universities, professional health groups, etc.) to close the gaps in health5. Develop a reciprocal accountability framework between FN and provincial government to clarify accountabilities for health service delivery
    27. 27. Transformative Change Accord’s 10-Year Action Plan Health Promotion and Disease/Injury Prevention
    28. 28. Transformative Change Accord –Health Promotion and Disease/Injury Prevention1. Minister of State for ActNow BC will collaborate with FN groups to create an Aboriginal-specific ActNow BC program. Increase number of FN community workers trained in chronic disease prevention from 140 to 300 over 3 years.2. Aboriginal Mental Health and Addictions Plan targeting high-risk areas for youth suicide through community- based programs (e.g. healing circles, cultural camps, counseling programs)3. Provide health screenings (hearing, dental, vision) for all Aboriginal children under 6 years of age
    29. 29. Transformative Change Accord –Health Promotion and Disease/Injury Prevention4. Match non-FN communities in terms of accessibility of primary health care services on-reserves5. Work with federal government to improve First Responder programs for remote communities6. Work with police on an information campaign regarding the use of seatbelts and safe driving7. Develop culturally appropriate detox beds in the community
    30. 30. Transformative Change Accord’s 10-Year Action Plan Health Services
    31. 31. Transformative Change Accord – Health Services1. Build a FN-run acute care hospital centre in Lytton, BC.2. Build on success of chronic disease prevention and management community collaboratives, by instituting a diabetes prevention pilot program in North Health Authority3. Dedicate post-secondary seats to Aboriginal health professions to increase the number of FN health professionals working in BC4. Develop a curriculum for cultural competency that will be mandatory for all Ministry of Health and BC Health Authority staff
    32. 32. Transformative Change Accord – Health Services5. Develop a Maternity Access Project to train midwives and bring women’s health care closer to the homes of expecting mothers6. Introduce self-management programs for diabetes, HIV/AIDS and Hepatitis C patients7. Develop a fully-integrated clinical telehealth network for on-reserve health care providers8. Expand role of Nurse Practitioners in primary health care clinics and healing centres to promote accessibility9. Recruit more Hospital Liaison staff to help FN patients better navigate the health care system
    33. 33. Transformative Change Accord’s 10-Year Action Plan Performance Tracking
    34. 34. Transformative Change Accord – Performance Tracking1. Provincial Health Officer will issue Aboriginal Health Reports every 5 years to monitor progress towards achieving goals, with interim reports published every 2 years2. Renew tripartite agreement between fed, prov and FN governments to ensure that all health data is shared to facilitate research3. Provincial Health Services Authority will expand its community health survey to include First Nations in its assessment of risk factors (e.g. nutrition, obesity, physical activity) in order to share this data with FN communities and Aboriginal health providers
    35. 35. Conclusion
    36. 36. Have a great week!

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