2023-09-25 04:01:00
For an Indigenous person who lives far from major centers, obtaining specialized health services represents quite a challenge. Researchers believe that this problem can be combatted by providing these remote communities with some relatively simple tools for disease detection and prevention.
Among the 16 recommendations that appear in a guide published Monday in the Journal of the Canadian Medical Associationa team of specialists focuses on self-tests to detect certain cancers.
According to Dr. Nav Persaud, one of the researchers who led this study, self-tests for colorectal cancer and cervical cancer are recommended in the case of disadvantaged populations, notably Aboriginal people who live in isolated or isolated regions. who have already experienced discrimination within the health care system.
The current approach requires people to make an appointment to have a pelvic exam and smear test. But if a person has experienced health care discrimination, they are unlikely to be inclined to make an appointment. HPV self-testing could be a way around this problem.
In their study, the experts looked at disparities in access to preventive care for several diseases, including different types of cancer, cardiovascular diseases, depression and infectious diseases.
Dr Persaud wishes to point out, however, that the guide concerns not only indigenous peoples but also all sections of the population who are disadvantaged in terms of access to preventive care due to racism, sexism and discrimination.
For example, we find racialized people, people who identify as 2SLGBTQI+ (two-spirit, lesbian, gay, bisexual, transgender, queer or questioning and intersex), people with disabilities and those with low income.
What motivated us to write these recommendations is that we know that inequalities exist when we talk about health. Our system can be more responsive to people experiencing these disadvantages, says Persaud, who is also an assistant professor at the University of Toronto’s faculty of family medicine.
He also says he is well aware of the evidence that exists regarding discriminatory practices against Indigenous people within the health system.
We are not talking about luxury care but about basic care that people need. It’s a simple human rights issue.
Tuberculosis: one visit instead of two
The study also highlights that members of the First Nations, Métis and Inuit are more likely to be infected with tuberculosis, a scourge in some indigenous communities.
This disease is also a typical example of a health problem linked to social circumstances, according to the signatories of the text published in the Journal of the Canadian Medical Association.
Being part of a population with a high incidence of tuberculosis is the main risk factor for latent tuberculosis infection.
In addition to making screening tests more accessible, Dr. Persaud also recommends screening with a blood test rather than a skin test. This last option requires two visits to the doctor and is less precise than a blood test which only requires a meeting with a professional. This would help reduce the number of visits to the doctor, emphasizes Dr. Persaud.
Researchers also point out that mortality and morbidity linked to tuberculosis are higher among certain disadvantaged groups, notably people who are incarcerated or homeless, two social categories where indigenous people are over-represented.
In Quebec, according to the last count carried out in 2022, Indigenous people represented 13% of the homeless, five times more than their proportion in the entire population. In Canada, they remain over-represented in the prison population. For example, in Saskatchewan, the incarceration rate for Indigenous people is the highest, 17.7 times higher than the rest of the population.
The study also looked at inequalities in access to dental care. For example, 21% of Indigenous people are less likely to have gone to the dentist in the past year, compared to non-Indigenous people.
The group behind this study, however, was keen to emphasize that Indigenous health could be specifically addressed through an Indigenous-led process focused on preventive care for Indigenous people, which was not Ours is not, although our recommendations could benefit many disadvantaged groups.
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