Unequal Health Outcomes Derive from Unequal Material and Social Conditions
First Nations People in Canada during and before the COVID-19 Pandemic
Canada’s COVID-19 woes have continued to impact racialized and Indigenous populations more harshly than white Canadians. Through colonialist practices and exploitation of workers, there has been a slight reprieve for the most impoverished. However, socioeconomic inequalities have placed significant portions of the “essential work” back on these same communities and have directly led to poorer health outcomes, especially for First Nations people. Systemic racism has also been a primary factor in poor health outcomes, high death counts and lack of access to care that First Nations people have faced throughout the COVID-19 pandemic. This paper will argue from a conflict perspective that a combination of systemic racism and neoconservative social policy have, during COVID-19, led to disproportionate health outcomes of Indigenous People in Canada and specifically Manitoba.
Systemic Racism in Canada
Systemic Racism towards Indigenous and First Nations peoples in Canada has been part of the national framework since colonization. Countless atrocities and genocides committed by the state against the First Peoples of Canada, including but not limited to the Indian Act, (“How the Indian Act”, 2021) Residential Schools (Dickson & Watson, 2021) and the federal failure to ensure clean drinking water on reserves (Dewey, 2020). These acts and actions by the state have disregarded the human rights and commitments made under the Charter and the Canadian Constitution. Consequently, Mosby & Swidrovich (2021) find these same actions and inactions have led to the vulnerability that has effectively “guaranteed that Indigenous Peoples have reduced access to adequate health care, healthy food and clean water, while also experiencing much greater levels of overcrowded housing, homelessness and incarceration” The Canadian Medical Association Journal authors also call out the Manitoba provincial government specifically for their response to COVID-19 and the effects that it has had on the Indigenous people in the province, citing residential schools and colonialist practices leading to the high percentage of vaccine hesitancy.
The figures released by the Manitoba First Nations COVID-19 Pandemic Response Coordination Team reflect this vulnerability. Despite making up just over 10% of the total population of the province, First Nations people make up 71% of active cases with COVID-19 and 50% of patients in the intensive care unit; the median age of death from COVID-19 for First Nations people is 66 compared with the provincial median of 83 for Manitobans, overall (Mosby & Swidrovich, 2021).
Unequal and inequitable health outcomes have been and are the goal of the colonialist, racist policies that have been in place in Canada since the arrival of Europeans (Gunn, n.d.). Dawn Martin-Hill, Associate Professor at McMaster University, states in an interview with Global News that part of the goal of these colonialist policies is to “destroy the Indigenous population and recreate them in their [Canada’s] image” by removing their autonomy in personal, social, economic, political and spiritual traditions that had endured for hundreds of years (Global News, 2019). The lack of responsibility that the Federal and Provincial governments have consistently shown regarding these issues has been unacceptable from a human rights perspective, a social equality and equity perspective and even from a nationalist perspective.
The COVID-19 pandemic has spotlighted the ways in which Indigenous peoples have continued to be subject to unfair treatment and discriminatory actions by public health officials. For example, the Manitoba government set up four Urban Indigenous Vaccine Clinics in Winnipeg, Brandon, Portage la Prairie and Thompson (Frew, 2021). On May 15, 2021, Manitoba’s medical lead of the vaccine task force, Dr. Joss Reimer, made a statement about non-Indigenous people using and taking up appointments designated for Indigenous people in the province.
These clinics are designed to increase accessibility and provide culturally safe spaces for First Nations — both status and non-status — Métis and Inuit peoples…When non-Indigenous people make appointments or use the walk-in spaces at those sites, it limits access for First Nations, Métis and Inuit peoples (Reimer as cited in Frew, 2021).
Dr. Reimer acknowledges the problem associated with having clinics set up to explicitly reduce health inequalities and the subsequent misuse by unintended patrons. However, what she fails to mention immediately after these statements is any regulation or restriction on the use of the clinics by non-Indigenous people. “Non-Indigenous people who don’t share a household with someone who self-identifies as Indigenous are asked to make appointments at supersites, community pop-up clinics, medical clinics, and pharmacies” (Reimer as cited in Rosen, 2021). Instead of restricting access to these facilities to strictly First Nations people, the Manitoba government’s official stance is to ask non-Indigenous people nicely to use the other sites. There is no conviction by Dr. Reimer, simply political pandering on behalf of her boss, Dr. Roussin and in turn, Premier Pallister. Rhetoric without actions to assure Indigenous people that these specific clinics will be available to them is, in the opinion of the author of this paper, a textbook definition of systemic racism through the limitation of access.
