Abstract
In the Canadian context, the persistence and growth of Aboriginal health and social inequity signals that we are at a critical public health policy juncture; current policy reflects an historic relationship between Aboriginal people and Canada that fails the contemporary health needs of Canada’s Aboriginal peoples. In this review, we highlight the need for healthy public policy that recognizes and prioritizes the rights of Canada’s Aboriginal people to achieve health equity. Drawing from a structural approach, we examine the historical scope and comprehensive breadth of the Indian Act in shaping modern Aboriginal health and social inequities. Canada’s failure to implement a national public policy for Aboriginal health reflects the proliferation of racism in modern day Canada, and a distinctly lacking political will at the federal level. Despite these structural challenges, there is great promise in community self-determination in health care and the role of community-led research as advocacy for policy reform. In our conclusion, we turn to the Report on the Truth and Reconciliation Commission of Canada (2015) and draw upon the concept of reconciliation as a fundamental precursor for Aboriginal health equity. The burden of systemic change needed to promote healthy public policy cannot be carried by any single group of advocates; it is a shared responsibility that will require the collaboration and integration of various actors and knowledges.
Highlights
The concept of healthy public policy was originally introduced in the Ottawa Charter for Health Promotion [1] (1986), as a tool to create the sorts of supportive environments that will enable people to live healthy lives by putting health on the policy agenda in all sectors, and at all levels
Less than a decade ago, Canada was one of four Western nations who voted against the adoption of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP)
Though Canada has since adopted UNDRIP, the nation’s initial resistance to the Declaration demonstrates its universal failure to acknowledge both the human rights and inherent rights of its Indigenous peoples
Summary
The concept of healthy public policy was originally introduced in the Ottawa Charter for Health Promotion [1] (1986), as a tool to create the sorts of supportive environments that will enable people to live healthy lives by putting health on the policy agenda in all sectors, and at all levels. The Ottawa Charter has become a powerful addition to public health theory and practice globally. It was informed by the 1974 Lalonde Report [2], wherein the concept of the ‘health field’ was first proposed to include four major elements: genetics, environment, lifestyle, and medical care. The Lalonde Report was conceptually important as it introduced the idea that there are determinants, distinct from the health care system, that affect the health of individuals and populations. There is recognition that in creating the conditions for equitable access to health services among vulnerable populations, such as that of Indigenous peoples, particular attention must be paid to their unique cultural contexts and histories [3]
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