Author's Notes

Where relevanL, Lhls reporL refers Lo Lachance, Possack, ?acoub & 1oope's (2009)
neoltb uetetmlooots fot lltst Notloos lo Albetto, publlshed by PealLh Canada (avallable aL
hLLp://publlcaLlons.gc.ca/collecLlons/collecLlon_2011/sc-hc/P34-217-2010-eng.pdf). lL provldes
mosL of Lhe daLa relaLed Lo Lhe general Canadlan populaLlon, as well as uene 1ha' speclflc
lnformaLlon on workforce and healLh characLerlsLlcs LhaL comes from boLh lnLernal and publlc
sources. Where lL ls used, lL ls referenced as (Lachance eL al., 2009).

A Lremendous amounL of graLlLude goes ouL Lo Lhe communlLy members of ChaLeh, who
never gave me a hard Llme when l asked Lhem lf Lhey would llke Lo flll ouL a communlLy healLh
survey. 1hank you for your hosplLallLy, paLlence, klndness, and LhoughLful feedback. AddlLlonal
Lhanks Lo Lhe sLaff aL Lhe ChaLeh PealLh CenLre for all of Lhe work LhaL Lhey do and all of Lhe
lmprovemenL LhaL Lhey have been worklng Lowards.






























Commun|ty rof||e
LocaLed ln norLhwesLern AlberLa, Lhe uene 1ha' llrsL naLlon conslsLs of seven separaLe
reserves: Amber 8lver, 8lsLcho Lake, 8ushe 8lver, Pay Lakes, !ackflsh olnL, upper Pay 8lver,
and Zama Lake for a LoLal acreage of 74,224. As of !une 2014, Lhe reglsLered populaLlon of Lhe
uene 1ha' llrsL naLlon ls 2,911, wlLh 2,110 llvlng on reserve. 1he Lhree prlnclpal communlLles
are ChaLeh (Pay Lakes), Meander 8lver (upper Pay 8lver), and 8ushe 8lver, wlLh ChaLeh belng
Lhe largesL communlLy (approxlmaLely 1,000). 1he communlLles are all accesslble - ln parL or ln
whole - by a provlnclal hlghway from Plgh Level. Meander 8lver ls locaLed 80 kllomeLers norLh
on Plghway 33, whlle 8ushe 8lver ls locaLed 10 kllomeLers easL on Plghway 38. ChaLeh ls
locaLed 103 kllomeLers norLhwesL of Plgh Level off of Plghway 38, and requlres an addlLlonal
13-kllomeLer drlve on a gravel road lncludlng a sLeep decllne Lo Lhe valley LhaL ChaLeh slLs ln.
8ased on Lhe locaLlon of all Lhree communlLles, LransporLaLlon ls a barrler Lo healLhcare, food,
and access Lo oLher servlces.
1he demography of Lhe area ls congruenL wlLh Lhe general growLh Lrend of llrsL naLlons
people ln Canada. lrom 2001 Lo 2006, Lhe on-reserve populaLlon only lncreased by 4.1,
however from 2006 Lo 2014 Lhe populaLlon lncreased by 22. As of 2006, 40 of Lhe uene 1ha'
populaLlon ls under 19 years of age. 1oday, lL ls esLlmaLed LhaL Lhere are aL leasL 1000 chlldren
ln Lhe uene 1ha' llrsL naLlon, as havlng 1000 reglsLered chlldren ls a requlremenL Lo Lransfer
Chlld Welfare Servlces Lo Lhe band - a process whlch ls belng underLaken aL Lhe presenL Llme.

Jocotloo, looqooqe, ooJ wotkfotce
8eglsLraLlon aL Lhe uene 1ha' CommunlLy School ln ChaLeh ls 430, whlle reglsLraLlon aL
Lhe upper 8lver School ln Meander 8lver ls around 70 (general populaLlon approxlmaLely 300).
1here ls no school ln 8ushe 8lver (populaLlon approxlmaLely 300), and sLudenLs commuLlng Lo
Plgh Level for Lhelr educaLlon. CurrenLly, norLhern Lakes College operaLes ouL of ChaLeh, and
offers upgradlng courses for hlgh school dlploma compleLlon. Powever, norLhern Lakes College
ls run on a conLracLual basls, whlch may explre or be cuL aL any polnL.
WlLh regards Lo educaLlonal aLLalnmenL, uene 1ha' has Lhe lowesL percenLage of hlgh
school graduaLes ln Lhe 1reaLy 8 area - 84 of resldenLs over Lhe age of 13 have less Lhan a
hlgh school dlploma (Lachance eL al., 2009). 1hls ls conLrasLed by Lhe facL LhaL over 73 of
resldenLs have knowledge of Lhe uene language, compared Lo Lhe provlnclal average of only
19 of llrsL naLlons people knowlng Lhelr language. ApproxlmaLely 30 of households speak
uene as Lhelr prlmary language aL home.
1he medlan famlly lncome ln Lhe uene 1ha' llrsL naLlon ls among Lhe lowesL ln all of Lhe
1reaLy 8 communlLles aL approxlmaLely $23,000 (Lachance eL al., 2009). 1he parLlclpaLlon raLe -
deflned as Lhose beLween 13 and 64 who are employed, expecLlng Lo begln work, on Lemporary
lay off, or acLlvely seeklng employmenL - ls 41 (Lachance eL al., 2009). 1he employmenL and
unemploymenL raLes are Lhe same - 31 are employed and 31 are unemployed (Lachance eL
al., 2009). 1he lncome supporL dependency raLe for Lhe norLh eace 1rlbal Councll area (whlch
also lncludes 8eaver ln, LlLLle 8ed 8lver Cree ln, Lublcon Lake ln and 1allcree ln) ls
approxlmaLely 40 (Lachance eL al., 2009).

coooectlvlty
All Lhree communlLles have communlLy radlo sLaLlons run by volunLeers. 1he role of Lhe
radlo sLaLlon ls far beyond playlng muslc, lL ls also used for announcemenLs, classlfleds, and
evenL llsLlngs. Arrow 1echnologles lnc. provldes resldenLlal lnLerneL servlce ln ChaLeh, alLhough
Lhere are frequenL lssues wlLh connecLlvlLy. lnLerneL servlce aL Lhe ChaLeh PealLh CenLre ls
conLracLed Lhrough Lhe 1echnlcal Servlces Advlsory Croup (1SAC) whlle AlberLa SuperneL
rellably connecLs many of Lhe oLher bulldlngs and schools ln ChaLeh, Meander 8lver, and 8ushe
8lver. Pome phone, wlreless phone, and saLelllLe Lelevlslon are avallable ln Lhe Lhree
communlLles.

Cverv|ew of nea|th Serv|ces
1he communlLy of ChaLeh grew exLenslvely followlng floodlng aL Pabay ln Lhe 1960s.
lormerly called AssumpLlon, ChaLeh was home of a resldenLlal school from 1930-1971. Medlcal
care evolved alongslde Lhe communlLy - ln Lhe 1930s Lhere was medlcal care ln Pabay, buL by
Lhe 1970s care had moved Lo ChaLeh. 1he lncreaslng demand for servlces lead Lo a new nurslng
sLaLlon belng bullL ln 1987 wlLh an addlLlon ln 1996. ln 2012, a new, 33,000 square fooL PealLh
CenLre was bullL wlLh several cllnlc rooms, a denLal offlce, an emergency room, a pharmacy,
and oLher faclllLles lncludlng a lab, docLor's room, flle room, and mulLlple conference rooms. An
overvlew of ChaLeh PealLh CenLre's currenL programs ls provlded below.

