Lyana Patrick | University of British Columbia (original) (raw)

Papers by Lyana Patrick

International journal of indigenous health, Mar 17, 2024

This paper reports on findings from a collaborative, communitybased project that worked to establ... more This paper reports on findings from a collaborative, communitybased project that worked to establish partnerships between re-Urban Indigenous health searchers at Simon Fraser University and Indigenous community Connection to Land members and organizations in Surrey, British Columbia. In Metro Indigenous determinants of health Vancouver, Surrey saw the biggest increase in its Indigenous pop-Impacts of COVID-19 ulation, which grew 77 per cent between 2006 and 2016 to 13,460. This was a timely project given that traditional health and social service models geared towards Indigenous populations tend to focus on on-reserve populations. The research aimed to look at the following: 1) to identify the health needs and priorities of Indigenous peoples in Surrey; 2) to determine what methodologies should be used when researching culture and health; 3) and to explore how existing data connected to Surrey's Indigenous population can be accessed to better align research priorities with the health status of Indigenous peoples in Surrey. Findings from the project included: the importance of culturally safe care and support in health and social service systems; the need for training and education among health and social service providers on the history and contemporary experiences of Indigenous peoples; and the importance of having access to Elder-led cultural teachings and land-based activities that support health and wellbeing of families and communities.

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Research Square (Research Square), Oct 30, 2023

Historical and ongoing colonial violence, racism, discrimination, criminalization, and intergener... more Historical and ongoing colonial violence, racism, discrimination, criminalization, and intergenerational trauma continues to impact the health of Indigenous women (cisgender and transgender) and Two-Spirit Peoples. Previous and ongoing work clearly articulate the deeply harmful roles of colonialism and racism in continuing to systemically exclude Indigenous Peoples from accessing equitable and culturally safe healthcare. While the COVID-19 pandemic has ampli ed structural inequities, little attention has been paid to how the pandemic impacts healthcare access for Indigenous women and Two-Spirit Peoples living in urban settings. The aim of this study was to evaluate factors associated with experiencing di culty accessing routine healthcare in a cohort of marginalized urban Indigenous women and Two-Spirit Peoples on the ancestral, occupied territories of the Musqueam, Squamish and Tsleil-Waututh Nations in what is now referred to as Metro Vancouver, Canada during the COVID-19 pandemic. Methods Data were drawn from AMPLIFY, a study of Indigenous cis and trans women and Two-Spirit Peoples in Metro Vancouver. Analyses drew on baseline and semi-annual questionnaire data collected with sex workers and women living with HIV from October 2020-August 2021. We used bivariate and multivariable logistic regression with generalized estimating equations (GEE) to model correlates of experiencing di culty accessing a family doctor, nurse, or clinic for routine healthcare during the COVID-19 pandemic in the last 6-months. Results Amongst 142 marginalized Indigenous women and Two-Spirit Peoples (199 observations), 27.5% reported di culty accessing routine healthcare. In multivariable GEE logistic regression, participants who had ever been pregnant (AOR:4.71, 95% CI:1.33-16.66) experienced negative changes in psychological and emotional wellbeing (AOR: 3.99, 95% CI: 1.33-11.98), lacked access to culturally safe health services (AOR:4.67, 95% CI:1.43-15.25), and had concerns regarding safety or violence in their community (AOR:2.72, 95% CI:1.06-6.94) had higher odds of experiencing recent di culty accessing routine healthcare. Discussion Findings are in line with the BC Commissioned In Plain Sight report which recommends the need for accessible, culturally safe, anti-racist, and trauma-informed routine healthcare for marginalized Indigenous cisgender and transgender women and Two-Spirit Peoples during the current and future pandemics. More community-based research is