Grant: Project Grant

Indigenous Historical Trauma (IHT) is an important but overlooked cause of health disparities in indigenous communities. Modern institutions often trigger IHT across generations through forms of bureaucracy that reproduce the stress, anxiety and helplessness found in the history of colonial institutions. Bureaucracy, thus, is a critical but often invisible barrier to access to health care for indigenous people in Canada. Indigenous patients are often unable to navigate the complex and confusing processes associated with health care. The lack of basic infrastructure in indigenous communities requires patients to travel long distances, often alone, to large, unfamiliar urban centres to get treatment. Their journeys are fraught with challenges. Transportation and accommodation may be difficult to access because of unfamiliarity or overt racism. Medical instructions may not be fully understood. Changes to itineraries require governmental approval with lengthy delays that cause many to abandon critical treatment. Indigenous patients must navigate two complex bureaucracies - the delivery of healthcare of the provincial government, and the payment for health care as structured by the federal government. From an economic perspective, the cultural barriers to navigating these bureaucracies create large inefficiencies - missed appointments, duplication of services, etc. - all of which magnify the cost of indigenous health care. From a social perspective, the cultural barriers to navigating bureaucracies trigger IHT and exacts a powerful psychological and emotional cost to patients. The focus of this study is to find a solution to overcome the impact of IHT on health care outcomes for indigenous populations. We seek to analyze the extent of the problem and find a solution. We focus on a potential solution offered by Quest Health, an indigenous led health entity based in Winnipeg, which has designed a range of programs to reduce the social and economic cost of IHT.