AJJlctloos
AddlcLlons LreaLmenL ls offered ln all Lhree uene 1ha' communlLles Lhrough Lhe naLlonal
naLlve Alcohol and urug Abuse rogram (nnAuA), lnlLlaLed ln 1998. 1he nnAuA program
offers counsellng, supporL, and LreaLmenL opLlons for uene 1ha' communlLy members. Whlle
Lhe program ls well aLLended across all communlLles, ulLlmaLely Lhe LreaLmenL model has yeL Lo
have been evaluaLed slnce nnAuA's lncepLlon. Clven Lhe sLrong famlllal Lles ln Lhe Lhree
communlLles as well as Lhe lmporLance of work, LreaLmenL ls ofLen seen as more of a seLback
Lhan a vlable opLlon.

commoolty neoltb
1he uene 1ha' llrsL naLlon has several lnlLlaLlves LhaL address communlLy healLh. 1hese
lnclude CommunlLy PealLh 8epresenLaLlves worklng ln ChaLeh and Meander 8lver, a 8rlghLer
luLures worker, and a [usLlce worker. 1hese lndlvlduals are responslble for healLh promoLlon
and prevenLaLlve educaLlon. 1hls lncludes programmlng such as women's groups, dlabeLes
walks and evenLs, runnlng a famlly and youLh camp, dolng ouLreach ln schools regardlng
healLhy eaLlng, safeLy, and sexual healLh, worklng wlLh vlcLlms and offenders of crlme, and
youLh menLal healLh.

ueotol cote
uenLal care ls noL offered ln Meander 8lver or 8ushe 8lver, buL ls offered beLween Lwo
and four Llmes per monLh aL Lhe ChaLeh PealLh CenLre. Cral healLh ls a pervaslve lssue ln llrsL
naLlons communlLles due Lo Lhe comblnaLlon of food lnsecurlLy, Lhe hlgh avallablllLy of
unhealLhy foods aL communlLy sLores, and Lhe barrlers Lo accesslng furLher LreaLmenL aslde
from regular cleanlng. As a resulL, denLlsL days" are some of Lhe buslesL aL Lhe ChaLeh PealLh
CenLre. Powever, lf a paLlenL requlres more exLenslve LreaLmenL Lhey musL Lravel lnLo Plgh
Level, Crand ralrle, or LdmonLon.
metqeocy 5etvlces
ln ChaLeh, llrsL 8esponders are avallable 24 hours a day, 7 days a week. 1hey are Lralned
Lo LreaL mlnor ln[urles and susLaln llfe ln Lhe case of ma[or Lrauma. Ambulance servlces arrlve
from elLher 8alnbow Lake or Plgh Level, approxlmaLely 43 mlnuLes and an hour away,
respecLlvely. 1hls means LhaL Lhe average paLlenL Lo emergency room Lrlp ranges from an hour-
and-a-half Lo Lwo hours. Powever, ChaLeh ls slLuaLed ln a valley, and Lhe long, sLeep decllne
lnLo Lhe communlLy has been suscepLlble Lo weaLher, mud, and ambulance rollovers, ulLlmaLely
delaylng LransporLaLlon ln lnclemenL weaLher. non-emergency paLlenL LransporLaLlon ls
arranged vla Lhe ChaLeh PealLh CenLre, and mosLly servlced by Parvey's Medlcal 1ransporLaLlon
Lhrough norLh eace 1rlbal Councll. Meander 8lver, locaLed approxlmaLely 80km from Plgh
Level, does noL offer emergency servlces and relles on LransporLaLlon Lhrough Laxl and
ambulance from Plgh Level vla Plghway 33, a paved provlnclal rouLe. Whlle Lhere ls no prlmary
or urgenL care provlded ln 8ushe 8lver, lLs locaLlon (only 10 kllomeLers ouLslde of Plgh Level)
means lL can rely on emergency servlces ouL of Lhe norLhwesL PealLh CenLre ln Plgh Level.
ollce servlces ln ChaLeh are provlded by Lhe local 8CM deLachmenL, based [olnLly ouL of
ChaLeh and 8alnbow Lake. 1he Plgh Level-eace 8lver 8CM deLachmenL servlces Meander
8lver and 8ushe 8lver.

nome cote
As one of Lhe programs offered by norLh eace 1rlbal Councll - Lhe governlng 1rlbal
Councll of Lhe uene 1ha' llrsL naLlon - home care ls offered ln all Lhree communlLles. 1hls
lncludes uene LranslaLlon servlces.

lteootol ooJ Motetool neoltb
As anoLher program offered by norLh eace 1rlbal Councll, maLernal healLh care ls
offered ln all Lhree communlLles. 1hese lnclude parenLlng workshops as well as moLher supporL
groups. ln addlLlon Lo whaL norLh eace 1rlbal Councll offers, docLors, nurses, and CommunlLy
PealLh 8epresenLaLlves collaboraLlvely address prenaLal healLh aL Lhe ChaLeh PealLh CenLre.
1hls lncludes prenaLal classes ln ChaLeh, as well as full prenaLal care ouL of Lhe ChaLeh PealLh
CenLre wlLh Lhe excepLlon of ulLrasounds.

ltlmoty cote
CurrenLly, prlmary care ls offered ln ChaLeh and Meander, wlLh a 0.3 publlc healLh nurse
and a once-a-week docLor ln Meander 8lver, and 3.3 nurses, a 0.3 nurse pracLlLloner, and
docLor's cllnlcs Lwo Lo Lhree Llmes a week ln ChaLeh. Powever, Lhe ChaLeh PealLh CenLre has
only 2 full Llme nurses aL Lhe presenL Llme, placlng a sLress on prlmary care. lurLher, docLor
cllnlcs frequenLly have docLors seelng ln excess of 40 paLlenLs per afLernoon. As a resulL, nurses
are drawn from oLher sources for speclallzed cllnlcs, such as lmmunlzaLlon, prenaLal, and sexual
healLh, and cllnlc walL Llmes are ofLen aL leasL Lwo hours for paLlenLs on an average day.
ConLlnulLy of care ls anoLher lssue LhaL affecLs Meander 8lver and ChaLeh resldenLs, for Lhere
are llmlLed opporLunlLles Lo see Lhe same docLor because of PealLh Canada's docLor roLaLlon
model. 1hls resulLs ln care belng noL as personal, Lhorough, or Lallored for each paLlenL.
When a prescrlpLlon ls requlred, lL ls senL Lhrough Lhe Plgh Level lCA harmacy and
dellvered by medlcal Laxl, desplLe Lhe ChaLeh PealLh CenLre havlng lLs own pharmacy. 1hls leads
Lo several compllcaLlons. llrsL, many resldenLs of ChaLeh - around Lwo-Lhlrds - do noL have
access Lo a vehlcle. Clven Lhe dlspersed spaLlal layouL of Lhe reserve, lL may mean a paLlenL
does noL have access Lo Lhelr prescrlpLlons for several days. Second, ln Lhe case of lmmedlaLe
danger - such as a baby or lnfanL belng lll - Lhe prescrlpLlon Lurn around Llme ls lnadequaLe Lo
address Lhe healLh of Lhe paLlenL. lL ls recommended and hopeful LhaL Lhe pharmacy wlll regaln
lLs llcense and keep emergency medlcaLlons, medlcaLlon for klds, and conLracepLlves on hand.

womeos neoltb & 5exool neoltb
1here ls a Lremendous legacy and lmpacL of colonlallsm on sexual healLh ln llrsL naLlons
communlLles, sLemmlng from a hlsLory of sexual vlolence Lhrough leglslaLlon and 8esldenLlal
Schools. As a resulL, women's and sexual healLh are carefully admlnlsLered buL lnfrequenLly
performed. 1hls can resulL ln less pap smears, mammograms and prosLaLe exams, whlch may
mean Lhere ls an underrepresenLaLlon of Sexually 1ransmlLLed lnfecLlons (S1ls).
ln ChaLeh, pap smears and S1l LesLlng has recenLly been lncreased Lhrough speclallzed
women's healLh cllnlcs and ln regular docLor cllnlcs. Mammograms are occaslonally performed
ln Plgh Level Lhrough Lhe Moblle Screenlng rogram, however ChaLeh does noL arrange
LransporLaLlon for LhaL program, whlch may affecL screenlng raLes. 8egardlng men's healLh,
prosLaLe exams are lnfrequenLly performed as parL of Lhe legacy of colonlzaLlon.

1elebeoltb
1he ChaLeh PealLh CenLre ls fully equlpped wlLh 1elehealLh and Leleconferenclng
servlces.

vlsloo cote
vlslon care ls noL offered aL Lhe ChaLeh PealLh CenLre and musL be soughL ln Plgh Level.

