Literature about Indigenous health has dramatically increased over the past few years, which has made it difficult to stay current—this is a good thing. This uptick indicates that this work is getting attention it deserves. However, every so often a collection comes along that provides an essential overview of the work being done, and Global Indigenous Health: Reconciling the Past, Engaging the Present, Animating the Future is one such book. It examines the impacts and effects of health determinants on Indigenous Peoples from across the globe, including Micronesia, Alaska, and Canada.
This study tested the assumption that geographical isolation is associated with poorer population health outcomes among First Nations in Manitoba. Our results show higher premature mortality rates (PMR) in northern communities, declining slower than for any other Manitoba communities. Our results also show lower ambulatory care sensitive conditions (ACSC) hospitalization rate in the North, suggesting barriers to prevention and early diagnosis. There remains a large gap in ACSC hospitalization rates between First Nations and all Manitobans. Further research is warranted to understand the relationship between the changes in the rates of ACSC and the difference in the rates between northern and southern communities.
Recognizing the right of self-determination of Indigenous Peoples is essential to improving the state of community-based primary healthcare of First Nations in Canada. Understanding communities’ priorities and local health agendas is critical for primary healthcare transformation. We used a community-based participatory research approach to engage our partners: Nanaandawewiwgamig, the First Nations Health and Social Secretariat of Manitoba, and eight First Nation communities. Community-based research assistants conducted 183 in-depth interviews in their respective First Nations. Key themes that emerged from these interviews include primary prevention focused on health and social determinants; an integrated healthcare system providing access to both Western and First Nations traditional health knowledge; infrastructure improvement; youth engagement; healthcare leadership; investing in community-based human resources; and promoting culturally respectful, responsive, geographically sensitive, and outcomes-oriented care. Policy approaches could implement some local priorities with direct impact on healthcare, while other social determinants will create indirect, albeit critical, conditions for health and healthcare changes over time.
Scoping includes the establishment of unambiguous spatial boundaries for a proposed development project (e.g., a treaty) and is especially important with respect to development on Indigenous homelands. Improper scoping leads to a flawed product, such as a flawed treaty or environmental impact assessment, by excluding stakeholders from the process. A comprehensive literature search was conducted to gather (and collate) printed and online material in relation to Treaty No. 9 and its Adhesions, as well as the Line-AB. We searched academic databases as well as the Library and Archives Canada. The examination of Treaty No. 9 and its Adhesions revealed that there is unceded land in each of four separate scenarios, which are related to the Line-AB and/or emergent land in Northern Ontario, Canada. Lastly, we present lessons learned from our case study. However, since each development initiative and each Indigenous Nation is unique, these suggestions should be taken as a bare minimum or starting point for the scoping process in relation to development projects on Indigenous homelands.
A series of recent legal and policy developments in Canada have potential to contribute to reconciliation efforts, particularly related to the overrepresentation of Indigenous children in child welfare systems. However, systematic collection, analysis, and synthesis of research knowledge—particularly, research that is locally grounded—on Indigenous child welfare involvement is notably missing from these efforts. With the aim of collating existing research knowledge on this topic, this scoping review of literature includes a broad swath of literature spanning decades (1973-2018) and countries with similar settler colonial histories (Canada, the United States, Australia, and New Zealand). Our search yielded 881 unique research publications. There was an increase in the number of publications over time in all four countries and a trend toward more empirical literature than non-empirical literature. We found that a plurality of publications focused on programs and services (n = 191), and policy or legal (n = 168) themes. While our review highlights a large base of literature on Indigenous child welfare involvement, it also illustrates the limits of the academic literature in representing the knowledge and experience of Indigenous Peoples and the need for more comprehensive synthesis and broader dissemination of the research related to Indigenous child welfare. These limitations restrict the extent to which existing research can inform the meaningful development of Indigenous child welfare policy in Canada. Due to these gaps, we advocate sustained investment in efforts to synthesize diverse sources of knowledge, support for open source publications, and structural support for Indigenous control of knowledge collection and dissemination regarding policy development related to their communities.
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