Acknowledging my Mother, Grandmother, G Mother, GG Grandmother, Daughter and Sister
Racism as a Social Determinant
of Indigenous Peoples’ Health
Charlotte Reading
Centre for Aboriginal Health Research
University of Victoria
Racism
1. A belief or doctrine that inherent differences among
the various human races determine cultural or
individual achievement, usually involving the idea
that one's own race is superior and has the right to
rule others.
1.
A policy, system of government, etc., based upon or
fostering such a doctrine; discrimination.
1. Hatred or intolerance of another race or other races.
Social Determinants of Health
Superiority
Discrimination
Hatred
Forms of Racism
• Structural
• Stigma and Stereotyping
• Social Exclusion
• Interpersonal
Structural - The Indian Act
• Defining identity
• Delegating land
• Controlling systems that influence
health (economic development, education,
health care, etc.)
Structural - Education
• Does not acknowledge the history or
contribution of Aboriginal peoples
• Creates low expectations for Aboriginal
students
• Inequitable distribution of resources to
facilitate learning for Aboriginal students
Social Exclusion
• Disconnection through legal sanctions,
institutional mechanisms or systemic
discrimination
• Exclusion from social goods: failure of society to
provide for needs such as housing and sanctions to
deter discrimination.
• Exclusion from social production: denial of
opportunities to contribute to and participate
actively in society.
• Economic exclusion: unequal or lack of access to
normal forms of livelihood.
Stereotyping and Stigmatizing
Demonized Other
Idealized Other
Thrifty Gene Theory
“A post-mortem has already begun for
the ‘thrifty-gene’ hypothesis, amid
suggestions that science flirted with
racism”
World Health Organization (2011)
The social determinants of health are the
conditions in which people are born, grow, live,
work and age, including the health system.
These circumstances are shaped by the
distribution of money, power and
resources at global, national and local levels,
which are themselves influenced by policy
choices. The social determinants of health are
mostly responsible for health inequities - the
unfair and avoidable differences in health
status seen within and between countries.
Social Determinants of Indigenous Health
Proximal Determinants
Intermediate Determinants
Distal Determinants
Distal (Root) Determinants
Most profound influence on the health of
populations
Represent political, economic, and social
contexts that influence all determinants.
Root Determinants
Colonialism (historic racism), contemporary
racism,
Clear connection between social inequalities
created by racism and the disproportionate
disease, disability, violence and early death
experienced by Indigenous Peoples
Historic Racism
“Colonization is a process that includes
geographic incursion, socio-cultural
dislocating, the establishment of external
political control and economic dispossession,
the provision of low-level social services and
ultimately, the creation of ideological
formulations around race and skin colour that
position the colonizer at a higher evolution
level than the colonized” Kelm (1998).
Racism as a SDIH
The collective burden of a repressive racist system
has created conditions of physical, psychological,
economic and political disadvantage for
Aboriginal peoples.
Historic, successively traumatic events affect
generations through ‘historic or cultural trauma’
Contemporary racism continues to detrimentally
influences the health of Indigenous peoples
Conclusion
Historic and contemporary racism are directly
and circuitously associated with:
 increased stress though lack of control
 diminished immunity and resiliency to disease
 social problems
 decreased capacity to address ill health.
Pathways to Illness
Chronic Disease
Infectious Disease
Geographic dispersion;
economic marginalization
∨
Historic trauma; contemporary
discrimination
∨
Poverty; food insecurity
hopelessness; childhood trauma
∨
Poor diet; obesity
∨
Intravenous drug use
Diabetes
HIV
Conclusion
Racism against Indigenous peoples has
consequences not just current health status,
but also for the health of subsequent
generations through the environments
created by physically, emotionally, mentally,
or spiritually unhealthy individuals,
communities and nations.
Approaches to consider
An Indigenous Equity Lens applied to every
policy, program, service and practice
implemented by local, provincial, territorial
and federal government in Canada.
A nation-wide Indigenous- focused antiracism social marketing campaign
Thank You