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Insiders’ insight: discrimination against Indigenous peoples through the eyes of health care professionals

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Summary:

This Canadian investigation invited healthcare providers and decisionmakers to identify any challenges that they see facing Indigenous patients and families when accessing health services in a large city in southern Ontario. The respondents identified widespread discrimination against Indigenous people as a major challenge for the healthcare system. Analyses of the interview data highlighted 3 key discrimination subthemes: (1) an unwelcoming environment; (2) stereotyping and stigma and; (3) practice informed by racism. The study researchers state that these findings highlight the importance of going beyond simply making health services more welcoming and inclusive, if healthcare access is to be meaningfully improved for Indigenous peoples. Moreover, they note that practice norms shaped by biases informed by discrimination against Indigenous people are widespread and compromise standards of care. The researchers call for a quality improvement strategy designed to address the problem throughout the healthcare system. As they note, addressing the problem in this way will require not only a significant shift in the attitudes, knowledge, and skills of healthcare providers, but also, healthcare organisations will need to establish accountabilities to ensure equitable health services for Indigenous peoples.

Comment:
Please read the whole paper, especially the quotes from health professional participants, who were forthright, open and challenging.
Reference: J Racial Ethn Health Disparities 2019;6(1):37-45
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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