More evidence of failures in health system for B.C.’s Indigenous peoples: report

VICTORIA – Indigenous peoples in B.C. have inequitable access to preventative and primary health-care services, which perpetuates poorer health outcomes for First Nations, Métis and Inuit populations in the province, the final report of the Addressing Racism Review shows.

A comprehensive data report, released today by Mary Ellen Turpel-Lafond, independent reviewer, brings together the data and information collected by the review, which was commissioned by B.C.’s Minister of Health in June 2020. The data report follows up on “In Plain Sight: Addressing Indigenous-Specific Racism in B.C. Health Care” full and summary reports released on Nov. 30, 2020.

“Our extensive review of data reveals a system that does not provide Indigenous peoples with sufficient and safe access to primary and preventative care, and is therefore skewed towards emergency and specialized treatment,” Turpel-Lafond said. “Indigenous peoples have substantially less access to physician services and less attachment to primary care practitioners.”

“When you combine these factors with the overwhelming evidence of racism in the health-care system – which we explored in depth in our previous reports – it’s not difficult to see why health outcomes for Indigenous peoples are poorer. New initiatives are positive attempts to fill this void, like the First Nations Health Authority’s (FNHA) ‘Virtual Doctor of the Day,’ however, a full continuum of care and networks of First Nations-led primary care are needed to overcome
the serious deficiencies we found for Indigenous peoples.”

The initial “In Plain Sight” reports offered 24 recommendations to eliminate Indigenous-specific racism and make health care safer and more effective in British Columbia. This data report builds on those earlier reports and offers baseline measurement of how the system is performing for Indigenous peoples, featuring more detailed breakdowns of the data, including by region. The work was made possible with extensive co-operation from the FNHA and Métis Nation BC (MNBC) (including their respective governance processes and/or analytical resources).

“Racism is toxic for people, and it is toxic for care,” said Adrian Dix, Minister of Health. “The situation as it exists, and as is depicted in the details of this report, cannot stand. I am very grateful to Dr. Turpel-Lafond and her team, and to every person who took part in this review. Your work, courage and commitment has provided a roadmap for meaningful change. Together with Indigenous leadership, health professionals, colleagues and partners, we will address systemic racism in our health-care system and root out its deeply damaging effects.”

The data report includes a more comprehensive look at the results of surveys of Indigenous peoples using the health-care system and of B.C.’s health-care workers, as well as the review’s collection of individual submissions detailing experiences of racism in health care. Together, these represented the perspectives of nearly 9,000 people.

It also features a closer examination of health-system utilization and health outcome data analyzed by the review – data which reflects approximately 185,000 Indigenous individuals. These data focus on primary care and hospital services and health outcomes, including chronic conditions and mortality, as well as the association of racism with other self-reported health and wellness indicators. Data examining priority issues, such as the two current public health emergencies and mental health and wellness are included, as are data regarding patient complaints and comments from participants in San’yas Indigenous Cultural Safety training.

“This data report is extremely important in its own right,” Turpel-Lafond said. “In addition to supplementing our previous reports, it serves as a stand-alone comment on health-system performance for Indigenous peoples in B.C. And it shows there is a great deal of room for improvement.”

This data report offers further evidence in support of the conclusions, findings and recommendations described in the review’s first volume of reports. Taken together, these three reports clearly demonstrate the need for immediate, principled and comprehensive efforts to eliminate all forms of prejudice and discrimination against Indigenous peoples in B.C.’s health-care system and increase access to culturally safe primary and preventative services.

The data report provides additional key information for the Task Team, led by Dawn Thomas, associate deputy minister of Health. The appointment of an associate deputy minister for Indigenous Health and the formation of the Task Team to implement recommendations were important steps recommended by the review.

Recommendations called for the establishment of an office of the Indigenous health representative and advocate, as well as improvements to complaints processes. The new representative and advocate position will receive concerns from people about Indigenous specific racism in the health-care sector. While the work to establish this office is underway, B.C.’s ombudsperson has agreed to the review’s suggestion that, in the interim, the ombudsperson assume management of the toll-free phone and email submission options offered to the public by the review. Turpel-Lafond will continue to be available to provide support on this issue.

