aboriginal health: educating minds, improving health....the following conditions were present in...
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Anishnawbe Health Toronto
Aboriginal Health:
Educating Minds, Improving Health.
Dr. C. P. Shah Staff Physician Anishnawbe Health Toronto; Professor Emeritus Dalla Lana School of Public Health;
How does Aboriginal Identity Influence Health Care?
• Racism & Discrimantion
• Sterotyping
• Lack of Understanding of:
Impact of Colonialism on Health
Aboriginal Concept of Health and Healing
WHAT DO YOU NEED TO KNOW ABOUT ABORIGINAL PEOPLE?
Overview
Part 1. Colonial & Post-Colonial Administrative Policies and Practices Impacting Health & Health Determinants.
Part 2. Demography, Health Determinants and Health Status of Aboriginal People.
Part 3. Aboriginal Concept of Health and Healing. Access and Barriers to Health Care System. Future Directions to Close the Gap in Health Inequity.
4
The Legacy of the Residential School System:
The following conditions were present in residential schools:
1. Physical, emotional, spiritual harm
2. Educational harm
3. Loss of culture and language
4. Harm to family structures
5. Students were separated from their siblings
6. Students were punished for speaking Aboriginal languages
7. Students were at risk for malnutrition and infectious disease
8. A high proportion suffered various forms of abuse, including physical, emotional, psychological and sexual abuse.
5
Impacts of Colonial Policies:
Loss of Culture
Loss of Language
Loss of Heritage
Loss of Identity
Loss of Parenting Skills
Intergenerational Family Violence
Loss of land & livelihood
Loss of self control & Self determination
6
Part 2. Demography, Health Determinants and Health Status of
Aboriginal People.
7
Population Reporting Aboriginal Ancestry Origin,
Canada, 1901 - 2006
491465
10026751172790
1319890
312766220121
165607
160937128890113724105611
1279410
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1901 1911 1921 1931 1941 1951 1961 1971 1981 1991 2001 2006
Po
pul
ati
on
Total Population8
SHAH’S DICTUM: ONE
WITH REGARDS TO POSITIVE HEALTH DETERMINANTS:
WHAT NON-ABORIGINAL PEOPLES HAVE, ABORIGINAL PEOPLES HAVE MUCH
LESS OF IT AND ALSO HAVE THE ADDED BURDEN OF: LEGACY OF RESIDENTIAL
SCHOOL & DISCRIMINATION.
9
SHAH’S DICTUM: TWO
WITH REGARDS TO DEATH, DISEASES AND DISABILITY:
ABORIGINAL PEOPLES HAVE TWO TO THREE TIMES MORE
DEATH, DISEASES AND DISABILITY THAN NON-ABORIGINAL PEOPLE,
ABORIGINAL PEOPLES ALSO GET IT EARLY AND IT IS MORE SEVERE IN NATURE
54
16.9
32.434.1
22.2
12.4
6.63.6
11
27.817.918.1
8.4
1.92.3
3.29.35.431.61.20.4
3.311.47
3.41.80.60.40
20
40
15-24 25-34 35-44 45-54 55-64 65+ Age-
Adj.
Can-M
Can-F
FN-M
FN-F
Can-M Can-F FN-M FN-F
Example: Diabetes First Nations and Labrador Inuit to the Canadian Population,
Age-gender-specific and age adjusted prevalence (%)
Source: Young, T.K. et al. and FNIRHS Steering Committee and Canadian data from the NPHS, 1994-95.
Age
Gender
11
Part 3 THE CONCEPT OF HEALTH AND HEALING AMONG ABORIGINAL
PEOPLES
12
MEDICINE WHEEL
13
Physical
Emotional
Mental
Spiritual
Emotional
Culturally Sensitive Programs Needed to Enhance Health
• Spiritual Programs: – Sweat Lodge,
– Shaking Tent
– Full Moon Ceremony
– Naming Ceremony
– Clan Feasts
– Pipe Ceremony
– Vision Quests
– Smudging
– Traditional Teachings
– Cultural Workshops
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What can health care professionals do?
PATIENT-CENTERED COMMUNICATION WILL RESULT IN:
PATIENT-CENTERED COMMUNICATION SKILLS
BUILDS TRUSTING RELATIONSHIP
PATIENT BECOMES A PARTNER IN HEALTH CARE
BETTER PATIENT ADHERENCE TO THERAPEUTIC PLAN
BETTER PATIENT HEALTH OUTCOMES
IMPROVED OVERALL HEALTH
AVAILABLE RESOURCES
• www.aht.ca/aboriginal-cultural-safety-initiave Anishnwabe Health Toronto
• Health Council of Canada: Empathy, Dignity and Respect: Creating Cultural Safety for Aboriginal People in Urban Canada, Dec. 2012
• Thomas King: The Inconvenient Indian, 2012. • www.culturalcompetency.ca: Indigenous Cultural
Competency Training Program, Province of B.C. • Ontario Federation of Indigenous Friendship Center
with Toronto Central LHIN