Anti-Indigenous Racism

One study found that (2001) racial discrimination and negative stereotypes are common experiences among First Nations women accessing health care services. Many First Nations women express that their health concerns are not taken seriously by HCPs or even dismissed entirely. Some of the women shared that their HCPs assume there is nothing wrong with them, and in some cases, First Nations women wait until their condition is severe before seeking care (Browne & Fiske, 2001). In a scoping review of Indigenous women’s perspectives of heart health and wellbeing, “some women described a fear of putting oneself first as a woman and of having one’s children taken away by social workers if they were to put themselves first” (Gomes, Hart & Downey, 2023, p.16) Resulting in social services/child welfare agencies being called to take the child in better and safer care.

With the intergenerational trauma of residential schools and experiences of sexual or physical abuse, some First Nations women feel uncomfortable and vulnerable to physical examinations especially when they are conducted by male health providers (Browne & Fiske, 2001). Lastly, First Nations women feel their life and social circumstances are ignored and not taken into consideration in terms of policies enacted in many healthcare settings. For instance, if they are late or missed an appointment due to external reasons, First Nations women are often unable to afford late fees, given that some live in poverty and have a variety of competing financial commitments (Browne & Fiske, 2001).

According to a Pauktuutit Inuit Women of Canada (2021) report, the Canadian government has failed to meet the unique health needs of Inuit people, specifically Inuit women. Inuit women continuously encounter inequities to access and delivery of health-related services in their communities. Inuit women face systemic discrimination with limited access and culturally relevant health care treatment.

Many times, Inuit women are forced to travel lengthy distances to access health care as there is limited or non-existent services in their community. Inuit women are leaving behind family and loved ones, and can become isolated resulting in feeling anxious, alone and experiencing trauma. Similarly, there is a language barrier, as English is considered a second language to many Inuit women. Many non-Indigenous health care practitioners are not familiar with Inuit culture nor speak Inuktitut or may require language translation, which creates a disconnection between patients and HCPs. This could lead to a misdiagnosis or inappropriate treatment (Pauktuutit Inuit Women of Canada, 2021).

In Monchalin, Smylie and Nowgesic’s (2020) Urban Métis study of Métis Women’s experiences with accessing health services, they found that urban Métis women also experience racial discrimination when accessing both non-Indigenous and Indigenous specific health services. By withholding information about their Métis ancestry, many women were able to avoid discrimination by HCPs. However, for those that did identify themselves as Métis and s they encountered negative stereotypes such as policing, or being denied access to medication. However, some Métis women also expressed feeling guilty of presenting as ‘white passing’ in health services to avoid discrimination. Métis women also receive discrimination and face lateral violence when accessing Indigenous specific health care as reception staff are skeptical of their Indigenous ethnicity (Monchalin, Smylie, & Nowgesic, 2020).

Please watch the following video clip, Indigenous knowledge to close gaps in Indigenous health where Marcia Anderson-DeCoteau engages in the conversation of racism, health inequities experiences faced by Indigenous people, and particularly Indigenous women Indigenous Knowledge to Close Gaps in Indigenous Health | Marcia Anderson-DeCoteau | TEDxUManitoba – YouTube. If you would like to watch the whole video clip, you can find this at the end of the module in the resource section.

These experiences resonate with the ongoing impacts of colonialism instilled in the Western biomedical health care model. There are different forms of racism which are embedded in the Western health care system, for example there is epistemic racism that positions certain knowledge as superior to another (Kitching et al., 2020). This can be seen in the Western biomedical perspective as evidence-based medicine treatments are preferred over Indigenous healing and medicines. Within the scientific and medical community, HCP’s rely on statistically proven test trials of treatment options for what is best for patients.

Through this Western lens, the validity of positive results of treatment outcomes outweigh the uncertainty and unknown effects of traditional medicines. HCP’s are unfamiliar with the traditional elements to treatment options for Indigenous patients and ultimately rely on Western medical perspectives when prescribing medication/treatment. Through this perspective, Western medicine is highly regarded and respected as an approach to treatment compared to Indigenous medicine (Anderson-DeCoteau, 2016). Through key informant interviews with Indigenous women during the Mending Broken Hearts project, many shared the feeling of being pressured to use western medications prescribed by their HCP. Some of the Indigenous women interviewed shared that they were reluctant to disclose their use of traditional medicines out of fear their HCP would reject the continuation of use.

Another form of racism is internalized racism in which an individual accepts and internalizes perspectives of others as inferior and less than (Kitching et al., 2020). Common misperceptions of Indigenous patients include when they are assumed to be challenging to deal with and that their behaviour is disruptive.

To hear more about the conversation regarding the hierarchy perspective between Western and Indigenous health, please listen to a short clip (Western/Indigenous view 11:07 to 12:34 OR Biomedical perspective in health 23:21 to 25:19) from the Raw Talk podcast episode, #53 Indigenous Perspectives on Health | Raw Talk Podcast. If you would like to listen to the whole podcast episode, you can find this at the end of the module in the resource section.