Racism and stereotyping against Indigenous patients is widespread in B.C.’s healthcare system according to an independent investigation — which saw 86 per cent of Indigenous respondents reporting they have experienced some form of discrimination in the system.
The “In Plain Sight” report, released Nov. 30, found a lack of cultural safety and hundreds of examples of prejudice and racism towards Indigenous people throughout the province’s health care system.
The independent investigation was spurred on by reports of a “Price is Right” game being played in B.C. emergency rooms during which staff would guess the blood-alcohol level of patients, however, the investigation found only anecdotal evidence of such activities.
“Our detailed examination of those allegations found no evidence of an organized game as originally depicted. Namely with prizes and … occurring throughout emergency rooms across British Columbia. What I did find was anecdotal and episodic evidence of multiple activities that resemble those allegations,” said Mary Ellen Turpel-Lafond, lead investigator, while reporting the results of the investigation Monday. “Not as a game with that name. Not as widespread as alleged, and in places not just targeting Indigenous people and Indigenous patients.”
However, Turpel-Lafond said, the review found a “much more widespread insidious problem.”
“Meaning, if there had simply been a game played away from patients, as difficult as that would have been to make that finding, what I found, in fact, was at the point of care there is direct prejudice and racism touching all points of care and impacting Indigenous people in B.C.,” Turpel-Lafond said. “Now, that doesn’t mean every Indigenous person, every First Nations, Metis or Inuit person in B.C. who seeks care at the point of care will experience direct personal racism today, it just means that any Indigenous person could face it because it is that pervasive and entrenched in the system.”
“We should all find that conclusion deeply troubling.”
The review included input from 9,000 indigenous patients, family members, third-party witnesses, healthcare workers and responses from two online surveys. The report also received direct submissions from 600 people and included 150 interviews with staff and people working within the health-care system.
“Examining all of this evidence we found pervasive, interpersonal systemic racism that adversely effects not just patient and family experiences but also long-term health outcomes for Indigenous people in B.C.,” Turpel-Lafond said.
According to the report, 52 per cent of Indigenous health care workers that responded experienced some form of racial prejudice. More than one-third of the thousands of non-Indigenous health care workers surveyed in the investigation reported witnessing interpersonal racism or discrimination against patients, family and friends.
“Indigenous people consistently told us, and this is confirmed by the health care workers who responded and the cases, that they are subject to negative assumptions. Negative assumptions based on prejudice, based on racism, based on beliefs that should not exist in our healthcare system,” Turpel-Lafond said. “Among the top negative assumptions that are circulating in our healthcare system today is the idea that Indigenous patients and people are less worthy, that they’re alcoholics, that they’re drug-seeking, that they’re bad parents, frequent fliers, non-complaint and incapable of adhering to treatment or medical advice.”
The review also examined health-care data of approximately 185,000 First Nations and Métis patients, showing that racism limits access to medical treatment and can negatively affect the health and wellness of Indigenous people. Indigenous women are disproportionately impacted by racism in health care and that racism contributes to Indigenous people being disproportionately affected by the current public health emergencies of COVID-19 and the overdose crisis as well, the report found.
A separate data report, which will offer a more in-depth look into the health system’s treatment of Indigenous people, will be released next month.
The report makes 24 recommendations to address what it calls a systemic problem, including establishing three new government positions to take the lead on the issue including a B.C. Indigenous health officer, an Indigenous health representative and advocate and an associate deputy minister of Indigenous health.
The review recommends that the B.C. government lead apologies for Indigenous-specific racism in the health care system, and direct and implement a comprehensive system-wide approach to addressing the problem. This includes changes in laws, policies and practices to align with the UN Declaration on the Rights of Indigenous Peoples (UNDRIP) as required by B.C.’s Declaration on the Rights of Indigenous Peoples Act.
Among other recommendations, the report calls for government to work with Indigenous organizations to improve the system’s patient complaint processes to address Indigenous-specific racism and for the development of a new approach to cultural safety and humility training for B.C. health-care workers. The report also calls for a new school of Indigenous medicine at the University of British Columbia.
The investigation has shed light on the fact that racism runs so rampant in society it has become the “unspoken norm,” said Grand Chief Stewart Phillip with the Union of BC Indian Chiefs.
“We need to use this report as a stepping-stone to change. We need to implement the recommendations and, importantly, we need to raise our voices loud and clear to call out those complicit in allowing racism to endanger and, in some cases, irreparably harm Indigenous lives. You have to go to the hospital sometimes — and it has to be safe for all British Columbians including First Nations,” Phillip said.
Find the full report, In Plain Sight, here: https://engage.gov.bc.ca/app/uploads/sites/613/2020/11/In-Plain-Sight-Full-Report.pdf
A summary version of the report is here:https://engage.gov.bc.ca/app/uploads/sites/613/2020/11/In-Plain-Sight-Summary-Report.pdf
Dale Boyd, Local Journalism Initiative Reporter, Times-Chronicle