Methodo|ogy
5otvey ueslqo
Whlle healLh ln all Lhree communlLles was consldered, ulLlmaLely a CommunlLy PealLh
needs AssessmenL was deslgned for Lhe ChaLeh PealLh CenLre. llrsL, ChaLeh has Lhe hlghesL
populaLlon of all Lhree uene 1ha' communlLles and feaLures Lhe ma[orlLy of uene 1ha'
resldenLs. Second, Lhe new bulldlng - less Lhan Lwo years old - employs many people and sees
many paLlenLs ln a day, however Lhere was a lack of dlrecLlon or vlslon for communlLy healLh ln
Lhe era of Lhe new ChaLeh PealLh CenLre.
ln order Lo compleLe Lhe CommunlLy PealLh needs AssessmenL, members of Lhe
communlLy and PealLh CenLre were consulLed prlor Lo developlng a meLhodology. Clven Lhe
challenges of healLhcare ln a remoLe communlLy, lssues wlLh access Lo medlcal and non-medlcal
LransporLaLlon, as well as wanLlng Lo gauge Lhe soclal deLermlnanLs of healLh, a survey was
chosen as Lhe meLhod of cholce. CuesLlonnalre surveys are an lndlspensable Lool when
prlmary daLa are requlred abouL people, Lhelr behavlours, aLLlLudes and oplnlons and Lhelr
awareness of speclflc lssues" (llowerdew & MarLln, 2003, p.78). lurLher, pasL PealLh CenLre
needs AssessmenLs and SLraLeglc lans have uLlllzed surveys successfully, so Lwo surveys were
ulLlmaLely creaLed for dlsLrlbuLlon - one for adulLs and one for youLh.
Surveys were deslgned wlLh Llme and llLeracy ln mlnd (see Appendlx 1 and 2, aLLached).
AdulL and youLh surveys Look beLween flve and Len mlnuLes Lo flll ouL dependlng on deLall
provlded and llLeracy level. CuesLlons were clear and conclse, and boldlng and underllnlng were
used Lo provlde emphasls on key words and quesLlons. Surveys asked abouL a varleLy of lssues
uslng open- and closed-ended quesLlons, as well as uLlllzed dlfferenL scales and caLegorles.
When necessary, surveys were admlnlsLered orally.
1he survey followed a loglcal formaL. 1he adulL survey opened wlLh quesLlons abouL
demography and Lhe respondenL's communlLy (lncludlng whaL Lhey llked abouL lL and Lhe
quallLy of Lhelr houslng and lnfrasLrucLure) before delvlng lnLo healLh. 8espondenLs were flrsL
asked abouL exlsLlng PealLh CenLre programs before belng asked abouL a number of communlLy
healLh challenges LhaL were lmporLanL Lo Lhem. lrom Lhere, personal and famlllal healLh was
addressed. 1hls lncluded self-raLlng Lhelr own healLh and uslng a 0-1-2 scale for how a healLh
challenge affecLs Lhelr famlly (wlLh 0 belng none of Lhelr famlly, 1 belng some, and 2 belng
mosL). 8espondenLs were also asked abouL blood LesLs for dlabeLes and Lhelr sexual healLh. 1he
survey ended wlLh quesLlons on seeklng care and maklng suggesLlons for lmprovlng healLh
servlces ln Lhe communlLy.
1he youLh survey followed a slmllar formaL. lL opened wlLh baslc demographlc quesLlons
before asklng 10 sLaLemenLs abouL Lhe youLh's wellbelng. 1hey could respond Lo Lhe quesLlon
by clrcllng a yes, no, or someLlmes smlley face. 1hls ensured LhaL Lhe survey appeared chlld-
frlendly, maklng Lhe survey less lnLlmldaLlng Lo flll ouL. lollowlng LhaL, open-ended quesLlons
were asked abouL youLhs' hobbles, communlLy, and role models. uslng open-ended quesLlons
llke Lhese allowed Lhe youLh Lo Lhlnk concreLely lnsLead of absLracLly, maklng Lhe quesLlons
approprlaLe for Lhe chlld's age and developmenL. 1he survey concluded wlLh closed-ended
quesLlons on lf Lhey spoke and/or wroLe uene Lo gauge lf Lhe language ls Lhrlvlng or survlvlng
for Lhe nexL generaLlon.

kectoltmeot
arLlclpanLs were recrulLed Lhrough a varleLy of meLhods. Surveys were lefL aL Lhe 8and
Cfflce, PealLh CenLre, and Soclal uevelopmenL ln vlslble places. 1he CommunlLy PealLh needs
AssessmenL was promoLed Lhrough posLers ln Lhe communlLy and on Lhe communlLy's radlo
sLaLlon. Surveys were avallable aL Assembly uays, Lhe annual culLural gaLherlng, as well as
dlsLrlbuLed durlng some afLernoon docLor's cllnlcs ln Lhe walLlng room. lor Lhelr Llme, survey
respondenLs were enLered lnLo a draw for four $30 glfL cards Lo Canadlan 1lre. ln LoLal, 100
surveys were reLurned - 71 from adulLs and 29 from youLh. 1hls represenLs a 10.3 response
raLe ln ChaLeh.

Aoolysls
Lach survey was enLered lnLo Lxcel for daLa organlzaLlon. Slnce Lhe resulLs and number
of respondenLs were manageable for Lhe researcher, closed ended responses were Lallled for
frequency and/or averaged, whlle open-ended responses were coded LhemaLlcally by hand.
8ecause Lhe lssue of LransporLaLlon affecLs many resldenLs of ChaLeh, LransporLaLlon was
overlapped wlLh oLher lssues - such as seeklng care and self-raLed healLh.

koowleJqe 1tooslotloo
CommunlcaLlng Lhe resulLs Lo Lhe communlLy - knowledge LranslaLlon - ls lnLegral Lo
Lhls meLhodology. 1wo posLers were prepared for Lhe communlLy (see Appendlx 3 and 4,
aLLached) as Lhe maln meLhod of knowledge LranslaLlon for communlLy members. 1hey were
made Lo be aLLracLlve and colourful ln order Lo sLand ouL on communlLy bulleLln boards and
were deslgned wlLh llLeracy ln mlnd. AddlLlonally, coples of Appendlces 3 and 4 were lefL aL Lhe
8and Cfflce, PealLh CenLre, and Soclal uevelopmenL, and were replenlshed several Llmes.
8rleflng noLes were dlsLrlbuLed Lo Chlef and Councll as well as PealLh Canada sLaff, whlch
feaLured Lhe 10 recommendaLlons menLloned laLer ln Lhls reporL. 1hls reporL has been glven Lo
Chlef and Councll, Lhe PealLh ulrecLor and Manager, and PealLh Canada sLaff. llnally, ln order
Lo conLlnue Lhe conversaLlon, a focus group gulde was developed for use by PealLh CenLre sLaff
ln Lhe fuLure.

kesu|ts
Ceoetol uemoqtopby
As per llgure 1.0, Lhe age dlsLrlbuLlon was relaLlvely proporLlonal Lo Lhe populaLlon,
wlLh approxlmaLely 40 of respondenLs under Lhe age of 23. 1hls compares Lo Lhe general
uene 1ha' sLaLlsLlc, whereby 40 of Lhe populaLlon are under Lhe age of 19. AddlLlonally,
havlng Lhe sllghL ma[orlLy of respondenLs under Lhe age of 31 means LhaL Lhe dlsLrlbuLlon of
survey respondenLs ls comparable Lo Lhe general llrsL naLlons populaLlon growLh Lrend and age
dlsLrlbuLlon.

llgure 1 - Age ulsLrlbuLlon of Survey 8espondenLs


ln addlLlon Lo age dlsLrlbuLlon, oLher demographlc characLerlsLlcs were recorded such as
gender, locaLlon, and famlly slze. 62 of adulL respondenLs and 61 of youLh respondenLs
ldenLlfled as female. 94 of survey respondenLs llved ln ChaLeh. 73 of respondenLs had klds,
wlLh an average of 3.1 klds per respondenL.

