#3 Health Inequities: A Crisis Within a Country of Health

By Gordon Elliott (ȻELOȽEMKEN), Director of Operations, W̱SÁNEĆ Leadership Council

This past summer, I took a leave from work — time I needed to recover, to reflect, and most importantly, to support my wife following her breast cancer diagnosis and treatment. After eight rounds of chemotherapy and an incredibly challenging eight months, I knew, we knew that we needed to step back and focus on healing — hers, mine, and ours together.

Bear Hill and X̱E,OL,X̱ELE₭ (Elk Lake) from PKOLS

Over the past 18 years as an elected Councillor in my community of Tsartlip, I have sat with many of our families through difficult times. For the past two years, I have served as Chair of the Tsartlip Health Committee, where I have witnessed firsthand the growing health challenges in our community. In my lifetime, I have seen illness rise at an alarming rate within our communities — not just physical & mental illness, but emotional and spiritual pain as well.

During my time away from work, I had space to think deeply — about my own health, my family, and the state of health within our W̱SÁNEĆ communities. The summer brought heartbreaking loss after loss, and it seemed that almost every week came with news of another illness, another young life taken too soon, or another family facing unimaginable challenges.

In my work with the W̱SÁNEĆ Leadership Council, I have learned a great deal about how we arrived at this point — how generations of government policy and systemic inequities have led us to the state of health we face today. I began reading, researching, and reflecting, trying to understand not just what is happening to our people, but why.

This blog is part of a larger effort to bring that understanding forward. My hope is to help our people — and others — see the connections clearly: how our history, our food systems, our economies, and our lands are all tied to our well-being. I write this with compassion, from a place of care, and with a sincere belief that by understanding where we are and how we got here, we can begin to move forward toward healing.

Have You Ever Wondered Why?

Have you ever wondered why, in a country often ranked among the healthiest places to live, so many First Nations families carry heavy burdens of illness and loss? Why are diabetes, heart disease, and addictions — serious diseases — so much more prevalent in our communities? Why do our people, who once lived strong and long lives, now face shortened lifespans and persistent health struggles?

These truths are not coincidences — they are part of the socio-economic gap, born of colonization and reinforced by policy failures. In a nation celebrated worldwide for health and livability, First Nations health outcomes remain dire. This is not only inequality — it is a public health emergency.

Canada’s Global Standing vs. First Nations Reality

To understand the depth of this health crisis, it helps to look at the contrast between how Canada performs globally and how First Nations people fare within those same borders.

Canada consistently ranks near the top in global health and livability indexes. It is regularly recognized as one of the “best countries in the world to live,” with a life expectancy of about 81–82 years overall — around 79–80 years for men and 84 years for women. (datadot)

But if First Nations health outcomes were measured as their own nation, the picture would change dramatically.

According to national data:

Life expectancy for First Nations males was estimated at about 72.5 years, and for females about 77.7 years, in earlier national studies — roughly 9–10 years shorter than for non-Indigenous men and women in Canada. (Statistics Canada)
The Human Development Index (HDI) — a United Nations measure that combines life expectancy, education, and income — is about 0.73 for Registered Indians, compared to about 0.84 for Canada as a whole. (Indigenous Services Canada)

If First Nations were ranked as their own country, these numbers would move us out of Canada’s “very high human development” category and into the “high human development” tier — alongside countries like Fiji, the Dominican Republic, or Iran.

The BC Reality

For W̱SÁNEĆ and other First Nations in BC, the situation is especially alarming:

Life expectancy for Status First Nations people in BC fell from 73.3 years in 2017 to 67.2 years in 2021 — a drop of more than six years in just four years, driven by COVID-19, the toxic drug crisis, and long-standing inequities. (FNHA)
The mortality rate among Status First Nations in BC increased from 117 deaths per 10,000 people in 2017 to 156 per 10,000 in 2021. (Province of British Columbia)
In one BC study, 12.5% of Aboriginal adults had diabetes, compared to 4.8% of non-Aboriginal adults. (BC Medical Journal)
Across Canada, diabetes rates for First Nations adults living on reserve reach 17.2%, compared with 5% in non-Indigenous adults. (Diabetes Guidelines)

This is the reality inside one of the “healthiest” and “most livable” countries in the world.

Health Before Colonization

For thousands of years, W̱SÁNEĆ people lived healthy, balanced lives rooted in the land and waters.

