Social Determinants of Health and Aboriginal Children. Margo Greenwood and Sandra Griffin September 26, 2013

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1 Social Determinants of Health and Aboriginal Children Margo Greenwood and Sandra Griffin September 26, 2013

2 Presentation Overview Situating Aboriginal Health Social Determinants of Health (SDOH) SDOH Models

3 Situating Aboriginal Health In Canada there are major health disparities between First Nations, Inuit and Metis peoples and other Canadians. Those disparities are multifaceted in origin and are largely influenced by socio-economic and environmental factors. Canada s long history of European colonization is at the root of the social inequalities and poor health that persist particularly for First Nations, Inuit and Metis children who bear the greater burden of these inequities than do other children in Canada

4 Colonialism and Colonization Eurocentric Dominant over Aboriginal peoples Objective was assimilation Legislative (Indian Act) Residential schools Other assimilation actions Acute traumatization to the health and social fibre of Aboriginal peoples.

5 Snapshot of Aboriginal Health Data collected at the national and provincial/territorial levels indicate that the health status of First Nations, Inuit and Métis is well below that of the non-aboriginal population of Canada. Significant gap between Aboriginal and non-aboriginal life expectancy and chronic diseases. High rates of: births suicide diabetes heart and circulatory disease fetal alcohol spectrum disorder infant mortality injury tuberculosis

6 Social Determinants of Health In 1996, the Royal Commission on Aboriginal Peoples (RCAP) report noted that socio-economic factors are important health determinants, but criticized the individual level analyses of socio-economic variables (such as income and employment) found in most health studies.

7 Social Determinants Social determinants of health are the historical, political, economic and social conditions under which people live their daily lives and which determine their health. - Aboriginal status - Early life - Employment & unemployment security - Gender - Education - Social exclusion - Employment & working conditions - Income - Food security - Health care

8 Unique Social Determinants that Affect Aboriginal Peoples Health Colonization & Colonialism Residential Schools Language and Culture Loss Dislocation Geographic Locale Racism Self-determination

9 Medicine Wheel Social Physical Mental Spiritual

10 Assembly of First Nations SDOH Model

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12 Ripple Effect

13 National Collaborating Centre for Aboriginal Health

14 NCCAH Activities WHO Commission on SDOH Aboriginal Sub-committee of the Canadian Reference Group UN Committee on the Rights of the Child General Comment on the Rights of Indigenous Children

15 DAY OF GENERAL DISCUSSION ON THE RIGHTS OF INDIGENOUS CHILDREN 15 September 3 October 2003 Article 30 one of the only articles of the Convention of the Rights of the Child to explicitly recognize indigenous children as rights-holders Even though indigenous children are disproportionately affected by specific challenges such as institutionalization, urbanization, drug and alcohol abuse, trafficking, armed conflict, sexual exploitation and child labour they are not sufficiently taken into consideration in the development and implementation of policies and programs for children Calls on States parties, UN specialized agencies, funds and programes, the World Bank and regional development banks, and civil society to adopt a broader rights-based approach to indigenous children based on the Convention and other relevant international standards such as ILO Convention 169, and encourages the use of communitybased interventions in order to ensure the greatest possible sensitivity to the cultural specificity of the affected community. Particular attention should also be paid to the variety of situations and conditions in which the children live.

16 Discussion Questions The Commission raised three questions: 1. What actions on the social determinants of Indigenous health would mitigate risk conditions and improve health outcomes for Aboriginal peoples in Canada? 2. What examples are there of successful action on the social determinants of health that have resulted in positive outcomes for health and well-being of Aboriginal peoples? 3. What policies concerning the social determinants of health are most likely to be effective in improving the health of Aboriginal peoples?