ANAC Election 2015 Statement to Federal Parties.Oct 15_15

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Aboriginal Nurses Association of Canada

Statement on Aboriginal Health and Aboriginal Nursing Needs

To All Parties in the Oct 19, 2015 Federal Election

For Immediate release

Oct. 15, 2015

Ottawa. With just days before Canada decides who will form the next government, the Aboriginal

Nurses Association of Canada is releasing this statement as it believes that health is a critical election

issue that requires attention by all Federal parties. Furthermore, Aboriginal health continues to curtail

any promises of improved Canadian-Aboriginal relations, as initiatives continue to be subject to

discretionary funding approaches that see programs allocated for, yet departments do not fully spend

these commitments.

The Royal Commission on Aboriginal People in 1996 called for 9000 Aboriginal health workers. Today,

we have close to that number in just Aboriginal Nurses; not to mention the numbers of Aboriginal

physicians, therapists, para-professionals, etc. So the primary question remains: Why are we not seeing

improved health outcomes for Inuit, Metis and First Nations people?

To answer this question, the Aboriginal Nurses Association of Canada believes that in large part, it is the

bureaucratic system that is failing. To this end, Aboriginal Nurses call on all federal parties to truly

commit to sustained changes and to answer these questions:

1) There is currently a complication of policies and legislations between the federal, provincial,

and municipal governments regarding who is responsible for inefficient health access regarding

Aboriginals. How will you work to ensure all three levels of governments collaborate to fix the

policies and improve Aboriginal people’s access to health services?

2) The federal budget over the years has been allocating an uneven financial distribution

between Aboriginal and non-Aboriginal health institutions. What will you do to review these

policies and what will you do to make the funding gap more improved?

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3) The Aboriginal population is still presented with many environmental issues to this day.

What kind of policies and strategies are you willing to enforce to improve environmental

conditions and clean up toxins and potential oil spills that are negatively affecting rural areas

where many Aboriginal people reside?

4) Recent information shows there are still problems with nurse practitioners in northern and

remote nursing stations that are put in place to provide Aboriginal health care. However, many

of these nurses are not fully trained, and some stations themselves lack the appropriate

resources to operate. How are you going to approach this problem to improve the health

services for the Aboriginal people in northern and remote communities?

5) Because of the past destruction of Aboriginal socio-cultural, economic and family values, a

large proportion of the Aboriginal population are struggling with serious key issues of poverty,

mental health issues, social exclusion, an unequal access to education and medical services.

What will you do to act on findings from the Truth and Reconciliation Commission to support

Aboriginal people to overcome many of these issues that are longstanding?

6) Many First Nations communities continue to live under boil orders for their drinking water or

must rely on water to be brought in. What immediate concrete steps would you take to

address safe drinking water for Aboriginal communities living in these types of situations?

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Contact: Aboriginal Nurses Association of Canada

50 Driveway

Ottawa ON K2P 1E2

Ph: 613-724-4677

www.anac.on.ca

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Background Research: (conducted by Vlad Hordyeyev, International Development and

Globalization studies, University of Ottawa)

Inequality issues

-Significant health disparities exist between Aboriginal and non-Aboriginal Canadians

-First Nations, Inuit, and Métis peoples continue to experience considerably lower health

outcomes than non-Aboriginal Canadians

-First Nations, Inuit, and Métis peoples continue to show a disproportionate burden of disease or health disparities. These disparities are often rooted in health inequities.

-Health disparities are directly and indirectly associated with or related to social, economic,

cultural and political inequities; the end result of which is a disproportionate burden of ill health

and social suffering on the Aboriginal populations of Canada.

-Social, economic, cultural and political inequities that impact the health of individuals and communities are often referred to as social determinants of health.

-Census data and other research show a persistent gap in socioeconomic status and well-being between Aboriginal and non-Aboriginal people in Canada.

-Fewer Aboriginal people between the ages of 25 and 34 obtained high school diplomas (68.1%)

than non-Aboriginal people (90.0%).

-Median income for Aboriginal people was almost $10,000 lower ($16,752) than for non-Aboriginal people ($25,955).

