Social determinants of indigenous health : case-analysis of Violence against aboriginal women in canada introduce Some previous studies have

lose focus on the role of social determinants of pblic health,as too much emphasised on presonal health behavior.however, social fators beyond the control of individual such as the inequlality in living environment , health care service , cultural influence can substancially effect health states ,It is can be easily documented : Major socioeconomic inequalities in mortality are observed in every country that collets relevant data. These inequality are noted for most major causes of death ,across almost all age groups ,and persist over time (Najman 2001,p,73).sociological factors of health can classfy into :proximal determinants, intermediate determinants ,and distal determinants.

Specifically,proximal determinants means obvious factors directly

impacting our health in our daliy life , like physical environments ,employment and income ,food security .intermediate determinants , the deeper health inequality behind proximal parts , will be mainly explored in this essay.while distal determiants refer to all the historical factors , in case of canada ,It can be seen clearly how unhealth personal habits responsible for the Low health outcomes: Among Aboriginal peoples, the most relevant health behaviours include the over or misuse of alcohol, which is related to increases in all-case mortalities (56), and excessive smoking, the health effects of which are clearly expressed in high rates of heart disease and increasing rates of lung cancer (5760). Even so ,all these facts become invaild without being put into social-context .Among these inequality ,ethnicity is a barrier to improving health . many developed country regarded as affluent society have to face this urgent priority as well.

Case study +historical factor In canada ,aboriginal people is recognized at the long-term disadvantage position attributing to the poverty , low social status ,inadequate access to health care .which can be reflected in the following specific case,according to the surey of the canadian women`s foundation feb.1.2012 . voilence is one of the paticular health concern of aboriginal women:R On average, every six days a woman in Canada is killed by her intimate partner. In 2009, 67 women were murdered by a current or former spouse or

boyfriend indigenous famle suffer from three times higher violence then nonaboriginal females. as shown in tale 1: talble 1 11493

reference category * significantly different from reference category (p < 0.05) 1. Spousal violence includes incidents of physical or sexual assault. 2. Rates are calculated per 1,000 females age 15 years and older. Note: Data from the Northwest Territories, Yukon and Nunavut were collected using a different methodology and are therefore excluded. Violent victimization includes sexual assault, robbery and physical assault. Includes female respondents age 15 years or older. Source: Statistics Canada, General Social Survey, 2009. The high rate of violence agianst aboriginal femela -espacilly male partner violence-has led to numerous negativephysical ,mental ,reproductive problemsR.simply Attributing these results to patriarchal dominance is insufficent to interpret this subject. Reference there are four aspects of this problem have to be addressed. colonize Firstly ,examinating the historical factor can help us clear understand the source cause of health disparity .colonization ,which rooted in indeginous canadian culture,yet shaped the context of mistreat aginast aboriginal women ,by dissociating the traditon society in which the role of Women and men are relativley equal.

colonialism,which has had a profoundly negative impact on indigenous communities as a whole ,has also affected the relations between indigenous women and indigenous men,and pushed many indigenous women to the margins of their own clutures and canadian society as a whole . 6-out. Employment and income Second ,althogh aboriginalis know as symbol of poverty .the pblic are still shocked to see the following statistics 21.7% had incomes below Statistics Canadas low income cut-off after tax, compared to 11.1% for the non-Aboriginal identity population (Statistics Canada, 2006a). High rate fo unemplyment can infer this revenue gap the employment rate ofAboriginal peoples being almost ten percentage points below that of the non-Aboriginal population (53.7% compared to 62.7% in 2005) (Alain noel . (2009). Aboriginal Peoples and Poverty in Canada: Can Provincial Governments Make a Difference?) Consequently, socioeconomic scare restrict the access to good living codition,security food ,adequted health service . In the case of violence agianst aboriginal women, low ecom-social status could expel the male parterner go stray.on the one hand ,low income exerts psychological pressure especially on male as a bread-winner ,which makes them feel threat disparaging the male identity.this feeling may drive them prone to be aggressive . on the other hand ,unemplyment develop vices .for instance: gambling ,alcohol and drug abuse ,the bad socail atmosphere exposure women to various disastruous incidents as mentioned by describe famale who died not as the result of violence, but in tragic circumstances that might be considered violentthrough drugs or alcohol, exposure or suicide(Sisters In Spirit 2010 Research Findings) Gender inequality The third aspect deal with the gender inequality, in aboriginal community ,the traditional role of women are concentrate on child and older care ;famale barely accept schooling;therefore,generally ,women have lower eduation level than their spouse, thus corresponding lower socieconomic status .previous study proved that women are more likely to experice discrimination in both family and workplce, and negative mental health outcomes ensure. The feredal government enacted relevant legislation (Discrimination in the Indian Act /Section 67 of the Canadian Human Rights Act)to eliminate the discrimination and guanrantee the right of aboriginal women,but little achievement witnessed in reshape the public awareness ,In reported case,lots criminals conceived of escaping the legal sanction flukey because the victims are aboriginal women.

