• Photograph by CC

Dreaming Healthy Nations: Indigenous stories & the social determinants of health

The Truth and Reconciliation Commission released its final report today. This landmark document demonstrates the myriad ways in which the health and well-being of Indigenous peoples were damaged by Canada's residential school policies.

In the spirit of building healthier relationships, we're releasing the first in a new series of articles for Upstream by Max Fineday, a young nêhiyaw leader who recently finished his second term as president of the University of Saskatchewan Student's Union. In this series, Max will explore the concept of the social determinants of health through an Indigenous lens, and the types of upstream interventions that could improve health outcomes for Indigenous peoples. In his own words, "My goal in this project is to explore how that idea relates to Indigenous lives, and how it might help us chart a way to a healthier balance and healthier relationships in Canada."

I was a toddler - I can’t remember exactly what age, only that my booster seat in the back of our family car gave me the perfect vantage point to see everything we were passing by. My mom, a woman with too many degrees to count who is the daughter of proud Norwegian farmers, and my Dad, a nêhiyaw traditional knowledge keeper and (especially by his own account) the funniest man alive, were in the front seat. I don’t remember their conversation, but I remember the word ‘sad’ being spoken as we passed by a young Indigenous girl, maybe in her mid-teens, waving at us as we drove by. It was winter in Saskatchewan, the kind that will chill you to your bones. I thought, with the naivety of a young boy, that she must be cold, after looking down at my puffy jacket, complete with mittens on strings. I didn’t hesitate to wave back, as we passed her, headed toward our warm, middle-class home on the other side of the river.


By 2050, Indigenous people will make up the majority of Saskatchewan’s population. In other parts of Canada, Indigenous people are the fastest growing community. When I think back to seeing that young girl standing on a street corner in the snow, a girl who could have been my relative, who could have been a classmate of yours, or your children’s, I wonder what kind of future we are making for ourselves leading up to 2050. That young girl, who is 4.5 times more likely to be murdered or go missing than other Canadian women, represents the fate of too many Indigenous people in Canada. Born into a wealthy nation, yet still suffering from poverty, at worst willfully neglected, at best ignored, so many Indigenous people have so few chances to enjoy all that their home territory has to offer.

But is this where Canada stops listening, after hearing the brief news story? Do they shake their heads or, recognize that ‘something must be done’?

I’ve seen it happen, around me in the community, and in my own family. Indigenous people starved for the nourishment that should be the fruit of a respectful treaty relationship. Indigenous people left to sit and wait for the leftovers while Canada continues to eat even when no longer hungry.

Canadians regularly hear about Indigenous peoples on the six o’clock news, about a tragedy in a First Nations community, or a crime committed by an Indigenous person in an urban centre. A typical newscast can include stories about poverty, education, sickness, violence, and discrimination relating to Indigenous peoples all before the first commercial break. But is this where Canada stops listening, after hearing the brief news story? Do they shake their heads or, recognize that ‘something must be done’? Do they simply shrug, and go about their lives, with some prejudice reinforced by what they’ve just heard? It’s not that Canadians don’t care. I know many would say that they do care about all people, but there has been little action to back that up. I think it is clear that for a long time Canadians didn’t care about the fate of Indigenous people, and maybe still don’t. Perhaps it’s largely because they have been taught that Indigenous people are a problem and because they don’t know, not really, what’s happening to Indigenous peoples behind those brief news stories.


I’m not sure that we’ve admitted to ourselves that we have a real problem – but it’s not “the Indian problem” as it was often phrased in the past. It’s a relationship problem. Indigenous peoples are over-represented in the criminal justice system and under-represented in post-secondary education. Indigenous women are more likely to be murdered or go missing than other women. Rampant poverty for Indigenous people is a wall that prevents them from reaching their full potential. Indigenous peoples are like the abused partner in a dysfunctional marriage, and Canada refuses to go to counseling.

