POVERTY AS a SOCIAL DETERMINANT of FIRST NATIONS, INUIT, and MÉTIS HEALTH Credit: Fred Cattroll, ID 318 Cattroll, Credit: Fred

SOCIAL DETERMINANTS OF HEALTH POVERTY AS A SOCIAL DETERMINANT OF FIRST NATIONS, INUIT, AND MÉTIS HEALTH Credit: Fred Cattroll, www.cattroll.com, ID 318 Cattroll, www.cattroll.com, Credit: Fred

Poverty and ill-health are inextricably of which “diminishes opportunities, children, ethnic and minority groups, linked. In rich and poor countries limits choices, undermines hope, and and the disabled) and geographic alike, ill-health follows a distinct social threatens health.”2 Poverty has been regions.4 For Aboriginali Canadians, gradient: the lower an individual’s associated with an increased risk of who experience significantly higher socioeconomic status, the worse their chronic disease, injury, poor infant rates of poverty and ill-health than the health.1 Poverty has many dimensions development, a range of mental health non-Aboriginal population, breaking the – material deprivation (food, shelter, issues (stress, anxiety, depression, and “poverty – ill-health – poverty” cycle sanitation, and safe drinking water), lack of self-esteem), and premature is critical to improving overall health social exclusion, lack of education, death.3 The burden of poverty falls outcomes.5 unemployment, and low income – each most heavily on certain groups (women,

i Aboriginal’ throughout this fact sheet refers collectively to the Indigenous inhabitants of Canada, including First Nations, Inuit and Métis peoples (as stated in section 35(2) of the Constitution Act, 1982). Wherever possible, we provide names and data for distinct groups/communities.

sharing knowledge · making a difference partager les connaissances · faire une différence ᖃᐅᔨᒃᑲᐃᖃᑎᒌᓃᖅ · ᐱᕚᓪᓕᖅᑎᑦᑎᓂᖅ ∙∙ Approximately 40% of off- reserve Aboriginal children live in poverty.12 ∙∙ Aboriginal people living in urban areas are more than twice as likely to live in poverty than non-Aboriginal people. In 2000 for example, 55.6% of urban Aboriginal people lived below the poverty line compared with 24.5% of Canada’s non-Aboriginal urban residents.13 ∙∙ Rates of poverty for Aboriginal women are double that of non-

Credit: Fred Cattroll, www.cattroll.com, ID 205 Cattroll, www.cattroll.com, Credit: Fred Aboriginal women.14

As a result of living under conditions of poverty:

∙∙ More than 100 First Nations communities are currently under boil water advisories and have little Defining and Measuring Poverty Amongst Canada’s or no access to clean water for Poverty Aboriginal Peoples drinking and sanitation.15 ∙∙ Nearly one in four First Nations Poverty is defined, conceptualized, Research indicates that “at best, the adults live in crowded homes and and measured within two broad health situation of Indigenous peoples 23% of Aboriginal people live in 16 frameworks. Absolute poverty is the mirrors that of the world’s poorest, but is houses in need of major repairs. severe deprivation of basic human made worse by their social and cultural ∙∙ First Nations suffer from ‘third needs such as food, safe drinking water marginalization.”9 The 1996 Royal world’ diseases such as tuberculosis and shelter, and is used as a minimum Commission on Aboriginal Peoples at eight to ten times the rate of 17 standard below which no one should (RCAP) noted that: Canadians in general. fall regardless of where they live.6 It is ∙∙ Aboriginal people in Canada were measured in relation to the ‘poverty line’ Aboriginal people are at the bottom found to be four times more likely or the lowest amount of money needed to experience hunger as a direct of almost every available index of 18 to sustain human life. Relative poverty socio-economic wellbeing, whether result of poverty. ∙∙ More than one quarter of takes a more country specific approach [they] are measuring educational and is defined as the inability to afford Aboriginal people off reserve the goods, services, and activities needed levels, employment opportunities, and 30% of Inuit children have to fully participate in a given society.7 In housing conditions, per capita incomes experienced food insecurity at some Canada, poverty is measured according or any of the other conditions that point.19 to the ‘low-income-cut-off’ or the give non-Aboriginal Canadians one ∙∙ Aboriginal children are drastically income below which a family is likely of the highest standards of living in overrepresented in the child welfare to spend 20% more of its income on the world.10 system. Physical neglect as a result basic necessities than the average family. of poverty, poor housing and In 2004, approximately 3.5 million Poverty amongst Canada’s Aboriginal substance abuse is a key factor in 20 Canadians were living in poverty, which population has seen only slight child apprehension. 8 is more than 11% of the population. improvements since RCAP. Recent data For Aboriginal peoples, who experience indicates that: poor and unequal living conditions on a national and global scale, poverty can be ∙∙ One in four First Nations children defined and measured in both absolute live in poverty as compared to one and relative terms. in six for non-Aboriginal children.11

