First Nations, Inuit and Métis Peoples Living in Urban Areas of Canada and Their Access to Healthcare: A Systematic Review

Simon Graham; Nicole M Muir; Jocelyn W Formsma; Janet Smylie

doi:10.3390/ijerph20115956

First Nations, Inuit and Métis Peoples Living in Urban Areas of Canada and Their Access to Healthcare: A Systematic Review

Int J Environ Res Public Health. 2023 May 25;20(11):5956. doi: 10.3390/ijerph20115956.

Authors

Simon Graham¹, Nicole M Muir², Jocelyn W Formsma³, Janet Smylie^{4

5}

Affiliations

¹ Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC 3010, Australia.
² Psychology Department, York University, Toronto, ON M3J 1P3, Canada.
³ National Association of Friendship Centres, Ottawa, ON K2P 0L9, Canada.
⁴ Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada.
⁵ Well Living House, and Department of Family and Community Medicine, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada.

Abstract

In Canada, approximately 52% of First Nations, Inuit and Métis (Indigenous) peoples live in urban areas. Although urban areas have some of the best health services in the world, little is known about the barriers or facilitators Indigenous peoples face when accessing these services. This review aims to fill these gaps in knowledge. Embase, Medline and Web of Science were searched from 1 January 1981 to 30 April 2020. A total of 41 studies identified barriers or facilitators of health service access for Indigenous peoples in urban areas. Barriers included difficult communication with health professionals, medication issues, dismissal by healthcare staff, wait times, mistrust and avoidance of healthcare, racial discrimination, poverty and transportation issues. Facilitators included access to culture, traditional healing, Indigenous-led health services and cultural safety. Policies and programs that remove barriers and implement the facilitators could improve health service access for Indigenous peoples living in urban and related homelands in Canada.

Keywords: Indigenous; barriers; culture; discrimination; facilitators; healthcare.

Publication types

Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Canada
Health Services Accessibility
Health Services, Indigenous*
Humans
Indigenous Canadians
Inuit*
Racial Groups

Grants and funding

The first author was able to travel to Toronto to collaborate with the other authors through a University of Melbourne Dyason fellowship (number: 604426). The first author’s salary is supported by an Australian National Health & Medical Research Council Investigator Grant (number: 2009727). The last author is supported by a Tier 1 Canada Research Chair in Advancing Generative Health Services for Indigenous Populations in Canada (number: 950232638).