Indigenous peoples in B.C. have inequitable access to preventative and primary health care services, which perpetuates poorer health outcomes for First Nations, Métis and Inuit populations in the province, the final report of the Addressing Racism Review shows.

A comprehensive data report, released today by independent reviewer Mary Ellen Turpel-Lafond, brings together the data and information collected by the review, which was commissioned by B.C.'s Minister of Health in June 2020. The data report follows up on "In Plain Sight: Addressing Indigenous-Specific Racism in B.C. Health Care" full and summary reports released on Nov. 30, 2020.

"Our extensive review of data reveals a system that does not provide Indigenous peoples with sufficient and safe access to primary and preventative care, and is therefore skewed towards emergency and specialized treatment," Turpel-Lafond said. "Indigenous peoples have substantially less access to physician services and less attachment to primary care practitioners.

"When you combine these factors with the overwhelming evidence of racism in the health-care system—which we explored in depth in our previous reports—it's not difficult to see why health outcomes for Indigenous peoples are poorer. New initiatives are positive attempts to fill this void, like the First Nations Health Authority's (FNHA) 'Virtual Doctor of the Day,' however, a full continuum of care and networks of First Nations-led primary care are needed to overcome the serious deficiencies we found for Indigenous peoples."

The initial "In Plain Sight" reports offered 24 recommendations to eliminate Indigenous-specific racism and make health care safer and more effective in British Columbia. This data report builds on those earlier reports and offers baseline measurement of how the system is performing for Indigenous peoples, featuring more detailed breakdowns of the data, including by region. The work was made possible with extensive co-operation from the FNHA and Métis Nation BC (MNBC), including their respective governance processes and/or analytical resources.

"Racism is toxic for people, and it is toxic for care," said Health Minister Adrian Dix. "The situation as it exists, and as is depicted in the details of this report, cannot stand. I am very grateful to Dr. Turpel-Lafond and her team, and to every person who took part in this review. Your work, courage and commitment have provided a roadmap for meaningful change. Together with Indigenous leadership, health professionals, colleagues and partners, we will address systemic racism in our health-care system and root out its deeply damaging effects."

The data report includes a more comprehensive look at the results of surveys of Indigenous peoples using the health-care system and of B.C.'s health care workers, as well as the review's collection of individual submissions detailing experiences of racism in health care. Together, these represented the perspectives of nearly 9,000 people.

It also features a closer examination of health-system utilization and health outcome data analyzed by the review—data which reflects approximately 185,000 Indigenous individuals. These data focus on primary care and hospital services and health outcomes, including chronic conditions and mortality, as well as the association of racism with other self-reported health and wellness indicators. Data examining priority issues, such as the two current public health emergencies and mental health and wellness are included, as are data regarding patient complaints and comments from participants in San'yas Indigenous Cultural Safety training.

"This data report is extremely important in its own right," Turpel-Lafond said. "In addition to supplementing our previous reports, it serves as a stand-alone comment on health-system performance for Indigenous peoples in B.C. And it shows there is a great deal of room for improvement."

This data report offers further evidence in support of the conclusions, findings and recommendations described in the review's first volume of reports. Taken together, these three reports clearly demonstrate the need for immediate, principled and comprehensive efforts to eliminate all forms of prejudice and discrimination against Indigenous peoples in B.C.'s health care system and increase access to culturally safe primary and preventative services.

The data report provides additional key information for the Task Team, led by Dawn Thomas, associate deputy minister of Health. The appointment of an associate deputy minister for Indigenous Health and the formation of the Task Team to implement recommendations were important steps recommended by the review.

Recommendations called for the establishment of an office of the Indigenous health representative and advocate, as well as improvements to complaints processes. The new representative and advocate positions will receive concerns from people about Indigenous-specific racism in the health care sector. While the work to establish this office is underway, B.C.'s ombudsperson has agreed to the review's suggestion that, in the interim, the ombudsperson assume management of the toll-free phone and email submission options offered to the public by the review. Turpel-Lafond will continue to be available to provide support on this issue.

Indigenous people wanting to share their experiences of racism and discrimination in the B.C. health-care system may still do so by toll-free phone at 1 888 600-3078 or email at Addressing_Racism@bcombudsperson.ca.

Find the review data report at https://engage.gov.bc.ca/app/uploads/sites/613/2021/02/In-Plain-Sight-Data-Report_Dec2020.pdf1_.pdf.

“The daily examples we hear of systemic racism toward Indigenous peoples in the health-care system are categorically unacceptable and highly disturbing,” said Chief Don Tom, vice-president of the Union of BC Indian Chiefs. “The new data report provides the sobering story of how our people continue to receive a lower standard of health care simply because of our identity as Indigenous peoples. We expect all health officials and staff in this province to review the report and commit to making change."