Our Health Counts highlights challenges Indigenous people face accessing health care in Thunder Bay, Ont.

A new study, coordinated by Anishnawbe Mushkiki, an Aboriginal health centre in Thunder Bay, Ont., highlights some of the challenges Indigenous people face, when accessing health care in the city.

The study was led by Dr. Janet Smylie, a Metis physician, and researcher at St. Michael's Hospital in Toronto. The largest barrier, was how Indigenous people are counted.

Official data from the 2016 census showed 9,780 Indigenous people living in the city. The study, called Our Health Counts, found the population may be between 23,080 and 42,641. The variance is because many Indigenous people did not fill out the census, Smylie said.

"You can see why there's so much pressure in regards to the Indigenous population having struggles, because we really don't know who lives in our neighbourhood," said Michael Hardy, the executive director of Anishnawbe Mushkiki.

"Who lives here, in regards to who's coming in and out. And, it's a growing trend." 

Hardy said he wants the study to be used by governments, funding organizations and other health care stakeholders to be able to plan for the health needs of the growing Indigenous community.

He said he didn't want to see services re-allocated from the non-Indigenous population to the Indigenous population; rather, an expansion of services to ensure all those who need help can be accommodated.

"We're here for the long haul. We're neighbours, we live together, and it's best for us to have a good heart and start to work together as much as we can. Because the stronger we are, the stronger the city is," he said.

While obtaining proper demographics is a key concern, a number of other issues cascade from that challenge.

For example, Indigenous households were 19 times more likely to have multiple families living in a household, compared to the average home in the city, the report noted.

Indigenous people were also found to be more likely to unemployed, at 67 per cent of those in the study compared to a provincial average of 11 per cent. Nearly 80 per cent of Indigenous people in the city are living below the poverty line.

When it came to racism, two thirds of the respondents said they experienced racism, a figure that was similar to other health studies in London, Hamilton and Toronto.

Accessing health care

Of those who said they experienced racism, 66 per cent said it impacted how they accessed health care services.

"We live in a country where we're supposed to have equitable health care," said Smylie, who noted there are obvious barriers to accessing primary care.

Fewer Indigenous people have a primary care physician, and nearly half of the respondents said they had gone to the emergency department within the past year. That is higher than the Ontario average accessing emergency medical care, at 19 per cent.

Part of the issue is that 11 per cent of the respondents said they had distrust in public organizations, like police, health and social services. A much larger proportion — 64 per cent — said they had no issues with those services. 

Social services play an important role in health services for Indigenous people, the report notes. Nearly three quarters of Indigenous adults have spent some time in prison, which is higher than figures reported in Toronto, with 52 per cent of the Indigenous population spending some portion of their life in jail.

Most of those who had been to jail, were there for a provincial offence.

"We (need to) build on the strengths in the community, the strengths of culture, the strengths of identity, the strength of traditional healing," Smylie said.