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“I Guess I Shouldn’t Come Back Here”: Racism and Discrimination as a Barrier to Accessing Health and Social Services for Urban Métis Women in Toronto, Canada

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Abstract

Racism serves as a major barrier in access to health and social services, leading to absent, delayed, and/or avoidance of treatment. Métis Peoples experience barriers to accessing both Indigenous-specific and mainstream services yet are often left out of discourses surrounding racism and service access. Racism and discrimination experienced by Métis people is rooted within a deep history of assimilative and racist colonial policies. The objective of this research was to create space for the all too often unacknowledged voices of Métis Peoples by engaging with the traditional community health experts, Métis women. This research aimed to learn from Métis women’s experiences to build an understanding on steps toward filling the health service gap. Nested within a longitudinal cohort study, this research employed a conversational method with urban Métis women in Toronto, Canada. In this paper, we share the experiences of racism and discrimination faced by urban Métis women when accessing and working within health and social services. Métis women (n = 11) experience racial discrimination such as witnessing, absorbing, and facing racism in mainstream service settings, while experiencing lateral violence and discrimination in Indigenous-specific services. This research highlights the need for reframing conversations around race, identity, health services, and the urban Métis community.

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Notes

  1. This estimate is slightly larger than that of 7265 persons reported by the Canadian Census for this population [38]. At the same time, the authors consider both numbers to be an underestimate of the actual size of the Métis population of the City of Toronto due to under participation of Métis in both the census and OHC Toronto.

  2. Absolon [1] writes, “[h]ealing is… implied through methodological concepts of reconnection, remembering, learning, recovering and reclaiming. In a sense, healing is woven throughout the re-search process (p. 93).

  3. This high non-response rate is consistent with the high mobility found in the larger Our Health Counts Toronto study [41].

  4. Many of the women that participated in this research project requested that their name remain anonymous. Following each quote from the Métis women, rather than use the word ‘anonymous’ or ‘participant 1, participant 2’ and so on, a medicinal plant name was assigned for each woman. This idea was inspired by Métis author Catherine Richardson [25] and how she shares that Métis stories are medicine. The medicinal names are in Michif (Île-à-la Crosse dialect) and come from Christi Belcourt’s [5] book called “Medicines to Help Us: Traditional Métis Plant Use” (translations were provided by Métis Elder/healer, Rose Richardson). For the anonymous women’s quotes that were used in this paper, the medicines below can be translated as follows: Nîpisiy: Willow; Misâskwatômin: Saskatoon Berry; Otîhimin: Strawberry; Kâ-Wâpiscikwâniyâsiki: Yarrow; Tohtôsâpôwaskaw: Milkweed; Masân: Stinging Nettle; Okinîwâpikwaniy: Wild Rose; Akwâminakisîmin: Burdock. The remaining women whose quotes were used in this paper are identified by their first name as per their request.

  5. Cultural safety is when the people who receive the care, decide what is culturally safe or unsafe. It aims to redress power imbalances that arise in health care settings [32].

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Acknowledgments

This research would not be made possible without the wisdom and knowledge shared by the urban Métis women in Toronto, and support from the Well Living House and Seventh Generation Midwives Toronto. Funding for this research was provided by Canadian Institutes of Health Research.

Author information

Authors and Affiliations

  1. Faculty of Human and Social Development, School of Public Health and Social Policy, University of Victoria, Victoria, BC, V8P 5C2, Canada

    Renée Monchalin

  2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Renée Monchalin, Janet Smylie & Earl Nowgesic

  3. Well Living House, Centre for Urban Health Solutions (CUHS) in the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada

    Janet Smylie

  4. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada

    Earl Nowgesic

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  1. Renée Monchalin
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Correspondence to Renée Monchalin.

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Appendix

Appendix

Appendix 1: Conversation guide

Prompt

Thank you for meeting with me today! I would like to have a conversation about your perspectives on Métis identity and your experiences with health services in Toronto. With this information, the goal of this research study is to address the health service gap for the Métis community in Toronto.

Remember that you can take breaks at any time, and that you can skip any question that you don’t want to answer. Please also remember that if you provided consent, you will be audio recorded or written notes will be taken. Further, to respect the confidentiality of yourself and others, please try to avoid identifying yourself or others by name, when possible. However, no identifiable data will be transcribed during the transcription process. If you have any questions, you can stop me at any time. I estimate that today’s interview will take about 1 hour. Do you have any questions? Are you ready to get started?

Question 1

How would you describe yourself?

Question 2

What does being Métis mean to you?

Question 3

Can you describe your experiences with health services in Toronto?

Question 4

Can you describe a time that you felt you did not receive health services you needed? What happened? What was your unmet need?

Prompt

This next question will be surrounding your experiences with racism and/or discrimination. We often hear about people being treated poorly or unfairly because they are Métis. Remember that you can take breaks at any time, and that you can skip any question that you don’t want to answer. If you have any questions you can stop me at any time.

Question 5

Can you think of a time that you have been treated poorly or unfairly because you are Métis? How did this impact your overall health and wellbeing?

Prompt

These next two questions will be surrounding your relationship to the land and holistic wellbeing.

Question 6

How would you describe your relationship to the land/ Mother Earth?

Question 7

Do you use traditional Indigenous medicines or practices to maintain your health and wellbeing?

Prompt

I want you to imagine a relationship with a health and/or social service provider in which you feel comfortable, respected and able to be yourself.

Question 8

How would it look?

Question 9

What are the things that the service provider does to make you feel comfortable and respected and able to be yourself?

Question 10

What about the space where the care is being provided? How does it look?

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Monchalin, R., Smylie, J. & Nowgesic, E. “I Guess I Shouldn’t Come Back Here”: Racism and Discrimination as a Barrier to Accessing Health and Social Services for Urban Métis Women in Toronto, Canada. J. Racial and Ethnic Health Disparities 7, 251–261 (2020). https://doi.org/10.1007/s40615-019-00653-1

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