Health care service As mention to the health care,the aboriginal don't have the same treaty right as the non-aboriginal counterpart ,the reasons are compound, jurisdictional ambiguity is central issue leading numerous aboriginal are offreserve .what`s more ,in the procedure of delivery adequte health care service, The federal government confront the dilemma in practice .remote geogracial location, language barrier ,cultural diversity among aboriginal community hinder the process.

Program
This part will focus on two program help to eradicate the health equity disscussed above, fist is the indigenous health initiatives founded by the Faculty of Medicine & Dentistry since 1998. the aim of this program is to encourage more aboriginal students choose medical care as career the ratio of Aboriginal physicians in Canada was 1:30,000 compared to the overall ratio of physicians to the general population in Canada which was 1:600. Cultivitaing aboriginal heathcare practioner would be a effecient way Out of the akward medical care state. Medical staff who have the same cultrual backgroud are easily accepted by local pepole. To ensure the program carry on, policies are made at the beginning ,in admission:The Faculty also has one position available for Aboriginal students in each of the following: in the Medical Laboratory Science Program, the D.D.S. Program and the Dental Hygiene Program. All other Professional Health Sciences Faculties at the University of Alberta also offer special positions reserved for Aboriginal students. By June 2010, 62 Aboriginal physicians graduated and engaged in health service

Another one is a program poviding trasition house and shelter for abused women in canada run by government and female right safegaurd orgnization: the main cause for women live in shelter are physical and phopsychological violence .due to government can only provide short trem accomodation and teartment ,nearly 75% women turn to the help of shelter afterwards. Recent years ,the figure and the types of the shelter Have increased stably as shown in table 2: table 2 Number of shelters by type of facility, Canada, 2006, 2008 and 2010 Data table for chart 1

1. 'Other' includes all other facilities not otherwise classified, such as Rural Family Violence Prevention Centres (Alberta), Interim Housing (Manitoba), and other types of emergency shelters. Source: Statistics Canada, Canadian Centre for Justice Statistics, Transition Home Surv In 2009/2010,shelters admissed approximately 64,5000 women,also ,some shelter are designed for aboriginal women accoding their special feature.help to them healing . analysis This analysis can be regard as a supplement to the issue dicussed above and will explore the Possible solutions as well. As other indeginous group in the world, aboriginal canadian `s health status lower than counterpart Non aboriginal in average ,considered specific social context , government and health orgnization should take futher action to interver and optimize .health of Aboriginal candian ,specifically speaking,social and economic policies have resposibility to percive and modify disregarded social determinants .goverment should define the jurisdiction to include off-reserve aboriginal into the welfare system ,mobilize medical resource ,build infrastructure medical facitlities ,shift the focus from the infectious illness to chornic illness. For women health ,policy are the source of gender inequality, more attention should be given about emilinating the discrimiantion ,improving their social status. Providing adequte access to eduction and workplace .

Unforcunately ,most violen incidence of reported case end up with letting the criminal away .it needs long-trem endeavors to improve the situation.in the future,the government ,law enforcement and anti-violence service originzaiton have to reinfore the communication with community ,instruct women as well the public find out a strategy to ensure safety of aboriginal women.

conclusion
This essay examined how enthnity influent individual health as soicl determinants.By specific investigate the case of violence among aboriginal canadian female above, the conclusion become obvious that the problem of pubic health lies not only in the health behaviour ,but largely determined by social fators . For indegnious people clonisam is the historial cause of incapable of integrate into society ,and the root of low social status, exclusion from the welfare system ,and Put the aboriginal women at the edge of the society . Poverty is the dominant intermate Component which can create distinct in living environment , access of education also related to stable mental state to some extent . we can see lots of policies are realsed to ensure aboriginal people enjoy the same health care service ,however, considered the situation.The results could be better convinced if the stakehoder in aboriginal health collaborate to develop the long-term strategy. In this process they should not lose sight of the cultral feature and tradition of the indeginous community.