SYSTEMIC MEDICAL RACISM
Canada’s Indigenous communities at greater risk post-surgery, study showsResearch published on Monday showed that Indigenous peoples had a 30 per cent increased risk of death after surgery and higher rates of complications, including post-operative infection, pneumonia and hospital readmission.
Saba Aziz
GLOBAL NEWS
GLOBAL NEWS
© Lucas Oleniuk/Toronto Star via Getty Images TORONTO, ONTARIO - APRIL 9: Women's College Hospital is revolutionizing the way knee-replacement surgery is done. It is starting to provide the procedure as an ambulatory service. Patients can go home…
Canada’s Indigenous communities are at a greater risk of death and health complications after undergoing surgery compared to other populations, according to a new study highlighting disparities in the country’s healthcare system.
Research published in the Canadian Medical Association Journal (CMAJ) on Monday showed that Indigenous peoples had a 30 per cent increased risk of death after surgery and higher rates of complications, including post-operative infection, pneumonia and hospital readmission.
Read more: Indigenous communities grapple with PPE shortages
They were also less likely to undergo life-saving procedures, including cardiac surgery, transplant and cesarean delivery, the review of 28 different studies showed. Indigenous peoples also experienced longer wait times by three-to-seven months for kidney transplants.
“This research illuminates inequities that are built into our surgical system,” said Dr. Jason McVicar, a Métis anesthesiologist at the Ottawa Hospital, and lead author of the study.
The research included 1.9 million patients, 10 per cent of whom were Indigenous.
Video: Red Dress Day in Edmonton honours Canada’s missing and murdered Indigenous people
These findings are consistent with inequities in surgical outcomes for Indigenous peoples in other high-income countries, the authors noted.
A lack of access to good quality healthcare and nutrition, as well as poor housing conditions means many are at an advanced stage of disease when they do undergo surgery in Canada, said Dr. Donna May Kimmaliardjuk, Canada’s first Inuk heart surgeon. This makes procedures more difficult and increases the likelihood of complications, she told Global News.
Distrust of the healthcare system is why members of the Indigenous communities are even hesitant to seek medical attention, Kimmaliardjuk said.
“It's important to provide equitable care to all patients, regardless of where you live," she added.
“But if you provide better care and better outcomes to the fastest-growing population, it can have not only good outcomes for the general health, but perhaps it can save on costs as well for the government.”
In a high-profile case last September, an Indigenous woman livestreamed video from a hospital in Joliette, Que., as female staff were heard insulting and mocking her.
Joyce Echaquan, 37, an Atikamekw mother of seven, was taken to hospital by ambulance with stomach pains on Sept. 26. She died there on Sept. 28, not long after posting the video.
Video: Coroner’s inquest begins into Joyce Echaquan’s death
“We see the difference. Sometimes it's unbelievably egregious and right in our face,” said Dr. Nadine Caron, First Nations Health Authority Chair (FNHA) in Cancer and Wellness at the University of British Columbia (UBC).
Indigenous peoples have also been disproportionately affected by the COVID-19 pandemic.
Read more: Ontario’s urban Indigenous communities, dialysis patients now have shorter COVID-19 vaccine intervals
As of May 13, 28,319 cases of COVID-19 had been confirmed on First Nations reserves, while 328 people had died from the disease, according to Indigenous Services Canada (ISC).
The rate of reported active cases among First Nations people living on reserves is currently 65 per cent of the rate for the general Canadian population.
McVicar said COVID-19 has exposed social disparities in Canada. He stressed the need for policymakers to take notice and action.
“We need to make sure that ... every step along the way that we are providing care that is culturally competent and is putting the needs of the patient and the community ahead of the conveniences of the healthcare system.”
-- with files from the Canadian Press.
Canada’s Indigenous communities are at a greater risk of death and health complications after undergoing surgery compared to other populations, according to a new study highlighting disparities in the country’s healthcare system.
Research published in the Canadian Medical Association Journal (CMAJ) on Monday showed that Indigenous peoples had a 30 per cent increased risk of death after surgery and higher rates of complications, including post-operative infection, pneumonia and hospital readmission.
Read more: Indigenous communities grapple with PPE shortages
They were also less likely to undergo life-saving procedures, including cardiac surgery, transplant and cesarean delivery, the review of 28 different studies showed. Indigenous peoples also experienced longer wait times by three-to-seven months for kidney transplants.
