The physical and social conditions in which someone is born, develops, lives, works, and ages will drastically affect their life expectancy (Government of Canada, 2018). The Government of Canada (2018) states that systemic health and social resources play a pivotal role in providing health care in Canada. But what if you did not trust this system? What if the resources were not allocated equitably? What if this inequality meant that you and your family would experience a significantly shorter life expectancy than other families?
Indigenous health inequalities exist in Canada as a result of political, social, and economical disadvantages (Government of Canada, 2018).
Although inequalities impact health in many ways, this post will use the social ecological model to focus on how colonialism, by the way of residential schools and intergenerational trauma, still effect life expectancy negatively in Indigenous communities today.
The social ecological model (SEM) is based on the principle that health is influenced by many factors: intrapersonal, interpersonal, institutional, community, and policy (Rural Health Information Hub, 2021). This model believes that health is not simply influenced by one’s personal health choices alone (ie: healthy food, exercise, sleep, etc.) but rather influenced by the larger societal system and experiences one has within this system (Golden & Earp, 2012).
The Social Ecological Model for Health
In 1831, Canada opened its first of over 130 residential schools; its purpose was to assimilate Indigenous youth into Canadian society through ways of cultural genocide (Menzies, 2021; Miller, 2021). Over the next 165 years, approximately 150,000 children attended these schools, the last closed in 1996 (Miller, 2021). Children who attended residential schools were taken from their homes by force or coercion, separated from their families and communities (siblings were also often separated once taken from their home), and banned from partaking in any cultural practices – this included being forced to cut their hair, change their clothes, change their language, change their spiritual beliefs, and even change their name (Miller, 2021). Indigenous children were physically, mentally, and/or sexually harmed if they were caught partaking in traditional practices (Menzies, 2021).
"How much different can life expectancy be between Indigenous and non-Indigenous Canadians? We all live in the same country and have the same health care" you ask?
The difference is 12 years, states Kolahdooz et al. (2015). Due to higher rates of preventable chronic disease (physical and mental), Indigenous Canadians die 12 years sooner than non-Indigenous Canadians (Kolahdooz et al., 2015).
Let us break down each category of the SEM to better understand how it effects Indigenous life expectancy.
Intrapersonal: Individuals affected by residential schools were mistreated by those identifying as healers and teachers (Wilk et al., 2017). They had their traditional knowledge, attitudes, behaviours, and sense of self stollen from them, while their dignity and physical autonomy were violated through physical harm, psychological harm, and forced sterilization (Kolahdooz et al., 2015; Menzies, 2021). These experiences forced Indigenous people to reject their traditional teachings and implement the only knowledge they had: abuse (Wilk et al., 2017). Indigenous individuals learned how to assimilate as a form of self preservation- they then passed these experiences, warnings, and lessons onto their children causing many to have low self-esteem, anxiety, uncontrolled anger, addiction, and depression (Government of Canada, 2018; Kolahdooz et al., 2015; Wilk et al., 2017). Indigenous people fear the medical and social system and refuse to seek care for fear of racism and other harm, thus leading to worsening health (Goldman, 2020).
An Indigenous Child Before and After Residential School
Source: https://bartasblog98.files.wordpress.com/2015/04/tumblr_nbreqhhtfb1tjbtbwo1_500.jpg?w=371&h=355
Interpersonal: Relationships within an Indigenous person’s home and community are often strained due to the trauma caused by residential schools (Menzies, 2021). Indigenous people’s gentle child rearing practices were replaced by food deprivation, physical violence, and other abusive tactics; these new practices affect brain development in infancy and childhood (Menzies, 2021; Wilk, et al., 2017; Miller, 2021). Residential school survivors often left these schools at age 16, and once they left, they often did not return their communities and traditional life due to shame and negative perceptions of their culture (Kolahdooz et al, 2015). The trauma and isolation from their heritage and community causes life limiting illnesses such as violence related to mental illness and ineffective coping mechanisms, suicide, and drug/alcohol dependencies (Kolahdooz et al, 2015).
