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ERIC SMITH presupposition that Indigenous persons are somehow less civilized and/or worthy of rights than any other group. Often times, this attribution of worth was linked to the high prevalence of pathogens such as tuberculosis in Indigenous populations (many of which were exacerbated, not necessarily introduced?, by settler impositions such as residential schools‘), leading Indigenous persons to be seen as “a threat to the nations] as a whole” In contemporary medicine, this mentality of lesser and/or differential worth persists in much less explicit forms, but the pervasiveness of the “problem” has not waned. Indigenous populations now experience higher rates of acute physiological illness, suicide, and illicit substance use than almost every other group in Canada’ or the U.S.’ Moreover, North American Indigenous peoples have a life expectancy between 5 and 15 years less than the Canadian and American national averages.® ° This disproportionate burden of illness is neither coincidence nor a manifestation of “the natural order.” Rather, these health disparities are made possible through an enduring colonial culture. In healthcare, finding appropriate and effective ways to navigate these culture-health ties is paramount. To be culturally appropriate and effective when working in healthcare, one first needs to have an understanding of culture. Importantly, the term “culture” here refers to a wide range of social, historical, and economic factors that are shared amongst groups of people. Culture encompasses all of the non-biological facets of the world that determine how someone lives their life (although biology can also be influenced by these facets’’). As such, the more knowledgeable a healthcare provider is regarding their patients’ culture, the more they know about how to appropriately and effectively care for these patients. This may seem like a self-evident statement, but the influence of culture on the uptake of a patient’s care plan, especially for minority groups,” is often overlooked. James Daschuk, Clearing the Plains, Regina, University of Regina, 2013, 30. 4 Maureen K. Lux, Seperate Beds - A History of Indian Hospitals in Canada, 1920s-1980s, Toronto, University of Toronto, 2016, 26, 42, 127. 5 Maureen K. Lux, Medicine That Walks - Disease, Medicine, and Canadian Plains Native People, 1880-1940, 3“ edition, Toronto, University of Toronto, 2012, 221. Charlotte Reading — Fred Wien, Health Inequalities and the Social Determinants of Aboriginal Peoples’ Health, National Collaborating Centre for Aboriginal Health Centre De Collaboration Nationale De La Santé Autochtone, 2009, 10-24. Indian Health Services, Disparities (2018), https://www.ihs.gov/newsroom/factsheets/ disparities/ (accessed 23 July 2019). 8 Ibid. 1. ° Life Expectancy Statistics Canada, 2015, https://www150.statcan.gc.ca/n1/pub/89-645-x/ 2010001/life-expectancy-esperance-vie-eng.htm (accessed 22 July 2019). Jonathan Michael Kaplan, When Socially Determined Categories Make Biological Realities: Understanding Black/White Health Disparities in the U.S., The Monist, Vol. 93, No. 2 (2010), 281-97. 1! Reading and Wien, ‘Health Inequalities’, 10-24. + 246 +
