The stereotype of the "drunk Indian" is the latest form of racism against aboriginal people, and it contributed to Brian Sinclair's death in a Winnipeg emergency room, a panel was told Friday.
"It's always seeing aboriginal people as social problems, always assuming maybe they are drunk, maybe they are violent, maybe they are scary," said Emma LaRocque, a University of Manitoba native studies professor.
LaRocque, one of several speakers at an afternoon panel discussion of Sinclair's case, wondered how 17 medical staff walked past the wheelchair-bound man without noticing he was in dire straits and how a security guard could assume Sinclair was "sleeping it off."
"You have a stereotype like that and that has nothing to do with racism?" she said. "We have a non-stop, decades-old chorus of denial and defensiveness... sometimes I could not believe the barely concealable untruths that the nurses and the security guards offered at the inquest."
Sinclair, 45, died in 2008 from a treatable bladder infection after spending 34 hours in Health Sciences Centre's emergency room. Sinclair's death sparked a provincial inquest that will wrap up in June and raised questions about institutional racism in the province's health sector, where critics say aboriginal people, especially men, are sometimes assumed to be drunk or malingering instead of sick.
In February, Sinclair's family and several aboriginal groups pulled out of the inquest after provincial court Judge Tim Preston ruled the hearings would not delve into the deeper question of systemic racism in the health-care system.
That move led a group of health researchers and lawyers to host the forum at the University of Manitoba Friday afternoon to explore some of those issues.
Aboriginal Legal Services of Toronto lawyer Emily Hill, who had standing at the inquest, said some key themes emerged from the weeks of testimony by hospital staff -- racism doesn't exist anymore in Canada and there's no need to worry about how the health staff approached Brian Sinclair because everyone is treated equally.
"In law we know that substantive equality actually means treating people differently," said Hill. "If you treat everyone equally, you get unequal outcomes."
She also heard frequently about the improper use of the emergency room by homeless, poor and marginalized people.
"The idea of the misuse of the ER and how it overshadowed how (Brian Sinclair) was perceived was another thing I heard about," said Hill. "He wasn't misusing an ER. He was sent there by a doctor. He was exactly the kind of person who should be there."
Research suggests more and more people are using emergency rooms for non-urgent problems. Between 33 and 55 per cent of all visits fall into that category, which is often tagged as a "misuse" of the ER.
"But it can serve as a really important social safety net" for the poor, said Annette Browne from the University of British Columbia's school of nursing.
She studied a big downtown emergency room in Western Canada -- one similar to HSC's -- and found patients who were homeless, transient, poor or in extreme phycological distress used the ER because they had no choice. And she found aboriginal patients were very tuned in to the judgmental gestures, language and vibes of doctors and nurses.
Browne said studies have shown racism and inequality in health care make people sicker. Stressful interactions, a denial of care and even being hypervigilant in anticipation of judgmental interactions are linked to poor health outcomes such as higher rates of hypertension.
One catchphrase commonly heard among policy experts is the "social determinants of health," the way in which poverty, education levels, housing or family supports affect a person's health. Why aboriginal people always fare so poorly when it comes to the social determinants of health is a question not asked often enough, said Barry Lavallee, a doctor who heads the U of M's Centre for Aboriginal Health Education.