It is no secret that the jurisdictional debates on the healthcare, poverty, and the general publics well-being are the key obstacles to achieving a better healthcare system for all in Canada. Despite the enactment of several policies and anti-poverty strategies in an attempt to reduce poverty, which has greatly affected the healthcare accessibility among the indigenous people in Canada, the healthcare system is still worsening even than ever before. Given the way Canadian government administration is constructed and managed, it is difficult to have a uniform healthcare program that will ensure that the social class is not an insurmountable barrier as it is currently. The majority of the affected population is the first nations or indigenous areas such as Inuit and Metis. However, apart from the Metis and Inuit people, those in the lowest income quintile in Canada, in general, are equally affected because their life expectancy rate is considered to be three to five times less than their counterparts in the highest income quintile. Therefore, poverty affects every aspect of the indigenous people and their social well-being. Despite the existence of policies that support better and healthy living conditions for the aboriginals the government has done almost nothing to improve their situation. This paper is going to examine how poverty has affected the health and healthcare accessibility of the Canadians in respect to the Indian Act of 1867 as a government policy or law to help deal with the poverty and poor healthcare accessibility among the indigenous people in Canada.
Poverty and its Effects on Health for the Indigenous People
Woolf and Braveman (2011) explain that the Canadian government has not officially adopted or enacted any policy or measure of poverty, especially among the indigenous groups. According to the authors, the disparities in the healthcare system within the Canadian government come as a no surprise to anyone who has lived in the country, especially someone coming from the indigenous areas. Richmond and Cook (2016) further note that the disparities can be rooted from unemployment, lack of education, and poor housing, which all are determinants of poverty. Although there is no established measure of poverty yet in Canada, low income is the commonly adopted measure or indicator used to determine who is poor and who is not poor. The low income is measured in a threshold that is commonly known as Low-income cut-offs (LICOs). According to Lavoie, Toner, Bergeron, and Thomas (2011), based on this indicator, some of the groups especially the indigenous population groups in Canada are more likely to live in poverty than their non-indigenous counterparts. Further, these groups that are considered at risk of poverty also have a higher rate of low-paid jobs or unemployment. Therefore, poverty is the minimum material resources that can enable one to participate in the society in a meaningful way. However, for the aboriginal or indigenous groups, it has been difficult to access proper healthcare services due to the socioeconomic level that they belong to.
The Indian Act of 1876 and its Implication on Aboriginals Social Life
Richmond and Cook (2016) argue that after the confederation in 1867, the federal government took the responsibility for the aboriginal groups and their reserves. However, up to date, this has not been effectively undertaken as it should have been. The aboriginal groups have been neglected in many ways especially when it comes to healthcare access. The current gaps that one can witness in the Canadian healthcare system can be reflected on the historic relationship between the aboriginal people and the government. Examining the historical scope, it is clear that the failure to enact new laws or implement the existing ones by the government is not something that started yesterday or a few days ago (Richmond & Cook, 2016). The gap has been in existence for as long as anyone can remember. There have been various policies and laws that have been enacted including the Ottawa Charter for Health Promotion of 1986 that aimed at creating and establishing a supportive environment that will enable the discriminated people to live healthy lives (Reading, 2015). The Charter aimed at achieving this equity through involvement and putting the health problems on the policy agenda in the governments policy. However, even though the charter became a powerful addition to the public health theory in Canada, but it has achieved very little to improve the social status of the aboriginal people. Today, the only legislation that is still active at the national level that supports the Aboriginal welfare and well-being is the Indian Act of 1876 (Richmond & Cook, 2016).
The Indian Act of 1876 gave the Federal government with the responsibility to ensure that the aboriginal people had access to better healthcare services and lived healthy lives like the non-aboriginals (Richmond & Cook, 2016). However, based on the assessment of the current healthcare situation among the aboriginal it is clear that this policy has not been implemented effectively. The Indian Act aimed at promoting equity among the people of Canada and reduces the disparity between the different demographic groups. According to Goraya (2016), the Indian Act emerged as a result of the assumption that the aboriginal groups were considered inferior to their non-aboriginal counterparts. They were also considered uncivilized and unequal to the non-aboriginals. Therefore, there was a need to integrate the different groups and include them in the federal administration. However, for over 40 years now this has not been achieved; the majority of the aboriginal people still languish in poverty, unable to get better-paying jobs, unable to access better healthcare services like the non-aboriginals who enjoy almost every privilege. The assimilation goal that the Indian Act of 1876 aimed to achieve has not been realized due to lack of effective implementation of the legislation. The Indian Act aimed at recognizing the aboriginals as part of the Canadian nation just like the non-aboriginals (Richmond & Cook, 2016).
