Indigenous Health Equity and Emergency Medical Services

A Shorter, Harder Life

Life expectancy in Northern Health is already 6.2 per cent lower than the provincial average. For women in Northern Health, it is 6.5 per cent lower than BC women; for men, 5.7 per cent lower. Between 2019 and 2022, life expectancy in Northern Health fell by 2.3 per cent — a faster decline than the provincial average of 1.4 per cent.

For First Nations peoples, the picture is more acute. The First Nations Health Authority reports that life expectancy among Indigenous peoples in BC has dropped by 7.1 years since 2015.

The Northern Health report identifies a critical and revealing discrepancy. The region's Standardized Mortality Ratio — which measures overall community deaths against expected rates — is the highest in BC and trending upward. Yet its Hospital Standardized Mortality Ratio is the lowest in BC. People in Northern Health are not dying at higher rates inside hospitals. They are dying at higher rates in the community, outside the health system's reach.

This is not a puzzle. It is a precise description of what happens when prehospital and emergency care systems fail to reach people where they are.

Access Is Not Equitable

The report documents that 54 percent of residents in the Northeast Health Service Delivery Area — covering Fort Nelson, Fort St. John, and Dawson Creek — reported that their access to healthcare was worsening. Northern Health has the highest rate of ambulatory care sensitive condition admissions in the province: hospitalizations for conditions that should be manageable in primary care. These are markers of a system that reaches people too late, too rarely, and too far from where they need to be.

The injury data are equally stark. In Northern Health, motor vehicle traffic injury hospitalizations occur at a rate of 100.3 per 100,000 population, compared with 65.8 per 100,000 provincially. Off-road vehicle injuries are 50.2 per 100,000, compared with 16.6 per 100,000 in BC overall. The median age at death from accidents in Northern Health is 60, twelve years younger than the BC median of 72. These are not statistics. They are descriptions of people dying younger, further from help, in circumstances that are often survivable if appropriate care arrives in time.

Northern Health also carries the highest rate of avoidable mortality from preventable causes in BC, and the highest rate of mortality from treatable causes — deaths that could have been avoided through timely and effective healthcare intervention.

What MRBC Brings to This Picture

The structural analysis is clear. Excess mortality in Northern Health is occurring in the community, not in hospitals. That is precisely the space that prehospital and retrieval medicine occupies. An interprofessional team that can reach a patient in Haida Gwaii, Fort Nelson, or Bella Coola — stabilize them at the point of illness or injury by bringing tertiary-level care to them, and manage their transfer if required — is not a luxury. It is the minimum standard of equity.

Mayor Pineault's March 2026 letter is consistent with this data. She named specific, structural failures, and she called for accountability. The Northern Health data give those concerns a quantitative foundation. MRBC's model of care is designed around the explicit recognition that geography and ethnicity should not determine whether a person survives a cardiac arrest, a trauma, or a medical emergency. The evidence says they currently do. We are working to change that.

Northern Health Population Health Status Report 2024: read the full report here