Page - 386 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE386 one-quarter (23.1%) of First Nations peoples on reserves live in crowded housing, and 44.2% live in houses needing major repairs.17 It is well established that overcrowding and substandard housing lead to poor health outcomes.18 In the context of the COVID-19 pandemic, crowded housing with poor air circulation would facilitate the trans- mission of the virus and prevent First Nations families from comply- ing with physical distancing recommendations.19 Moreover, housing shortages on and off reserves for low income First Nations families, combined with public health directives on con- finement, increase the risk faced by First Nations women and chil- dren, who are disproportionately affected by domestic, physical, and sexual violence, notably as a result of the intergenerational trauma induced by sexist and patriarchal colonial laws and policies.20 The harm for women and children is heightened by the dire lack of safe houses and shelters on reserves21 and long-standing inequities in the funding of child welfare services.22 Furthermore, First Nations peoples are more likely to develop complications from COVID-19 due to the prevalence within their communities of chronic diseases considered as risk factors, includ- ing diabetes and severe asthma. Yet the capacity of First Nations communities to prevent SARS-CoV-2 infections and address related complications are considerably reduced by unequal access to health care services.23 Many First Nations communities lack access to health 17. Statistics Canada, Census in Brief. The  Housing  Conditions  of  Aboriginal  peo- ple in Canada, Catalogue No 98-200-X2016021 (Ottawa: Statistics Canada, 25 October 2017); OAG 2011, supra note 10 at paras 4.35-4.45. 18. UNHRC, supra note 1 at 1. 19. Ibid. 20. MMIWG, supra note 11 at vol. 1a, 229-307, 319; Native Women’s Association of Canada (NWAC), “NWAC President Says COVID-19 is Increasing Violence Against Indigenous Women, Says Government Must Release an Action Plan”, NWAC  News  &  Press  Releases (7 May 2020), online: NWAC <www.nwac.ca/nwac- president-says-covid-19-is-increasing-violence-against-indigenous-women- says-government-must-release-an-action-plan/>; Teresa Wright, “Violence against Indigenous Women during COVID-19 Sparks Calls for MMIWG Plan”, CTV News (10 May 2020), online: <www.ctvnews.ca/canada/violence- against-indigenous-women-during-covid-19-sparks-calls-for-mmiwg-plan- 1.4932833>. 21.  MMIWG, supra note 11 at vol 1b, 149. 22. Marina Sistovaris et al, Child  Welfare  and  Pandemics:  Literature  Scan (Toronto: Policy Bench, Fraser Mustard Institute for Human Development, University of Toronto, 2020). 23. Canada, House of Commons, The  Challenges  of  Delivering  Continuing  Care  in  First  Nations Communities: Report  of  the  Standing  Committee  on  Indigenous  and  Northern