A Perspective on Aboriginal Child Health

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A Perspective on Aboriginal Child Health

• Dr. Evan Adams
• Aboriginal Health Physician Advisor
• BC Ministry of Health
• Office of the Provincial Health Officer
• Director
• Division of Aboriginal Peoples Health,
• UBC Department of Family Practice

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An Historical Look at Aboriginal Health in
British Columbia

• First Contact then sustained contact with
  Europeans fundamentally altered Aboriginal
  peoples health in Canada

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Historical factors profoundly affecting health

• The Reservation system
• Lost traditional territory
• Lost fishing and hunting sites
• Lost water rights
• Loss of fishing and hunting stocks
• Dominance of Canadian foods
• Alcohol, cigarettes, drugs
• Hygiene

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Historical factors profoundly affecting health

• Overcrowding
• Poverty
• Stress
• Decreased social and family structure
• Decreased wealth
• Increased Church control
• Decreased economic power
• Decreased political power

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The Residential School System Health
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The Residential School System Health

• Exposure to disease
• Overwork
• Underfeeding
• Overcrowding

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Capturing bodies, capturing minds

• By 1907, Dr. Peter Henderson Bryce found that
  one-quarter of students died while on school
  rolls
• From school to cemetery

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The Residential School System Health

• Separation from parents
• Punitive religiosity
• Physical abuse
• Cultural abuse
• Emotional abuse
• Assimilation

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• Ill never forgive Sister V. I had to do the
  stairs, great big long stairs, and she was coming
  down the stairs and she saw this little spot, way
  in the middle of the hall that Id missed when I
  was waxing it. She made me do the whole hall over
  again. I was crying and scrubbing We worked
  hard. It was no easy life.

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Background

• Children under 16 years represent 40 of the
  Aboriginal population in Canada.
• Although they represent a greater proportion
  and a faster growing segment of Aboriginal
  communities, they lag far behind other Canadian
  children when it comes to their health. 
• Infant mortality rates are twice to three times
  as high in First Nations and Inuit communities
  (CPHI, 2004).

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Background

• The suicide rate among Aboriginals is two to six
  times that of the overall Canadian population.
  (CPHI, 2004).
• Aboriginal children are at a higher risk for
  unintentional injuries and early deaths from
  drowning and other causes. Injuries are the
  biggest contributor to premature death among
  First Nations on reserve rates are four times
  that of the overall Canadian population (CPHI,
  2004, Health Canada 2005).

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Background

• Rates of diabetes (largely as a result of
  obesity) are higher among Aboriginal youth than
  among other adolescents. (CPHI, 2004).
• A greater proportion of Aboriginal families face
  problems with housing and food affordabiltity.
  (CPHI, 2004).
• First Nations and Canadian populations had
  similar proportions of low birth weight births in
  2000 however, almost twice as many First Nations
  babies were classified as high birth weight than
  in Canada as a whole. (Health Canada, 2005)
• Immunization rates among First Nations children
  are lower than among other children in Canada.
  (Health Canada, 2005).

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Infant Mortality
Source Provincial Health Officers Annual Report
2002
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Teen Pregnancy (age 15-19)
Source Provincial Health Officers Annual Report
2002
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Youth Suicide by Band
More than half of all bands had NO suicides
From Cultural continuity as a hedge against
youth suicide, Chris Lalonde, Associate
Professor, University of Victoria
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The Transformative Change Accord

• The First Nations Health Plan
• Supporting the Health and Wellness
• of First Nations in BC

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Transformative Change Accord

• New relationship between the Province of BC and
  the First Nations leaders guided by principles of
  trust, recognition, and respect for Aboriginal
  rights and title
• Greater collaboration to close the gap in the
  quality of life between the First Nations
  population and other BC residents

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Key Targets in Improving Health of First Nations
Population

• Life expectancy at birth
• Mortality rates for all causes
• Youth suicide rates
• Infant Mortality rates
• Diabetes rates
• Childhood obesity
• Practicing, certified First Nations
• health care professionals

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The First Nations Health Plan

• 2. The Provincial Health Officer will appoint an
  Aboriginal physician to advise on Aborginal
  health issues.
• 5. Establish a province-wide Health Partners
  Group.
• 6. Develop a reciprocal accountability framework
  to address gaps in health services for FN in BC.
• 8. Adult mental health, substance abuse as well
  as young adult suicide will be addressed through
  an Aboriginal Mental Health Addictions Plan.
• 10. Aboriginal children under age six (on- and
  off-reserve) will receive hearing, dental and
  vision screening.

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The First Nations Health Plan

• 11. FN and the province will follow up on the BC
  Coroners Service Child Death Review Report (2005)
  recommendation that all levels of government,
  educators, parents, and Aboriginal leaders and
  their communities forge new relationships led by
  the Aboriginal people to address the results of
  this report that clearly illustrate that
  Aboriginal children are dying at
  disproportionately higher rates.

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The First Nations Health Plan

• Premier Gordon Campbell announces 9.5 Million
  for Aboriginal health, April 10, 2007
• Premier Campbell launches 65-Million Aboriginal
  Post-Secondary Education Strategy, April 24, 2007

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2nd Report on Health and Well-being of Aboriginal
Population in BCPathways to Health and Healing

• 2006 Provincial Health Officers Annual Report
• (Release date December 2007)

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our own views

• Certainly, our own views of our childrens health
  bear consideration
• the principles of equality
• self-management
• holism
• recognition of our colonial past
• intergenerational participation (i.e. of Youth
  and Elders)
• inclusion of family, community and environmental
  contexts
• cultural identity
• and the principles of resilience and
  self-determination.

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Calls to Action

• A national strategy is needed to generate
  concrete action to improve the health of
  Aboriginal children and youth, especially to
  address health inequities.   
• The Government of Canada should adopt the
  declaration from the Many Hands, One Dream
  summit "We will raise a generation of First
  Nations, Inuit and Métis children and youth who
  do not have to recover from their childhoods. It
  starts now, with all our strength, courage,
  wisdom and commitment.
• The federal, provincial, and territorial
  governments should adopt Jordan's Principle, a
  child-first principle to ensure that
  jurisdictional disputes do not result in delays
  of health and health care services to Status
  Indian children.

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