When considering our health, we quickly think of going to the hospital or doctor’s office, having appendicitis, a heart attack, cancer or the flu. We also generally think that we all have fairly equal access to services to treat illness, we don’t usually think of the other factors that play a major factor in our health let alone the barriers the other factors create for all to have equal opportunity for health. The Canadian Public Health Association lists the following social determinants of health; income and income distribution, education, unemployment and job security, employment and working conditions, early childhood development, food insecurity, housing, social exclusion, social safety network, health services, aboriginal status, race, gender and disability (Canada public health, 2019). These social determinants of health play a bigger part in our health than many realize, especially for the indigenous population.
Education seems to be a very big predictor of health. Education is tied with being able to make more money leading to the ability to have better housing and food choices (Canada Public Health, 2019). Higher education is also connected to being able to make better decisions as they relate to health (Lam et al., 2013). Unfortunately, the rate of Indigenous people who have been unsuccessful in obtaining a high school diploma is at a very high rate, 32% versus 15% for their non-Indigenous counterparts (Bethune et al., 2018). Indigenous Canadians continue to make less money than their non-Indigenous peers and in Alberta, the use of government transfers is around 6.5% higher than the non-Indigenous group (Kolahdooz, Nader, Yi, Sharma).
A decreased education is directly tied to earning potential. In the study by Bethune et al. it was shown that Indigenous people with a higher education and or a higher income self-reported having better health (Bethune et al., 2018). Clearly improved educational options is an area of opportunity for improvement. To help provide improved educational opportunities to Indigenous Canadians in order to improve health outcomes will help reduce the current gap that exists between Indigenous and non-Indigenous Canadians. We need to work harder to ensure Indigenous feel included at our Colleges and Universities, in Alberta, Indigenous people are 3.5 times less likely to complete post-secondary education when compared to their non-Indigenous peers (Kolahdooz et al.). Shankar et al. note an “impersonal, intimidating and hostile environment in which little of the cultural knowledge, traditions and values they bring are recognized or valued” await Indigenous students at an Alberta college. Certainly, this can contribute to a student’s social well-being (Lam et al. 2018). Being aware that different cultures have different beliefs needs to be incorporated in creation of support programs in the future. For example, Indigenous people feel a strong connection to cultural activities related to the land and their feeling of wellness (Wilson and Cardwell, 2012). Access to traditional healers for Indigenous people is tied to better well-being. It is evident that the culture of aboriginal people plays a large part in their real and perceived health. We need to incorporate different tools for Indigenous students such as mentorship with their Elders, healers and others as ways to engage students to not only complete high school but to carry on with their education at a post-secondary level.
“Indigenous Canadians have a life expectancy 12 years lower than the national average and experience higher rates of preventable chronic diseases compared with non-Indigenous Canadians” (Kolahdooz, Nader, Yi & Sharma, 2015.). This reduction can be attributed, at least in part, to the social determinants of health. Lower education is directly connected to making poorer choices such as drinking and smoking which leads to reduced health, and higher mortality rates (Kolahdooz et al. 2015). We also need to be more mindful of what our Indigenous citizens need to help them be successful in the education stream. By addressing the barriers to education, we can help raise the income individuals make, directly impacting many of the social determinants of health.
Going forward we need to do more asking questions and really listening to the answers about what supports the Indigenous population needs to help them be successful with their educational journey. What we do know is education is directly connected to many key social determinants of health and without changes to the success rates of Indigenous people in post-secondary education, it will continue to be difficult to improve the real and perceived health of this vulnerable population in the future.
References
Bethune, R., Absher, N., Obiagwu, M., Qarmout, T., Steeves, M., Yaghoubi, M., Tikoo, R., Szafron, M., Dell, C., & Farag, M. (2018). Social determinants of self-reported health for Canada’s indigenous peoples: a public health approach. Public Health. Retrieved from https://0-doi-org-aupac.lib.athabascau.ca/10.1016/j.puhe.2018.03.007
Canada Public Health Association. What are the Social Determinants of Health? Retrieved October 14, 2019 from
Kolahdooz,F., Nader, F., Yi, K.J. & Sharma, S. (2015). Understanding the social determinants of health among Indigenous Canadians: priorities for health promotion policies and actions. Global Health Action, (0), 1. Retrieved from https://0-doi-org.aupac.lib.athabascau.ca/10.3402/gha.v8.27968
Lam, G., Zulla, R.T., Couture, J., Tan, S., Ip, E., Khalema, E., & Shankar, J. (2013). Education as a Social Determinant of Health: Issues Facing Indigenous and Visible Minority Students in Postsecondary Education in Western Canada. International Journal of Environmental Research and Public Health, (9), 3908. Retrieved from https://0-doi-org.aupac.lib.athabascau.ca/10.3390/ijerph10093908
Wilson, K., & Cardwell, N. (2012). Urban Aboriginal health: Examining inequalities between Aboriginal and non-Aboriginal populations in Canada. Canadian Geographer, 56(1), 98–116. Retrieved from https://0-doi-org.aupac.lib.athabascau.ca/10.1111/j.1541-0064.2011.00397.x
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