Mental Health Matters: A Framework for First Nations

May 2013 – In a series of four related fact sheets, author Janet Smylie explores the importance of maternal, infant and child health in Aboriginal communities in British Columbia. “As sacred gifts from the spirit world,” Smylie writes, “children are an integral part of the family, the community and the culture of a people.”

Our Babies, Our Future: Aboriginal birth outcomes in British Columbia, presents the different measures of birth outcomes, such as rates of infant mortality and preterm births, and birth weights, comparing Aboriginal and non-Aboriginal populations. Unfortunately, there are significant gaps in the data available on Aboriginal infant and child health measures, though existing information provides evidence for persistent disparities between Aboriginal and non-Aboriginal infant health measures.

For example, overall death rates for infants born to First Nations compared to non-First Nations parents were at least twice as high according to a longitudinal study in BC for the years 1981 to 2000. Most of the deaths for First Nations infants between the ages of one month and a year old were due to preventable causes such as sudden infant death syndrome (SIDS) and infections. The author concludes that this data “supports the need to address the difficult living conditions facing many Aboriginal families” as well as the need to assess the effectiveness of SIDS prevention information for Aboriginal communities.

A second related factsheet, Honouring our Children: Aboriginal children’s health in British Columbia, discusses the health and well-being of Aboriginal children in the province with a particular focus on the social determinants of health, health outcomes, and promising practices. Topics include access to health care, dental health, obesity and nutrition, activity, medical conditions, school attendance and performance, and family/emotions/behavior. The author notes that a growing body of literature continues to document the links between factors such as adequate food supply, housing, employment, education level and environmental exposures and Aboriginal child health status.

For example, the 2009 NCCAH study, Health Inequalities and Social Determinants of Aboriginal People’s Health, noted that, “since health is experienced over the course of one’s life, the circumstances of the physical and emotional environment impact not only children’s current health but set the groundwork for future vulnerabilities and resiliencies.”

Addressing the Social Determinants of Health of Aboriginal Infants, Children and Families in British Columbia provides an overview of the unique social determinants of health that impact Aboriginal communities and children, including income and employment levels, education, housing and food security— as well as colonization, racism and political marginalization. This fact sheet outlines a number of initiatives designed to address these SDOH disparities, such as the Royal Commission on Aboriginal Peoples (RCAP), the Kelowna Accord, the Transformative Change Accord (signed between the Province of B.C. and the First Nations Leadership Council), as well as community mobilization as a part of Aboriginal ActNow B.C. initiatives.

In fourth fact sheet of the series, Strong Women, Strong Nations: Aboriginal maternal health in British Columbia (to be released in 2013), Smylie highlights the importance of Aboriginal knowledge and traditions in maternal health and birthing. Although limited data exists on Aboriginal maternal health, available information shows that Aboriginal women often face significant barriers to accessing culturally appropriate maternal care, and have higher rates of gestational diabetes, intimate partner violence, smoking during pregnancy, and post-partum depression when compared to non-Aboriginal groups. In a context where Aboriginal women may need to travel for hundreds or thousands of kilometers to access a medical care centre, culturally appropriate and accessible maternal health practices such as Aboriginal midwifery and doula practices hold great promise for improving birth outcomes and experiences at a community level.

Although gaps in data exist and there remain unjust differences for Aboriginal infant and child health measures in comparison to non-Aboriginal infants and children, strides are being made towards improvements. These two NCCAH fact sheets provide insight into these complex issues within the specific context of British Columbia.

National Collaborating Centres For Aboriginal Health (NCCAH)

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