Canada’s Indigenous communities at greater risk post-surgery, study shows

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Canada’s Indigenous communities are at a greater risk of death and health complications after undergoing surgery compared to other populations, according to a new study highlighting disparities in the country’s healthcare system.

Research published in the Canadian Medical Association Journal (CMAJ) on Monday showed that Indigenous peoples had a 30 per cent increased risk of death after surgery and higher rates of complications, including post-operative infection, pneumonia and hospital readmission.

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They were also less likely to undergo life-saving procedures, including cardiac surgery, transplant and cesarean delivery, the review of 28 different studies showed. Indigenous peoples also experienced longer wait times by three-to-seven months for kidney transplants.

“This research illuminates inequities that are built into our surgical system,” said Dr. Jason McVicar, a Métis anesthesiologist at the Ottawa Hospital, and lead author of the study.

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The research included 1.9 million patients, 10 per cent of whom were Indigenous.

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These findings are consistent with inequities in surgical outcomes for Indigenous peoples in other high-income countries, the authors noted.

A lack of access to good quality healthcare and nutrition, as well as poor housing conditions means many are at an advanced stage of disease when they do undergo surgery in Canada, said Dr. Donna May Kimmaliardjuk, Canada’s first Inuk heart surgeon. This makes procedures more difficult and increases the likelihood of complications, she told Global News.

Distrust of the healthcare system is why members of the Indigenous communities are even hesitant to seek medical attention, Kimmaliardjuk said.

“It’s important to provide equitable care to all patients, regardless of where you live,” she added.

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“But if you provide better care and better outcomes to the fastest-growing population, it can have not only good outcomes for the general health, but perhaps it can save on costs as well for the government.”

In a high-profile case last September, an Indigenous woman livestreamed video from a hospital in Joliette, Que., as female staff were heard insulting and mocking her.

Joyce Echaquan, 37, an Atikamekw mother of seven, was taken to hospital by ambulance with stomach pains on Sept. 26. She died there on Sept. 28, not long after posting the video.

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“We see the difference. Sometimes it’s unbelievably egregious and right in our face,” said Dr. Nadine Caron, First Nations Health Authority Chair (FNHA) in Cancer and Wellness at the University of British Columbia (UBC).

Indigenous peoples have also been disproportionately affected by the COVID-19 pandemic.

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As of May 13, 28,319 cases of COVID-19 had been confirmed on First Nations reserves, while 328 people had died from the disease, according to Indigenous Services Canada (ISC).

The rate of reported active cases among First Nations people living on reserves is currently 65 per cent of the rate for the general Canadian population.

McVicar said COVID-19 has exposed social disparities in Canada. He stressed the need for policymakers to take notice and action.

“We need to make sure that … every step along the way that we are providing care that is culturally competent and is putting the needs of the patient and the community ahead of the conveniences of the healthcare system.”

— with files from the Canadian Press. 

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