First Peoples, Second Class Treatment: The role of racism in the health and well-being of Indigenous peoples in Canada

Scope and Purpose of the Review, Page 1-2:

"Racism has played a foundational role in the development and maintenance of the Canadian nation state. The colonization of Indigenous lands and peoples was fueled by racist beliefs and ideas about Indigenous peoples, values, ways of knowing and being, customs and practices. These race-based beliefs served to justify acts of racial discrimination, including violence, cultural genocide, legislated segregation, appropriation of lands, and social and economic oppression enacted through such policies as the Gradual Civilization Act and the Indian Act. Policies and practices emerging from imperialistic and colonial ideologies have been extremely destructive to the health and well-being of Indigenous peoples, cutting across the broad spectrum of social determinants of health, impacting access to education, housing, food security, employment and health care, and permeating societal systems and institutions that have profoundly impacted the lives and well-being of Indigenous peoples including the child welfare and criminal justice systems. The discriminatory treatment of Indigenous peoples within these systems is evidenced on one hand in the egregious overrepresentation of Indigenous children and youth in the care of child welfare agencies and Indigenous youth and adults in the custody of detention centres and federal prisons, and on the other hand, in the lack of political and societal response to the ever growing number of missing and murdered Indigenous women in Canada (Human Rights Watch, 2013; Mathysen, 2011; The Sisterwatch Project of the Vancouver Police Department & The Women’s Memorial March Committee, 2011).

This paper explores the role of racism in the health and well-being of Indigenous peoples in Canada. It provides an overview of the historical and contemporary contexts of racism which have and continue to negatively shape the life choices and chances of Indigenous peoples in this country, and then examines the ways in which racism fundamentally contributes to the alarming disparities in health between Indigenous and non-Indigenous peoples. Indigenous peoples experience the worst health outcomes of any population group in Canada (Royal College of Physicians and Surgeons of Canada, 2013), underscoring the urgency and importance of understanding and addressing racism as a determinant of Indigenous health.

Racism is a complex social construction. In order to elucidate the ways in which racism contributes to current and future health disparities and vulnerabilities among Indigenous peoples, this paper is composed of three key sections. First, we examine racism and colonization as root determinants of Indigenous/non-Indigenous health inequities. We draw on Indigenous approaches to the social determinants of health and focus on describing specific colonial policies and how these policies have historically shaped and continue to shape Indigenous health determinants, outcomes and access to care. Second, we review the literature documenting and describing Indigenous peoples’ experiences of racism in Canada and the links to health, well-being and access to health care. Third, we review responses and interventions aimed at addressing the impacts of racism at the individual, community, health services and policy levels. We conclude with emerging ideas and recommendations for moving forward that we hope will contribute to broader discussions and collaborative action." (1-2).