-The unemployment rate for Aboriginal people in 2006 was still more than twice that for non-Aboriginal people (13.0% compared to 5.2%)

-Aboriginal people were three times as likely as non-Aboriginal people to live in houses in need

of major repair.

-Indigenous peoples are affected by major health problems at rates much higher than non-Indigenous populations.

National Collaborating Center For Aboriginal Health, "An Overview of Aboriginal Health in

Canada". (2013). Retrieved October 12, 2015, from http://www.nccah-

ccnsa.ca/Publications/Lists/Publications/Attachments/101/abororiginal_health_web.pdf _____________________________________________________________________________

-Aboriginals are less likely to enjoy many of the privileges and amenities the majority of Canadians do.

-Health indices all clearly indicate that Aboriginal Canadians are not as healthy as other

Canadians.

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Queen's University, "Aboriginal Health" School of Medicine, Department of Family Medicine

(n.d.). Retrieved October 12, 2015, from

https://familymedicine.queensu.ca/education/enhanced/aboriginal

______________________________________________________________________________

-In 2006, the median income for Aboriginal peoples was $18,962, a full 30% lower than the $27,097 median income for non-Aboriginal people.

-Aboriginal people have historically faced higher unemployment rates than non-Aboriginal

people.

-Aboriginal youth are also over represented among criminalized young people and are jailed at earlier ages and for longer periods of time than non-Aboriginal young people.

-Higher rate of incarceration for Aboriginal people has been linked to systemic discrimination

and attitudes based on racial or cultural prejudice, as well as economic and social deprivation, substance abuse and a cycle of violence across generations.

Joseph, B. (2012, September 10). "Key Issues for Aboriginal People in Canada." Indigenous

Corporate Training. Retrieved October 12, 2015, from http://www.ictinc.ca/blog/8-key-

issues-for-aboriginal-people-in-canada ______________________________________________________________________________

Damage done

-Diseases and conflicts of colonization devastated Indigenous populations and their systems of Indigenous health knowledge.

-A common history of colonialism and resulting economic, social and cultural marginalization

has had profound health impacts on Indigenous peoples.

-Many Aboriginal people in Canada have suffered the loss of connections to their land, cultures,

languages and traditional ways of life through colonial practices such as forced relocations, the

Indian reservation system and the residential schooling system, which removed several

generations of children from their families and communities. In this context, the revitalization

and recovery of Aboriginal cultures, traditions and ways of knowing can have profound restorative impacts on health and well-being at both the individual and the community levels.




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-Aboriginals when questioned agree that we must address the issues of colonization, racism and inequity that have pursued us.

-Life for Aboriginal Canadians is much more difficult than for non-Aboriginals since Columbus made his landfall in the West Indies.


(n.d.). Retrieved October 12, 2015, from https://familymedicine.queensu.ca/education/enhanced/aboriginal

______________________________________________________________________________

-Colonialism accounts for many bitter, demoralizing legacies, the most pervasive of which is

education. The root of this particular legacy is that ultimate national experiment in assimilation.

The Indian Residential School system. According to Statics Canada's 2011 Aboriginal Survey, 22.8% of Aboriginal Peoples had completed high school and post-secondary education.



issues-for-aboriginal-people-in-canada ______________________________________________________________________________

-Aboriginals have a long and proud history and traditions. Many of the traditions were altered or

even taken away by the Europeans.

-The forced European culture and values had an effect of a social, physical and spiritual destruction.

-Being forced to relocate has had drastic effects on the population. No planning, infrastructure or an economy was set up. The people were restricted to small lands.

-Destruction of traditional ways of living.

-Many Aboriginals died due to lack of shelter, food, health care and money.

-Canadian governments put tight restrictions on relief efforts to reserves, pushing the people into

more poverty.

-Europeans brought many new diseases that had devastating effects.

- Residential schools were most effective for destroying the culture and identity. Destruction involved emotional, mental, physical abuse.

