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CAP Health Mandate
CAP’s mandate is to advocate for policy and program change that would better reflect the unique situations and corresponding health needs of all Aboriginal peoples in Canada regardless of status or residency.

Vision
CAP’s Health Policy Program works to advance off-reserve Aboriginal and Métis perspectives on health in a balanced, positive, proactive manner, fostering positive working relationships, partnerships and collaborative approaches to health and healing. CAP maintains a grass roots approach to health issues in order that wholistic, forward thinking changes can occur that reflect identified needs, and are consistent with traditional teachings of the seven generations.

Background
CAP is managing its Health Policy Program with the underlying objective of building sustainable capacity and expertise at the national, regional and local levels. The Health Policy Team is responsible for liaising with Federal Departments and agencies, non-governmental organizations, professional associations, political and Aboriginal organizations at all levels. The Team is also responsible for ensuring that organizational priorities and objectives reflect direction received from CAP’s Health Advisory Committee.

CAP National Health Advisory Committee
The CAP National Health Advisory Committee (HAC) is a nationally representative body whose members possess political and/or technical health expertise. Committee members provide a critical link to health issues occurring at the local level and support communications between the Health Policy Program and CAP affiliate offices, ensuring regional and local perspectives are reflected in all our work. The Committee ensures a bottom-up approach to issues is maintained, directs the identification of health program priorities and health data requirements, and drives the development of health policy positions as necessary.

2007 - 2008 Activities
CAP receives support to work on the following program and policy areas:

In its most recent budget the Federal Government announced plans to establish a National Mental Health Commission allocating $10 Million over the next two years and $15 million per year starting in 2009-2010. The Commission will direct the development of a national mental health strategy – the first of its kind in Canada.

CAP applauds this announcement and welcomes the opportunity to work along side the Commission to address the unique and pressing mental health and wellness needs that have long been ignored by both mainstream and Aboriginal specific programming models. CAP intends on being fully engaged in the activities of the Commission and is optimistic that through the Commission, mechanisms and partnerships will be developed to ensure that the needs of its constituency will begin to be met in a fair and equitable manner.

CAP has a duty to ensure that the mental health needs of its constituency are provided priority attention and that this attention is acknowledged at all levels of government. To this end CAP will continue to work with Health Canada to identify project opportunities aimed at improving the mental wellness of Aboriginal peoples regardless of status or residency.

National Aboriginal Youth Suicide Prevention Strategy

In September 2004 at a meeting of Aboriginal leaders and Canada’s First Ministers, the Prime Minister agreed to address suicide prevention amongst Aboriginal youth. $65 million was committed in the 2005 Federal Budget to be allocated over a 5-year period.

The National Aboriginal Youth Suicide Prevention Strategy (NAYSPS) was developed with the goal of reducing risk factors and promoting protective (preventive) factors against suicide.

• Be evidence-based;
• Target support for community-based approaches;
• Be culturally appropriate;
• Addresses all levels of prevention;
• Involve youth;
• Consider varying level of community-readiness;
• Promote preventing suicide as the responsibility of all - people, communities, agencies, organizations, and governments; and
• Promote life and well-being

1. Primary Prevention
Activities focus on promoting mental health to increase resiliency and reduce risk.

2. Secondary Prevention
Activities focus on supporting collaborative, community-based approaches to preventing suicide.

3. Tertiary Prevention
Activities focus on increasing the effectiveness of responding to and stabilizing crisis, and of after-care for survivors.

The primary prevention part of this strategy targets all Aboriginal groups. Funding for the secondary and tertiary prevention parts specifically target reserve and Inuit communities. Some funding will support off-reserve Aboriginal people to gather data and examine the issue of youth suicide. This knowledge will provide the evidence required to plan how best to proceed. This will involve provincial and territorial partners due to their mandates for off-reserve Aboriginal people including Métis and urban Inuit.*

CAP’s Involvement in the NAYSPS
During the 2006-2007 fiscal year CAP received a small amount of funding from the First Nations Inuit Health Branch (FNIHB) of Health Canada to participate in the National Aboriginal Youth Suicide Prevention Strategy. The project provided CAP with the opportunity to engage its Affiliate and Partner Organizations through the Health Advisory Committee for the purpose of identifying gaps in programs, services, and research and to identify project priorities.