needed to understand access needs for culturally safe routine healthcare amongst marginalized Indigenous cisgender and transgender women and Two-Spirit Peoples. The COVID-19 pandemic has impacted social and structural health inequities for Indigenous[1] women, Two-Spirit[2] Peoples, and people with marginalized and minoritized sexual and or gender identities, including, lesbian, gay, bisexual, pansexual, asexual, transgender, non-binary, gender uid, and queer +. Indigenous cisgender and transgender women continue to face multiple layers of ongoing discrimination, criminalization and intergenerational trauma (1). Ongoing colonial violence and gender-based violence continues to impact the health and well-being of Indigenous women, Two-Spirt Peoples, sex workers, and women living with HIV (2-6). Historical and ongoing colonial violence has impacted Indigenous health and Indigenous women Two-Spirit Peoples, women living with HIV, and sex workers face multiple barriers to accessing reliable healthcare services (7) and people with marginalized and minoritized gender identities face increased barriers to accessing healthcare on the ancestral, occupied territories of the Musqueam, Squamish, and Tsleil-Waututh Peoples in what is now referred to as Vancouver (8, 9). Barriers that impact health access are rooted in racism and discrimination. In Canada, racism remains a key determinant of health and signi cantly impacts Indigenous Peoples access to non-Indigenous-led health services and is well documented in reports such as the British Columbia (BC) Commissioned In Plain Sight report (7, 10, 11). The impacts of the COVID-19 pandemic have left gaps in knowledge that are not only essential to address now but also in preparation for future pandemic planning in the health system. Structural health inequities, including, access to healthcare services and community-based services (10, 12-15), gender-based violence (16, 17), and mental health disparities (14, 18, 19) have been impacted by the COVID-19 pandemic (20), yet little is known about marginalized Indigenous cisgender and transgender women and Two-Spirit Peoples access to routine healthcare services during the pandemic. The COVID-19 pandemic further magni ed existing health inequities that disproportionately impacts the health and well-being of Indigenous women and Two-Spirit Peoples (6, 10, 21). Sex workers and women living with HIV have been affected by the COVID-19 pandemic facing loss of income and lack of access to outreach services as well as stigmatization and harassment by governments and police (22, 23). Gendered impacts of COVID-19 include increased economic insecurity, unplanned pregnancy, lack of access to health services, domestic violence, lack of women's voice and agency, and mental health issues (6, 12, 15, 24). The impacts are particularly felt by racialized groups that are marginalized by social and structural inequities, including Indigenous women and Two-Spirit Peoples. Due to COVID-19 pandemic lockdowns, mandated social distancing, and fear of the virus, there has been a signi cant increase in psychological and emotional stress (6, 18, 25-27). Marginalized Indigenous women and Two-Spirit Peoples face intersecting and compounding forms of oppression, and we hypothesize that psychological and emotional stress may further impact healthcare access and utilization. Considering how the intersection of gender and Indigeneity impact access to healthcare, gender diverse[3] and Two-Spirit populations face mental, physical, and sexual health disparities (28) as well as high rates of racism, stigma, and discrimination from healthcare providers that impact their access to healthcare services (24, 29, 30). Sex workers and women living with HIV who identify as a minority gender face increased barriers to accessing healthcare in Vancouver, BC (9, 31). The COVID-19 pandemic has impacted gender diverse populations access to healthcare services and gender-a rming care, including higher rates of violence and victimization (24). Our understanding of access to healthcare and the impacts of the COVID-19 pandemic among Two-Spirit and gender diverse Indigenous Peoples remains limited. Responsive and culturally appropriate research is needed to address the lack of understanding of the health inequities that Two-Spirit and gender diverse Indigenous Peoples face, as well as the reclamation of their healing.