-Views of Residential school system continues to effect Aboriginal children today in our schools.

http://www.ictinc.ca/blog/indian-residential-schools-a-collection-of-articles

http://www.ictinc.ca/blog/aboriginal-peoples-survey-2011-a-snapshot

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-There is very little Aboriginal content in school curriculum today.

Social Justice, "Aboriginal Issues." (n.d.). Retrieved October 12, 2015, from http://www.socialjustice.org/index.php?page=aboriginal-issues

______________________________________________________________________________

-Racism and social exclusion have been a reality for Aboriginal peoples since first contact with

British colonizers. The colonial system created social stratification along ethnic lines, with a

consequent hierarchical distribution of resources, power, freedom and control, all of which ultimately influenced Aboriginal health.



ccnsa.ca/Publications/Lists/Publications/Attachments/101/abororiginal_health_web.pdf

______________________________________________________________________________

Difficulties with access

-Aboriginal health policy in Canada is made up of a complicated “patchwork” of policies,

legislation and agreements that delegate responsibility between federal, provincial, municipal

and Aboriginal governments in different ways in different parts of the country. Although in some

cases, the administration of Aboriginal health services is adequate, in other cases the gaps and

ambiguities created by a complicated policy. Environment and jurisdictional confusions have created barriers to equitable access to health care and services.

-Health care services to Aboriginal people in Canada is in a constant state of flux.

-In the absence of a clear national Aboriginal health policy, jurisdictional gaps and inconsistent

levels of funding continue to create barriers for many Aboriginal communities.



ccnsa.ca/Publications/Lists/Publications/Attachments/101/abororiginal_health_web.pdf ______________________________________________________________________________

-Quality health care is out of reach for many Aboriginal Canadians. Federal, provincial and

jurisdictional disputes, cultural barriers and geo isolation have impeded Aboriginal peoples'

access to the health care system.

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Social Justice, "Aboriginal Issues.", (n.d.). Retrieved October 12, 2015, from http://www.socialjustice.org/index.php?page=aboriginal-issues

______________________________________________________________________________

-In order to realize the benefits of an advanced system of health care, Canadian individuals must

have physical, political and social access to those services; this is often not the case for Aboriginal peoples.

-Social access to health care is similarly limited or denied to Aboriginal peoples through health

systems that account for neither culture nor language, or the social and economic determinants of

Aboriginal peoples’ health.

-Aboriginals are limited by needed services not being covered or approved by the federal Non-

Insured Health Benefit plan and by doctors or nurses not being available in their area. Feeling

that the health care provided was inadequate or not culturally appropriate were also barriers that

were frequently mentioned. The fact that many First Nation adults live in rural and more isolated

communities, and at very low levels of income, led to a number of economic barriers to accessing health care.

-Adequate education, which in many ways continues to be denied to Aboriginal peoples, has a

profound impact on income, employment and living conditions.




Specific Health Issues

-These health issues include high infant and young child mortality; high maternal morbidity and

mortality; heavy infectious disease burdens; malnutrition and stunted growth; shortened life

expectancy; diseases and death associated with cigarette smoking; social problems, illnesses and

deaths linked to misuse of alcohol and other drugs; accidents, poisonings, interpersonal violence,

homicide and suicide; obesity, diabetes, hypertension, cardiovascular, and chronic renal disease

(lifestyle diseases); and diseases caused by environmental contamination (for example, heavy metals, industrial gases and effluent wastes).

-Aboriginal populations in Canada face many urgent health issues. Aboriginal people are over-

represented in HIV infection rates.

-They also experience disproportionate rates of tuberculosis at 26.4 times the rate of Canadian-

born non-Aboriginal people.

-Type 2 diabetes is now considered to have reached “epidemic” levels in First Nations

communities, where adults are four times as likely to suffer from Type 2 diabetes and are more

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likely to experience health complications related to the disease than are non Aboriginal Canadians.

-The suicide rate among Inuit communities in Arctic Canada is ten times that of the general

Canadian population.

-Violence against Aboriginal women is also considered to have reached epidemic proportions in

many parts of the country, with Aboriginal women 3.5 times more likely to experience violence than other Canadian women.

