international journal of regional and local history,

Vol. 10 No. 1, May, 2015, 32 – 46

The Impact of Colonization and Western

Assimilation on Health and Wellbeing of
Canadian Aboriginal People
Cathy MacDonald
Saint Francis Xavier University, Canada

Audrey Steenbeek
Dalhousie University, Canada

Colonization and government assimilation (i.e., into mainstream Western

society) impacted all aspects of Aboriginal life, including: health, traditional
roles, culture, socio-economic conditions, access to services, and equity
among others. Consequently, many Canadian Aboriginal people today
experience health inequities, loss of tradition and traditional practices, and
breakdown of the family unit. To gain an understanding of how to promote
equity in health care for Aboriginal people, a critical examination of the root
causes of health and healthcare inequities must be considered within
historical, economic, and socio-political contexts. The following paper uses a
post-colonial feminist theoretical perspective to situate inequities in
Aboriginal people’s lives and health by focusing on the impact of colonization
and assimilation on Aboriginal people.

keywords colonization, assimilation, Canadian Aboriginal people, health and

well-being

By restoring traditional cultures and strengthening spirituality, Aboriginal peoples of

Canada1 are resilient survivors, who continue to thrive in less than adequate
circumstances that have resulted from colonization and assimilation. Overall,
colonization and government assimilation policies and procedures contributed to the
marginalization of Aboriginal people from mainstream society, and had a profound
and disruptive impact on the health, socio-economic welfare, access to healthcare
services, and culture of Canadian Aboriginal and other Indigenous populations around
the world.2 Despite the diversity in affiliations and lifestyles of Indigenous peoples,
most have a common history of being colonized.3 For the majority of Indigenous
populations, colonization was considered the first encounter with Europeans.

ß W. S. Maney & Son Ltd 2015 DOI 10.1179/2051453015Z.00000000023

IMPACT OF COLONIZATION ON HEALTH AND WELLBEING OF CANADIAN ABORIGINAL PEOPLE 33

This paper offers a perspective that does not characterize Aboriginal people and
communities individually or collectively as dysfunctional and pathologic,
or “ignore the historical resilience and resistance of Aboriginal peoples in the
face of adversity brought on by European colonization”.4 Instead, it highlights the
need to review the impacts and effects of colonization and assimilation on
the health, socio-economic welfare, access to services, and the effects on the culture
of Aboriginal people living in Canada through the lens of a non-Aboriginal nursing
researcher/clinician using a post-colonial feminist theoretical perspective. A post-
colonial feminist theoretical perspective not only provides direction for under-
standing how the past (i.e., legacy of colonialism and assimilation) shapes the
present context of health and health inequities for Aboriginal people, but also offers
a theoretical perspective for decolonizing research.5 A recent PhD research study
“exploring Aboriginal women’s experiences with Pap smear screening in Nova
Scotia” will also be used to highlight some of these impacts. A brief discussion
on the implications of gender and status on Aboriginal women’s health will also
be presented.6

Post-Colonial Theoretical Perspectives

Problematizing Indigenous people in Western research has negatively impacted
Aboriginal peoples historically, politically, economically, spiritually, collectively,
and personally.7 According to Smith, research is colonizing as its silencing
paradigms and ethnocentric discourses imposes superiority and dominant
worldviews over colonized peoples.8 Aboriginal health research agendas not
based in Indigenous paradigms can be colonizing by disregarding Indigenous views,
voices, and ways of knowing.9 Sherwood suggests decolonizing research
approaches and balancing power requires a two-way approach that includes
Indigenous philosophies and ethics. Decolonizing research requires research
practices that are more respectful, ethical, sympathetic, and useful against racist
assumptions, practices, and attitudes that exploit Indigenous people. The authors of
this article used post-colonial theoretical perspectives to assist in unpacking
research as a colonializing tool. Post-colonial theoretical perspectives share
a common interest in the political and social impacts of colonialism and how
it continues to shape the lives, well-being, and health of people.10 The term “post”
in “post-colonialism” does not mean that “colonialism [is] finished business”.
but rather, it “refers to a notion of both working against and beyond colonialism”,
and that there are compelling inequities still present.11
Post-colonial theoretical perspectives have been increasingly influential for
researching health inequities, and for critically analysing the factors that tend to
shape those inequities in health and health care for Aboriginal people.12 According to
Anderson, a post-colonial feminist theoretical perspective is an inclusive and
comprehensive framework for exploring how women’s lives and health have been
positioned and shaped by politics and history. Importantly, post-colonial feminist
theoretical perspective expands beyond positioning of ill health as lifestyle and
personal choice, to an examination of the broader historical, economic, and socio-
political contexts that impact upon health status.13 Further “attention to class,
34 CATHY MACDONALD and AUDREY STEENBEEK

racialization, historical positioning, and gender as factors that intersect to predispose

particular groups of people with certain health conditions” is a consideration of a
post-colonial feminist theoretical perspective.14 Post-colonial theoretical perspectives
will also guide the discussion of the impacts of colonization and assimilation on the
health, socio-economic conditions, access to services, gender, and the effects on the
traditional cultures of Canadian Aboriginal people.

