Cancer in Metis People in Canada – The Past, The Present, The Future Marc LeClair representing Metis National Council

Who we are Recognized in the Canadian Constitutions Act of 1982 Live across Canada but largely in the West Metis are a distinct Aboriginal culture Young and growing population Metis people are one of three Indigenous Peoples recognized in the Canadian Constitutions Act of 1982 Metis people live all across Canada, but largely are situated in western Canada Metis are a distinct Aboriginal culture The 2001 and 2006 Census reflect that Metis are a younger and growing population than other Canadians

What we know from the past Little is known about the overall health of Metis people From our ancestors we know that in the past little, if any, cancer was seen. It was not ‘known’ by them While much is know about other Aboriginal peoples in Canada, little is known about the overall health of Metis people The knowledge we have about Metis population health in the past is largely anecdotal From our ancestors we know little, if any, cancer was seen. It was not ‘known’ by them

What we know now Now it seem as though many of us can identify one, or several, Metis individuals who we know have been treated for cancer Cancer is one of the two leading causes of death in Canada Cancer affects both men and women and occurs in all age groups Cancer also affects children – the hope for the future of our nation Metis specific rates remain largely unknown Now I think we can each identify one, or several, Metis individuals who we know have been diagnosed and treated for cancer Cancer affects not only the individual but also the family and community Cancer is one of the two leading causes of death in Canada Cancer affects both men and women and occurs in all age groups Cancer also affects children – Children are the hope for the future of our Nation. And, strong and healthy children are the key to ensuring a strong healthy Metis Nation Metis specific rates remain largely unknown

What we know now Metis people face lower levels of income, education, and access to resources - all important determinants of health. Each is a factor in cancer prevention and treatment Based on numerous medical and social research studies, most researcher, physicians and policy makers agree that Aboriginal populations are faced with lower levels of education, economic insecurity, income inequality, below par living conditions, and exposure to environmental factors - all of which influence the development of cancer. Statistics from the recent 2006 Aboriginal Peoples Survey and the Aboriginal Children’s Survey show us that these income, security, and education factors predominate in the Metis population – especially in the Metis homeland in western Canada We know that most Metis children live in urban areas – 22% are less than six years old and have young 15-20 year-old parents compared with other Canadian children where only 8% have parents this young Clearly, young parents have less education and lower family incomes – as a result both the parents and their children are less able to afford to live healthy lives in healthy environments Proof of this lies in the 2006 Aboriginal Children’s Survey which tells us that 32% of Metis children live in low income families vs. only 8% of other Canadian children

What we know now Access to the cancer control system across Canada may be limited for the Metis population: Most Metis people have a family doctor but initial screening and follow up may be limited by satisfaction with the primary care they receive Those in urban areas may not be able to afford public transportation Many live in rural communities with limited access to public transportation and often incur out-of-pocket expenses Those with low income jobs lack health benefits There is no ‘Non-insured Health Benefit Program’ for the Metis population Access to the Cancer Control System may be limited for some Metis people for a variety of reasons. In the 2006 Aboriginal Peoples Survey most Metis people reported having a family doctor. However, there were mixed responses about the satisfaction of care being received. About one in ten Metis people said that in the past year there was a time they needed health care but did not receive it and reported long wait times. Individuals not accessing or dissatisfied with primary care may not receive appropriate screening or follow up for cancer. Metis living in urban areas may have public transportation but it is costly for those with low income and results in inaccessibility of medical treatment. Many Metis people also live in rural communities with limited access to public transportation. As a result, regular visits to the doctors may be difficult to accomplish. Many Metis people may incur out-of-pocket expenses. Metis people with low income jobs usually don’t have health benefits and there is no ‘Non-Insured Health Benefit Program’ for Metis people. This has an impact on Metis individuals and their families to assume the cost burden for cancer related medication.

What we know now To build knowledge, work is beginning in some MNC Governing Member Organization to determine rates of cancer in Metis For example: In Manitoba, a “Cancer in Metis in Manitoba” study will provide reliable information (available in Nov 2009) Such information is essential to support future planning around cancer programs and services relating to the Metis population To build knowledge, work is being done to determine rates of cancer in Metis people. For example, in Manitoba, a study is being undertaken entitled “Cancer in Metis in Manitoba”. This data linkage study is initiated by the Manitoba Metis Federation, and in collaboration with CancerCare Manitoba this study will provide reliable information about the prevalence of and treatment for cancer in the Metis population in Manitoba. Results will be published in November 2009. These results will be used to support future assessment and planning around cancer programs and services relating to the Metis population in Manitoba.

What we need in the future Determine the burden of illness in Metis people Identify most prevalent types of cancer to target prevention and treatment efforts Federal and provincial commitment to assist us in developing cancer control programs that respect the Metis way of life There are several areas requiring attention: Determining the burden of illness in our communities will enable health programs and services as well as policy to be adapted to meet the specific needs of Metis individuals and families affected by cancer. Identification of the most prevalent types of cancer will enable prevention and treatment efforts to be targeted to Metis people who are most at risk. Ultimately, cancer prevention remains the key to ensuring the health of future generations of Metis in Canada. We need federal and provincial commitment to assist us in developing cancer control programs that respect the Metis way of life. Metis people think of ‘healthy living’ in a holistic way. Preventing and managing a disease means caring for the whole person and being sensitive to the environment that they live in; not just the disease itself. Respecting the Metis way of life also means recognition of and building upon the strengths that exist in the Metis people, their families, and their community. The Metis National Council appreciate this opportunity to share knowledge about the Metis Nation and welcomes new partnerships to improve the health and wellness of all Metis people in Canada. Thank you.