“This research illuminates inequities that are built into our surgical system,” said Dr. Jason McVicar, a Métis anesthesiologist at the Ottawa Hospital, and lead author of the study.
The research included 1.9 million patients, 10 per cent of whom were Indigenous.
Video: Red Dress Day in Edmonton honours Canada’s missing and murdered Indigenous people
These findings are consistent with inequities in surgical outcomes for Indigenous peoples in other high-income countries, the authors noted.
A lack of access to good quality healthcare and nutrition, as well as poor housing conditions means many are at an advanced stage of disease when they do undergo surgery in Canada, said Dr. Donna May Kimmaliardjuk, Canada’s first Inuk heart surgeon. This makes procedures more difficult and increases the likelihood of complications, she told Global News.
Distrust of the healthcare system is why members of the Indigenous communities are even hesitant to seek medical attention, Kimmaliardjuk said.
“It's important to provide equitable care to all patients, regardless of where you live," she added.
“But if you provide better care and better outcomes to the fastest-growing population, it can have not only good outcomes for the general health, but perhaps it can save on costs as well for the government.”
In a high-profile case last September, an Indigenous woman livestreamed video from a hospital in Joliette, Que., as female staff were heard insulting and mocking her.
Joyce Echaquan, 37, an Atikamekw mother of seven, was taken to hospital by ambulance with stomach pains on Sept. 26. She died there on Sept. 28, not long after posting the video.
Video: Coroner’s inquest begins into Joyce Echaquan’s death
“We see the difference. Sometimes it's unbelievably egregious and right in our face,” said Dr. Nadine Caron, First Nations Health Authority Chair (FNHA) in Cancer and Wellness at the University of British Columbia (UBC).
Indigenous peoples have also been disproportionately affected by the COVID-19 pandemic.
Read more: Ontario’s urban Indigenous communities, dialysis patients now have shorter COVID-19 vaccine intervals
As of May 13, 28,319 cases of COVID-19 had been confirmed on First Nations reserves, while 328 people had died from the disease, according to Indigenous Services Canada (ISC).
The rate of reported active cases among First Nations people living on reserves is currently 65 per cent of the rate for the general Canadian population.
McVicar said COVID-19 has exposed social disparities in Canada. He stressed the need for policymakers to take notice and action.
“We need to make sure that ... every step along the way that we are providing care that is culturally competent and is putting the needs of the patient and the community ahead of the conveniences of the healthcare system.”
-- with files from the Canadian Press.
Indigenous patients face higher risk of death post-surgery, study suggests
"The Canadian health-care system is currently getting the outcomes it is designed to get. It is based on a highly colonial structure."
"If we are honest about transformative change in terms of improving outcomes for First Nations, Inuit and Métis people, then we need to address change at every level in the system."
© Provided by The Canadian Press
Indigenous surgery patients are nearly a third more likely to die after their procedures than other populations in Canada and face higher risks of complications, new research suggests as doctors warn these inequities could worsen with the COVID-19 crisis.
The Canadian Medical Association Journal published a systemic review on Monday consisting of 28 separate studies. The research involved roughly 1.9 million participants — about 10 per cent of whom identified as Indigenous — to assess the surgical outcomes for Indigenous patients in Canada across a range of procedures.
Lead author Dr. Jason McVicar said the findings underscore the need for the First Nations, Inuit and Métis communities to lead a data-informed overhaul of health care, particularly as the pandemic raises concerns that Indigenous patients will fall behind in the mounting backlog of surgeries.
"This study tells Canadians two things: that we need better data, and the data that we have tells us that we need to do better," said McVicar, a Métis anesthesiologist at The Ottawa Hospital.
Researchers found Indigenous Peoples face a 30 per cent higher death rate after surgery compared to non-Indigenous patients, according to data from four studies with a combined 7,135 participants.
The authors also analyzed literature indicating that Indigenous patients suffered higher rates of surgical complications, including post-operative infections and readmissions to hospital.
The data also showed Indigenous patients were less likely to undergo surgeries aimed at improving quality of life, such as joint replacements, as well as potentially life-saving procedures including cardiac surgery, transplants and caesarean sections.
