Indigenous people lack access to health care because of systemic racism, report says

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British Columbia’s dwindling supply of COVID-19 vaccines has meant public-health teams have virtually halted the delivery of first doses, with just 400 shots delivered one day this week. The shortages have heightened tensions over the province’s vaccine rollout plan overall, but especially for remote and isolated Indigenous communities that were promised priority access because they face higher health risks, and have greater barriers to health care.

“The priorities remain the priorities, but you can only deliver based on what you have,” Health Minister Adrian Dix said.

On Thursday, Mr. Dix released a data report on the impact of systemic racism in health care, showing that Indigenous peoples have less access to the provincial health care system – a disparity that has widened in the pandemic.

The study “reveals a system that does not provide Indigenous peoples with sufficient and safe access to primary and preventative care, and is therefore skewed toward emergency and specialized treatment,” said the report’s author, Mary Ellen Turpel-Lafond, a former judge who was asked last summer to investigate allegations of racist acts in B.C. hospitals. She concluded that racism experienced by Indigenous peoples leads to avoidance of care, in large part because Indigenous people seek to avoid being stereotyped, profiled, belittled and exposed to prejudice.

She said the delivery of COVID-19 vaccines has to factor in those challenges. “We do know who is deeply at risk and deeply vulnerable [to COVID-19], and it is disproportionately First Nations people,” she told reporters. The study notes that First Nations in B.C. experienced a higher rate of infection than what has been seen in the general population of the province.

Mr. Dix, who will on Friday release an update on the province’s vaccination rollout, would not say on Thursday how far behind B.C. is in meeting its targets for immunization in Indigenous communities.

However, the report comes on the heels of the government’s apology to the Nuxalk Nation, after concerns were raised about the withdrawal of COVID-19 vaccines that had been brought to the remote community in Bella Coola. Mr. Dix reiterated his apology on Thursday, saying it is critical that COVID-19 vaccines are delivered “in a culturally safe way. I think it’s clear in this case that we failed to meet that expectation.”

The first phase of the province’s vaccine distribution plan is supposed to distribute to vulnerable Indigenous populations as well as residents and workers in long-term care homes. But delays in shipments of both the Moderna and Pfizer vaccines have forced the province to scale back and focus on delivering booster shots to those who have already had their first shot.

“Obviously it means that we’re not able to move down the list of priority as fast as we’d like,” Mr. Dix said.

Ms. Turpel-Lafond’s report, the third in a series, focused not only on the pandemic but on access to preventative care. It found that Indigenous people are less likely to access common cancer detection tests, prenatal screening and pediatric care.

“The rates of pediatrician and obstetrician services were lower among First Nations, suggesting that comparatively more First Nations are relying on the primary care system for perinatal and child health instead of specialty maternal and child health services,” the report found, “despite evidence of higher rates of preterm and very preterm births, increased rates of asthma, depression, mood and anxiety disorder and epilepsy, and poorer oral health outcomes in the child and youth population.”

Mr. Dix said his government is committed to bringing change. “The data and the analysis show that this is toxic for people’s health,” he said.

“Together we can direct the change that will give people in B.C. the confidence that when they arrive at the doors of our health care system, they will be seen as they are, as they are without bias and prejudice, and with care and respect.”

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