Understanding And Addressing Healthcare Accessibility Issues In Canada For Aboriginal Individuals

The Problem with Healthcare Accessibility for Aboriginals

Canada has an excellent healthcare system and is recognized as one of the world's best. The Health Act in the country has made healthcare "universal" for all citizens (Martin et al., 2018). However, all individuals do not get equal healthcare accessibility. Aboriginal individuals are among such individuals. Due to the socio-economic position, lack of infrastructure, geography, cultural or language barriers, aboriginals face difficulty accessing the support or services. Huot et al., (2019) inform that a scarcity of healthcare providers and medical services in several indigenous regions of the country have severely impacted the aboriginal individuals’ health outcomes. As opined by Moore, von der Porten & Castleden (2017), lack of proper funding, financial assistance, and initiatives for the Inuit, Métis, and First Nations, who are the aboriginal groups, and complexities and uncertainties in the country's jurisdiction have worsened the situation. Several indigenous people reside in cities, but still, they face issues while accessing medical services. Highlighting and addressing the issues faced by the aboriginals in accessing health care services is very important. This paper aims to shed light on aboriginal health care. The essay will discuss the issues that aboriginals encounter while accessing healthcare support, followed by a discussion on the changes required and the proposed approach for implementing the changes to improve the conditions of the aboriginals in accessing healthcare services.

Reading Nelson & Wilson (2018), information gained is around 52% of the aboriginals reside in metropolitan areas, and despite rapid urbanization, the aboriginals dwelling in the cities face massive discrimination and are underserved in medical services and policy. Medical services are more readily available in urban areas than rural regions, but the aboriginals face issues accessing healthcare services even in cities (Nelson & Wilson, 2018). According to Horrill et al., (2018), healthcare access is generally acknowledged as a health determinant. Horrill et al., (2018) also informed that the country's healthcare system aims are the fair distribution of medical services based on requirements and appropriate access to healthcare facilities without monetary or other constraints (Canada Health Act, 1985). From further reading, it is known that the accessibility is not uniform among all citizens of Canada, and the aboriginals face issues in getting medical services compared to the non-indigenous residents of Canada (Horrill et al., 2018). Richmond & Cook (2016) informed that Aboriginal rights are protected by the constitution of Canada, including healthcare access. However, there is jurisdictional uncertainty in the Aboriginal policy. The policies of governments in delivering healthcare services and financial commitments for the indigenous people is still unclear (Richmond & Cook, 2016). Challenges to access health services for aboriginals in Canada are acknowledged by Health Canada, which highlights the services availability and healthcare professionals to on-reserve First Nations as one illustration (Lavoie et al., 2016). Other barriers in obtaining healthcare services are prolonged waiting lists and restricted access to preventative and screening services. Reading Lavoie et al., (2016), it is further known that geographic barriers and transportation costs hinder healthcare access for individuals residing in rural and remote places. As stated by Martin et al., (2018), the citizens of Canada residing in remote locations frequently travel several miles to obtain healthcare services. 58% of the individuals requiring outpatient and inpatient medical care in Northern Canada’s Nunavut region, an indigenous area, are sent outside the region (Martin et al., 2018). All the variables are categorized as factors contributing to physical services' inaccessibility (Lavoie et al., 2016). Horrill et al., (2019) inform that a complicated healthcare system generates additional obstacles to healthcare access for Canada's indigenous people. It is significantly affected by discrepancies in health coverage among Inuit, First Nations and Métis individuals and the discrepancies in benefits rendered among various regions in the country (Horrill et al., 2019). When age and education are considered, aboriginals confront up to 50% wage disparities instead of non-indigenous groups. Social isolation and racism have encompassed the country's healthcare system, justice, and education systems. Gaps in students’ performance, incarceration rates and several other factors frequently drive frightening healthcare statistics. Horrill et al., (2018) informed reduced education levels have been correlated with poorer health, and this trend can be observed in aboriginals in Canada. Reading Horrill et al., (2018), information gained is that reduced education indicates a lack of consciousness about early diagnosis and preventive care that generates an obstacle to healthcare access. When services costs are not covered, monetary hurdles to access healthcare may be developed (Horrill et al., 2018).

