interview question - aboriginal

[Guest deeds16]

I'm from Toronto and don't have a clear idea on some of the aboriginal issues with health care. I do understand that due to the lack of GPs in rural areas, there is not enough access to adequate medical care for them. But I think that that is an issue for ANYone living in a rural area. Can someone please mention any specific issues regarding health care and the aboriginal peoples?

[Guest Ali]

Hi I am not too familiar with issues facing aboriginals in Manitoba in particular, but I do know that Type II diabetes is a huge problem in aboriginal communities, some with more than 30% of adults affected. Other issues are social issues such as alcoholism and gambling which tend to be higher on reserves for a variety of reasons. I think a real challenge for physicians wanting to work with Aboriginals in general is understanding the social context of our medicine in their eyes. There is still a lot of traditional healing practices which can be difficult for someone to understand if they have no experience.

[Guest deeds16]

Thanks for the reply Ali. I will look further into some of those issues.

 

Someone mentioned to me that obesity was also an issue with the aboriginals (hence a linkage with Type II diabetes). I never knew this. Any thoughts?

[Guest Roall]

Obesity is a huge problem with all demographics, but aboriginals especially, partly due to the higher cost of healthy food and lower incomes for most aboriginals, lack of access to those foods on reserves, and poor education and incentive to lead healthy lifestyles diet and exercise wise. This in turn leads to inactivity, and increases in the risk for diabetes, stroke, heart disease, and many other conditions.

[Guest ManitobaMed]

Adding a little more...

 

While obesity is indeed an issue for aboriginal people (and for all Manitobans in general), I seem to recall that the type II diabetes rates are higher for aboriginals even when taking such factors into account. Also, aboriginal patients tend to suffer many complications as a result of their diabetes, with renal failure and amputation being particular concerns. Aboriginals also have a higher rate of kidney problems even once diabetes is accounted for.

 

As far as access to care, issues for aboriginal people extend beyond simple "rural" issues. For example, the core of Winnipeg has a large aboriginal population. Unfortunately, access to primary care in this area is limited, so many people end up visiting emergency rooms and walk-in clinics, which have limited consistency and follow-up. Also, a number a reserves are not easily accessible, as they include both fly-in communities and communities far removed for the province's tertiary care hospitals. This means that aboriginal patients requiring more than their smaller local hospitals/nursing stations can offer them must be flown into the environs of HSC/St. Boniface Hospital in Winnipeg and away from their home communities.

 

And, the above issues don't really take into account the majority of the "determinants of health", including such things as safe environment and education, which are ultimately the factors most important in determining the health of ANY community, including the aboriginal people.

 

Hope this helps. Or at least makes sense. I'm still recovering from our Block V exam. :\