​Progress made in education and infant mortality, but life expectancy and all-cause mortality worsen

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Unceded territories of the xʷməθkʷəy̓ əm (Musqueam), Sḵwx̱wú7mesh (Squamish) and səlilwətaɬ (Tsleil-Waututh) Nations | Vancouver

A report released today by the First Nations Health Authority (FNHA) and British Columbia's Office of the Provincial Health Officer (OPHO) provides an update to the indicators of population health and wellness of First Nations Peoples in BC. 

“Although the report indicates some modest improvements to the health and wellness of First Nations Peoples in BC, it underscores persistent gaps in BC's health and supportive systems which continue to fall short of their responsibilities to First Nations Peoples in BC, their families, communities and Nations," said Dr. Nel Wieman, Chief Medical Officer with the FNHA. “Moving forward, we must uphold First Nations self-determination, advance Truth and Reconciliation between First Nations Peoples and other BC residents and continue to develop our working partnerships and coordination between the provincial and federal governments and First Nations in BC."

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The report, titled First Nations Population Health and Wellness Agenda (PHWA): First Interim Update is a follow up to the 2021 report of the same name and contains updates on 14 of 22 PHWA indicators of health and wellness being monitored from 2020 to 2030. The update highlights:

• Improvements in two indicators (education and infant mortality);
• No or minimal change in four indicators (avoidable hospitalizations, physicians identifying as First Nations, serious injuries and youth or young adult suicide); and,
• Worsening in four indicators (healthy birth weight, diabetes, life expectancy and all-cause mortality). 
  

“The findings in this report are not just data, they represent our loved ones - our children, parents, grandparents, siblings and cousins. While some improvements have been made since the baseline report, overall progress has been limited and we must continue to work together to do more to achieve optimal health and wellness for First Nations Peoples," said Dr. Danièle Behn Smith, Deputy Provincial Health Officer for Indigenous Health in BC. “We must work collectively to eradicate Indigenous-specific racism and discrimination and take courageous actions that uphold inherent First Nations rights to address persistent health disparities and inequities. We hope this report can help to light the way forward as we work to transform our systems so they are culturally safe and free from racism and discrimination." 

Key findings from the report include that:

• Connection to land has an important role in First Nations culture, Ceremony, language, and identity, which are key to the wellness of First Nations Peoples;
• There has been no meaningful change to the proportion of registered First Nations physicians in BC since the baseline report. Only 0.39 per cent of registered physicians in BC self-identified as First Nations in 2023, compared to 0.32 per cent in 2019;
• For the first time, the FNHA and OPHO are reporting on the proportion of First Nations nurses and midwives in BC. In 2023, only 1.5 per cent of nurses and 1.7 per cent of midwives registered with the BC College of Nurses and Midwives self-identified as First Nations;
• Education (the proportion of students who complete high school within eight years of starting Grade 8) has improved by 4.3% among Indigenous students;
• Among First Nations people in BC, infant mortality is down 0.7 per 1,000 live births (from 5.3 per 1,000 live births in 2013-17 to 4.6 per 1,000 in 2015-2019);
• Life expectancy at birth for Status First Nations Peoples in BC decreased from the baseline of 73.3 years in 2017 to 67.2 years in 2021;
• The mortality rate among Status First Nations Peoples in BC increased from the baseline of 117.3 per 10,000 population in 2017 to 156.0 per 10,000 in 2021; and
• First Nations Peoples in BC have been disproportionately impacted by the dual public health emergencies of the toxic drug crisis and the COVID-19 pandemic. 

The PHWA is a 10-year partnership initiative and reporting series of the FNHA's Office of the Chief Medical Officer and the OPHO in BC. Through this work, the partners monitor, report on and honour the health and wellness journeys of First Nations in BC (those Nations whose ancestral Territories collectively form what is now known as the province of BC) and all First Nations Peoples in BC (all First Nations Peoples in the province, including those whose ancestral Territories are outside of BC). 

In addition to presenting data on the health and wellness of First Nations Peoples in BC, the 2021 PHWA report called on system partners and institutions to work with First Nations organizations and collectives to nourish First Nations roots of wellness by advancing the seven areas listed below. The PHWA partners have updated the wording of six of these actions since the 2021 report was released to reflect the evolution of the PHWA goals and objectives:

1. Affirm, uphold, support and advance First Nations rights and self-determination.

2. Advance First Nations data governance and uphold principles of OCAP (First Nations' ownership, control, access to and possession of data).

3. Catalyze intersectoral actions to build supportive, anti-racist, trauma-informed, culturally safe systems, with particular attention given to connection to Land.

4. Advance the roots of health and wellness for the next generations, including priority populations such as First Nations babies, children and youth.

5. Embed First Nations wellness approaches in policies, programs and services.

6. Commit to cultural safety and humility and eradicating Indigenous-specific racism across all systems.

7. Increase access, good relations, and attachment to anti-racist, trauma-informed and culturally safe primary health care.

This report also provides updates on the We Walk Together project which explores how to measure, monitor and advance the Connection to Land indicator. The project holds stories and teachings shared by Knowledge Keepers and youth exploring what connection to land, water and territory means to the health and wellness of First Nations Peoples. We Walk Together project participants represent 23 distinct Nations across three FNHA health regions: Vancouver Coastal, Fraser Salish and Northern. Three key themes guide the continuing work on this indicator: Ancestral Knowledge, Land and water wellness and accountability. 

“Substantial gaps still remain between the health and wellness outcomes of First Nations Peoples in BC and those of other BC residents," said Dr. Bonnie Henry, BC's Provincial Health Officer. “It is my hope that this report can draw attention to the work that is still needed to help curb the disproportionate impact on First Nations Peoples of emergencies including the toxic drug crisis and the COVID-19 pandemic that we see in indicators like worsening life expectancy and all-cause mortality. The We Walk Together project, also in this report, highlights the ways we can work together to make a difference in the lives of First Nations children, families and communities through connection to Land, water and culture." 

Read the full report at: First Nations PHWA - Interim Update 2024 

Quick Facts:

• The PHWA baseline report was published in June 2021 and outlined 22 indicators with targets within three main spheres of health and wellness that will be monitored over a 10-year period;
  
• This is the first interim update since the PHWA baseline report and updates 14 of the 22 indicators (those for which new data or qualitative updates are available);
  
• The PHWA partners are committed to presenting data in ways that:
  
• are wellness-based, decolonized and grounded in First Nations Peoples' teachings, perspectives and values;
• explicitly acknowledge the experiences, resistance and resilience of First Nations Peoples in the face of persistent and ongoing settler colonialism, Indigenous-specific racism and discrimination; and
• honour First Nation​s self-determination, data governance and Truth and Reconciliation.

To read more about the 2021 PHWA report, visit: FNHA News - Joint Report on F​irst Nations Health and Wellness Is Now Available

Media Contacts:

First Nations Health Authority Media Relations

604 329-9544

media@fnha.ca 

Office of the Provincial Health Officer Andy Watson, Director of Communications 236-475-3094