Social Determinants of Indigenous Health and Indigenous Rights in Policy: A Scoping Review and Analysis of Problem Representation

George, Emma; Mackean, Tamara; Baum, Fran; Fisher, M.

doi:10.18584/iipj.2019.10.2.4

Cited by 28 publications

(31 citation statements)

References 36 publications

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“…The specific considerations in relation to the right to health for Indigenous peoples imply a need for an Indigenous-focused approach to this area of research, grounded in Indigenous worldviews and explicitly centering Indigenous lived experiences and realities [29]. Social policy in settler colonial contexts universally fails to adequately consider social determinants of Indigenous health and Indigenous rights [30], which means that generic equity analyses miss important outcomes for Indigenous populations.…”

Section: Introductionmentioning

confidence: 99%

Climate Change Mitigation Policies and Co-Impacts on Indigenous Health: A Scoping Review

Jones

Macmillan

Reid

2020

IJERPH

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Climate change mitigation policies can either facilitate or hinder progress towards health equity, and can have particular implications for Indigenous health. We sought to summarize current knowledge about the potential impacts (co-benefits and co-harms) of climate mitigation policies and interventions on Indigenous health. Using a Kaupapa Māori theoretical positioning, we adapted a validated search strategy to identify studies for this scoping review. Our review included empirical and modeling studies that examined a range of climate change mitigation measures, with health-related outcomes analyzed by ethnicity or socioeconomic status. Data were extracted from published reports and summarized. We identified 36 studies that examined a diverse set of policy instruments, with the majority located in high-income countries. Most studies employed conventional Western research methodologies, and few examined potential impacts of particular relevance to Indigenous peoples. The existing body of knowledge is limited in the extent to which it can provide definitive evidence about co-benefits and co-harms for Indigenous health, with impacts highly dependent on individual policy characteristics and contextual factors. Improving the quality of evidence will require research partnerships with Indigenous communities and study designs that centralize Indigenous knowledges, values, realities and priorities.

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Section: Introductionmentioning

confidence: 99%

Climate Change Mitigation Policies and Co-Impacts on Indigenous Health: A Scoping Review

Jones

Macmillan

Reid

2020

IJERPH

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“…Beliefs, values, and assumptions held by health service providers shape their behaviors and interactions with patients and are influenced by discourses within society (16). In addition, the policy, legislative, historical, and social conditions that impact access for Indigenous peoples represent structural barriers to accessing health services (17,18). Research shows that Indigenous peoples experience individual and systemic discrimination when seeking healthcare (19,20), despite efforts within the health system to promote cultural responsiveness (20).…”

Section: The Meaning Of Health System Responsiveness For Indigenous Peoplesmentioning

confidence: 99%

Health Systems Responsiveness in Addressing Indigenous Residents' Health and Mental Health Needs Following the 2016 Horse River Wildfire in Northern Alberta, Canada: Perspectives From Health Service Providers

Fitzpatrick

Wild

Pritchard

et al. 2021

Front. Public Health

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Following the 2016 Horse River Wildfire in northern Alberta, the provincial health authority, the ministry of health, non-profit and charitable organizations, and regional community-based service agencies mobilized to address the growing health and mental health concerns among Indigenous residents and communities through the provision of services and supports. Among the communities and residents that experienced significant devastation and loss were First Nation and Métis residents in the region. Provincial and local funding was allocated to new recovery positions and to support pre-existing health and social programs. The objective of this research was to qualitatively describe the health systems response to the health impacts following the wildfire from the perspective of service providers who were directly responsible for delivering or organizing health and mental wellness services and supports to Indigenous residents. Semi-structured qualitative interviews were conducted with 15 Indigenous and 10 non-Indigenous service providers from the Regional Municipality of Wood Buffalo (RMWB). Interviews were transcribed verbatim and a constant comparative analysis method was used to identify themes. Following service provider interviews, a supplemental document review was completed to provide background and context for the qualitative findings from interviews. The document review allowed for a better understanding of the health systems response at a systems level following the wildfire. Triangulation of semi-structured interviews and organization report documents confirmed our findings. The conceptual framework by Mirzoev and Kane for understanding health systems responsiveness guided our data interpretation. Our findings were divided into three themes (1) service provision in response to Indigenous mental health concerns (2) gaps in Indigenous health-related services post-wildfire and (3) adopting a health equity lens in post-disaster recovery. The knowledge gained from this research can help inform future emergency management and assist policy and decision makers with culturally safe and responsive recovery planning. Future recovery and response efforts should consider identifying and addressing underlying health, mental health, and emotional concerns in order to be more effective in assisting with healing for Indigenous communities following a public health emergency such as a wildfire disaster.

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“…This process empowers those embedded in Western culture to acquire and maintain a strong sense of identity by contrasting themselves with the Other. Othering effectively marginalises and suppresses Indigenous knowledge systems and ways of knowing [16]. A systemic impact of colonialism upon Indigenous Australian's health is that Indigenous people are continually positioned as the problem [17].…”

Section: Postcolonialismmentioning

confidence: 99%

“…The impact of a focus on biomedical knowledge and, more broadly, Western scientific knowledge, as a superior and more valid form of knowledge, is seen by critical Indigenous theorists as part of a coloniser's perspective that perpetuates Othering and systematic racism [16]. Thus, dominant medical narratives and interactions can be seen as mechanisms by which "ideas about ethnicity and race are created, negotiated and resisted" [35].…”

Section: Critical Thinking Regarding Biomedical Dominancementioning

confidence: 99%

Voices behind the Statistics: A Systematic Literature Review of the Lived Experience of Rheumatic Heart Disease

Haynes,

Mitchell,

Enkel

et al. 2020

IJERPH

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In Australia, Aboriginal children almost entirely bear the burden of acute rheumatic fever (ARF) which often leads to rheumatic heart disease (RHD), a significant marker of inequity in Indigenous and non-Indigenous health experiences. Efforts to eradicate RHD have been unsuccessful partly due to lack of attention to voices, opinions and understandings of the people behind the statistics. This systematic review presents a critical, interpretive analysis of publications that include lived experiences of RHD. The review approach was strengths-based, informed by privileging Indigenous knowledges, perspectives and experiences, and drawing on Postcolonialism and Critical Race Theory. Fifteen publications were analysed. Nine themes were organised into three domains which interact synergistically: sociological, disease specific and health service factors. A secondary sociolinguistic analysis of quotes within the publications articulated the combined impact of these factors as ‘collective trauma’. Paucity of qualitative literature and a strong biomedical focus in the dominant narratives regarding RHD limited the findings from the reviewed publications. Noteworthy omissions included: experiences of children/adolescents; evidence of Indigenous priorities and perspectives for healthcare; discussions of power; recognition of the centrality of Indigenous knowledges and strengths; and lack of critical reflection on impacts of a dominant biomedical approach to healthcare. Privileging a biomedical approach alone is to continue colonising Indigenous healthcare.

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Social Determinants of Indigenous Health and Indigenous Rights in Policy: A Scoping Review and Analysis of Problem Representation

Cited by 28 publications

References 36 publications

Climate Change Mitigation Policies and Co-Impacts on Indigenous Health: A Scoping Review

Climate Change Mitigation Policies and Co-Impacts on Indigenous Health: A Scoping Review

Health Systems Responsiveness in Addressing Indigenous Residents' Health and Mental Health Needs Following the 2016 Horse River Wildfire in Northern Alberta, Canada: Perspectives From Health Service Providers

Voices behind the Statistics: A Systematic Literature Review of the Lived Experience of Rheumatic Heart Disease

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