Health (18-24): Current Problems

Ongoing Health Crisis


February 17, 2021


NU

Access to Health in Inuit Nunangat

Inuit life expectancy is 10 years shorter than the average Canadian, according to Statistics Canada.

Nunavut News – “Tackle lack of basic health care for Indigenous peoples, then worry about racism, Nunavut’s MP says”. Nunavut member of Parliament Mumilaaq Qaqqaq says the lack of medical care available in Nunavut currently is proof that the Government of Canada doesn’t care about Inuit. “The complaints I’m getting about health care are about access to health care more than about discrimination… (it’s) the shortage of resources in notable areas like mental health,” said Nunavut Conservative Senator Dennis Patterson. Nunavut Tunngavik Inc. (NTI) submitted a statement indicating that broader social conditions affect the health of Inuit in Nunavut, such as income, education, adequate housing, stress/trauma and food security.

NTI also expressed support for the Canadian Public Health Association’s recommendations:

  • to adopt a formal statement condemning racism;
  • undertake system-wide reviews of regulations, policies, processes and practices to identify and remove any racist systems and approaches;
  • identify and remove racist laws, regulations, procedures and practices;
  • provide mandatory, rigorous and system-wide anti-racism and anti-oppression training for all staff and volunteers within their organizations;
  • enhance public health surveillance systems by collecting and analyzing race and ethnicity data in an appropriate and sensitive manner; and
  • monitor organizations for stereotyping, discrimination, and racist actions and take corrective actions.

March 31, 2018


MB

Access to Health Services: Virgo Report

Release of the Virgo Final Report: “Improving Access and Coordination of Mental Health and Addiction Services: A Provincial Strategy for all Manitobans” specifically emphasizes the discovery made during the system review that for almost every service encountered, the largest percentage of people being served were of Indigenous background.

The report acknowledges the “history of colonization and historical trauma, and ongoing challenges with respect to social determinants of health. More importantly, we believe the overall system of services will not improve significantly in terms of access or coordination without a concerted and sustained effort to better meet the needs of the province’s Indigenous people.

Of the many issues brought forward unique to Indigenous people, two were particularly salient:

  • the need for more culturally informed services, including land-based programs, and support for those community members whose customary language is their own native language and who have trouble understanding words and concepts expressed in English.
  • Last, the “jurisdictional issue”— a fundamental challenge to be addressed going forward as it underlies significant issues related to access and coordination. This was one of the top priorities identified in the validation events.

Other specific issues identified previously with respect to the preceding Strategic Priorities, including,

  • the need for more local, and more flexible, services, including longer term treatment and pre-and post-treatment supports;
  • the need for better integration of SUA and MH (substance use/addiction and mental health problems and illnesses) services;
  • the need to fill specific gaps for youth and women; and
  • a critical need for Withdrawal Management Services (WMS), transitional stabilization to support access to treatment, housing, transportation and crisis services, including post-crisis healing opportunities.

https://www.gov.mb.ca/health/mha/docs/mha_strategic_plan.pdf


September 29, 2020


AB, BC, Fed. Govt., MB, NB, NL, NS, NT, NU, ON, PE, QC, SK, YT

Beyond Hunger – The Hidden Impacts of Food Insecurity in Canada”

Community Food Centres (CFC) – Release of “Beyond Hunger – The Hidden Impacts of Food Insecurity in Canada”. Even before COVID-19, food insecurity affected nearly 4.5 million Canadians. In the first two months of the pandemic, that number grew by 39 per cent. Food insecurity now affects one in seven people, disproportionately impacting low-income and Black, Indigenous and People of Colour (BIPOC) communities. “Beyond Hunger illustrates that food insecurity is about equity and income,” says Saul. “We urgently need a national solution that goes beyond emergency food assistance. We need a solution founded in solid policy that addresses inadequate social programs, systemic racism and precarious employment.”