The more troubling issue with the attempt to implement this Act is the way the legislation has influenced the public perception regarding the aboriginal groups. Scholars have argued that the perception that the general public has towards the aboriginal has been greatly shaped by the way the government treats them (Loignon et al., 2015). For instance, the aboriginal groups, due to the high rate of unemployment and poverty among the population, have been considered a sick and defenseless group. As a result, they are considered a burden to the Canadian society. However, all these perceptions have been contributed by the governments reluctance to implement the assimilation strategies that may help include the marginalized groups in the system. Some of the governments treatment towards the aboriginal groups includes the programs and systems that remain significantly underfunded as compared to the same programs for their non-aboriginal counterparts (Reading & Farber, 2015). This wrong perception is further perpetuated in educational curricula and media coverage of the aboriginal people that all reinforce the negative perceptions and stereotypes.
Research shows that the infant mortality rate among the aboriginal groups is higher as compared to the non-aboriginal groups (Richmond & Cook, 2016). For instance, in a research carried on the regional infant mortality rate shows that, in British Columbia, the rate among the First Nations is twice as high as compared to the non-First Nations. Another finding in Manitoba shows almost the same disparity; for instance, infant mortality rate among the First Nations was twice that of the non-First Nations (Richmond & Cook, 2016). Research further indicates that most of the aboriginal people suffer or even die from preventable or controllable diseases because they are neglected (Richmond & Cook, 2016). In one of the research on the leading causes of aboriginal mortality rates injury and poisoning, diabetes, circulatory diseases, cancer, respiratory diseases, and chronic diseases. According to Richmond and Cook (2016), it is estimated that the rates of diabetes among the aboriginal groups is three to five times the national average. However, injury and poisoning are considered the most common cause of death among the aboriginals, conditions that can all be controlled or prevented to reduce the death rate if only the government could take its responsibility seriously.
Although the Indian Act aimed at assimilating the aboriginals into the non-aboriginal identity, it also identified the uniqueness and focused on the need to let the aboriginal people enjoy the privileges associated with their nativity such as living their own ways. However, colonization might have ruined this already as by the time Canada broke away from the colonialist's majority of the aboriginal people had already lost their language or cultural practices including the medicine (Lavoie et al., 2011). However, this came as a result of the forced assimilation by the colonial period. Today, approximately 50% of the aboriginal people live in the local or rural areas where it is almost impossible to access the healthcare services; thus, the increased mortality rates among the indigenous groups as compared to the non-indigenous groups that mostly reside in the urban areas.
As mentioned earlier, the government has significantly contributed to the predicaments that the aboriginal people experience today. One may wonder why despite being a first world country Canada still has a third world sections within its borders. The simple answer is poverty and lack of seriousness from the governments side to deal with the menace. The governments strategies and plans significantly affect the healthcare system. Goraya (2016) asserts that it is the governments poor response to the problems facing the aboriginal people that reinforce the negative stereotypes or perceptions that they experience from the rest of Canada. The government begins small projects or programs in the name of improving the conditions of the aboriginals but fails because they are extremely underfunded. For instance, the pledged $48 million by the Economic Action Plan 2013 is a good example of such projects that further diminishes the aboriginal people (Goraya, 2016). The pledged money was expected to improve the health care delivery to the remote Aboriginal communities. There was a great expectation from the general public especially the aboriginal population that their health conditions and facilities would be updated and equipped with the machines, drugs, and skilled doctors to help enhance the healthcare delivery in those regions. This project if well-funded would have improved the general infrastructure of the communities including the hospitals in the region. However, two years down the line which the project was supposed to be completed, the situation is still the same and even worse in some areas. The health services access is still a great problem and the aboriginal communities remain underdeveloped just like before. The Federal government has undermined and neglected the aboriginal population especially those living in the rural areas. With lack of resources and clinical facilities, they are unable to obtain better healthcare services as their non-aboriginal counterparts in the urban areas (Loignon et al., 2015).
According to Richmond and Cook (2016), The Indian Act of 1876 had set some precedence for the aboriginal people to access better services like the rest of the Canadians. Despite the governments reluctance, the aboriginal people have engaged in some self-determinat...
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