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For decades, Canada’s Indigenous populations have experienced high rates of suicide relative to the general population. This commentary suggests that suicide among Indigenous people cannot be explained solely through the causal effects of downstream determinants of health; upstream health determinants such as Canada’s colonial past and cultural continuity are equally, if not more, instructive in understanding the tragedy that is taking place in many Indigenous communities across Canada. Medical trainees and physicians can contribute to improvements in Indigenous health by advocating for culturally safe healthcare access and research, as well as Indigenous-oriented medical training.
Pendant des décennies, les populations autochtones au Canada ont connu des taux élevés de suicide comparativement à la population générale. Ce commentaire suggère que le suicide chez les personnes autochtones ne peut être expliqué uniquement par les effets causaux des déterminants de la santé « en aval » ; les déterminants de la santé « en amont », tels le passé colonial du Canada et la continuité culturelle, sont tout aussi, sinon plus importants pour comprendre la tragédie se déroulant dans plusieurs communautés autochtones à travers le Canada. Les médecins et étudiants en médecine peuvent contribuer à l’amélioration de la santé autochtone en plaidant pour de la recherche et un accès aux soins de santé qui sont culturellement sécuritaires, et pour des formations médicales axées sur la santé autochtone.
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