Social Sciences

This article centers on the nonprofit landscape in Vancouver, Canada, a city that occupies the te... more This article centers on the nonprofit landscape in Vancouver, Canada, a city that occupies the territories of the xʷməθkʷəy̓əm (Musqueam), sḵwx̱wú7mesh (Squamish), and səlilwətaɬ (Tsleil-Waututh) nations, which have never been ceded to the colonial occupation of Canada. Vancouver has a competitive nonprofit field, with an estimated 1600+ nonprofits operating within city limits. This descriptive review starts by defining what a nonprofit industrial complex (NPIC) is, then outlines an abbreviated history of the nonprofit sector on the aforementioned lands. The article then explores issues related to colonialism, anti-poor legislation, neoliberal governance, the fusing of the public and private sectors, and the bureaucratization of social movements and care work as mechanisms to uphold the status quo social order and organization of power. Focusing on under-examined issues related to the business imperatives of nonprofit organizations in the sectors of housing, health and social servic...

From its 19 th century origins, the modern western idealization of community planning has been ab... more From its 19 th century origins, the modern western idealization of community planning has been about social justice, including the health and well-being of people and their environment, from the "garden cities" of the late 19 th century to today's healthy built environment work. But there has always been a dark side to this ideal. In North America, sociolegal frameworks were developed that deployed the language of "health" and "hygiene" to exclude specific groups of people from cities and towns. Indigenous peoples whose ancestral lands were adjacent to towns and cities were dispossessed of their territories and became the target of colonial bylaws that sought to criminalize their presence in urbanizing areas. Bringing together the fields of public health, planning and Indigenous studies, my research sought to understand how Indigenous experiences of health in urban areas have been discursively framed by colonization and continually impacted through settler colonialism. This case study explored how urban Indigenous community planning might be conceptualized at the nexus of health and justice in the work of one urban Indigenous organization, the Native Courtworker and Counselling Association of BC (NCCABC). Through an examination of the dayto-day labours of frontline workers, I answered my primary research question: In what ways do the resurgent practices of NCCABC relate to the emerging theory and practice of Indigenous community planning? Information was gathered through immersive participation, interviews, a talking circle, and document analysis in four primary sites of study: NCCABC Health Services in downtown Vancouver, NCCABC Prince George office, and First Nations Courts in New Westminster and North Vancouver. I want to thank the Native Courtworker and Counselling Association of BC (NCCABC) who patiently let me sit in on meetings, trainings, events, workshops and countless circles over many years. In particular, I thank the health team in Vancouver and Native Courtworkers in Prince George. I thank the Native Courtworkers who graciously gave their time for an interview, and all those I talked with informally and who provided important context, history and insights into NCCABC's work. I give special thanks to the clients and community members who spoke with me, who shared their stories, and who I was fortunate to sit with in circle. I have been inspired by so many friends, colleagues and mentors that I've been fortunate to meet throughout my years working at UBC and in the broader community. I hope that this dissertation resonates with the good work that you all do. Thank you to Leah Walker, James Andrew, Evan Adams, and Betty Calam for welcoming me into the field of Indigenous health and inspiring me to find unique ways to approach health and well-being. Thank you to Linc Kesler and Alannah Young who I first met at the First Nations House of Learning. Thank you to the Indigenous staff and faculty who continue to create spaces of safety and belonging for Indigenous students on campus. I'm grateful for the amazing work of the DUDES Club and the DUDES members all across BC. Many thanks to Paul Gross and Sandy Lambert for expanding my understanding of Indigenous men's health and community. Henry Charles is watching us all with a smile from the next world. I am so grateful to Genevieve Leis for setting me on the path with my research partner, and for your friendship and support through the years. To the friends and colleagues I have met through my studies at UBC, thank you for your friendship, guidance, laughter, music, and generally making me feel sane. Thanks to my cohort, Magdalena Ugarte and Jacopo Miro (and Jessica Hallenbeck who started out with us!). Thank you to the many cohorts of Indigenous Community Planning students. Thank you to Kate

Journal of Planning Education and Research, Nov 13, 2015

Lemon, Jim. 1996. Liberal Dreams and Nature’s Limits: Great Cities of North America since 1600. T... more Lemon, Jim. 1996. Liberal Dreams and Nature’s Limits: Great Cities of North America since 1600. Toronto: Oxford University Press. McLuhan, Marshall. 1964. Understanding Media: The Extensions of Man. Toronto: Oxford University Press. Relph, Edward. 2014. Toronto: Transformations in a City and Its Region. Philadelphia: University of Pennsylvania Press. Rheingold, Howard. 2003. Smart Mobs: The Next Social Revolution. New York: Basic Books. Sewell, John. 2009. The Shape of the Suburbs: Understanding Toronto’s Sprawl. Toronto: Toronto University Press.

Background Students in the Faculty of Dentistry at the University of British Columbia have articu... more Background Students in the Faculty of Dentistry at the University of British Columbia have articulated challenges in understanding learning objectives in their oral epidemiology and statistics course. This study aimed to measure the impact of a course renewal intended to enhance student learning. Examples of educational interventions included providing more time for activities, increasing student interactivity, and integrating more hands-on applicable exercises using statistical software. Methods An online mixed-methods survey using a 5-point Likert scale and open-ended questions was distributed to 43 dental hygiene students before the course renewal and again to a second cohort of 43 students after course revisions. The survey asked students to rank their levels of challenge and self-confidence in learning 23 of the course objectives throughout each academic year. Four semi-structured interviews were also conducted with faculty and staff members involved in teaching or coordinating this course to understand their experiences after the course revisions. Results Response rates were 32% to 57%. After the course renewal, the extent to which students in the entry-to-practice cohort felt extremely challenged to learn each objective was significantly reduced (25% vs. 3%, p < 0.001), and students' self-confidence scores significantly increased (12% vs. 30%, p < 0.001).The changes on the challenge and confidence scores in the degree-completion cohort were not statistically significant (23% vs. 24% and 31% vs. 36%, respectively). Student satisfaction levels increased in all 6 categories measured. Conclusion Providing students with more time to absorb their learning, increasing interactivity, offering timely feedback, and integrating applicable exercises using statistical software resulted in an enhanced learning environment.

