The 180

"They treated me like crap, and I know it was because I was Native"

A new report on the healthcare experiences of Aboriginal people living in Vancouver's inner city concludes that provocative title goes a long way to describing how the health care system works for Indigenous people - particularly drug users. Lead author Ashley Goodman explains.
The lead author of a new report sharing the experiences of Indigenous people with health care providers says often the medical education doctors receive doesn't adequately contextualize the social, political and historical determinants that shape aboriginal health. (iStock)

A new report on the healthcare experiences of people living in Vancouver's inner city concludes the health care system fails Indigenous people — particularly drug users.

Lead author Ashley Goodman says the majority of participants in the study shared experiences that were negative, and often lead people to delay care or disengage from care entirely. 

"There was one participant who hadn't accessed a doctor in 25 years- Ashley Goodman

Misdiagnosis was also common amongst study participants.

Goodman said one participant's story stood out to her in particular - a man went to see his doctor suffering from awful pain on his right side. The doctor told him to go home and walk it off, without any medication to manage the pain. That night, the patient woke up with severe pain in his chest and later discovered he had a collapsed lung.

"That was a such a common experience of having symptoms trivialized and dismissed by healthcare practitioners," says Goodman.

To Goodman, the experiences the study captured stem from the broader systemic racism that Indigenous people face which in her view are often rooted in stereotypes.

"A lot of it stems from a lack of education and we see that in our health care in terms of when you look at medical schools," says Goodman, noting that Indigenous health is often an elective course within the curriculum, or as a lecture that concentrates only on the statistics on disease prevalence and health status.

Often these statistics aren't... contextualizing the social, political and historical determinants that shape these statistics, and that's when these stereotypes are formed. These stereotypes obviously influence clinical practice, so it really comes down to a lack of education and a lack of understanding of aboriginal people and how these historical and current experiences continue to influence and shape aboriginal people's health care experiences and health status.- Ashley Goodman

Goodman says medical education needs to widen clinician understanding beyond traditional biomedical concepts of health to include issues like cultural safety, power imbalances, and racism.