Aboriginal Cultural Competency. Presented by Terri Stewart Aboriginal Cancer Care Coordinator

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1 Aboriginal Cultural Competency Presented by Terri Stewart Aboriginal Cancer Care Coordinator

2 Introductions Role of the Aboriginal Cancer Care Coordinator Definitions Demographics in BC Importance of Cultural Competency Canadian Study Cancer in Aboriginal Populations Characteristics of Aboriginal Cancer Patients Cultural Aspects to the Centre Indigenous Cultural Competency Training Questions? Overview

3 Role of the Aboriginal Cancer Care Coordinator Support patients and families from Aboriginal Communities Help patients and families navigate the health care system Promote increased health care provider cultural competence and bridge Western and First Nations approaches to health Work with an Aboriginal Cancer Care Advisory Committee to implement an Aboriginal Cancer Care Strategy which has four pillars: Early Detection Navigation Survivorship Cultural Competency

4 Definitions Aboriginal refers to First Nation, Metis or Inuit First Nation means First Nations People - The term is not a synonym for Aboriginal Peoples because it doesn't include Inuit or Métis. The term First Nations People generally applies to both Status and Non-Status Indians that are usually connected to an Indian Reserve or Indian Band Metis The word Métis is French for "mixed blood." The Constitution Act of 1982 recognizes Métis. Historically, the term Métis applied to the children of French fur traders and Cree women Inuit are the Aboriginal People of Arctic Canada. Inuit live primarily in the Northwest Territories, Nunavut and northern parts of Quebec and throughout most of Labrador

5 Demographics First Nations, Metis and Inuit in BC First Nations Metis Inuit

6 Demographics Where do Aboriginal people live? Off-reserve: 145,000 On-reserve: 51,000 Regions with the largest concentrations of the offreserve Aboriginal population: Thompson/Cariboo/Shuswap Northern Interior South Fraser Central Vancouver Island Northwest NHA 46% of offreserve Aboriginal population in BC

7 Demographics Distribution of Aboriginal Population by Health Authority 24.5% 12.5% 22.9% 20.7% 19.4%

8 Demographics of Northern BC Northern BC is comprised of over 54 First Nations communities. They make up 24.5% of the overall northern BC population, which is the highest proportion in British Columbia. Of the 24.5% (49,500 people), more than 55% live off reserve. Those who live on reserve are typically located in rural, remote and/or isolated communities that vary in size from 150 to 1,200 people. Source: Statistics Canada, 2006 Census data, provided by BC Stats; prepared by the Office of the Provincial Health Officer and Corporate Support, Planning and Legislation, Ministry of Healthy Living and Sport, 2008

9 Why is Cultural Competence and Safety Needed? Aboriginal people generally have poorer health status and health outcomes than other Canadians ex. Aboriginal people are more likely than other Canadians to live with chronic conditions and infectious diseases, and to die prematurely Health status is closely linked to determinants of health Aboriginal people are more likely to live in poverty, which is associated with: Inadequate Housing Lack of Transportation Unemployment Poor Health Emotional Stress Lower Education Levels

10 First Nations Perspective of Wellness

11 Cultural Competence..why is it needed? In December 2012 the Health Council published a report on Creating cultural safety for Aboriginal people in urban health care Aboriginal participants talked about the challenging balance between the Aboriginal holistic approach to health and the Western medical world view that is represented in the image by the turtle rattle in one hand and a medicine bottle in the other. The tears show the hurt that happens when someone is not treated with empathy, dignity, and respect. The roots of the tree refer to how we are all rooted in a common experience.

12 There may be identifiable cellular pathways by which racial discrimination amplifies cardiovascular and other agerelated disease risks.

13 2010 Canadian Study Aboriginal Peoples Dr. Cheryl Currie Faculty of Health Sciences, University of Lethbridge Research Questions: In the past 12 months, have you ever experienced discrimination, been prevented from doing something, or been hassled or made to feel inferior getting medical care because of your Aboriginal race, ethnicity or colour? Is there anything you would like to share about these experiences?

14 2010 Canadian Study Aboriginal Peoples Racial Discrimination experienced by Aboriginal Canadians: Societal High levels of racism

15 2010 Canadian Study Aboriginal Peoples Did you experience racism in any of these situations in the past 12 months? YES 1. In a public place 50% 2. In school 50% 3. In a store or restaurant 43% 4. Trying to find work 40% 5. Trying to find housing 38% 6. From the police 35% 7. At work 33% 8. Trying to get medical care 28% 9. At a bank 15%

16 Canadian Aboriginal Children Teachers don t treat me fairly I don t feel safe at school I don t feel part of my school I don t feel close to people at my school Non Aboriginal First Nations Children Inuit Children 15% 22% 32% 12% 20% 30% 15% 23% 23% 15% 25% 23% Sample size: 45,000 Canadian children Currie et al. (2012)

17 How does Racism impact Health

18 How does Canada Rank? UN Human Development Scale places Canada 6 th out of 174 Nations (2006) Does not account for economic and social wellbeing of its Aboriginal Population According to the information reported in the December 2004 report for the Commission on Human Rights, this population would be ranked 48 th among countries in the world. Our First Nation People live in a 3 rd world environment Joe Gallagher, Chief Executive Officer of FNHA

19 Cancer in Aboriginal Populations Cancer rates amongst Aboriginal people are still below non Aboriginal rates but increasing dramatically Aboriginal people have limited access to prevention and screening Treatment and diagnosis takes longer due to limited access to health care Social Determinants to Health contribute to increasing cancer rates Cancer is often diagnosed in the later stages, which leads to high mortality rates

20 For providers, cultural competency starts with the understanding that they should not make assumptions about people s culture Culturally competent staff know to ask questions about what their patients need, find out how to get it, and are willing to advocate for it They also recognize that Aboriginal communities have different beliefs, cultural practices, and languages, and that not all Aboriginal people are interested in following traditional ways Understanding Differences

21 Considerations of Aboriginal Patients in the Cancer Centre We have large families and when a person is sick or dying we don t like to leave a family member alone so expect a lot of people involved in care Elders often speak English as a second language; speak slowly or get assistance from a family member when helping Speak plainly and quietly Don t expect eye contact Talking about ill health isn t common Speaking to strangers isn t always easy there could be years of distrust

22 Spiritual Care Room

23 The Transformed Spiritual Care Room

24 Therapeutic Garden

25 Smudging Pavillion

26 Functional Organizational Chart First Nations Health Authority Board of Directors Internal Audit Chief Executive Officer Joe Gallagher FNHC Secretariat Harmony Johnson FNHDA Secretariat Christine Stahler Medical Health Officer Health Benefits John Mah Innovation and IM/IT, CIO Joseph Mendez A/Corporate Services and Transition Michael Hilson Community Health Services TBD Chief Financial Officer TBD Human Resources and Org Dev Elaine Wass Policy, Planning and Strategic Services Richard Jock

27 Indigenous Cultural Competency Training It is strongly recommended for PHSA employees to take a cultural competency training program such as the Provincial Health Services Authority Indigenous Cultural Competency online Program

28 Questions? Takla Lake First Nation 2008

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