Article

Indigenous Health Part 2: The Underlying Causes of the Health Gap

Department of Medicine, University of Alberta, Edmonton, AB, Canada.
The Lancet (Impact Factor: 45.22). 08/2009; 374(9683):76-85. DOI: 10.1016/S0140-6736(09)60827-8
Source: PubMed

ABSTRACT In this Review we delve into the underlying causes of health disparities between Indigenous and non-Indigenous people and provide an Indigenous perspective to understanding these inequalities. We are able to present only a snapshot of the many research publications about Indigenous health. Our aim is to provide clinicians with a framework to better understand such matters. Applying this lens, placed in context for each patient, will promote more culturally appropriate ways to interact with, to assess, and to treat Indigenous peoples. The topics covered include Indigenous notions of health and identity; mental health and addictions; urbanisation and environmental stresses; whole health and healing; and reconciliation.

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    • "Past segregationist practices of the Big Event have led to existing structural violence. For instance, Indigenous peoples receive inequitable funding for mental health and other social services on-reserve, have insufficient housing and experience home overcrowding , have fewer educational and economic opportunities , and have lost traditional patterns of subsistence (Gracey & King, 2009; King, Smith, & Gracey, 2009; Kirmayer et al., 2014; Richardson & Nelson, 2007; US Commission on Civil Rights, 2004). "
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    • "To be explicit, inequalities in health status are typically the result of societal inequalities (Marmot 2005). Determinants of socioeconomic status are multi factorial: ethnicity, sexual orientation, disability, geographical location, poor nutrition, relatively lower income, poorer economic and education opportunities, poorer housing conditions, access to social support, and greater exposure to environmental risks have all been cited (Adler and Rehkopf 2008, Fiscella et al 2000, King et al 2009). Nevertheless, limitations in accessing health care services do contribute to health inequality (Lurie and Dubowitz 2007) and in New Zealand there are access discrepancies between groups at primary and secondary levels of care (Baxter 2002, Westbrooke et al 2001). "
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    • "Past segregationist practices of the Big Event have led to existing structural violence. For instance, Indigenous peoples receive inequitable funding for mental health and other social services on-reserve, have insufficient housing and experience home overcrowding , have fewer educational and economic opportunities , and have lost traditional patterns of subsistence (Gracey & King, 2009; King, Smith, & Gracey, 2009; Kirmayer et al., 2014; Richardson & Nelson, 2007; US Commission on Civil Rights, 2004). "
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