CAP was successful in negotiating support this year to conduct a small research project aimed at addressing the data gap that exists on the subject of suicide among Aboriginal youth living off reserve. It is expected that the information gathered during this project will advance our participation in the NAYSPS to include the development and piloting of prevention-based projects. Activities for this project will include the following:

Mental Health Service Directory: The goal of the directory is multi-faceted. First, the directory will provide CAP Affiliate and Partner Organizations with information needed to assist in the referral of clients to appropriate services. The directory will identify potential partnership opportunities at the national, provincial, and local levels as well as potential funding sources. Finally, the directory will allow the identification of gaps in existing services including those related to Aboriginal mental health human resources, culturally relevant services, and culturally adaptable services.

Pilot Research Project: CAP will work in partnership with a number of service delivery organizations for the purpose of gathering aggregate data on the mental health and youth. As per funding requirements, the purpose of this pilot is to create a "picture" of the suicide situation that exists off reserve - an area of research largely ignored. The type of information to be gathered varies and will be dependent upon what is actually out there. CAP is cognizant of sensitivity and privacy issues related to collecting this data and honours the principles of Ownership, Control, Access and Possession (OCAP).

* First Nations Inuit Health Branch National, Aboriginal Youth Suicide Prevention Strategy: Program Framework, 2004.

Aboriginal Health Transfer Fund (AHTF) 2005-2010

Aboriginal peoples’ overall health status falls far below that of the general Canadian population: A fact that does not change with residency. Barriers to increased health status are not alleviated with mobility; in fact, some barriers are compounded off reserve. The purpose of the AHTF is to address some of these issues by encouraging provincial and territorial governments to adapt existing health programs and services to better meet the unique needs of Aboriginal people.

Many CAP constituents share common concerns about the jurisdictional obstacles they face off reserve. They experience prohibitive, inaccessible health care services and stress that more culturally relevant health care should be made available. Health authorities and delivery mechanisms typically do not approach health and healing from a wholistic or traditional perspective. It is anticipated that Aboriginal peoples’ poor health status might be addressed if services are offered in a culturally sensitive manner

To improve health outcomes of Aboriginal populations and narrow the health status gap between Aboriginal and non-Aboriginal people in Canada, the federal government committed $100M over five years.

Funding will flow through the First Nations and Inuit Health Branch national and regional contribution agreements or contracts to a variety of organizations, institutions, associations, agencies, universities and/or colleges as outlined in the FNIHB Health Governance/Infrastructure Support Authority .

The AHHRI is intended to complement and integrate, where possible, with work that is already underway in the provinces and territories with the Pan-Canadian Health Human Resources Strategy (2003). The basic premise being that the health care system requires change and supplement to adequately meet the needs of Canadians. Statistics supporting the implementation of AHHRI include:

Longer-term institutional change requires that both supply and demand issues be addressed. The AHHRI initiative targets the following areas:

Priority 1. Increase in Health Care Providers
The goal is to create heightened awareness of health careers, increase the number of students in health careers and establish the necessary supports.

Priority 2. Improve Retention
The intent is to lay the foundation for the development of retention strategies.

Priority 3: Provide Supportive Elements
Investments will be made to increase Aboriginal capacity to meaningfully participate in the implementation of AHHRI at both the national and regional levels.

AHHRI Governance
Two advisory committees govern the AHHRI, one specific to First Nations and Inuit, the other specific to Métis, non-status and off reserve Aboriginal populations. . Each Committee will be co-chaired by Health Canada and an Aboriginal organization and will exist for the duration of the Initiative. They will comprise approximately 10-15 members representing National Aboriginal Organizations and federal and provincial governments.

Roles
The roles of the National Aboriginal Organizations (NAO) are to advance the specific priorities of their constituents within the context of health human resources, and to become engaged in all aspect of HHR planning and implementation.

Activities
Increasing bursary and scholarship funds for Aboriginals health career students; data collection and research; development of core competencies and standards for allied health care workers; work with national associations to facilitate post secondary, health education curricula changes to enhance cultural competency; program evaluation, and research.

