Abstract
Health disparities are, first and foremost, those indicators of a relative disproportionate burden of disease on a particular population. Health inequities point to the underlying causes of the disparities, many if not most of which sit largely outside of the typically constituted domain of “health”. The literature reviewed for this synthesis document indicates that time and again health disparities are directly and indirectly associated with social, economic, cultural and political inequities; the end result of which is a disproportionate burden of ill health and social suffering upon the Aboriginal populations of Canada. In analyses of health disparities, it is as important to navigate the interstices between the person and the wider social and historical contexts as it is to pay attention to the individual effects of inequity. Research and policy must address the contemporary realities of Aboriginal health and well-being, including the individual and community-based effects of health disparities and the direct and indirect sources of those disparities.
Résumé
Les disparités sur le plan de la santé sont, d’abord et avant tout, les indicateurs d’un fardeau de maladie relatif disproportionné imposé à une population particulière. Les inégalités en matière de santé font ressortir les causes principales des disparités, dont un grand nombre–sinon la plupart–dépassent largement le domaine habituel que constitue la « santé ». Plus particulièrement, la documentation examinée en vue de rédiger le document de synthèse indique que maintes et maintes fois, les disparités sur le plan de la santé résultent directement et indirectement des inégalités sociales, économiques, culturelles et politiques, dont le résultat final est d’imposer un fardeau disproportionné de mauvaise santé et de souffrances sociales aux populations autochtones du Canada. Dans les analyses de ces disparités, il est important d’explorer tout le champ des relations entre les individus et les contextes sociaux et historiques plus larges, tout comme il convient de prêter attention aux effets individuels des iniquités. La recherche et les politiques doivent se pencher sur les réalités contemporaines de la santé et du bien-être des Autochtones, dont les effets individuels et communautaires des disparités sur le plan de la santé et leurs causes directes et indirectes.
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Acknowledgements and Sources of Support: The Reducing Health Disparities Cross-cutting Initiative, Canadian Institutes of Health Research, commissioned an initial draft of this article for an International Think-Tank held in Ottawa, Sept. 21–23, 2003. The author wishes to acknowledge the Think-Tank participants for a stimulating discussion of an earlier draft of this paper, and thanks Ms. Elizabeth Guerrier for research assistance on both the original synthesis paper and the current supplement article. Statistics Canada information is used with the permission of Statistics Canada. Users are forbidden to copy this material and/or redisseminate the data, in an original or modified form for commercial purposes, without the expressed permission of Statistics Canada. Information on the availability of the wide range of data from Statistics Canada can be obtained from Statistics Canada’s Regional Offices, its World Wide Web site at https://doi.org/www.statcan.ca, and its toll-free access number 1–800–263–1136.
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Adelson, N. The Embodiment of Inequity: Health Disparities in Aboriginal Canada. Can J Public Health 96 (Suppl 2), S45–S61 (2005). https://doi.org/10.1007/BF03403702
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DOI: https://doi.org/10.1007/BF03403702