The result of all of these differences is more sickness and shorter lives for Indigenous people in this country. We suffer from higher infant mortality rates, far higher levels of chronic illnesses like diabetes, heart disease, and HIV/AIDS, and shorter lifespans overall. An Indigenous woman is likely to live 5 years less than the national average, for a man the difference is 9 years.

Indigenous peoples are like the abused partner in a dysfunctional marriage, and Canada refuses to go to counseling

This isn’t happening because people are First Nations or Métis, it’s entirely dependent on the social, political and historical factors that affect the lives of Indigenous people in Canada. When social factors such as income, education, employment, housing and food security are controlled for, the differences in health outcomes disappear. The reality, however, is that when it comes to these social determinants of health, the deck is stacked against Indigenous people.

The social determinants of health provide a framework that can predict how healthy someone will be in their lifetime based on their living conditions: where they work, live, learn and play. Some of the most compelling reading on the social determinants and the path to a health society is coming from Upstream. My goal in this project is to explore how that idea relates to Indigenous lives, and how it might help us chart a way to a healthier balance and healthier relationships in Canada.

Social Determinants of Health

1. Income and Income Distribution
2. Education
3. Unemployment and Job Security
4. Employment and working conditions
5. Early childhood development
6. Food Security
7. Housing
8. Social Inclusion
9. Social Safety Net
10. Health Services
11. Aboriginal Status
12. Gender
13. Race
14. Disability

Source: canadianfacts.org

When I first heard about the social determinants, and saw the list, I couldn’t help but draw connections to what I’ve seen in my community, in my family, and in neechidom as a whole.

Although Indigenous peoples may not use the same academic language as medical professors in Canadian universities, grassroots Indigenous people and organizations have been advocating for better healthcare, education, training, and living conditions as pieces of solutions that will increase the well-being in Indigenous communities. The National Indian Brotherhood (now the Assembly of First Nations) was born out of the struggle for Indian Control of Indian Education. All those years ago, leaders realized that the children from their communities would be at a disadvantage, would be less healthy, unless they were given a proper education.


In contemporary times we see Idle No More – the resistance and the resurgence of pride that spread across the country – calling for equitable treatment, respect, and justice for Indigenous peoples. When hundreds of people gather in spaces across Canada to tell the story of young First Nations people walking to Ottawa to demand that a school be built in their community, when people come together with a single voice to insist that children born on reserve should not have to wait in hospital while the provincial and federal governments bicker about who should pay for their home care, they are speaking the language of the social determinants of health.

It’s time for Canada to hear these stories, the ones only whispered by Indigenous families across the land

We know that challenges exist in Indigenous communities across our province, and across our country, but few are talking about real action for meaningful change. Instead of leadership and action, many in government are focused on issues that will win more votes. When was the last time an election was won over issues of treaty adherence, or ending injustice towards Indigenous people? In the coming weeks, I’ll be writing about the social determinants of health and how they impact Indigenous communities. They will be stories from communities, they will highlight challenges, and shine the light on examples of hope. It’s time for Canada to hear these stories, the ones only whispered by Indigenous families across the land.

And if we take action now, in the future, when I’m driving with my children during a Saskatchewan winter, in a cold that will chill you to your bones, they won’t have to wonder why a young girl who looks like them, who reminds them of a cousin, or an auntie, is standing outside in the freezing cold, waving to strangers as they drive by.


Max FineDay is nêhiyaw (Cree) from Sweetgrass First Nation, he recently finished serving as the President of the University of Saskatchewan Students’ Union representing 18,000 undergraduate students for 2013-2014 and 2014-2015.

Most of Max’s work focuses on both the student and First Nations movements. He is passionate about youth leadership development, theories for change making, and increasing the accessibility of post-secondary education for traditionally underrepresented communities. Max was the first co-coordinator/developer of “Next Up: First Nations & Metis Youth in Action” which focuses on Indigenous Youth Activist Training & Leadership development. He has just completed a Bachelor of Arts degree majoring in Political Studies at the University of Saskatchewan and has also studied in the Arctic Circle at the University of Nordland in Bodø, Norway.

When Max isn’t rabble-rousing you can find him learning nêhiyawewin (Cree language), tweeting, and laughing at his own jokes.

