Aboriginal peoples in Canada, living both on reserves and in urban centres, continue to experience significant health inequities compared with the rest of the population. In my work with the First Nations Health Authority in BC, I was involved in strategies for improving Aboriginal peoples’ experiences with health services.
Partnership agreements between First Nations and health system leaders have changed the conversation in BC about who is responsible for the health of First Nations people. Agreements have highlighted a shared responsibility to address health inequities.
This is not to say that inequities in health and health care services for Aboriginal people don’t exist in BC. What is different is that partnerships are emerging to produce a co-ordinated response across health care systems to take on these inequities. Cultural safety training, Indigenous spaces in hospitals, and partnerships to increase primary care physician services on-reserve are some of the initiatives aimed to tackle barriers that Aboriginal people face in accessing health services in BC.
After moving to Ontario in 2013, it became apparent to me that things here have not yet progressed to the same level of shared commitment. In Ontario, jurisdictional boundaries remain strongly in place, where health services available for the population as a whole are often denied to those living on reserve. In addition, there are challenges in coordination between on and off-reserve health services.
My Phoenix fellowship project is aimed at taking on these challenges, focusing on London Ontario and the surrounding communities. The aim of this project is to pilot transdisciplinary collaboration across a range of health services, creating a community of culturally safe and compassionate care that connects hospitals and primary care with community based prevention programming.
The focus groups and interviews have explored the successes and challenges health care providers face in ensuring culturally competent care. Respondents have highlighted the value of transition case workers, patient navigators and building relationships with families and communities. Some of the challenges raised have included the lack of awareness about the context of Aboriginal peoples’ lives (poverty, lack of transportation, limited access to affordable healthy food), stereotyping of Aboriginal patients, and a western model of care that lacks a holistic perspective of wellbeing. Transforming the practices within health care services remains an uphill struggle.
Despite the challenges, there is a real window of opportunity and appetite for change. Health care providers are recognizing the gaps and asking for more opportunities for knowledge sharing. New cultural safety training initiatives offered in partnership with the Southwest LHIN and the Southwestern Ontario Aboriginal Health Access Centre are providing a strong basis of knowledge to support changes in health care (see http://www.culturalcompetency.ca/training/ontario).
This is a great time to make meaningful change to ensure compassionate and culturally safe care across the health care system in Ontario. The AMS Phoenix project is making a positive and lasting difference to support health professionals to provide humane, compassionate, person-centred care.
We invite you to join us in this transformative work.
To see more about my research work, check out: https://www.youtube.com/watch?v=i_jN6xaCV5I&sns=fb
– Lloy Wylie, September 2015
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