1

Reconciliation in Canadian Healthcare Systems

Student’s Name

NorQuest College

ENGL 2550: Section Number

Instructor’s Name

Example Assignment 2c: Critical Analysis Essay

Date, Year
 2

Abstract

Racial bias against Indigenous people in Canada has a negative impact on their health and

wellbeing. Unequal power relations between Indigenous and non-Indigenous patients and

healthcare professionals have created a culture of discrimination and mistrust in Canadian

healthcare systems. This paper will discuss strategies to address racial biases in healthcare

through use of improved data systems, education and training initiatives, integration of more

Indigenous people in healthcare facilities, and supporting regulatory vigilance. Support from

applicable governing bodies and healthcare facilities, as well as a shift in healthcare providers’

attitudes, cultural knowledge, and skills are essential in implementing these strategies.
 3

The Canadian healthcare system requires interventions to address racial bias, health

disparities, and the quality of care Indigenous people receive. Racism can include verbal or

physical attacks, but also the actions and attitudes of healthcare workers though a lack of

consideration, accommodation, or the provision of a safe and comfortable environment. Racism

in healthcare has led to poor treatment, misdiagnoses, inaccurate documentation, and a culture of

mistrust in healthcare providers and institutions. Canadian healthcare services need to address the

issue of systemic racial bias against Indigenous peoples. In order to provide bias-free care,

healthcare services in Canada must integrate improved data systems, implement new initiatives in

educating and training healthcare professionals, increase the number of Indigenous healthcare

providers, and support regulatory vigilance.

Systematic data collection on Indigenous health must be routinely recorded to identify

health disparities and improve data accuracy. Improving methods of data collection on health

information is useful for “improving the health of Indigenous populations, enhancing Indigenous

health knowledge and data, and the elimination of health disparities” (Chino et al., 2019,

Introduction, para. 3). There is a lack of data regarding Indigenous peoples’ health which results

in inaccurate statistics and misunderstanding of diseases and conditions. Misclassification of

Indigenous status has led to significant underestimates on deaths and lack of health statistics

(Chino et al., 2019). Correctly classifying Indigenous status will identify trends in health

outcomes to allow organizations to improve the quality and safety of treatments. Ensuring data is

accurate and complete is essential to identifying and monitoring health disparities among

Indigenous and non-Indigenous populations (Chino et al., 2019). Identifying health disparities

will allow healthcare providers to plan interventions that will prevent diseases and illnesses.

To effectively diagnose and treat patients, it is essential to know data on specific factors

that influence their health and health outcomes, for example: socio-economic status, ethnicity,
 4

culture, and environment. Statistical data on chronic illnesses, injuries, and mental health

concerns affecting Indigenous communities will gauge the overall health and well-being of their

population in specific regions (Chino et al., 2019). However, in order to prevent generalization, it

is also important to consider the diversity within the Indigenous populations when discussing

statistical data; for example, what might be a health concern for an Indigenous group in Alberta

may differ in other provinces. Eliminating systemic racism requires an extensive data system of

Indigenous health records, health trends, determinants of health, statistics, and interventions that

were effective in treating Indigenous health concerns. Health disparities on Indigenous

populations in Canada have been recognized but there is still uncertainty of the extent it has

affected their population due to lack of accurate and complete data.

Prioritizing education on Canadian Indigenous history and effects of post-colonialism

will ensure healthcare providers are giving culturally safe care while building respectful

relationships. Educational institutes training healthcare providers must implement curriculum

related to the effects of colonization and systematic challenges that lead to poor health outcomes

and illnesses for Indigenous populations (Beavis et al., 2015). The Indian Act is now regarded as

racist and unjust, as it was used by the Canadian government to erase Indigenous peoples’

cultures and identities, control their lives, and prevent them from practicing their traditions.

