The health of Aboriginal people in Canada can be discussed in terms of three aspects: 1. health and disease, 2. traditional medicine and 3. health-care delivery.
Health and Disease
The health of Aboriginal people suffered drastic changes after the arrival of Europeans from the 16th to the 19th century. The introduction of "new" diseases, particularly infections such as smallpox, measles, and influenza, resulted in epidemics, famines, and social disruptions. Across the land, many Aboriginal communities were severely depopulated. Some groups, such as the Beothuk in Newfoundland and the Sadlermiut Inuit on Southampton Island in the Arctic, suffered complete physical extinction. Tuberculosis became the main scourge in the south and east from the mid-18th century and in the west and north in the mid-19th century. Exposure to infection was increased by crowding on permanent settlements and poor housing, sanitation and water supply (see Indigenous People: Social Conditions). Resistance to disease was further lowered by malnutrition resulting from loss of traditional food supplies and alcohol abuse.
Since the beginning of the 20th century, the Aboriginal population began to recover slowly (see Demography of Indigenous People) as infectious diseases became increasingly brought under control. As an indicator of overall health, the infant mortality rate (the number of deaths under 1 year of age per 1000 live births) has steadily declined, although in the early 1990s the registered Aboriginal population rate was still about twice the national average. The decline among the Inuit has been even steeper, although it remains higher than the Aboriginal rate. However, new health problems have emerged. Violence, suicides and accidents, most of them related to alcohol abuse, now account for as much as a third of all deaths. Chronic, noninfectious diseases such as diabetes and heart disease have assumed increasing importance as a result of changes in such lifestyle factors as diet and physical activity.
Before the arrival of Europeans, Aboriginal people had their own medical systems, with a variety of healers. Aboriginal beliefs regarding the causes of disease included "soul loss,""object intrusion" and sorcery. Different Aboriginal people developed different diagnostic and therapeutic techniques and ceremonies: some Plains communities used Medicine Bundles, the Haudenosaunee (Iroquois) had Falce Face Societies and several groups used the Shaking Tent and Sweat Lodge in their healing. All used some herbal remedies obtained from the land. Chanting, rattling, and the burning of tobacco was widely used. The use of massages, enemas, blood letting and scarification had parallels in other non-Amerindian cultures.
As medicine was integrated with other aspects of Aboriginal culture and religion (see Indigenous People: Religion), it also suffered a decline under the acculturating influences of the dominant Euro-Canadian society and its institutions, especially the churches and the government. However, Aboriginal medicine did not disappear and in recent years there are signs of its resurgence. Traditional healers travel far and wide to serve clients in Aboriginal communities, and there is increasing evidence of collaboration between modern Western physicians and traditional Aboriginal healers, especially in the field of mental health.
Health Care Delivery
The provision of health services to Aboriginal people in Canada has been the subject of much debate and controversy over the years. Of the treaties signed between Canada and the First Nations, only one, Treaty No. 6, which covered central Saskatchewan and Alberta, mentioned that a "medicine chest" would be kept by the Aboriginal Agent for the use of the First peoples. Interpreted literally, the medicine chest is merely a wooden box. It alternatively represents the full range of medical technology which grows with time. Several court cases have been fought over this interpretation.
A rudimentary Aboriginal health service has been in existence since the early 1900s. After the Second World War, health care for Aboriginal people on reserves and all residents of the Northwest Territories was transferred to the Medical Services Branch of the federal health department, with a phenomenal increase in budget, staff and facilities. Over the past two decades the federal government has initiated a process of "transfer of control" to Aboriginal communities and regional organizations and health care has become an integral aspect of Aboriginal self-determination.