FASD & the Justice System

Disparity in FASD-related health outcomes in Indigenous communities

According to Statistics Canada, in 2016 there were 94,400 people who are Indigenous living in the Atlantic provinces of Canada (Newfoundland-Labrador, Nova Scotia, New Brunswick, and Prince Edward Island). Using the recent general population prevalence estimate of 3.6%, we can project that approximately 3400 Aboriginal people in Atlantic Canada need FASD health services at this time. However, in 2011, there were only 10 diagnostic slots in Atlantic Canada. Subsequently, with the opening of the New Brunswick FASD Centre of Excellence, capacity increased to approximately 30; but most of these diagnostic slots do not serve the Indigenous population. 99% of the Indigenous population affected by FASD in Atlantic Canada do not have access to FASD health services in terms of diagnosis and disability accommodations treatment.  Similar limitations on access to diagnostic services are found across Canada.

The disadvantage faced by an Indigenous person with an FASD disability is exacerbated by the already significant gap they have to traverse in health, education, housing, and all other determinants of health. According to the 2014 UN report of the Human Rights Council:

The health of First Nations, Inuit, and Métis people in Canada is a matter of significant concern….significant gaps still remain in health outcomes of aboriginal as compared to non-aboriginal Canadians, including in terms of life expectancy, infant mortality, suicide, injuries, and communicable and chronic diseases such as diabetes. The health situation is exacerbated by overcrowded housing, high population growth rates, high poverty rates and the geographic remoteness of many communities, especially Inuit communities in the north.

Socio-economic status is one of the biggest risk or protective factors identified in people who are diagnosed with FASD. Researchers compared the offspring of upper middle class and lower class women. The study population all had chronic drinking problems and similar prenatal alcohol consumption when pregnant yet the incidence of FAS in offspring was 4.5% for upper-middle class mothers vs. 70.9 % for lower-middle class mothers. There were significant differences in rates of intellectual deficiency but also in areas that could not be attributed to post-natal environment, such as a significant reduction in head circumference and growth, as well as increased congenital malformations.