-As of 2010, the Native Women’s Association of Canada had documented 582 cases of missing

or murdered Aboriginal women.

-Aboriginal peoples in Canada are also disproportionately affected by environmental

contamination, particularly in Arctic regions where the traditional food sources of Inuit populations have accumulated environmental toxins, leading to a variety of health problems.



ccnsa.ca/Publications/Lists/Publications/Attachments/101/abororiginal_health_web.pdf ______________________________________________________________________________

-Survey of the health of Aboriginal Canadians by an Aboriginality controlled organization

(NAHO) found that 32% of Aboriginal Canadians participating rated their water supply as

unsafe, 24.6% reported overcrowded living conditions (vs. 1% of the general population)and

32.9% were living in housing requiring major repairs.

-Aboriginal Canadians have a higher incidence of such infectious diseases as gastroenteritis,

tuberculosis, diphtheria, pertussis, rheumatic fever, respiratory problems, STIs, and infectious hepatitis, many of which are preventable.

-Chronic diseases are also becoming an increasing problem with an epidemic of diabetes(3-4

times the national average), obesity (up to 90-95% of people over the age of 50 in some studies),

metabolic syndrome and the subsequent cardiovascular(2-3 times higher) and renal

complications of these diseases hitting many aboriginal people and communities with

devastating results.

-Rates of suicide overall are about twice the national average, but in the younger age groups they are much higher.

-Both suicide and other unintentional injuries have at least some relationship to substance abuse, which is also an issue that is more prevalent in the aboriginal population.



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______________________________________________________________________________

-First Nations people and Inuit face some serious health-related challenges, such as high rates of

chronic and contagious diseases and shorter life expectancy.

-Compared to the general Canadian population,

o Heart disease is 1.5 times higher;

o Type 2 diabetes is 3 to 5 times higher among First Nations people and rates are increasing

among the Inuit; and

o Tuberculosis infection rates are 8 to 10 times higher.

Health Canada "Diseases and Health Conditions", Aboriginal and Inuit Health (2014,

December 18). Retrieved October 12, 2015, from http://www.hc-sc.gc.ca/fniah- spnia/diseases-maladies/index-eng.php

______________________________________________________________________________

-Aboriginal people remain at higher risk for illness and earlier death non-Aboriginal

people. Chronic diseases such as diabetes and heart disease are on the increase. There are

definite links between income, social factors and health. There is a higher rate of respiratory

problems and other infectious diseases among Aboriginal children than among non-Aboriginal

children - inadequate housing and crowded living conditions are contributing factors.

-Children in Aboriginal families also have high rates of unintentional injuries and early deaths

from drowning and other causes. According to Health Canada statistics, Aboriginal children are

three to four times more likely to die from unintentional injury than non-Aboriginal children of

the same age.

-Suicide rates are five to seven times higher for First Nations youth than for non-Aboriginal

youth.



issues-for-aboriginal-people-in-canada ____________________________________________________________________________

-Physical environments such as crowded housing conditions have been associated with stress in all three age groups.

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-These conditions can also indirectly contribute to substance overuse and parenting difficulties,

which may result in poor school performance among youth and children. This particular

interaction of life-stage health issues begins with a social determinant, which contributes to the creation of an environment for youth and child development.

-Physical environments that are largely detrimental to health have been imposed through historic dispossession of traditional territories as well as current reserve or settlement structures.

-Aboriginal peoples living in remote rural and reserve communities face considerable food

insecurity related to challenges acquiring both market and traditional foods. The cost of

transporting market foods to remote communities means that healthy, nutritious food is not affordable to most families.

-With respect to poverty specifically, the most widely discussed impact of poverty is a lack of

access to material resources, such as nutrient dense food, which leads to high rates of obesity and diabetes and resultant poor cardiovascular and renal health.

-Poverty is also linked to social exclusion, low social cohesion and increased crime.