Why Food Insecurity happens in Canada:

  • People are stuck in low wage and precarious jobs
  • Canadians are struggling with a rising cost of living
  • Colonialism and systemic racism
  • Low social assistance rates trap people in poverty
  • More and more people are living alone
  • Food in the North is unaffordable

Findings:

  • 81% say it takes a toll on their physical health
  • 79% say it impacts their mental health
  • 57% say it is harder to find and keep a good job
  • 53% say it is a barrier to finding meaning in life
  • 58% say it limits their ability to take part in social activities
  • 46% say it limits their ability to celebrate their culture

We believe government policy is necessary to address the real cause of food insecurity. Policy is what will increase incomes and make life more affordable — for everyone. Here are four policy changes for the federal government to act on:

  1. Invest in income supports for low income Canadians
    • Increase income benefits for single adults who suffer disproportionately from food insecurity by:
      • Ensuring low-wage workers have equal access to Employment Insurance
      • Improving existing tax benefits so they provide more income by making them refundable
      • Creating a tax credit specifically for working-age adults
    • Ensure low-income Canadians, especially First Nations living on reserve, have better access to tax filing supports and benefit services
  2. Make life more affordable for Canadians
    • Speed up the implementation of the Canada Housing Benefit, which supports people who can’t afford their housing
    • Increase federal funding for early learning and child care
    • Move forward with a universal public pharmacare program
  3. Set targets and improve reporting on food security
    • Set targets to reduce food insecurity
    • Ensure Statistics Canada reports on food insecurity annually and collects better race-based data
  4. Ensure progress on food insecurity is achieved equitably
    • In partnership with Northern leadership, continue to reform Nutrition North Canada
    • In partnership with Indigenous leadership, create an Indigenous food sovereignty fund
    • In partnership with Black communities, create a fund to decrease food insecurity for Black Canadians
    • Apply a racial equity lens to all poverty and food-security policies

https://cfccanada.ca/getmedia/57f5f963-af88-4a86-bda9-b98c21910b28/FINAL-BH-PDF-EN.aspx?_ga=2.197064812.159489303.1604624936-1692352870.1604624936


July 11, 2022


Fed. Govt.

Canada needs to implement pandemic preparedness in dealing with TB

The goal to eliminate TB by 2030 can happen if lessons learned from COVID are implemented. This includes investing in health and telemedicine.

Policy Options: by Elizabeth Rea,  Tina Campbell,  Petra Heitkamp

Because of the pandemic, tuberculosis deaths globally have increased for the first time in over a decade. Concerning considering that before COVID, TB was the leading infectious-disease killer in the world.

In Canada we also see disruptions in services, damaging our progress toward TB elimination as part of the United Nations sustainable development goals (SDGs). Overall rates of TB are low in Canada, but the federal government has committed to ending TB by 2030 with a focus on Inuit Nunangat. This goal was reaffirmed on World TB Day 2021 by the national Inuit organization Inuit Tapiriit Kanatami (ITK) and the Canadian government. Relevant milestones in these efforts include ITK’s launch of an Inuit-specific TB elimination strategy and the establishment of a task force in 2017.

The federal government aims to achieve TB elimination by addressing social determinants of health. The subnational governments are responsible for TB clinical, laboratory and preventive services, and public health programs including contact follow-up, epidemiology and outcome monitoring. But cross-national (federal-provincial-territorial) co-ordination, data and surveillance are critical for success.

Apologies and promises are not enough to end TB in the North

What Canada needs to do to end TB

Pharmaceutical policy excludes the most vulnerable

As research shows, the impact of COVID-19 has included staff diversions to deal with the pandemic and a de-prioritization of essential public-health activities such as contact-tracing and TB preventive treatment. Alarmingly, findings also indicate delays in diagnoses, which have resulted in more severe illness.

The ripple effects may prove further damaging as the disease spreads to family and community members. Recent outbreaks in Nunavut and Saskatchewan show that Canada is not immune to the devastating long-term implications of the pandemic on health care.

survey by Stop TB Canada provides additional details of the negative effects of the pandemic on TB services. Provinces and territories are struggling with burned-out health-care workers.  One TB staff member said: “75 per cent of our workforce [was] diverted to [the] COVID-19 response team and they continue to remain there.”

Yet, the pandemic has brought health-system improvements and innovations that are  opportunities. These include initiatives like telemedicine, new investments in laboratory systems, substantial medical research and development, and broad access to paid sick leave.

