20 Patchy and Southern Centric: Rewriting Health Policies for Northern and Indigenous Canadians

Lavoie, Josée G.; Kornelsen, Derek; Boyer, Yvonne

doi:10.3138/9781487514600-028

Cited by 2 publications

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“…We acknowledge that organising healthcare delivery in Circumpolar communities is complex, as a result of political history, geography, climate, and low population density [ 1 ]. In some jurisdictions, policies implemented in rural and remote regions were originally developed with urban contexts in mind [ 47 ]. This poses challenges to the creation of adapted system designs, and perpetuates health inequities for Indigenous and non-Indigenous residents of these regions.…”

Section: Healthcare Among Indigenous Peoples Around the Circumpolar N...mentioning

confidence: 99%

Cultural competence and safety in Circumpolar countries: an analysis of discourses in healthcare

Lavoie

Stoor

Rink

et al. 2022

International Journal of Circumpolar Health

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Circumpolar Indigenous populations continue to experience dramatic health inequities when compared to their national counterparts. The objectives of this study are first, to explore the space given in the existing literature to the concepts of cultural safety and cultural competence, as it relates to Indigenous peoples in Circumpolar contexts; and second, to document where innovations have emerged. We conducted a review of the English, Danish, Norwegian, Russian and Swedish Circumpolar health literature focusing on Indigenous populations. We include research related to Alaska (USA); the Yukon, the Northwest Territories, Nunavik and Labrador (Canada); Greenland; Sápmi (northmost part of Sweden, Norway, and Finland); and arctic Russia. Our results show that the concepts of cultural safety and cultural competence (cultural humility in Nunavut) are widely discussed in the Canadian literature. In Alaska, the term relationship-centred care has emerged, and is defined broadly to encompass clinician-patient relationships and structural barriers to care. We found no evidence that similar concepts are used to inform service delivery in Greenland, Nordic countries and Russia. While we recognise that healthcare innovations are often localised, and that there is often a lapse before localised innovations find their way into the literature, we conclude that the general lack of attention to culturally safe care for Sámi and Greenlandic Inuit is somewhat surprising given Nordic countries’ concern for the welfare of their citizens. We see this as an important gap, and out of step with commitments made under United Nations Declarations on the Rights of Indigenous Peoples. We call for the integration of cultural safety (and its variants) as a lens to inform the development of health programs aiming to improve Indigenous in Circumpolar countries.

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Section: Healthcare Among Indigenous Peoples Around the Circumpolar N...mentioning

confidence: 99%

Cultural competence and safety in Circumpolar countries: an analysis of discourses in healthcare

Lavoie

Stoor

Rink

et al. 2022

International Journal of Circumpolar Health

Self Cite

View full text Add to dashboard Cite

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Bridging the distance: understanding access to healthcare through stories from Gwich’in medical travellers in Northwest Territories

Milligan,

Greenland,

Storr

et al. 2024

International Journal of Circumpolar Health

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In northern Canada, medical travel – the movement of patients to a larger centre to access healthcare services outside their home community – is a dominant feature of the healthcare system. This qualitative study explored the medical travel experiences of Gwich’in living above the Arctic Circle in the Gwich’in Settlement Area in Northwest Territories (NT). Data collection in 2020 comprised storytelling sessions with 10 Gwich’in medical travellers (6 female, 4 male). Using inductive and deductive methods with continual critical reflexivity, and guided by Gwich’in values, concerns about access to healthcare were found to be at the heart of each story. A broad conceptualisation of access was applied to understand and interpret the results according to six dimensions: accessibility, availability, affordability, adequacy, acceptability, and awareness. Situated within a context of colonialism, structural inequities and other factors relevant across the Circumpolar North, the results suggest that the NT medical travel policy framework provides only partial access to care. This article illustrates a need for healthcare and other government systems to think about policy and programmes in a more wholistic, equitable and relationship-centred way, which would help not only to bridge distances across geography, but also between peoples.

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20 Patchy and Southern Centric: Rewriting Health Policies for Northern and Indigenous Canadians

Cited by 2 publications

References 0 publications

Cultural competence and safety in Circumpolar countries: an analysis of discourses in healthcare

Cultural competence and safety in Circumpolar countries: an analysis of discourses in healthcare

Bridging the distance: understanding access to healthcare through stories from Gwich’in medical travellers in Northwest Territories

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