A severe shortage of healthcare workers is impacting the whole country, but rural and remote regions, including Indigenous communities, bear the greatest burden – with a critical lack of primary care providers and frequent emergency room closures that restrict access to healthcare and jeopardize residents’ health.
Efforts to address the situation, including offering incentives to encourage healthcare workers from urban centres to move to rural communities, have only had limited success.
A more promising solution lies in building a health workforce within rural and remote regions, particularly Indigenous communities which face greater barriers accessing healthcare than elsewhere in Canada.
Investing in strategies to expand the Indigenous health workforce is a unique opportunity for the federal government to achieve several policy aims at once – solving endemic rural and remote health worker shortages while also addressing long-standing Indigenous policy issues.
Tackling health workforce shortages in rural and remote communities – with small populations spread over large geographic areas – presents distinct challenges.
Not only are health professionals unevenly distributed across these regions, but they must also have a broader scope of practice to meet the high demand for care, complicating recruitment and retention efforts.
The challenges are even greater in Indigenous communities. Canada’s colonial past and ongoing systemic racism urgently require that healthcare in these communities be culturally informed and safe.
While the federal government has implemented measures to tackle staffing shortfalls – including forgiving student loans for graduates of health programs who work in rural and remote communities – these efforts largely miss the mark.
Research shows that applying urban-based approaches to solve rural and remote workforce shortages do not work.
Instead, we need to train and develop a local workforce – a strategy promoted by the World Health Organization.Research suggests that students trained in rural or remote communities are more likely to practice there after they graduate.
There is no better place to start building that workforce than with Indigenous youth – a rapidly growing segment of Canada’s population.
With well-planned strategies and investments in their education, Canada could build a pipeline for Indigenous youth to enter different health professions and fill vital healthcare roles in their community.
The Indigenous population is also younger than the non-Indigenous population – 33.6 years compared to 41.8 years – making investments to create a dedicated pipeline of future healthcare professionals an excellent long-term return on investment.
Investing in Indigenous education would also close significant gaps between Indigenous and non-Indigenous youth – Indigenous young people are much less likely to complete high school or pursue post-secondary education than their non-Indigenous counterparts – and yield good jobs for Indigenous youth in the future.
Developing healthcare workers locally would also produce positive results for Indigenous communities.
Not only would the people living there have greater access to healthcare services, but there would also be more continuity of care, with fewer out-of-area health professionals being flown in for temporary stays.
And since the healthcare professionals working there would be from the area, they would already have a deep understanding of the community and its needs – enhancing patient care and empowering the community to address local challenges instead of having to rely on urban outsiders.
Just as importantly, increasing the number of Indigenous healthcare workers would achieve one of the calls to action put forward by the Truth and Reconciliation Commission more than a decade ago – helping to advance reconciliation.
In developing strategies, though, the federal government must be mindful of its approach.
Any initiatives it undertakes must be done in partnership with Indigenous communities – respecting their sovereignty and valuing Indigenous knowledge and practitioners. Indigenous people must have key leadership roles in designing and delivering programs.
The government must also ensure that strategies involve more than just scholarships or bursaries for post-secondary education. They must also support primary and secondary schooling needs so that more Indigenous youth can enter post-secondary healthcare education programs.
Investments must also include wraparound services – including technical supports like laptops and internet connectivity – to ensure students can easily access education and training in their own communities.
Finally, the government must also consider any tax and regulatory changes necessary to ensure initiatives meet their objectives.
It is time to recognize that we cannot solve rural and remote problems, especially in Indigenous communities, with urban ideas. We need a new approach.
The federal government needs to expand the Indigenous health workforce. The investments it makes will not only address critical health staffing shortages, but will also advance broader Indigenous policy objectives – a winning formula.
Photo courtesy of DespositPhotos
