Inequality Among Aboriginals of Canada
The public health policy of Canada does not adequately cater to the Aboriginal
people. This group of indigenous people does not receive the same level of care as the non-indigenous populations. Richmond and Cook (2016) say this is because of a “proliferation of racism in modern-day Canada, and a distinctly lacking political will at the federal level.” Barriers towards equitable health resources are not unique to the Aboriginals of Canada. Most societies exhibit disparate behavior towards indigenous cultures. The UN Human Rights organization says that indigenous people are in the 15percent of the poorest people in the world. The adverse treatment of the Aborigines of Canada has roots in socio-economic problems that started during the colonial years. Colonialism and racism, socio-economic and political gaps, lack of sound public policy, and self-determination repression have had an adverse effect on the current healthcare provision for the Aborigines.
In 1986, public health policy was introduced called the Ottawa Charter for Health Promotion. The sole aim or result of this meeting was to achieve health for all by the year 2000. In regards to creating equitable access to populations such as the Aborigines, the Charter recognized the need to pay attention to the culture and history of these indigenous groups. Despite the presence of this agreement, little was done policy-wise to address this human rights issue among Aborigines (Richmond & Cook, 2016). According to Richmond and Cook (2016), there have been some improvements in health care access for the Aborigines; however, there is a worrying trend of chronic disease appearing among the Aborigines today.
The 1876 Indian Act that is currently in use today gives the Federal government the responsibility to provide and manage healthcare for this community. Richmond and Cooke (2016) say that this should be the responsibility of the provincial government. The mishandling of this issue among these two government bodies has led to discriminatory practices such as underfunding and eventually to health inequity.
Socio-Economic and Political Discrepancies
The Aborigines lived a subsistence life until the Europeans invaded their land (Trovato et al., 2015). The Europeans, on the other hand, had a highly competitive market economy. This meant that the Aborigines, who traded in fur, sometimes lived at the mercy of these markets. Furthermore, the Europeans took over their fertile land, which further complicated the resource situation.
The limited access to health care is not the only public service that is denied the community. The Aboriginals of Canada also lack quality education, housing, and employment. These factors prevent them from improving their social and economic status. The lack of critical resources and poverty has also lead to situations such as nutritional deficiencies and social isolation. This has led to mental health issues, subsequent drug abuse, and suicide in some communities(Leger, 2016).
The Canadian government lacks goodwill to improve the health situation of the indigenous people. This is evidenced by the failure to address the structural changes that were proposed in the Romanow report of 2002. The Kelowna Accord of 2005, on the other hand, was to improve the education, employment, and living conditions of the Aboriginals. This was also not implemented. It is clear that even though the provincial governments were willing to follow these recommendations, lack of support from the federal government led to the failure of both initiatives (Richmond & Cook, 2016).
Colonialism and Racialism
Canada’s colonial past ultimately contributed to the systemic entrenchment of racism in Canada. This has consequently resulted in the healthcare inequalities being witnessed currently. For example, the Indian Act is still affecting how Aborigines are treated in healthcare settings. This legislation still limits access to healthcare for the Aborigine communities. For instance, these communities face discrimination when accessing health care services, up to now (Horrill et al., 2018). This has also led members of this community to withdraw from accessing healthcare services because of adverse treatment. The colonial system classified society along racial lines with the Europeans classified as superior and relegating indigenous Canadians to the bottom of the social strata. As a result, resources, freedom, and powers in Canada were distributed along racial lines.
Lack of Healthy Public Policy
A robust public policy seeks to incorporate: the cultural perspective of indigenous groups, their right to self-determination, and their indigenous knowledge. This is supposed to act as a process in how health services can be equitably offered (Adelaide Recommendations on Healthy Public Policy, 1988 as cited in WHO). Despite the understanding of the importance of a community-based approach to policy, the national policy on health services for the indigenous people ignores the importance of their involvement (Richmond & Cook, 2016). Current Canadian health policies exclude the marginalized, most of who are indigenous people.
Repression of Self-Determination
The freedom to act without external compulsion can result in the restructuring of the healthcare system; this can be beneficial in promoting health standards among the indigenous people of Canada (Richmond & Cook, 2016). Colonial agendas that were enforced on Aboriginal Canadians denied them equal participation in activities, decisions, and processes that controlled their own lives. This lack of self-determination led to disproportionate power dynamics that blocked aboriginal Canadians from equal participation in politics and governance. This action, therefore, denied them equity across political and health situations.
