While universal health care is envisioned as a fundamental human right for all, its seemingly contradictory reality presents unique challenges in which health disparities continue to negatively harm Indigenous communities. This is due to the damaging effects of settler colonialism in Canada, contributing to challenges that intensify diseases, impeding these populations from achieving good health and well-being. The United Nations reported that the average life expectancy of Indigenous peoples is 17 years lower than that of non-Indigenous peoples. This article intends to systematically analyze works evaluating the histories of colonialism, leading to unequal allocation of resources and access to institutions that aggravate inequities among Indigenous people today due to the failure to implement existing policies. This can allow policymakers to better understand the disparities between the health of Indigenous peoples and the broader Canadian population to devise improved strategies, carrying out policies that address health-related social factors to achieve real change.
The influence of health outcomes for different social groups can be evidenced through environmental factors predicated on facets such as race, religion, and social position. Excessive burdens of diseases are then pushed onto impoverished communities through unequal distributions of healthcare due to systemic disparities such as unequal access to pharmaceuticals and income disparities. Scholars including Paul Farmer contend that existing socioeconomic inequalities are acts of “structural violence” where vulnerable groups bear disproportionate burdens of disease through bio-social realities. Furthermore, although medical care is often viewed as affordable and easily accessible in North America (i.e. Canada’s Universal Healthcare), marginalized groups remain exposed to and host chronic illnesses due to challenges such as limited access to medical infrastructures. For example, according to the WHO, numerous studies suggest that socioeconomic status accounts for between 30% to 55% of adverse health outcomes. Indigenous communities in Canada are perhaps a targeted demographic most vulnerable to these socioeconomic variables that lead to high rates of structural violence influenced by Canada’s colonial history.
While prehistoric North America was far from a disease-free utopia, the prevalence of disease was low compared to the biological assault unleashed by European settlers. All through the 18th and 19th centuries, the development of Canadian trade networks and increased engagement among Europeans and Indigenous groups propagated foreign pathogens such as Tuberculosis (TB). The emergence of Canada’s dominion further guided overt politics that purposefully harmed these communities by forcing them onto reserves and limiting their autonomy. For example, John A. Macdonald used food malnourishment to manipulate Indigenous communities, culminating in the spread of TB at the hands of colonists. Thus, to this day, Canada’s colonial dominance has continued to deny Indigenous communities the authority to govern their land, capital activities, and medical services.
Subsequently, the Canadian government established residential school systems, endorsing the act of liberating pagan children from their “uncivilized parents.” These schools were operated in abhorrently unsanitary conditions and directly affected Indigenous health, ranging from overcrowding to insufficient food access, consequently, many children became ill and died as a direct result. Thus, the detrimental effects of colonialism actively and passively shape structural inequalities centered on the destruction of Indigenous livelihoods; these long-term repercussions for Indigenous health in Canada have contributed significantly to today’s oppressive health disparities. It has become abundantly evident that Indigenous peoples worldwide continue to have significantly worse health outcomes than their non-Indigenous counterparts, as “the lower the socioeconomic position, the worse the health.”.
Contemporary health inequities can be evidenced by colonial interactions affecting land dispossession, inadequate water sanitation, and discrimination within healthcare institutions that subvert Indigenous peoples and pose detrimental challenges to their well-being. While mortality rates may be declining, morbidity rates have steadily risen, suggesting a higher incidence of disease and chronic illnesses. Thus, at the bottom of the socioeconomic hierarchy, Indigenous communities encounter a link between poverty and ill health. They are forced to confront the complexities of their exposure to hazardous health determinants, which intensifies their vulnerability to maladies while decreasing opportunities. Furthermore, Indigenous lands are deeply connected with their heritage, belief systems, traditional lifestyles, and employment prosperity; however, these groups have been forcibly removed from their lands, forced onto artificial reserves and robbed of their holistic livelihoods. Therefore, Indigenous communities are economically isolated with little monetary assistance and no viable economic opportunities as they fall victim to financial hardships.
Indigenous peoples’ health and well-being continue to lag behind that of the general Canadian population as a result of colonial policies and practices in the public health system. Canadian healthcare systems are founded on the notion that Indigenous peoples deserve minimal treatment to foster the goal of maintaining oversight over Indigenous peoples. Because of an absence of physical, political, and social accessibility to healthcare facilities today, Indigenous communities are frequently restricted from these systems for a range of factors, including, but not limited to, long waiting lists (33.2%), insufficient medical services (16.8%), and inaccessible services in the region in which they live (18.5%). For instance, in 2008, Brian Sinclair, an Indigenous man from Manitoba, died in urgent care after thirty-four hours of being dismissed and untreated while suffering from an easily curable urinary infection. Although occupiers presume that Indigenous health problems result from their own faults, there is a disregard for Canada’s colonial past, which is at the root of several barriers they face, including cultural oppression, socioeconomic status disparities, and racism.
Given that the discourse regarding Indigenous rights has continuously prioritized cultural, environmental, and political concerns, certain exploitable flaws in Indigenous health have been overshadowed, only manifesting themselves in contexts that illustrate past violence while often disregarding present-day obstacles. While there are extensive studies on Indigenous people’s current health outcomes, conventional research on colonization is rarely acknowledged. Indigenous health disparities reveal a historical link in which Canada’s governmental policies fail to achieve Indigenous communities’ healthcare needs. For example, the UN Declaration on the Rights of Indigenous Peoples (UNDRIP), is endorsed as an international body implemented to institutionalize the rights establishing “the minimum standards of survival, dignity, and well-being…,” created to safeguard both the collective and individual rights of Indigenous peoples. However, scholars such as Duane Champagne criticize UNDRIP because it lacks legal safeguards to keep these measures in place and fails to account for individual barriers and unique Indigenous entitlements—further harming Indigenous communities.
Therefore, growing socioeconomic inequalities in health among Indigenous peoples must warrant more attention. Policies should mitigate inequalities as it is unacceptable that indigenous peoples continue to endure discrimination when seeking health services in Canada, something that should be a human right. Together Indigenous partners, health professionals, and Canadian governing bodies must come together to enhance access to safe and equitable medical services. We must pay special attention to the real-life experiences that Indigenous peoples face today to change these unequal and discriminatory structures and promote high standards of health. Though it will take time, it is crucial to start working on it immediately.
Edited by Ruqayya Farrah
In her third year at McGill University, Shannon is a staff writer for the Catalyst. Pursuing a double major in Sociology and Art History for her B.A., she is especially interested in social-political discrimination affecting Indigenous communities within Canada and across the globe.