Foods: Reef net–caught salmon, bottom fish, shellfish, herring, deer, elk, camas, berries, roots, bulbs, greens, and medicinal plants formed a diet rich in clean protein, healthy fats, fibre, and micronutrients.
Harvesting: Harvesting, fishing, and hunting were part of daily life — keeping people active, teaching skills, and connecting families to each other and territory.
Medicines: Plants like cedar, nettle, devil’s club, roots, and many others provided powerful medicines that supported healing and prevention. (BC Medical Journal)
Balance: Health was holistic. The mind, body, spirit, and community were all connected through land, kinship, and ceremony.

Health was not separate from life — it was life. Our diets were largely low-glycemic, based on whole, unprocessed foods. Our “exercise program” was built into everyday living on the land and water.

A Rapid Disruption

Colonization shattered this balance in a very short period of time:

Loss of food systems: Reef net fishing was banned in 1916. Salmon stocks were heavily impacted by industrial overfishing and mismanagement. Hunting and gathering areas were taken, logged, or destroyed. Important shellfish beds were polluted by sewage and industrial activity. (Indigenous Services Canada)
Processed foods: Traditional diets were replaced with government rations — flour, sugar, lard — and later with cheap, ultra-processed foods high in refined carbohydrates, sugar, and unhealthy fats.
Overcrowding and disease: The reserve system forced many families into small areas with poor housing and poor infrastructure, helping infectious diseases spread. (Statistics Canada)
Residential schools: Children were taken away, often malnourished, abused, and traumatized, with long-term impacts on physical and mental health that are still felt today.

Today, the impacts of these disruptions are still felt across the W̱SÁNEĆ communities. Much of our territory is now privately owned, developed, or restricted, leaving almost no places where our people can hunt safely or freely. Fishing is no longer what it once was — salmon stocks have collapsed, regulations limit full access, and decades of mismanagement have damaged critical ecosystems. Many of our traditional shellfish beds are contaminated or permanently closed, making harvesting unsafe. What was once a rich, self-sustaining food system grounded in land stewardship has become heavily fragmented, regulated, and often inaccessible. This is not “loss of culture,” it is the destruction of food sovereignty caused by colonial expansion, environmental degradation, and the systematic removal of W̱SÁNEĆ people from our own territory.

These losses are not just the result of environmental decline or population growth — they are a breach of the Douglas Treaties. The Treaties promised that W̱SÁNEĆ people would be able to “carry on our fisheries as formerly,” which included food harvesting, trade, and the economic relationships tied to fishing and hunting. Yet almost immediately after the Treaties were signed, colonial governments imposed laws, licensing regimes, land pre-emptions, and private property systems that made it impossible to exercise those rights. Reef net fishing was banned, commercial access to fisheries was restricted or criminalized unless controlled by Crown authority, and harvesting areas were taken or fenced off. The collapse of salmon, the contamination of shellfish beds, and the loss of access to our territory all occurred under a legal framework that was supposed to protect — not erase — our rights. This failure to uphold the Treaty is a major reason why W̱SÁNEĆ food systems, health, and economies collapsed so rapidly.

A diet and way of life that sustained us for thousands of years was disrupted in just a few generations. Our bodies — adapted to nutrient-dense, low-glycemic foods — were never given a chance to adjust.

A Personal Turning Point

After my wife’s diagnosis, I spent much of my time reviewing medical literature on cancer metabolism, inflammation, and nutritional support. What stood out immediately was how much evidence-based “anti-inflammatory,” “metabolic,” or adjunctive cancer-supportive dietary approaches closely resembled the nutritional profile of our traditional foods. Research consistently shows that diets low in processed foods, refined carbohydrates, and added sugars, and higher in clean protein, omega-3 fats, fibre, and nutrient-dense whole foods, can help regulate inflammation, improve metabolic function, and support overall physiological resilience during treatment and healing. The characteristics of this way of eating align almost precisely with the foods our ancestors relied on from the land and water.

At the same time, I was managing my own health issues — high blood pressure, arthritis, pre-diabetic markers, and sleep apnea. My wife and I agreed that if we were going to change how we ate to support her healing, we would do it together and commit fully. We switched to a diet that eliminated all processed foods, sugars, and refined carbohydrates, focusing instead on low-glycemic, whole, nutrient-dense foods. In many ways, it was a step back to how our ancestors ate — even though, in today’s world, we mainly choose modern grocery-store foods, the salmon that we preserved over the summer became even more critical, providing clean, omega-3-rich proteins and healthy fats. We learned quickly that this was more than a diet — it was a lifestyle change. It required us to select foods more consciously, prepare meals much differently, and source higher-quality foods whenever possible. It also became clear that eating this way was expensive and that affordability could be a significant barrier.

