Running head: THE INFLUENCE OF DISCOURSE ON HEALTH CARE
The Discourse of On Reserve Housing
Centre of Nursing Science
MNS 620 Culture and Health
Margo deJong Berg
The Discourse of On Reserve Housing
The substance of this paper will be to discuss the discourse regarding the inequalities facing aboriginal peoples living on reserves in the northwestern corner of Ontario. Inequality is not naturally occurring; poverty is not an innate cultural trait that accumulates at the feet of the marginalized (Schick & St.Denis, 2005, p.304). Stephens, Nettleton and Porter stated in the Lancet (2005) “Aboriginal people in Canada suffer enormous inequalities in health and in accessibility to health care (p.4).” The discussion will review the discourse surrounding the significant implications substandard and over crowded housing has on the health of the First Nations people living in these communities. Many reserve communities face overcrowding and substandard housings, such that only 55% of on-reserve housing is not in need of major repairs or replacement (Indian and Northern Affairs Canada, 2000). The inadequacy of the housing conditions is visible evidence of the poverty and marginalization experienced disproportionately by Aboriginal people. It will also reflect on whether changing the dominant discourse would illuminate the poor health effects of substandard and overcrowded housing on this population. Therefore the purpose of this paper will be to analyze the discourse in a northern nursing practice setting as it relates to the housing issues of Aboriginal peoples living of reserve.
Currently the multiple ways in which Aboriginal problems are spoken of within academic, policy and a broader political discourse closely shapes how we view the chronically poor Aboriginal peoples. Looking at the discourse with regard to the housing conditions on reserves in northwest Ontario is a first step to understanding how housing affects the health of these communities. In 1986, the Ottawa Charter for Health promotion (WHO, 1986) recognized shelter as a basic prerequisite for health. People with low socio-economic status are more likely to be exposed to housing health risks and less likely to be aware of the risks and less able to address or avoid the risks (Canadian Council on Social Development, 2000). For instance housing policy for First Nations has been such a daunting problem it has been under review by the federal government since 1988, with no sign of resolution (Indian and Northern Affairs, 2000). Overcrowded housing conditions can increase exposure of susceptible people with infectious respiratory disease, and in doing so increases the probability of transmission. The association between overcrowded housing and the incidence of tuberculosis (TB), paediatric TB, and TB mortality has long been recognized (Hawker, Bakhashi, Ali & Farrington, 1999). Although TB was endemic in North America prior to the arrival of Europeans, the TB epidemic among Aboriginal people in this country did not begin until recently. A combination of malnutrition, confinement on crowded reservations with poor sanitation, and lack of immunity to the TB bacillus created the ideal conditions for a terrible epidemic (Health Canada, 1999). Another health issue related to poverty and poor living conditions is HIV/AIDS. Although incidence (new HIV infections among the total population) has gone down in the Canadian population, it appears that HIV rates have been steadily increasing in First Nations. Aboriginal people are at increased risk for HIV infections for several reasons, including social, economic, and behavioral factors such as poverty, substance use, including injection drug use, sexually transmitted diseases, and limited access to health services (Health Canada, 2004). Likewise mould and mildew in the homes is a common problem for people living...
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