Résumés
Abstract
This article examines the changing nature of Indigenous healthcare and policy in Manitoba focusing on two critical healthcare gaps in the province: the health transfer policy, a policy that continues to be counterproductive to Indigenous health and well-being; and the intended closure of Grandview’s EMS station and its failure to consider First Nations and Métis perspectives and access to care. Drawing on over a decade of community-engaged research in the province, our research argues for the need to move beyond soft reconciliation efforts in Indigenous health to reinterpreting Canada’s colonial history by recognizing Indigenous Peoples’ hard rights to healthcare. Reconciliation should bring about changes to bureaucratic structures and challenge non-Indigenous peoples’ values. Health system changes in Indigenous communities, without consultation, will continue to negatively impact community life and wellbeing. This article is intended to contribute to a broader discussion about the future of Indigenous healthcare, policy, and reconciliation efforts in Manitoba.
Keywords:
- Indigenous healthcare,
- Indigenous health policy,
- First Nations and Métis health and well-being,
- Manitoba,
- community-engaged research,
- access to care,
- governance,
- self-determination,
- soft rights,
- reconciliation
Veuillez télécharger l’article en PDF pour le lire.
Télécharger
Parties annexes
Bibliography
- Adelson, N. (2005). The embodiment of inequity: Health disparities in Aboriginal Canada. Canadian Journal of Public Health, 96, S45-S61. https://doi.org/10.1007/BF03403702
- Allan, B. and Smylie, J. (2015). First Peoples, second class treatment: The role of racism in the health and well-being of Indigenous Peoples in Canada. The Wellesley Institute. https://www.wellesleyinstitute.com/wp-content/uploads/2015/02/Summary-First-Peoples-Second-Class-Treatment-Final.pdf
- Blackstock, C., and N., Trocmé (2005). Community-based child welfare for Aboriginal children: Supporting resilience through structural change. Social Policy Journal of New Zealand, 24(1), 12-33. https://www.msd.govt.nz/documents/about-msd-and-our-work/publications-resources/journals-and-magazines/social-policy-journal/spj24/24-pages12-33.pdf. https://doi.org/10.4135/9781412976312.n7
- Bombay, A., Matheson, K., & Anisman, H. (2014). The intergenerational effects of Indian Residential Schools: Implications for the concept of historical trauma. Transcultural Psychiatry, 51(3), 320–338. https://doi.org/10.1177/1363461513503380
- Boyer, Y. (2003). Aboriginal health: A constitutional rights analysis. Discussion paper series in Aboriginal Health, No. 1. National Aboriginal Health Organization and The Native Law Centre, The University of Saskatchewan. https://web.archive.org/web/20140731080804/http://www.naho.ca/documents/naho/english/publications/DP_rights.pdf
- Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, and Social Sciences and Humanities Research Council of Canada. (2020) Tri-Council policy statement: Ethical conduct for research involving humans 2018. https://ethics.gc.ca/eng/policy-politique_tcps2-eptc2_2018.html
- Coulthard, G. S. (2014). Red skin, white masks: Rejecting the colonial politics of recognition. University of Minnesota. https://doi.org/10.5749/minnesota/9780816679645.001.0001
- Culhane Speck, D. (1989). The Indian Health Transfer Policy: A step in the right direction, or revenge of the hidden agenda. Native Studies Review, 5(1), 187-213. http://iportal.usask.ca/docs/Native_studies_review/v5/issue1/pp187-213.pdf
- Gabel, C. (2011). Tootinowaziibeeng Treaty Reserve community health plan 2012 - 2017: Embracing the past, building on the present, designing the future. [Prezi]. https://prezi.com/_eunigeola6k/ttr-community-health-plan-2012-2017/
- Gabel, C. A., DeMaio, P., & Powell, A. (2017). Towards healthier Indigenous health policies? Navigating the labyrinth for answers. Journal of Indigenous Wellbeing, 2(1), 47-59. https://journalindigenouswellbeing.com/journal_articles/towards-healthier-indigenous-health-policies-navigating-the-labyrinth-for-answers/
- Crown-Indigenous Relations and Northern Affairs Canada [CIRNAC]. (2021). First Nations. https://www.rcaanc-cirnac.gc.ca/eng/1100100013791/1535470872302
- Government of Manitoba. (2017a). Wait times reduction task force: Final report. https://www.gov.mb.ca/health/documents/wtrtf.pdf
- Government of Manitoba. (August 2, 2017b). Improvements to Emergency Medical Services (EMS) in rural Manitoba. https://news.gov.mb.ca/news/index.html?archive=&item=46257
- Health Canada (2003). Annual report on First Nations and Inuit control 2002-2003: Program policy transfer secretariat and planning directorate, health funding arrangements. https://publications.gc.ca/collections/collection_2012/sc-hc/H33-2-2003-eng.pdf
- Hutchins, A., (Aug. 20, 2018). What’s killing rural Canada? Maclean’s. https://www.macleans.ca/killing-rural-canada/
- Lavoie, J., O’Neil, J., Reading, J., & Allard, Y. (2008). Community healing and Aboriginal self-government. In Y. D. Belanger & J. H. Hylton (Eds.), Aboriginal self-government in Canada: Current trends and issues. Purich.
