Studies track impact of racism on Indigenous health
Research led by SFU health sciences associate professor Angela Kaida shows that women living with HIV who experience high levels of racism are less likely to be engaged in HIV care.
The study involved more than 1,400 women across Canada and is published this week in the Journal of Acquired Immune Deficiency Syndromes (JAIDS).
“Experiences of racial discrimination account for a very significant loss from HIV care, but we observed no such relationship when we looked specifically at ethnic identity,” says Kaida, an associate professor in the Faculty of Health Sciences and associate researcher at the BC Centre for Excellence in HIV/AIDS (BC-CfE). The study was led by SFU, BC Women’s Hospital and Health Centre, and the BC-CfE.
“These findings show that it is not that Indigenous women, for example, are somehow ‘at risk’ of attrition from care because they are Indigenous. Rather, the environments in which they live, interact with daily and seek care, shape their engagement across the HIV care cascade.”
The highest levels of everyday racial discrimination were reported by those who identified as Indigenous, taken from measurements on a eight-point scale asking women how often they experienced racism, such as being treated with less courtesy or receiving poorer service because of their race.
“There is ever growing evidence regarding the negative effects of racism and discrimination on health outcomes for women, including women living with HIV," says Kaida. “The findings of our study re-inforce calls for culturally-competent HIV care for women living with HIV in Canada. Working with Indigenous women living with HIV in the planning and delivery of such care is essential."
Study team member Valerie Nicholson, an elder and Indigenous woman living with HIV, says the study shows a need to “achieve more inclusive care for individuals who may feel culturally or otherwise excluded from existing care systems. Accounting for a historical system of colonialization is also critical to effectively include all individuals in consistent HIV treatment and care."
Meanwhile new research will also look at the role that racism plays in impacting the higher rates of chronic disease, such as heart disease, cancer and diabetes, among Indigenous people.
SFU health sciences PhD student Krista Stelkia, of Syilx/Tlingit descent, is a member of the Osoyoos Indian Band with strong family connections to Tlingit/Tagish in Yukon Territory.
A recent recipient of a prestigious Canadian Institute of Health Research (CIHR) doctoral award, she will receive research funding over three years to investigate the issue. She says the funding will ensure that she has ample time to engage First Nations communities in a meaningful way, right from the beginning.
“I feel very driven to conduct research that aims to address the issue of neglect and racism against Indigenous peoples in the health-care system; it’s a topic that First Nations communities have been asking for,” she says.
Stelkia will carry out interviews with Indigenous people living with chronic health conditions and analyze data from two Canadian health surveys. The approach will help tease out complex ways in which racism can influence the risk factors, disease prevalence, access to treatment and health outcomes.
She hopes her findings will also help identify gaps in health-care delivery, treatment and screening, which can be used to inform the development of culturally safe interventions to improve health outcomes and the patient-oriented care journey.
Stelkia will carry out her research under the supervision of Jeff Reading, SFU Faculty of Health Sciences professor and First Nations Health Authority Chair in Heart Health and Wellness, in partnership with the I-HEART Centre, based at the Providence Health Care Research Institute at St. Paul’s Hospital, and First Nations community partner Nuu-chah-nulth Tribal Council.