Appendix B: Integrated Pan-Canadian Healthy Living Strategy 2005 – Aboriginal peoples and the healthy living strategy – summary report

Appendix B: Aboriginal Peoples and the Healthy Living Strategy – Summary Report ^{Footnote 35}

Background

Aboriginal Peoples suffer a great risk and burden of poor health compared to the general Canadian population. Type 2 diabetes, in particular, is increasingly prevalent as is its main risk factor – excess body weight. Rates have escalated from 9.3% in 1995 to 15% in 2002.

One of the goals of the Healthy Living Strategy is to ensure that it meets the unique needs of Aboriginal Peoples. At their annual meeting in October 2004, Ministers of Health re-confirmed their commitment to the Healthy Living Strategy and asked that a Healthy Living Strategy be presented to them in September 2005.

Aboriginal Participation

Aboriginal participation in activities related to the development of the Healthy Living Strategy was diverse and varied depending on the particular activity.

Intersectoral Healthy Living Network Coordinating Committee and Working Groups
Three National Aboriginal Organizations (NAO) were invited to participate in the Coordinating Committee: Assembly of First Nations, Inuit Tapiriit Kanatami, and Métis National Council. These same NAOs were also invited to join any of the four Working Groups which were established in September 2004. One member of the Research and Surveillance Working Group represented the First Nations House of Learning at The Longhouse of the University of British Columbia. The Public Information Working Group developed a social marketing strategy in collaboration with Indian and Northern Affairs Canada.

A number of meetings were held with the five NAOs (Assembly of First Nations, the Inuit Tapiriit Kanatami, the Congress of Aboriginal Peoples, the Native Women’s Association of Canada and the Métis National Council) to determine an agreed-upon approach to address specific discussions on the involvement of Aboriginal Peoples. The approach included the following three key elements: an initial Information Session; group-specific reports with recommendations; and an Advisory Session.

Information Session on Healthy Living
An Information Session was held on January 31, 2005, with participating NAOs to discuss, and provide a starting point for, the Aboriginal Dialogue process on healthy living. It provided an opportunity to examine the various aspects of the Integrated Pan-Canadian Healthy Living Strategy (HLS), and related activities that were underway.

Group-specific Reports with Recommendations
Four NAOs agreed to develop a group-specific report with recommendations and to share their outcomes in an Advisory Session. They are the following: the Assembly of First Nations, the Inuit Tapiriit Kanatami, the Congress of Aboriginal Peoples and the Native Women’s Association of Canada.

Advisory Session on Healthy Living
An Advisory Session was held on March 3 – 4, 2005 to invite NAOs to present their draft reports, including their perspectives on healthy living, and to examine approaches to involving Aboriginal Peoples in current activities within the scope of the HLS. A facilitated discussion was held with an Aboriginal consulting firm in order to develop overall recommendations that could be brought forward to the Advisory Committee on Population Health and Health Security. Various participants were in attendance.

Two key questions guided the process, and they are the following:

• How do the initial areas of focus of the Healthy Living Strategy, specifically physical activity and healthy eating, relate to the situation and context of Aboriginal Peoples?
• How do Aboriginal Peoples want to be involved in the current strategic directions and F-P/T activities of the Healthy Living Strategy (eg. Coordinating Committee of the Intersectoral Healthy Living Network, research and surveillance, Fund, social marketing, school health, and others)?

Recommendations Made by the National Aboriginal Organizations

Each NAO presented key points specific to each Aboriginal community. The following is a common summary of the key points made by the four participating NAOs (the Assembly of First Nations, the Inuit Tapiriit Kanatami, the Congress of Aboriginal Peoples and the Native Women’s Association of Canada) at the Advisory Session on Healthy Living of March 3 – 4, 2005.

Issue-related Topics

• Mental health and food security are priorities;
• Physical activities to support healthy living must be promoted and encouraged at all public events;
• Programs and services available to the Aboriginal population must be coordinated; Carry out Aboriginal community (on/off reserve) surveys to capture needs Support and build on existing programs (not just pilots)
• Increase access to suitable housing;
• Increase health promotion and prevention opportunities;
• Better coordination of services is necessary;
• Domestic, racialized and sexualized violence must be taken into consideration;
• Realities of Aboriginal women’s lives need to be considered;
• Must support women-centered activities and sports;
• Innovative approaches need to be considered;
• Sexual and reproductive health information needs to be integrated into approaches;
• Promote positive messages;
• Program design must be open and flexible (not prescribed) to support community control

Stakeholders

• The Aboriginal community needs to be involved in all HLS activities including all facets of the consultation process;
• Youth must be involved in all Healthy Living Strategy processes;
• Control of off-reserve programs by Aboriginal off-reserve organizations;
• Include INAC, HC, PHAC, First Nations Governments, CCOH and the National First Nations Health Technicians Network;
• Strategy needs to happen at national, regional and local levels

Process

• Build on the precedents set by the Blueprint on Aboriginal Health and the next First Ministers Meeting;
• Recognition of First Nations jurisdiction in health service delivery founded on Treaty and Inherent Rights;
• Minimal national framework with measurable, attainable expectations;
• A gender-based analysis is required.

Further Development
The NAOs support the further development of an Aboriginal specific component of the Integrated Pan-Canadian Healthy Living Strategy through the following activities or processes:

• Funding allocated to each Aboriginal organization leading this development, both at the national and regional levels through their different, yet complementary, processes;
• Meaningful engagement of NAOs in the federal, provincial and territorial processes;
• Regional Dialogues led by Aboriginal governments, service delivery organizations and community groups;
• A gender-based analysis that recognizes the unique role of Aboriginal women in promoting health and well-being;
• Involvement of Aboriginal youth;
• Exploration of the necessary linkages to existing F-P/T and Aboriginal processes.

Consensus was reached by the participating NAOs on key guidelines for success in the further development of an Aboriginal component of the Integrated Pan-Canadian Healthy Living Strategy.

Linkages with Other Initiatives

At the September 13, 2004 Special Meeting of First Ministers and Aboriginal Leaders, F/P/T Ministers responsible for Health and Aboriginal Affairs were tasked to work in partnership with Aboriginal Leaders to develop a Blueprint on Aboriginal Health and report back within one year at the Fall 2005 First Ministers Meeting.

The purpose of the Blueprint is to improve the health status of Aboriginal peoples and health services in Canada through concrete initiatives for:

• improved delivery of and access to health services to meet the needs of all Aboriginal peoples through better integration and adaptation of all health systems;
• measures that will ensure that Aboriginal peoples benefit fully from improvements to Canadian health systems; and,
• a forward looking agenda of prevention, health promotion and other upstream investments for Aboriginal peoples.

Efforts will be made to coordinate work of the Healthy Living Strategy with the above initiatives.