Health, Well-being, and Social Determinants
Health, Well-being, and Social Determinants
Learning Goal: I can explain what social determinants of health are and identify at least three specific factors that negatively affect the health outcomes of Indigenous communities in Canada. I can connect those factors to the history of colonization, forced relocation, and loss of cultural practices.
A social determinant of health is a condition in a person's daily life that shapes health long before a doctor gets involved. Income, education, employment, and housing sit at the center of the idea. A stable income buys nutritious food and a safe place to live. Secure housing means fewer respiratory problems and better sleep. Steady employment carries benefits and a sense of purpose that protects mental health. These four determinants build on each other, so a gap in one tends to open gaps in the rest.
The National Collaborating Centre for Indigenous Health names colonization as the determinant underneath all the others for First Nations, Inuit, and Métis peoples. Residential schools, which you studied in Lesson 16, cut children off from parents who could teach them how to eat, cook, and care for their bodies inside their own knowledge systems. The Indian Act restricted where First Nations people could live and work for over a century. The Sixties Scoop, covered in Lesson 17, removed thousands of children from families who could have passed on that same knowledge. None of these were personal choices. Each was a policy decision that reshaped who has access to the basic building blocks of health.
The gap shows up in the data, and so does the difficulty of collecting that data honestly. Statistics Canada admitted in a June 2025 release that no consistent national source tracks life expectancy by Indigenous identity, because Canada's vital statistics death records do not ask about it. Researchers instead link census records to death records years later just to produce an estimate. A country that tracked this number as carefully as it tracks the general population's life expectancy would already know the answer.
Diabetes gives a clearer picture. Diabetes Canada's 2025 Saskatchewan backgrounder reports that First Nations adults living off-reserve are diagnosed with diabetes at 1.72 times the rate of non-Indigenous adults, and Métis adults at 1.22 times the rate. The same report names the ongoing burden of colonization as a contributing cause, not a footnote. Diabetes can shorten a lifespan by five to fifteen years and multiplies the risk of amputation, kidney failure, and blindness. A number like 1.72 times sounds abstract until it is translated into who keeps their eyesight, their kidneys, and their limbs, and who does not.
Fort Qu'Appelle shows what a different answer looks like. All Nations' Healing Hospital opened its doors on June 12, 2004, replacing the old Fort Qu'Appelle Indian Hospital that had operated under federal control since 1935. File Hills Qu'Appelle Tribal Council and Touchwood Agency Tribal Council own and operate the new hospital themselves, funded through a transfer agreement with Health Canada rather than run directly by the federal government. Inside, acute care, emergency services, and dialysis sit down the same hall as traditional knowledge keepers, traditional medicines, and spiritual counselling. Patients choose which kind of care fits their situation, or both at once.
The White Raven Healing Centre operates inside that same building. Elder Margaret Keewatin of Okanese First Nation works there, guiding patients toward the medicines her own grandparents taught her when she was a girl. "We have our own medicines, but you have to believe in medicines so they work," she told CBC News in November 2025. Keewatin keeps a room at the centre where medicine hangs to dry, and she teaches younger staff what each plant treats. A hospital built and run by the nations it serves, with an elder from one of those nations working inside it, shows what self-determination looks like when it reaches directly into health care.
Key Idea: Health disparities among Indigenous peoples in Canada trace back to colonization, not to individual choices. Income, housing, education, and access to care are the visible determinants, but policies like the Indian Act, residential schools, and the Sixties Scoop shaped all of them. Indigenous-led institutions like All Nations' Healing Hospital show one way communities are answering that history on their own terms.
National Collaborating Centre for Indigenous Health. "Social Determinants of Health." https://www.nccih.ca/28/Social_Determinants.nccah
Diabetes Canada. "Diabetes in Saskatchewan: 2024 Backgrounder." April 2025. https://www.diabetes.ca/getmedia/ef92531c-70e8-480d-b257-ddfdc5cb87f7/2024-Backgrounder-Saskatchewan.pdf
Statistics Canada. "The Daily — Life Expectancy at Birth and Infant Mortality Rates of Indigenous Populations in Canada." June 3, 2025. https://www150.statcan.gc.ca/n1/daily-quotidien/250603/dq250603b-eng.htm
File Hills Qu'Appelle Tribal Council. "All Nations' Healing Hospital." https://fhqtc.com/entities/tfhq-entities/all-nations-healing-hospital/
BigEagle, Louise. "These First Nations Women Teach People About Natural Medicines for Healing." CBC News, November 17, 2025. https://www.cbc.ca/news/indigenous/first-nations-traditional-medicine-9.6979073