Racism, Sexism, and Colonialism

Aboriginal women in Canada carry a disproportionate burden of poor health. Aboriginal women have lower life expectancy, elevated morbidity rates, and elevated suicide rates in comparison to non-Aboriginal women (Prairie Women's Health Centre ofExcellence, 2004). Aboriginal women living on reserves have significantly higher rates of coronary heart disease, cancer, cerebrovascular disease and other chronic illnesses than non-Aboriginal Canadian women (Waldram, Herring, and Young, 2000). A significantly greater percentage ofAboriginal women living offreserve, in all age groups, report fair or poor health compared to non-Aboriginal women; 41 per cent of Aboriginal women aged 55-64 reported fair or poor health, compared to 19 per cent ofwomen in the same age group among the total Canadian population (Statistics Canada). In addition, chronic disease disparities are more pronounced for Aboriginal women than Aboriginal men. For example, diseases such as diabetes are more prevalent among Aboriginal women than either the general population or Aboriginal men (Statistics Canada). Epidemiologists suggest that many of these chronic health conditions are a result of the forced acculturation imposed on Aboriginal peoples (Young 1994). Yet, for Aboriginal women, low income, low social status, and exposure to violence also contribute to poor health. Aboriginal women face the highest poverty and violence rates in Canada. Joyce Green (2000) notes that in 1991 eight out of ten Aboriginal women reported victimization by physical, sexual, psychological, or ritual abuse; this rate is twice as high as that reported by non-Aboriginal women. These issues are evident in Saskatchewan where the Saskatchewan Women's Secretariat (1999) determined that at least 57 per cent of the women who used shelters in 1995 were ofAboriginal ancestry, yet they comprised only 11 per cent of the total female population. These numbers reflect the magnitude of the ~roblem. Redressing these injustices requires awareness of the processes that create negative health consequences and mobilization of action to correct these processes. The Saskatchewan Women's Secretariat notes: "Studies have shown that health differences are reduced when economic and status differences between people, based on things such as culture, race, age, gender and disability are reduced (44). Gender and ethnicity have been shown to be influential determinants of health across populations. Conceptual distinctions between definitions of "gender" and "sex" have led to our understanding that the processes ofsexism (such as increased exposure to violence) are more likely to contribute to women's poor health than biological or genetic differences between women and men. Similarly, conceptual distinctions between definitions of "ethnicity" and "race" in population health research suggests that "race" is used to describe natural units or populations that share distinct biological characteristics; whereas ethnic groups are seen as being culturally distinct (Polednak). In population health research, these two terms are used interchangeably, often leaving out a discussion of the processes by which racism creates conditions of poor health for certain ethnic groups (Young 1994). Racism is a biopsychosocial stressor that has severe negative health effects on racialized individuals (Clark, Anderson, Clark and Williams). Sexism is blatantly dangerous to women's health in many ways (Lips). Racism and sexism have this in common; they operate via external power structures to contribute to poor health in certain disadvantaged groups. Research suggests that culture and cultural differences also have an impact on health (Amaratunga; Wienert). However, little is written about howwhat we describe as culture