In a sobering editorial piece published on May 6, 2019, in the CMAJ (Canadian Medical Association Journal), authors Davinder Singh, Sarah Prowse, and Marcia Anderson addressed the troubling and disproportionate incarceration rates of Indigenous people in Canada, bringing to light a health crisis that extends beyond the confines of the country’s prisons (https://doi.org/10.1503/cmaj.181437).
Across Canada, Indigenous communities face challenges rooted in centuries of discriminatory policies and practices. However, the issue of overincarceration remains particularly pronounced and the subsequent health implications are profound.
Overincarceration as a Health Determinant
The overrepresentation of Indigenous individuals in the Canadian criminal justice system is both a symptom and a contributor to ongoing health disparities. Studies have shown that time spent in incarceration is linked to negative health outcomes, both mental and physical. Overincarceration can exacerbate chronic conditions, increase the risk of infectious diseases, and lead to psychological stress and trauma.
A retrospective cohort study in Ontario revealed that individuals who have spent time in provincial custody are subject to a higher mortality rate over a 12-year period (Kouyoumdjian et al., 2016; [PMC4933645](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933645/)). These statistics along with reports on the health profile of First Nations (Health Canada, 2014) illustrate the urgent need to address this as a health crisis.
Years Lost to Incarceration
The toll on Indigenous people’s life expectancy due to incarceration is staggering. A study estimated that years of life lost to incarceration display a striking disparity between Aboriginal and non-Aboriginal Canadians (Owusu-Bempah et al., 2014; [PMC4082275](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4082275/)). This loss is not limited to the individuals imprisoned but also affects community health and wellbeing.
Structural Racism and Inequity
Underpinning the overincarceration issue is the systemic racism entrenched within Canada’s institutions. From law enforcement to the judiciary, Indigenous people encounter biases that increase their chances of being detained and receiving longer sentences (Report of the Aboriginal Justice Inquiry, 1991).
The final report of the Truth and Reconciliation Commission of Canada (2015) emphasized the need to confront this institutional racism to heal historical wounds and rectify social inequities.
Reintegration Challenges post-Incarceration
Once released, formerly incarcerated individuals face formidable barriers re-entering society. Employment opportunities are scarce for those with criminal records (Pager et al., 2009; [PMC3583356](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583356/)), leading to economic hardships that perpetuate health inequalities. The segregation caused by incarceration may contribute more to adverse outcomes than the stigma associated with having been in prison (Massoglia et al., 2011).
Physical Health Impacts
Incarceration has been linked to an increase in stress-related illnesses and infectious diseases (Massoglia, 2008). Another study suggested that incarceration affects body mass index trajectories, potentially leading to obesity-related health issues (Houle, 2014; [PMC4010134](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4010134/)).
Impacts on Families and Communities
The repercussions of overincarceration extend to families and communities. The effect of parental imprisonment on child mortality is profound (Wildeman, 2012). These outcomes underscore the generational impact of incarceration on Indigenous peoples’ health.
Striving for Solutions
Addressing the issue requires a multifaceted approach. The Office of the Provincial Health Officer in British Columbia, for instance, has raised concerns about potential impacts of legislative changes on the health of Aboriginal people (Kendall, 2013). Also, the Canadian Public Health Association has made clear policy statements against racism in public health, seeking to tackle the root causes of health disparities (Policy and position statements, 2018).
Keywords
1. Indigenous incarceration Canada
2. Health disparities Indigenous peoples
3. Canadian prison system reform
4. Systemic racism in Canadian justice
5. Overincarceration health impacts
In summary, the overincarceration of Indigenous people in Canada is not solely a criminal justice issue but a pressing public health crisis. The data indicates a direct correlation between incarceration and adverse health outcomes, demanding immediate attention and action. As Canada seeks to reconcile its past, addressing the overincarceration of Indigenous peoples and its consequent health implications is a moral imperative. It is crucial to work toward an equitable justice system and accessible health care for all, with recognition and respect for Indigenous rights and sovereignty at the forefront of this endeavor.