Health Equity and Self-Determination in Ontario Health Teams: Addressing Service Delivery Gaps for Indigenous Communities
Overview
This briefing note addresses underlying health issues and inequities affecting Indigenous communities within Ontario Health Teams. It traces the historical evolution of health policy transfer and self-determination rights from 1960 to present, identifying current coordination gaps between provincial and federal systems and proposing solutions centered on Indigenous self-governance and improved service delivery in rural and remote areas.
What this coursework covers
- Background: Historical context of government policies and their detrimental effects on Aboriginal communities, including assimilation and forced relocations
- Policy Timeline: Chronological account of key health transfer agreements and self-determination initiatives from 1960-1995
- Current Issues: Analysis of existing health equity challenges including poor coordination, limited primary care access, and inadequate specialist services in rural and remote Indigenous communities
Preview
BRIEFING NOTE
Purpose
The purpose of this briefing note is to address several underlying health issues and gaps to develop solutions to these challenges among Ontario Health Teams.
Background
In the last few decades, governments have established the detrimental effect of their policies and practices on the Aboriginal communities’ welfare. Several issues stem from assimilation, forced relocations, and the abolition of self-determination. Since this realization, there have been efforts to transfer health accountability to Aboriginal communities (“Cancer Care Ontario E-Learning,” 2020). Delivery of health services under programs based on policies and health services were not based on best practices of delivering care and health services. There were complaints from clinicians about the challenges of health delivery and the fact that payments and approvals were delayed. Some medical professionals began to avoid First Nation patients and would prefer patients under insurance programs. Increased mobility rates have been attributed to poor coordination within the healthcare system. Considering events that have led to the current situation, the report outlines:
1960: The Community Health Representative program aimed at providing support to non-Aboriginal nurses who dominated the health service. They also acted as a link between the nurses and the community.
1972: James Bay regime introduced a new local government system and first nations control on education and health authorities.
1979: The Federal Indian Health Policy realizes that the First Nation communities may ignore their responsibility in implementing aspects of their community health programs.
1988: Transfer Agreement imposes responsibility for Universal Health Programs to the government of the Northwest Territories.