Canadian journal of dental hygiene : CJDH = Journal canadien de l'hygiene dentaire : JCHD, 2021

Dr. Patrick received her BA and MA from the University of Victoria, where she specialized in Cana... more Dr. Patrick received her BA and MA from the University of Victoria, where she specialized in Canadian history, film studies and Indigenous Governance. She went on to study Indigenous documentary film at the University of Washington through a Canada/US Fulbright Fellowship. Dr. Patrick completed her PhD at the University of British Columbia in 2019. Her doctoral studies brought together research interests in Indigenous community health and well-being and self-determination in urban health governance models. These interests were informed in part by three years spent completing pre-requisites for medical school and several years working in the BC Government in treaty negotiations. She joined the Faculty of Health Sciences in 2019

Journal of Planning Education and Research, 2015

aboriginal policy studies, 2016

Human Rights Review, 2004

This thesis examines the impacts of indigenous dispossession from lands and resources by utilizin... more This thesis examines the impacts of indigenous dispossession from lands and resources by utilizing a concept in ecology, that of ecological keystone species, and extending it to species that play a key, characterizing role in a particular culture or society. A storytelling methodology is used to determine the presence of cultural keystones in stories and place names of Tla'amin peoples, a Northern Coast Salish group whose traditional territory is located along the coast 130 kilometres northwest of Vancouver, British Columbia. I extend the storytelling methodology to encompass film and video projects that exhibit characteristics of Fourth World Cinema and discuss how such films can be used to empower indigenous communities and reclaim cultural and political rights.

Canadian Family Physician, Jun 1, 2016

The Lancet Planetary Health

International Indigenous Policy Journal, 2021

The DUDES Club is a novel men’s health and wellness organization founded in 2010 in Vancouver, BC... more The DUDES Club is a novel men’s health and wellness organization founded in 2010 in Vancouver, BC. Since 2017, the DUDES Club has rapidly expanded in Northern BC and, with the help of a partnership with the First Nations Health Authority, has grown to include 40 sites in British Columbia and 2 sites nationally. In this study, we analyze interviews (n = 5) and 15 focus groups (n = 101) conducted as part of a program evaluation with DUDES Club members, Elders, providers, and health care professionals. We focus on men’s experiences with the DUDES Club to identify four main themes in the data: brotherhood and community, accessible health care information, disrupting colonial constructions of masculinity, and systemic and structural challenges. We conclude with policy recommendations.

Ecopsychology, 2021

W e are a diverse group of scholars, both Indigenous People and settlers. We share deep concerns ... more W e are a diverse group of scholars, both Indigenous People and settlers. We share deep concerns around environmental issues, social justice, and building positive reciprocal relationships between Indigenous

Canadian Family Physician, 2016

Problem addressed In Canada, there are few health promotion programs for men, particularly progra... more Problem addressed In Canada, there are few health promotion programs for men, particularly programs focused on indigenous and other men marginalized by social and structural inequities. Objective of program To build solidarity and brotherhood among vulnerable men; to promote health through education, dialogue, and health screening clinics; and to help men regain a sense of pride and fulfilment in their lives. Program description The DUDES Club was established in 2010 as a community-based health promotion program for indigenous men in the Downtown Eastside neighbourhood of Vancouver, BC. Between August 2014 and May 2015, 150 men completed an evaluation survey developed using a logic model approach. Responses were analyzed based on the 4 dimensions of the indigenous medicine wheel (mental, physical, emotional, and spiritual). Evaluation results demonstrated high participant satisfaction and positive outcomes across all 4 dimensions of health and well-being: 90.6% of respondents indica...

Canadian Family Physician, 2016

International journal of indigenous health, Mar 17, 2024

photocopying or other means, without permission of the author.

Research Square (Research Square), Oct 30, 2023

Social Sciences

Journal of Planning Education and Research, Nov 13, 2015

Canadian journal of dental hygiene : CJDH = Journal canadien de l'hygiene dentaire : JCHD, 2021

Journal of Planning Education and Research, 2015

aboriginal policy studies, 2016

Human Rights Review, 2004

Canadian Family Physician, Jun 1, 2016

The Lancet Planetary Health

International Indigenous Policy Journal, 2021

Ecopsychology, 2021

Canadian Family Physician, 2016

Review of the book "Determinants of Indigenous Peoples’ Health in Canada: Beyond the Social," edi... more Review of the book "Determinants of Indigenous Peoples’ Health
in Canada: Beyond the Social," edited by Margo Greenwood, Sarah de Leeuw, Nicole Marie Lindsay, and Charlotte Reading, Canadian Scholars’ Press, Toronto, 2015, 279 pp.

Book review of "Unlearning the Colonial Cultures of Planning" by Libby Porter in Journal of Plann... more Book review of "Unlearning the Colonial Cultures of Planning" by Libby Porter in Journal of Planning Education and Research.

A review of the exhibit "c̓əsnaʔəm, the city before the city" at the Museum of Anthropology in Va... more A review of the exhibit "c̓əsnaʔəm, the city before the city" at the Museum of Anthropology in Vancouver, BC featured in the "see to see" section of the Capilano Review.