!
#
$!
$#
%!
%#
&'$! $$'$( $)'%& %#'*$ *%'*) *+'&# &,'#$ #%'#) #+',# ,,-
!"# %&'"#(
!"# )*(+,*-.+*/'
./0120345
AdulL-Speclflc 8esulLs
1toospottotloo
WlLh regards Lo LransporLaLlon, 66 - or Lwo-Lhlrds - dld noL own a car or a Lruck. 1hose
who owned a vehlcle (n=24) esLlmaLed Lhe average cosL of gas was $83.13 for a round Lrlp Lo
Plgh Level - Lhe nearesL Lown of over 1,000 people. 1hose who dld noL own a car had varlous
meLhods Lo geL lnLo Lown, ranglng from hlrlng someone Lo relylng on famlly and frlends Lo
hlLchhlklng. Powever, Lhe ma[orlLy (31) hlred a rlde mosL ofLen. 1he cosL Lo hlre ranged from
$80.00 Lo $130.00, wlLh an average cosL of $93.00. Clven Lhe workforce sLaLlsLlcs of Lhe area,
Lhls ls subsLanLlally hlgh, and represenLs a slgnlflcanL barrler Lo healLhy foods and accesslng
oLher servlces.

noosloq ooJ loftosttoctote
Pouslng and lnfrasLrucLure were also a focal polnL of Lhe survey. 1he average home has
2.97 bedrooms, buL 3.03 people llvlng ln lL. uslng Lhe deflnlLlon provlded by SLaLlsLlcs Canada of
a crowded home - where Lhe number of rooms (lncludlng klLchen and llvlng room) ls less Lhan
Lhe number of people - Lhe number of rooms can be generallzed based on Lhe number of
bedrooms LhaL respondenLs provlded plus Lwo, dlvlded by Lhe number of people llvlng Lhere.
uslng Lhls formula, 36 of homes can be deflned as crowded, wlLh an addlLlonal 22 aL
capaclLy (one person per room). 1hls well surpasses Lhe AlberLa and Canadlan average of 3
and Lhe llrsL naLlons average of 17.7 (Lachance eL al., 2009).
Pouslng quallLy ls anoLher lssue LhaL affecLs people ln ChaLeh. ApproxlmaLely 33 of
homes need ma[or repalrs (Lachance eL al., 2009). 60 of respondenLs sald LhaL Lhe quallLy of
walls and doors were poor, whlle Lhe ma[orlLy of respondenLs sald LhaL Lhelr floors, appllances,
LemperaLure, and alr quallLy were elLher falr or poor. When survey respondenLs had an
opporLunlLy Lo provlde furLher deLalls on Lhelr houslng lssues, commenLs ranged. AbouL 36 of
commenLs Louched on mlnor repalrs LhaL would be remedled wlLh general malnLenance,
anoLher 18 spoke of mold, and 21 menLloned Lhe age of Lhelr dwelllng. As survey
respondenLs ofLen noLed, Lhere ls a correlaLlon beLween houslng quallLy and healLh, wlLh one
parLlclpanL sLaLlng LhaL Lhey are worrled abouL klds healLh because of mold ln basemenL."
llnally, one of Lhe mosL lnLeresLlng and conLroverslal lssues ln ChaLeh ls waLer quallLy.
uesplLe a brand new 12-mllllon dollar WaLer 1reaLmenL lanL lnsLalled nexL Lo Lhe PealLh
CenLre ln ChaLeh, only 37 of respondenLs sald Lhelr waLer quallLy was good." 1hls breaks
down Lo roughly Lhe dlsLrlbuLlon of plped vs. clsLern waLer dellvery. Cne respondenL
summarlzed Lhe challenge of havlng clean drlnklng waLer qulLe clearly, sLaLlng LhaL dellvered
waLer quallLy good, buL waLer Lank ls conLamlnaLed, on boll waLer for 4 years, waLer Lank never
cleaned." 8ecause around 100 households are on Lhe clsLern Lank sysLem, Lhelr waLer ls
dellvered vla Lruck once-per-week. 8eyond only havlng a cerLaln amounL of waLer Lo use per
week, waLer Lanks face a number of challenges underground - polluLlon from groundwaLer, Lhe
hlgh waLer Lable, Lhe presence of oll and gas ln Lhe area, Lhe proxlmlLy of clsLerns Lo sewer
Lanks, and Lhe chance of becomlng polluLed Lhrough feces, anlmals, or garbage. ulLlmaLely, Lhe
WaLer 1reaLmenL lanL dld noL provlde as much of a soluLlon Lo waLer quallLy problems as was
anLlclpaLed.


commoolty llvloq
When asked abouL whaL Lhey llked abouL llvlng ln Lhelr communlLy, a number of
responses were recelved. 1hese resulLs were all coded LhemaLlcally. Cne-Lhlrd of respondenLs
llked Lhe people - Lhe famlly, frlends, and supporL sysLems LhaL llvlng ln a small communlLy llke
ChaLeh faclllLaLes. Cne respondenL noLed, lL's awesome, Lhe people ln my communlLy are Lhe
besLesL of Lhe besL people. klnd and carlng. lun Lo be around." AnoLher 30 menLloned
someLhlng abouL culLure, language, or LradlLlons, such as speaklng uene, golng hunLlng or berry
plcklng, or Lhe gaLherlngs and Lea dances LhaL occur ofLen. As one respondenL vouched, ChaLeh
ls Lhe only place l know whlch has horses, dogs, buffalo, bears, fox, ducks, eaLable planLs,
berrles and medlclnal planLs." unforLunaLely, 14 menLloned noLhlng," whlle anoLher 8
chose Lo focus on Lhe negaLlves of Lhe communlLy lnsLead of Lhe poslLlves. Some focused on a
llLLle blL of everyLhlng, such as Lhe communlLy ls good ln a way when nobody drlnks," and l
llke Lhe weekdays buL Lhe weekends are Loo nolsy." uesplLe recelvlng a mlxed bag of
commenLs, Lhe ma[orlLy agreed LhaL ChaLeh offered Lhem someLhlng, from frlends, famlly, and
supporL sysLems, Lo Lhe beauLlful surroundlng area, Lo Lhe culLural acLlvlLles and gaLherlngs,
ChaLeh ls a unlque place Lo llve ln.

neoltb ltoqtoms
8espondenLs were asked Lo llsL Lhe programs and servlces LhaL Lhe PealLh CenLre runs. A
remarkable 33 elLher sald Lhey dldn'L know, sald Lhere were none, or dld noL llsL any
programs aL all. 1he mosL commonly referenced program - menLloned by 14 of respondenLs -
was Lhe lamlly and CommunlLy Wellness program, whlch runs addlcLlons counsellng and
LreaLmenL. lollowlng LhaL, prenaLal and maLernal healLh was broughL up by 10 of parLlclpanLs,
whlle oLher programs (women's group, elder's programs, lmmunlzaLlon, and LransporLaLlon, for
example) were referenced by less Lhan 3 people.
lollowlng belng asked abouL whaL programs are currenLly run, respondenLs had an
opporLunlLy Lo lndlcaLe whaL healLh programs or servlces were mosL lmporLanL Lo Lhem.
1wenLy-four programs made Lhe llsL - from youLh programs Lo domesLlc vlolence awareness Lo
menLal healLh counsellng and resldenLlal school supporL and everyLhlng ln beLween. AddlcLlons
counsellng and LreaLmenL and lmprovlng LransporLaLlon Lo Plgh Level and LdmonLon were Lled
for mosL lmporLanL wlLh 81.1 of respondenLs' vlewlng Lhose challenges as slgnlflcanL Lo Lhem.
1hls was closely followed by 79.7 for culLural programs and 78.2 for abuse and domesLlc
vlolence awareness. Llders programs (76.8) and recreaLlon programs (73.3) round ouL Lhe
Lop flve mosL lmporLanL programs. lnLeresLlngly, some of Lhe programs offered by Lhe PealLh
CenLre - home care and pregnancy supporL, for example - dld noL make Lhe Lop 10 programs,
however Lhey are only lmporLanL Lo a cerLaln proporLlon of Lhe communlLy. uesplLe Lhe walL
Llme ofLen assoclaLed wlLh docLor's cllnlc, decreaslng walL Llmes was only ranked 20
Lh
ouL of 24
programs.

