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Health Forum Takeaway: Self-Government Is Key to Improving Health

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With substance abuse topping the list of aboriginal health concerns, and culturally integrated treatment indicated, a recent health forum convened by the Assembly of First Nations focused on self-governance as key to addressing that and other problems.

In the largest gathering of its kind in more than a decade, about 800 health-care professionals from all over Canada, plus some global experts, came to Ottawa for the AFN National Health Forum from November 7–9. Concurrently in Vancouver, the Issues of Substance 2011 conference, the Canadian Centre on Substance Abuse National Conference, was also held.

"First Nations are continuing to advance plans for a new way forward, where we are in control of our own health outcomes, to better achieve improved health and wellness for our citizens and communities," said AFN National Chief Shawn Atleo in a statement.

"First Nations control of First Nations health, combined with First Nation–driven, new and innovative approaches to health and wellness, must be the new way forward," he said. "No longer will we take a back seat. We are taking action, and moving forward. First Nation rights, responsibilities and jurisdiction must be respected, and First Nation plans and governments must be supported to implement equitable and culturally relevant health systems that will achieve better outcomes for our peoples."

Aboriginals have an extremely high rate of diseases and conditions including youth suicide, with First Nation communities showing a rate that’s five to seven times higher than other Canadians; a tuberculosis infection rate that’s 30 times the national average, and a four-time higher likelihood of developing type 2 diabetes, the AFN said, which means that one in five First Nation citizens has the condition.

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In line with the top health priority, addiction, the AFN and its partners unveiled a new paradigm for treatment, a program called Honouring Our Strengths: A Renewed Framework to Address Substance Use Issues Among First Nations People in Canada, which outlined a network of issues that encompass cultural connectedness and strengthens the response to these issues at the community, regional and national levels.

The program is the brainchild of the National Native Addictions Partnership Foundation (NNAPF) and the AFN in partnership with Health Canada. It grew out of a four-year review of the National Native Alcohol and Drug Abuse Program (NNADAP) and a survey of services designed to mitigate substance abuse. This collaborative approach is already being implemented in health care facilities across the country, the AFN said.

The Vancouver Sun noted that although 58 First Nations treatment centers, 550-plus community based prevention programs and about 1,000 treatment counselors and community-based workers all over Canada deal with substance-abuse problems, they often ignore culture’s contribution to overcoming addiction.

"We haven't always fully understood or fully appreciated the role culture has to play,” Carol Hopkins, executive director of the National Native Addictions Partnership Foundation, told the Sun. "Its use has been intermittent across the national program."

Treatment programs focus more on the individual than on his or her context—families and communities, she added.

"It doesn't mean we leave aside attention to individuals, but it certainly means that when we are working with individuals it's always in the context of family and community."