Why Canada's health-care system needs more Indigenous professionals

When Dr. Danièle Behn Smith first saw the data on Indigenous life expectancy, her mind went to her own family.

The recent report by the B.C. First Nations Health Authority found that life expectancy for Indigenous people in the province had dropped by more than six years between 2017 and 2021. The life expectancy for Indigenous people in the province in 2021 was 67.2 years, compared to 82.5 years for non-Indigenous people.

In that same time frame, Behn Smith, B.C.'s Deputy Provincial Health Officer for Indigenous Health, lost an aunt, her brother and six cousins — eight family members in total.

"Although people can look at that and see data and numbers, those are our loved ones. Those are members of our family that we love and care about who are no longer sitting at our table," Behn Smith told The Current's Matt Galloway. 

In 2015, the Truth and Reconciliation Commission's final report called on the government to publish annual progress reports that capture a number of health indicators about Indigenous populations, including life expectancy, though not all provinces have followed through.

A 2023 report found that the life expectancy of Indigenous people in Alberta had dropped by seven years since 2015, to 60 years for Indigenous men and 66 for Indigenous women. The life expectancy among non-Indigenous people sat at 79 years for men and 84 years for women in that same time period.

For Behn Smith, the numbers are a "gut wrenching" reminder of how Indigenous people aren't given proper care within health-care systems across the country.

She and other experts say the health-care system needs more Indigenous doctors, nurses and decision-makers — through changes in recruiting practices in health care and education programs — to improve Indigenous people's health outcomes.

"Most of the decisions [about health-care programs and systems] are made at a very, very high level … by non-Indigenous people," said Dr. Esther Tailfeathers, a family physician on the Blood Tribe reserve in Alberta and the former medical lead at Alberta Health's Indigenous Wellness Core. "Those decision-making tables need to have Indigenous people who are well informed of what's going on with our health care and with the drug crisis."

Behn Smith says the problem is made more urgent because when Indigenous people die, their cultural knowledge is at risk of dying with them. She estimates there are only a few thousand members of her Eh Cho Dene community still living and only a handful who speak their language.

"We need every single member of our nation to be vibrant and healthy and self-determining so that we can keep ourselves going," Behn Smith said.

Poor health resources in Indigenous communities and racism in the health-care system all contribute to the increasingly low life expectancy for Indigenous people, according to Tania Dick, a registered nurse and the Indigenous Nursing Lead at the University of British Columbia. 

Dick says many remote communities rely on nurses for the majority of their health-care needs. While doctors and other health-care professionals fly in and out of the communities as needed, nurses are more likely to live in the communities and are there around the clock, taking on cases involving trauma, addictions and mental health that they may not have the training to handle.

"It ends up burning out our nurses," Dick said. If nurses leave the profession as a result, it can sometimes be months before a new one picks up the job, she added.