Health disparities between the Natives and non-Natives in Canada and the COVID-19

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The count of total cases of COVID-19 in Canada was 113,911 as of July 26, 2020.
The count of total cases of COVID-19 in Canada was 113,911 as of July 26, 2020.

In 1966 of Canada, the Medical Care Act[1] was passed to provide provincial Medicare based on the criteria of public administration, comprehensiveness, universality, portability, and accessibility[2]. Tommy Douglas[3] and Ernest Manning[4] have initiated distinct universal healthcare systems to reform the societal changes of fairness - attributes to all Canadians.[5] Douglas’ Medicare is prominent in Canada establishing Canadian national identity of “solidarity” and “equity”[6] regarding the sharing community rather than the ability to pay.[7] U.S. News and World Report reported Canada performs the most developed health care policies for the public. Although the Indigenous people remain vulnerable, especially in the COVID-19 pandemic. And yet, the Indigenous populations remain doomed as not receiving sufficient and essential supports in the battle with the pandemic.[8]


History of Healthcare in Canada

Differences between Douglas and Manning's Medicare models

Rise of the welfare state

In Canadian society, helping the community members as a whole - solidarity - is deeply rooted in Canada's Medicare[9]. In the 1940s, Canada had disputable Medicare proposals of Tommy Douglas and Ernest Manning to establish the postwar welfare state. While the main objective of Douglas’ Medicare intends universality and public administration in pursuit of the universal right of citizenship, Manning’s model highlights individual responsibility through voluntary premiums of subsidiarity.[5]


The National Medical Insurance Act

According to Douglas, the concept of universality refers to compulsory taxation considering “Christian duty” as a means of “collective solutions to common problems.”[5] The free accessibility of Medicare is comprised of fundamental level of human rights.[5] Indeed, public administration under a governmental authority enables the medical and hospital services to effectively benefiting environment for all citizens.[5] Contrary to Douglas, Manning proposed “voluntary” involvement of local governments and thus discredited Douglas’ model as an intervention of “federal coercion” due to human desire to conquest “something for nothing.”[5] Despite a few disagreements, on December 8, 1966, based on Douglas' Medicare criteria, the National Medical Care Insurance Act[10] was passed with overwhelming supportive votes of 177 to 2. Starting from July 1, 1968 to 1971, henceforth, the federal government and all provinces had established Medicare plans that met the criteria.[11]


Constant inequality of health towards the Natives

Injustice of post-colonialism

Canada is confronting on-going intergenerational inequality of social, economic, and political[12] between the Natives and non-Natives. Refer to Harris (2002) and MacDonalds and Hudson (2012), the impact of white settler-colonialism over the Indigenous people would fostered certain "genocidal practices" against the Indigenous communities resulting in intergenerational trauma and social injustice.[13][12] The self-interest seeking environment was ignited by the European settlers, including the overwhelming amount of technological supremacy and disoccupation that manifested the dominant nature of the settlers and injustice treatment towards the Indigenous people.[13]


Coercive reconciliation

The formation of white racial supremacy underlines “the well-being of the patriarchal family, social standing, prosperity,” which eventually aimed for the European settlers' utopian vision while excluding the Natives.[13] According to the “Euro-Canadian ideology,” the white settlers saw the land of British Columbia in Canada as “unsettled and unused land” waiting to be developed.[13] Enabling European industrialism and civilization in Canada, the settlers forced the Aboriginals to reconciliation of white-dominant society, which resulted in the severe inequality of the Natives through the Indian Residential Schools system (IRS), for instance.[12] This cultural genocide engaged with the destruction of Aboriginal people’s languages, religions, and cultures.[14] In detail, the aftermaths of the IRS are sexual abuse, severe physical threats, humiliation, and severe injuries to health, and even death.[12] Those mental and physical maltreatments towards the Indigenous people led to residual sufferings. As a result, the Indigenous communities present a high rate of PTSD, poverty, division of a family, family violence, alcohol abuse, and sexual abuse as the dominant issues associated with intergenerational trauma.[14]


Medicare in Pandemic

Exclusion of ethnocultural minorities

Regarding Douglas’ universal Medicare that features social democracy,[6] the improvement of medical and hospital services reinforced “Canadian social generosity”[15] - which infers an inclusive environment of equitable access to healthcare and simplicity of the system.[6] Driven by the "standard of public morality[1], Canadians consider themselves sharing communities. Notwithstanding, in the outbreak of the COVID-19, the ethnocultural individuals seem degraded as their needs and demands of the essential supplies - such as hand sanitizer, soap, masks, gloves, and access to nutritious foods for a fundamental living - hasn't been distributed to all communities.[16] Those are either not immediately available or are hard to get in remote communities. Typically, the Indigenous people are marginalized from health treatments.[5] Following Medicare’s pursuit of "social utopia"[5] leaves a question: To what extent does universal Medicare marginalizes/stratifies ethnocultural individuals (First Nations and other Indigenous people) in such a pandemic situation?


