Whose Voices Really Matter? Indigenous Maternal-Child Health Research in Alberta


Angie Wong, University of Calgary

Racism against Indigenous Peoples has been identified in news media, grey literature, and personal testimony as a critical social determinant of health that has direct impacts on the relationships between patients and providers in healthcare settings. Unfortunately, and despite the growing scholarship on the ways in which racism against Indigenous Peoples in health care settings impacts delivery of care, testimonials from urban First Nations and Métis women in Calgary and Edmonton, Alberta reveal that their child birthing experiences in the provincial healthcare system were entrenched with racist interactions and encounters. This is no surprise given the ways in which western Canadian settler colonial expansion utilized the residential school and the Indian hospital systems to absorb Indigenous children and youth into the establishing Canadian body politic. To this end, distrust due to an awareness of colonial health systems and colonial health interactions continues to shape health care interactions in Alberta. To better understand the facilitators and barriers that shape Indigenous mothers and families’ experiences in health care, the provincial health care system of Alberta, known as Alberta Health Services (or AHS), developed and adopted a number of statements and policies that speak directly to how race and racism are social determinants of health. Indeed, AHS even published a guiding organizational document called the “Indigenous Health Commitments: Roadmap to Wellness,” which explains how AHS intends to engage more fulsomely with First Nations and Métis health authorities and partners. As a Humanities scholar and senior consultant in the sector of Indigenous health, innovation, and research I was invited to conduct community-based participatory action research. In November 2023, I developed a report entitled “Voices for Indigenous Maternal-Child Health and Wellness,” which contains testimonials, sharing circle stories, and interviews with Blackfoot, Dene, Chippewan, and Métis mothers, their families, scholars, grandmothers (Elders, specifically), Aunties, and practicing midwives and doulas about child birthing and child rearing in Alberta. The findings of this report align with grey literature to reveal that systemic racism is a major contributing factor to the distrust of the health care system, which leads to poor health outcomes for Indigenous mothers and children. Yet, five major recommendations were made for organizational change and individual health care provider reform. How AHS is taking up these recommendations is ongoing. As health care systems adopt new understandings for how to address and eliminate racism in health care (e.g. B.C. “In Plain Sight” report), there remains a feeble understanding of why and how settler colonialism shapes Canadian health care (most still refer to Canada as a classical colonial situation, or even worse, post-colonial ). As a result, imbalanced power dynamics emerge in interactions between racialized health care providers and Indigenous patients, confusing an understanding of how racism is expressed and experienced. I would like to share the findings of the “Voices for Indigenous Maternal-Child Health and Wellness” report and further explore the disconnect between the priorities of First Nations and Métis and the agendas of provincial health care systems that are influenced by provincial politics. I believe this presentation would fit well in the potential session: (HEA3) Race and racism is a social determinant of health: A roadmap to challenging hate.

This paper will be presented at the following session: