Reclaiming Indigenous Health in the US: Moving beyond the Social Determinants of Health (original) (raw)
Related papers
British Journal of Social Work, 2019
Welcome! From where the sun rises in the East to where it settles in the darkening stillness of the West, we honour the Breath of Life that resides within each of us and that moves between us. This issue is published in the United Nations' International Year of Indigenous Languages and reflects the aspiration to perpetuate language and culture while simultaneously, advancing Indigenous health and well-being (United Nations Division for Sustainable Development [UNDSD], 2018b). In this editorial, we provide the background significance for the special issue, briefly summarise its content and offer thoughts for future action. Indigenous health and well-being in the global context An estimated 370 million Indigenous peoples dwell in about ninety nations around the world (World Bank, 2016). Although diverse in socio-cultural characteristics, language and history, Indigenous peoples commonly are recognised as the descendants of those who inhabited a geographical region prior to the arrival of colonising forces. Colonisers rarely came in peace and, for the most part, leveraged their dominance through invasion, war, seizure of natural resources, settlement, usurpation of Indigenous economies and other means for asserting power and control. As a distal social determinant of health (SDOH), colonisation has threatened Indigenous governance systems, language and culture; neo-colonialism continues to alienate Indigenous Peoples from their ancestral lands (Czyzewski, 2011; United Nations Permanent Forum on Indigenous Issues [UNPFII], 2017). In contemporary times, Indigenous peoples living in both developed and developing nations face continuous social marginalisation-often leaving many to feel like 'strangers in their own world'. In comparison to settler populations, Indigenous peoples are disproportionately burdened by extreme poverty, sub-optimal health outcomes and life expectancies that are www.basw.co.uk
Palgrave Macmillan, 2020
Indigenous communities are those with historical claims to native lands, practices, and customs that have sustained them for millennia. In many parts of the world, they continue to draw on age-old wisdom and practices to sustain their health in the modern, and, now, digital age. Yet, their cultural assets for health and wellbeing are less well recognized by mainstream culture, and often, their approaches to health and wellbeing are regarded as complementary or alternative to mainstream modern medicine. In this chapter, we review regional and international definitions of indigenous communities and trace the history of research and practice in indigenous health in Africa, Australia, and North America. We follow this up by discussing the main themes in sustaining the health of indigenous communities, informed by their assets and potentialities, applying human rights-based approaches. Next, we consider the cultural, professional, and legal issues that influence health and wellbeing among indigenous communities, and related disciplines for understanding and promoting indigenous health systems. Finally, we review the critical research and practice issues for sustainable community health among indigenous communities in a globalized, digital age world.
Canadian journal of public health = Revue canadienne de santé publique
Comparing the key determinants of health articulated by the Public Health Agency of Canada (the Agency) with the spiritual and cultural knowledge systems of First Nations peoples, as expressed by the Four Worlds International Institute for Human and Community Development (Four Worlds) and their 14 determinants of well-being and health, reveals differing philosophical perspectives. The key determinants of health can be interpreted as lacking a holistic and inclusive approach to public health services. As a result, many public health programs in Canada marginalize, ignore and suppress the needs of First Nations communities and people. Incorporating the Four Worlds guiding principles and its 14 health determinants model within the context of Canadian public health services geared towards First Nations populations provides the opportunity to develop a deeper understanding of social determinants of health. Therefore, when implementing public health initiatives to address the health statu...
The Imperative for Research to Promote Health Equity in Indigenous Communities
Prevention science : the official journal of the Society for Prevention Research, 2017
Health disparities exact a devastating toll upon Indigenous people in the USA. However, there has been scant research investment to develop strategies to address these inequities in Indigenous health. We present a case for increased health promotion, prevention, and treatment research with Indigenous populations, providing context to the recent NIH investment in the Intervention Research to Improve Native American Health (IRINAH) network. We discuss the disproportionate costs and consequences of disparities borne by Indigenous groups, the limited evidence base on effective intervention for this population, how population uniqueness often makes transfer of existing intervention models difficult, and additional challenges in creating interventions for Indigenous settings. Given the history of colonial disruption that has included genocide, forced removal from lands, damaging federal, state and local policies and practices, environmental contamination, and most recently, climate change...
Towards healthier Indigenous health policies? Navigating the labyrinth for answers
2017
This research is based on two years of community-based participatory research that draws on Indigenous understandings of health policy in five First Nations in Ontario, Canada. While a number of policies have been put in place to increase Indigenous control over community health services, we argue that policies enacted to promote Indigenous self-determination in health care have been counterproductive and detrimental to Indigenous health and wellbeing. Instead, we suggest that Indigenous health policy exists on a continuum and aim to balance the need for including diverse Indigenous groups with comprehensive control from program funding and design to implementation. This poses some difficult questions: How do Indigenous peoples perceive the concept of self-determination, community-controlled health care and the efforts of the Canadian government to form collaborative arrangements between Indigenous communities, organisations and government? What does an inclusive and comprehensive I...
Social Determinants of Indigenous Health
The Australian Journal of Anthropology, 2009
Background: The marginalization of Indigenous women in Canada has resulted in adverse pregnancy and infant health outcomes. While the epidemiological research focuses on statistical evidence, it fails to address the context and underlying causes, including social determinants of health. Despite clear evidence of how social determinants influence health, there is limited research on Indigenous women's perspectives and experiences. Indigenous women's narratives during pregnancy, birth and the early months of parenthood are critical to understand the underlying causes and proposed solutions. This research demonstrates how Indigenous women's maternity experiences are embedded within their historical, social and cultural experiences, thus explaining the importance of addressing contexts related to social determinants of health. Methods: Through an Indigenous and decolonized lens, maternity narratives from ten indepth interviews were conducted with Indigenous birth mothers in British Columbia, Canada. Thematic content analysis findings contextualize Indigenous maternity experiences within proximal, intermediate and distal determinants of health. Results: The proximal determinants include barriers to education, employment, income, food (in)security and a lack of safe and affordable housing and homelessness due to urban migration and violent relationships. Intermediate experiences included barriers to accessing maternity healthcare, including geographic barriers and experiences of racism. Distal determinants including traumatic narratives related to immediate and intergenerational impacts of colonialism, including the Indian residential school system and foster care, which has impacted mental health and addictions. Conclusion: This research contributes to expanding research on culturally safe and improved maternal-child health, healthcare and maternity research, as well as highlighting the need to address and alleviate adverse social determinants.
Social-Relational Understandings of Health and Well-Being from an Indigenous Perspective
This article presents the findings from a research project that examined how well-being, especially with regard to diabetes prevention, was understood within an Indigenous community, Kahnawà:ke, a Kanien'kehá:ka community on the St. Lawrence River near Montreal, Quebec, Canada. Both philosophical hermeneutics and Indigenous ways of knowing were used to achieve a decolonized research approach to undertaking and analysing interviews from key stakeholders. The research findings revealed that the social-conditions created by external Western influences on culture, language, and epistemologies are strongly connected to the relational conditions that continue to influence the health and well-being of individuals, families, and the community. Indigenous well-being was found to be closely related to the concept of being Onkwehon:we, to the roles and responsibilities of families as nurturers of health-promoting relationships, and to processes expected to promote the healing of multigener...