The Meaning of Colonization

Ing has described colonization as “how a foreign power or nation superimposes its
values and institutions upon another nation for exploitation”.15 Europeans,
primarily explorers and fur traders, were in pursuit of inexpensive natural
resources, lands, and the discovery of new sources of wealth, subsequently
facilitating the initiation of European control over Indigenous peoples.16
Colonization is similar to what Freire described as a “cultural invasion”,
a characteristic of cultural action whereby:
the invaders penetrate the cultural context of another group, in disrespect of the latter’s
potentialities; they impose their own views of the world upon those they invade and
inhibit the creativity of the invaded by curbing their expression.17

Within the Canadian context colonization resulted in the loss of many of the
traditional ways of knowing, language, cultural practices, and medicines for many
Aboriginal peoples.18
Battiste asserted that “colonization was a system of oppression rather than
a personal or local prejudice”19 bringing disorder to the lives of Aboriginal people
by impacting their language, traditions, social relations, and “ways of thinking”,
feeling, and interacting in the world. Essentially, colonization had a devastating
impact on all aspects of the health of Aboriginal peoples, particularly the physical,
emotional, mental, and spiritual dimensions.20 Henderson maintained that
400 years of rule over Indigenous people created systematic colonialism and
racism in which Indigenous peoples were alienated from their “beliefs, languages,
families, and identities; that deprived Indigenous peoples of their dignity,
their confidence, their souls, and even their shadows”.21
Throughout the colonization process, Indigenous peoples of North America were
portrayed as barbarians without laws, or governance who needed to be assimilated
into the value systems and ways of the colonizers.21 Governments and hierarchies
were created by the colonizers that acknowledged Europeans as being far superior
to Indigenous people, forcing the assimilation of Indigenous peoples into European
society, education systems (i.e., residential schools) and government policies.21,22

The Effects of Assimilation on Aboriginal Peoples of Canada

The Meaning of Assimilation
Assimilation is defined as “the process by which a minority population is absorbed
into a prevailing dominant culture”,23 and therefore, integrated into mainstream
society. Assimilation results in the cultural identity of a dominant group being
assumed while the language, education, tradition practices, values, customs,
IMPACT OF COLONIZATION ON HEALTH AND WELLBEING OF CANADIAN ABORIGINAL PEOPLE 35

and practices of the other group are abandoned.23 The entrenchment of

government policies and legislation endorsing assimilation must be considered in
order to acknowledge and comprehend the issues of Aboriginal peoples.2
Assimilation meant that Aboriginal people would become “civilized” by embracing
European customs, values, language, government, and health practices.23

An Assimilation Example: Residential Schools Impact on Aboriginal Peoples of

Canada
In the seventeenth century, Europeans arriving in Canada believed that Aboriginal
people were different and uncivilized; therefore children had to be removed from
their homes, families, and communities in order to become educated and
domesticated to European ways.24 By 1879, residential schools were an official
government policy of assimilation of Aboriginal peoples in Canada. Therefore,
the Canadian Government developed and implemented residential schools in
collaboration with various religious organizations with the aim of fulfilling the
obligations of the Indian Act—the provision of education to all Aboriginal peoples.
Children were forced to leave their communities that “were culturally rich societies
where family was central, and complex religious beliefs were the basis for
numerous ceremonies, and knowledge was passed on from one generation to the
next through oral traditions”.25 Many Aboriginal children also experienced
physical, psychological, sexual, and spiritual abuse, as well as racism, while being
prohibited from using their language and traditional customs and rituals.26
The violence, abuse, and neglect experienced by Aboriginal children were clearly
described in detail by Knockwood who described how children were deprived of
food, punished for not speaking English, witnessed abuse of other children, and
were often “silenced and repressed not so much by physical violence as by
psychological intimidation”.27 Amnesty International reports that numerous
residential school children “faced inhuman living conditions caused by chronic
under-funding and neglect. Harsh punishments sanctioned by the school authorities
included beatings, chaining children to their beds, or denying them food”.28
According to Kelm children in residential schools stole food to survive, ran away,
attempted to fight back, and some committed suicide to escape the devastation of
the residential school system.29
The introduction of residential schools by the Canadian Government still has an
impact upon Aboriginal people today. Since being forced to relinquish their cultural
identity, beliefs, religion, and language, and being forcibly separated from their
families and communities, Aboriginal people and their communities are continually
being confronted with issues of physical and sexual abuse, family violence,
and addictions to drugs and alcohol.30

Assimilation Impacting the Health of Aboriginal People

Assimilation negatively impacted the traditional healing practices and traditional
medicines of many Aboriginal communities.31 Unfortunately, assimilation caused
Aboriginal people to deny their origins and traditional healing practices that
promoted mental, physical, and spiritual well-being using ceremonies, spiritual
rituals, counselling by community members, and the wisdom of the community
36 CATHY MACDONALD and AUDREY STEENBEEK

Elders.32 With the loss of traditional medicine and healing practices, Aboriginal
people were forced to accept foreign medicines and to rely upon patriarchal
healthcare systems that:
medicalize social problems as arising from individual lifestyles, cultural differences or
biological predisposition - rather than from impoverished social and economic
circumstances, marginalization and oppressive internal colonial politics.33

