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Backgrounder on Health Crises in First Nation Communities
Health Status
- In 2000, life expectancy at birth for the First Nations population was estimated at 68.9 years for men and 76.6 years for women. This represents a gap of 7.4 years and 5.2 years respectively with the Canadian population.
- The gaps in potential years of life lost between First Nations and Canadians were estimated in 1999 to be three times greater on injuries, almost double in endocrine diseases such as diabetes and more than double from mental illness.
- In 1999, the First Nation suicide rate was 27.9 deaths per 100,000; the Canadian suicide rate was 13.2 deaths per 100,000 population.
- In 1999, the First Nations infant mortality rate (0 to 1 years) was 8.0 deaths per 1,000 live births (based on 65 deaths), compared with 5.5 for Canada as a whole.
- Over half of on-reserve First Nations children are either overweight (22.3%) or obese (36.2%).
- In 2001, the incidence of tuberculosis (TB) disease in First Nations communities was, on average, ten times higher than that of the Canadian population as a whole (6 per 100,000).
- In 1999, the gap between First Nations and Canadian rates of enteric, food and waterborne diseases among children, ages 0-14 years, were reported as twice for giardiasis, more then ten times for hepatitis A and 22 times for shigellosis.
- 191,000 First Nations are currently living with disabilities (31.4% of total population).
Health Determinants
- The 1999 Tuberculosis in First Nations Communities report from FNIHB states that: “TB is far more likely to occur in communities with higher levels of crowding. It is recognized that overcrowded communities may also be more likely to suffer from other risk factors for TB, such as poverty, substance abuse, remoteness, and various underlying medical conditions.” In fact, housing density was seen as a significant predictor of TB incidence.
- First Nations’ homes are four times more likely to need major repairs. Less than half of First Nations’ on-reserve homes are considered adequate by the federal government. In 1999, 41.4% of First Nations communities had 90% of their homes connected to centralized water treatment plants and 36.6% connected to community sewage disposal systems. In 2002-03, First Nations were 25 times more likely to live in an overcrowded home than Canadians.
- First Nations are twice as likely not to complete high school than Canadians, and more than three times less likely to not complete university degrees.
- 9,000 First Nation children are in the care of First Nation agencies across Canada, and in 38% of these cases exposure to family violence was the substantiated form of maltreatment leading to placement.
- Aboriginal youth are 8 times more likely to be incarcerated due to a series of factors: higher rate of families reliant on social assistance (47%), substance abuse problems (57% confirmed and 24% suspected), involvement in the child welfare system (39%), lower rates of high school completion (2%), suicidal attempts (1 in 5).
Wait Times
- First Nations experience greater challenges in accessing health care as a result of: a larger health care burden (higher levels of acuity and urgency), greater challenges in recruitment and retention of health care staff in First Nations communities, geographic remoteness (30% of First Nations communities located more than 90 km from physician services), language and cultural differences, and impacts of provincial health reforms (such as hospital closures) coupled with cutbacks in federal medical transportation funding.
- First Nations are ten times more likely to have difficulty accessing family physicians.
- First Nations with disabilities are twice as likely to not be able to afford medical transportation and child care. Nearly two-thirds of children with special needs are refused child care services by licensed facilities because they do not have the funding to adequately meet the child’s needs. Almost half of children with disabilities do not have access to adapted transportation within their community.
- The 2005 First Nations Framework in the Blueprint on Aboriginal Health was aimed at recommending innovative strategies that would address the disparities in access to quality care between First Nations and other Canadians.
Fiscal Imbalance
- There is 3% cap in federal First Nation health funding vs. a 6% escalator granted to provinces and territories.
- There is a 2% cap on federal First Nation socio-economic program funding resulting in a 13% actual decrease in the total budget since 1999/2000. Total federal spending which, adjusted for inflation and growth in the Canadian population, held steady from 1999-2000 to 2004-05.
- $269 million in cutbacks in federal First Nation health funding are being implemented As non-discretionary funding that must take into account population growth and inflation, any decreases in the Canada Health and Social Transfer require new legislation to be passed.
- Honoring the Kelowna Agreement would raise federal First Nation health funding from the 3% cap to a comparative 6% annual growth for 3 years. Fiscal equalization in a First Nations context means no difference in the capacities of communities or tribal councils to provide services to their populations.
- Most First Nation recipients of income assistance live well below the poverty line.
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