5elf-koteJ neoltb
uslng Lhe LxcellenL-very Cood-Cood-lalr-oor scale, survey respondenLs were asked Lo
raLe Lhelr personal healLh. Compared Lo over 60 of AlberLans and Canadlans and 40 of on-
reserve llrsL naLlons people, only 23.3 raLes Lhelr healLh as very good or excellenL ln ChaLeh.
ln conLrasL, 41 of ChaLeh's resldenLs raLed Lhelr healLh as falr or poor, whlle Lhe remalnder -
33.3 - raLed Lhelr healLh as good. Whlle Lhose who ranked Lhelr healLh as falr or poor were
generally evenly dlsLrlbuLed amongsL Lhe dlfferenL age groups, 33.8 of respondenLs aged 39-
43 raLed Lhelr healLh as falr or poor.
When self-raLed healLh was overlapped wlLh LransporLaLlon, Lhe resulLs suggesLed LhaL
Lhose wlLh a car are more llkely Lo raLe Lhemselves hlgher. 70 of Lhose who raLed Lhelr healLh
as excellenL owned a vehlcle, whlle 71 who raLed Lhelr healLh as poor dld noL own a vehlcle.
Meanwhlle, 46.4 of Lhose who dld noL own a car ranked Lhelr healLh as falr or poor, compared
Lo 34.2 of Lhose wlLh a car. Whlle vehlcle ownershlp can be relaLed Lo socloeconomlc sLaLus -
a deLermlnanL of healLh - Lhe challenges of llvlng wlLhouL a vehlcle are much greaLer ln ChaLeh
(where Lhe nearesL Lown ls over 100 kllomeLers away) Lhan ln an average Canadlan communlLy,
and should be LreaLed accordlngly from a healLh and servlce provlslon perspecLlve.

lomlllol neoltb cbolleoqes
Survey respondenLs raLed Lhe lncldence raLe of 27 dlfferenL healLh challenges ln Lhelr
famlly, asslgnlng a value of 0 for none of Lhelr famlly, 1 for some of Lhelr famlly, and 2 for mosL
or all of Lhelr famlly. All values were lnpuLLed for each challenge (lncludlng zeros) and Lhen
averaged ouL and ranked Lo produce a llsL of Lhe mosL common healLh challenges. llgure 2
ouLllnes Lhe Lop Len mosL pervaslve challenges ln ChaLeh:

llgure 2.0 - PealLh Challenges ln ChaLeh, ranked
Cha||enge Inc|dence kate (Average)
Smoklng or chewlng Lobacco 1.31
AddlcLlon Lo drugs and/or alcohol 1.21
ArLhrlLls 1.208
SLress 1.12
Cral healLh 1
Plgh blood pressure 0.902
uepresslon 0.891
ulabeLes 0.863
ln[urles 0.844
Allergles 0.816

Comparable Lo oLher communlLles and daLa collecLed on llrsL naLlons healLh (see
Lachance eL al., 2009), Lobacco use, addlcLlons, and arLhrlLls are Lhe mosL common healLh
challenges ln ChaLeh. ln conLrasL, epllepsy (0.173), S1ls (0.262), seelng or hearlng Lhlngs LhaL are
noL Lhere (0.30), memory loss (0.323), and Luberculosls (0.349) were Lhe flve leasL common
healLh challenges. Powever, lL should be noLed LhaL respondenLs mosL llkely do noL know abouL
Lhe prevalence of S1ls ln Lhelr famlly, and people may noL be forLhcomlng wlLh lnformaLlon on
Lhelr sexual healLh or Lhey may noL have been recenLly LesLed. 1hls ls reflecLed laLer ln Lhe daLa,
for only 30 of women 18+ have had a pap smear ln Lhe pasL year. Slmllarly, only 12 of men
had a LesLlcular/prosLaLe exam ln Lhe pasL year. As a resulL, lL ls mosL llkely LhaL S1l lncldenL
raLes are underrepresenLed.
WlLh depresslon ranked 7
Lh
, menLal healLh was a recurrlng Lheme ln Lhe daLa. Whlle
hearlng or seelng Lhlngs LhaL are noL Lhere was relaLlvely uncommon (0.30), oLher faceLs of
menLal healLh had a generally hlgh lncldence raLe wlLh depresslon measurlng ln aL 0.891 and
anxleLy aL 0.809. Conslderlng LhaL Lhere are llmlLed opLlons or proacLlve programs for menLal
healLh ln ChaLeh - Lhere ls one reglsLered psychologlsL who mosLly focuses on klds - Lhls ls an
avenue Lo explore wlLh programs and servlces ln Lhe fuLure. AddlLlonally, some survey
respondenLs noLed LhaL a female psychologlsL/counselor would be beneflclal for Lhe
communlLy.

5eekloq cote
8espondenLs were spllL almosL evenly wlLh regards Lo Lhe quesLlon, have you ever felL
llke you needed healLhcare buL dld noL go see a docLor or a nurse?" 47 of respondenLs
answered yes and have noL soughL care, whlle Lhe remalnlng 33 sald Lhey do see a docLor or a
nurse when slck. 8easons for seeklng or refuslng Lo seek care were coded, and flve Lhemes
emerged. 1he mosL common reason was relaLed Lo walLlng, wlLh one respondenL saylng,
When you need Lo see docLor, Lhey Lell nexL week. Pow would l know l wlll be slck nexL
week?" AnoLher key Lheme LhaL emerged was sLaff lssues, such as docLors have no empaLhy or
paLlence Lo properly communlcaLe (llsLen Lo whaL l'm Lelllng Lhem), lL's llke Lhey don'L llke Lhelr
[ob, Lhey [usL rush you ouL," and l came Lo see a nurse and she sald "why do you keep comlng
here?"" 1ransporLaLlon - as prevlously menLloned as a barrler Lo care - was also a clLed reason.
1he remalnlng Lhemes were fear - of blood work or Lhe resulLs - and some respondenLs felL llke
Lhey knew whaL Lo do Lo make Lhemselves feel beLLer when Lhey are slck.

ootb-5peclflc kesolts
?ouLh were asked 10 dlfferenL quesLlons on Lhelr healLh, happlness, educaLlon, and dally
llves, LhaL had closed-ended responses: yes, no, and someLlmes, and an addlLlonal four open-
ended quesLlons on Lhelr hobbles and communlLy. ?ouLh agreed Lhe mosL on school: 83 wenL
Lo school some or all of Lhe Llme, buL only 31 acLually llked school. ln addlLlon, youLh raLed
Lhelr own healLh slmllarly, wlLh 66 answerlng yes Lo Lhe sLaLemenL l am healLhy." 1hls ls
relnforced by Lhe facL LhaL only one youLh sald Lhey dld noL llke frulLs or vegeLables aL all, and
LhaL 69 brush Lhelr LeeLh every day (93 brush every day or someLlmes every day).
uesplLe youLh havlng a hlgh self-raLlng of healLh and good oral healLh, only 41 sald
Lhey wenL Lo a docLor or a nurse when Lhey felL slck. lurLhermore, only 14 of youLh exerclsed
every day. ln parL, Lhls ls relaLed Lo Lhe dearLh of recreaLlonal opporLunlLles ln ChaLeh, Lwo-
Lhlrds agreed LhaL Lhere were noL or only someLlmes enough games or acLlvlLles ln Lhelr
communlLy. Meanwhlle, less Lhan half - 43 - sald Lhey celebraLed Lhelr culLure aL Lhelr school.
llnally, only half sald Lhey were happy, alLhough 41 sald Lhey were happy someLlmes."
Cenerally speaklng, klds have good role models rlghL ln Lhelr home - Lwo-Lhlrds sald Lhey would
go Lo one of Lhelr parenLs lf Lhey needed help, whlle many more sald Lhey had oLher supporL
sysLems llke Lhelr frlends or oLher famlly members.
When asked abouL Lhelr favourlLe hobbles, 69 of youLh menLloned elecLronlc devlces -
vldeo games, Lelevlslon, or Lhelr cell phone - as a hobby. Meanwhlle, only half of LhaL - 34 -
menLloned any ouLdoor acLlvlLy. When asked abouL whaL Lhey would llke Lo be able Lo do ln
ChaLeh, a remarkable 77 menLloned recreaLlon - a playground, skaLe park, or more games
and acLlvlLles, whlle Lhe ma[orlLy of oLher respondenLs (20) sald Lhey would llke Lo be able Lo
do someLhlng" or anyLhlng." ulLlmaLely, boredom affecLs many youLh ln ChaLeh, and should
be addressed accordlngly ln youLh programmlng ln order Lo promoLe harm reducLlon.
llnally, lL ls lmporLanL Lo noLe Lhe prevalence of uene speakers ln youLh. 32 of youLh
surveyed spoke uene, however, only a quarLer could wrlLe lL. More of Lhe older youLh could
speak uene Lhan Lhe younger youLh - 60 of Lhose 11 and up could speak uene, sllghLly hlgher
Lhan Lhe overall proporLlon. neverLheless, as one adulL respondenL menLloned, we sLlll have
our language and culLure, buL we need Lo use lL for our young ones." Clven LhaL Lhe youLh
surveyed speak uene aL a lesser raLe Lhan Lhe communlLy's average (73), language and
culLural programs are evermore lmporLanL now.

