A new study looking at the health of Manitobans shows that while most of the population is living longer, the average life expectancy of the province’s First Nations peoples remains stagnant and is even decreasing for Indigenous women.
Researchers from the First Nations Health and Social Secretariat of Manitoba and the University of Manitoba analyzed data over two five-year periods spanning two decades running from 1994 to 1998 and from 2012 to 2016.
They found the life expectancy at birth of non-Indigenous Manitobans in 1994 was 81 for women, and 76 for men. By 2016, that had increased to 83.7 years for women and 79 for men. But for First Nations peoples, there was no correlating improvement. For women, life expectancy actually decreased to 72 from 73, while for men, it remained unchanged at 68.
The study, published Monday in the Canadian Medical Association Journal, was initiated in response to one of the recommendations from the Truth and Reconciliation Commission calling on the federal government, in consultation with First Nations peoples, “to establish measurable goals to identify and close the gaps in health outcomes between Aboriginal and non-Aboriginal communities.”
Researchers combed through provincial data and looked at changes in health indicators between registered First Nations peoples and all other residents in Manitoba. In addition to life expectancy, they also looked at premature mortality, rates of primary care visits and how many days people spent in hospital. They found that First Nations peoples have higher rates of hospitalization, and often face worse outcomes than other Manitobans.
“I think Canadians tend to too often blame First Nations peoples for their own health problems saying, this is up to them, to improve their health. What this study is showing is that we need to look at the cause, the underlying cause,” said Alan Katz, one of the researchers with the Manitoba Centre for Health Policy at the University of Manitoba. “We need to try to understand why these differences exist, and it’s not about just trying harder.”
According to Dr. Katz, a longer life expectancy is a good indicator of the general health of a population.
Leona Star, director of research with the First Nations Health and Social Secretariat of Manitoba, said although the research is not new, the data sends a clear message.
“The current health system as it sits is currently failing First Nations.”
Ms. Star said that supports are needed for a First Nations-driven health care system that align with their own needs, priorities and world views. She said the current model is driven by provincial or federal systems not ideally created to provide the best primary care, support and continuity of care within their nations.
Dr. Katz said that when we’re looking at the disparities between First Nations peoples and the rest of the population, we must consider both the social and historical determinants of health.
“The history and impact of colonialism is still being felt by First Nations and this is wherein the problem starts,” he said.
Whether you’re looking at factors such as the high cost of food in the North, lack of employment or poverty, all of these affect the health of First Nations peoples, Dr. Katz said.
The study concludes that work must be done to “decolonize” the health care system. Ms. Star goes further saying First Nations need “health care sovereignty,” which can be achieved though the repatriation of birthing practices and reasserting their cultural way of treating their people.
Ms. Star said First Nations need to assert their own governance and become more involved with the interpretation of data to ensure that analysis is done according to their understanding of how to achieve better health outcomes. And this must be done while also respecting the beauty and uniqueness of what health and wellness looks like to the distinct First Nations, Inuit and Métis groups in the province.
“What really makes us well is our connection to land, language and culture, and when we look at the data that currently exists, none of the data currently captures that,” she said.
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