Addressing the Issues with Health Care Accessibility for Aboriginal individuals

Davy et al., (2016) inform that it is universally recognized that guaranteeing primary health care access is crucial in enhancing health outcomes. Accessing the medical service is important for the aboriginals as they struggle with increased rates of chronic illness (Davy et al., 2016). As opined by Tang et al., (2015), when the healthcare sector of the country is considered as a type of social relationship, and access is perceived as an element of political, historical, or social context, then substantially possible strategies emerge for enhancing access. Davy et al., (2016) further informed that when the interventions are adapted to the requirements of the aboriginals, or when the aboriginals manage and operate the services, the primary care access can be enhanced. Tang et al., (2015) further inform that enhanced healthcare access then focuses on social spaces and social interactions, targeting reducing social distance and creating a healthcare environment that is safe and socially welcoming. Boyer (2017) states that racism exists in the country's health care system. Aboriginal women have been forcefully sterilized, and indigenous men have suffered and died as they were neglected in emergency departments. Discrimination and racism will continue to prevail in the healthcare system unless the health care provided is culturally responsive and the perspectives of the aboriginals are accepted (Boyer, 2017). Reading Hayward et al., (2020), information gained is that the aboriginals in Canada continue to lag behind the non-aboriginal individuals of the country. Completely unsupported and disorganized primary healthcare, which mainly focuses on acute patient care over chronic illness, worsens disease's efficient management (Hayward et al., 2020). Poor connectivity between community preventive measures and clinical initiatives, rising medical staff turnover, insufficient understanding of incorporating traditional medicines and restricted disease monitoring are the challenges specific to the aboriginal groups (Hayward et al., 2020). Webster (2018) informs that language barriers impact the healthcare system severely, and the aboriginals face severe issues while accessing medical services as language barriers influence patient confidentiality, care plans and medical expenses. The care quality also gets severely impacted due to language barriers, and it often leads to medical mistakes, misdiagnoses and incorrect medication (Webster, 2018).

Changes are needed in the country's healthcare system to improve the conditions of the indigenous people in accessing healthcare services. The implementation of community-based research strategies will enhance the formulation of smart policy for the indigenous people of Canada. The aboriginals can develop research by participating in community-based work, and it will influence their own lives (Richmond & Cook, 2016). Allen et al., (2020) inform that healthcare professionals in Canada do not have adequate knowledge in preventive medicine as they do not get proper training regarding the indigenous groups' community-specific concerns and spiritual, cultural, social, and psychological concerns. Further reading Allen et al., (2020), information gained is that individuals like healing professionals, who are adept in dealing and communicating with the aboriginals’ cultural ways of thinking, are required in healthcare partnerships, patient care and choice-making procedures. Collaborating with the aboriginals offers new techniques of collaborative practice, whether in distant clinics or community-based treatment centres. The partnerships enhance the holistic health outcomes of the aboriginals and preventive care (Allen et al., 2020). Nguyen et al., (2020) inform that various methods have been adopted in Canada to resolve the inequitable health concerns among the indigenous groups. It includes financial assistance for developing infrastructure, educating and providing employment to the aboriginals, developing culturally appropriate medical and educational systems, and involving seniors and the aboriginals in policy-making procedures (Nguyen et al., 2020). The aboriginals face policy hurdles while accessing healthcare facilities. Therefore Nguyen et al., (2020) state that it is important to enhance accessibility. It can be achieved by addressing the hurdles, increasing services, and generating competence within aboriginal communities. As stated by Nguyen et al., (2020), one major drawback of the existing education system in the country is that it does not integrate traditional methods and holistic approaches in the educational curriculum. As a result, the aboriginals are deterred from pursuing healthcare jobs. The medical students who do not belong to the indigenous groups will face problems with indigenous practices while dealing with indigenous individuals in the future. The aboriginals will lack faith in government-aided healthcare (Nguyen et al., 2020).