As a result of colonization and assimilation policies from the fifteenth century

onwards, Aboriginal peoples incurred epidemics such as tuberculosis (TB) and
chronic diseases such as alcoholism, diabetes, mental health issues, cardiac diseases,
cancer, physical and sexual violence, sexually transmitted infections (STIs),
and obesity, which were not prevalent in Aboriginal communities prior to
colonization and the introduction of assimilation practices.34 Aboriginal people,
particularly the Inuit of Nunavut, were reported to have TB rates nearly forty times
higher than the national average.33 The TB epidemic in Canada’s far north is a
component of a global resurgence of the disease which is being fuelled by the gap
between the rich and poor around the world.35
With the implementation of the reserve system in the late nineteenth century,
conditions were created that supported the flourishing of newly introduced diseases
which followed well-established trade routes and settlement patterns in Canada.36
Prior to European contact, Aboriginal peoples were able to treat their own illnesses
and conditions with traditional healers and with medicines that came from the
lands. With the introduction of European diseases, however, these medicines and
traditional healing practices were rendered ineffective.37 The Europeans inflicted
ecological changes to Indigenous lands by introducing foreign plants and animals
that carried pathogens and diseases previously unknown to Aboriginal peoples.36
In some cases, communities were decimated, causing the merging of some bands,
assimilation of one band by another, or migration, which in turn “sometimes spread
the disease farther and occasionally encouraged intertribal warfare”.38 The loss of
community members affected leadership roles which in turn disrupted the social
structure of the Indigenous community.
Many of the chronic diseases that afflicted Aboriginal peoples of Canada were
directly caused by the changes in lifestyle that occurred after the arrival of
Europeans settlers, particularly around dietary changes which were incurred by
Aboriginal peoples forced off their lands by treaty agreements that negatively
impacted traditional hunting and gathering of foods. Due to limited access to
traditional foods, Aboriginal peoples were often forced into relying on poor-quality
commodity foods from the government. They also lost valuable physical activity
associated with hunting, thereby dramatically impacting their health and culture.39
Aboriginal people noticed the impact of dietary changes on their general health,
especially related to lung, chest, and intestinal disorders which occurred often in
winter. Furthermore, life expectancy was overall reduced and, nearing the end of
the seventeenth century, longevity for Aboriginal peoples was noted as being quite
rare due to their adaptation of European lifestyles and foods.40
Europeans destroyed Aboriginal lands by methods such as over-grazing by
livestock, and destroying grasslands and forests that contained precious seeds
IMPACT OF COLONIZATION ON HEALTH AND WELLBEING OF CANADIAN ABORIGINAL PEOPLE 37

and roots that were edible and used in traditional Aboriginal healing practices.41
For many Aboriginal people, the land was not only a source of food and medicines,
but a symbolic connection with ancestors, and ties with the landscape, earth, soils,
minerals, water, and air.41 The loss of land altered the identity of Aboriginal peoples
creating a loss of socio-economic status, and thus creating a reliance on the colonial
system for survival.42

Assimilation Impacting the Socio-economic Conditions of Aboriginal People

Paul posits that the social structure of Aboriginal communities was based upon
family, band, and tribal associations that were communal societies.43 There were
chiefs (considered “leaders”) in each of the communities who were respected,
knowledgeable, exceptional individuals chosen to make decisions about the well-
being of the community. Each chief “headed up a group composed of his
biologically extended family and probably some unrelated individuals as well who
chose to ally themselves with him”.44 Chiefs were assisted in decision-making by
male Elders in the community. Family members and followers of the chief were
responsible for hunting and fishing, and making equipment for these activities.
They were also expected to be warriors. In contrast, Aboriginal women were
responsible for maintaining the camp, food preparation and preservation, sewing
clothing, herbal medicines preparation, and caring for the family and the tribe
With the arrival of the Europeans came a profitable economy of fur-trading with
Aboriginal peoples in Canada. The Europeans brought alcohol to be included in the
trading, with “one keg of brandy could fetch as many furs as an entire canoe-load of
useful goods”.45 It was estimated that in 1774, The Hudson’s Bay Company traded
with Indigenous peoples 864 gallons of alcohol for valuable furs. Prior to the fur
trade, Aboriginal peoples did not have alcohol, and lived primarily off the land.
When introduced, alcohol had a destructive impact upon Aboriginal peoples,
as drinking to excess brought violence and abuse into their lives and homes.46
The reserve system and the development of treaties, by the Canadian
Government dramatically impacted Aboriginal peoples’ socio-economic con-
ditions. However, it is important to note that there are various types of treaties and
perspectives about treaties in Canada, which have not been supported by the
Canadian Government and challenged in Canadian courts.47 Some treaties (like the
Upper Canada Treaties (1764 to 1862), Vancouver Island (Douglas) Treaties
(1850 to 1854) and Numbered Treaties in Ontario, across the Prairies, as well as
parts of the Northwest Territories (1871 to 1921) meant the surrendering of First
Nation lands in exchange for money or benefits.48 In many situations the
government took advantage of the situation by keeping the monies in trust,
and only giving small amounts of funds at a time.45 According to Youngblood
Henderson, “colonial legislatures’ treatment of Aboriginal peoples has been the
failure of the rule of law and majority rule to respect and implement these
constitutionally recognized treaty rights”, which continues to be colonializing and
infringes upon the constitutional rights of Aboriginal peoples.49 Canadian federal
law even denied Aboriginal people as “persons” until recently under the Canadian
Charter of Human Rights. It is also worthy to note, that funding for Indian and
Northern Affairs and services for Aboriginal people came from land sales and not
38 CATHY MACDONALD and AUDREY STEENBEEK