2 Credit: Fred Cattroll, www.cattroll.com, ID 376 Aboriginal and non-Aboriginal non-Aboriginal and Aboriginal between funding government in gap the close to is poverty Aboriginal for reducing strategy akey Canada, In citizens. most vulnerable of its circumstances socio-economic the improve will which strategy development a implement and adopt to governments role for national acentral is There [and] mobilize domestic resources domestic mobilize [and] sector, private the and entrepreneurship promote society, civil empower and engage actively governance, improve “to parties by all efforts for intensive need the identify hunger and poverty extreme by reducing conditions socio-economic global of improving (MDG) Goals Development Millennium Nations’ United The live. people which under environments social and living the improve to conditions housing and opportunities, employment education, as such determinants of health range full the target that up approaches bottom- and top-down both require They multi-faceted. and integrated be to need poverty alleviate to Strategies Reduction Strategies for Poverty 21 …” …” $16,000. $7000-$8000 compared to $15,000- Canadians: of average amount the half 23%) of is rate only on agrowth (based Nations on First spending capita per on real costs. on real based developed must be arrangements fiscal and removed must be communities Aboriginal to on services cap budget The services. and programs to respect with particularly population, growing of a demands socio-economic the with up keep to unable are governments population. non-Aboriginal for the ofrate increase 8% the than faster times six nearly 45%, by increased population Aboriginal the 1996 2006, and Between Canadians. further impoverishment offurther indigenous and discrimination marginalization, the worsening even and prolonging thus assimilation, accelerated and resources, natural and loss of land be]… may [there accelerated account, into taken are peoples Indigenous of voices and situation particular the “unless that argued widely been It has Canada. in poverty Aboriginal alleviating in important equally are approaches Bottom-up 23 As a result, First Nations Nations First aresult, As 22 Despite this increase, increase, this Despite 24 Poverty as a Social Determinant of First Nations, Inuit, and Métis Health Métis and Inuit, Nations, First of Determinant aSocial as Poverty economic development rise.” development economic of sustainable chances the power, decision-making of their degree and scope the “expand people Aboriginal as that suggests that by research supported of Aboriginal poverty. of Aboriginal eradication the to critical as campaign History Poverty Make Nations’ First Assembly the of by identified been on Aboriginal peoples will be essential. be will peoples on Aboriginal spending capita per federal in inequity the addressing this, In decisions. implement to resources financial the with accompanied musthowever, be Self-determination, services. and programs improved to leading wealth community generate can and members, of community circumstances economic the improve can which opportunities building capacity and employment provide also can development economic peoples.” shifts accountability. shifts and development, community and economic in engagement civic fosters hands, Indigenous into development economic and for social used be can which resources puts It also viable. and appropriate be will solutions that likely it more making knowledge, and agendas Indigenous reflects decision-making over bottom-up approaches. bottom-up both and top-down require They faceted. multi- integrated and need to be poverty Strategies alleviate to 25 Self-determination has has Self-determination 28 Sustainable Sustainable 26 This claim is is claim This 27 Control Control 3 9 Stephens, C., Porter, J., Nettleton, C., & 20 Trocmé, N., et al. (2004). Canadian Incidence Endnotes Willis, R. (2006). Disappearing, displaced, and Study of Reported Child Abuse and Neglect (CIS). undervalued: A call to action for Indigenous Final report. Ottawa, ON: Minister of Public 1 World Health Organization (2008). Closing the health worldwide. The Lancet, 367: 2023. Works and