Various approaches are needed for implementing the changes needed in Canada's healthcare system. Dawson et al., (2020) stated that telehealth or telemedicine is an excellent treatment delivery method focused on addressing the issues encountered by underprivileged populations worldwide. Utilizing synchronous modes of treatment approaches such as phone, teleconferencing, or video technologies assists the requirement of long-distance health education and healthcare (Dawson et al., 2020). As stated by Andermann (2016), multidisciplinary groups, including the aboriginals, can improve cultural understanding like psychological wellness groups, which have been created in the country. Senior people, doctors, nurses, social workers, and other specialists can collaborate to deliver relevant and appropriate psychological health treatments to the aboriginals. Andermann (2016) further states that it is important to comprehend and address the fundamental issues so that disparities in accessing healthcare services are reduced, and more patient-centred care is provided. Reading Nguyen et al., (2020), information gained is that western medicine has been prioritised over traditional methods in the healthcare sector. As Ward (2018) opined, a health care system prospers when there is good communication between the health care professionals and the patients. Reading Xing & Bolden (2018), information gained is that there are people in Canada who cannot communicate in English, so good communication enhances the health and well-being of such individuals and minimizes their stress. When the indigenous people can communicate in their native language, the diagnosis of the disease and treatment can be provided effectively. Robard et al., (2019) inform that indigenous translators or interpreters may facilitate the communication process, and therefore the aboriginals’ accessibility to medical services are improved as they can participate in decision-making procedures regarding their care.

A proper and culturally secured healthcare system involves providing discrimination-free services, serving the requirements of the aboriginals, and healthcare professionals collaborating with the indigenous groups (Nguyen et al., 2020). It is important that health equity is being prioritised in the healthcare sector, and actions for eliminating disparities have to be incorporated in healthcare services and initiatives for promoting population health (Andermann, 2016). Smylie & Firestone (2015) opined that Canada's social and health statistics are renowned globally because of their significance to public policy and high quality. Researchers Smylie & Firestone (2015) state that there are issues in the data quality of the aboriginals, like non-response discrimination and misclassification mistakes. It underestimates the disparities in health status, medical care access, and health determinants between the aboriginals and the non-aboriginals in the country. After analysing, the researchers Smylie & Firestone (2015) further informed that the absence of aboriginal specific characteristics that are reliable and appropriate in significant social and health information sources is the primary quality barrier behind the biases and mistakes. The researchers further inform that Canada’s census eliminated an aboriginal identity issue, worsening the already corrupt system. Therefore, the researchers Smylie & Firestone (2015) suggest that it is important to integrate aboriginal self-identification that is appropriate while redesigning the basic health information sources. The enhancements must be implemented by collaborating with the aboriginals and the governmental bodies. Webster (2018) informs that aboriginals' language barriers in accessing medical facilities can be reduced by providing proper training to healthcare professionals who can communicate in local languages. As opined by Webster (2018), the aboriginals in Canada who can communicate in the local language feel more associated with the culture, and as a result, their well-being is improved. In the same way, when people cannot communicate in their native language, it leads to poor health outcomes as it denotes cultural disconnection (Webster, 2018).

Therefore, from the above discussion, it can be said that the indigenous people in Canada face major issues while accessing healthcare services. The First Nations, Inuits and Métis, the aboriginal groups, are deprived of getting medical services. Severe racial discrimination also exists in the country, and it has been noticed that despite living in urban areas, the aboriginals do not get assistance regarding healthcare services. From the above discussion, it has also been noticed that the educational facilities provided to the aboriginals are improper, and the indigenous students face difficulties in getting healthcare jobs. There have been medical errors in the diagnoses of the indigenous people. It is important to identify opportunities to address the aboriginals' issues to enhance their well-being and health. It is important to develop the infrastructure of the indigenous regions, and programs are required to be initiated which are related to health. Assisting the indigenous community by providing financial assistance, educational development, and many more, culturally relevant and discrimination-free, will benefit the aboriginals. Communication and language barriers can be overcome by providing proper training to healthcare professionals. Telemedicine is also beneficial in providing medical assistance to indigenous groups as they live in remote locations where there is a lack of proper healthcare facilities, and traditional medicine practices must be prioritised. If the challenges are properly addressed, and changes are made accordingly, it would benefit the deprived indigenous groups.

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