Canadian government monies. Alfred maintains that even today Canada’s financial
agreements with First Nations are framed within government policies that do not
really consider First Nation’s needs or objectives and do not provide an
autonomous means to generate revenue or support self-determination.50
Other treaties did not include the acquisitions of traditional land or resources.
For example, there were peace and friendship treaties like those in Eastern Canada
that were signed with Mi’kmaq, Maliseet, and Passamaquoddy First Nations
intended to end hostilities and foster cooperation between the British and First
Nations peoples. Mi’kmaq and Maliseet First Nations continue to have treaty rights
to hunt, fish, and gather for maintaining their livelihood in the Maritimes.48
However to this day, the Canadian Government has yet to reconcile the legislation
regarding the constitutional provisions of Aboriginal rights and treaties. Therefore,
the upholding of Aboriginal rights and treaties has been assumed by courts due to
the unwillingness to change bureaucracy and embedded neocolonial attitudes.49
Unemployment rates for Canadian Aboriginal people are another socio-
economic hardship. The average employment rate for Aboriginal people in 2009
was 57.0%, compared with 61.8% for non-Aboriginal people, with the
employment gap widening to 4.8 percentage points from 3.5 percentage points in
the previous year. The unemployment rate increased for Aboriginal people from
10.4% in 2008 to 13.9% in 2009, while the rate for non-Aboriginal people rose
from 6.0% to 8.1%.51 Given that there are few employment opportunities on
Aboriginal reserves/communities, Aboriginal people were forced to leave their
homelands and migrate to urban centres to find low-paying work. This situation
was further compounded by lack of formal education, and job market
discrimination.52 The poor socio-economic status of Aboriginal people in Canada
is a direct consequence of colonization and government assimilation policies and
treaties. The loss of lands, lack of education, cultural genocide, and job market
discrimination have not only caused Aboriginal poverty, but have contributed to
the marginalization of Aboriginal people in Canada.53

Assimilation Impacting the Equality and Marginalization of Aboriginal Peoples of

Canada
Colonization and assimilation policies had a dramatic impact upon the equality of
Aboriginal people, marginalizing women’s and men’s roles in this society.
Historically, women were the centre of the community and the family, gender
relations were egalitarian, and women’s work was equally valued to that of men’s.54
Aboriginal women were responsible for the establishment of all the community
norms whether they were political, economic, social, or spiritual.55 They were held
in the highest regard as they were viewed as being closest to Mother Earth and
Creation, as well as the foundation of the universe.56 Aboriginal women assumed
positions of authority and were pivotal in decision-making regarding the social and
economic organization of the community.57 Aboriginal women were also central
healers and caregivers in the community, a role that was truly valued.58 However,
due to assimilation policies and procedures, Aboriginal women were marginalized
and viewed as inferior to men in their communities and to white women in general,
while Aboriginal men were seen as inferior to white men.59
IMPACT OF COLONIZATION ON HEALTH AND WELLBEING OF CANADIAN ABORIGINAL PEOPLE 39

Colonization and assimilation policies disrupted the traditional roles of

Aboriginal women, as “men began to move into areas that had previously been
the province of women, adopting some of the white attitudes toward women and
treating them as inferiors rather than equals”.60 In addition, colonization has
resulted in Aboriginal peoples becoming marginalized and feeling disadvantaged
based on their race, gender, and class. Suppression of Aboriginal people’s roles has
resulted from the imposition of patriarchal legislation and government policies
based on European ideals rather than traditional Aboriginal beliefs.61

The Government Was Instrumental in Marginalizing Aboriginal People in

Canada
Government legislations such as the Indian Act (1876) were aimed at assimilating
Aboriginal people, and although altered numerous times, “still governs the state’s
relationship to Aboriginal peoples today”.62 Another government assimilation policy
was enfranchisement “whereby individuals were endowed the rights of citizenship”
and in doing so, relinquished their Indian status legally.63 A common example of
enfranchisement, specifically based on gender bias, occurred when an Aboriginal
woman married a non-Aboriginal man; her status and the status of her children as
Aboriginal (or Indian) were relinquished, as she became a citizen. If an Aboriginal man
married a white woman, his status was retained and his wife and children automatically
adopted Aboriginal status.64 These examples perpetuated oppression and differential
treatment that Aboriginal women experienced as a result of enfranchisement. Altering
Aboriginal women’s traditional valued roles in their communities resulted in
Aboriginal women becoming marginalized from their communities.

Assimilation Impacting Access to Services for Canadian Aboriginal Peoples

Inequities in health should not be attributed to lifestyle, behaviour or culture
alone, but rather encompass the interplay of historical, socioeconomic, and
political conditions that influence health and access to healthcare services.65
Many of the traditional ways of knowing, such as Aboriginal knowledge and
traditional healing practices, have been socially and culturally disrupted by
colonization, residential schools, government policies of assimilation, and
Western medicine.66 Furthermore, the imposition of Western contemporary
policies upon Aboriginal peoples has negatively impacted health outcomes and
broadened an existing gap of health inequities through lack of understanding of
health disparities in relation to social, economic, cultural, and political influences
on health and accessibility to equitable health care.67 Previous research has
indicated that emotional, cognitive, and socio-economic factors are significant
barriers to accessing healthcare services.68 In addition to these barriers,
Aboriginal peoples are also confronted with issues related to culturally
appropriate healthcare access, discriminatory attitudes when interacting with
healthcare providers, and lack of services for Aboriginal peoples both in urban
and rural areas.69 The Health Council of Canada claimed that Aboriginal people
are dissatisfied with mainstream health services.70 Healthcare institutions can be
symbolic of colonization, as some healthcare providers’ negative perceptions and
40 CATHY MACDONALD and AUDREY STEENBEEK