We are still on a long healing journey, but I can share this much: my wife remained strong enough to continue playing soccer throughout all eight rounds of intense chemotherapy. She even played a match the night before she rang the bell on her final treatment day. I also learned that this diet approach can also increase the efficacy of chemotherapy and could become part of standard treatment protocols one day. At the cancer clinic, they often refer to her as their “all-star” and often ask if she is the one who kept playing soccer through chemo. She also responded incredibly well to treatment, is still actively playing soccer and is feeling healthier than she has in years.

As for me, I lost around 45 pounds, my blood pressure returned to normal, my pre-diabetic markers disappeared, my sleep apnea disappeared, my arthritic pain significantly decreased, and at 58 years old, I played my first soccer game in 20 years.

For legal and ethical reasons, I want to be clear: I am not a doctor, and this is not medical advice. This is simply part of our story — a story about resilience, healing, and the power of returning, as much as possible, to the foods and macros that have sustained our ancestors for thousands of years.

I often find myself wondering: What would it look like if our people once again had full access to the traditional diet that kept our ancestors so strong and healthy for thousands of years?

At some time in the future, I will share our entire journey in a separate article, because it is a story of health, resilience and healing. I mention it here because it helped confirm something I already knew deep in my heart: when we reconnect with our original food systems — or at least adopt their core principles — our bodies respond. And that is very important when we discuss health, healing and the socio-economic gap.

The Economic Side of Health

Health is not just about individual choice. It is also about what is accessible and affordable.

Fresh, healthy foods are often more expensive and less available than cheap, processed options — especially for low-income families or people living on reserve.
Many families face food insecurity, relying on what is cheapest and most filling, which often means high-carb, high-sugar, and highly processed foods.
Lower incomes, high unemployment, and the cost of living make it much harder to maintain a healthy diet, prioritize physical activity, or access preventive care.

This is how the socio-economic gap and the health gap feed into each other. When a community has less income, food sovereignty is destroyed, less employment, overcrowded housing, and underfunded health services, the conditions are created for chronic illness to spread. Poor diets are not a personal failing — they are a predictable outcome of systemic inequities.

The Toll on Our Families

Every W̱SÁNEĆ family has been touched by health inequities. The numbers are painful, but they help us name what we already see and feel.

Diabetes and Metabolic Disease

In one BC study, 12.5% of Aboriginal adults had diabetes, compared with 4.8% of non-Aboriginal adults — about 2.6 times higher, or a 7.7 percentage point difference.
Nationally, among First Nations adults living on reserve, about 17.2% live with diabetes compared to 5% of non-Indigenous adults — roughly 3.4 times higher, a 12.2 percentage point difference.

Put simply: for every 100 people, around 17 First Nations adults on reserve are living with diabetes, compared with only 5 non-Indigenous adults. That gap is not “individual lifestyle” — it is the long shadow of colonization, food system disruption, and economic inequality.

Liver Disease

Chronic liver disease is another area where First Nations people carry a disproportionate burden:

In BC, deaths from chronic liver disease were reported to be about five times more common in First Nations women than in non-First Nations women in earlier provincial data.
At the national level, First Nations women living on-reserve have been found to be over eight times more likely to die from chronic liver disease and cirrhosis than non-Indigenous women.
Research also suggests that autoimmune liver diseases (like primary biliary cholangitis and autoimmune hepatitis) occur more often and with more severe complications in Indigenous patients, including more advanced liver damage and liver cancer at the time of diagnosis.

These conditions are linked to multiple factors — including viral hepatitis, autoimmune disease, alcohol use, and increasingly, metabolic liver disease tied to obesity, diabetes, and poor access to nutritious food.

Cancer

Cancer is now the leading cause of death in Canada overall. (CMAJ) For First Nations people, the picture is complex, but several patterns emerge:

Studies show higher cancer mortality rates among First Nations people compared with non-Indigenous people, even when the overall incidence is similar. Survival outcomes are often worse. (PMC)
In Ontario and other regions, First Nations people have shown higher rates of death from cancers such as lung, colorectal, kidney, and cervical cancer, particularly among women and younger age groups.
Some cancers linked to metabolic and lifestyle factors — like kidney and colorectal cancer — are elevated in First Nations populations, reflecting the combined impacts of diet, smoking, stress, and inequitable access to prevention and screening.

These statistics match what many of us see: more diagnoses, more complex illnesses, and more loved ones lost too soon.

Mental Health, Toxic Drugs, and Early Death

Suicide rates among First Nations youth have been estimated as high as seven times higher than national averages, depending on the region and method of measurement.
In BC, First Nations people died from toxic drug poisoning at about 5–6 times the rate of other BC residents in recent years. For First Nations women, the rate has been around 10–11 times higher than for other women.

