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

Abstract

We examined the explanatory roles of social determinants of health (SDOH) for First Nations people using a four-domain model of health and wellness based on the Medicine Wheel (i.e., physical, mental, emotional, and spiritual health), including colonial-linked stressors (i.e., historical trauma, childhood adversities, racial discrimination) and cultural resilience factors (i.e., cultural strengths, traditional healing practices, social support). Data were collected in partnership with a First Nation in Ontario, Canada in 2013 through a community survey (n = 194). For each outcome (physical, mental, emotional, and spiritual health), a modified Poisson regression model estimated prevalence ratios for the SDOH, adjusting for age, sex, education, and marital status. Negative associations were found for historical trauma with physical, mental, emotional, and spiritual health; for childhood adversities with mental health; and for racial discrimination with physical, mental, and emotional health. Positive associations were found for cultural strengths with physical, mental, and emotional health and for social support with physical, mental, emotional, and spiritual health. We observed negative associations between use of traditional healing practices and mental and emotional health. Our findings suggest that these SDOH may play important roles in relation to wellness through associations with the domains of health modelled by the Medicine Wheel.

Predictors of Land-Based Activity Participation in a National Representative Sample of Indigenous Individuals Living Off-Reserve

“…The results in the present study support the relationships described in the FNMWCF model-specifically, that belonging fostered through culture is a significant predictor of engagement in land-based activities. This finding supports existing models that describe how increased engagement in cultural practices and identities among Indigenous communities is protective against adverse physical and mental health outcomes, including racial discrimination, colonialism, and historical trauma [33,38,39,49]. For example, cultural resilience has been significantly associated with mental, physical, emotional, and spiritual wellbeing, including self-reported physical health [49].…”

“…It is possible that there may be a bidirectional relationship between individuals who use land-based activities to promote mental and physical health, not explored in the present study, as these strategies are used for both healing (i.e., those with lower mental health ratings) and general wellness promotion (i.e., likely those with higher mental health ratings). For example, a previous analysis of the use of traditional healing practices found that engagement in these practices was associated with poorer self-reported health [49]. The authors suggested that it was possible that individuals with diminished wellness may be more likely to seek such services to address these areas of need.…”

Theoretical Foundations of Culturally Responsive Teaching and Connections to Saskatchewan Curriculum and Indigenous Education

“…Physical wellness for Indigenous peoples is living a healthy, active lifestyle to maintain physical strength, fitness, and health (National Collaborating Centre for Aboriginal Health, 2013). Emotional wellness for Indigenous peoples can refer to affective or mood elements (Tanner et al, 2022).…”

Conversations on Cannabis and Mental Health: Recommendations for Health and Social Care Providers from Indigenous 2SLGTBQQIA+ People in Canada

“…To date, urban and off-reserve First Nations and Métis populations are dramatically underrepresented in health research (Koutouki & Lofts, 2019). Further, ways of evaluating mental health in the current Canadian health system differ from Traditional Indigenous Knowledges and ways of assessing wellness (Tanner et al, 2022). Operating from a colonial perspective and relying on Western approaches to healthcare when serving Indigenous communities and individuals further marginalizes and stigmatizes the unique challenges experienced by First Nations, Inuit, and Métis Peoples, and often is severely detrimental to their health.…”