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Recommandations: Health Care Priorities in Northen Ontario Aboriginal Communities

Numéro d’article: C0571

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Access to quality health care in rural, remote and
northern communities is a long standing issue in Ontario
(Jacklin & Warry, 2012). It is well documented that
the burden of disease for Aboriginal communities
is disproportionately higher than non-Aboriginal
populations (Adelson, 2005; Jacklin & Warry, 2012).
Aboriginal populations in Ontario have higher rates
of diabetes, Chronic Obstructive Pulmonary Disease
(COPD), infectious diseases, addiction and suicide
(Warry, 2012; Health Canada, 2010). Jurisdictional
issues regarding specific funding structures and the
fragmentation of healthcare responsibilities and
service provision between the federal and provincial
governments further complicate healthcare for
Aboriginal persons (Glazier, 2012; North East Local
Health Integration Network [NELHIN], 2013a; Jacklin
& Warry, 2012). Historically, the federal government
provides targeted health care funding to Aboriginal
communities on reserve, while the provinces are
responsible for funding healthcare services off-reserve
(Health Canada, n.d., Kelly, 2011). This funding currently
resides under the First Nation Inuit Health Branch
(FNIHB) at Health Canada. The Indian Health Transfer
Policy (1986) was announced in 1986; the policy
provided the option of transferring health funding and
administrative responsibilities to Aboriginal communities
to provide greater flexibility to communities over the
provision of services (Health Canada, 2005; Jacklin
& Warry, 2012). This allows Aboriginal communities to
respond to their own community health needs within
the accountability guidelines of the First Nation Inuit
Health Branch (FNIHB) (FNIHB, 2008). The policy has
since been modified to allow for flexible uptake for
communities who wish to pursue variable degrees of
authority over federal health service funding (Jacklin
& Warry, 2012). The complexity of Aboriginal health
status and health policy is poorly understood, however,
enhanced self-governance has improved the quality
and effectiveness of services in some communities from
a client perspective (Lavoie & Gervais, 2012; Jacklin &
Warry, 2012).

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2016