Commun|ty Suggest|ons for Improvement
lltst kespooJets
CommunlLy suggesLlons revolved around 4 key Lhemes - llrsL 8esponders,
LransporLaLlon, more workshops/ouLreach, and sLafflng. llrsL 8esponders/9-11 servlce was
menLloned by 12 of respondenLs. Whlle Lhe llrsL 8esponders are Lralned ln Lmergency llrsL
Ald and can call an ambulance or arrange alLernaLlve LransporLaLlon, several communlLy
members do noL feel lL ls enough glven Lhe challenges of geLLlng an ambulance Lo Lhe PealLh
CenLre. As one communlLy member suggesLed, servlce would be lmproved lf Lhey had a real
nurse on call for Lhe weekend and evenlngs. ?ou would geL a nurse lnsLead of a flrsL responder
because Lhey can'L do much for you when you need medlcal LreaLmenL. lL mlghL even save a
llfe." AnoLher respondenL Louched on llfe and deaLh as well when Lhey menLloned, SomeLlmes
flrsL responders do noL answer Lhe phone. ueaLh due Lo lack of response (hearL aLLack)." lL ls
lmporLanL Lo noLe here LhaL Lhe ChaLeh PealLh CenLre has a dlfflculL Llme reLalnlng llrsL
8esponders, as crlLlcal lncldenLs can and do happen. ln LhaL clrcumsLance, especlally ln Lhe case
of a deaLh, communlLy members occaslonally shlfL blame Lo Lhe llrsL 8esponders. Powever, Lhe
blame should fall on lssues relaLlng Lo Lhe LransporLaLlon challenges and locaLlon of ChaLeh.

1toospottotloo
As prevlously menLloned, LransporLaLlon ls a huge barrler Lo accesslng Lhe PealLh
CenLre, and abouL 13 of suggesLlons lnferred LhaL LransporLaLlon should lmprove, such as
glvlng rldes home, dellverlng prescrlpLlons, or regalnlng Lhe pharmacy.

Mote wotksbops/Ootteocb
23 of communlLy members spoke abouL provldlng more workshops, ouLreach, and
programmlng - such as recreaLlon or youLh programs. lor example, dlabeLlcs ln Lhe communlLy
are glven a purchaslng order (C) for food Lo use. As one respondenL sald, l'm dlabeLlc and
Lhey don'L run any programs [usL glve you C for food of 130. Would llke Lo see more
acLlvlLles." Some oLher communlLy members Louched on how lnformaLlon ls communlcaLed. lL
ls common for PealLh CenLre sLaff Lo go on Lhe radlo Lo Lalk abouL programs or lssues LhaL have
arose. Powever, noL everyone llsLens Lo Lhe radlo all day, and when Lhe PealLh CenLre goes on
Lhe radlo lL ls noL ofLen promoLed. As one communlLy member relnforced, brlng MC8L
AWA8LnLSS!!!! 1alklng on Lhe radlo sLaLlon doesn'L counL."

5toffloq
Whlle some suggesLlons were made abouL lncreaslng Lhe overall number of sLaff -
brlnglng more band sLaff [obs ln and hlrlng more docLors, for example - 46 of commenLs
recelved focused on sLaff accounLablllLy and collaboraLlon. CommunlLy members who knew
abouL PealLh CenLre programs had several reasons for noL aLLendlng Lhem, lncludlng LhaL Lhe
programs are of no lnLeresL Lo me because follow Lhrough of sald programs are poorly
organlzed." AnoLher communlLy member remarked LhaL Lhe PealLh CenLre should make
speclflc cholces and follow Lhrough wlLh lL. 8e organlzed and don'L walL unLll Lhe lasL mlnuLe."
1hls lncludes [geLLlng] sLaff lnLo Lhelr rlghL programs Lhey're asslgned Lo and [maklng] Lhlngs
happen," 1LAMWC8k!!!!!," collaboraLlon," and more communlcaLlon beLween people and
nurslng sLaLlon." SLaff aLLlLudes was anoLher Lhlng broughL up by respondenLs, show more
compasslon Lowards publlc," and beware of sLaff famllles pushed flrsL and communlLy less for
servlces." ulLlmaLely, Lhe currenL percepLlon of Lhe PealLh CenLre ls one where dlsorganlzaLlon
and a lack of collaboraLlon are aL Lhe forefronL, lnsLead of Lhe varlous programs and servlces
LhaL Lhe PealLh CenLre does run.

kecommendat|ons
8ased off of Lhe lnformaLlon collecLed ln Lhe CommunlLy PealLh needs AssessmenL, Lhe
followlng 10 recommendaLlons are made:
1. kun the nea|th Centre on a proact|ve - not react|ve - menta||ty.
2. Improve programm|ng for d|abet|cs.
3. kun a shutt|e van to n|gh Leve|.
4. Increase recreat|ona| opportun|t|es for commun|ty members.
S. Lffect|ve|y commun|cate w|th commun|ty members.
6. kega|n pharmacy ||cense.
7. Increase ant|-tobacco programm|ng.
8. Cont|nue to work on co||aborat|on and mora|e among nea|th Centre staff.
9. Cont|nue the conversat|on about hea|th |n Chateh.
10. Increase |nteragency co||aborat|on among the Dene 1ha' I|rst Nat|on.

1. kun the nea|th Centre on a proact|ve - not react|ve - menta||ty.
uue Lo governmenL fundlng and agreemenLs, Lhe number or frequency of docLor vlslLs
are unllkely Lo lncrease aL Lhe ChaLeh PealLh CenLre. As a resulL, proacLlve approaches Lo
healLhcare LhaL recognlze Lhe soclal deLermlnanLs of healLh should be Lhe mlndseL of Lhe
ChaLeh PealLh CenLre sLaff movlng forward. 1he bulldlng has all of Lhe sLaff and space Lo
effecLlvely run programs, however nelLher are belng uLlllzed as efflclenLly or as Lhoroughly as
posslble. Workshops and programs are ofLenLlmes well aLLended when run and organlzed
properly, and can and wlll be successful ln Lhe fuLure. lurLhermore, Lhere should be an
lncreased focus on promoLlng exlsLlng programs Lhrough meLhods oLher Lhan Lhe radlo sLaLlon
(see recommendaLlon 3).
A key example of where proacLlvlLy ls needed ls ln oral healLh. 1he hlgh lncldence raLe of
oral healLh problems such as LooLh decay or cavlLles speaks volumes abouL Lhe quallLy and
llmlLedness of oral healLhcare ln Lhe communlLy. roacLlvlLy should be encouraged aL Lhe
communlLy healLh level. Whlle Lhe ma[orlLy of youLh - 69 - brush Lhelr LeeLh every day,
geLLlng lnLo Lhe schools Lo Lalk abouL oral healLh, conducLlng workshops on oral healLh for
adulLs and glvlng ouL free LooLhbrushes and LooLhpasLe aL communlLy evenLs needs Lo be
furLher promoLed. AnoLher proacLlve approach Lo promoLlng oral healLh ls Lhrough Leachlng
youLh and adulLs abouL meal plannlng and healLhy foods, as well as servlng healLhler foods aL
communlLy evenLs.

