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While an overall increase in the Healthy Populations domain is positive for Saskatchewan, it also hides some troubling symptoms that cannot be ignored, especially for residents living outside the urban centres and for Indigenous peoples. Without good health, people are less able to be fully engaged with their families and friends or to be active participants in their communities. They engage less in democratic activities, in leisure and cultural pursuits, in work, and in lifelong learning.
Certainly, individuals have a role in ensuring they are proactive in positive health behaviours, such as getting their annual shots against the flu, being more physically active, eating well, and not smoking. However, our communities and society as a whole also have a responsibility to ensure adequate access to health care, to nutritious foods, and by creating conditions that support and promote population health. Some of the challenges to making these things happen in the province include an aging population, a large Indigenous population that is at greater risk of ill health (due in large part to social marginalization and poverty), and many residents living in areas with less access to health care. These challenges frequently lead to greater disparities in health status for many of the people in our communities. By working to ensure all residents of Saskatchewan have similar access to and positive outcomes from our health care system, we can close gaps in health status. We must also understand, however, that an optimal solution lies in recognizing that health extends beyond primary care. While individual lifestyles and behaviours play an important part, our social and physical environment is arguably even more influential on health outcomes. As the World Health Organization’s Commission concluded in its report, Social Determinants of Health, action is needed on social justice and equity-oriented measures, such as poverty alleviation, better access to health care and medications, and affordable housing. |
Perhaps the most pressing need is in providing greater access and support to Indigenous peoples. Overall, compared to the non-Indigenous population in Saskatchewan, about 20% fewer Indigenous peoples of all ages, both on- and off- reserve, report very good or excellent overall health and mental health; and rates of daily smoking are four to five times higher. These and several other issues have been highlighted in the report of the Truth and Reconciliation Commission of Canada, Calls to Action, which pointed to the need for a range of specialized and alternate health care services that were culturally sensitive and appropriate. Among the Commission’s recommendations were to increase the number of Aboriginal professionals working in the health care field, ensure the retention of Aboriginal health-care providers in Aboriginal communities and provide cultural competency training for all health-care professionals; and calls on medical and nursing schools in Canada to require courses dealing with Aboriginal health issues.
One of the most profound limitations to making – and seeing – progress in improved health status for all residents of Saskatchewan is the serious lack of reliable data. The health behaviours, experiences, and perspectives of First Nations, Métis, and Inuit people in the province are either absent or underrepresented in the data, and as a result, they are left out of discussions about solutions. Given that Indigenous peoples account for 16.4% of the population of Saskatchewan and are the fastest growing demographic in the country, addressing gaps in physical and mental health and the related social, housing, food security, education, income and equality issues that are at the root of them is critical for the entire province’s future wellbeing. |
