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Home , Blackfoot Confederacy, First Nations

Blackfoot Confederacy

Aapooyaki Bonnie Healy Health Director Chair First Information Governance Centre Important Notes

–Focus on populations: – …however, Health has working relationships with the Metis of Alberta and Metis Settlements General Council

–Population-level data: – Individual and family care important; however, we’ll be discussing data primarily related to population health

–Two of many: – We’re just a few in a long list of partners and collaborators who have contributed a great deal to the work we’ll be discussing Overview

Background Current considerations 1. Data availability and existing challenges 2. Respectful relationships and potential solutions 3. Examples Data availability:

• Surveys e.g. Canadian Community Health Survey (Statistics )

• Vital statistics e.g. Births, deaths

e.g. Emergency department visits, hospital • Administrative records discharge data, physician claims, pharmaceutical data (including NIHB)

• Disease registry data e.g. Alberta Cancer Registry, congenital anomalies, notifiable diseases (like sexually transmitted ) Data availability:

–Surveys

o e.g.: StatsCan surveys o Self-identification Data availability:

• Surveys

• Vital statistics

In Alberta in most cases, no • Administrative records information about ‘Indigenous status’

• Disease registry data Data availability:

Health-related databases First Nations identifying (All Alberta) information

First Nations individuals identified Data availability:

First Nations identifying A list is provided by First Nations information representatives

Alberta Health Care Insurance Plan Registry Data availability:

X$ ?

2009 2017 No additional Health premiums external information First Nations eliminated identifiers less reliable Data availability:

Implications and current limitations

• Currently limited ability identify people affiliated with a specific band in recent years (after around 2010)

• Limited ability to identify on/off reserve

Reserve • Information used to compiled First Nations-specific info currently based on First Nations who have ‘Status’

• Not able to identify First Nations client at point of care

Postal code Source: Alberta Health Interactive Health Data Application (Retrieved May 11, 2016)

First Nations Male First Nations Female

115 85+ 186 274 80-84 355 562 75-79 635 869 70-74 1 017 1 418 65-69 1 700 2 201 60-64 2 415 3 324 55-59 3 546 4 547 50-54 4 582 5 209 45-49 5 253 5 415 40-44 5 636 5 596 35-39 5 820 6 141 30-34 6 556 6 735 25-29 6 815 8 058 20-24 7 508 7 608 15-19 7 268 7 322 10-14 7 138 8 221 5-9 8 028 7 888 0-4 7 689

10 000 8 000 6 000 4 000 2 000 0 2 000 4 000 6 000 8 000 10 000 Source: INAC Indian Registry System

Off Reserve First Nations Male Off Reserve First Nations Female

183 85+ 308 126 80-84 241 182 75-79 357 257 70-74 478 420 65-69 761 622 60-64 973 935 55-59 1282 1 346 50-54 1579 1 487 45-49 1681 1 560 40-44 1698 1 665 35-39 1762 1 827 30-34 1898 1 900 25-29 2038 2 027 20-24 1996 1 973 15-19 1931 2 253 10-14 2176 2 616 5-9 2500 1 383 0-4 1297

3 000 2 000 1 000 0 1 000 2 000 3 000 Figure: Proportion of male and female First Nations and non-First Nations people in Alberta within 5-year age groups, 2017

0,0% 0,0% 90 + Males FN 0… 0,1% 85-89 yrs. Females FN 0,2% 0,2% 80-84 yrs. 0,4% 0,4% 75-79 yrs. Males Non-FN 0,6% 0,7% 70-74 yrs. Females Non-FN 1,0% 1,1% 65-69 yrs. 1,5% 1,7% 60-64 yrs. 2,2% 2,3% 55-59 yrs. 2,8% 2,9% 50-54 yrs. 3,1% 3,2% 45-49 yrs. 3,2% 3,3% 40-44 yrs. 3,4% 3,6% 35-39 yrs. 3,8% 3,9% 30-34 yrs. 4,4% 4,3% 25-29 yrs 4,9% 4,5% 20-24 yrs 4,3% 4,2% 15-19 yrs. 4,5% 4,5% 10-14 yrs. 4,9% 4,8% 5-9 yrs. 4,6% 4,4% 0-4 yrs.

