Health is a basic human right.
But across Canada, First Nations, Inuit and Métis Peoples face unacceptable health disparities.
Due to the legacy of colonialism and systemic racism, they are more likely than other Canadians to experience persistent poverty, food insecurity and barriers to housing and education — key contributors to chronic illnesses and other health challenges.
Seeking medical care is fraught. Indigenous Peoples face a dire lack of health services, particularly in remote communities. They also experience anti-Indigenous racism in health systems, a lack of cultural safety and acceptance of Indigenous health and healing models. And despite making up more than 4.5% of Canada’s population, less than 1% of the country’s physicians identify as Indigenous.
These issues were highlighted in the 2015 Truth and Reconciliation Commission report on the devastating legacy of Canada’s residential schools. Eight of the 94 calls to action are aimed at wide-ranging transformations to health care.
A meaningful apology
Trust comes before reconciliation. Building that trust starts with taking responsibility for the past.
In June 2023, the CMA announced our commitment to a formal apology to Indigenous Peoples, on behalf of the CMA and as the national voice of physicians.
Our hope is that honest reflection on both the past and the present can advance healing as well as meaningful change in health care and in the relationship between physicians, medical institutions and Indigenous Peoples.
The CMA will deliver a public apology with an associated ceremony in September 2024.
Indigenous Peoples guiding the change
The Canadian Medical Association (CMA) is committed to advancing reconciliation in health care — led by Indigenous Peoples. Improving health outcomes for Indigenous Peoples must start with Indigenous voices leading the way.
In June 2022, we convened a Guiding Circle with 16 First Nations, Inuit and Métis leaders, experts and knowledge-keepers. Together, they identified a new long-term goal that will serve as the North Star for the CMA’s work to ensure Indigenous Peoples:
Achieve measurable, on-going improvements in health and wellness, supported by a transformed health system that is free of racism and discrimination; upholds Indigenous Peoples’ right to self-determination; values, respects and holds safe space for Indigenous worldviews, medicine and healing practices; and provides equitable access to culturally safe, trauma-informed care for all First Nations, Inuit and Métis.
The Guiding Circle is an opportunity to address the historic devaluation, and in many cases outright dismissal, of Indigenous Peoples’ voices regarding their own health care.— Dr. Alika Lafontaine, CMA past president
This goal builds on the CMA’s allyship with Indigenous Peoples.
An Indigenous lens is critical to our work on health and climate change. The CMA’s contribution to Canada’s first National Adaptation Strategy includes a call to fund, promote and learn from Indigenous-led, land-based mitigation efforts.
The CMA advocates for better health policies affecting Indigenous Peoples. In May 2022, CMA President Dr. Alika Lafontaine appeared before a House of Commons committee to discuss the Non-Insured Health Benefits program, explaining how improving its administration and accessibility is key to addressing health inequities between Indigenous and non-Indigenous people in Canada.
The CMA Foundation continues to support the work of Indigenous-led organizations, most recently with a $2-million contribution to the Indigenous Peoples Resilience Fund and a $1-million grant to the Indigenous Physicians Association of Canada to support the sustainability and longevity of the organization and to develop a national mentorship program.
We have a teaching called Seven Generations, meaning I’m the product of seven generations and my impact will be felt forward for seven generations. So we have a responsibility to the younger generations that they not only survive medical school, but thrive throughout their medical careers.— Dr. Nel Wieman, Acting Chief Medical Officer of the First Nations Health Authority
The CMA also continues to build awareness of the impact of colonization on Indigenous health through training for employees, and through public-facing projects such as the film The Unforgotten.
Building relationships with Indigenous partners
The CMA is in the process of building meaningful relationships with Indigenous Peoples and Indigenous-led organizations and initiatives. In order to incorporate Indigenous perspectives in all of its work, the CMA also solicits expertise from Indigenous organizations such as NVision, an Indigenous-owned and led consultancy group.
I am pleased to hear that the CMA is looking deeply at their history and also the role that physicians have played in the history of Canada. Recognition of the truths of the traumas inflicted, as well as the ongoing harm and racism occurring today in health care, will be essential if we are to support healing through partnered action rooted in a common understanding.— Tammy White Quills-Knife, CMA Patient Voice
What physicians can do to help
Collaboration with physicians and learners of all ages, stages and specialties, from rural and remote communities as well as big cities, is essential for a better way forward.