Loppie, C., & Wien, F. (2009). "Health Inequalities and Social Determinants of Aboriginal

People's Health", National Collaborating Center For Aboriginal Health Retrieved October 12, 2015, from http://ahrnets.ca/files/2011/02/NCCAH-Loppie-Wien_Report.pdf

______________________________________________________________________________

Insufficient medical training

-Physicians interested in serving Aboriginal populations need to be better prepared; not only

should they be clinically competent, but also culturally sensitive and politically aware of the variety of issues that impact on the health of Canada's Aboriginal people.



______________________________________________________________________________

Unsafe Water

- As of July 31, 2015, there were 133 Drinking Water Advisories in effect in 93 First Nations

communities across Canada, excluding British Columbia.

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Health Canada, (2015, September 10). "Drinking Water and Wastewater", Retrieved October 12,

2015, from http://www.hc-sc.gc.ca/fniah-spnia/promotion/public-publique/water-eau-

eng.php#s2b

______________________________________________________________________________

-Access to clean drinking water is tenuous in many municipalities and in Indigenous

communities.

-In Ontario, Ministry of Health and Long-Term Care stated 149 boil water advisories were in place in January 2015.

-As of January 2015, there were 169 DWAs in 126 First Nation communities. Ontario has the

highest number of DWAs for Indigenous communities (79), followed by British Columbia (35),

Saskatchewan (24), Alberta (17), the Atlantic (7) and Quebec (2).

-Most DWAs in Indigenous communities are boil water advisories.

-The number of people affected by each DWA ranges from 0 to 5,000, yet for many communities the number of people affected is marked “unknown” on the Health Canada website.

-Example, Shoal Lake First Nation... had its boil water advisory which has been in place for more than 17 years.

-In June 2014, Health Canada began posting the names of First Nations communities that were

under DWAs. However, they do not provide reasons for the DWAs. An access to information

request from January 2011 listed various reasons for the DWAs including: “unacceptable

microbiological quality, inadequate disinfection or disinfectant residuals, operation of system

would compromise public health, significant deterioration in source water quality, unacceptable

turbidity [cloudiness] or particle count and equipment malfunction during treatment or distribution.”

-There are routinely more than 100 water advisories in effect, with more than half of the

advisories in place for between five to 15 years. These advisories in First Nations communities

are "a black eye" for the Canadian government, pointing to the long-standing and systemic failure to provide clean, safe drinking water to Indigenous communities.

- suggestion?

Establish national enforceable drinking water standards.

Recognize water as a human right.

Respect Indigenous water rights.

Invest in water and wastewater infrastructure, particularly in First Nations communities

Lui, E. (2015, March 1). "On Notice for a Drinking Water Crisis in Canada" Council of

Canadians Retrieved October 12, 2015, from http://canadians.org/sites/default/files/publications/report-drinking-water-0315_0.pdf

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_____________________________________________________________________________

-The number of First Nations under drinking water advisories has grown by nearly 40 per cent since 2006

-The number of First Nations living under drinking water advisories grew to 131 in 2011 from 95

in 2006

-The number of communities under drinking water advisories grew nearly every year between

2006 and 2011. Only 2007 saw a drop with 93 communities under advisories, according to

numbers provided by Health Canada. The number of First Nations under advisories jumped to

103 in 2008, 111 in 2009, 119 in 2010 and 131 in 2011.

APTN National News "More First Nations Under Drinking Water Advisories". (2012, February

3). Retrieved October 12, 2015, from http://aptn.ca/news/2012/02/03/more-first-nations- under-drinking-water-advisories/

______________________________________________________________________________

Other research shows

-Early commentary by an education expert indicates that the funds allocated to education are

much lower than what is needed for “infrastructure to build more schools, to bring more

resources and support to students in schools.” The education funding proposed in this Budget is

lower than the $1.9 billion the Prime Minister promised for education in February 2014.

Federal Budget Statement 2015

______________________________________________________________________________

- Health Canada department had not assessed whether each nursing station had the capacity to

provide services, nor had it informed First Nations individuals what essential services were

provided at the station.

- Nursing stations that are non-compliant with health and safety requirements or building codes

can put patients and staff at risk and may limit access to health services.