2. Improve programm|ng for d|abet|cs.
1he currenL sysLem for dlabeLlcs does noL ensure LhaL dlabeLlcs are maklng healLhy food
cholces. ulabeLes was ln Lhe Lop Len for mosL common healLh challenges, wlLh an average of
0.863. uesplLe Lhe hlgh presence of dlabeLes ln ChaLeh's famllles - and on reserve ln general -
less Lhan half (47) have had a blood LesL for dlabeLes. As a resulL, dlabeLes programs should
focus more on LesLlng, prevenLlon, and educaLlon Lo reduce Lhe lncldence raLe of dlabeLes.
Cne avenue Lo explore ls Lhrough Lhe creaLlon of communlLy food baskeLs for dlabeLlcs.
CurrenLly, Lhe uene 1ha' CommunlLy School recelves food shlpmenLs weekly from Calahoo
MeaLs, and agreed LhaL lf we pald for Lhe addlLlonal shlpplng charges LhaL we could order food
Lhrough Lhelr orderlng sysLem. As shown ln llgure 3.0, a sample baskeL and cosL ls ouLllned
below.

llgure 3.0 - ulabeLes lood 8askeL CosL
Iood Item uant|ty (tota|) er person breakdown Cost
8uLLer 30 lbs 1 lb $261.38
?ogurL 48 conLalners 173 g $42.08
Cereal, bran 48 boxes 670 g $268.16
asLa sauce 48 cans 400 mL $68.48
Corn, canned 48 cans 400 mL $34.68
asLa, spagheLLl 80 lbs 1.3 lbs $72.16
Lggs, large 30 dozen, dlvlded 7 eggs $88.10
Salad dresslng 400 packs, 18mL 8 packs $34.40
8read, whole wheaL 30 loaves 1 loaf $106.00
Cround beef 30 lbs 1 lb $203.00
Apples 80 lbs 2-3 apples $87.88
Crapes 36 lbs small bunch $74.34
8omalne leLLuce 60 heads 1 head $107.82
8aked poLaLoes, foll 100 2 $43.80
Cranges 80 lbs 2-3 oranges $82.34
=1617.02 x 2 (Lwlce
monLhly) = 3234.04
D|abetes 1ota| Iood 8udget - 3,7S0 a month (S0 d|abet|cs x 57S]month)

llgure 3.0 shows LhaL uslng Lhe money glven dlrecLly Lo dlabeLlcs - recenLly reduced Lo
$73 - Lo buy bulk amounLs of fresh food and dlsLrlbuLlng food bags baskeLs blweekly could be a
more effecLlve and cosL-efflclenL way Lo ensure dlabeLlcs' food needs are meL. 1hls provldes
dlabeLlcs wlLh access Lo healLhy foods wlLhouL oLher barrlers, such as LransporLaLlon.

3. kun a shutt|e van to n|gh Leve|.
When overlapped wlLh seeklng care and self-raLed healLh, access Lo LransporLaLlon
affecLs ChaLeh's adulLs and youLh lmmensely. CommunlLy members are paylng ln excess of 80
dollars [usL Lo be able Lo geL Lo Lown Lo geL healLhy foods for Lhelr famllles. lL ls proposed LhaL
Lhe PealLh CenLre operaLe a shuLLle uslng Lhelr 13-passenger van on key daLes LhroughouL Lhe
monLh such as when lncome AsslsLance and penslon cheques go ouL and band sLaff payday. ln
order Lo subsldlze Lhe cosL of gas, Lhe PealLh CenLre could charge $10 - $20 dollars per Lrlp.

4. Increase recreat|ona| opportun|t|es for commun|ty members.
1here ls currenLly no dlrecL fundlng for recreaLlon aL Lhe PealLh CenLre. Powever,
recreaLlonal opporLunlLles and regular exerclse are noL only deLermlnanLs of healLh, buL also acL
Lo combaL addlcLlons and menLal healLh challenges. 1hls pasL summer, communlLy baseball was
a hlL and aLLracLed many people Lo ChaLeh's CommunlLy 8all ark. Movlng forward, Lhls needs
Lo conLlnue year round. 1here are also llmlLed opporLunlLles for Llders Lo geL LogeLher ln
ChaLeh, and as a resulL Llders programs - wlLh LransporLaLlon provlded - should be
emphaslzed.

S. Lffect|ve|y commun|cate w|th commun|ty members.
Whlle Lhe radlo does reach ouL Lo mosL communlLy members, some are sLlll lefL behlnd.
lL ls recommended LhaL Lhe ChaLeh PealLh CenLre creaLe a lacebook group Lo communlcaLe
evenLs, programs, and cancellaLlons, as well as provlde a space for people Lo organlze
Lhemselves (for example, people can posL and see lf anyone else wanLs Lo play baseball and
Lhen slgn ouL Lhe equlpmenL). Whlle lnLerneL ls noL always avallable for all communlLy
members, many have lnLerneL avallable on Lhelr phones, especlally Lhe youLh. uslng a Lool llke
lacebook wlll connecL Lhe communlLy furLher and provlde anoLher way for Lhe PealLh CenLre Lo
promoLe programs and acLlvlLles.

6. Work towards rega|n|ng pharmacy ||cense.
1he currenL sysLem Lo send and recelve prescrlpLlons ls cosLly and lneffecLlve, especlally
glven LhaL Lhe PealLh CenLre has a pharmacy wlLhln lL slLLlng unused. 1wo-Lhlrds of ChaLeh's
resldenLs do noL have access Lo a vehlcle, presenLlng challenges noL only Lo geLLlng Lo Lhe
PealLh CenLre buL also lnLo Plgh Level. CfLenLlmes when a prescrlpLlon ls requlred, Lhe paLlenL
goes home and cannoL geL back Lo Lhe PealLh CenLre Lo plck lL up, whlch may make Lhem slcker,
mean Lhey are more suscepLlble Lo compllcaLlons, or render Lhe prescrlpLlon lneffecLlve. ln Lhe
case of lmmedlaLe danger - such as a baby or lnfanL belng lll - Lhe prescrlpLlon Lurn around
Llme ls lnadequaLe Lo address Lhe healLh of Lhe paLlenL. lf prescrlpLlons were lnsLanLaneous - as
ls Lhe case ln mosL oLher remoLe communlLles - Lhere would be no paLlenL Lurn around, and
money would be saved from Lhe LransporLaLlon of prescrlpLlons never geLLlng plcked up or
havlng Lo be redone. lL ls recommended LhaL Lhe pharmacy wlll regaln lLs llcense and keep
emergency medlcaLlons, medlcaLlon for klds, and conLracepLlves on hand, Lo beLLer lmpacL Lhe
healLh of ChaLeh's resldenLs.
7. Increase ant|-tobacco programm|ng.
Smoklng or chewlng Lobacco ls Lhe blggesL healLh challenge ln ChaLeh. Powever, Lhere
are llmlLed anLl-smoklng posLers or workshops ln Lhe communlLy or ln Lhe PealLh CenLre.
lncreaslng awareness and slgnage of smoklng-relaLed healLh challenges ls recommended.

8. Cont|nue to work on co||aborat|on and mora|e among nea|th Centre staff.
As shown ln Lhe PealLh needs AssessmenL, Lhe communlLy can feel Lenslon and a lack of
communlcaLlon and collaboraLlon ln Lhe PealLh CenLre. lL ls lmporLanL LhaL PealLh CenLre sLaff
can supporL each oLher as lL ls a very challenglng, rewardlng, and hearL-wrenchlng fleld Lo work
ln. lncreaslng morale Lhrough regular sLaff meeLlngs and communlLy meals as well as furLher
Lralnlng ln confllcL resoluLlon, Leamwork, and collaboraLlon ls recommended.

9. Cont|nue the conversat|on about hea|th |n Chateh.
1he PealLh needs AssessmenL ls one Lool ln Lhe Loolbox of communlLy healLh ln ChaLeh.
ulLlmaLely, Lhere ls sLlll much more work Lo do so LhaL Lhe communlLy's healLh needs are meL
and ChaLeh becomes healLhy. lL ls recommended LhaL Chlef and Councll, Lhe PealLh ulrecLor,
Lhe PealLh Manager, and PealLh Canada sLaff conLlnues Lo Lalk abouL healLh challenges ln
ChaLeh. 1hls lncludes furLher conversaLlons aL Lhe communlLy healLh level - Lhrough focus
groups, for example - as well as Lhe developmenL of a SLraLeglc lan for Lhe PealLh CenLre Lo
move forward wlLh.

