Alberta has hired its first “patient navigator” to help Indigenous people find their way through a complex health-care system that is spread between two levels of government and often a source of distrust in First Nations communities.
Chloe Crosschild, a registered nurse whose work focuses on community health, will take on the role from her home base of Chinook Regional Hospital in Lethbridge, located a two-hour drive southeast of Calgary. The hiring of Ms. Crosschild, a member of the Blood Tribe, is part of a three-year research project that could see similar positions open across the province.
The program is being launched at a time when racism toward Indigenous patients within the health care system has faced increased scrutiny, particularly after the case of Joyce Echaquan, a 37-year-old mother and member of Quebec’s Atikamekw Nation who streamed a video on Facebook showing her being demeaned at a hospital near Montreal before her death.
Ms. Crosschild said that in addition to helping Indigenous people access the care they need, her role serves as a bridge between those patients and a system that many have legitimate reasons to view with suspicion.
“There is a lot of mistrust between Indigenous peoples and the health care system based on the historical relationships that have occurred,” Ms. Crosschild said in an interview.
“... Systemic racism, individual racism – it’s definitely happening everywhere, southern Alberta not excluded. But I think that this is a good start to addressing some of those [problems] and enhancing those relationships between the health care system and Indigenous peoples.”
Indigenous patients have worse health outcomes than the general population. In Alberta, for instance, the life expectancy for Indigenous people is 10 years lower than non-Indigenous residents. Indigenous communities also have higher rates of infant mortality and conditions such as diabetes.
The patient navigator is a referral-based program for Indigenous people who could benefit from one-on-one help at any point during their treatment. Ms. Crosschild, who will eventually be joined by a second navigator in southern Alberta, will help patients deal with obstacles such as language barriers while ensuring their care is culturally appropriate.
Ms. Crosschild recalled her own grandmother dealing with several overlapping medical conditions. Her first language was Blackfoot, so she needed information about her treatment translated. She was diabetic but also participated in cultural ceremonies that required fasting.
“Having those conversations about what that’s going to look like in terms of blending Indigenous practices and Western practices to ensure the health and wellbeing of Indigenous clients – that’s a unique perspective that this service will bring to the table,” she said.
The service is available to people receiving in-patient and out-patient care.
The project will also involve creating a medical body chart translated into Blackfoot, and a guide for health care workers in Indigenous cultural practices.
First Nations health care is provided through a mix of federally funded programs and provincially run facilities. That shared jurisdiction further complicates the reality for Indigenous patients, said Katherine Chubbs, Alberta Health Services' chief officer for the province’s south zone.
Dr. Chubbs said the goal is to simplify that process to make health care easier to access.
“For anyone, understanding medical diagnoses and having to navigate the health care system is very challenging. If you add in the unique challenges encountered by Indigenous people, Chloe, with her clinical knowledge, will be able to really help to navigate and translate some of those things – ultimately ending up with a better health care outcome and experience.”
The officials involved in the project will be looking for signs that it’s working, such as improved health outcomes, she said. If there is progress, the province could set up Indigenous patient navigators across Alberta.
Ms. Echaquan’s story in Quebec has brought new urgency to problems that First Nations leaders say have been longstanding.
There have been other high-profile instances of Indigenous people experiencing racism while accessing care, such as allegations out of British Columbia earlier this year that emergency room staff played a crude game in which they would guess the blood-alcohol levels of Indigenous patients. The province launched an outside investigation.
Federal ministers held an emergency meeting with Indigenous leaders and health professionals last Friday to discuss racism in health care.
Ms. Crosschild said her role could play a small part in helping to rebuild trust.
“Having a familiar face, somebody that is local, somebody that you know they can place within their own family tree or within their own community, gives a start to that trusting relationship."
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