There are many reminders around us that reinforces the disparities in regard to society's most vulnerable populations. One of the most poignant examples is the inequalities between Indigenous and non- culturally sensitive healthcare. Accessibility can be understood as “the availability of good health services within reasonable reach of those who need them and of opening hours, appointment systems and other aspects of service organization and delivery that allow people to obtain the services when they need them” (Evans, Hsu, & Boerma, 2103, p. 546).
Race is a strong indicator and predictor of poor health outcomes within the community and no more so than with Canada’s Indigenous populations. The social determinants of health such as low income, access to healthy food, housing that is safe, stable and accessibility to a good education delay in receiving healthcare, are all linked to disparities in accessing adequate health services. Indigenous people in Canada in general, are "particularly impacted by poor health outcomes resulting from social inequities "(The Truth and Reconciliation Commission of Canada, 2015). An example of this can be seen in the City of Hamilton.
The City of Hamilton is located in southern Ontario on what was traditionally Haudenosaunee (Iroquoian) territory and is near two First Nations reserves: Six Nations of the Grand River and Mississaugas of the New Credit. According to the 2006 Census. The total Aboriginal population in Hamilton was 13 735 people, comprising 2.8% of the total population of the city. (Firestone et al., 2014) The City of Hamilton consists of four tertiary care hospitals. One being McMaster Children’s hospital (MCH). MCH is located in the West end of Hamilton which is a relatively affluent area of the city. Many low-income families and single parents reside in the north and east end of the city. In some cases, a minimum of 2 to 3 buses are required to get to MCH. If the family is fortunate enough to have a vehicle, then they also need to contend with a $20.00 parking fee. Many of the First nations people in Hamilton fall into the low-income bracket and therefore reside in the centre core or north end area of the City. There are many barriers such as long wait times and the inability to afford healthcare as having an impact on their health. (Smylie et al., 2011). Where there may not be a direct bias in the location of MCH it does most definitely impact access to care for low-income indigenous families within the city. Of the indigenous people residing in Hamilton “78 percent earned less than $20,000 a year and 70 per cent lived in the lowest income neighborhoods in the city”. (Poverty and Chronic Disease Plaguing Hamilton’s Aboriginal Population, n.d.)
As part of Hamilton Health Sciences twenty-year plan there will be a relocation of MCH to the Hamilton General Hospital (HGH) campus. The HGH campus is located in the downtown core and will be more accessible to those low-income and indigenous families. In the meantime, these families will be required to travel to MCH site for, not only child health care services, but also women’s health care. Although there is still some women’s health and pediatric services offered at the St. Josephs site on Charlton Ave in the downtown core, the MCH site remains the predominant care facility for many women and children who require outpatients’ clinics, pediatric surgery and high risk maternal newborn care.
Access to health Profile-of-Hamilton's-Aboriginal-residents Nations, Inuit and Métis health [PDF]. (2019). https://www.nccih.ca/docs/determinants/FS-AccessHealthServicesSDOH-2019-EN.pdf
Evans, D. B., Hsu, J., & Boerma, T. (2013). Universal health coverage and universal access. Bulletin of the World Health Organization, 91(8), 546–546A. https://doi.org/10.2471/blt.13.125450
Firestone, M., Smylie, J., Maracle, S., Spiller, M., & O'Campo, P. (2014). Unmasking health determinants and health outcomes for urban first nations using respondent-driven sampling. BMJ Open, 4(7), 1–8. https://doi.org/10.1136/bmjopen-2014-004978
Poverty and chronic disease plaguing Hamilton’s Aboriginal population. (n.d.). De dwa da dehs nye>s Aboriginal Health Centre. https://aboriginalhealthcentre.com/poverty-and-chronic-disease-plaguing-hamiltons-aboriginal-population/
Mayo, S. (2015). Profile-of-Hamiltons-Aboriginal-residents [PDF]. http://www.sprc.hamilton.on.ca/wp-content/uploads/2015/04/Profile-of-Hamiltons-Aboriginal-Residents.pdf
Smylie, J., Fell, D., & Ohlsson, A. (2010). A review of Aboriginal infant mortality rates in Canada: Striking and persistent aboriginal/non-aboriginal inequities. Canadian Journal of Public Health, 101(2), 143–148. https://doi.org/10.1007/bf03404361
Truth and reconciliation commission of Canada. (n.d.). https://www.rcaanc-cirnac.gc.ca/eng/1450124405592/1529106060525
Wright, A. L., Jack, S. M., Ballantyne, M., Gabel, C., Bomberry, R., & Wahoush, O. (2019). Indigenous mothers’ experiences of using primary care in Hamilton, Ontario, for their infants. International Journal of Qualitative Studies on Health and Well-being, 14(1), 1600940. https://doi.org/10.1080/17482631.2019.1600940
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