All photographs supplied by Max Fineday.

Want to Keep Exploring?

Read the rest of this series Dreaming Healthy Nations, as it's published!

"What will it take for you to disobey?" - Erica Lee speaking at Saskatoon Changemakers.

You're About to Enter an Empowerment Zone - Max Fineday speaking at Saskatoon Changemakers.

Showing 2 reactions

  • B R
    commented 2015-06-11 13:27:08 -0600
    S C, I’d like to briefly respond to the comment you made regarding your discomfort with Indigenous rights. Many Canadians strongly endorse a ‘universalist’ or classic ‘liberalist’ approach to human rights like you and express discomfort with Indigenous rights, which they see as providing more than the rights already universally afforded to Canadian citizens. One of the problems with such a universalist or liberalist approach, however, is that it fails to acknowledge the fact that ‘difference’ exists regardless of whether one’s preferred legal or philosophical theory is able to account for that difference.

    Imagine a First Nation’s claim to the lands and resources of their traditional territories. These claims are often based on the occupation of these lands, the use and stewardship of these resources over hundred to thousands of years, and Indigenous peoples’ own legal systems that typically govern use, access, ownership and stewardship of these lands and resources. How is this any different from the claims that Canada or any province or territory makes to the same (their so-called ‘asserted sovereignty’)? How powerful is the justification of a provincial or federal government to the remote Indigenous territories of northern Canada and coastal BC, for example? In many cases it’s little more than a paper-based assertion of sovereignty and ownership, with very few improvements, services provided or even explorations made. And yet these governments purport to have the sole and exclusive power to set the rules for who can develop and exploit the resources within these territories through ‘universally’ available commercial fishing licences or environmental assessment processes that are only universally available so long as you have millions of dollars of capital to work with. This is one of the pernicious practical realities that Indigenous rights need to contend with and universalist perspectives are unable to. Lands and resources that Indigenous peoples always used, owned and governed are sold to third parties based on assertions of sovereignty and ownership by governments that have never so much as stepped foot there.

    How does liberalism account for your ability to have the benefits of citizenship in Canada or whatever country you are privileged enough to live in? A Guatemalan citizen cannot step foot on Canadian soil and start to claim our freshwater, fish, oil or timber for themselves, not without entering into a mutually beneficial agreement as to royalties and such. Citizenship in a western democracy has been aptly described as the modern day equivalent of the class privilege nobles were born into in feudal Europe. Most of us are born into it and take it for granted and assume that it somehow has more credibility than the claims of Indigenous nations. If you look more closely, however, you’ll see that there’s little to back up that perspective in many cases. What is dressed up as universal can often amount to little more than an elaborate justification for the expropriation of lands and resources. If anyone is benefiting from treaties in this country it is first and foremost the descendants of the settler population. To then ask that all consideration flowing to the other parties now be stymied so they can join us or disappear is the arrogant underpinning of the hard-line liberalist argument.
  • S C
    commented 2015-06-03 17:08:27 -0600
    I have to say I always am ambivalent about indigenous issues. On the one hand I am absolutely in favor of bettering the living circumstances of indigenous people. I recognize that all sorts of measurable outcomes diverge wildly from the rest of Canada and I want the gap closed, whatever it takes. Indigenous people are my neighbours and I want them enjoying the same quality of life I do both out of a sense of justice and also out of a sense of self-interest – indigenous people working to their full potential are going to be better neighbours to me, and more productive citizens challenging their hardwork or unique genius into improving things for all Canadians.

    On the other hand I find ‘indigenous rights’ very hard to be comfortable with. This is not, of course, to say I don’t think indigenous people should have no rights. I think they should certainly have rights. I just can’t square my belief in universal human rights as being the most important legal principle with an idea of added rights, on top of those I have, for indigenous people. Treaty adherence says to me that indigenous people should have Canadian rights and also should have additional rights that other Canadians don’t have. That is not something I am OK with despite my really strong sympathy for the suffering (past and present) of indigenous people.
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