Funding the pandemic response for Indigenous Peoples: an equity-based analysis of COVID-19 using a Health Equity Impact Assessment (HEIA) Indigenous lens tool

international journal of circumpolar health cover

28 May 2024

Hillier et al.

This study examines the allocation of COVID-19 funding for Indigenous Peoples in Canada, Australia, New Zealand, and the United States during the pandemic’s first wave. Indigenous communities, already facing health disparities, systemic discrimination, and historical forces of colonisation, found themselves further vulnerable to the virus. Analysing the funding policies of these countries, we employed a Health Equity Impact Assessment (HEIA) tool and an Indigenous Lens Tool supplement to evaluate potential impacts. Our results identify three major funding equity issues: unique health and service needs, socioeconomic disparities, and limited access to community and culturally safe health services. Despite efforts for equitable funding, a lack of meaningful consultation led to shortcomings, as seen in Canada’s state of emergency declaration and legal disputes in the United States. New Zealand stood out for integrating Māori perspectives, showcasing the importance of consultation. The study calls for a reconciliation-minded path, aligning with Truth and Reconciliation principles, the UN Declaration on the Rights of Indigenous Peoples, and evolving government support. The paper concludes that co-creating equitable funding policies grounded in Indigenous knowledge requires partnership, meaningful consultation, and organisational cultural humility. Even in emergencies, these measures ensure responsiveness and respect for Indigenous self-determination.

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Key issues

HEALTH SERVICES AND SYSTEMS

Covering developments in the provision, funding and organisation of health care services.

EQUITY

Exploring the impacts of the health system on minorities within the population, notably including Māori, Pacifica, Asians and LGBTQI.

DRUGS, DEVICE AND DIAGNOSTICS

Covering prescription medicines and medical devices.

PUBLIC HEALTH

Focusing on efforts to promote health and prevent disease through social and economic interventions.

DIGITAL HEALTH

Exploring the potential digital transformation to provide a more connected and accessible health system.

TE TIRITI

Monitoring how the health reforms and the performance of the health sector uphold Te Tiriti obligations.