10. Increase |nteragency co||aborat|on |n the Dene 1ha' I|rst Nat|on.
CurrenLly, lnLeragency collaboraLlon ls done Lhrough Chlef and Councll, as each
councllmember holds a cerLaln porLfollo. Powever, lncreaslng programs and opporLunlLles for
communlLy members needs Lo be looked aL and Lalked abouL by oLher agencles. An example of
Lhls ls uLlllzlng Lhe uene 1ha' CommunlLy School, Lhe school has beauLlful gym faclllLles LhaL
could be used for adulL open gyms or Lo provlde a space for chlldren's programs afLer school. 8y
lncreaslng lnLeragency collaboraLlon, Lhese conversaLlons are bound Lo happen, and healLh wlll
be lmproved accordlngly.





uene 1ha' llrsL naLlon
!"##$%&'( *+,-'. /++01 211+11#+%' 3$45+( !"# %&'()*
name: _________________________________________
hone number C8 e-mall: _________________________________________

"#$%& '$%('$%) *$++%,-&.
1. 6.&7. 7"##$%&'( 0" ("$ -&5+ &%? lease clrcle. 8ushe ChaLeh Meander
2. 6.,' &1 ("$4 8+%0+4? Male lemale
3. *"9 "-0 ,4+ ("$?
18 - 24 23 - 31 32 - 38 39 - 43 46 - 31 32 - 38 39 - 63 66+
4. :" ("$ .,5+ ;&01? ?LS nC lf yes, ."9 #,%(? _________
3. :" ("$ "9% , 7,4 "4 '4$7;? ?LS nC
lf (+1, how much does a Lrlp Lo Plgh Level and back cosL (ln gas)? _____________
lf %", how do you usually geL ln Lo Lown?_____________________________________________
6. <% ("$4 ."#+= ."9 #,%( >+04""#1 ,4+ '.+4+? _______
7. *"9 #,%( @+"@-+ 4+8$-,4-( -&5+ &% ("$4 ."$1+ A&%7-$0&%8 ;&01B? _______
8a. <% ("$4 ."#+= ."9 9"$-0 ("$ 4,'+C (please clrcle)
WaLer quallLy: CCCu lAl8 CC8
Alr quallLy: CCCu lAl8 CC8
CondlLlon of walls and doors: CCCu lAl8 CC8
CondlLlon of floors: CCCu lAl8 CC8
CondlLlon of appllances (refrlgeraLor, sLove): CCCu lAl8 CC8
1emperaLure (furnace): CCCu lAl8 CC8
CLher concerns or more deLall: __________________________________________________________
____________________________________________________________________________________
9. 6.,' 0" ("$ -&;+ ,>"$' ("$4 7"##$%&'(?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
10. 6.,' @4"84,#1 ,%0 1+45&7+1 0" '.+ *+,-'. !+%'4+ "4 /$41&%8 3','&"% 4$%?
____________________________________________________________________________________
____________________________________________________________________________________
*$++%,-&. /012&3

6.&7. "D '.+ D"--"9&%8 7"##$%&'( .+,-'. 7.,--+%8+1 ,4+ #"1' &#@"4',%' '" ("$? Aplease checkB
___Abuse and domesLlc vlolence awareness
___Accesslng healLh speclallsLs
___AddlcLlons counsellng and LreaLmenL
___Chlldren's programs (1-7 years old)
___CulLural programs
___uecreaslng PealLh CenLre walL Llmes
___uleL and exerclse counsellng
___LducaLlon/llLeracy programs
___Llders programs/care
___lamlly programs (parenL(s) and chlldren)
___llrsL responders and emergency servlces
___Pome Care
___lmmunlzaLlon
___lmprovlng healLh LransporLaLlon Lo Plgh
Level or LdmonLon
___lmprovlng Lhe quallLy of drlnklng waLer
___Language programs
___MenLal healLh counsellng
___regnancy supporL
___8ecreaLlonal programs (organlzed sporLs)
___8esldenLlal school counsellng/supporL
___Sexual healLh awareness
___?ouLh programs (8-24 years old)
CLher: _________________________________

444444444444444444444444444444444444444444444*%& 30)0 &$ #0 0,&0)05 -, &30 5)167444444444444444444444444444444444444444444444
uene 1ha' llrsL naLlon
!"##$%&'( *+,-'. /++01 211+11#+%' 3$45+( !"# %&'()*
name: _________________________________________
hone number C8 e-mall: _________________________________________
!"#$%&'( *"'(+,

1. *"6 6"$-0 ("$ 4,'+ ("$4 .+,-'.7 lease clrcle your response.

LxcellenL very Cood Cood lalr oor

use Lhe followlng scale when respondlng Lo Lhe quesLlon below:

0 1 2
/"%+ of My lamlly 3"#+ of My lamlly 8"1' of My lamlly

2. 9% ("$4 &##+0&,'+ :,#&-(; ."6 #,%( <+"<-+ ,4+ ,::+='+0 >( '.+1+ .+,-'. =.,--+%?+17

___AddlcLlon (Lo alcohol or
drugs)
___AddlcLlon (Lo medlcaLlon or
prescrlpLlons)
___Allergles
___AnxleLy
___ArLhrlLls
___AsLhma
___uepresslon
___ulabeLes
___Lczema/skln problems
___Lpllepsy
___LyeslghL loss
___Pearlng loss
___Pearlng or seelng Lhlngs
LhaL aren'L Lhere
___PearL problems
___Plgh blood pressure
___Plgh cholesLerol
___ln[urles (spralns, broken
bones)
___Memory loss
___MoblllLy problems (dlfflculLy
walklng or movlng)
___Cral healLh (LooLh decay,
paln)
___Sexually 1ransmlLLed
lnfecLlons (S1ls)
___Smoklng or chewlng
Lobacco
___SLress
___SLroke
___18
___unexplalned paln or
dlscomforL
___ WelghL problems


@ A /"%+ of my famlly

B A 3"#+ of my famlly

C A 8"1' of my famlly





CLher challenges ln your famlly: _________________________________________________________

3. 1he followlng quesLlons requlre you Lo answer (+1, %", 0"%D' E%"6, or %+5+4. Clrcle your response.
- Pave you ever had a >-""0 '+1' for 0&,>+'+1? ?LS nC uCn'1 knCW
F"4 #+%,
ln Lhe pasL year, have you had a '+1'&=$-,4 or <4"1','+ +G,#? ?LS nC nLvL8 uCn'1 knCW
F"4 6"#+%,
ln Lhe pasL year, have you had a >4+,1' +G,#H#,##"?4,#? ?LS nC nLvL8 uCn'1 knCW
ln Lhe pasL year, have you had a <,< 1#+,4? ?LS nC nLvL8 uCn'1 knCW
-"&"#'( *"'(+, ./"$+0%&$
1. *,5+ ("$ +5+4 :+-' -&E+ ("$ %++0+0 .+,-'. =,4+ >$' 0&0 %"' ?" 1++ , 0"='"4 "4 %$41+7 ?LS nC
lf (+1; why?: _______________________________________________________________________
__________________________________________________________________________________
2. *"6 ="$-0 .+,-'. 1+45&=+1 &#<4"5+ &% ("$4 ="##$%&'(7
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
1hank you for Laklng Lhe Llme Lo compleLe Lhls survey. uon'L forgeL Lo enLer Lhe raffle!
uene 1ha' llrsL naLlon
!"##$%&'( *+,-'. /++01 211+11#+%'
!"#$% '(% )*+," -+./01



1. Pow old are you? ______ Are you male or female? _______________

2. Where do you llve? (lease clrcle) 8ushe ChaLeh Meander

3. ln your oplnlon, clrcle Lhe smlley face LhaL answers Lhe quesLlon.
no SomeLlmes ?es

l am happy.
! " #

We celebraLe my culLure aL my school.
! " #

l exerclse every day.
! " #

1here are enough games and acLlvlLles for klds ln my communlLy.
! " #

l am healLhy.
! " #

l llke eaLlng frulLs and vegeLables.
! " #

l go Lo school.
! " #

l llke school.
! " #

l brush my LeeLh every day.
! " #

l see a docLor or a nurse when l am slck.
! " #

4. WhaL do you do ln your spare Llme (when you are noL ln school)?
____________________________________________________
____________________________________________________

3. WhaL do you llke abouL your communlLy (8ushe, ChaLeh, or Meander)?
____________________________________________________
____________________________________________________
____________________________________________________

6. WhaL would you llke Lo be able Lo do ln your communlLy?
____________________________________________________
____________________________________________________

7. lf you needed help, who would you go Lo? Why?
____________________________________________________
____________________________________________________

8. uo you speak uene? lease clrcle. ?LS nC

9. uo you wrlLe uene? ?LS nC