Indigenous Community and Cardiovascular Diseases in Canada

Addressing health disparities has been a priority in public health in recent years.  Research has shown that factors like education, income, and access to healthcare are significant social determinants contributing to these disparities. 

The many years of colonization and discrimination have resulted in the marginalization of the Indigenous population globally.  As a result, inequitable healthcare was created for the Indigenous population.  This includes poor access to healthcare due to historical colonial policies, inaccessible healthcare facilities due to remote displacements of Indigenous groups, underfunded healthcare for Indigenous communities, lower social determinants of health,  history of mistreatment leading to the skepticism in trusting non-Indigenous groups, differences amongst Western and traditional Indigenous medicine, history of racism and prejudice towards Indigenous patients in healthcare settings, lack of Indigenous education provided to staff and lack of Indigenous representation/healthcare workers to support needs.

With the known baseline gaps for the Indigenous community to access basic healthcare, access to even more specialized medicine beyond primary care is even more difficult.  Ontario is home to 133 Indigenous communities (Government of Ontario, n.d.).  As mentioned in my previous post, chronic diseases are the leading cause of death globally.  Cardiovascular disease is one of the leading causes of death in Northern Ontario, which is home to 78% of Ontario’s Indigenous population (Government of Ontario, n.d.).  The Indigenous peoples in Canada are at a higher risk of cardiovascular diseases compared to non-Indigenous populations (Vervoort, D et al., 2002).  With the inaccessibility to healthcare as well as the added skepticism in healthcare experienced by Indigenous communities, there are many barriers to providing consistent and timely monitoring and treatment to patients.  Chronic disease prevention is also problematic due to insufficient outreach and unfavourable social determinants of health, such as low income, which leads to lower education, access to healthy food due to high costs and poor housing (Anand et al., 2001).

The lack of social, mental health, and addiction support contributes to the use of drugs, tobacco and alcohol by the Indigenous communities. It is a normalized habit and is used as a coping mechanism to help overcome historical oppression, trauma and stressors in life due to the experienced lower social determinants of health (Anand et al., 2001).  The use of tobacco and alcohol is known to contribute to the increased prevalence of cardiovascular diseases.  With all these factors as well as inaccessible immediate healthcare for acute conditions such as myocardial infarctions and aortic dissections due to the lack of nearby cardiologists and testing facilities (Anand et al., 2001).  Even if the patient was able to get immediate care to treat the acute condition, long-term monitoring and cardiac care is required to prevent the event from reoccurring or worsening (Anand et al., 2001).  However, accessing care from a remote location is unfeasible for most Indigenous patients due to financial barriers to afford the travelling fees.

                  To reduce health disparities within the Indigenous population, more Indigenous-led healthcare initiatives have been started to work towards more equitable care for the community.  Potential solutions can include increasing funding for Indigenous healthcare infrastructure, increase mobile primary care/cardiology clinics and phone/virtual clinics, providing anti-racism and Indigenous cultural education to healthcare workers and including traditional Indigenous healing methods with Western medicine.  From 2024 to 2025, the Ontario government issued the Indigenous Health Equity Fund (Indigenous Services Canada, 2024).  It is an initiative to provide $2 billion over 10 years to address challenges and work towards more equitable healthcare for the Indigenous community (Indigenous Services Canada, 2024).

References:

1.        Anand, S. S., Yusuf, S., Jacobs, R., Davis, A. D., Montague, P. A., & Lonn, E. (2001). Cardiovascular health among Canada's Aboriginal populations: A review. Canadian Journal of Cardiology, 17(3), 271-279. https://www.researchgate.net/publication/228060514_Cardiovascular_Health_among_Canada%27s_Aboriginal_Populations_A_Review

2.        Government of Ontario. (n.d.). Indigenous peoples in Ontario. Ontario.ca. Retrieved March 24, 2025, from https://www.ontario.ca/document/spirit-reconciliation-ministry-indigenous-relations-and-reconciliation-first-10-years/indigenous-peoples-ontario

3.        Indigenous Services Canada. (2024). Indigenous Health Equity Fund. Retrieved August 9, 2024, from ​https://www.sac-isc.gc.ca/eng/1721758041536/1721758068269#

4.        Vervoort, D., Kimmaliardjuk, D. M., Ross, H. J., Fremes, S. E., Ouzounian, M., & Mashford-Pringle, A. (2022). Access to Cardiovascular Care for Indigenous Peoples in Canada: A Rapid Review. CJC open, 4(9), 782–791. https://doi.org/10.1016/j.cjco.2022.05.010