Surgery is more dangerous for Indigenous people, Prince George doctor says

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Indigenous patients in Canada are 30 per cent more likely to die after surgery than other patients, according to new research. And that’s not going to change without transformational change to address anti-Indigenous racism in health-care systems in B.C. and across Canada, according to the first First Nations woman surgeon in Canada.

A recent review of 28 studies co-authored by Prince George surgeon Dr. Nadine Caron, who also teaches in the UNBC and UBC medical programs, found that after surgery, Indigenous people die at a rate 30-per-cent greater than other patients. 

Indigenous patients also experienced higher rates of post-operative infections and complications than others, despite getting surgeries less often.

The data did not surprise Caron or her co-authors Dr. Jason McVicar and Dr. Alana Poon, but it raises essential questions about what’s causing the poorer outcomes. Are patients waiting longer for surgery, or suffering from poor health that add to their risks? 

Caron said it’s important to move beyond those basic questions and look for the underlying causes.

“Is it because of delayed access? Then why is there delayed access? Is it because of the lack of utilization of the health-care services, or that they’re not there at all?” asked Caron, who is a member of the Sagamok Anishnawbek Nation in Ontario.

All these problems are made worse by widespread anti-Indigenous racism in the health-care system, as documented in the In Plain Sight report released in November.

Racism also puts Indigenous people at greater risk for chronic illnesses and early deaths from causes like toxic drugs.

Caron, who is co-director of UBC’s Centre for Excellence in Indigenous Health, said the relationship between Indigenous people and the health-care system need careful examination.

“Is the problem not particularly the access, but the lack of access to culturally safe care, to a health-care system without racism embedded within the walls of the institutions Indigenous people have to walk into?” she asked.

Surgery is an essential part of health care, Caron said. But there is so much more to one’s health than how smoothly things go while under the knife.

Needing surgery can represent a failure of health services to prevent a condition from worsening due to factors driven by systemic racism. Evidence of poorer outcomes demonstrates “the necessity to ensure that we address the In Plain Sight report, and eliminate Indigenous-specific racism and racism as a whole in our health-care system,” said Caron.