Indigenous children were forcibly removed from their families and placed in residential schools

where they were stripped of their identities to conform to “Western” values. The Indian Act and

residential schools are examples of colonial events that have directly affected Indigenous mental

and physical health. Healthcare providers must understand how these events have affected the

past and present-day health of Indigenous people through cultural genocide and systematic

challenges (Wylie & McConkey, 2019). Acknowledging that colonialism is not over and that

many aspects of Canadian healthcare are still rooted in colonial practice is necessary when
 5

addressing Indigenous health and the ongoing effects of racial bias in Canadian healthcare.

Understanding how historical events have created poor health outcomes and mistrust will help

guide healthcare providers on how offer culturally sensitive and appropriate care, understand

health concerns, and build respectful relationships.

The provision of culturally appropriate healthcare to Indigenous people requires ongoing

education, training strategies, and improvements in healthcare facilities. Integrating Indigenous

medicine, traditions, and healers into Canadian medical practices will increase understanding of

culturally-specific healthcare needs, allowing healthcare workers to provide a culturally inclusive

environment (Beavis et al., 2015). One strategy to promote Indigenous health is using a strength-

based approach emphasizing resilience (Crowshoe et al., 2021). This approach empowers

Indigenous people instead of perpetuating stereotypes of weakness or inferiority. Empowering

Indigenous cultures in healthcare facilities will not only help promote a welcoming environment

for Indigenous people, but also educate non-Indigenous healthcare providers on how to give

appropriate care. This requires educational programs and facilities to develop curriculum in

consultation with members of Indigenous communities on how to incorporate traditional

Indigenous medicine in clinical settings. These strategies will be effective in reducing racial

biases because they emphasize the value of Indigenous health practices and cultures. Building a

healthcare system that respects Indigenous cultures and practices will encourage mutual trust and

reconciliation, and result in better health outcomes.

Reflective strategies are important for healthcare providers to identify their own privileges

and recognize racist assumptions and biases against Indigenous people (Phillips-Beck et al.,

2020). In order for healthcare workers to reflect on personal biases, it is essential to first have

factual and reliable information and then to identify any misconceptions, stereotypes, or stigmas.

Re-education on Indigenous culture, the effects of colonialism, and systematic challenges will
 6

enable healthcare providers to re-evaluate misinformation and/or systemic racial biases that may

be influencing their behaviours. Healthcare facilities should require employees to practice self-

reflection routinely to identify any perceived or systemic racial biases. Providing unbiased care to

Indigenous people requires a complex understanding of Indigenous history, traditions, language,

and values, while also reflecting on one’s own beliefs and values and how they may differ. Self-

reflection and knowledge of Indigenous culture will ensure a climate of mutual respect during

care in order to build a collaborative team to address health concerns and promote wellness.

Canadian healthcare facilities must conscientiously recruit more Indigenous healthcare

providers to promote safe and culturally appropriate care. Developing a greater capacity of

Indigenous healthcare workers will promote respectful interactions, help identify racial biases,

and close the racial gap between Indigenous and non-Indigenous communities (Crowshoe et al.,

2021). Indigenous healthcare professionals should be recruited to teach clinical training programs

to promote intercultural communication and the provision of culturally safe care (Beavis et al.,

2015). Receiving training from experienced individuals familiar with Indigenous values will

allow healthcare providers to build relationships and trust. Increased trust and respect will

encourage Indigenous people to seek medical care and feel supported in achieving health goals.

The partnership between Indigenous and non-Indigenous populations in healthcare is essential in

the restoration of the Indian culture and gaining trust and mutual respect (Wylie & McConkey,

2019). This partnership can determine best practices to promote the health and well-being in a

way that values and respects their culture.

An interprofessional collaboration will address racial disparities and show the healthcare

system’s determination to close the racial gap. Closing the racial gap between Indigenous and

non-Indigenous people in healthcare settings is essential for reconciliation and a path forward for

health and prosperity. Directly working with more Indigenous people in healthcare facilities will
 7

ensure cultural appropriate care and help to eliminate racist misconceptions, stereotypes, and

stigmas (Wylie & McConkey, 2019). Stereotypes and stigmas are often formed by a lack of

knowledge, learnt behaviours, and misconceptions. Misguided assumptions about Indigenous

people such as the alcoholism stereotype have led to harmful misconceptions and misdiagnoses.

