The first comment to make in looking at the health status statistics is that if you remove the aboriginal health statistics the data still shows that the health status of people in rural and remote areas is worse than the general population. When you ask what's behind it, sometimes there's an assumption that it's the poor state of aboriginal health in rural areas that drags down the whole picture. That's not the case.
There are specific issues, and John mentioned some of those, around lifestyle and the occupations of people in rural areas and so on, that contribute to the health statistics of people in rural and remote areas. They overlap with aboriginal...but they are distinct from the factors that contribute to the poor state of aboriginal health in this country.
I'm not sure who you spoke to last time, but those who have an interest in aboriginal health will tell you that there are as many aboriginal people living in urban and semi-rural areas as there are in rural and remote parts of the country. Aboriginal health is not just about rural and remote; it's also about urban and metropolitan.
Having said that, in northern Ontario we have over 100 first nations. They are amongst the most socially and educationally disadvantaged communities, and certainly in terms of health status, amongst the worst in the country.
In northern Ontario, with our social accountability mandate, we have a focus on aboriginal health and aboriginal issues. There are a number of elements to that. We are working very hard at developing and continuing strong relationships with aboriginal organizations, people, and communities. We have aboriginal people on our board of directors, involved in the governance of the school. We have aboriginal people involved in all aspects of the development and delivery of our curriculum and the running of the school, including elders who are members of our senior leadership group. We have aboriginal people who are our learners, medical students, and residents. In fact in our first intake of students, 11% of the class were aboriginal medical students, the highest percentage ever in a medical class in Canada.
We have a strong focus on aboriginal issues and aboriginal health, with the intent that our students and graduates have an understanding of the history, tradition, culture, social, and health issues of aboriginal people and that they are responsive to that. We have a thread that runs through our whole curriculum on aboriginal health. In the first year our students have four weeks where they're living and learning in aboriginal communities. That's an immersion experience for them, where they're really learning from the community.
I think it's important to understand that in rural and remote areas the aboriginal communities and their health issues are very much a part of the big picture of rural and remote health issues, but there are also specific dimensions that are cultural, historical and so on, that affect aboriginal people and communities.