Presentation to the CAOT

June 13, 2008

First Nations and Inuit Health Branch:Program Overview andCommunities in Crisis

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2007 Projected Registered Indian Population

131,91131,9100

8,3478,347

127,53127,5333

105,59105,5922

17,74317,743

72,56572,565178,08178,08

00

130,33130,3355

33,64533,645

Total: 805,750

Inuit Population (2007) is 48,700 across the four land claims regions: Inuvialuit,

Nunavut, Nunavik, and Nunatsiavut

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Demographic Profile

First Nations and

Inuit Population

805,750 Projected Registered Indian population (2007)

48,700 Inuit population (2007)

First Nations and Inuit population is 2.6% of Canada’s population

Projected Average Annual Growth Rate compared to

Canada overall

( 2001 to 2017)

First Nations: 2.86 times higher

Inuit: 3.3 times higher

Young Population 50% of First Nations are under 25 (Census 2006)

56% of Inuit are under 25 (Census 2006)

Communities 606 First Nations communities

90% of First Nations communities have a population of under 1000

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Health Status of First Nations and InuitGap in life expectancy Registered Indians: 5 years (females); 7 years (males)

Inuit: 11 years (females); 13 years (males)

Infant Mortality First Nations infant mortality rate has been declining but remains higher than the Canadian rate

HIV infections Aboriginal Peoples account for an estimated 7.5% of all existing HIV infections in Canada (2005)

Rate of Diabetes FN on reserve: 3.8 times higher than the general Canadian pop’n

Inuit: 47% lower than the general Canadian population

Leading Cause of Deaths in Children and Youths

Injury (primarily suicide, motor vehicle collisions and fires)

Rate of First Nations youth (10-19 years) suicide is 4.3X greater than for Canada in 2000; suicide rate for Inuit regions (1989-2003) is 8.3x higher than for Canada

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Mandate of the First Nations and Inuit Health Branch (FNIHB)

With respect to First Nations and Inuit:• improving health outcomes;• ensuring availability of, or access to, quality health

services; and• supporting greater control of the health system by

First Nations and Inuit.

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FNIHB: Major Program Areas

1. Health Protection and Public Health

2. Primary Care

3. Community Programs

4. Non Insured Health Benefits (NIHB) Program

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1. Health Protection and Public Health• Communicable Diseases:

– communicable disease control and surveillance

– HIV/AIDS; TB• Environmental Health:

– water quality monitoring on-reserve

– mould inspections in housing on-reserve

2. Primary Care: • Over 670 community health nurses;

• more than 70 nursing stations;

• 229 health centres,

• home care programs in 600+ communities

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3. Community Programs• Mental Health and Addictions:

– alcohol and drug prevention / promotion– alcohol and drug / youth solvent abuse in-patient treatment

centres– youth suicide prevention

• Chronic Disease and Injury Prevention– Aboriginal Diabetes Initiative– nutrition and physical activity promotion

• Children and Youth– Maternal/Child Health– Aboriginal Head Start– Prenatal supports– FASD

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Aboriginal Diabetes Initiative (ADI)

• diabetes among First Nations reaching epidemic proportions- for FN/I 3 to 5 times national rates

• in 2006 $190M invested over 5 years in community-based diabetes initiatives

• ADI objective: reduce type 2 diabetes in Aboriginal pop’n thru:- promotion- prevention- screening- treatment- delivered mostly by trained community-based workers

• >600 FN/I communities are funded for ADI projects• ~50 projects target Métis, off-reserve FNs and urban Inuit

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Payer of last resort for approx. 780,000 First Nation and Inuit beneficiaries for:

4. Non-Insured Health Benefits (NIHB)

drugsmedical supplies and equipmentdentalmedical transportationvision caremental health counselingprovincial health care premiums (BC, AB), co-insurance payment deductibles

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Draft Vision of Health Canada’s First Nation Communities in Crisis Initiative

Through strategies aimed at strengthening

community resilience, First Nation community

wellness is enhanced (thereby minimizing the

incidence of communities being at-risk or in crisis).

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Initial Plan of Action

data

collection analysis

Expert

Advisory

Committee

framework

consultation development

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Data Collection

• literature reviews • commissioned studies • lessons learned from formal evaluations:• watching brief on parallel initiatives• community profiles

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Community Resilience as

BALANCE among a set of categories of Determinants of Community

Health

self-determination

economic development

social development

environmental development

community development

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Examples of Determinants of Community Health

Self-Determinationcontrol over local services and programscultural continuitycolonialism/dependence on govt.nature of justice system/ restorative justice

Economic Developmentequitable distribution of household incomediversity of economic resources in the

communityequitable distribution of economic

opportunities/jobs in the communityequitable distribution of economic “power”

within familieslabour force capacity, ie. levels of

educational attainmentincidence of welfare recipients

Social Developmentsocial capital traditional spiritualityculture and languagecultural safetyovercoming the residential school

experience / truth and reconciliationincidence of suicide and suicide ideationincidence of addictive & abusive behaviour

Environmental Developmentsustainabilityexisting or emerging human riskquality of water/sewage infrastructurequality of housing stock

Community Developmentbasic community capacitiesgovernance capacityleadership

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Social Development

Desired outcomes

(protective factors)

Evidence-based strategies Applicable circumstances

high level of social capital at community level

1.

2.

3.

low levels of suicide and addictions

1.

2.

3.

high level of practice of traditional spirituality

1.

2.

3.

high level of intergenerational transfer of traditional language

1.

2.

3.

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community development

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COMMUNITY RESILIENCE AS A BALANCE AMONG COMPONENTS OF

THE MEDICINE WHEEL

community

self-determination continuum

self-determination continuum

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resilience

resilience

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thank you / merci