McVicar said the findings were limited by the scant and poor quality research available, noting that none of the data specifically pertained to Inuit and Métis communities.
He called for a national strategy to measure and address the disparities in surgical outcomes for Indigenous Peoples. But for such an effort to work, McVicar argued it should be led by the First Nations, Inuit and Métis health workers, researchers and organizers who are best equipped to meet the needs of their communities.
Indigenous surgery patients are nearly a third more likely to die after their procedures than other populations in Canada and face higher risks of complications, new research suggests as doctors warn these inequities could worsen with the COVID-19 crisis.
The Canadian Medical Association Journal published a systemic review on Monday consisting of 28 separate studies. The research involved roughly 1.9 million participants — about 10 per cent of whom identified as Indigenous — to assess the surgical outcomes for Indigenous patients in Canada across a range of procedures.
Lead author Dr. Jason McVicar said the findings underscore the need for the First Nations, Inuit and Métis communities to lead a data-informed overhaul of health care, particularly as the pandemic raises concerns that Indigenous patients will fall behind in the mounting backlog of surgeries.
"This study tells Canadians two things: that we need better data, and the data that we have tells us that we need to do better," said McVicar, a Métis anesthesiologist at The Ottawa Hospital.
Researchers found Indigenous Peoples face a 30 per cent higher death rate after surgery compared to non-Indigenous patients, according to data from four studies with a combined 7,135 participants.
The authors also analyzed literature indicating that Indigenous patients suffered higher rates of surgical complications, including post-operative infections and readmissions to hospital.
The data also showed Indigenous patients were less likely to undergo surgeries aimed at improving quality of life, such as joint replacements, as well as potentially life-saving procedures including cardiac surgery, transplants and caesarean sections.
McVicar said the findings were limited by the scant and poor quality research available, noting that none of the data specifically pertained to Inuit and Métis communities.
He called for a national strategy to measure and address the disparities in surgical outcomes for Indigenous Peoples. But for such an effort to work, McVicar argued it should be led by the First Nations, Inuit and Métis health workers, researchers and organizers who are best equipped to meet the needs of their communities.
"The Canadian health-care system is currently getting the outcomes it is designed to get. It is based on a highly colonial structure," he said. "If we are honest about transformative change in terms of improving outcomes for First Nations, Inuit and Métis people, then we need to address change at every level in the system."
The issue is all the more urgent in light of the COVID-19 pandemic's disproportionate impact on Indigenous communities, said McVicar, adding such inequities could ripple through the medical system for years to come if Indigenous patients aren't prioritized for treatment amid a growing backlog of postponed surgeries. In Ontario alone, that number stretches into the hundreds of thousands.
"When we go back to address that backlog, we know that those with the political agency to strongly advocate for themselves will inevitably get to the front of the line," McVicar said. "This again will disproportionately impact First Nations, Inuit and Métis communities."
The research comes amid a national reckoning over anti-Indigenous racism in the health-care system after Joyce Echaquan, a 37-year-old Atikamekw woman, died last September in a Joliette, Que., hospital after filming staff making derogatory comments about her.
The widely shared video prompted the federal government to host a two-day summit to discuss systemic racism against Indigenous Peoples in health care. A Quebec coroner's inquest into Echaquan's death got underway last week.
Dr. Alika Lafontaine, an Indigenous health advocate and incoming president of the Canadian Medical Association, said Monday's research represents the tip of the iceberg in unpacking the layers of discrimination against Indigenous patients.
"The pandemic has revealed a lot of things that those of us who treat high proportions of Indigenous patients in our practices, or are Indigenous ourselves, have appreciated for years," said Lafontaine, an anesthesiologist in Grande Prairie, Alta.
"It's a big problem that we haven't spent a lot of time studying, and even less time trying to solve."
As the COVID-19 crisis has laid bare the life-threatening consequences of medical racism, Lafontaine said it has also provided an opportunity to implement the sweeping changes needed to ensure all Canadians have access to first-class health care.
"This research becomes so much more important, because it identifies the people and the populations that we haven't designed the system around, so we can build a better system after," he said. "That's the real promise, I think, of a post-pandemic health-care system."
This report by The Canadian Press was first published May 17, 2021.
Adina Bresge, The Canadian Press
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