Institutional: With the pain and trauma caused by residential school experiences (ie: a loss of traditional teachings, physical harm, isolation, etc.), it is no wonder why Indigenous people are not involved in many educational institutions (Ashworth, 2018). Racism is ever present towards Indigenous people and as a result, these communities shy away from formal institutions such as schools, hospitals, and other medical/social institutions (Ashworth, 2018). Education is a determinant of health that is associated with life expectancy, income/stability, and health behaviours (The Lancet, 2020). Poor life expectancy, low income/instability, and poor health behaviours are key health inequalities of Indigenous Canadians (The Government of Canada, 2018). The “Sixties Scoop” was an occurrence in the 1960’s that was organized by provincial child welfare agencies to remove Indigenous children from their homes in large numbers; this malicious plan was orchestrated instead of setting up supportive community resources (Henderson, 2021). This occurrence continued to cement the narrative that Indigenous children are not safe within any system (social, health, education, etc.) (Henderson, 2021).
Community: Community engagement facilitates knowledge sharing, issue definition, problem solving, and decision making (Saskatoon Health Region, 2012).
As stated, Indigenous cultural norms and values were purposefully eradicated from Indigenous communities (Kim, 2019). The concept of health for Indigenous communities is an overarching concept that includes not just mental and physical well being, but spiritual and cultural well being (Kim, 2019). Residential schools and the Indian Act promoted the very opposite of that (Henderson, 2021; Miller, 2021). Community gatherings were banned for decades; if Indigenous people partook in community events, they faced imprisonment (Henderson, 2021). Wall-Wieler et al. (2017) states that the mental health outcomes of mothers who have had their children apprehended from them are poorer than those mothers who have suffered the death of a child. Imagine the impact this will make when multiplied by hundreds of communities over hundreds of years. medicine wheel
Policy: The Indian Act was created by the Crown to control Indigenous people’s identity, governance, education, and culture (Henderson, 2021). It was within this piece of legislation that allowed the Canadian government the ability to take Indigenous children and enrol them in residential schools (Henderson, 2021). The Indian Act prohibited Indigenous people from owning land, voting, cultural practices such as festivals and religious ceremonies, and more (Henderson, 2021). Removing their right to vote made it impossible for Indigenous people to have any political impact until the 1960’s (Facing History and Ourselves, 2021).
Although many racist and cruel aspects of the Indian Act have been amended, the trauma from this piece of legislation still haunts communities and impacts health today (Henderson, 2021).
Indigenous communities in Canada see disproportionate levels of chronic illness (substance abuse, diabetes, hypertension, mental illness, etc.), physical abuse, and higher mortality rates when compared to Canada’s general population (Kim, 2009).
After reading the above, is this of any surprise to you? Comment your thoughts below.
References
Ashworth, A. (2018). Understanding the factors influencing the Aboriginal health care experience. Canadian Journal of Dental Hygiene, 52(3), 208-212. https://files.cdha.ca/profession/journal/aAshworth.pdf
Christensen, J. (2016). Indigenous housing and health in the Canadian North: Revisiting cultural safety. Health & Place, 83-90. https://www.pearltrees.com/s/file/preview/238083348/Indigenous%20housing%20and%20heal th%20in%20the%20Canadian%20North%20Revisiting%20cultural%20safety.pdf?pearlId=349570 305
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Goldman, B. (2020, November 27). Fear of racism deters many Indigenous people from seeking medical treatment, says health-care leader. CBC Radio. https://www.cbc.ca/radio/whitecoat/fear-of-racism-deters-many-indigenous-people-from-seeking-medical-treatment-says-health-care-leader-1.5817730
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Menzies, P., Intergenerational trauma and residential schools. The Canadian Encyclopedia. Retrieved February 21, 2021, from https://www.thecanadianencyclopedia.ca/en/article/intergenerational- trauma-and-residential-schools Miller, J. Residential schools in Canada. The Canadian Encyclopedia. Retrieved February 21, 2021, from https://www.thecanadianencyclopedia.ca/en/article/residential-schools
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