Volume 16, numéro 1, 2025

EN :

Healthcare inequalities among Australian Indigenous people are significantly influenced by sociocultural factors. Understanding these influences and potential solutions benefits from insights into behavioural factors in parallel with social and cultural perspectives of beliefs and attitudes. Deeper analysis of breast cancer among Indigenous women is required to better understand factors and solutions to close the inequality gap.

A systematic and critical review of peer-reviewed literature was undertaken using the MEDLINE (Pubmed) electronic database. After inclusion and exclusion criteria were applied, and critical appraisal undertaken, 20 articles were identified that aligned with breast cancer incidence or survival among Indigenous Australians.

The analysis revealed three central themes; pathological factors, cultural factors and social factors. Data linkage strategies reveals inequality in both incidence and 5-year survival for Indigenous breast cancer patients. Both sociocultural behaviours and sociocultural attitudes and beliefs about health, illness and healing contribute to inequality among Indigenous breast cancer patients.

Poorer outcomes relate to Indigenous patients presenting with more advanced disease. Cultural and socioeconomic behaviours, attitudes and beliefs are significant barriers that create disparities between Indigenous and non-Indigenous women’s access to and engagement with breast cancer services.

EN :

Municipalities are being called on to become more participatory in their approach to policy making and governing. Concurrently, they are working toward making their policies, programs, and staff complements more inclusive and equitable, and more responsive to the ongoing consequences of colonialism and other forms of systemic discrimination. These developments share common normative and theoretical foundations, but municipalities are not necessarily actively working on these changes in tandem. In response, we ask, “What are the problems and possibilities that emerge in efforts to centre Indigenous Knowledges and intersectional commitments in participatory policymaking processes at the local level?” We highlight two barriers that arise persistently in these efforts and suggest modest ways forward that will be useful for municipal public servants working on community engagement; diversity, equity, inclusion efforts; and building relationships with Indigenous residents.

EN :

We aimed to investigate the perceptions of Mapuche young adults in Araucanía, Chile, regarding the impact of the COVID-19 pandemic on their communities, adherence to restrictions, and coping responses. Eight Mapuche individuals were included in this qualitative study, segmented by gender. Interviews with a semi-structured script were carried out between February and May 2023. A thematic analysis of the discourse was used with subsequent triangulation and validation of the results. The people interviewed believed that, although the pandemic affected their communities, this challenge strengthened ties and contributed to the recovery of the ancestral worldview. There was a temporal dynamic in adherence to restrictions, with initial distrust but high compliance, including vaccination. There was complementarity between Western and traditional Mapuche medicine, which highlights the importance of intercultural health strategies. The pandemic had an impact on young Mapuche adults by altering community dynamics and cultural practices, with the potential to exacerbate inequalities in their communities. This study emphasizes the need to integrate the indigenous worldview in decisions about restrictions and advocates considering cultural diversity in future health crises.

EN :

This article considers the many ways in which mechanisms delivering funding for health and social services to First Nations on reserve embed colonial biases. Against a backdrop of trade-offs inherent in different funding mechanisms, we examine the extent to which colonial biases result in greater need for health and social services for which the same per unit funding would be inadequate, and how the colonial biases in operationalizing the funding mechanisms result in lower per unit funding than is afforded Canadians, in some instances. For better informing current efforts to co-develop a renewed fiscal federalism, we conclude with a path forward cast as different decolonizing options of increasing complexity.