The pandemic has shown that investments in public health are essential to the well-being of our society. We need to build on the innovations in response to COVID-19 to “build back better” and refuel our TB response in Canada. The TB workforce and services are the backbone for any future respiratory pandemic.

Stop TB Canada has five specific calls for action to eliminate TB in Canada:

Convene a national TB elimination taskforce: It is not enough for the federal government alone to make commitments on TB. Given the recent outbreaks in Saskatchewan and Nunavut, the provincial governments must increase the response and support to communities in need. Health-care and public-health teams need to be specifically made available to provide services for TB and freed up from other duties.

Health services need to be provided with adequate funding and diagnostic and treatment supplies to deal with the outbreaks. Preventive measures need to be improved. A national parliamentary inquiry by the Health Committee would be a good method to review progress on TB elimination toward the SDGs. It could also note systemic solutions for a more equitable health system. At the same time, discussions in parliament and cabinet related to pandemic preparedness, such as Bill C-293, need to build on TB lessons and infrastructure.

Step up the TB response in First nations and Inuit communities: Canada has committed to a 50 per cent reduction in TB across Inuit Nunangat (the Inuit homeland) by 2025 and to eliminating TB by 2030. Delivering on these promises is an essential component to our nation’s commitment to reconciliation. Action is needed. A concrete example is to ensure that the diagnostic platforms (GeneXpert), for COVID testing, remain there with TB test cartridges. This avoids the diagnostic delay from transporting specimens hundreds of kilometers to southern laboratories.

“TB testing capacity needs to be a priority, especially in high incidence locations. Despite the devastating effects of our current TB outbreak, there is no capacity for utilization of Gene-Xpert for TB testing while people are being tested multiple times for COVID. Opportunities to diagnose Active TB are missed, says Tina Campbell, a nurse in Saskatchewan and co-chair of Stop TB Canada.

Invest in TB vaccines and product development in Canada: New TB drugsand vaccines are badly needed. Massive research investments led to multiple highly effective COVID vaccines coming to market within a year. Yet, there is only one TB vaccine – the century-old and ineffective Bacille Calmette-Guérin vaccine. The pandemic has highlighted Canada’s dependence on importation of vaccines. Let’s build on our domestic expertise in medical sciences to step up vaccine capacity and TB research specifically, and meet Canada’s “fair share” expenditure on TB research.

Urgently improve TB data and surveillance systems: COVID highlighted the need for strong surveillance, integrated digital health information systems, and rapid information sharing. These are essential for analyzing trends quickly and tailoring interventions for specific areas and populations. Nearly 100 countries now report monthly to quarterly TB case notifications, and developing countries are moving to digital real-time TB surveillance. In contrast, Canada’s most recent national TB data is from four years ago with only a single infographic update for 2020.

Address health inequity: Canada’s chief public health officer Theresa Tam stated: “The COVID-19 pandemic has heightened awareness about the health and social inequities that exist in Canada, and the need to address the social determinants of health that lead to health disparities.” Crowded housing, poverty, inadequate access to health care, stigma and other social inequities are central to ending TB (and many other illnesses).

Canada must implement a comprehensive multi-sectoral TB strategy, including the needs of both Indigenous Peoples and newcomer Canadians originally from high-TB-incidence areas. TB response and systems are a pathfinder for addressing underlying issues of inequity and social determinants.

Canada is only TB free when the world is TB free. Neither COVID nor TB stop at national borders. In light of COVID-19-related disruptions in TB programs globally, Canada needs to invest $1.2 billion, its fair share, in the Global Fundto fight AIDS, TB and malaria. These resources would help to rapidly recover health and TB programs and prevent further increased disease burden and death.

We are starting to think about “living with COVID-19” – but we don’t have to “live with TB.” The pandemic is an inspiration to step up our fight to truly eliminate TB in Canada and around the world. Investing in health systems contributes directly to pandemic preparedness. The health workforce, testing and treatment infrastructure and preventive methods have all proven to be of significant use for the pandemic and also provide the foundation for the future. Canada has an opportunity now to build equitable health systems that serve the most vulnerable populations, eliminate TB and strengthen our preparedness all in one.


