Unit References

This unit allowed me to focus on a vulnerable population - Canada's Indigenous Peoples - and reflect on how and why they experience significantly lower health outcomes when compared to the rest of Canadians. I focused specifically on how they are disproportionately affected by osteoarthritis, the possible reasons for this disparity, and what we need to do to improve their health outcomes moving forward.

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Unit 6 Resources

For a full list of references, please visit my Zotero public group here. Below is a selection of pertinent resources for this unit, accompanied by a brief description.

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This editorial goes into detail regarding why addressing OA in Indigenous communities is so important, how it relates to the overall burden of chronic disease in Indigenous populations, what the research shows, where the gaps are, and most importantly, a call to action.

O’Brien, P., Bunzli, S., Lin, I., Gunatillake, T., Bessarab, D., Coffin, J., Garvey, G., Dowsey, M., & Choong, P. (2020). Tackling the Burden of Osteoarthritis as a Health Care Opportunity in Indigenous Communities—A Call to Action. Journal of Clinical Medicine, 9(8), 2393. https://doi.org/10.3390/jcm9082393

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This article discusses the ongoing inequities between Indigenous and non-Indigenous health in Canada. Systemic racism is still very much present in the Canadian health care system, and until that is effectively addressed, we will continue to see disparities. The article points to the Report on the Truth and Reconciliation Commission of Canada (2015) as the first steps needed in order to effect positive change in Indigenous health.

Richmond, C. A. M., & Cook, C. (2016). Creating conditions for Canadian aboriginal health equity: The promise of healthy public policy. Public Health Reviews, 37(1), 2. https://doi.org/10.1186/s40985-016-0016-5

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Learn about what is required in order to improve osteoarthritis related health outcomes for Indigenous groups. In particular, this article focuses on the need to include Indigenous Peoples, and their cultural healing practices, in any future programs.

Allen, L., Hatala, A., Ijaz, S., Courchene, E. D., & Bushie, E. B. (2020). Indigenous-led health care partnerships in Canada. CMAJ, 192(9), E208–E216. https://doi.org/10.1503/cmaj.190728

This journal article states that the prevalence of osteoarthritis in First Nations groups in Alberta is twice that of the rest of the province. In addition, the research shows inequities in primary care vs. specialty care use – which is not yet fully understood.

Barnabe, C., Hemmelgarn, B., Jones, C. A., Peschken, C. A., Voaklander, D., Joseph, L., Bernatsky, S., Esdaile, J. M., & Marshall, D. A. (2015). Imbalance of Prevalence and Specialty Care for Osteoarthritis for First Nations People in Alberta, Canada. The Journal of Rheumatology, 42(2), 323–328. https://doi.org/10.3899/jrheum.140551

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We know that socio-economic status is a major indicator of health outcomes, but did you know that high socio-economic status does not lead to better health outcomes for all populations? This study showed that although higher income had an inverse relationship with weight/obesity for White people, it did not have the same effect for Black people. This means that even health determinants that we look at as ‘protecting’ or ‘improving’ an individual’s health will not provide benefit universally. This is important to remember when considering vulnerable groups.

Assari, S., Bazargan, M., & Chalian, M. (2020). The Unequal Effect of Income on Risk of Overweight/Obesity of Whites and Blacks with Knee Osteoarthritis: the Osteoarthritis Initiative. Journal of Racial and Ethnic Health Disparities, 7(4), 776–784. https://doi.org/10.1007/s40615-020-00719-5