Understanding Health Equity for Indigenous Peoples: A Medical Laboratory Perspective
Health inequities in Canada, especially among Indigenous Peoples, do not occur randomly or coincidentally, but are the result of historical, social, and structural factors (Government of Canada, 2024). Although, as a MLT in Ontario, I am rarely in a situation where I meet the individuals from whom the samples I process come from, every value I report is not just biology, but also whether or not that individual had access to care, their socio-economic status, and the result of systemic discrimination. This motivates me to perform my job correctly, and I am able to conduct laboratory testing that is culturally safe for all populations and evidence-based (Indigenous and Northern Affairs Canada & National Collaborating Centre for Indigenous Health, 2022; Government of Canada, 2024).
Interpreting Lab Results Through a Social Lens
Building on this broader understanding of health inequities, colonialism, systemic discrimination, and their long-term effects continue to shape the health outcomes of Indigenous patients, with under-resourced systems reinforcing these gaps. Remembering these structural realities enables me to approach each sample with cultural humility and awareness, because I read laboratory values not just as clinical data but as reflections of lived and often inequitable experiences (Drazenovich, 2025; Mahabir et al., 2021). When I examine inflammatory markers or metabolic panels, I consider factors such as delayed access to care, housing instability, and previous negative encounters with the health-care system, all of which may shape the laboratory patterns I observe. This allows me to interpret results in a more thoughtful and respectful manner, even though my role as an MLT is distal from direct patient care.
Although MLTs cannot influence sample prioritization or patient care pathways, we can regulate our accuracy, consistency, and culturally sensitive interpretation, and by doing so, we can ensure that our information contributes to fair clinical decision-making (Borras, 2023; Public Health Agency of Canada, 2022). Following these standards allows me to remain part of quality patient care, and I also recognize the systemic barriers that contribute to adverse health outcomes in Indigenous peoples.
Structural Barriers and Data Interpretation
The health inequities faced by Indigenous Peoples are not limited to the laboratory, because in Ontario, many Indigenous communities have limited access to primary care, diagnostic services, and culturally safe care environments (Drazenovich, 2025; Mahabir et al., 2021). Many First Nations people living off-reserve do not have a regular health-care provider. Between 2017 and 2020, the gap was 20.3% compared with 14.5% for non-Indigenous Canadians (Yangzom, Masoud, & Hahmann, 2023). These systemic differences can have a direct impact on lab testing in practice because without regular follow-up, there may be a delay in obtaining a second test, and results may be more difficult to interpret, thus care can become fragmented. The delay in receiving results may also influence clinical decisions and can skew long-term trends. Recognizing these systemic issues helps us to better interpret lab results in the context of the social determinants of health (Yangzom, Masoud, & Hahmann, 2023).
Furthermore, systemic discrimination and everyday racism in healthcare can impact how people seek and use care (Mahabir et al., 2021), and this is something that I, as an MLT, am aware of when I interpret an abnormal result, or when I receive a request for a repeat sample. I do my best to read each sample in context, because I understand that the numbers I am looking at are more than clinical data, but a person’s full social and human context.
Supporting Equity Within Professional Boundaries
While MLTs operate within a defined scope of practice, we can still contribute to equity in concrete ways, because we implement evidence-based testing protocols, keep detailed records, follow high-quality standards, and help ensure that laboratory services are equitable and unbiased for all patients. Race-based and Indigenous identity data can be used in the same way, as it provides context for laboratory results and allows clinicians to make informed decisions (Canadian Institute for Health Information, 2020). However, it is a reminder that the work of change must be done at the organizational and policy level, but my work will continue to centre on the accuracy, reliability, and culturally informed interpretation of diagnostic data.
For example, Public Health Ontario (2023) state that actual barriers in digital health are lack of access to the internet and low digital literacy, and in the lab, I ponder how these gaps in service could affect patients receiving results or follow up instruction. I do not have the ability to independently address these systemic problems, however, I can be mindful of them. This awareness assists me in reporting results in a manner that is accurate, clear, and culturally sensitive to support equitable care and remain within my scope, as outlined by Public Health Ontario in 2023.
Reflection and Personal Insight
My career as an MLT has shown me that health is not just biological, and that the lab can be a window into the social injustices that shape the health of populations, because I am part of a system. I must be careful, follow the ethics of my practice, and interpret my results judiciously, therefore my learning about the health inequities faced by Indigenous peoples has only strengthened this lesson. It has taught me the value of cultural humility, reinforced the importance of professional integrity, and demonstrated the need for collaboration, thus I may not have the power to decide the priority of a sample or the policies of my workplace, but I can still act with fairness, accuracy, and patient-centred care. There is more to interpreting lab results than the numbers, because there is history, context, and equity, and with a reflective, culturally aware lens, I can make a real difference, and I can do it within my scope of practice.
References:
Borras, A. M. (2023). The challenge of exposing and ending health inequities in Canada: Class, race/ethnicity and gender. Canadian Journal of Public Health. https://journals.sagepub.com/doi/10.1177/27551938221148376
Canadian Institute for Health Information. (2020). Race-based and Indigenous identity data: A supplementary report. Retrieved November 18, 2025, from https://www.cihi.ca/sites/default/files/document/race-based-and-indigenous-identity-data-supplementary-report-en.pdf
Drazenovich, G. (2025). Discrimination in health care: A scoping review of the Ontario experience. HHR Journal, 27(1), 27–41. https://www.hhrjournal.org/2025/06/13/discrimination-in-health-care-a-scoping-review-of-the-ontario-experience/
Government of Canada. (2024). Social determinants of health and health inequalities. RetrievedNovember18,2025,from https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
Indigenous and Northern Affairs Canada & National Collaborating Centre for Indigenous Health. (2022). Understanding Indigenous health inequalities through a social determinants of health lens. Retrieved November 18, 2025, fromhttps://www.nccih.ca/Publications/Lists/Publications/Attachments/10373/Health_Inequalities_EN_Web_2022-04-26.pdf
Mahabir, D. F., O’Campo, P., Lofters, A., Shankardass, K., Salmon, C., et al. (2021). Experiences of everyday racism in Toronto’s health care system: A concept mapping study. International Journal for Equity in Health, 20, 74. https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-021-01410-9
Public Health Agency of Canada. (2022, July 7). Inequalities in health of racialized adults in Canada. Retrieved November 18, 2025, from https://www.canada.ca/en/public-health/services/publications/science-research-data/inequalities-health-racialized-adults-18-plus-canada.html
Public Health Ontario Library Services. (2023). Barriers and strategies to equity in digital health programs/services. Retrieved November 18, 2025, from https://www.publichealthontario.ca/-/media/Documents/E/2023/eb-barriers-strategies-equity-digital-health-programs-services.pdf
Yangzom, K., Masoud, H., & Hahmann, T. (2023). Primary health care access among First Nations people living off reserve, Métis and Inuit, 2017 to 2020. Statistics Canada. https://www150.statcan.gc.ca/n1/pub/41-20-0002/412000022023005-eng.htm