Note that FNIHB Regions will not be responsible for activities related to the Métis and Non-Status components of the AHHRI.

All orders of government in Canada have made a commitment to children and families. In 2003, the federal, provincial, and territorial Multilateral Framework for Early Learning and Child Care identified ELCC as a shared priority, with agreed objectives and principles.

The provinces and territories receive support from the federal government in the provision of childcare through the Canada Social Transfer. In 2006, the federal government launched the Universal Child Care Benefit, which provides up to $1200 per year to families for each child less than six years of age. Under Health Canada’s Health Consultation and Liaison (HCON) program, CAP receives funding to support engagement with the federal early childhood learning and childcare initiative.

Aboriginal children’s issues have long been a priority at CAP, from our landmark report The Circle of Care (1989), to the Royal Commission on Aboriginal Peoples (1996), to the National Children’s Agenda (1999), to the F/P/T Early Childhood Development Initiative (2001).

In 2007/08, we will be providing input into the development and implementation of various components of the initiative and disseminating information throughout our affiliates. We will continue to work with Health Canada officials on ELCC and participate in various ELCC learning events. CAP provides funding to our affiliates so that they can be engaged with the ELCC agenda. We hold an annual working group meeting on ELCC, which allows an opportunity for our affiliates to develop a greater awareness of various initiatives and to meet with experts in the field.

In addition to identifying potential opportunities for participation in these strategies CAP engaged its Provincial and Territorial Organizations in a series of exercises that informed the organization about existing gaps in both services and research with goal of developing future projects aimed at reducing the rate of cancer among Aboriginal peoples.

CAP has yet to receive a commitment of support from Health Canada or the CPACC for fiscal 2007-2008 but is optimistic that through negotiation and the dedication of all parties will be successful in securing new project funding for this year.

CAP continues to engage with the CPACC and will continue participate in this worthwhile initiative to ensure that the cancer related needs of our constituency are addressed by the Partnership in an equitable manner that is both culturally relevant and responsive.

Social Determinants of Health

The health of Aboriginal people in this country is inferior to that of non-Aboriginal people, and we anticipate severe implications for future generations if the situation is allowed to continue unabated. Not only do Aboriginal people have a lower life expectancy, they also have higher rates of infant mortality and experience more years lost. Rates of chronic disease such as diabetes are much higher; they are more likely to suffer from tuberculosis; they are more likely to suffer mental illness and addiction. Aboriginal people are less likely to report their health as “good”.*

* CAP’s work on SDOH began a few short weeks ago. As such, we are at somewhat of a disadvantage compared to other Aboriginal organizations. Other NAOs have been engaged in the development of policy positions on SDOH for years, receiving sustained support from Health Canada to contribute their perspectives at national and international fora. CAP has begun to develop a position that is unique and specific to the Aboriginal populations we represent, and we are hopeful that this valuable work will be supported.

The Aboriginal Diabetes Initiative (ADI) is a national program funded by the First Nations and Inuit Health Branch (FNIHB) of Health Canada.

Its goals are to reduce the incidence of diabetes among Aboriginal peoples and to improve the quality of life for individuals with diabetes.

To achieve these goals, Health Canada funds diabetes related projects in two categories: First Nations On Reserve and Inuit in Inuit Communities (FNOIIC); and for Metis, Off-reserve Aboriginal and Urban Inuit Primary Prevention and Promotion (MOAUIPP).

Under FNOIIC, projects are funded for care and treatment, prevention and promotion, and lifestyle support. All MOAUIPP funded projects are for prevention and promotion.

Type 2 diabetes is a pandemic in Aboriginal communities in Canada and its prevalence is estimated to be three to five times the national average. The disease has a devastating impact on people living with the disease, their families, and communities.

For further information, view the CAP type 2 diabetes newsletter - Transitions, which is available in PDF format in both English and French.

National Aboriginal Youth Suicide Prevention Strategy

Aboriginal Health Transfer Fund (AHTF) 2005-2010

SUPPLY

DEMAND

Social Determinants of Health