Transcript First Nations

First Nations and Inuit Health Branch:
Program Overview and
Communities in Crisis
Presentation to the CAOT
June 13, 2008
2007 Projected Registered Indian Population
Inuit Population (2007) is 48,700 across
the four land claims regions: Inuvialuit,
Nunavut, Nunavik, and Nunatsiavut
8,347
17,743
127,533
105,592 130,335
131,910
72,565
178,080
33,645
Total: 805,750
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Demographic Profile
First Nations and
Inuit Population
Projected Average Annual
Growth Rate compared to
Canada overall
( 2001 to 2017)
Young Population
Communities
805,750 Projected Registered Indian population (2007)
48,700 Inuit population (2007)
First Nations and Inuit population is 2.6% of Canada’s
population
First Nations: 2.86 times higher
Inuit: 3.3 times higher
50% of First Nations are under 25 (Census 2006)
56% of Inuit are under 25 (Census 2006)
606 First Nations communities
90% of First Nations communities have a population of
under 1000
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Health Status of First Nations and Inuit
Gap in life expectancy
Registered Indians: 5 years (females); 7 years (males)
Inuit: 11 years (females); 13 years (males)
Infant Mortality
First Nations infant mortality rate has been declining but
remains higher than the Canadian rate
HIV infections
Aboriginal Peoples account for an estimated 7.5% of all existing
HIV infections in Canada (2005)
Rate of Diabetes
Leading Cause of
Deaths in Children and
Youths
FN on reserve: 3.8 times higher than the general Canadian
pop’n
Inuit: 47% lower than the general Canadian population
Injury (primarily suicide, motor vehicle collisions and fires)
Rate of First Nations youth (10-19 years) suicide is 4.3X greater
than for Canada in 2000; suicide rate for Inuit regions (19892003) is 8.3x higher than for Canada
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Mandate of the First Nations and Inuit Health Branch (FNIHB)
With respect to First Nations and Inuit:
• improving health outcomes;
• ensuring availability of, or access to, quality health
services; and
• supporting greater control of the health system by
First Nations and Inuit.
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FNIHB: Major Program Areas
1.
2.
3.
4.
Health Protection and Public Health
Primary Care
Community Programs
Non Insured Health Benefits (NIHB) Program
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1. Health Protection and Public Health
• Communicable Diseases:
– communicable disease control and surveillance
– HIV/AIDS; TB
• Environmental Health:
– water quality monitoring on-reserve
– mould inspections in housing on-reserve
2. Primary Care:
• Over 670 community health nurses;
• more than 70 nursing stations;
• 229 health centres,
• home care programs in 600+ communities
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3. Community Programs
• Mental Health and Addictions:
– alcohol and drug prevention / promotion
– alcohol and drug / youth solvent abuse in-patient treatment
centres
– youth suicide prevention
• Chronic Disease and Injury Prevention
– Aboriginal Diabetes Initiative
– nutrition and physical activity promotion
• Children and Youth
– Maternal/Child Health
– Aboriginal Head Start
– Prenatal supports
– FASD
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Aboriginal Diabetes Initiative (ADI)
•
•
•
•
•
diabetes among First Nations reaching epidemic proportions
- for FN/I 3 to 5 times national rates
in 2006 $190M invested over 5 years in community-based
diabetes initiatives
ADI objective: reduce type 2 diabetes in Aboriginal pop’n thru:
- promotion
- prevention
- screening
- treatment
- delivered mostly by trained community-based workers
>600 FN/I communities are funded for ADI projects
~50 projects target Métis, off-reserve FNs and urban Inuit
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4. Non-Insured Health Benefits (NIHB)
Payer of last resort for approx. 780,000 First
Nation and Inuit beneficiaries for:
drugs
medical supplies and equipment
dental
medical transportation
vision care
mental health counseling
provincial health care premiums (BC, AB),
co-insurance payment deductibles
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Draft Vision of Health Canada’s
First Nation Communities in Crisis Initiative
Through strategies aimed at strengthening
community resilience, First Nation community
wellness is enhanced (thereby minimizing the
incidence of communities being at-risk or in crisis).
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Initial Plan of Action
data
collection
analysis
Expert
Advisory
Committee
consultation
framework
development
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Data Collection
•
•
•
•
•
literature reviews
commissioned studies
lessons learned from formal evaluations:
watching brief on parallel initiatives
community profiles
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Community
Resilience as
BALANCE
among a set of
categories of
Determinants
of Community
Health
self-determination
community
development
environmental
development
economic
development
social
development
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Examples of Determinants of Community Health
Self-Determination
Social Development
control over local services and programs
cultural continuity
colonialism/dependence on govt.
nature of justice system/ restorative justice
social capital
traditional spirituality
culture and language
cultural safety
overcoming the residential school experience
/ truth and reconciliation
incidence of suicide and suicide ideation
incidence of addictive & abusive behaviour
Economic Development
equitable distribution of household income
diversity of economic resources in the
community
equitable distribution of economic
opportunities/jobs in the community
equitable distribution of economic “power”
within families
labour force capacity, ie. levels of
educational attainment
incidence of welfare recipients
Environmental Development
sustainability
existing or emerging human risk
quality of water/sewage infrastructure
quality of housing stock
Community Development
basic community capacities
governance capacity
leadership
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Social Development
Desired outcomes
(protective factors)
Evidence-based strategies
high level of social capital at
community level
1.
2.
3.
low levels of suicide and
addictions
1.
2.
3.
high level of practice of traditional
spirituality
1.
2.
3.
high level of intergenerational
transfer of traditional language
1.
2.
3.
Applicable circumstances
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resilience
self-determination continuum
environmental development
community
healing / wellness
healing / wellness
community development
economic development
COMMUNITY
RESILIENCE AS A
BALANCE AMONG
COMPONENTS OF
THE MEDICINE
WHEEL
social development
self-determination continuum
resilience
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thank you / merci
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