Aging and Health: An Examination of Differences between Older Aboriginal and non-Aboriginal People

The Aboriginal population in Canada, much younger than the general population, has experienced a trend towards aging over the past decade. Using data from the 2001 Aboriginal Peoples Survey (APS) and the 2000/2001 Canadian Community Health Survey (CCHS), this article examines differences in health status and the determinants of health and health care use between the 55-and-older Aboriginal population and non-Aboriginal population. The results show that the older Aboriginal population is unhealthier than the non-Aboriginal population across all age groups; differences in health status, however, appear to converge as age increases. Among those aged 55 to 64, 7 per cent of the Aboriginal population report three or more chronic conditions compared with 2 per cent of the non-Aboriginal population. Yet, among those aged 75 and older, 51 per cent of the Aboriginal population report three or more chronic conditions in comparison with 23 per cent of the non-Aboriginal population.Aboriginal people, health status, health care use

Rights and health versus rights to health: Bringing Indigenous Peoples’ legal rights into the spaces of health care services

The political-legal discourse of Indigenous rights continues to be separated from discussions of health care services in geographic scholarship, due to the ways in which political-legal, settler-colonial definitions of rights fail to take Indigenous understandings into account, as well as a distrust on the part of scholars of the limited and contingent notion of “rights.” While Indigenous rights, inherently tied in Canada to recognition by the settler-colonial state, have limited application in achieving social justice or decolonization for Indigenous peoples, we argue that Indigenous rights can be used as a complementary discourse to Indigenous resurgence, within broader discourses of Indigenous justice, to lend legal and political weight to arguments for cultural safety and human rights in health care. We draw on a study conducted with 50 Indigenous community members and 15 health services professionals in the northern city of Prince George, Canada, to elucidate how Indigenous peoples’ experiences in health care settings may be improved by giving attention to rights discourse and removing the geographic and identity-based limitations of Indigenous rights to health care in Canada

Indigenous health organizations, Indigenous community resurgence, and the reclamation of place in urban areas

Research around the world has been nearly unanimous about the positive impacts of Indigenous-led health organizations on Indigenous peoples\u27 qualitative experiences in health care, in the face of often negative experiences in non-Indigenous-led health care settings. Urban environments, including health care environments, are areas of increasing attention with regard to Indigenous peoples\u27 health in Canada. In this study, which took place in the northern city of Prince George, British Columbia, 65 Indigenous community members and health services workers participated in interviews and focus groups, describing their experiences with urban Indigenous-led health organizations—defined in this study as non-governmental organizations that prioritize the values and practices of local Indigenous communities. Employing perspectives on place and relationships drawn from Indigenous critical theory and Indigenous community resurgence to analyze the findings of this qualitative study leads to a focus on how relationships impact and can even constitute places, enabling new understandings of the roles of Indigenous-led health organizations in urban Indigenous community resurgence

The mental health of Indigenous peoples in Canada: A critical review of research

Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness. Research indicates that colonialism and its associated processes are important determinants of Indigenous peoples’ health internationally. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health. This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada. We searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006–2016. Over two hundred papers are included in the review and coded according to research theme, population group, and geography. Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps. Mental health research related to Indigenous peoples in Canada overemphasizes suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples. The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world

Understanding barriers to health care access through cultural safety and ethical space: Indigenous people\u27s experiences in Prince George, Canada

Almost 1.7 million people in the settler colonial nation of Canada identify as Indigenous. Approximately 52 per cent of Indigenous peoples in Canada live in urban areas. In spite of high rates of urbanization, urban Indigenous peoples are overlooked in health care policy and services. Because of this, although health care services are more plentiful in cities as compared to rural areas, Indigenous people still report significant barriers to health care access in urban settings. This qualitative study, undertaken in Prince George, Canada, examines perceived barriers to health care access for urban Indigenous people in light of how colonialism impacts Indigenous peoples in their everyday lives. The three most frequently reported barriers to health care access on the part of the 65 participating health care providers and Indigenous clients of health care services are: substandard quality of care; long wait times; and experiences of racism and discrimination. These barriers, some of which are common complaints among the general population in Canada, are interpreted by Indigenous clients in unique ways rooted in experiences of discrimination and exclusion that stem from the settler colonial context of the nation. Through the lenses of cultural safety and ethical space – frameworks developed by international Indigenous scholars in efforts to better understand and operationalize relationships between Indigenous and non-Indigenous individuals and societies in the context of settler colonialism – this study offers an understanding of these barriers in light of the specific ways that colonialism intrudes into Indigenous clients’ access to care on an everyday basis

Development of a web-enabled learning platform for geospatial laboratories: improving the undergraduate learning experience

This paper describes a web-enabled learning platform providing remote access to geospatial software that extends the learning experience outside of the laboratory setting. The platform was piloted in two undergraduate courses, and includes a software server, a data server, and remote student users. The platform was designed to improve the quality of the learning experience and to increase student confidence and proficiency with software-based geospatial skills. Laboratory grades of students using the platform were significantly higher than those of students who did not use the platform, and survey responses reported that students overwhelmingly liked the convenience of the platform, which allowed them to work from any location

Spatial accessibility to health care services: identifying under - serviced neighbourhoods in Canadian urban areas

Background Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. Methods This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. Results The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. Conclusions The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood level. In particular, the results show that the low access neighbourhoods tend to be clustered in the neighbourhoods at the urban periphery and immediately surrounding the downtown area

Beyond the Cosmopolis: Sustaining Hyper-Diversity in the Suburbs of Peel Region, Ontario

Globalization has increased the flow of transnational migrants into many European and North American cities. These shifting socio-demographic patterns have resulted in the rapid development of ‘cosmopolitan’ urban centres where difference and diversity are ubiquitous (Sandercock, 2003). However, as ethnic enclaves form outside the urban core in suburban communities, there is uncertainty about whether cultural homogeneity is desirable or sustainable in a multicultural country. Indeed, planning communities for increasing diversity and difference will remain, what Leonie Sandercock (2004) calls, “one of the greatest tasks for planners of the 21st century”. Thus, this article uses the theory of hyper-diversity to illuminate how immigrants’ interactions with their local suburban community represents cultural pluralism and diversity beyond ethnicity. Specifically, this study explores differing attitudes, activities and lifestyles among diverse immigrant populations in the Region of Peel, one of the fastest growing and most culturally diverse areas in Canada. Focus groups with 60 immigrant youth and 55 immigrant adults were conducted to qualitatively capture perspectives and experiences in ethnic enclaves. The findings highlight the existence of attitudes in favor of multicultural lifestyles, activities that take newcomers beyond the borders of their enclaves, and lifestyles that require additional infrastructure to support sustainability of immigration in the suburbs. In conclusion, this article adds to the debate on cultural pluralism and ‘homogeneous’ ethnic enclaves by using the emergent concept of hyper-diversity as a way to think about the future sustainability of suburbs in an era of global migration