Disparities amidst plenty: a health portrait of Indigenous peoples in circumpolar regions

Abstract

This paper describes the extent and variation in health disparities between Indigenous and non-Indigenous people within Alaska, Greenland and the northern regions of Canada, Russia and the Nordic countries. We accessed official health statistics and reviewed research studies. We selected a few indicators of health status, health determinants and health care to demonstrate the health disparities that exist. For a large number of health indicators Indigenous people fare worse than non-Indigenous people in the same region or nationally, with the exception of the Sami in the Nordic countries whose health profiles are similar to their non-Sami neighbours. That we were unable to produce a uniform set of indicators applicable to all regions is indicative of the large knowledge gaps that exist. The need for ongoing health monitoring for Indigenous people is most acute for the Sami and Russia, less so for Canada, and least for Alaska, where health data specific to Alaska Natives are generally available. It is difficult to produce an overarching explanatory model for health disparities that is applicable to all regions. We need to seek explanation in the broader political, cultural and societal contexts within which Indigenous people live in their respective regions.

Exploring the impact of rural health system factors on physician burnout: a mixed-methods study in Northern Canada

“…During the 2014-2016 period, life expectancy in the territories (Table 1) was between 3 and 10 years lower than in Canada overall [17]. Similar gaps between northern Indigenous populations and the general population are evident for other key population health indicators including premature mortality due to injuries and suicide, hospitalization for ambulatory care sensitive conditions, and rates of diabetes, tuberculosis, and cancer [18][19][20][21]. These inequalities are proximally related to inequities in the social determinants of health, but have their upstream origins in structural determinants related to colonization [22,23].…”

Cross-Cultural Interpreting With Aboriginal and Torres Strait Islander Patients

“…Previous research has highlighted a range of barriers to health communication that are common to Aboriginal, immigrant, and refugee populations alike, including language barriers (Henry et al, 2020;Shrestha-Ranjit et al, 2020); low literacy levels (Ha & Longnecker, 2010); complex medical discourse (Andrulis & Brach, 2007;McGrath & Holewa, 2007); nondisclosure of information (The et al, 2000); resistance by patients via the questioning and challenging of information provided by physicians (Lee & Garvin, 2003); divergent health beliefs (Diette & Rand, 2007); being unaware that cultural constructs such as the characteristics people attribute to social categories, including illness and death, are socially constructed (Andrews & Boyle, 2016); assigning a passive role to patients during consultations (Shaw et al, 2015); and a lack of cultural sensitivity, particularly the ability to value and respect cultural diversity so as to be able to optimize interventions based on patients' cultural needs (Jirwe et al, 2006;Willis, 1999). Although these barriers span both Aboriginal and non-Aboriginal populations, it has been well established that Aboriginal populations across the globe are affected more severely and suffer worse health outcomes (Gone et al, 2019;Young et al, 2020).…”

Historical foundations and contemporary expressions of a right to health care in Circumpolar Indigenous contexts

“…86-121, for a detailed discussion). These health inequities can be attributed in part to differential access to determinants of health such as appropriate housing, safe drinking water, economic opportunities, food security, and appropriate local infrastructure (Young et al, 2020). Providing access to health services cannot palliate social and economic marginalization, compensate for underinvestment in infrastructure, rectify racism and dismissal, nor address the imposition of national over local interests in public policy (Marmot and Wilkinson, 2006;Greenwood et al, 2015): Access to responsive and appropriate health care can at best expand life expectancy and improve quality of life.…”