Alain Beaudet shares an excerpt of his speech, given at last week’s annual Forum of the Canadian Academy of Health Sciences, which outlines research priorities for indigenous health.
. . . [K]udos to the Canadian Academy of Health Sciences for devoting a full day of its annual meeting to a major forum on solutions to inequities in indigenous health. The topic is a critical one. Indeed, as you all know, many Canadian indigenous communities are living in a real state of crisis.
Some indigenous communities have tuberculosis rates that are four hundred times the rates of non-indigenous communities and some Inuit communities have forty times the suicide rates of non-Inuit communities.
Obesity, diabetes and hypertension are on the rise, with rates akin to those of low and middle income countries. For example, obesity rates exceed 26% among First Nations people, 22% for Métis, and 26% for Inuit, compared with 16% for non-indigenous Canadians. Smoking rates are also over two times higher among indigenous groups than the non-indigenous population, leading to increased incidences of lung cancer and chronic lung diseases.
And all this in a developed country, a member of the select group of G7 countries and a country particularly proud of its universal healthcare system.
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The Canadian Institutes of Health Research (CIHR) has made indigenous health one of its top research priorities in its last two 5-year strategic plans and its investments in this field have increased accordingly, growing from $2.14 million in 2001-02 to $30.8 million in 2014-15, in the face of a stagnating CIHR budget. We have, for instance, dedicated $25 million over 10 years to the Pathways to Health Equity for Aboriginal Peoples strategic initiative, which applies implementation research and delivery science to developing multilevel and scalable interventions to reduce health inequities facing indigenous peoples.
These investments have led to a significant buildup of research capacity, with the proportion of researchers working on indigenous peoples’ health growing from 1% to 10% of all CIHR-funded researchers from 2000 to 2015.
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Despite our undeniable progress in closing disparity gaps, much remains to be done. And the time has never been more propitious for taking action. The Truth and Reconciliation Commission has released its report on the impact of the residential school system on Canada, including 94 Calls to Action, with six focused on health. The Supreme Court of Canada has ruled that Métis and non-status Indians be recognized under the Indian Act. The Minister of Indigenous Affairs, Carolyn Bennett, has announced Canada’s commitment to uphold the principles of the UN Declaration on the Rights of Indigenous Peoples at the UN forum.
CIHR has heard the clear and firm commitment made by the current government to close the gaps with the indigenous communities, while at the same time articulating the need for evidence-based policy.
Already, we have taken a number of measures to tackle these issues.
To reinforce our commitment to integrate indigenous perspectives on health and health research, we have established a new, CIHR-wide Institute Advisory Board on Indigenous Peoples’ Health, where the majority of the members are indigenous. This Board will be chaired by Jeff Cyr, former Executive Director of the National Association of Friendship Centres.
Also, CIHR’s Governing Council has dedicated the whole two days of its latest retreat to reflect on the organization’s past and future actions in indigenous health research. It has done so with the participation of representatives from the Assembly of First Nations, Métis National Council, Inuit Tapiriit Kanatami, Aboriginal Health Research Steering Committee, Indigenous and Northern Affairs Canada, and other stakeholders.
At this meeting, Council committed to further fostering the advancement of a national health research agenda to improve and promote the health of First Nations, Inuit and Métis peoples in Canada, through research, knowledge translation and capacity building.
A full action plan will be released later in the year, but already steps have been taken to: (1) develop a common understanding and definition of indigenous health research; (2) adopt principles of indigenous health research that build on tri-council policies, the work of the Truth and Reconciliation Commission, and the United Nations Declaration on the Rights of Indigenous Peoples; and (3) inform culturally appropriate approaches to peer review through the mobilization of an indigenous co-led reference group.
CIHR has a unique opportunity, in fact a unique responsibility, to be a change agent in matters of indigenous peoples’ health.
Canada’s First Nations, Inuit and Métis peoples have enormous resilience and strength. It is our belief at CIHR that by working alongside our indigenous partners we can support research that will have significant impact not only in improving indigenous health outcomes, but also in strengthening indigenous leadership capacity.
Canadians do not expect less from us.
Alain Beaudet is the President of the Canadian Institutes of Health Research.