Hep C in Indigenous Populations

In Canada, we will soon observe the National Day for Truth and Reconciliation, a new statutory holiday to honor the Indigenous children forced to attend residential schools. The holiday aims for Canadians to reflect on the treatment of Indigenous people in Canada, which involved significant physical, emotional, and sexual abuse.¹

On that day, I reflected on the significant health disparities Indigenous people have faced and continue to face due to colonization. For example, in Canada, Indigenous people are disproportionately affected by hep C, with the rate of newly diagnosed cases at least 2.5 times higher than non-indigenous populations.²

Some other studies show the rate being as high as five times more. What is also troubling is the lack of sufficient data that highlights these inequalities.³

Why do these health disparities exist?

There are several reasons why Indigenous people are at a higher risk of hep C. The effect of residential schools and former Canadian policies have significantly impacted the spread of hep C. It is important to note that all of the below disparities are directly linked to the stress of colonization. These include:⁴

• Poor access to health services
• History of sexual abuse
• Intravenous drug use
• Social exclusion and remote living
• Tattoos
• Incarceration

What can be done about health disparities?

Interventions that help address hep C in Indigenous populations must consider this population's cultural, spiritual, and geographical uniqueness.

For example, a couple of years ago, I traveled to a First Nation reserve to help conduct dried blood spot testing. This type of testing helps diagnose hep C.

Dried blood spot testing involves collecting a few drops of blood from the finger, which are then blotted onto a particular type of paper, dried, then mailed to a center for analysis for blood-borne infections.⁵

Overall, it requires less training, is less painful, and allows for easier testing in people who live in remote areas.

I attended the dried blood spot testing event over two days which involved Elder participation, rituals, and food. Overall, the event was more engaging and successful than had these individuals been simply told to get a blood test.

Events like these, in which the rich culture is considered, are more successful in facilitating hep C testing for people living in remote communities.

Addressing medical discrimination

Too often, we see Indigenous people listed as an individual risk factor for hep C, among those in prison, men who have sex with men, and injection drug users. This is fundamentally flawed because it signals that being Indigenous is the risk factor.⁵

The risk is increased due to the effects of colonization, which increases individual risk factors such as injection drug use.⁵

More work to be done

Overall, there is still quite a bit of work that needs to be done within the healthcare system to address these inequalities. As a hep C advocate, the most important thing you can do is to recognize and speak up against discrimination and racism.