These are not abstract numbers. They are our mothers, fathers, siblings, children, aunties, uncles, cousins, and friends. Every statistic represents a family carrying grief, a community carrying another hole that cannot be filled.

Healing and Resurgence

Despite these harsh realities, W̱SÁNEĆ people continue to do what we can with what we have. We recognize that major changes are needed to close the health gap, but without adequate resources, we can only make small, subtle shifts in the right direction.

Food Sovereignty: Reef net revival, hunting & fishing, and community gardens are helping some families reconnect with traditional foods — but these efforts are still small compared to the scale of what was taken and lost.
Cultural Healing: Land-based wellness programs and cultural ceremonies are helping people reconnect spiritually and emotionally, but many who need support still lack consistent access.
Indigenous-led Health Services: Our health staff and clinics work tirelessly to provide culturally safe care, yet they remain underfunded relative to the depth of the health challenges we face.
Building Capacity: Some of our people are becoming doctors, nurses, counsellors, and other health professionals. We also urgently need dietitians and nutritionists dedicated to our communities to help families understand food choices and navigate affordability.
Youth Leadership: Our young people are reclaiming SENĆOŦEN, our ceremonies, and land-based practices — but they need sustained support, opportunities, and resources to turn this resurgence into systemic change.

W̱SÁNEĆ Youth Revitalizing the SX̱OLE (Reef Net)

Healing will require full sustainable programs focused on redesigning household diets, improving food security, restoring food sovereignty, supporting mental health, and restoring access to traditional foods and activities. We are doing what we can. But without proper investment, we cannot address this crisis at the level it demands.

Author’s Reflection – From a W̱SÁNEĆ Perspective

As I write these words, I am reminded that despite the challenges, our people are still here — strong, capable, and carrying the teachings of our ancestors. I believe deeply in the strength of the W̱SÁNEĆ people and in the power of our families and communities to create change and begin a healing journey.

The next generation is rising — our young people are reclaiming language, ceremony, and the responsibility of caring for the land and waters. It gives me hope that through their leadership, guided by the wisdom of our Elders, we will find balance again. Healing will take time, but it begins with truth, compassion, and the courage to imagine a healthier, stronger future for all our people.

Closing the Loop

Community Note:

When we ask: Why are so many of our families suffering from illness, addictions, and premature death? The answer is not weakness. It is through colonization; it is the destruction of our food systems; loss of economies, it is the forced adoption of diets and living conditions our bodies and spirits cannot sustain. These inequities are not natural — they were imposed. But just as they were created, they can be undone. By returning to our foods, teachings, and ways of living — and by demanding the resources we are owed — we can begin to heal and rebuild our children’s and grandchildren’s health.

Call to Action:

This is not only a community crisis — it is a national emergency. Canada ranks among the healthiest and most livable countries in the world, but within its borders, First Nations health outcomes resemble those of countries facing much deeper poverty. That contrast is unacceptable.

The W̱SÁNEĆ Leadership Council is exploring ways to close this socio-economic gap, recognizing that real change requires resources and capacity-building. The Joint Statement between W̱SÁNEĆ, Canada, and British Columbia provides a foundation to begin this work with greater focus — including engaging communities and Band health departments to identify specific needs and priorities.

Historic Signing of the Joint Statement by the W̱SÁNEĆ Leadership Council, B.C. and Canada

Through this work with families and communities, detailed term sheets can be developed that call for:

Investment in food sovereignty and traditional food systems
Culturally safe, Indigenous-led primary care and mental health services
Major capital investments in health infrastructure and facilities, so our communities finally have the clinics, wellness centres, and treatment spaces required to deliver care at the level our people need
A formal, Nation-led study to identify the full extent of the health gap, including data on chronic disease, access to healthcare, infrastructure needs, food insecurity, and the socio-economic conditions that drive illness — because solutions must be grounded in accurate, community-driven research
Training and permanent funding for Indigenous health professionals, including doctors, nurses, counsellors, dietitians, nutritionists, Elders in health roles, and traditional healers
Long-term, sustainable resources—not project-based or short-term funding agreements—this will require a multi-generational healing plan.

This work is essential. Without proper investment in both people and infrastructure, the health gaps we face will continue to grow. We will also follow up this blog with a detailed health report focused solely on this issue — because our people’s lives depend on it.

✦ Next Post: Housing & Infrastructure

Health Inequities: A Crisis Within a Country of Health