Indigenous Health during COVID-19
Social class and economic mobility have been critical issues for Indigenous peoples in Canada since colonization. “Racism, discrimination, social exclusion and lower socioeconomic status have a synergistically negative effect on the health of Indigenous people” (Gunn, n.d.). Throughout the pandemic, Indigenous people have had some of the worst health outcomes in addition to being pushed back to work early by employers and government regulations. 36% of Indigenous people in Canada reported that COVID-19 and the subsequent closings of workplaces led to a “strong or moderate impact on their ability to meet financial obligations or essential needs”(Arriagada et al., 2020). These impacts of requesting governmental financial support alongside the unequal and frankly unfair treatment throughout history have led to an increase in pandemic-related mental health outcomes as well.
Often disregarded from public discussion is the relation to the economic standing of Indigenous peoples in Canada compared to the level to which the Federal government is openly hostile and refusing their requests, which the Supreme Court of Canada has upheld in favour of First Nations previously. For example, The Toronto Star released an article titled Indigenous defenders are front-line essential workers. In the article, the author, Amy Ede reminds readers of the inherent inequities in the legal system regarding the protection of Indigenous land and resources.
Canadian courts overwhelmingly favour corporations over First Nations, granting nearly 81 percent of injunctions that seek to remove defenders from the land, according to research from the Yellowhead Institute. The 2019 study found that, conversely, 80 percent of injunctions filed by First Nations to stop extractive activities in their territory were denied in court (Ede, 2020).
Amnesty International has spoken out against the Canadian government on various issues relating to the handling of Indigenous issues, but their overview of the situation should not be shocking to any informed Canadian.
The federal government repeatedly claims to spend large amounts of money on Indigenous peoples. But, the reality is that despite the urgent and pressing needs of Indigenous peoples, funding for many basic services for Indigenous peoples is often significantly less than what is provided in predominantly non-Indigenous communities (Amnesty International, n.d.).
From the forced expulsion from traditional lands to systemic and structural racism in the Canadian healthcare system, it is no surprise that these First Nations peoples were the most heavily impacted demographic in Canada throughout the pandemic.
Employment and Neoconservatism
While these previous examples are horrific, there have been nefarious actions taken against the greater working poor of Canada based on neoconservative public policy. The primary example of neoconservatism alive and well in Canada today is the Employment Insurance (EI) program. According to Statistics Canada data, Indigenous people have a 6.1% higher true unemployment rate than non-Indigenous Canadians. In Manitoba, the employment gap between Indigenous and non-Indigenous Manitobans is 7.2% (“Labour force characteristics”, 2021). There are no official statistics on race for EI beneficiaries, but it is logical that with a higher true unemployment rate than non-Indigenous Canadians, First Nations people likely require the social safety net of EI regular benefits at a disproportionate rate. In the opinion of the author, these employment statistics alone should show that the Federal and Provincial governments need to be spending more money on education, health, and employment opportunities for Indigenous Canadians. Neoconservatism would explain that these people do not require additional assistance because they do not deserve it. The federal and provincial governments of Canada have proven time and time again that instead of spending money to fix the inequities and inequalities, they would rather exacerbate the problem and exploit First Nations peoples and their land for profit. To a neoconservative, the protectors of the land are the ones in the way of white progress, and in doing so are undeserving of freedom, and basic human rights to self-determination. When a governmental body removes these basic human rights from its own people, that is generally considered a form of genocide or cultural genocide. The negative impacts of neoconservative thought and policy both in the past and today have led to the extreme inequalities and lack of opportunities that have only gotten worse throughout the pandemic.
The socioeconomic impacts of the COVID-19 pandemic have been intense for many working-class people in Canada, as has been extrapolated throughout this paper. Indigenous’ essential workers’ have played a significant role in maintaining the neoliberal status quo in which they are frequently left outside on social, economic, racial, religious and political grounds. Systemic and structural racism exists in the healthcare and social welfare realm of Canadian government policy and law. Neoconservative policy on ‘who deserves the aid?’ has been front and centre of the debate around acknowledging the rights that First Nations individuals have. These racist laws need to be abolished, and the First Nations of Canada deserve equal rights and access to the care and services they need, if not more than settler Canadians due to the repeated genocides of the past and present.
Amnesty International. Indigenous Peoples in Canada. Amnesty International Canada. Retrieved 12 June 2021, from https://www.amnesty.ca/our-work/issues/indigenous-peoples/indigenous-peoples-in-canada.
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Dewey, M. (2020). Class Action Lawsuit over Access to Clean Drinking Water on First Nations Reserves has been Certified — The Canada Files. The Canada Files. Retrieved 12 June 2021, from https://www.thecanadafiles.com/articles/calcw.
Dickson, C., & Watson, B. (2021). Remains of 215 children found buried at former B.C. residential school, First Nation says | CBC News. CBC. Retrieved 12 June 2021, from https://www.cbc.ca/news/canada/british-columbia/tk-eml%C3%BAps-te-secw%C3%A9pemc-215-children-former-kamloops-indian-residential-school-1.6043778.
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