misconceptions about Aboriginal peoples may shape their healthcare experiences,

and can impact upon the accessing of future healthcare services.71
Recent research has suggested that many Aboriginal people may be reluctant to
access healthcare services due to the historical trauma that they and their ancestors
experienced as a result of colonization, residential schools, and racism. This
contributes to the gap in healthcare status between Aboriginal and non-Aboriginal
peoples.72 Furthermore, issues such as previous experiences of abuse from
individuals in power, shortages of Aboriginal healthcare providers, geographical
barriers, and the lack of choice in health care are additional contributing factors
that impact upon Aboriginal peoples seeking access to healthcare services, while
contributing to the inequities of health status for Aboriginal peoples.73
In remote or rural areas, access to care maybe restricted by lack of
transportation, lack of home supports for individuals, limited access to healthcare
providers, and the lack of economic supports for accessing healthcare services.74
Moreover, the Indian Act first passed in 1876 by the Canadian Government has also
impacted access to services for Aboriginal peoples (such as healthcare services by
creating the legal categories of “status” (or registered) Indians or “non-status”
Indians. Under the Act, certain Aboriginals, (for example the Prairie Provinces in
Canada) were provided with a unique registration number.75 The Act was drafted
for the purpose of facilitating the administration of programs to Aboriginal
peoples, in addition to facilitating their assimilation into Canadian society.76
However, the Indian Act applied only to status Indians and has not historically
recognized Métis, Inuit peoples and some other First Nations people, like the
Mi’kmaq of Qualipu First Nation Band in Newfoundland, who became officially
recognized by the government of Canada on 22 September 2011 through an Order-
in-Council of the Governor General.77 The Métis and Inuit have not had Indian
status and the rights conferred by this status despite being Indigenous to Canada
and participating in Canadian nation building. Yet, this colonial policy not only
perpetuated control over who was considered an “Indian” and how such status
could be gained or lost, but affected the lands reserved for them, and also affected
their access to services.78 “Status” Aboriginal peoples tended to obtain the majority
of federal government resources/funding, leading to more self-governance within
reserves, than did non-status Aboriginals. As a result, this created a layer of
discrimination for non-status Aboriginal people who were often marginalized by
their own people due to their place of residence.79
Haug and Prokop contended that the status of the individual as delineated by the
federal government, often affects accessibility and diversity to services. For
example, off-reserve Aboriginal peoples fall under provincial government
jurisdiction when it comes to services such as homecare, which nullifies off-reserve
Aboriginals’ access to on-reserve homecare programs.80 Thus, individuals do not
receive home care that is congruent with Aboriginal world views, knowledge,
beliefs, and Indigenous healing methodologies, which has led to a gap in healthcare
services. According to Amnesty International, Aboriginal off-reserve individuals
must access programs and services that were designed for the general population;
services that often are not meeting the specific needs of Aboriginal peoples,
or provided in a culturally appropriate or sensitive manner.81
IMPACT OF COLONIZATION ON HEALTH AND WELLBEING OF CANADIAN ABORIGINAL PEOPLE 41

Access to services is further impacted by the lack of basic health facilities such as
health clinics and hospitals, specifically in remote and rural areas of Canada.82
Remote and rural communities rely primarily on non-Aboriginal healthcare
workers for medical and non-medical services. Additionally, many Aboriginal
people must be evacuated from their communities in order to obtain healthcare
services and medical treatment, and often encounter culturally insensitive care,
racism, and discrimination in treatment facilities.83 Moreover, there is a frequent
turnover of healthcare professionals, particularly in remote areas of Canada, which
dramatically affects medical management, the range of services offered, and access
to services. It also results in client disengagement in services, illness exacerbation,
and an additional burden of care for families and the community, which translate
into poor health outcomes.84

Assimilation’s Effect on Traditional Culture of Canadian Aboriginal Peoples

Colonization results in oppression, which is defined as the processes in society that
prevent the oppressed individuals from learning and using social skills in socially
recognized settings, or “social processes which inhibit people to play and communicate
with others or to express their feelings and perspective on social life in contexts where
others can listen”.85 Oppressed individuals also experience inhibition of their ability to
develop or exercise capacity, and express needs, feelings, and thoughts. Similarly,
Freire maintained that oppression comes from the ability of a dominant group to
determine the values and norms of a particular society.86 The oppressed group’s beliefs,
culture, and language are not considered or valued, as they differ from those of the
dominant group. The oppressed group believes that in order to become accepted and
gain control, they must internalize and adapt the characteristics of the oppressor,
resulting in the loss of traditional culture, knowledge, and teachings that were handed
down from one generation to the next by way of oral tradition and story-telling.87
Colonization has disrupted the traditional ways of sharing knowledge, which has
resulted in the inferiority of women to men. Prior to colonization, many Indigenous
cultures were matriarchal or semi-matriarchal, which valued equality, and the inherent
power and honour of women.88 Even the residential school system resulted in the loss
of traditional culture, as Aboriginal children were prohibited from speaking their
language, participating in customs, rituals, and ceremonies, or using traditional
medicines. Residential schools diminished traditional cultural ways as the use of
language, ceremonies, healing, knowledge, teaching, and wisdom were discouraged,
and eventually, lost. Residential schools also separated children from their families and
communities that were central to their lives, and as a result, teachings about life that
were previously passed on through oral traditions were lost.89
The impact of colonization and government policies and procedures has resulted
in the loss of traditional culture. Canadian governments have not only separated
Aboriginal peoples from their traditional cultures, but also created the conditions of
physical and financial dependency on state resources. The strong cultural identities
of Aboriginal peoples that were rooted in traditional practices and world views
have been eroded by a culture of dependence, due to the banning of cultural
practices and the promotion of assimilation policies and practices, which have led
to historical trauma and unresolved grief across generations.90
42 CATHY MACDONALD and AUDREY STEENBEEK

