By Nicole O’Reilly
Hamilton’s urban aboriginal population faces striking poverty, a disproportionately high rate of chronic diseases and more frequent visits to hospitals’ emergency departments, a new study says.
The magnitude of the results is shocking, even to aboriginal health advocates.
Those interviewed for the study reported higher instances of arthritis, hypertension, asthma and diabetes, and 10.6 per cent had made six or more emergency room visits in the previous two years.
A staggering 78 per cent earned less than $20,000 a year and 70 per cent lived in the lowest income neighbours in the city.
On the other end of the scale, only 3 per cent of study participants fell in the highest income bracket, where 15 per cent of Hamilton residents and 20 per cent of Ontarians fall.
The report is the first of its kind to study health data in Canada’s urban aboriginal population. It is being published in the online journal BMJ Open on Thursday.
“It’s quite surprising that while over 60 per cent of aboriginals in Ontario live in urban centres, we don’t have access … to health data sets,” said lead author Michelle Firestone, a St. Michael’s research associate with a PhD in public health.
She noted the lack of data is largely because of gaps in how health-care data is collected.
Firestone worked with the De dwa da dehs nye>s Aboriginal Health Centre in Hamilton to recruit 554 First Nations adults living in Hamilton. Clients of the centre went out into their community and recruited people who traditionally don’t access health care or participate in census collection.
The results were both expected and shocking for Constance McKnight, executive director of De dwa da dehs nye>s Aboriginal Health Centre.
“Although it was something we knew as a community, in black and white, (the numbers) were startling,” she said.
In particular, the poverty rate was much greater than she expected. She also pointed to diabetes rates at three times greater than Hamilton’s general population, which she said was also higher than she expected.
“I’m hoping that (the community) will recognize the disparity between the general population and the aboriginal people,” she said.
When aboriginal people end up in hospital, there is no form they can fill out identifying themselves as aboriginal, and so they can’t be referred to aboriginal services. She said there is a need for more culturally sensitive programs.
Firestone said her team chose Hamilton because of its proximity to reserves, large urban aboriginal population and health care infrastructure.
“It’s interesting because I think a lot of what we found are things that have been known in the community,” she said. “But I think some of the data or information that we found with poverty is pretty shocking.”
She believes they were able to reach community members not captured in traditional census data. They were interviewed between 2009 and 2010, however, Firestone said there are plans to do follow up research and also expand research to other communities.
The biggest barriers to health care — and in particular to preventive health care — identified include long wait lists, limits to transportation and costs.
Firestone said urban areas with high aboriginal populations need to do more to build aboriginal-specific services, services that are “culturally safe” and services that “support aboriginal self-determination.”
Health data from 554 urban-living First Nations in Hamilton:
• 78 per cent earned less than $20,000 a year
• 31 per cent reported having arthritis, compared to 20 per cent among Hamilton’s overall population
• 26 per cent reported having hypertension, compared to 20 per cent among Hamilton’s overall population
• 19 per cent reported having asthma, more than twice the rate of Hamilton’s overall population
• 16 per cent reported having diabetes, approximately three times the rate of Hamilton’s overall population
• 25 per cent reported being injured in the previous year
• 9 per cent reported being Hepatitis C positive
• 73 per cent reported an upper respiratory tract infection in the previous year
• 40 per cent felt their access to health care was fair or poor — on a scale of poor, fair, good or excellent.
Source: Unmasking Health Determinants and Health Outcomes for Urban First Nations Using Respondent Driven Sampling
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