- Lavoie, J. G., Forget, E., Prakash, T., Dahl, M., Martens, P., & O'Neil, J. D. (2010). Have investments in on- reserve health services and initiatives promoting community control improved First Nations' health in Manitoba? Social Science & Medicine, 71(1), 717-724. https://doi.org/10.1016/j.socscimed.2010.04.037
- Lavoie, J.G., & Dwyer, J. (2016). Implementing Indigenous community control in health care: lessons from Canada, Australian Health Review, 10 (1), 453. https://doi.org/10.1071/AH14101
- Laychuk, R., (Aug. 11, 2017a). Doctors in Grandview, Man., call public meeting over plan to close EMS garage. CBC News. https://www.cbc.ca/news/canada/manitoba/grandview-manitoba-doctors-1.4242254
- Laychuk, R., (Aug. 17, 2017b). 'There were a lot of boos': 500 pack hall in Grandview, Man., to discuss EMS overhaul. CBC News. https://www.cbc.ca/news/canada/manitoba/grandview-ems-meeting-1.4251700
- Laychuk, R., (June 29, 2017c). ‘Rural Manitoba to lose 18 EMS stations in emergency medical services overhaul.’ CBC News. https://www.cbc.ca/news/canada/manitoba/manitoba-government-closing-18-emsstations-1.4184424
- Lightfoot, S. R. (2010). Emerging international Indigenous rights norms and ‘over-compliance’ in New Zealand and Canada. Political Science, 62(1), 84-104. https://doi.org/10.1177/0032318710370584
- Manitoba Health, Seniors and Active Living, Government of Manitoba. (2018a). Statistical and EMS response time information. https://www.gov.mb.ca/health/ems/stats.html
- Manitoba Health, Seniors and Active Living, Government of Manitoba. (2018b). Health system transformation. https://www.gov.mb.ca/health/hst/program.html
- Martens, P.J., Bartlett, J., Burland E., Prior, H., Burchill, C., Huq, S., Romphf, L, Sanguins, J., Carter S., & Bailly, A. (2010). Profile of Métis health status and healthcare utilization in Manitoba: A population-based study. Manitoba Centre for Health Policy, June 2010. http://mchp-appserv.cpe.umanitoba.ca/reference/MCHP-Metis_Health_Status_Full_Report_(WEB)_(update_aug11_2011).pdf. https://doi.org/10.1186/1471-2458-11-814
- Martens, P. J., Bartlett, J. G., Prior, H. J., Sanguins, J., Burchill, C. A., Burland, E. M., & Carter, S. (2011). What is the comparative health status and associated risk factors for the Métis? A population-based study in Manitoba, Canada. BMC Public Health, 11(1), 814. https://doi.org/10.1186/1471-2458-11-814
- Métis National Council. (2023). Citizenship. https://www.metisnation.ca/about/citizenship
- Nation, M., Bess, K., Voight, A., Perkins, D. D., & Juarez, P. (2011). Levels of community engagement in youth violence prevention: The role of power in sustaining successful university-community partnerships. American Journal of Community Psychology 48, 89–96. https://doi.org/10.1007/s10464-010-9414-x
- Peachey, D., Tait, N., Adams, O. & Croson, W. (2017). Provincial clinical and preventive services planning for Manitoba: Doing things differently and better. https://www.gov.mb.ca/health/documents/pcpsp.pdf
- Powell, A., & Gabel, C. (2018). Addressing inequalities: Understanding Indigenous health policy in urban Ontario. In R. Henry, A. Lavallee, N. Van Styvendale, & R. Innes (Eds.), Decolonizing Indigenous global health: Reconciling the past, engaging the present, animating the future. University of Arizona Press, p. 237 - 256. https://doi.org/10.2307/j.ctv513dtj.16
- Powell, A. K. (2014). Addressing inequalities: Aboriginal health access centres in urban Ontario. [Masters Thesis]. McMaster University. http://hdl.handle.net/11375/16406
- Government of Canada. (2019). Reclaiming power and place: The final report of the National Inquiry into Missing and Murdered Indigenous Women and Girls. https://www.mmiwg-ffada.ca/final-report/
- Stoecker, R. (1999). Are academics irrelevant?: Roles for scholars in participatory research. American Behavioral Scientist, 42, 840–854. https://doi.org/10.1177/00027649921954561
- Stoecker, R., & Bonacich, E. (1992). Why participatory research? Guest editors’ introduction. The American Sociologist, 23, 5–14. https://doi.org/10.1007/BF02691927
- Tait, C., Butt, P., Henry, R., Bland, R. (2017). “Our next generation”: Moving towards a surveillance and prevention framework for youth suicide in Saskatchewan First Nations and Métis populations. Canadian Journal of Community Mental Health, 2017, 36, 55-65. https://doi.org/10.7870/cjcmh-2017-004
- Toews, R., (2013). Manitoba EMS system review. Consultant Report to Manitoba Health, Seniors and Active Living. https://www.gov.mb.ca/health/documents/ems.pdf
- Waldram, James, Herring, Ann, & Young, T. Kue (2006). Aboriginal health in Canada: Historical, cultural and epidemiological perspectives. University of Toronto Press.
- Weaver, Sally. (1990). A New Paradigm in Canadian Indian Policy for the 1990s. Canadian Ethnic Studies. 25 (3), 8- 18.