Documentation:Systemic Racism Against Indigenous Peoples in the Canadian Health Care System

Source: Wikimedia Commons

It has long been recognized that there are widespread health disparities in Canada for Indigenous peoples. This is further aggravated by numerous issues that plague the current Canadian health care system. For instance, in a concerning report from 2015, the Auditor General of Canada concluded that indigenous individuals living in Manitoba and Ontario did not have access to clinical and client care services. In addition to issues linked to the access of health care, systemic racism has contributed to a unique set of challenges for Indigenous peoples trying to navigate the Canadian health care system.

Systemic Racism

The College of Family Physicians of Canada describes systemic racism in the health care system as “unintentional racism commonly manifested in the form of erroneous assumptions (based on negative stereotypes) regarding patient health behaviours or diagnoses”. This has been recognized as one of the main drivers of the lower health outcomes experienced by Indigenous individuals in Canada. The discriminatory assumptions made against them also makes interacting with health care workers an especially stressful experience for Indigenous individuals, as they must anticipate potential negative treatment.

Origins of Systemic Racism Against Indigenous Peoples

The current systemic racism indigenous individuals can be traced back to colonialism. Discriminatory colonial practices in Canada notably included starvation, government-sponsored biomedical experimentation, and the forceful displacement of children from their families to residential schools in an attempt at assimilating them. These practices were fueled by the colonialists’ notions that their culture, religion and race was superior to that of Indigenous populations. In addition to the intergenerational trauma that still affect Indigenous peoples, these colonial practices and notions created the basis for racial stereotypes that are still present to this day. Perhaps the most common stereotypical view of Indigenous individuals is the image of the “drunken Indian”, which is a harmful assumption that has had negative consequences in health care settings.

Current Implications of Colonialism on Indigenous Health Care Policies

Source: Wikimedia Commons

In Canada, health care policies are provincially based. Provinces are responsible for the organisation and delivery of health care services, while the federal government provides administrative and limited financial support. However, the Canadian Constitution act gives the federal government jurisdiction over “Indians, and Lands reserved for the Indians”. This has recently led to a jurisdictional debate between the provincial and federal government over which should level of government should have the responsibility of delivering health care services for Indigenous peoples.

Currently, Indigenous individuals with off-reserve status can use provincial facilities and their expenses are paid by the federal government’s Medicare program (Health Canada’s Non-Insured Health Benefits Program). While this program provides coverage for hospital and primary care, it only offers limited vision and dental coverage. As for Indigenous individuals with on-reserve status, the federal government directly finances and delivers health care services through the First Nations and Inuit Health Branch (FNIHB). This branch focuses on providing primary health care centres and nursing station for remote communities as well as providing individuals with on-reserve status with insurance benefits. However, the FNIHB only has provisions for about 200 remote communities, which leaves many unfilled gaps in the health care system.

The Brian Sinclair Case

This highly publicised 2008 case was centered on the tragic death of Brian Sinclair, a 45-year-old Indigenous man, at the Winnipeg Health Sciences Centre (HSC). Sinclair was also a double amputee and had previously suffered some cognitive impairment. He had been referred to the HSC’s emergency room by his family physician to treat a bladder infection. However, while waiting at the emergency room, he was ignored and left unattended for 34 hours despite vomiting several times. Unfortunately, this lack of treatment led to Sinclair’s untimely death.

In 2014, an inquiry into Brian Sinclair’s death was launched. The early findings of the inquiry suggested that, on the account of numerous witnesses, the staff at the HSC assumed that Sinclair was intoxicated and homeless. This assumption is directly linked to the stereotypical view of the “drunken Indian”. Additionally, video footage showed that staff had directly looked at Sinclair’s wheelchair in the waiting room, but had ignored him. However, the scope of inquiry was modified to exclude issues of racism, disability, and substance use. As such, the inquiry was not a definitive look at the underlying case of systemic racism in the Brian Sinclair case. Instead, the presiding judge chose to change the inquiry’s goal to pinpointing preventative measures for similar cases in the future.