Contrary to the stereotypes, First Nations, Métis and Inuit peoples of Canada are strong, resilient and fully capable of managing our own affairs. As far as the question of cultural genocide is concerned, we very much want to put it behind us. But that cannot occur without reconciliation.

When it comes to health and health care, we want to eliminate the profound inequities in health determinants, health status, and health service access that together ravages our urban, rural and remote communities, causing preventable disease, disability and premature death.

Reconciliation means addressing the socio-economic determinants of Indigenous health including disparities in income, education, employment, housing, infant mortality rates that are two to four times higher than the norm, child food insecurity, substance use, extreme poverty and social exclusion, which combined lead to higher prevalence rates for most diseases.

If the rationale for social justice and equity is not enough, then consider the economic impacts of the fact that Aboriginals are the fastest growing population in Canada with the worst health status. The costs of not implementing health and social interventions, which we know will work, is the continuation of a downward spiral of ill health and the costs associated with avoidable treatments, often performed many miles away from loved ones where the patient is isolated from family and community, frightened and alone. This situation can and must change.

The Truth and Reconciliation Commission (TRC) is calling on the federal, provincial, territorial and Aboriginal governments to acknowledge that the current state of Aboriginal health in Canada is a direct result of Canadian government policies, including residential schools, and to recognize and implement the heath care rights of Aboriginal people as identified in international law, constitutional law and under the treaties.

The TRC made a number of health recommendations, including identifying and analyzing the gaps in health outcomes between Aboriginal and non-Aboriginal communities, funding Aboriginal healing centres and providing cultural competency training for all health care professionals.

These recommendations, among all 94 of those put forth by the TRC, signal a tremendous paradigm shift in Aboriginal health. Now we need to put these ideas into action. An Indigenous governing body to implement these recommendations in an integrated way is crucial.

An Ontario Indigenous Peoples’ Health Authority is one option that could completely change the way we approach Aboriginal health care. The British Columbia Tripartite Agreement on First Nation Health Governance is a model that could be expanded to Ontario and across Canada. In this agreement, B.C.’s First Nations Health Authority implemented “community-driven — (first)-nation-based” programs that are preventing illness, improving care and saving tax dollars through proven strategies that are designed by and for Aboriginal Peoples.

The B.C. model would certainly need to be adapted for an Ontario context, but some of their early successes in primary care service coordination and eHealth may be easily translated.

The Waakebiness-Bryce Institute for Indigenous Health based at the University of Toronto could convene a forum for dialogue among Indigenous community leaders and advocates, academics and policy-makers to develop innovative ways to implement the TRC’s recommendations.

As the first privately endowed Indigenous health institute in the world, it can help facilitate a national summit on reconciliation in health care services. In Ontario, a process between First Nations, Métis, Inuit, federal and provincial governments could be developed that takes inspiration from the B.C. model, but also respects regional differences and interests.

Reconciliation is a journey, taken one step at a time as demonstrated by the courageous survivors of residential schools who shared their stories with the Truth and Reconciliation Commission.

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Establishing an Ontario Indigenous Peoples’ Health Authority connected to a Canadian network would not only save taxpayers a whole lot of money, it would represent a huge step toward reconciliation, in addition to being a lasting legacy to any government in power.