Intermediate Determinants

Intermediate determinants of HCV among Indigenous peoples

While proximal determinants represent the end manifestations of much ill health among Indigenous populations, intermediate determinants can be thought of as factors which mediate the relationship between the proximal determinants of health and the larger over-arching structures which affect the health status of Indigenous peoples and populations (Reading & Wien, 2013). Specific examples of intermediate determinants include poverty, gender, deleterious physical environments, barriers to health care and a lack of community infrastructure, resources and capacities (Reading & Wien, 2013).
Age and gender

Deviating from national trends are the demographics of HCV infection, where young …show more content…
(2008), Miller et al. (2011) and Uhanova et al. (2013) demonstrate the importance of age as an intersectional determent of health, as HCV positive Indigenous peoples are often younger in comparison to non-Indigenous populations. For example, Mehrabadi et al. (2008) found that individuals in the Indigenous cohort of their study were diagnosed with chronic HCV on average five years earlier in comparison to those in the non-Indigenous cohort. Similarly, Miller et al. (2011) found that 30% of young, urban Indigenous persons who injected drugs became positive for HCV over a two-year study period. The above results further illustrate that young Indigenous people are at very high risk of HCV seroconversion early in their injection careers, as injection drug use accounts for 70-80% of new HCV infections in Indigenous young people under the age of …show more content…
Its contribution has been through multiple mechanisms, including at the individual, family, community and societal levels (Reading & Wien, 2013). Specifically, cultural identities were eroded through this systematic approach to assimilation which has led to the loss of language, tradition and connectedness for many Indigenous communities (Reading & Wien, 2013). As a result, many residential school survivors and their families experience shame and deeply rooted mistrust and anger. This, in turn, has resulted in social isolation, marginalization and poor coping mechanisms for many Indigenous peoples, further contributing the increased prevalence of risk behaviours and environments associated with HCV acquisition (Sadler & Lee,

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