37 is too young to die: Indigenous and marginalized in Toronto


Erratum: My original post suggested that urban Indigenous people in Canada may suffer the “worst life expectancy in the world.” After speaking with Dr. Chandrakant Shah from Anishnawbe Health Toronto, however, I’ve corrected my mistake. Dr. Shah’s report discusses “average age of death,” and refers only to those Indigenous people who used the services of the two major Toronto health units used in the report discussed below.


At the end of March, Anishnawbe Health Toronto, a community health centre, presented a report to Toronto city council outlining “premature deaths” among the city’s Indigenous community. How premature? According to the report, the average age of death for Indigenous people using health services in Toronto is 37.

The report shocked the nation, and at times it seemed impossible to escape the constant analysis in the media. The Canadian public was stunned, shocked, and rose up to demand action. I jest, of course: our national public broadcaster didn’t even pick up on the story until nearly a month after the report came out.

Just 37 years—35 for men, 41 for women. These figures are abhorrent. For context, the average age of death for all Torontonians using the same health services is 75, more than twice that of Indigenous people.

My original post compared these stats to the average life expectancy in Canada (80) and Sierra Leone (47.5), which it turns out was not correct (the world of statistical analysis is a strange and murky place). Average life expectancy and average age of death are different beasts. However, it remains helpful for me to know that Indigenous people using health services in Toronto—Canada’s largest (and self-described greatest) city—are still at risk of dying 10 years earlier than the lowest life expectancy rate in the world.

This is not a national embarrassment; this is a national crisis. And we need to start dealing with it, now. Thankfully, Anishnawbe Health Toronto has already done some legwork identifying the root causes:

“Indigenous peoples face some of the heaviest burdens of ill health,” says the report. “This is due to histories of colonization, marginalization, discrimination and racism, which results in a multitude of issues, such as loss of identity, culture, unstable housing and homelessness, a lack of education and stable jobs, and a lack of social supports.”

The report goes on to identify two specific root causes. The first is the impact of colonial and postcolonial policies (including assimilation, systemic discrimination, and cultural disruption) on the social determinants of health. The second is chronic stress as a result of these policies, resulting in “violence towards self and other, identity issues, mental health challenges, addiction, and social isolation.”

A typical medical chart of someone who has died prematurely includes diabetes, high blood pressure, obesity, inadequate housing, tobacco addiction, substance abuse, anxiety, depression, posttraumatic stress, and chronic stress. This is the medical manifestation of what one person quoted in the report calls a “broken heart syndrome.”

Although the authors of the report suggest a number of programs be put in place to counteract the problems they outline (one of which they politely refer to as the “empathy gap”), they have refrained from specific recommendations, suggesting everyone involved get together to start finding solutions together.

Yes, let’s begin. Let’s begin now. No one deserves to suffer such deplorably early deaths. Least of all our own neighbours.

***

The Anishnawbe Health Toronto’s report, “Early death among members of Toronto’s Aboriginal Community: Walking in their shoes,” is available here, and the backgrounder here.

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