Gender Compounding the Affects of Assimilation on Aboriginal Women’s Health

It has been reported that “Aboriginal women are one of the most politically, socially,
and economically marginalized populations in Canada”.91 According to Philips
“women’s health involves women’s emotional, social, cultural, spiritual and physical
well-being, and is determined by the social, cultural, political and economic context
of women’s lives as well as by biology”.92 Aboriginal women are faced with
individual and institutionalized discrimination on the basis of race, class, and gender.
Likewise, Aboriginal women experience greater health disparities than non-
Aboriginal women, especially with respect to chronic diseases and life expectancy.93
For example, Aboriginal women’s life expectancy in 2017 is projected to be 78–80
years, in comparison to 83 years for non-Aboriginal women in Canada.94
In Canada, the rates of spousal and non-spousal violence and sexual abuse are
higher for Aboriginal women than for non-Aboriginal women.95 Aboriginal
women are more likely than non-Aboriginal women to have endured violence
causing physical injury that required medical attention; to have experienced ten or
more episodes of violence; and feared that their life was in danger. Aboriginal
women live in environments where substance abuse and spousal violence are
widespread; experience higher incidences of depression; and have high rates of
smoking and substance abuse, and sexually transmitted diseases.96
Aboriginal women are burdened with poor health compared to other Canadian
women and Aboriginal men.97 The introduction of tobacco and alcohol has led to
chronic respiratory diseases, lung cancer, and addictions which in turn have led to
high rates of physical and sexual violence, depression, and mental illnesses.
Statistics indicate that Aboriginal women are four times more likely than non-
Aboriginal women to experience spousal abuse and to report fearing for their lives as
a result of spousal violence (52% versus 31% of non-Aboriginal female victims).98
Furthermore, Aboriginal women, after separating from their partners, are more likely
than non-Aboriginal women to be forced into prostitution and contract HIV.99

