Understanding Inequalities in Access to Health Care Services for Aboriginal People

Abstract

We present findings from an Access Research Initiative to reduce health disparities and promote equitable access with Aboriginal peoples in Canada. We employed Indigenous, interpretive, and participatory research methodologies in partnership with Aboriginal people. Participants reported stories of bullying, fear, intimidation, and lack of cultural understanding. This research reveals the urgent need to enhance the delivery of culturally appropriate practices in emergency. As nurses, if we wish to affect equity of access, then attention is required to structural injustices that act as barriers to access such as addressing the stigma, stereotyping, and discrimination experienced by Aboriginal people in this study.

“They treated me like crap and I know it was because I was Native”: The healthcare experiences of Aboriginal peoples living in Vancouver's inner city

“…This confusion speaks to the complexities of multiple intersecting identities encountered by those historically oppressed and marginalized populations. While we do not claim our findings are representative of all Aboriginal peoples, nor would such a claim be congruent with an intersectionality perspective, other studies have provided very similar accounts in which Aboriginal patients describe feelings of being lessened as a person and having analgesics withheld (30, 31, 34, 64–66). Fiske and Brown (37) note this ‘lessening’ is embedded within the social discourse that construes Aboriginal peoples as “discredited medical subjects who lack legitimacy in healthcare settings” (p. 91).…”

“…Despite inhabiting a country that prides itself in its public healthcare system, Canada’s Aboriginal peoples continue to contend with inequalities in access to healthcare and service utilization (7, 12, 43). Evidence of such differential treatment appears to be mounting; in a national poll on Aboriginal health and healthcare, only 64% of First Nations respondents provided a positive rating for the quality of healthcare received within the previous year in contrast to 84% of non-Aboriginal Canadians (44).…”

“…Access to appropriate healthcare services is essential to addressing the health disparities facing Aboriginal peoples (7). For Aboriginal peoples, access to healthcare is not only defined by physical access, but is mediated by wider social and historical contexts, and clinical practice (29–31). Mainstream healthcare services, medical services relying on western medicine and conventional public health approaches, tend not to address the social and economic determinants that greatly affect individual health, and rarely do services accommodate for cultural differences.…”

Understanding access to healthcare among Indigenous peoples: A comparative analysis of biomedical and postcolonial perspectives

“…Improving access to healthcare, then, targets social relationships and social spaces, aiming to reduce social distance (Tang et al., 2015) and create spaces for healthcare that are safe, inviting, and socially accepting (Browne et al., 2011; Cameron et al., 2014). Intentionally developing such environments fosters agency and a sense of worthiness in seeking healthcare services (Browne et al., 2016).…”

Aboriginal Women's Experiences With Gestational Diabetes Mellitus

“…To restructure social relationships to promote equality in health care, nurses need to learn how unequal relationships are formed and sustained in society. 50 Nurses need to attend more closely to Mi'kmaq women's concerns and provide the space for the relationships to develop. Some Mi'kmaq women learn from family and friends about GDM, whereas others receive and appreciate education from community health nurses, community health representatives, and Aboriginal Diabetes Initiative workers, health directors, doctors, nurses, dietitians, and others.…”