# Influence of the COVID-19 pandemic on chronic disease management among indigenous people in Canada

## TL;DR

This study explores how the COVID-19 pandemic affected chronic disease management and healthcare access for Indigenous people in Canada.

## Contribution

The paper provides new insights into how Indigenous communities in Canada managed chronic diseases during and after the pandemic.

## Key findings

- 79% of respondents delayed chronic disease care during the peak of the pandemic.
- Long waiting times were the most common reason for not accessing healthcare during the pandemic.
- Healthcare access challenges persisted even after the peak of the pandemic.

## Abstract

In Canada, little is known about how the Coronavirus-19 (COVID-19) pandemic has influenced Indigenous people with chronic disease. Even without the additional burden of the pandemic, many Indigenous communities lack access to high-quality health care and preventive measures. This study examines the impact of the COVID-19 pandemic on chronic disease management (CDM) and healthcare access and utilization by describing the CDM experiences of the Indigenous people across Canada.

In collaboration with Indigenous leadership, we conducted an online survey across Canada. Eligible participants included Indigenous people (on- and off-reserve), who are current members of a Dynata research panel and willing to participate in the survey. Questions on self efficacy, healthcare utilization, and COVID-19 impact on healthcare access and utilization were asked. Descriptive statistics and multivariable regression were used.

There were 869 respondents in which 60% were females (N = 520) and the majority lived off-reserve (N = 657, 76%). The health condition with the highest frequency in this cohort of respondents was ‘mental illness’ (N = 397, 46%). Overall, 79% of respondents reported delaying chronic disease care during the COVID-19 peak. When comparing peak versus post COVID-19, the category of ‘access,’ specifically ‘waiting time too long’ (63.6% (peak) and 58.4% (post)) was the most frequently reported reason for not accessing healthcare (p < 0.001). Trends were similar regardless of the number of health conditions and reserve status.

Our survey on chronic disease management during peak and post-COVID-19 revealed that, while some COVID-19 related barriers improved post-pandemic, persistent challenges in healthcare access remain for Indigenous peoples in Canada.