Divergence in NB and Ontario concerning marginalized groups

Table 1  

Divergence in NB and Ontario concerning marginalized groups

	NB	Ontario
Social Determinants of Health	Work on housing and homelessness.  Pilot program for prevention of youth substance use (Planet Youth).  Participates in early childcare subsidized services.  School breakfast programs.  School lunch program in progress.  Harm reduction supplies provided free of charge to Indigenous communities.  Policy 713 in schools re safe, inclusive. environments for LGBTQ students (issues re this with last government-parent’s rights vs students’ rights/safety).	Urban Indigenous populations in ON have access to education, employment, and social services than those in rural or northern communities.  Social determinants of health remain a significant issue for many First Nations communities, especially in remote and northern areas.
Healthcare Policies	Travel nursing contracts created during COVID-19 being terminated due to large financial costs and need to recruit and retain from within.  New policies allowing bridging of licensing and regulation for healthcare workers from across Canada for faster ability to work within the province.  Issues with Canada Health Act transfers related to private Eye clinics and the need for continued funding for private care (e-visit, Beyond ADHD).  One medical school at Dal UNBSJ and another being created (Centre de formation médicale).  Changes to scope of practice for NPs to allow for more flexibility with lab and diagnostic procedures outside of the RHAs and work with controlled substance prescriptions.	ON has comprehensive policies focused on improving Indigenous health, driven by a higher Indigenous population and strong advocacy from Indigenous organizations.  The province’s health system includes more federally supported programs for Indigenous people.  These programs cover areas like remote health services, maternal and child health, and mental health support.
Access to healthcare	Work on collaborative care clinic due to thousands of residents in NB without a primary care provider.  e-visit program continues to be paid for by the province to try to bridge the gap.  Long wait times for emergency rooms.  Concerns with people losing primary care providers and getting prescriptions for controlled substances.	Urban centers in ON, such as Toronto, Ottawa, and Thunder Bay, provide access to healthcare services for Indigenous populations.  Healthcare remains a significant challenge in rural and northern communities, particularly for Indigenous people in remote areas like Northern ON.  Barriers to healthcare access in remote communities include distance, inadequate infrastructure, and a lack of culturally appropriate services.  Larger cities in ON have a developed network of Indigenous health professionals and community health services.
Health disparities	Reliance on natural resources in many communities such as fishing, mill industry causing issues when move away from fossil fuels, and tariffs, etc.  GBA+ and Health Equity Impact Assessments on some work done at GNB.   Price of goods including fuel, food more than other provinces related to costs to transport here vs some of the province’s goods are imported or produced in.  Work being done on funding for chronic illnesses. Diabetes pump, insulin and supply funding, cancer care, but need for more med coverage and funding.	Indigenous populations in ON experience high rates of chronic conditions, mental health issues, and substance abuse.  ON’s developed healthcare infrastructure offers opportunities for health promotion and intervention.  Despite these opportunities, Indigenous communities face high levels of discrimination and systemic barriers in healthcare institutions.  These challenges contribute to worsening health disparities for Indigenous populations in ON.
Traditions and practices	Acadian population-mainly in the north but throughout the province.  Only bilingual province in Canada.  Issues around language of choice and language of service at times.  French immersion programs starting in grade 1 or 6.  15 Indigenous communities across the province.  Diversity of cultures through temporary foreign worker programs and newcomers to the province over the past 10-15 years have reshaped the way the province looks.	ON has an approach to integrating traditional Indigenous practices into healthcare.  Programs are in place to provide Indigenous people access to traditional medicine, healers, and cultural practices alongside Western medical services.  Urban Indigenous health services in cities like Toronto offer a blend of traditional healing and clinical care.  This integrated approach provides more holistic health solutions for Indigenous populations.
Mental Health and substance use	Community addiction and mental health clinics around the province.  Detox beds used but not well in some opinions-alcohol vs opioids-who gets priority.   Lack of rehab beds-often have to travel hours away from home for rehab and long waits.  Gap in youth mental health and addiction treatment.  Shortage of psychiatrist and psychologists-push to recruit and retain.	ON has dedicated programs addressing mental health and addiction issues within Indigenous communities, both urban and remote.  Challenges persist, particularly in northern and rural communities.  Stigma surrounding mental health and substance abuse remains, highlighting the ongoing need for culturally informed care.

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