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Federal health report helps CNA focus its work on stigma and health

Ottawa, December 20, 2019 – Canada’s chief public health officer, Dr. Theresa Tam, released her report on the State of Public Health in Canada 2019, with a special focus on stigma and health. The report provides an opportunity to reflect on population-level health indicators and consider how CNA and nurses in Canada can lead the health system and other sectors to address the shifting health needs and priorities of people in Canada.

With more than 1 in 4 people in Canada reporting at least one experience of discrimination in their lifetime, the Canadian Nurses Association (CNA) welcomes the chief public health officer’s focus on stigma as a public health concern. We have long advocated for addressing social determinants of health such as stigma and improving access to health care. What we know is that barriers to care are not always physical or geographical in nature, and that there is much work to be done to remove seemingly intangible barriers to improve access to health and health care for people in Canada. CNA understands the significant adverse health outcomes related to stigma, including reduced access to resources and health services. Nurses see the effects every day wherever they practise. CNA recognizes the importance of addressing drivers of stigma such as language, bias, racism and organizational culture.

The report outlines the Stigma Pathways to Health Outcomes Model as an important and necessary tool to encourage understanding of multiple forms of stigma and how they interact to create inequitable health outcomes. This resource can support nurses in understanding the impact of stigma(s) on patients and better enable the provision of safe, compassionate, evidence-informed and ethical care. CNA actively advocates for healthy public policies to advance health outcomes and reduce inequities.

We are encouraged by the chief public health officer’s leadership in the development of the Action Framework for Building an Inclusive Health System to support a comprehensive approach to addressing stigma and its health effects. As nurses are the largest health-care professional group in Canada, we have a critical role to play in addressing stigma within the health system. This tool provides a guide to support nurses in leading destigmatizing practices at the individual, institutional, community and population level.

“Nurses are integral to preventing disease and injury and to promoting the health of all people in Canada. This report, like those before it, will inform CNA’s work to advance the health of all individuals, families and communities and sharpen our focus on populations where there are significant health inequities,” said Claire Betker, CNA president.

“Indigenous Peoples’ health inequities have been long standing and continue to grow. The chief public health officer’s report highlights these ongoing iniquities experienced by First Nations, Inuit and Métis. The positive aspect of this report is the extensive efforts Dr. Tam and her team undertook towards exploring the impacts of stigma on health and wellness. The presentation of an action framework which focuses on building an inclusive health system for all peoples comes at a very critical time for Canada as it supports and aligns with the efforts Canada is taking towards implementation of the Truth and Reconciliation Commission of Canada’s Calls to Action,” said Lea Bill, Canadian Indigenous Nurses Association (CINA) president.

CNA has long advocated for the improvement of health and this report further highlights key areas of focus to improve the state of public health in Canada, such as substance use, climate change and antimicrobial resistance, among other important indicators. We remain concerned with the report’s indication of increased morbidity and mortality of young adults as it relates to opioids. Although intense efforts to address this crisis through harm reduction have likely reduced the impact of the crisis, there remains a lot of work to do. CNA is encouraged to see climate change and health prioritized and echo the call for increased adaptation and mitigation measures to lessen vulnerabilities of communities and decrease exposure to extreme weather events. CNA also supports this report’s focus on increased efforts to reduce unnecessary use of antibiotics, but we recognize that multi-faceted strategies are needed to address antimicrobial resistance and stewardship.

In line with the chief public health officer’s report, CNA has provided resources, support and continuing professional development to nurses in understanding their role in addressing these important health issues. CNA has recognized that climate change is inextricably linked to negative health outcomes and supported nurses through guidance (e.g., position statements and infographics) to build capacity. CNA continues to prioritize antimicrobial resistance and antimicrobial stewardship and nurses’ role through advocacy and resource development, as well as through collaboration with organizations, such as Choosing Wisely Canada. CNA advocates for harm reduction services to support groups stigmatized by substance use and has developed resources to enhance nurses’ understanding and capacity to take action.

CNA continues to collaborate with organizations to address barriers experienced by groups who face disproportionate levels of stigma. CNA’s Nursing Now campaign is partnering with CINA and Indigenous Services Canada to enable and support current and future nursing and midwifery workforce to provide culturally safe care across Canada. CNA’s position statement, Promoting Cultural Competence in Nursing [PDF, 1.7 MB], affirms our commitment to cultural competence and safety as essential to providing high-quality, safe and equitable nursing care.

CNA recognizes the shared responsibility of health system leaders, individuals and our own professional nursing associations to ensure health policies and practices are in place and evaluated to protect and support all people living in Canada. We will continue to collaborate, partner and lead such initiatives, including strong advocacy for system change, to guide the transformation of policy, practice, education, training and professional competencies. CNA looks forward to working with Dr. Tam and other health professionals to address this significant public health concern.

Background Information:


The Canadian Nurses Association is a powerful, unified voice for the Canadian nursing profession. We represent nurses in all 13 jurisdictions as well as retired nurses from across the country. We advance the practice and profession of nursing to improve health outcomes and strengthen Canada’s publicly funded, not-for-profit health system.

For more information, please contact:

Eve Johnston
Media and Communications Coordinator
Canadian Nurses Association
Tel: 613-237-2159, ext. 114
Cell: 613-282-7859
Email: ejohnston@cna-aiic.ca