Background: Since the legislation of the Indian Act in 1876, Indigenous peoples of Canada have faced years of systemic racism and discrimination, resulting in the marginalization of this group. While the act has long since been abolished, barriers to equitable healthcare continue to impact Indigenous communities. Consequently, health outcomes of these communities are significantly below par compared to individuals who are non-Indigenous and Canadian-born, leading to disproportionately lower life expectancy and a higher prevalence of chronic conditions within this population.¹ 

63% of First Nations adults are diagnosed with at least one chronic condition.² Due to socioeconomic factors like overcrowded housing, inaccessible treatment, and lack of education on certain illnesses, there are higher rates of infectious diseases. Moreover, Indigenous communities also experience higher rates of mental illness as a result of intergenerational trauma and current hardships, exacerbated by the lack of access to equitable care.³ Education and increased awareness about health disparities and social determinants of health are needed. This can help to reduce healthcare provider bias and is imperative in guiding equitable policies and improving healthcare outcomes for Indigenous communities.

In spite of increasing awareness and use of cultural competency and safety concepts, few programs have been successfully implemented.⁴ One Canadian medical school had distributed questionnaires in three cohorts of their first year students, which had shown that students were strongly interested in Indigenous health, but ultimately did not believe they were adequately educated or prepared to work in Indigenous communities.⁵ Despite universities such as the Northern Ontario School of Medicine, which aims to help healthcare graduates that have the skill and desire to work in rural communities; there is still a significant gap in knowledge on Indigenous reconciliation, cultural practices, and health inequities.

Objective: This study is to assess and determine the lack of awareness and education pertaining to postcolonialism and health inequities (PCHI) faced by Indigenous Peoples of Canada among Ontario post-secondary students studying healthcare (medical science, health science, nursing, and other allied-healthcare students). 

Methodology: A cross-sectional study will be performed through an anonymous survey consisting of both multiple choice and short answer questions. Questions aimed to evaluate the knowledge and awareness of undergraduate and postgraduate students on PCHI, cultural practices and social determinants of health of Indigenous peoples of Canada. We will do this by qualitatively assessing the level of understanding and education through knowledge-based questions. Literature on PCHI in combination with knowledge gained from Indigenous members of the community will be used to guide the themes of the questionnaire. The inclusion criteria for this study will be undergraduate students studying healthcare related subjects with intent to work in healthcare after graduation, and students currently in professional training programs to become healthcare workers. The questionnaire will be distributed online through various social media platforms and student groups. 

Conclusion:  Results from this study can shed light on the current gaps in education and awareness of PCHI among future healthcare providers. Furthermore, a comparison between healthcare students and current healthcare professionals can outline the next steps necessary to mitigate healthcare provider bias and inform relevant policies to improve healthcare delivery. 

References:

1. Beavis, Allana S. W., et al. “What All Students in Healthcare Training Programs Should Learn to Increase Health Equity: Perspectives on Postcolonialism and the Health of Aboriginal Peoples in Canada.” BMC Medical Education, BioMed Central, 23 Sept. 2015, bmcmededuc.biomedcentral.com/articles/10.1186/s12909-015-0442-y. 
2. The First Nations Information Governance Centre. First Nations Regional Health Survey (RHS) Phase 2 (2008/10): National Report on Adults, Youth and Children Living in First Nations Communities. In: RHS Phase 2 (2008/10) – National Reports. 2012.
3. Boyle, Justin, et al. “Indigenous Health in Ontario An Introductory Guide for Medical Students.” Edited by Sarah Park, 26 Nov. 2014. 
4. Guerra, Olivia, and Donna Kurtz. “Building Collaboration: A Scoping Review of Cultural Competency and Safety Education and Training for Healthcare Students and Professionals in Canada.” Taylor & Francis,
5. Yeung, Sharon, et al. “Predictors of Medical Student Interest in Indigenous Health Learning and Clinical Practice: a Canadian Case Study.” BMC Medical Education BioMed Central, 14 Dec. 2018,link.springer.com/article/10.1186/s12909-018-1401-1.