Working with Indigenous healthcare providers will help to correct those misconceptions and

create a path for reconciliation. Both Indigenous and non-Indigenous healthcare professionals

should be involved in advocating, communicating, and promoting culturally appropriate care for

Indigenous people (Crowshoe et al., 2021). Miscommunication often leads to poor outcomes;

therefore, patient advocacy is important to promote health while maintaining dignity and respect.

Increased regulatory efforts will focus on identifying discriminatory behaviours or biases

against Indigenous people. Healthcare facilities implementing a regulatory vigilance system will

promote health, safety, and effectiveness of care. Healthcare professionals should be held

accountable to report and document any observed or direct incidents of culturally unsafe care

toward Indigenous people. Health statistics on patient outcomes should be used to identify any

Indigenous health disparities within a facility and what measures should be taken to mitigate

them (Beavis et al., 2015). Data showing high frequency of poor health outcomes in a facility

should initiate an investigation. Discriminatory behaviours are not always from a select few but

can exist more broadly in a system embedded in racist practices. Health facilities should develop

anonymous data collection from both healthcare providers and recipients of care to report

discriminatory behaviours, unsafe practices, and racial bias. A regulatory vigilance system would

be effective in identifying and addressing reported or observed discriminatory behaviours while

holding care providers and facilities accountable. It allows healthcare professionals to feel

confident they are providing unbiased and culturally appropriate care, as well as promoting a
 8

trusting relationship between the healthcare system and Indigenous people. Individual and facility

vigilance against discriminatory behaviours and racial bias will help provide culturally safe care.

Improved initiatives and methods in Canadian healthcare facilities and education training

programs are needed to effectively address racial bias against Indigenous people. Collaboration

between healthcare systems and Indigenous communities is essential for the transformation of

Indigenous health equity and progressive health outcomes. The responsibility of addressing racial

biases in healthcare should not be left solely in the hands of the government. It is also the social

responsibility of the non-Indigenous population to re-educate themselves on racial, historic, and

cultural indifferences toward Indigenous people and how to apply that knowledge to effectively

change Indigenous health outcomes.

 9

References

Beavis, A. S., Hojjati, A., Kassam, A., Choudhury, D., Fraser, M., Masching, R., & Nixon, S. A.

(2015). What all students in healthcare training programs should learn to increase health

equity: Perspectives on postcolonialism and the health of Aboriginal Peoples in

Canada. BMC Medical Education, 15(1), 1-11.

https://doi.org/10.1186/s12909-015-0442-y

Chino, M., Ring, I., Pulver, L. J., Waldon, J., & King, M. (2019). Improving health data for

Indigenous populations: The international group for Indigenous health

measurement. Statistical Journal of the IAOS, 35(1), 15-21. https://doi.org/10.3233/SJI-

180479

Crowshoe, L., Sehgal, A., Montesanti, S., Barnabe, C., Kennedy, A., Murry, A., Roach, P.,

Green, M., Bablitz, C., Tailfeathers, ER., Henderson, I. (2021). The Indigenous primary

healthcare and policy research network: Guiding innovation within primary healthcare

with Indigenous peoples in Alberta. Health Policy, 125(6), 725-731.

https://doi.org/10.1016/j.healthpol.2021.02.007

Phillips-Beck, W., Eni, R., Lavoie, J. G., Avery Kinew, K., Kyoon Achan, G., & Katz, A. (2020).

Confronting racism within the Canadian healthcare system: Systemic exclusion of First

Nations from quality and consistent care. International Journal of Environmental

Research and Public Health, 17(22), 8343. https://doi.org/10.3390/ijerph17228343

Wylie, L., & McConkey, S. (2019). Insiders’ insight: Discrimination against Indigenous peoples

through the eyes of healthcare professionals. Journal of Racial and Ethnic Health

Disparities, 6(1), 37-45. https://doi.org/10.1007/s40615-018-0495-9