Challenges

Chronic diseases disproportionately affect Indigenous people in Saskatchewan both on- and off- reserve.  A lack of equitable access to healthcare contributes to Indigenous people having high rates of HIV, hepatitis C, diabetes and other chronic diseases, which are major contributors to reduced quality of life, loss of productivity, premature death, and increased hospitalization and health care costs. Delayed access to diagnostic tests and treatment leads to increased morbidity, mortality and increased costs. 

Despite the serious need, equitable access to health care for those most affected by chronic and communicable disease is lacking. This exacerbates epidemics, especially for individuals who are living with chronic poverty, and who struggle with addictions and mental health challenges. 

Over the last decade, Saskatchewan has witnessed the highest rate of HIV in Canada and has one of the country’s highest rates of hepatitis C.  Indigenous peoples in Saskatchewan have rates six to seven times above the national average. While the Saskatchewan HIV Strategy (2010-2014) was a good step to improvement, sustainable resources at the right level have not been realigned to effectively advance this strategy to see improved outcomes. Information about the Saskatchewan HIV Strategy (2010-2014) is available at https://skhiv.ca/wp-content/uploads/2017/11/SKHIV-Strategy-2010-2014.pdf     

The Indigenous population also has a three to five times greater risk of developing diabetes than the general population. Diabetes complications are associated with premature death. Diabetes has significant negative impacts, including reducing lifespan and increasing hospitalization due to cardiovascular disease, end-stage renal disease and non-traumatic lower limb amputation.  Diabetes contributes to 30% of strokes, 40% of heart attacks, 50% of kidney failure requiring dialysis, 70% of non-traumatic lower limb amputations and the leading cause of vision loss. Information about Diabetes Canada – Diabetes in Saskatchewan is available at https://www.diabetes.ca/DiabetesCanadaWebsite/media/About-Diabetes/Diabetes%20Charter/2018-Backgrounder-Saskatchewan_JK_AB-edited-13-March-2018.pdf

There is a tremendous need for comprehensive, culturally safe, specialized care for Indigenous individuals with complex health needs and multiple comorbidities.  For Indigenous people, culture is the key to health and healing. We recognize that when the healthcare received is sensitive to, draws upon, and is respectful of culture, health outcomes are drastically improved.  However, there is currently a complex and historical stigma that Indigenous people face within the current health care system.  In some cases, poor treatment may be the result of systemic, institutional or individual racism; in other instances, its simply due to misunderstanding, miscommunication and a general lack of awareness of, and respect for, Indigenous peoples, their histories, traditions, values and belief systems.  (FSIN, 2013)

Clearly the need for culturally responsive care is necessary to address health disparities between cultures. Indigenous people require care that responds to their own cultural and healing belief system in order to have a more integrated approach to healing in complex situations.