Indigenous people in British Columbia are getting consistently sub-standard access to health care, according to new report digging into anti-Indigenous racism in the health-care system.
Former children’s commissioner Mary Ellen Turpel-Lafond released the report Thursday, which provides data to follow up on systemic racism identified in a November report.
“Our reports, including this data report, present evidence of the impacts of racism (and) the need for immediate principled and comprehensive evidence-based efforts to combat that racism,” Turpel-Lafond said.
“The healthcare system in B.C. is a much different experience if you are an Indigenous person than if you are a non-Indigenous person.”
Health Minister Adrian Dix said the data provided substantial support for the conclusions of Turpel-Lafond’s earlier report.
“It’s toxic for people and it’s toxic for care,” he said. “The situation as it exists, and as depicted in the details of this report, cannot stand.”
The report concludes that First Nations, Metis and Innuit people in the province do not have equal access to primary care and preventative services, which has translated into life-long poorer health outcomes.
The report looked at data collected from across the healthcare system, along with a detailed analysis of more than 600 submissions from Indigenous people.
It also examined cancer screening, multi-morbidities, acute and chronic conditions, how and how often Indigenous people are forced to resort on using emergency services, and how often they’re not admitted on a first visit.
“Indigenous people in British Columbia are receiving services in a healthcare environment that is skewed away from primary preventative care, and pushes them into secondary and tertiary care and treatment,” Turpel-Lafond said.
“The inadequacy at this time of B.C.’s primary care system is evident. There’s a high burden of disease among Indigenous people in British Columbia, and First Nations people in particular of all ages have comparatively lower attachment rates to (primary care doctors and nurses).”
Elders, who are among the most likely to require continuing care, were not attached to primary care at a rate 89 per cent higher than non-Indigenous people, the report found.
Turpel-Lafond said that poor access has meant many Indigenous people are missing screening for preventable or treatable diseases.
For example, First Nations women were about a third less likely to receive a pap smear than non-First Nations women, but had a rate of cervical cancer 1.6 times higher, she said.
Indigenous women are getting less access to prenatal health services, she said, and fewer were accessing specialty maternal and obstetric services, despite higher rates of pre-term and very pre-term birth.
The report also links poor access to pediatric services to higher rates of asthma, depression, mood and anxiety disorder, epilepsy and poor oral health in Indigenous kids and youth.
Turpel-Lafond described the data as a “baseline” against which necessary improvements must be considered.
“There will need to be substantial work done to come close to achieving equality, but we must measure and demonstrate whether progress is happening,” she said, adding that health authorities will need to continue to report on key metrics in a timely and consistent manner.
Turpel-Lafond was initially hired to investigate claims that emerged in June that staff at a B.C. hospital were playing a game guessing the blood alcohol level of Indigenous patients.
Her investigation did not substantiate the allegation but did find a much larger problem of racism and fear from Indigenous people due to the treatment within the health-care system.
Once the province appoints an Indigenous health representative and advocate, that person will be able to collect reports and concerns about anti-Indigenous racism in the system, she said.
Until then the province will maintain a 1-800 number and email address, overseen by the BC Ombudsperson, who is to receive the complaints.
Dix said the province was committed to implementing the 24 recommendations in Tuprel-Lafond’s November report.
Dix said the province had already hired nine of 32 new Indigenous health liaison positions to be distributed around the province, and is requiring at least two Indigenous members on the board of each health authority.
“It is our goal that these positions will make a meaningful and immediate difference for Indigenous patients who are accessing our healthcare system today,” he said.
The province has also hired Island Health vice-president Dawn Thomas to be B.C.’s new Associate Deputy Minister of Indigenous Health to lead implementation of Turpel-Lafond’s recommendations and coordinate provincial response.
Additionally, Dix said B.C. was reviewing medical bylaws and the Health Professions Act to include expectations of cultural safety among practitioners.
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