First Nations Life Expectancy Has Plummeted. How to Change That

By Michelle Gamage
Local Journalism Initiative Reporter
The Tyee

Due to the toxic drug crisis and later the COVID-19 pandemic, life expectancy for First Nations people in British Columbia decreased by 7.1 years between 2015 to 2021.

The largest drop happened between 2019 and 2021 when life expectancy shortened 5.8 years, says Dr. Nel Wieman, chief medical officer at the First Nations Health Authority. Wieman is Anishinaabe from Little Grand Rapids First Nation.

The unregulated toxic drug supply is the leading cause of the decrease, with First Nations people “vastly overrepresented” in toxic drug deaths, Wieman says.

In comparison, life expectancy of non-Indigenous residents of B.C. decreased by 1.1 years between 2019 to 2021.

Some of the biggest factors are inequities and trauma caused by colonialism; Indigenous-specific racism in every part of the health-care system, as reflected in the 2020 “In Plain Sight” report; stigma around drug use; and a lack of services available for First Nations people, experts told The Tyee.

For the last 50 years, First Nations life expectancy had been increasing annually by 0.2 years, says Dr. Danièle Behn Smith, deputy provincial health officer for Indigenous health. Behn Smith is Eh Cho Dene of Fort Nelson First Nation and Franco-Manitoban/Métis from the Red River Valley.

In 2011, life expectancy was 75.9 years. Then 2014 hit, when the powerful synthetic opioid fentanyl entered the unregulated drug market and drove up toxic drug deaths for First Nations and the general population alike. The COVID-19 pandemic exacerbated harm by isolating people, keeping them from harm reduction services and driving them to use alone.

Historic and present-day colonial impacts create inequity in almost every part of society for First Nations people, Behn Smith says. There is food insecurity when people are unable to access traditional food systems. There is “manufactured poverty” — where Canada has gotten rich from resource extraction, but the majority of First Nations have not. There are high rates of overcrowding or being unhoused.

For these reasons and others, First Nations have higher rates of underlying health conditions that, for example, affect lung health and increase rates of diabetes.

Then there’s intergenerational trauma from a history of colonialism and system of oppression.

Tania Dick, Indigenous nursing lead at the University of British Columbia’s school of nursing, says residential schools added “hugely traumatic layers to our existence that are still raw and fresh.” Indigenous Peoples are trying to work their way through the trauma and heal but society at large isn’t helping them do that, she adds. Some Indigenous people use drugs and alcohol as a coping mechanism, leading to high rates of addiction.

Behn Smith says that when she worked as a family doctor, she would acknowledge drug use as “really powerful medicines that they need right now,” and then see if she could shift a patient to something with less harmful side-effects over time.