Social factors having greater negative impact on health of First Nations people, northern Manitobans

Racism, colonialism and low incomes are among the reasons some Manitobans are living shorter, less-healthy lives than others, according to a report released Tuesday by Manitoba Health.

The Health Status of Manitobans Report, titled Healthy Communities: A Role for Everyone, emphasizes the role social determinants have on the health of Manitobans. 

It says only 25 per cent of overall health outcomes are influenced by the health-care system and its services, whereas social determinants contribute up to 60 per cent to a population's health status.

The report — which was released nearly two years later than planned, due to the COVID-19 pandemic — delves into several areas of health care with the use of existing data, some of which dates back to 2016. 

Written by Chief Provincial Public Health Officer Dr. Brent Roussin, the report notes that measuring gaps in health inequities, as well as the structural factors that underpin them, will improve the health of all Manitobans. 

Roussin concludes that the disparities detailed in the report are not due to chance, genetics or poor life choices. Instead, he says, "health inequities are due to, and perpetuated by, social and systemic factors, including employment opportunities, housing conditions, poverty and racism.

"In order to address these disparities in health outcomes, we must first address these systemic factors. Improving these long-standing factors is complex and will require community engagement and significant time and resources to implement."

Disparity in life expectancy

Life expectancy is one of the most widely used indicators of a population's health status, and it's increasing in each of the province's five health regions.

But the same can't be said for First Nations people.

As of 2016, life expectancy for First Nations people was 72 years for females and 68 years for males. This falls considerably below the average of all other Manitoba females (82.8) and males (78.5), and the gap is growing, according to the report.

Populations with a higher premature mortality rate — death before the age of 75 — tend to have poorer overall health, and from 1997 to 2016, it dropped in all of Manitoba's health regions except the Northern Health Region.

There is a strong relationship between low income and premature mortality, and the report says that rate is three times higher for First Nations people in the province.

Premature deaths account for 81 per cent of all deaths among First Nations and 35 per cent among all other Manitobans, as referenced in a fall 2019 report on health care for First Nations people in the province.

Potential years of life (PYLL) adds the number of years "lost" when a person dies before turning 75.

The province's PYLL rate has decreased, but the gap between First Nations people and other Manitobans is widening. It's up to 10 years since 2002, and almost four times higher for First Nations people.

The infant mortality rate is also higher in northern Manitoba, measuring 9.2 per 1,000 live births, per the report. The provincial average is 5.1.

Pandemic negatively impacted overall health

The report also notes a disparity in the impacts of the pandemic.

It says First Nations people accounted for 31 per cent of hospital admissions, 41 per cent of ICU admissions and 20 per cent of deaths, as of April 21, 2022 — all much higher than their percentage of the overall population.

"Long-standing structural factors including overcrowded housing, and income and food insecurity, have contributed to this disproportionate disease burden," the report says. "Higher severity of disease is also likely the result of higher rates of underlying chronic illnesses, which are also caused by structural gaps."

The report also notes other ethnic communities were also disproportionately impacted by COVID at different times during the pandemic.