The connection wasn't obvious to me at first, but keep reading to learn alongside me.
This week I am focusing my learning activity on reviewing how employer practices and workplace sponsored employee health benefits can become inclusive towards the health and wellness needs of Indigenous employees. Something I observe in my own practice in workplace health promotion is a gap in how workplaces consider policies and program with equity towards Indigenous health needs.
Employment is viewed as a determinant of health with relation to both physical and mental health, as it provides income, which is associated with better health (Brydsten et al., 2018). Indigenous peoples in Canada have higher rates of unemployment (9.1% compared to 4.9% of the general population), and low income and reliance of social assistance is associated with stress, poor nutrition and overall poorer health outcomes (National Collaborating Centre for Aboriginal Health, 2017). The challenges and barriers to reduce unemployment rates amongst Indigenous people will require a multi-level approach, the level I’m looking at within this blog is the workplace.
Figure 1. Retrieved from the report Employment as a social determinant of First Nations, Inuit and Métis Health (National Centre for Aboriginal Health, 2017), this portion of the infographic highlights the employment and income disparity amongst this vulnerable population.
Strategies for Employers to Support Indigenous Health and Wellbeing
Inclusive Hiring Practices and Job Training
There is a skills-gap amongst the general Indigenous population as a result of barriers to education, however, employers should consider, when appropriate, the work and lived experienced of indigenous candidates, rather than always leaning on formal education in job candidates. On the job training and upskilling programs will help to diversify a workforce and include talent of indigenous peoples (Davey et al., 2020).
Coverage for Indigenous Wellness Professionals
There can be systemic fear and apprehension towards mainstream healthcare based on previous negative experience with services of providers of health care (Horrill, et al., 2018). For indigenous employees, employer sponsored health insurance should have included within it coverage to culturally competent care providers, if that is how the indigenous employee would be best supported for their health and wellbeing (Dunne, 2021). I’ve included below a Cultural Safety Measurement Conceptual Framework from Johnson & Sutherland (2022) to provide high level insight to how an indigenous person's experience within the health system impacts the quality of care and thus their health outcomes.
Figure 2. From the National Collaborating Centre for Indigenous Health (Johnson & Sutherland, 2022) this framework is cited by the authors as a strategy to improve both the health system for Indigenous Peoples and the experience of the care which they receive.
Connection with Elders
In lieu of only having a traditional Employee Assistance Program, employers should opt to have options for counselling services with indigenous counselling services, such as those through elders (Dunne, 2021). Services which provide emotional support be tailored to the holistic health care needs and definitions of health by Indigenous peoples (National Collaborating Centre for Indigenous Health, 2019), including those mental health
supports by the employer.
Physical Spaces Within the Workplace for Cultural Practices
Having open discussions with employees is important to understand if, and how, they can be supported in the workplace for any culturally practices, such as smudging. Employers could consult with an elder to ensure consideration is made for employees who may follow traditional practices during the workday (Davey et al., 2020)
Bereavement Leave
A common benefit to employees is bereavement leave for the death of an immediate family member. In indigenous communities a family member could be someone within their extended family. This benefit should be eligible for the employees definition of family as a means to support to emotional wellbeing and grief of the employee (Benefits Canada, 2021).
Summary
Admittingly, it wasn’t initially obvious to me at first how employers can make an impact on the health of Indigenous peoples. Though, throughout my resource search and composition of the blog I’ve come to see a few ways how employees can support this vulnerable population. As outlined above, by increasing the hiring of Indigenous peoples, employers are first supporting this vulnerable population in many ways including offering employment (an thus income) a key determinant of health. Furthermore, employers who sponsor private employee benefit plans should evaluate whether they offer coverage to culturally competent care such as access to elders and coverage for services by indigenous wellness practitioners. We all play a part in supporting the health and wellbeing of vulnerable populations, such as that of Indigenous peoples.
- Kylie
References
Brydsten, A., Hammarström, A., & San Sebastian, M. (2018). Health inequalities between employed and unemployed in northern Sweden: a decomposition analysis of social determinants for mental health. International Journal for Equity in Health, 17(1), 59. https://doi.org/10.1186/s12939-018-0773-5
Davey, J., Fidler, D. R., Giang, V., & McCaie, A. (2020). Inclusive Futures: Indigenous engagement in Canada’s workforce. Action Canada. https://actioncanada.ca/publications/inclusive-futures-indigenous-engagement-in-canadas-workforce/
Dunne, M. (2021, November 19). How employers can use benefits offerings to support Indigenous employees. Benefits Canada.Com. https://www.benefitscanada.com/archives_/benefits-canada-archive/how-employers-can-use-benefits-offerings-to-support-indigenous-employees/
Horrill, T., McMillan, D. E., Schultz, A. S. H., & Thompson, G. (2018). Understanding access to healthcare among Indigenous peoples: A comparative analysis of biomedical and postcolonial perspectives. Nursing Inquiry, 25(3), e12237. https://doi.org/10.1111/nin.12237
Johnson, H., & Sutherland, J. (2022). A conceptual framework for Indigenous cultural safety measurement. National Collaborating Centre for Indigenous health. https://www.nccih.ca/495/A_conceptual_framework_for_Indigenous_cultural_safety_measurement.nccih?id=10375
National Collaborating Centre for Aboriginal Health (2017). Employment as a social determinant of First Nations, Innuit and Métis health. https://www.ccnsa-nccah.ca/docs/determinants/FS-Employment-SDOH-2017-EN.pdf
National Collaborating Centre for Indigenous Health. (2019). Access to health services as a social determinant of First Nations, Inuit and Métis health. https://www.nccih.ca/docs/determinants/FS-AccessHealthServicesSDOH-2019-EN.pdf
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