Vervoort Dominique, Kimmaliardjuk Donna May, Ross Heather J, Fremes Stephen E, Ouzounian Maral, Mashford-Pringle Angela
Division of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
CJC Open. 2022 Jun 4;4(9):782-791. doi: 10.1016/j.cjco.2022.05.010. eCollection 2022 Sep.
Indigenous peoples in Canada are at an increased risk of cardiovascular disease compared to non-Indigenous people. Contributing factors include historical oppression, racism, healthcare biases, and disparities in terms of the social determinants of health. Access to and inequity in cardiovascular care for Indigenous peoples in Canada remain poorly studied and understood. A rapid review of the literature was performed using the PubMed/MEDLINE, Web of Science, and Indigenous Studies Portal (iPortal) databases to identify articles describing access to cardiovascular care for Indigenous peoples in Canada between 2002 and 2021. Included articles were presented narratively in the context of delays in seeking, reaching, or receiving care, or as disparities in cardiovascular outcomes, and were assessed for their successful engagement in indigenous health research using a preexisting framework. Current research suggests that gaps most prominently present as delays in receiving care and as poorer long-term outcomes. The literature is concentrated in Alberta, Manitoba, and Ontario, as well as among First Nations people, and is largely rooted in a biomedical worldview. Additional community-driven research is required to better elucidate the gaps in access to holistic cardiovascular care for Indigenous peoples in Canada. Healthcare professionals, researchers, and policymakers should reflect further upon their actions and privilege, educate themselves about historical facts and the Truth and Reconciliation Commission, tackle prevailing disparities and systemic barriers in the healthcare systems, and develop culturally safe and ethically appropriate healthcare interventions to improve the health of all Indigenous peoples in Canada.
与非原住民相比,加拿大原住民患心血管疾病的风险更高。促成因素包括历史压迫、种族主义、医疗保健偏见以及健康社会决定因素方面的差异。加拿大原住民在心血管护理方面的可及性和不公平性仍未得到充分研究和理解。利用PubMed/MEDLINE、科学网和原住民研究门户(iPortal)数据库对文献进行了快速回顾,以确定2002年至2021年间描述加拿大原住民获得心血管护理情况的文章。纳入的文章在寻求、获得或接受护理方面的延迟背景下进行了叙述性呈现,或者作为心血管疾病结果的差异进行呈现,并使用现有的框架评估其在原住民健康研究中的成功参与情况。当前的研究表明,差距最突出地表现为接受护理的延迟和较差的长期结果。文献集中在艾伯塔省、曼尼托巴省和安大略省,以及原住民群体中,并且很大程度上植根于生物医学世界观。需要开展更多由社区驱动的研究,以更好地阐明加拿大原住民在获得全面心血管护理方面的差距。医疗保健专业人员、研究人员和政策制定者应进一步反思自己的行为和特权,了解历史事实以及真相与和解委员会的情况,解决医疗保健系统中普遍存在的差异和系统性障碍,并制定具有文化安全性和符合伦理的医疗保健干预措施,以改善加拿大所有原住民的健康状况。