Indigenous Professionals Needed
Increasing Indigenous Representation in Healthcare in Canada
Français • May 14, 2025
Why measure representation?
This analysis is part of the Future Skills for Indigenous Healthcare research project undertaken for Canada’s Future Skills Centre. The project will develop insights that can be used to increase both the Indigenous talent pool and professional development for Indigenous people in healthcare professions in Canada.
This online experience examines Indigenous representation in primary care occupations in Canada.
The Future Skills for Indigenous Healthcare project includes multiple components that will examine Indigenous people’s participation in health professions in Canada. This first component features a quantitative analysis of Indigenous representation in primary care occupations in Canada.
In forthcoming publications, we will take an in-depth look at physicians and paraprofessionals. We are interviewing Indigenous students, physicians, and paraprofessionals to understand their experiences and the barriers they encounter to training in these healthcare professions. We are also conducting case studies and gathering insights from existing programs that promote healthcare career paths and support the training of Indigenous physicians and paraprofessionals.
Indigenous representation in healthcare matters
Considerable health inequities exist between Canada’s Indigenous and non-Indigenous populations, including disproportionately higher rates of chronic diseases, mental health issues, and lower life expectancy among Indigenous populations.1 Systemic barriers, including racism, discrimination, and unequal access to care, limit Indigenous people’s chances of receiving fair and timely care.2
Increasing the number of Indigenous healthcare professionals can play an important role in addressing these inequities. In 2015, the Truth and Reconciliation Commission called upon governments and post-secondary institutions to increase the number of Indigenous professionals working in the healthcare field.3
Care delivered by Indigenous health professionals fosters inclusion and helps to counter systemic discrimination.4 This builds trust and improves access to culturally relevant and safe care.5 Patients who receive culturally safe care are more likely to access care—and access it early—and to provide details about their health, share their treatment preferences, and follow treatment plans.6
Indigenous leadership and decision-making in Canada’s healthcare system also ensures that care is more responsive to the needs of Indigenous people and communities, respecting Indigenous histories, cultures, and healing practices.7
How big is the gap in representation?
In this first component of the Future Skills for Indigenous Healthcare initiative, we use national data from Statistics Canada’s Census of Population to examine Indigenous representation in primary care professions across Canada and in different geographic contexts. We also look at changes to Indigenous representation in each primary care occupation between 2016 and 2021.
Please see the technical report for more information about our analysis.
What do we mean by equal representation?
Equal representation is met when the proportion of Indigenous people working in a healthcare profession in a given geographic region reflects the proportion of Indigenous people living in that region. Because Indigenous population sizes vary across the country, targets for equal representation differ by geography.
Primary care
Primary healthcare is frequently the first and main point of entry into the Canadian healthcare system. It includes routine care, diagnosis, treatment, and management of health conditions as well as health promotion and disease prevention.8
However, Indigenous people in Canada are less likely to have access to critical primary care than non-Indigenous populations, with those living in rural and remote regions experiencing the largest disparities.9
Family doctors and nurse practitioners are the backbone of primary care in Canada. But due to the Northern, rural, and remote locations of many Indigenous communities and the limited healthcare infrastructure in these regions, other healthcare professionals play key primary care roles in Indigenous communities. We chose to focus on Indigenous representation in the following primary care occupations:
- general practitioners and family physicians
- nurse practitioners
- registered nurses and registered psychiatric nurses
- psychologists
- pharmacists
- dietitians and nutritionists
- dentists
- dental hygienists and dental therapists
- paramedical professionals
- clinical and laboratory medicine specialists
Please see the technical report for the rationale behind our choice of healthcare occupations important to primary care for Indigenous people.
While our focus in this analysis is on primary care occupations, please download our supplementary data that provides estimates of Indigenous representation in 2021 at the national level for all healthcare occupations.
- Public Health Agency of Canada, “Key Health Inequalities”; Loppie and Wien, “Understanding Indigenous Health Inequalities”; Reading and Wien, “Health Inequalities and Social Determinants.”
- Statistics Canada, “Health Care Access and Experiences”; Yangzom, Masoud, and Hahmann, “Primary Health Care Access”; Barbo and Alam, “Indigenous People’s Experiences.”
- Truth and Reconciliation Commission of Canada, “Truth and Reconciliation Commission of Canada: Calls to Action.”
- Barbo and Alam, “Indigenous People’s Experiences”; Gibson and others, “Enablers and Barriers to the Implementation of Primary Health Care Interventions for Indigenous People”; Bearskin and others, “Truth to Action”; First Nations Health Authority, “FNHA’s Policy Statement on Cultural Safety and Humility.”
- Barbo and Alam; Gibson and others; Bearskin and others; First Nations Health Authority.
- National Collaborating Centre for Aboriginal Health, “Towards Cultural Safety for Métis”; Swidrovich, “Indigenous Awareness and Effective Interaction”; Baba, “Cultural Safety in First Nations.”