Conclusion
Despite differences in diversity and lifestyles, Aboriginal peoples nationally and
internationally continue to experience historical trauma resulting from coloniza-
tion and assimilation. All aspects of Aboriginal health and lifestyles, traditional
roles, culture, socio-economics, and access to services were disrupted as a result of
colonization and assimilation practices. Further, the key determinants of health,
gender and social status are factors further compounded by the effects of
assimilation on Aboriginal people. Aboriginal women, in particular, have
experienced poorer health, with gender compounding the affects of assimilation
on Aboriginal women’s health. To gain an understanding of how to promote equity
in health care for Aboriginal people, a critical examination of the root causes of
health and healthcare inequities must be viewed from historical, economic, and
socio-political contexts by using a post-colonial feminist perspective. Consequently,
the impacts of colonization and assimilation on the health, socio-economic
conditions, access to services, and the effects on the traditional cultures of Canadian
Aboriginal people were discussed. It is essential to understand the distinct impact of
colonization and assimilation policies and practices to gain an understanding of the
IMPACT OF COLONIZATION ON HEALTH AND WELLBEING OF CANADIAN ABORIGINAL PEOPLE
devastating and lasting implications that these processes had, and continue to have,
on all aspects of Aboriginal people’s lives and health.
Acknowledgements
Thanks to Atlantic Aboriginal Health Research Program (AAHRP); Psychosocial
Oncology Research Training (PORT) Fellowship; Electa MacLennan Scholarship,
Dalhousie University; Canadian Nurses Foundation AstraZeneca Rural Scholarship.
Notes
1
“Aboriginal Peoples” is a collective name for all of
the original peoples of Canada and their descen-
5
dants. Section 35 of the Constitution Act of 1982
specifies that the Aboriginal Peoples in Canada
consist of three groups – Indian (First Nations),
Inuit, and Métis. It should not be used to describe
only one or two of the groups. Although in this article
“Aboriginal people” is a general term, in some
instances related to treaties and land claims specific
bands, tribes, or Nations will be distinguished.
2
See, for example, Naomi Adelson, ‘The Embodi-
ment of Inequity: Health Disparities in Aboriginal
6
Canada”, Canadian Journal of Public Health 96
(2005): S45 – S61; Marie Battiste, Reclaiming
Indigenous Voice and Vision (Vancouver: Univer-
sity of British Columbia Press, 2000); Annette
7
J. Browne et al. ”Access to Primary Care from the
Perspective of Aboriginal Patients at an Urban
Emergency Department”, Qualitative Health
8
Research 21 (2011): 333–48; Madeleine Dion
9
Stout, “Ascribed Health and Wellness, Atikowisi
miýw-āyāwin, to Achieved Health and Wellness,
Kaskitamasowin miýw-āayāwin: Shifting the Para-
10
digm”, Canadian Journal of Nursing Research 44,
no. 2 (2012): 11 –14; Bernard Guerin, “A Frame-
work for Decolonization Interventions: Broad-
ening the Focus for Improving the Health and
11
Wellbeing of Indigenous Communities”, Pı́matı́sı́-
wı́n 8, no. 3 (2010): 61 –83; Wayne Warry, Ending
Denial: Understanding Aboriginal Issues (Peter-
borough, ON: Broadview Press, 2007); National
Aboriginal Health Organization, Ways of Know-
12
ing: A Framework for Health Research (Ottawa,
Canada: Policy Research Unit, 2003).
3
National Aboriginal Health Organization, Ways
of Knowing; Anne MacMurray, “Health and its
Socio-ecological Determinants”, in Community
Health and Wellness: A Socio-ecological Approach
(Sydney, Australia: Mosby, Incorporated, 2007).
4
Caroline L. Tait, “Disruptions in Nature: Disrup-
tions in Society: Aboriginal Peoples of Canada and
the ‘Making’ of Fetal Alcohol Syndrome”, in
Healing Traditions: The Mental Health of Abori-
ginal Peoples in Canada, Lawrence E. Kirmayer
43
and Gail Guthrie Valaskakis, eds. (196– 220).
Vancouver: UBC Press, 2009, p. 241.
See, for example, J.M. Anderson, “Lessons for a
Postcolonial-Feminist Perspective: Suffering and a
Path to Healing”, Nursing Inquiry 11 (2004):
238 –46; A.J. Browne, V.L. Smye and C. Varcoe,
“The Relevance of Postcolonial Theoretical
Perspectives to Research in Aboriginal Health”,
Canadian Journal of Nursing Research 37, no. 4
(2005): 16–37; R.J.C. Young, Postcolonialism:
An Historical Introduction (Oxford: Blackwell,
2001).
C. MacDonald, “Exploring Mi’kmaq Women’s
Experiences with Pap Smear Screening in Nova
Scotia”, Unpublished PhD Diss., Dalhousie
University, Halifax, Nova Scotia, 2013.
L.T. Smith, Decolonizing Methodologies:
Research and Indigenous Peoples (Dunedin,
New Zealand: Otago University Press, 1999).
Ibid.
J. Sherwood, “Do No Harm: Decolonizing Abori-
ginal Health Research”, Unpublished PhD Diss.,
University of New South Wales, Australia, 2010.
Examples of this approach include Young, Postcolo-
nialism; S.R. Kirkham and J.M.Anderson, “Postcolo-
nial Nursing Scholarship: From Epistemology to
Method”, ANS 25, no. 1 (2002): 1–17.
Smith, Decolonizing, 98; C. McConaghy, Rethink-
ing Indigenous Education: Culturalism, Colonial-
ism and the Politics of Knowing (Brisbane,
Australia: Post Pressed, 2000), 268. See also
Stout, “Ascribed Health and Wellness”.
Smith, Decolonizing; A. Browne and V. Smye,
“A Post-Colonial Analysis of Healthcare
Discourse Addressing Aboriginal Women”, Nurse
Research 9, no. 3 (2002): 28 –41; A.J. Browne,
V.L. Smye and C. Varcoe, “The Relevance of
Postcolonial Theoretical Perspectives to Research
in Aboriginal Health”, in Women’s Health in
Canada: Critical Perspectives on Theory and Policy,
ed. M. Morrow, O. Hankivsky and C. Varcoe
(Toronto: University of Toronto Press, 2007);
C. MacDonald, “Exploring Mi’kmaq Women’s
Experiences with Pap Smear Screening in Nova
44 CATHY MACDONALD and AUDREY STEENBEEK
Scotia”; J.M. Anderson, “Toward a post-colonial
feminist methodology in nursing research: explor-
ing the convergence of post-colonial and black
feminist scholarship”, NR 9, no. 3 (2002): 7 –27.
13
Kirkham and Anderson, “Postcolonial Nursing
Scholarship”; Browne and Smye, “A Post-Colonial
Analysis of Healthcare Discourse”.
14
Browne, Smye and Varcoe, “The Relevance of
Postcolonial Theoretical Perspectives to Research
in Aboriginal Health”, 135.
15
R. Ing, “Canada’s Indian Residential Schools and
its Impacts on Mothering” (paper presented at
Mothering, Race, Culture, Ethnicity and Class
Conference, Toronto, Canada, October 2005), 6.
16
See I. Knockwood, Out of the Depths: The
Experiences of Mi’Kmaw Children at the Indian