6,0% 4,0% 2,0% 0,0% 2,0% 4,0% 6,0% Data availability:

First Nations identifying information from the Indian Registration System (or other identifiers like band lists) is not seen by anyone except a select few data analysts

X

Information (administrative, lab, diseases, births, deaths)

Copy of relevant data pieces

$$$ Disease Registries Vital Statistics First Nations- specific health information Respectful relationships:

• On-going relationships with specific First Nations (e.g. sharing of immunization data)

• June 2013: Chiefs resolution requests that data-related issues be addressed Respectful relationships:

Successful!

• INAC’s Data Access and Review Committee has granted us permission to develop an information sharing agreement that will permit the movement of IRS data to Alberta Health (drafting an ISA and PIA).

• We received permission to receive IRS data from across Canada so that all First Nations residing in Alberta will be included: In 2009, 21.1% of First Nations living in Alberta (almost 33,000 people) were affiliated with a First Nation outside of the province. Examples:

–Collaborative process

–Goal is to identify topics communities are interested in or would find useful

–Topic ideas to be brought to AFNIGC Ultimate Goal

Support First Nations communities in Alberta so they can tell their own (data) stories Strategic Priorities 2018-20

To develop and implement a Blackfoot Confederacy Health Strategy Plan, with measurable outcomes rooted in Siksikaitsitapi Knowledge Systems. Goal No.1: Health - close the gaps in health outcomes between Indigenous and non- Indigenous communities within quality of life indicators and determinates to health. Benchmarks for Success: • Siksikaitsitapi Health Framework developed with Blackfoot indicators of well-being • Improved Health outcomes for BFC members • Sustainable fully funded Siksikaitsitapi PCNs Evaluation: • Develop comprehensive Siksikaitsitapi Logic Model to measure progress over time –As First Nations our oral teachings and Sovereign Nations origin stories dictate that we have always been here, we come from the stars and return to the stars –Prior to European contact we as Nations were sovereign people who had their own laws and systems that governed their people (i.e.. Medicines, healers, kinship and systems, roles and responsibilities that related to the plants, animals, lands and waters) – Blackfoot Confederacy is an example of a prominent pre-colonial governance structure and –iipoh’pii’ah - means “disruption” in the it’s impacts on –Before colonization there was an First Nations of existing natural and cosmic order Canada to things that governed Indigenous worldviews and philosophy on living a respectful life –Colonization disrupted Indigenous knowledge –Impacts include displacement, spiritual disconnection, imbalance, and cultural disintegration, and loss – all resulting in toxic stress Indigenous perspectives on ‘sustainability’

–Underlying intent to life is responsibility to all things living and sustaining this for future generations

–Soksiikso’kawaamatsii’op – means to practice good relationships with all things

–What do we want to measure? – data measures the damage of interruption to life for –Indigenous measures focus on sustainability of life Historically First Nations well-being has been measured against urban, Non-First Nations and Canadian standards Why do we Such measures of progress counted First Nations as “deficit white need First people”

Nations Allows researchers to continue to measure our state of health based Indicators of on western standards of illness not wellness

Wellbeing? The data that exists measures the assimilation of the Indigenous Nations into the larger Canadian

First Nation indicators Measure the life that we were intended for as the Original peoples of our territories, the life our ancestors had prayed for us List of topics/indicators from First Nations Health Status Truth and Reconciliation Report Table of Contents Recommendation #19 http://www.afnigc.ca/main/includes/media/html_files/Fir st_Nations_COVID19_Dashboard_Alberta2020-06- 10_13-49.html Questions?