Government Services Canada, p. gap in a generation: Health equity through action on 10 Royal Commission on Aboriginal Peoples 10 the social determinants of health. Geneva: WHO. (1995). Choosing life. Special report on suicide among 21 United Nations Development Programme 2 Haines, A., Heath, I., & Smith, R. (2000). Aboriginal people. Ottawa, ON: Supply and (2005). Investing in development: A practical plan to Joining together to combat poverty: Services, p. 24. achieve the Millenium Development Goals. London, Everybody welcome and needed. British Medical 11 Campaign 2000, Oh Canada! Too many UK: Earthscan, p.55. Journal, 320: 1. children in poverty for too long: 2006 Report card 22 Statistics Canada (2008). Aboriginal peoples in 3 Phipps, S. (2003). The impact of poverty on on child and family poverty in Canada, http:// Canada in 2006: Inuit, Métis and First Nations health: A scan of research literature. Ottawa, ON: www.campaign2000.ca/rc/rc06/06_ 2006 Census. Ottawa, ON: Ministry of Canadian Population Health Initiative; World C2000NationalReportCard.pdf [accessed Industry, Catalogue no. 97-558-XIE . Health Organization and World Bank (n.d.). January 16, 2009], p4. 23 Assembly of First Nations, Make Poverty Dying for change: Poor people’s experience of health 12 Ibid, p. 4. History (2007) presentation, http://www.afn. and ill-health. Geneva: WHO and WB. 13 Canadian Council on Social Development ca/cmslib/general/mph2006101893457. 4 World Bank (1990). World development report (2003). Social challenges: The well-being of pps#276,3, Truth About Spending on First 1990: Poverty. Oxford: Oxford University Press, Aboriginal people, 2003, www.ccsd.ca/cpsd/ Nations [accessed January 16, 2009] p. 2. ccsd/c_ab.htm [Accessed January 16, 2009] 24 Assembly of First Nations, The $9 billion myth 5 Braveman, P. and Gruskin, S. (2003). Poverty, 14 Townson, M. (2005). Poverty issues for Canadian exposed: Why First Nations poverty endures, www. equity, human rights and health. Bulletin of the women. Ottawa, ON: Status of Women Canada, afn.ca/cmslib/general/M-Ex.pdf [Accessed World Health Organization, 81(7): 539. Government of Canada, 2005, hwww.swc-cfc. January 16, 2009] 6 Gwatkin, D.R. (2000). Health inequalities and gc.ca/cgi-bin/printview. pl?file=/resources/ 25 UN Permanent Forum on Indigenous Issues the health of the poor: What do we know? consultations/ges09-2005/poverty_e. html (2005) as cited in Stephens, C., Porter, J., What can we do? Bulletin of the World Health [accessed January 28, 2009] Nettleton, C., & Willis, R. (2006), p. 2026. Organization, 78(1): 3-18. 15 Assembly of First Nations (n.d.). The reality for 26 Assembly of First Nations, The $9 billion myth 7 Walter, M. (2007). Aboriginality, poverty and First Nations in Canada: Fact Sheet, www.afn.ca/ exposed. health – Exploring the connections. In Beyond article.asp?id=764 [accessed January 16, 2009]. 27 Cornell, S. (2006). Indigenous peoples, poverty and bandaids: Exploring the underlying social determinants 16 Ibid. selfdetermination in Australia, New Zealand, Canada of Aboriginal health, I. Anderson, F. Baum, & 17 Public Service Alliance of Canada, PSAC and the United States. Tucson, AZ: Native M. Bentley (eds), p. 80. Darwin: Cooperative Statement on National Aboriginal Peoples Day Nations Institute for Leadership, Management Research Centre for Aboriginal Health, Papers June 21, 2008: Making Aboriginal poverty and Policy, p. 16. from the Social Determinants of Aboriginal history, www.psac.com/what/humanrights/ 28 Ibid., p. 17. Health Workshop, Adelaide, July 2004. june21factsheet1-e.shtml [Accessed January 8 A profile of economic security in Canada, Fact 16, 2009] Sheet #2: Poverty, Canadian Council of Social 18 McIntyre, L., Connor, S., & Warren, J. (1998). Development http://www.ccsd.ca/factsheets/ A glimpse of child hunger in Canada. Ottawa, ON. economic_security/poverty/index.htm Applied Research Branch, Strategic Policy, [accessed January 15, 2009]. Human Resources Development Canada. 19 Office of Nutrition Policy and Promotion (2007). Income related household food security in Canada. Ottawa, ON: Health Canada.

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