Canada Research Chair in Aboriginal Health

and Wellness comments on Racism in Health
March 2, 2015
BRANDON, MB – With respect to current discussions around racism experienced by Indigenous
peoples accessing health care in Canada, Dr. Yvonne Boyer, who is Brandon University’s Canada
Research Chair in Aboriginal Health and Wellness, offers the following commentary:
The recent report authored by Dr. Janet Smylie and Dr. Billie Allen, “First Peoples, Second Class
Treatment: The role of racism in the health and well-being of Indigenous peoples in Canada” is
an important reminder of the problems that many Indigenous people face when accessing health
care in Canada. Ironically, not only do Aboriginal people hold equality and the right to life rights
under the Charter of Rights and Freedoms, but they also hold constitutionally protected rights to
Aboriginal and treaty rights through Section 35 of the Constitution Act, 1982. First Nations,
Metis and Inuit are the only people in Canada to hold these remarkable rights. Section 35
recognizes the inherent or Aboriginal rights and Treaty rights (as legally binding agreements
between two sovereign nations). These documents affirm the right to health and health care as an
important part of Canada’s agreement with the First Peoples. But yet, we hear of Indigenous
people in Canada dying in emergency rooms and being ignored by some health care
professionals who assume the Aboriginal clients seeking help are homeless and looking for a
“free ride” in their emergency room.
Such incidences, rather than reinforcing the role of care that grounds the health care system and
its providers, perpetuate the injustices suffered by the most vulnerable of the vulnerable – the
homeless and others who are sexually exploited or involved in sex work on the streets. Research
has shown time and again that historical and complex socioeconomic issues for many Indigenous
people in Canada have resulted from racism, including the legacy of physical and sexual abuse
experienced in the residential school system, dispossession of identity and culture via the Indian
Act, violence, and the marginalization of Indigenous women. These racial attacks on cultures and
nations of Peoples undermine cultural knowledge, attack self-esteem, promote poverty, and
create a heightened vulnerability to being trafficked as human beings. Experts, who have lived
the experiences and were canvassed for the 2014 Public Safety Canada Report, “Trafficking of
Aboriginal Women and Girls,” were clear that racist experiences were a strong element, if not the
overarching theme, in the experiences of vulnerable women when accessing health care. Stories
told and retold were experiences of racism, including routinely asked questions such as: “How
much have you had to drink?” “What drugs have you done?” and “You are a prostitute, are you
not?” These vulnerable women told of the horrors of being trafficked and raped and having to
endure the smack of racism from cold responses, racial questioning and refusal of care. Some of
the women learned to rely upon a trusted advocate to ensure the violence they endured would be
taken seriously by the health care system. There was a perception that the nursing staff hoped the

woman would just go away. Indeed, women do often get tired of waiting, go back to a shelter
and do not return to the hospital and the rape goes unreported.
In Ottawa, Dr. Jeff Turnbull, an expert in inner city health, has designed an approach that will
offer better health outcomes for the homeless by having hospital-based health care provided
directly to Ottawa’s five shelters. Dr. Janet Smylie emphasizes that cultural competency is
critical when delivering health care to the Aboriginal population and has proposed that a standalone Ambulatory Health Care clinic be developed in centres with a high Aboriginal population.
The Public Safety Report heard that “street nurses, doctors or nurse practitioners” would help
ease the health gap for the street sex workers.
Multigenerational racism experienced by Indigenous peoples in the health care system has been
well documented in the stories of the vulnerable and captured by many in academic literature and
numerous inquiries and studies. There are no easy answers, but the first step is recognizing that
there are problems that have solutions. The solutions lie in recognizing that a process must be
implemented to start addressing some of the inequities in the health care. Concentrated efforts at
reform through a constitutional legal lens coupled with health policy changes and cultural
awareness training for healthcare workers may be a logical start to begin to address these issues.
Dr. Yvonne Boyer has published extensively on the topics of First Nations, Métis and Inuit and
the intersect between health and the law as well as Aboriginal and treaty rights and their
constitutional protections. A former Canadian Human Rights Commissioner and an appointed
Member of the Federation of Saskatchewan Indian Nations, First Nations Appeals Tribunal, Dr.
Boyer is a member of the Law Society of Upper Canada and the Law Society of Saskatchewan.
She has held the Canada Research Chair in Aboriginal Health and Wellness at Brandon
University since January, 2014.