Indigenous people wanting to share their experiences of racism and discrimination in the B.C. health-care system may still do so by toll-free phone at 1 888 600-3078 or email at:

What people are saying about the Addressing Racism Review

Cheryl Casimer, First Nations Summit Political Executive

“We appreciate the efforts of Mary Ellen Turpel-Lafond and her team for compiling this critical data report on the B.C. health-system performance for Indigenous peoples. The data clearly shows that racism in the health-care system leads to lower health-care outcomes for Indigenous patients. The Province must take immediate steps to fully implement the recommendations contained in the ‘In Plain Sight’ report, including the establishment of a fulltime B.C. Indigenous health officer to ensure this important data is expanded and tracked on a regular basis so it can be used to influence policy and care quality with a goal to improving health care and outcomes for all Indigenous peoples in B.C.”

Chief Don Tom, vice-president, Union of BC Indian Chiefs

“The daily examples we hear of systemic racism toward Indigenous peoples in the health-care system are categorically unacceptable and highly disturbing. The new data report provides the sobering story of how our people continue to receive a lower standard of health care simply because of our identity as Indigenous peoples. We expect all health officials and staff in this province to review the report and commit to making change.”

Terry Teegee, Regional Chief, BC Assembly of First Nations

“The data report provides critically important and timely information that must immediately galvanize action and ideas to target profound change within British Columbia’s health-care system. Health authorities and leadership must remain vigilant on the issue of racism in health care by regularly monitoring and updating both the qualitative and quantitative data that is included in this report. In addition, future health-care research can be further enriched and expanded by including First Nations’ measures of wellness, questions and methods. Significant resources and supports will be needed, and increased over time, to improve and support this ongoing work. Once again, I raise my hands in gratitude to Dr. Mary Ellen Turpel-Lafond, her team and participants who brought this important information forward during this time of emergency.”

Daniel Fontaine, deputy minister, Métis Nation BC

“It was incredibly challenging to read the stories of so many Métis and Indigenous peoples who did not receive the care and attention that so many British Columbians are used to when using our health-care system. It shows real systemic issues in the system that need to be addressed. Métis Nation BC welcomes the opportunity to move forward with the government as it begins implementing the recommendations in this report and renewing the relationship with the Province so that Métis people in B.C. can experience better outcomes in the healthcare system today – and into the future.”

Keith Marshall, president, First Nations Health Directors Association

“Members of the First Nations Health Directors Association are the voice of the community, working to transform and decolonize the health-care system – an essential step to creating an experience free of racism for First Nations people. Along with our partners within the made-in- B.C. health governance structure – the First Nations Health Authority and the First Nations Health Council – we will work with the new task group to address systemic racism and improve
our peoples’ experiences and outcomes.”

M. Colleen Erickson, chair, First Nations Health Authority

“The First Nations Health Authority welcomes the ‘In Plain Sight’ data report and acknowledges its importance. The report gathered essential information and data, including the barriers and inequities faced. The two reports clearly show that First Nations people in B.C. experience systemic anti-Indigenous racism within the B.C. health-care system.”

Richard Jock, CEO, First Nations Health Authority

“We recognize these issues of racism are of critical importance. We continue to see unfortunate events on a frequent basis that need redress. The First Nations Health Authority is pleased to start the work with the task force to advance actions. We look forward to working with our partners to make the necessary system change.”

Charlene Belleau, chair, First Nations Health Council

“The data report released today discloses what we as First Nations people already know – poorer health outcomes for B.C. First Nations are due to the lack of a safe, appropriate process for B.C. First Nations to disclose incidences of racism and discrimination. B.C. First Nations must be the ones to provide input and advice on culturally appropriate processes to empower our people to come forward and to receive the quality care they deserve. Data quality and assertion of data sovereignty will be critical for B.C. First Nations to measure the impacts of the changes proposed in the ‘In Plain Sight’ report.”


Jeff Rud
Communications and Engagement
Addressing Racism Review
250 216-4725

Ministry of Health
250 952-1887 (media line)