FIGURE 4: ACCESS TO PRIMARY HEALTH CARE AMONG INDIGENOUS ADULTS IN TORONTO COMPARED TO THE GENERAL CANADIAN AND ONTARIO POPULATION*
11%
Ontario adults age 12 years and older
28%
Canadian adults age 12 years and older
OHC Toronto adults age 15 years and older
PERCENTAGE
OVER 1 IN 4 INDIGENOUS ADULTS IN TORONTO HAD UNMET HEALTH NEED IN THE PAST 12 MONTHS
Reasons why these were not met:
10%
••
Inability to get transportation
••
Inability to afford transportation
••
Lack of trust in the health care provider
*Source: Our Health Counts Toronto
In February 2016, the College of Family Physicians of Canada’s Indigenous Health Working Group and the Indigenous Physicians Association of Canada released a fact sheet on systemic racism with insights and recommendations specifically for family doctors. The fact sheet provides ways that family doctors can get more involved with Indigenous health in their clinics, communities and training institutions (The College of Family Physicians Canada 2016). The suggestions include providing a Culturally Safe Environment in clinics by ensuring a patient’s ways of knowing and decision-making process are respected and building partnerships with local Indigenous organizations. Family medicine educators should also introduce Trauma-Informed Care into medical curricula. This care “acknowledges and teaches about the Indigenous-specific effects of colonial policies and how they are linked to historic and current medical services for Indigenous peoples” (The College of Family Physicians of Canada, 2016). The University of Toronto Department of Family and Community Medicine has set the goal of becoming the family medicine residency program of choice for Indigenous post-graduate learners across Canada. To achieve this, the department is currently examining how to increase the number of Indigenous faculty and post-graduate learners and ensure they are learning and teaching in a supportive and culturally safe environment. We are also supporting the development of Indigenous leadership within our department and providing faculty, post-graduate leaners, students and staff with opportunities to enhance their knowledge and understanding of Indigenous culture and health. 74 | Chapter 13
The Department is doing meaningful and impactful work toward improving the health outcomes for this nation’s Indigenous communities, in urban, rural and remote locations, but there is still much more we can and need to do.
Helena Medeiros is a Research Officer at the Department of Family and Community Medicine at the University of Toronto Dr. Katherine Rouleau is Vice-Chair, Global Health and Social Accountability at the University of Toronto Department of Family and Community Medicine and a family doctor at St. Michael’s Hospital. Sara Wolfe is an Indigenous Registered Midwife with Seventh Generation Midwives Toronto and Community Partner Lead on the Our Health Counts Toronto study Cheryllee Bourgeois is a Metis Exemption Midwife with Seventh Generation Midwives Toronto. Dr. Janet Smylie is a family doctor and research scientist in Aboriginal health at St. Michael’s Hospital, Centre for Research on Inner City Health (CRICH), where she directs the Well Living House Applied Research Centre for Indigenous Infant, Child and Family Health