Inadequate COVID-19 healthcare support

The Canadian federal government allocated $305 million to support First Nations, Inuit, and Metis communities, including $15 million for organizations providing services to those living in reserves or urban cities.[8] However, a large portion of Indigenous people living off reserves, the organization merely received five percent to help those individuals. According to this underfunding, Christopher Sheppard-Buote, president of the friendship centers association, commented on the government's funding plan is "disrespectful." He was disappointed by the delay of providing funds, which is still insufficient, and competitive steps to get the aid. Although, at the finalizing the pandemic funding proposal, only $3.75 million had allocated to 100 different organizations to share for more than 900,000 urban Indigenous people.[17] Indeed, the Congress of Aboriginal Peoples (CAP) - representing 90,000 off-reserve and non-status Indigenous Peoples - announced needs of $16 million to alleviate several issues of Indigenous communities, yet received merely $250,000. Thus, CAP has criticized the "inadequate and discriminatory" funding compared to other Indigenous groups.

Going out safely during COVID-19 issued by Government of Canada (Public Health Agency of Canada)


Difficulties and delay of getting aid

While the most prominent way to prevent the transmission of coronavirus is frequent hand-washing,[18] the majority of First Nations communities on reserves have difficulties accessing clean and purified water.[19] In this facet, the Canadian government has failed to act in the COVID-19 pandemic, which "resulted in disparities between the Natives and non-Natives, in access to housing, health care, and safe drinking water". Furthermore, these inequalities exacerbate the health risks to First Nations.


Several comments about the marginalization of the Indigenous communities by the federal government's COVID-19 funding maneuver, even though there are circumstantial barriers of Indigenous peoples.[20] Considering the scarcity environment of accessing welfare systems in reserves, they would have fewer opportunities to get essential help. Besides, there are chronic housing concerns with overcrowded houses in almost one-quarter (23.1%) of First Nations dwelling on-reserves.[19] For instance, Inuit peoples tend to live in overcrowded dwellings with higher risks of infection, such as over half of Inuit individuals living in overcrowded homes. These features prevent difficulties in following the public health guidelines such as social distancing and self-quarantine of the sick.[21]


Indeed, the former chief commissioner for the National Inquiry into Missing and Murdered Indigenous Women and Girls Marion Buller says, the government is exploiting the COVID-19 pandemic "as an excuse for delaying a national action plan." At the same time, there is an increasing number of calls for struggles with sexual and family violence, health, housing, and poverty.[22]


Conclusion

Deep-rooted European settler colonialism - severing disparities between the Natives and non-Natives in Canada - has been drastically devasted the Indigenous populations.[8][23] European settlers to Canada accompanied the several strikes of epidemics regarding smallpox, tuberculosis, scarlet fever, influenza, and measles, while the Indigenous people weren't ready to defeat the viruses but be decimated.[24] In 2020, about two centuries after the great epidemics, First Nations and Indigenous people are still struggling with unjust treatment in health. Arlen Dumas, Grand Chief of the Assembly of Manitoba Chiefs, clearly asserts, “the days of designing systems that are imposed on First Nations without consultation and consent must end.”[25]


