In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care
Introduction to the Effects of Indigenous Specific Racism Within our Health System
Much of the content in the following article has been adapted from In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care by Dr. Mary Ellen Turpel-Lafond.
In December 2020, Dr. Mary Ellen Turpel-Lafond presented findings from her investigation into anti-indigenous racism within BC’s health care system. The report, entitled In Plain Sight, is based on consultations with almost 9,000 Indigenous peoples and health care workers and finds clear evidence of widespread systemic racism within our province.
“Racism against Indigenous people is a malignant disease that has been in the health system in British Columbia since inception. Every person who works in the health care system, in fact every British Columbian, must acknowledge this reality and work together to ensure health care for Indigenous people is equitable a culturally safe and focuses on the needs of the individual, not the attitudes of the system.”
Grand Chief Steward Phillip,
President, Union of BC Indian Chiefs
The report found that the majority of Indigenous people in BC have encountered racism and discrimination within our health care system, whether as a patient or a health care worker. Indigenous respondents described experiencing stereotyping, unacceptable personal interactions and poorer quality of care, as well as noting that they do not feel safe when accessing health care services and interacting with health providers.
This article is the first in a series of articles dissecting the report and discussing its findings with pharmacy professionals.
For a more in-depth look at these findings, you can view the report in its entirety at:
Widespread Indigenous-specific stereotyping, racism and discrimination exist in the BC healthcare system
Almost half of Indigenous health care workers surveyed, and one-quarter of non-Indigenous health care workers reported incorrect assumptions and negative stereotyping were a regular occurrence when caring for Indigenous patients.
Common Stereotypes included:
- “Less Worthy” of care – Indigenous patients seen as inherently less valuable that non-indigenous (and particularly white) patients due to a number of generalized, negative perceptions of Indigenous people.
- Drinkers/alcoholics – Patients presumed by staff to be intoxicated or have a drinking problem
- Drug-seeking – Patients requiring pain medication presumed to have ulterior motives (e.g. to obtain prescription drugs to use for non-medical purposes or to sell)
- Bad parents – Negative judgments made about the capacity of patients to care for their children
- Irresponsible/Non-compliers – Patients seen as unwilling to take responsibility for their health care or to follow through on aftercare instructions
- Less capable – Patients seen as lacking the capability to take responsibility for their health care
- Unfairly advantaged – Patients seen as “always getting their stuff for free”
The pervasiveness of negative stereotyping and profiling of Indigenous patients leads to discriminatory behaviour, poorer quality of care and ultimately poorer health outcomes. Indigenous respondents to the In Plain Sight investigation were 2 to 2.5 times more likely than non-Indigenous respondents to report “always” having adverse experiences across six subjective care experience categories.
Forms of Discriminatory Treatment and Poorer Quality Care
- Unacceptable personal interactions
- Long wait times/denial of service
- Lack of communication/shunning
- Not believing/minimizing concerns
- Inappropriate/no pain management
- Rough treatment
- Medical mistakes
- Lack of recognition/respect regarding cultural protocols
The Relationship Between Health and Human Rights
In Plain Sight places added urgency on the College to continue to work toward fulfilling its commitment to Cultural Safety and Humility for First Nations and Aboriginal peoples within our healthcare system. The findings within the report reinforce the need to create a healthcare environment free of racism and discrimination, that ensures Indigenous people in BC can access and receive safe and equitable health care services.
The College would like to reinforce, as is done in the report, the relationship between health and human rights in the specific context of Indigenous peoples.
“The Indigenous right to health means that Indigenous peoples must be able to fully access appropriate health care services and ensure their individual well-being is cared for. To respect this right, such services must be free of obstacles and hindrances that don’t exist for other people, and at the same time must be provided in ways that affirm and uphold the distinctive cultural and social context of Indigenous peoples” (In Plain Sight, p. 174-175)
System racism and intolerance toward Indigenous worldviews and traditional approaches to health, as well as the enduring legacy of colonialism all present as persistent barriers for Indigenous people when accessing appropriate health care services.
While a more comprehensive approach to addressing racism in BC’s healthcare system is underway, as a starting point, the College would like to remind BC’s pharmacy professionals to acknowledge the existence of anti-Indigenous racism within our health system and that Indigenous people have an equal right to the enjoyment of the highest attainable standard of physical and mental health.
- In Plain Sight - Data Report
- Principles respecting the Government of Canada’s relationship with Indigenous peoples
- United Nations Declaration on the Rights of Indigenous Peoples
- Declaration of Cultural Safety and Humility in Health Services Delivery for First Nations and Aboriginal Peoples in BC