Residential School at Shubenacadie, Nova Scotia
(Black Point, Nova Scotia: Roseway Publishing,
2001); J.B. Waldram, D.A. Herring and T.K. Young,
Aboriginal Health in Canada, 2nd ed. (Toronto,
ON: University of Toronto Press Incorporated,
2006); P. Freire, Pedagogy of the Oppressed
(New York: Seasbury, 1997), 133.
17
P. Freire, Pedagogy of the Oppressed (New York:
Seasbury, 1997), 133.
18
P. Freire, Pedagogy of the Oppressed (New York:
Seabury,1997), 133; Knockwood, Out of the
Depths.
19
Battiste, Reclaiming Indiginous Voice, xvii.
20
J. Smylie et al., “A Guide for Health Professionals
Working with Aboriginal Peoples”, Journal of
Obstetrics and Gynaecology Canada 23 (2001):
255–61.
21
J.Y. Henderson, “The Context of the State of
Nature”, in Battiste, Reclaiming Indigenous Voice,
29.
22
Battiste, Reclaiming Indiginous Voice; Warry,
Ending Denial; A. Garman, K. Doull, “Embracing
the Healing Journey”, Journal of Aboriginal
Health 5, no. 1 (2009): 2 – 3.
23
Warry, Ending Denial, 23.
24
J.I. Steckley and B.D. Cummins, Full Circle:
Canada’s First Nation (Toronto: Pearson Prentice
Hall, 2008).
25
D. Smith, C. Varcoe and N. Edwards, “Turning
Around the Intergenerational Impact of Residen-
tial Schools on Aboriginal People: Implications for
Health Policy and Practice”, Canadian Journal of
Nursing Research 37, no. 4 (2005): 38 –60, 19.
26
R. Barnes, N. Josefowitz and E. Cole Residential
schools impact on Aboriginal students’ academic
and cognitive development. CJS, 21, no 1 –2
(2006): 18 –32.
27
Knockwood, Out of the Depths, 10.
28
Amnesty International. “Canada: Stolen Sisters:
A Human Rights Response to Discrimination
and Violence Against Indigenous Women in Canada”,
Amnesty International, 3 October 2004,
https://www.amnesty.org/en/documents/amr20/
003/2004/en/.
29
M.E. Kelm, Colonizing Bodies: Aboriginal Health
and Healing in British Columbia (Vancouver:
University of British Columbia Press, 2001).
30
See MacDonald, “Exploring Mi’kmaq Women’s
Experiences with Pap Smear Screening in Nova
Scotia”; also A. Fridkin, “Decolonizing Policy
Processes: An Intersectionality-Based Policy Anal-
ysis of Policy Processes Surrounding the Kelowna
Accord” (PhD diss., University of British Colum-
bia, 2012). Available at http://www.sfu.ca/iirp/
documents/IBPA/6_Kelowna%20Accord_Fridkin
%202012.pdf.
31
Stout, “Ascribed Health and Wellness”; Knock-
wood, Out of the Depths.
32
A. Garman and K. Doull. Embracing the healing
journey. JAH 5, no. 1 (2009): 2 –3.; Warry, Ending
Denial.
33
Browne and Smye, “A Postcolonial Analysis of
Healthcare”, 29.
34
Browne et al., “Access to Primary Care”; Stout,
“Ascribed Health and Wellness”; L. Haskell and
M. Randall, “Disrupted Attachments: A Social
Context Complex Trauma Framework and the
Lives of Aboriginal Peoples in Canada”, Journal of
Aboriginal Health 5, no. 3 (2009): 48 –99.
35
J. Miller, Tuberculosis: Canadian Arctic tragedy,
growing global threat. International Committee
of the Fourth International. 2011. Available at
http://www.wsws.org/en/articles/2011/02/inui-
f16.html.
36
Waldram, Herring and Young, Aboriginal Health
in Canada.
37
J.S. Frideres and R.R. Gadacz, Aboriginal peoples
in Canada: Contemporary conflicts (Toronto:
Pearson Education Canada Inc, 2001).
38
Waldram, Herring and Young, Aboriginal Health
in Canada, 291.
39
Warry, Ending Denial.
40
V.P. Miller, “The Micmac: A Maritime Woodland
group”, in Native Peoples: The Canadian Experi-
ence, ed., R.B. Morrison and C.R. Wilson
(Toronto: McClelland & Stewart, 1995).
41
Warry, Ending Denial; Haskell, N. Adelson,
“The embodiment of inequity”.
42
D.N. Paul, We Were Not the Savages: A Mi’kmaq
Perspective on the Collision of European and
Native American Civilizations (Halifax, Nova
Scotia: Fernwood, 2000); Warry, Ending Denial;
Frideres and Gadacz, Aboriginal Peoples in
Canada: Contemporary Conflicts.
43
D.N. Paul, We Were Not the Savages: A Mi’kmaq
Perspective on the Collision of European and
Native American Civilizations.
44
Miller, “The Micmac’”, 355.
45
Steckley and Cummins, Full Circle, 183.
46
Ibid.
IMPACT OF COLONIZATION ON HEALTH AND WELLBEING OF CANADIAN ABORIGINAL PEOPLE
47
Warry, Ending Denial; T. Sable and B. Francis, The
Language of this Land, Mi’kma’ki (Sydney, Nova
Scotia, Canada: Cape Breton University Press,
2012); D. Smith et al., “Rethinking Nursing Best
Practices with Aboriginal Communities: Informing
Dialogue and Action”, Nursing Leadership 22, no.
4 (2012): 24 –39.
48
For details see “Peace and Friendship Treaties”,
Aboriginal Affairs and Northern Development
Canada, https://www.aadnc-aandc.gc.ca/eng/
1100100028589/1100100028591; Youngblood,
”Generis and Treaty Citizenship”.
49
J.S. Youngblood Henderson, “Sui Generis and
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415–440, 420.
50
G.T. Alfred, Colonialism and State Dependency.
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51
“Aboriginal People”, Statistics Canada, Govern-
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52
J. Kendall, Circles of disadvantage: Aboriginal
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53
T. Sable and B. Francis, The language of this land,
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54
L. Morgan and J.L. Wabie, “Aboriginal Women’s
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55
A. Reeves, Honouring Womanhood: Understand-
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56
Morgan and Wabie, “Aboriginal Women’s Access
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C. Kenny, A Holistic Framework for Aboriginal
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57
P. Moore, “Na-Dene”, in Aboriginal Peoples of
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58
E. Haug and S.T. Prokop, “Aboriginal Women and
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59
Battiste, Reclaiming Indiginous Voice.
45
60
E. LaRocque, “The Colonization of a Native Scholar”,
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63
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64
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Cathy MacDonald, RN, PhD, is Associate Professor at the School of Nursing, Saint
Francis Xavier University, Antigonish, Nova Scotia, Canada.
Audrey Steenbeek, RN, PhD, is Associate Professor and Assistant Director of
Graduate Programs at Dalhousie University, Nova Scotia, Canada.
Correspondence to: Cathy MacDonald. Email: cmacdon@stfx.ca
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88
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89
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96
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