October 20, 2019


NU

Denial of medicine for Inuit babies

Globe and Mail – A group of doctors is urging officials in Nunavut to offer an effective but costly drug to all Inuit babies living in remote communities in the territory to protect them against a respiratory virus that disproportionately leads to their hospitalization. But Nunavut’s chief medical officer disagrees, saying there isn’t enough evidence to support such an approach. Palivizumab, the only available prophylactic treatment for RSV, is currently given to infants in Canada who are considered at high risk of complications, such as those born prematurely or who have underlying heart or lung conditions. But it is not routinely administered in Nunavut to healthy Inuit infants who are born at full term.

For most people, symptoms of RSV infection are indistinguishable from the common cold, although an estimated 1 to 3 per cent of infants in developing countries experience complications requiring hospitalization. Inuit babies in Canada, however, have an exceptionally high rate of RSV complications. Among some Inuit communities on Baffin Island, as many as half to two-thirds of babies are hospitalized with lower respiratory lung infections, mostly owing to RSV, according to Anna Banerji, an expert on Indigenous and refugee health and associate professor of pediatrics at the University of Toronto who helped start the petition. Although it is not entirely understood why, experts believe Inuit infants are disproportionately affected because of a combination of genetic and environmental factors, including food insecurity and a lack of adequate housing arising from a history of forced settlement.


July 14, 2016


AB, BC, Fed. Govt., MB, NB, NL, NS, NT, NU, ON, PE, QC, SK, YT

Fire protection on reserves

NationTalk – There is no national fire protection code that mandates fire safety standards or enforcement on reserves. All other jurisdictions in Canada including provinces, territories, and other federal jurisdictions (such as military bases, airports, and seaports) have established building and fire codes. The Aboriginal Firefighters Association of Canada (AFAC), NIFSC’s parent organization, supports the development of a national First Nations Fire Protection Act and is willing to work with First Nations leadership as a technical resource.

In the absence of legislation act or regulations, AFAC and the NIFSC are addressing identified gaps to improve fire safety in Indigenous communities by supporting them in creating fire safety standards, doing fire protection and response research, and establishing fire safety bylaws and building standards. Indigenous Peoples across Canada are over 5 times more likely to die in a fire compared to the rest of the population. That number increases to over 10 times for First Nations people living on reserve. Inuit are over 17 times more likely to die in a fire than non-Indigenous people. Rates among Métis were higher than non-Indigenous estimates (2.1), but these rates were not significantly different.

Fire-related injuries resulting in hospitalization are also disproportionate to Indigenous Peoples. First Nations people are over 4 times more likely, Métis are over 1.5 times more likely, and Inuit are over 5 times more likely than non-Indigenous people to be hospitalized due to fire-related injuries.

What has led to this situation?

Many social determinants contribute to the higher fire-related mortality among Indigenous Peoples. These include poverty, inadequate housing conditions, housing without smoke alarms, and more.

Core capital funding provided by Indigenous Services Canada (ISC), which includes funding for fire protection, is flexible. This means community leadership can use designated fire protection funds if the community has more immediate or pressing needs (e.g., a school needing repairs or social housing maintenance). Without a fire protection mandate or regulatory maintenance of fire protection standards for Indigenous communities, fire services and fire and life safety can be deprioritized or forgotten.
https://nationtalk.ca/story/new-study-shows-that-indigenous-peoples-across-canada-are-between-5-and-17-times-more-likely-to-die-in-a-fire-compared-to-the-rest-of-the-population

How the NIFC Project will help Indigenous Communities

  • Offer culturally sensitive and relevant fire and life safety training and education programs that are created for and delivered by Indigenous Peoples. These services are available to First Nations populations living on reserve, leadership, and individuals working or volunteering in emergency services.
  • Launched close to 80 programs and services that provide training and ongoing support to more than 600 First Nations communities in Canada. Programs include:
    • education, support, and training in the areas of community fire safety, community governance support, community infrastructure and engineering support, fire department management, fire investigation services, and fire department operations.
    • Training, education programs and services being offered by the NIFSC Project have not previously been available to First Nations communities, whereas they have been available in most other communities in Canada
  • improve fire-related mortality and morbidity amongst Indigenous Peoples is through more accurate data collection. The creation of the National Incident Reporting System (NIRS) will, over time, provide the data regarding fire incidents in Indigenous communities that has been missing.

