Beyond deficit: ‘strengths‐based approaches’ in Indigenous health research

Abstract

Health research concerning Indigenous peoples has been strongly characterised by deficit discourse—a ‘mode of thinking’ that is overly focused on risk behaviours and problems. Strengths‐based approaches offer a different perspective by promoting a set of values that recognise the capacities and capabilities of Indigenous peoples. In this article, we seek to understand the conceptual basis of strengths‐based approaches as currently presented in health research. We propose that three main approaches exist: ‘resilience’ approaches concerned with the personal skills of individuals; ‘social–ecological’ approaches, which focus on the individual, community and structural aspects of a person's environment; and ‘sociocultural’ approaches, which view ‘strengths’ as social relations, collective identities and practices. We suggest that neither ‘resilience’ nor ‘social–ecological’ approaches sufficiently problematise deficit discourse because they remain largely informed by Western concepts of individualised rationality and, as a result, rest on logics that support notions of absence and deficit. In contrast, sociocultural approaches tend to view ‘strengths’ not as qualities possessed by individuals, but as the structure and character of social relations, collective practices and identities. As such, they are better able to capture Indigenous ways of knowing and being and provide a stronger basis on which to build meaningful interventions.

Key recommendations for developing a national action plan to advance the sexual and reproductive health and rights of women living with HIV in Canada

“…Moreover, a strength-based approach is conceptualized as necessitating a re-balancing of power between health care/social care providers and women living with HIV. 26 …”

Understanding Social Determinants of First Nations Health Using a Four-Domain Model of Health and Wellness Based on the Medicine Wheel: Findings from a Community Survey in One First Nation

“…Despite these adversities, many of the first peoples of Canada have continued to thrive, demonstrating great resilience in the face of the attempted destruction of their ways of life [ 7 , 14 ]. For First Nations peoples, ensuring resilience in light of these adversities can involve drawing upon First Nations identity, which is inextricably linked to history and culture [ 7 ].…”

Indigenous strengths-based approaches to healthcare and health professions education – Recognising the value of Elders’ teachings

“…Engaging in health-related activities focused on cultural attributes and resilience is associated with meaningful engagement (Cooper and Driedger, 2018) and positive health outcomes (Antonio et al, 2020;Kirmayer et al, 2011). To address the view that strengths-based approaches are vaguely defined (First Nations Information Governance Centre [FNIGC], 2020), findings from Bryant et al (2021) are helpful in identifying three main strengthsbased approaches: 'resilience' approaches related to personal skills, 'socio-ecological' approaches , 2007), this identified six guiding principles to improve the health and wellness of Indigenous peoples based on the TRC (2015a), ethical space (Ermine, 2007), and Etuaptmumk/two-eyed seeing (Marshall et al, 2015). The Alberta Indigenous Primary Health Care and Policy Research (IPHCPR) Network, funded by the Canadian Institutes of Health Research (CIHR), aims to improve health outcomes among Indigenous peoples (Crowshoe et al, 2021;Henderson et al, 2018).…”

“…Engaging in health-related activities focused on cultural attributes and resilience is associated with meaningful engagement ( Cooper and Driedger, 2018 ) and positive health outcomes ( Antonio et al, 2020 ; Kirmayer et al, 2011 ). To address the view that strengths-based approaches are vaguely defined ( First Nations Information Governance Centre [FNIGC], 2020 ), findings from Bryant et al (2021) are helpful in identifying three main strengths-based approaches: ‘resilience’ approaches related to personal skills, ‘socio-ecological’ approaches related to environmental context, and, ‘socio-cultural’ approaches related to social context including identity and cultural practices. Of interest, ‘resilience’ and ‘socio-ecological’ approaches are often construed as Westernised and individualistic, while the collectivist relationality of the ‘socio-cultural’ approach is more aligned with Indigenous ways of knowing.…”