B.C. Deputy Provincial Health Officer for Indigenous Health Dr. Daniele Behn Smith, from left to right, First Nations Health Authority Chief Medical Officer Dr. Cornelia Wieman and B.C. Provincial Health Officer Dr. Bonnie Henry stand during a song before a news conference, in Vancouver, on Aug. 21.DARRYL DYCK/The Canadian Press
The number is horrifying – and it represents a failure in Canada’s work toward reconciliation: Life expectancy among status First Nations people in British Columbia has plunged by six years.
The stark revelation is part of new research from First Nations Health Authority in B.C., an organization established 15 years ago. It is the only one of its kind in Canada. Three years ago, in a partnership with the B.C. government, the First Nations Health Authority published an initial health and wellness report covering 22 indicators, from life expectancy and infant mortality to education and Indigenous people working in health care. That report launched a decade-long project, to regularly gather data and – crucially – set goals for improvement.
Canadians are becoming generally aware about the long struggles of Indigenous people in Canada, from several centuries of colonization through the brutal history of residential schools. Voting in federal elections, for one small example, was generally prohibited until 1960. But what is lacking is a more specific understanding of the current and evolving challenges, across a range of issues, faced by Indigenous people and communities across the country.
Statistics Canada produces solid data, as have reports from the First Nations Information Governance Centre and information assembled by the federal government. But the work delivered by the First Nations Health Authority in B.C. highlights what more can be done, starting with timely data. It puts a finger on the problem and points a way to a better future. The work shines a light on a gap in reconciliation, ahead of the National Day for Truth and Reconciliation on Sept. 30.
The most prominent result in the latest report from the First Nations Health Authority, released in late August, is deeply negative. Indigenous life expectancy at birth between 2017 and 2021 plummeted to 67.2 years from 73.3 years. The main reason is deaths from drug overdoses. Pandemic deaths were also a factor. Life expectancy for people in B.C., excluding status First Nations people, fell slightly over the same period to 82.5 years from 82.7, the report showed. An already large gap grew much larger.
Life expectancy among status First Nations people in B.C. had been rising until 2013, when it hit 75.7 years. It thereafter started to slip, because of drug overdoses. The original 2021 Health Authority report set a goal to get back to 74.9 years by 2027, first eclipsed in 2010. The worsening drug crisis and pandemic have upended that goal.
On other factors, there is progress. The rate of Indigenous young people finishing high school has climbed to 74.2 per cent from 69.9 per cent. The goal is 83.3 per cent. The general B.C. high-school graduation rate is 93.9 per cent. The infant mortality rate has also improved to 4.6 per 1,000 live births in the latest data, down from 5.3. The goal is 4.1. The general infant mortality rate in B.C. is 3.3.
Part of the recent impetus for this research was a 2020 report from the B.C. government that detailed systemic racism as a barrier to access to health care for First Nations people in the province. Such problems have existed across the country for too long. In an important step on Sept. 18, the Canadian Medical Association – which represents doctors – plans to apologize for “its role and the role of the medical profession in the harms caused to Indigenous Peoples in the health system, both through action and inaction.” The ceremony is in Victoria. Taking such steps is valuable but can only really resonate if they are a springboard for action. The process has been led by Alika Lafontaine, an anesthesiologist from Alberta who in 2022 became the first Indigenous president of the doctors’ association.
The First Nations Health Authority research also considered the medical system itself. One factor it is tracking is the number of Indigenous people working in health care. The new data reported 59 First Nations physicians, 0.39 per cent of a total of 15,246 doctors. The goal for 2027 is to reach 0.64 per cent, double that of the first report. The new report also included initial data for nurses (First Nations are 1.54 per cent of the total) and midwives (1.72 per cent of the total).
The work of reconciliation is a long process, after hundreds of years of pain inflicted on Indigenous communities. The efforts in B.C. should be emulated across the country. How to solve problems starts with understanding how we’re failing.