October 21, 2020


AB, BC, Fed. Govt., MB, NB, NL, NS, NT, NU, ON, PE, QC, SK, YT

Food Insecurity

The Narwhal – Human Rights Watch released “My fear is Losing Everything: Climate Crisis and First Nations’ Right to Food” in Canada. The report details how longer and more intense forest fire seasons, permafrost degradation, volatile weather patterns and increased levels of precipitation are all affecting wildlife habitat and, in turn, harvesting efforts. The report also outlines how there are more hunting and foraging risks due to warming temperatures. For instance, it’s harder — and sometimes impossible — to hunt caribou because the ice and permafrost they travel on isn’t stable enough for hunters.

“Climate change threatens to decimate these food systems, risking further serious consequences for livelihoods and health,” the report states. The report also found that climate change is driving up prices for less-nutritious, store-bought alternatives that need to be brought in from the south. This is in part due to the fact that roads constructed from snow and ice are becoming less reliable because of warmer winters, meaning food needs to be flown in, which is far more expensive. This compounds the risk of food poverty for First Nations people, the report states.

Canada gets a failing grade on mitigating the effects of climate change, according to the report. The country is among the top 10 emitters of greenhouse gas emissions in the world, with per capita emissions upward of four times higher than the global average, the report states, noting that between 1990 and 2017, emissions increased by roughly 19 per cent, mainly due to mining and oil and gas production. Canada is warming roughly twice as fast as the global average; in the North, it’s even worse, with temperatures rising three times as quick.

The report also found that climate change is driving up prices for less-nutritious, store-bought alternatives that need to be brought in from the south. This is in part due to the fact that roads constructed from snow and ice are becoming less reliable because of warmer winters, meaning food needs to be flown in, which is far more expensive. This compounds the risk of food poverty for First Nations people, the report states.

Canada gets a failing grade on mitigating the effects of climate change, according to the report. The country is among the top 10 emitters of greenhouse gas emissions in the world, with per capita emissions upward of four times higher than the global average, the report states, noting that between 1990 and 2017, emissions increased by roughly 19 per cent, mainly due to mining and oil and gas production. Canada is warming roughly twice as fast as the global average; in the North, it’s even worse, with temperatures rising three times as quick.

Human Rights Watch lays out several recommendations for the federal government, including that:

  • Canada deem the right to food a basic human right
  • strengthen its climate change policies to reduce emissions
  • improve climate adaptation measures in First Nations and
  • support a transition toward renewable energy, including for First Nations, in the COVID-19 stimulus package

https://thenarwhal.ca/climate-change-indigenous-food-insecurity-report/


June 30, 2021


ON

Grassy Narrows Care Home

Toronto Star – After more than 50 years of failed negotiations, the federal government committed $90M for a care home that will treat those poisoned by mercury. The deal includes:

  • $68.9M in a trust for operational and servicing costs over 30 years and an agreement to periodically review the funding levels.
  • $19.5M previously announced for construction costs for the facility.
  • The new care home, once completed, is expected to offer palliative care, physiotherapy, counselling, traditional healing and have both in- and outpatient services. It will be able to treat 22 in-patients.

Over the past three years, the Star and scientists have revealed that fish near Grassy Narrows remain the most contaminated in the province; that there are mercury-contaminated soil and river sediments at or near the site of the old mill; and that the provincial government knew in the 1990s that mercury was visible in soil under that site and never told anyone in Grassy Narrows or nearby Wabaseemoong (Whitedog) Independent Nations. Scientists strongly suspect that old mercury still contaminates the mill site and pollutes the river.

Grassy Narrows First Nations has been fighting all levels of government for over 50 years since the paper Mill in Dryden dumped over 10 tons of toxic mercury into the Wabigoon River upstream of Grassy Narrows in northern Ontario.


