Indigenous Peoples at Higher Risk in Health System: Government Report

The final report investigating racism within British Columbia’s health care system has come to some stark conclusions about health outcomes for Indigenous peoples.
February 5, 2021, 5:05pm
An ambulance speeds to an emergency call in Vancouver, B.C. on Thursday, October 1, 2020.

The final report from a government-sponsored investigation into racist practices within British Columbia’s health care system shows numerous ways Indigenous peoples are at higher risk of negative health outcomes. 

The report is the last of three released by lawyer Mary Ellen Turpel-Lafond, who was tasked by the provincial Ministry of Health to lead a review of racial stereotyping by health care workers against Indigenous patients in July 2020. 

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One of the key findings shared in the 240-page document is that Indigenous patients are 75 percent more likely to end up in the emergency room than any other group, largely due to a lack of access to primary care services such as family doctors.

Further, First Nations women are nearly twice as likely to die of overdose than non-Indigenous women. 

“Indigenous people have inequitable access to primary and preventative health care services, which perpetuates and cascades into poor health outcomes all across the lifespan,” said Turpel-Lafond at a press conference on Thursday. 

“When you combine these factors with the overwhelming evidence of racism in the health care system ... it’s not difficult to see why health outcomes for Indigenous peoples are poorer,” Turpel-Lafond said at a press conference on Thursday.

Her initial report released in November revealed the presence of extensive anti-Indigenous racism: 84 percent of Indigenous peoples engaged during the investigation said they experienced some form of discrimination at the hands of health care workers, including verbal and physical abuse.

The latest document builds on those findings, this time uncovering a shocking lack of access to primary and preventative care options, which leaves Indigenous peoples at higher risk of both acute and chronic conditions. 

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When it comes to diagnosis, for example, Turpel-Lafond said poor access to primary care may be driving lower screening rates for treatable cancers among Indigenous peoples.

Indigenous women get pap smears about 68 percent less frequently than their non-Indigenous counterparts, but are diagnosed with cervical cancer 1.6 times more often. 

The investigation also found that many pregnant Indigenous women arrive at the hospital in labour without having had any prenatal exams, due to a lack of specialized care options.

Evidence shows Indigenous children have higher rates of asthma, depression, mood disorders, epilepsy, and poor oral health conditions, the reports says.

Yet, fewer First Nations women have access to specialty health care practitioners such as obstetricians and pediatricians. 

Because of this lack of primary care options available to Indigenous peoples, they are forced to seek care in emergency rooms and urgent care centres, where the majority of racial profiling incidents reportedly take place.

“This data report is extremely important in its own right,” said Turpel-Lafond. 

“In addition to supplementing our previous reports, it serves as a standalone comment on health system performance for Indigenous peoples in BC. And it shows there is a great deal of room for improvement.”

As part of the initial report, Turpel-Lafond and her team made 24 recommendations to the provincial Ministry of Health that focused on improving accountability, increasing Indigenous leadership in health care, considering a joint degree program in medicine and Indigenous medicine, and establishing a new School for Indigenous medicine.

B.C. Health Minister Adrian Dix said work is already underway to implement the recommendations.

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“Racism is toxic for people, and it’s toxic for care,” Dix told reporters Thursday. “Together with Indigenous leadership, health professionals, colleagues, and partners, we will address systemic racism in our health care system and root out its deeply damaging effects."

He said Indigenous peoples and health care workers engaged in this investigation have told him they are tired of reports and reviews, and want to see action. 

In November, the provincial health ministry created 32 new Indigenous health liaison positions across all health authorities in the province. This week, Dix announced funding for five more positions.

So far, nine liaisons have already been hired and the remaining are in the recruitment process. 

The minister also announced the appointment of Dawn Thomas, former Island Health member, to the newly created role of associate deputy minister of Indigenous health, to oversee the implementation of Turpel-Lafond’s recommendations. 

One of the recommendations involves the creation of a better complaints process to register and address reports of anti-Indigenous racism in health care settings. 

Until a new office has been set up to handle these complaints, the province is maintaining a toll-free phone line and email address where people can keep submitting their reports even after the end of the formal investigation. 

Follow Brishti Basu on Twitter.