References

  1. 1.0 1.1 "Canada's Health Care System". Government of Canada.
  2. "Canada's health care system". Governmant of Canada.
  3. "Tommy Douglas". Wikipedia.
  4. "Ernest Manning". Wikipedia.
  5. 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 Marchildon, Gregory (2016). "Douglas versus Manning: The Ideological Battle over Medicare in Postwar Canada". Journal of Canadian Studies. 50: 129–149 – via Project MUSE.
  6. 6.0 6.1 6.2 Martin, Danielle; Miller, Ashley; Quesnel-Vallée, Amélie; Caron, Nadine; Vissandjée, Bilkis; Gregory, Marchildon (2018). "Canada's universal health-care system: achieving its potential". The Lancet (British edition). 391 (10131): 1718–1735. doi:10.1016/S0140-6736(18)30181-8 – via Clinicalkey Flex.
  7. Tuohy, Carolyn (May 2018). "What's Canadian about Medicare? A Comparative Perspective on Health Policy". Healthcare Policy. Longwoods Publishing. 13 (4): 11–22 – via NCBI.
  8. 8.0 8.1 8.2 Seymour, Ann (April 23, 2020). "Canada's unequal health system may make remote Indigenous communities more vulnerable to the coronavirus". The Conversation. Retrieved July 15, 2020.
  9. Davies, Ben; Savulescu, Julian (2019). "Solidarity and Responsibility in Health Care" (PDF). PUBLIC HEALTH ETHICS. Oxford University Press (OUP). 12 (2): 133–144. doi:10.1093/phe/phz008 – via UBC Library.
  10. Martin, Danielle; Miller, Ashley; Quesnel-Vallée, Amélie; Caron, Nadine; Vissandjée, Bilkis; Marchildon, Gregory (February 23, 2018). "Canada's universal health-care system: achieving its potential". Lancet (London, England). 391: 1718–1735 – via The Lancet.
  11. Brown, Lorne; Taylor, Doug (July 3, 2012). "The Birth of Medicare". Canadian Dimension.
  12. 12.0 12.1 12.2 12.3 MacDonald, David; Hudson, Graham (2012). "The genocide question and Indian residential schools in Canada". Canadian Journal of Political Science. 45: 427–449. doi:10.1017/S000842391200039X – via Cambridge University Press.
  13. 13.0 13.1 13.2 13.3 Harris, Cole (2002). Making Native Space : Colonialism, Resistance and Reserves in British Columbia. Brenda and David McLean Canadian studies series. UBC: Vancouver: UBC Press. pp. 45–69. ISBN 9780774809016.
  14. 14.0 14.1 "Chapter 1: To Christianize and Civilize: Canada's Residential Schools, and Chapter 6:The Continuing Legacy of Residential Schools". They Came for the Children: Canada, Aboriginal peoples, and residential schools. desLibris - Documents: Truth and Reconciliation Commission of Canada. 2012. ISBN 1-100-19995-0.
  15. Glouberman, Sholom; Zimmerman, Brenda (2002). Complicated and Complex Systems: What Would Successful Reform of Medicare Look Like? (PDF). Discussion paper / Commission on the Future of Health Care in Canada; no. 8. Commission on the Future of Health Care in Canada. pp. 4–15.
  16. "Accessing additional public health support for First Nations and Inuit communities during COVID-19". Government of Canada. Government of Canada. July 10, 2020.
  17. Wilson, Kory. "PULLING TOGETHER: FOUNDATIONS GUIDE". BC Open textbooks. Pulling Together: Foundations Guide – via Creative Commons Attribution-NonCommercial.
  18. "Preventing COVID-19". Coronavirus disease (COVID-19): Prevention and risks. Government of Canada.
  19. 19.0 19.1 Levesque, Anne; Thériault, Sophie (July 15, 2020). "Indigenous communities at increased risk during the coronavirus pandemic". The Conversation.
  20. Kirby, Tony (June 1, 2020). "Evidence mounts on the disproportionate effect of COVID-19 on ethnic minorities". The Lancet. Respiratory medicine. 8 (6): 547–548. doi:10.1016/S2213-2600(20)30228-9 – via Elsevier Ltd.
  21. Mercer, Greg (April 5, 2020). "'We are not prepared': Inuit brace for coronavirus to reach remote communities". THE GLOBE AND MAIL.
  22. Stefanovich, Olivia (May 26, 2020). "Ottawa delays release of national action plan on missing and murdered Indigenous women". CBC News.
  23. Skye, Courtney (May 12, 2020). "Colonialism Of The Curve: Indigenous Communities & Bad Covid Data". Yellowhead Institute.
  24. "The Impact of Smallpox on First Nations on the West Coast". Indigenous Corporate Training Inc. April 17, 2017. Retrieved June 30, 2020.
  25. Dumas, Arlen (July 3, 2020). "First Nations must have a seat at the table". Winninpeg Free Press.