Falling Through the Cracks

Falling Through the Cracks: Systemic Drivers of Urban Indigenous Health Disparities in St. John’s, Newfoundland & Labrador (March 2026) examines how systemic factors continue to shape unequal health outcomes for Indigenous people living in St. John’s and the surrounding Census Metropolitan Area. While Indigenous health disparities are often associated with rural or remote communities, this report highlights that inequities in urban settings are just as urgent and are frequently overlooked.

Drawing on demographic context and research evidence, the report explores how the social determinants of health, systemic racism, and jurisdictional ambiguity contribute to gaps in access to care and fragmented services. It also points to proven Indigenous-led and culturally grounded models of care elsewhere in Canada and identifies the need for coordinated policy responses grounded in cultural safety, trauma-informed care, and Indigenous leadership in urban settings.