The first solution to improving healthcare availability within the Aboriginal community is for the Federal and Provincial governments to work jointly to define and clarify how the community’s healthcare standards can be developed. Without this support, at the national level, most of the proposed intervention plans are likely to fail. Palmer et al. (2017) argue that this lack of clarity creates a gap in healthcare provision within the community. Palmer et al. (2017) point out one solution that was tendered was to create two arms of the Federal government, which would deal with land and governing issues and the other one to deal with the delivery of federal services. The challenges would be, therefore, to make it culturally appropriate and reflective of community goals ( Palmer et al. 2017). This governmental support can lead to a successful program such as the First Nations Health Authority (FNHA). Richmond and Cook (2016) say that FNHA has resulted in the use of community “knowledge and preference” through community-based research projects.
The second solution also depends on the Federal government, and it deals with statistical data. Statistics is an essential component of any healthcare system. It enables planning, evaluation, and distribution of healthcare services to any community. For example, statistics can: show the vaccinations needed in a community, what kind of diseases the population is grappling with, and even how many health workers are in the community and what is the shortfall, among other considerations. Failure by the Federal government to take a proper census in these community areas results in some of the healthcare gaps the community is witnessing (Finn, 2016).
A poverty reduction plan needs to be put in place and adhered to. For example, the Kelowna Accord can be beneficial in improving the lives of the Canadian Aborigines. However, this plan must use data provided by the Federal government through a population census. Finn (2016) proposes a three-part plan of reducing poverty: direct income support, employment prospects, and long-term solutions. If these plans can be implemented in the right way, they have a high likelihood of improving the lives of the Aborigines.
Another solution is improving the educational standards within the community. This will result in more members of the community taking up educational, healthcare roles, among others. Research has shown that marginalized community members who receive medical training, go back to those communities to practice ( Xiarelli & Nivet, 2018). This will result in uplifting the standards of not only healthcare but other critical needs of the community.
The final solution that can be explored is the incorporation of traditional healing methods alongside modern ones. The Canadian Aborigines believe in a holistic healing process, which involves the body, mind, spirit, and emotions. This process has been useful in the FNHA program. The result is in increased participation of members of the community (Traditional Healing). For example, in the FNHA, it is used in the treatment of chronic diseases- a condition identified to affect the Canadian Aborigines.
The Federal government in Canada has a lot to do in uplifting the living standards of the Aborigine community by ensuring: the right to free, quality, and equitable healthcare for this community, just as for the other Canadians. This can be done by improving educational standards, addressing poverty levels and enacting modern laws and policies that will enhance the rights of this community. Furthermore, it needs to use appropriate data to ensure that all members of the community are included in the national statistics. Data from the community is the only way that the Federal government will be able to know the particular needs of this community.
The federal government also needs to address the historical injustices that have been meted out against the community. Past wrongs have led to the current health conditions being experienced by members of this community. For example, lack of proper nutrition due to inadequate food sources, as all the fertile land was taken away, systematic oppression has led to discrimination in allocating funds for education and health, among others. Reconciliation, between the Canadian Aborigines and members of the other communities residing in Canada would be beneficial as it would enable the charting of a plan to improve the lives of this community
Finally, the Canadian Aborigines should continue advocating for their rights for quality healthcare, education and improved living standards. This is through methods such as citizen engagements and political activism.
Horrill, T., McMillan, D., Schultz, A., & Thompson, G. (2018). Understanding access to healthcare among Indigenous peoples: A comparative analysis of biomedical and postcolonial perspectives. Nursing Inquiry, 25(3). doi: 10.1111/nin.12237
Leger, L.M. (2016). First Nations community grappling with suicide crisis: ‘We’re crying out for help. The Observer, Canada. https://www.theguardian.com/world/2016/apr/16/canada-first-nations-suicide-crisis-attawapiskat-history
Palmer, K., Tepper, J. & Nolan, M. (2017). Indigenous health services often hampered by legislative confusion. Healthy Debates. https://healthydebate.ca/2017/09/topic/indigenous-health
Richmond, C.A.M., &Cook, C. (2016). Creating conditions for Canadian aboriginal health equity: the promise of healthy public policy. Public Health Reviews, 37, 2 (2016). https://doi.org/10.1186/s40985-016-0016-5
Traditional Healing. First Nations Health Authority. https://www.fnha.ca/what-we-do/traditional-healing
Trovato, F., Pederson, A., Price, JA & Long, C. (2015). Economic conditions of the indigenous peoples of Canada. The Canadian Encyclopedia. https://www.thecanadianencyclopedia.ca/en/article/aboriginal-people-economic-conditions
World Health Organization. ( n.d.). “Adelaide Recommendations on Healthy Public Policy”.https://www.who.int/health promotion/conferences/previous/adelaide/en/index6.html
Xierali, I. M., & Nivet, M. A. (2018). The Racial and Ethnic Composition and Distribution of Primary Care Physicians. Journal of Health Care for The Poor And Underserved, 29(1), 556–570. https://doi.org/10.1353/hpu.2018.0036
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