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”.*

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For Aboriginal people, health and wellness is best understood in a broad context. It’s not simply the absence of illness; it is the inclusion of spiritual, cultural, community, mental, physical, emotional and environmental well-being. Promoting health in this sense means nurturing growth, self-determination, peace and above all, balance.

CAP supports a population health approach to wellness. This approach addresses the entire range of influences that determine the health outcomes of individuals with the goal of impacting the health of the entire population. It goes beyond identifying physical symptoms of disease and instead recognizes social determinants that have led to poor health status. Several determinants have been identified nationally and internationally, including: 

income and social status (food security)
employment 
education 
social environments 
physical environments (housing, environment)
healthy child development 
personal health
practices and coping skills
health services 
social support networks (social exclusion, social safety nets)
biology and geneticendowment
gender culture

Addressing each of these determinants is vital to achieving optimal health, particularly as they apply to those populations who are most disadvantaged and suffer the largest inequities. However, one set of determinants that seem to override all others for and within Aboriginal populations is that of social exclusion.

Social Exclusion
Social exclusion refers to the process by which people are denied opportunity to participate in aspects of cultural, economic, social, and political life. This exclusion has manifested itself in three ways:

• First, like all Aboriginal people CAP constituents face racism and discrimination in their day to day lives. This occurs at the hands of mainstream populations. It contributes to and perpetuates negative stereotypes, which in turn create barriers that prevent many Aboriginal people from accessing services.
• Second, we experience exclusion through the perpetuation of colonial policies, laws, and legislation that serve to undermine the life chances of Aboriginal people. Until these issues are resolved in manner that is inclusive of the needs of all Aboriginal peoples and in a way that is respectful to the inherent right of Aboriginal people to self-determination we will not see meaningful change.

Lateral Violence
Lateral violence is a product of colonization and describes the conditions of various oppressed minority groups. It amounts to a situation where the oppressed become the oppressors. It is a well known phenomenon that has effectively divided us as Aboriginal peoples into small factions, ultimately preventing us from becoming a stronger, more unified peoples.**

The above is an excerpt from CAP’s presentation to the Senate Sub-Committee on Population Health June 1st, 2007.