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Abstract
Given that the health care system for Indigenous people tends to be complex, fragmented, and multi-jurisdictional, their cancer experiences may be especially difficult. This needs assessment study examined system-level barriers and community strengths regarding cancer care experiences of Indigenous people in Saskatchewan. Guided by an advisory committee including Indigenous patient and family partners, we conducted key informant interviews with senior Saskatchewan health care administrators and Indigenous leaders to identify supports and barriers. A sharing circle with patients, survivors, and family members was used to gather cancer journey experiences from Indigenous communities from northern Saskatchewan. Analyses were presented to the committee for recommendations. Key informants identified cancer support barriers including access to care, coordination of care, a lack of culturally relevant health care provision, and education. Sharing circle participants discussed strengths and protective factors such as kinship, connection to culture, and spirituality. Indigenous patient navigation, inter-organization collaboration, and community relationship building were recommended to ameliorate barriers and bolster strengths. Recognizing barriers to access, coordination, culturally relevant health care provision, and education can further champion community strengths and protective factors and frame effective cancer care strategies and equitable cancer care for Indigenous people in Saskatchewan.
Highlights
Indigenous cultures are richly diverse across the globe, and yet similar colonial legacies have created disparities in health, poverty, and life expectancy even in economically developed countries (Australia, Canada, New Zealand, and the U.S) [1,2]
Themes from key informant interviews were used to capture health system-level perspectives on the barriers to Indigenous cancer care, while the sharing circle, having no structured interview questions, explained community-level strengths relating to the cancer journey. By using these separate methods, we provide a picture of supports and barriers from patient, family, community, and system-level perspectives to inform Indigenous cancer care recommendations
A total of six key informant interviews were conducted with one senior cancer care administrator and five First Nations and Métis leaders and physicians
Summary
Indigenous cultures are richly diverse across the globe, and yet similar colonial legacies have created disparities in health, poverty, and life expectancy even in economically developed countries (Australia, Canada, New Zealand, and the U.S) [1,2]. Cancer is one of the leading causes of death in Native Americans and Alaskan Natives [3], Aboriginal and Torres Strait Islander People [4], Māori [5], and Indigenous Peoples of Canada The higher rates of cancer diagnosis and mortality for Indigenous Peoples constitute a phenomenon that requires attention across continents [1]. First Nations and Métis Peoples in Canada have previously experienced lower rates of all cancer incidence and mortality compared to the general population [10]. In recent decades, a concerning trend has occurred among Indigenous patients, who develop cancer at higher rates than previous generations [11].
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