July 14, 2016


ON

Grassy Narrows mercury clean-up ignored for over 30 years

Toronto Star – Ontario’s former environment minister called for a clean-up of mercury contaminating Grassy Narrows First Nation, historical cabinet memos obtained by the Star show. But nothing was done by the government of the day to clean up the polluted river and lakes, and more than 30 years later the fish that feed the community are still contaminated. The March 30, 1984, recommendation to cabinet from then-Environment Minister Andrew Brandt said the government should endorse a $2-3 million remediation plan to “cover the mercury sediments” in the nearby Clay Lake on the English-Wabigoon River, but hold off on the more disruptive and costly option of dredging the river system pending further study.

What had prompted the former environment minister’s advice was a scientific report by the 1983 Canada-Ontario Steering Committee on the English-Wabigoon River System. The report said the mercury had contaminated sediments in the surrounding rivers and lakes and that the fish would be contaminated for generations if the mercury wasn’t cleaned up. (Today, one meal of Walleye from Clay Lake contains up to 150 times the safe dose of mercury recommended by the U.S. Environmental Protection Agency.) The committee recommended, among other things, to place clean sediment in the water so that it settles on the bottom of Clay Lake to stabilize the mercury-contaminated sediment — a method called resuspension — as well as some dredging of the river. A small pilot project done for the 1983 report tested the method of resuspension in Clay Lake and found it reduced mercury levels in fish “by ten times.” The provincial government should not appear reluctant to take action on the report’s recommendations,” wrote a senior environment ministry staffer in a briefing note circulated within the department in the spring of 1984”. 37 years ago and the Indigenous people of Grassy Narrows First Nation and Wabaseemoong First Nation are still waiting – and dying!”


June 30, 2021


Fed. Govt.

Jordan’s Principle Funding

The Matawa Education and Care Centre (MECC), – formerly, the ‘Matawa Learning Centre,’ yesterday released their report entitled ‘Matawa Education and Care Centre 5th Annual Report on the Seven Youth Inquest – Academic 2020-2021.’ For the first time—it included an alert regarding MECC’s potential inability to meet inquest recommendations 64, 71, 81, 83, 84, 85, 114 as a result of the lack of federal government commitment to funding the Jordan’s Principle and Choose Life programs past March 2022. The continuation of these programs has been advocated over the past number of months and more recently, in a joint Nishnawbe-Aski Nation (NAN), Keewaytinook Okimakanak (KO), Northern Nishnawbe Education Council (NNEC) letter to Indigenous Services Canada Minister Marc Miller on June 10, 2021.

Without this commitment, MECCC will lose the following programs and services for its students:

* Mental Health Staff and Services;
* Special Education Staff and Services;
* Outdoor Education Staff and Services;
* Elders Program;
* Cultural Program;
* Staff Professional Development;
* Student Education and Training;
* a partnership with St. Joseph’s Care Group which includes in-school access to a:
* Clinical Supervisor;
* Mental Health and Addiction Counsellors;
* Child and Youth Workers;
* Nurse Practitioner;
* Psychologist;
* Family Therapist and
* a Psychiatrist.

“It is incumbent upon Canada to provide funding via a stable and predictable mechanism that allows for long term strategic planning and discretionary decision making as stated in Inquest Recommendation #12,” said MECC Principal, Brad Battiston. “Stable reliable funding moving forward will provide adequate academic and mental wellness programming for our students.


March 13, 2020


MB

Safe and Sound: A Special Report on the Unexpected Sleep-Related Deaths of 145 Manitoba Infants

Release of Manitoba Advocate for Children and Youth (2020): Safe and Sound: A Special Report on the Unexpected Sleep-Related Deaths of 145 Manitoba Infants” According to population projections, Indigenous infants account for between 20-30% of live births in Manitoba during the study period (Jan. 2009 – Dec. 2018), but represent 57% of sleep-related infant deaths. That translates to 83 First Nations and Métis infants.

Policies articulated in the Indian Act have excluded Indigenous Peoples from participation in economic life for generations, leading to intergenerational poverty. In evidence of ongoing systemic racism, many Indigenous families have unequal access to health services, they lack suitable stable housing, and access to clean drinking water. The health gap between Indigenous and non-Indigenous Manitobans is widening (Katz et al. 2019). Of the 13 recommendations, 7 are directed towards First Nations and Métis governments and various federal and provincial ministries.

https://manitobaadvocate.ca/wp-content/uploads/SafeSleep-Report.pdf