- Testing nurses experience it was found that only 1 nurse in the sample of 45 had completed all

five of the mandatory training courses we selected for examination.

- In one of the communities there were health and safety issues found in the nursing station and

in the residences used to accommodate visiting health care providers. The ventilation and air

conditioning in both the nursing station and residences needed to be repaired. According to

Health Canada officials, these deficiencies were causing heat-related symptoms for staff and

patients. Furthermore, one of the residences had been unusable for more than two years because

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the septic system had not been repaired. Consequently, health specialists cancelled their visits to

the community.

- In many regions, First Nations individuals struggle with the medical transportation services,

and sometimes are denied access.

Reports of the Auditor General of Canada, "Access to Health Services for Remote First Nations

Communities" Spring 2015

______________________________________________________________________________

Aboriginal people and communities under water advisories and

specifically boil water advisories in Canada.

- As of July 31, 2015, there were 133 Drinking Water Advisories in effect in 93 First Nations

communities across Canada, excluding British Columbia.

Health Canada

http://www.hc-sc.gc.ca/fniah-spnia/promotion/public-publique/water-eau-eng.php#s2b

______________________________________________________________________________

-Access to clean drinking water is tenuous in many municipalities and in Indigenous communities.

-In Ontario, Ministry of Health and Long-Term Care stated 149 boil water advisories were in

place in January 2015.

-as of January 2015, there were 169 DWAs in 126 First Nation communities. Ontario has the

highest number of DWAs for Indigenous communities (79), followed by British Columbia (35), Saskatchewan (24), Alberta (17), the Atlantic (7) and Quebec (2).

-most DWAs in Indigenous communities are boil water advisories.

-The number of people affected by each DWA ranges from 0 to 5,000, yet for many communities

the number of people affected is marked “unknown” on the Health Canada website.

-example, Shoal Lake First Nation... had its boil water advisory which has been in place for more than 17 years.

-In June 2014, Health Canada began posting the names of First Nations communities that were

under DWAs. However, they do not provide reasons for the DWAs. An access to information

request from January 2011 listed various reasons for the DWAs including: “unacceptable

microbiological quality, inadequate disinfection or disinfectant residuals, operation of system

would compromise public health, significant deterioration in source water quality, unacceptable

turbidity [cloudiness] or particle count and equipment malfunction during treatment or distribution.”

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-There are routinely more than 100 water advisories in effect, with more than half of the

advisories in place for between five to 15 years. These advisories in First Nations communities

are "a black eye" for the Canadian government, pointing to the long-standing and systemic failure to provide clean, safe drinking water to Indigenous communities.

Some of our suggestions can be:

Establish national enforceable drinking water standards.

Recognize water as a human right.

Respect Indigenous water rights.

Invest in water and wastewater infrastructure, particularly in First Nations communities

Council of Canadians

http://canadians.org/sites/default/files/publications/report-drinking-water-0315_0.pdf

_____________________________________________________________________________

-The number of First Nations under drinking water advisories has grown by nearly 40 per cent since 2006

-The number of First Nations living under drinking water advisories grew to 131 in 2011 from 95 in 2006

-The number of communities under drinking water advisories grew nearly every year between

2006 and 2011. Only 2007 saw a drop with 93 communities under advisories, according to

numbers provided by Health Canada. The number of First Nations under advisories jumped to 103 in 2008, 111 in 2009, 119 in 2010 and 131 in 2011.

APTN News

http://aptn.ca/news/2012/02/03/more-first-nations-under-drinking-water-advisories/

______________________________________________________________________________

http://www.cbc.ca/news/politics/canada-election-2015-justin-trudeau-first-nations-boil-water-advisories-1.3258058

- This article refers to the stance Justin Trudeau will take regarding the water issues.

http://www.cbc.ca/news/aboriginal/neskantaga-first-nation-demands-action-on-20-year-boil-

water-advisory-1.3256929

- This article is one of the major examples that brought media attention to the problems.

___________________________________________________________________________

ANAC Election 2015 Statement to Federal Parties.Oct 15_15

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