- Greenwood, Leeuw, and Lindsay, “Challenges in Health Equity.”
- Health Canada, “About Canada’s Health Care System”; Statistics Canada, “Survey on Health Care Access.”
- Yangzom, Masoud, and Hahmann, “Primary Health Care Access.”
Representation must increase
To address the Truth and Reconciliation Commission’s Call to Action to increase the number of Indigenous health professionals, post-secondary institutions are building partnerships with Indigenous health organizations and communities to implement targeted programs that support career development for Indigenous students.
However, in 2021, Indigenous people remained under-represented nationally in all of our studied primary care occupations except paramedical roles. In many primary care occupations, Indigenous representation must increase by over 100 per cent to reach equal representation.
Higher education limits representation
Indigenous people are under-represented in all healthcare professions that require educational attainment beyond high school, and representation declines as educational requirements rise. We see the lowest levels of Indigenous representation in primary care occupations that require the highest levels of education, such as dentists and general practitioners and family physicians.
Provinces/territories
Some provinces fare better with representation
Indigenous people were under-represented in nearly every primary care occupation we studied across each province and territory in 2021. However, some provinces and territories have farther to go before reaching equal representation.
Urban/rural, North/South
Representation lags in rural and Northern Canada
Indigenous representation in primary healthcare occupations is worse in rural and Northern regions than in urban and Southern regions of Canada.
Indigenous students from Northern and rural areas face unique challenges in pursuing post-secondary education, which puts them at a disadvantage. Those challenges include fewer local post-secondary programs (resulting in higher relocation costs), a lack of culturally relevant curricula, and limited access to preparatory resources such as tutoring, academic counselling, and mentorship.10
- McKeown and others, “Indigenous Educational Pathways”; Gordon and White, “Indigenous Educational Attainment in Canada.”
First Nations/Inuit/Métis
Representation is driven by First Nations & Métis
Métis make up the majority of Indigenous professionals in most primary care occupations we studied, followed by First Nations professionals. Inuit participation in primary care occupations remains low.
Inuit communities, primarily located in the Arctic, face considerable challenges due to their remote locations and underdeveloped infrastructure, which limit access to essential services, including education.11 In 2021, Inuit had the lowest education levels among the three recognized Indigenous groups in Canada.12 Since specialized healthcare fields require advanced education and training, these barriers likely contribute to the low representation of Inuit in healthcare professions.
- Crown-Indigenous Relations and Northern Affairs, “Arctic and Northern Policy Framework.”
- Statistics Canada, “Table 98-10-0413-01.”
Representation improving
Representation is improving for doctors and nurses
Since the Truth and Reconciliation Commission released its Calls to Action, support for recruiting and retaining Indigenous healthcare professionals has improved. These include initiatives that promote healthcare career paths and investments in programs that support access to and completion of healthcare education and training. Institutional reforms to healthcare education are also underway to increase inclusion and integrate traditional medicine and Indigenous healing and wellness practices into program curricula.13
Indigenous representation increased across most of the primary care occupations we studied between 2016 and 2021. The largest gains were for general practitioners, family physicians, registered nurses, and registered psychiatric nurses.
- Aziz, Saba, and Ward, “Indigenous Representation in Health Care Improving”; CBC News, “Truth and Reconciliation in Canada.”
The methodology and forecasting assumptions for each scenario are detailed in our technical report:
This research was prepared with financial support provided through the Future Skills Centre. Signal49 Research is proud to serve as a research partner in the Future Skills Centre consortium. For further information about the Centre, visit their website at fsc-ccf.ca.
Many Signal49 Research colleagues helped to bring this research to life. Adam Fiser, Principal Research Associate, PhD, conceived of this initiative and provided oversight throughout the research process. Jacob LeBlanc, Research Associate, MAE, Amanda Thompson, Lead Research Associate, PhD, and Alicia Hussain, Senior Research Associate, PhD, executed the research and Stefan Fournier, Executive Director, MA, provided feedback on early drafts. Natasha Delrosario, Graphic Designer designed this online experience.
We also wish to thank our project partners and the members of the research advisory board who supported this research:
- Richard Budgell, Assistant Professor, Department of Family Medicine, McGill University
- Sydney Forbes, Co-Chair East, Indigenous Medical Students’ Association of Canada
- Leila Gillis, Acting Director General and Chief Nursing Officer, Office of Primary Health Care, First Nations and Inuit Health Branch, Indigenous Services Canada
- KC Herne, Medical Student, Faculty of Medicine, McGill University
- Melanie Osmack, Executive Director, Indigenous Physicians Association of Canada
- Sarah Konwahahawi Rourke, Director, Indigenous Health Professions Program, McGill University
- Sam Senecal, Director, Indigenous Affairs, Northern Ontario School of Medicine University
- Derek Thompson, Director of Indigenous Engagement, University of British Columbia
