Week 7: Indigenous Health Inequalities (PDF)

Readings October 22nd & 24th Understanding Indigenous Health Inequalities Through a Social Determinants Model (26-33)----------------- Child welfare policies and systems ○ Intergenerational t...

Readings October 22nd & 24th Understanding Indigenous Health Inequalities Through a Social Determinants Model (26-33)----------------- Child welfare policies and systems ○ Intergenerational trauma, poverty, mental illness, substance abuse are most commonly associated with child welfare involvement ○ Indigenous women vulnerable to having children apprehended Criminal justice system ○ Indigenous overrepresented as victims and offenders ○ Systemic discrimination in justice system ○ Forceful police interventions Health care system ○ Unequal access ○ Used to deny services based on jurisdiction ○ Untimely access to services ○ Widespread stereotyping and racism Educational system ○ Receive less funding for education ○ Lower education completion rates among first nations ○ More uni education over the years, but gap remains Community infrastructure, resources and capacities ○ Community heavily impacts health ○ Communities receive less funding to implement programs and services ○ Gap in economic development Environmental stewardship ○ Colonial expansion resulted in dispossession of land and forced segregation ○ Do not acknowledge indigenous traditions ○ Industrial contamination of wildlife, fish, vegetation forced indigenous to move away ○ Control over lands = better health Cultural Continuity as a Determinant of Indigenous Peoples Health (pp-10-19)----------------------------------- Themes the arose from the analysis ○ Theme 1 = cultural continuity linked to health for indigenous ○ Theme 2 = conceptualizations of cultural connectedness and continuity ○ Theme 3 = knowledge transmission important part of cultural continuity ○ Theme 4 = experiences with cultural continuity and disconnection/barriers to cultural continuity Health and wellness outcomes ○ Wellness outcomes associated with sense of cultural identity & self-esteem ○ Increased sense of community, belonging, social purpose = outcomes of cultural connection ○ Strong sense of identity helps to heal from trauma ○ Practicing spirituality is a way of resisting colonization ○ Health outcomes = holistic health and balance + increased coping skills for stress and grief ○ Cultural continuity also improves specific health issues (cancer, diabetes, heart disease, addiction) Components of cultural connectedness and continuity ○ Practicing spirituality and ceremonies promotes holistic health and balance Attending cultural events and participating in activities is important ○ Culture includes connections to land and language Knowledge transmission  ○ Teaching youth important part of cultural rehabilitation ○ Passing down beliefs and practices among women was important strength ○ Importance of elders, grandparents, and teachers in sharing knowledge ○ Elder death is challenge in knowledge transmission Journeys of cultural discontinuity ○ Disconnections during childhood and adolescence Felt lost, detached, rejected culture, questioned identity ○ Concept of walking in 2 worlds Indigenous people try to balance western and traditional cultures Try to incorporate indigenous teaching into everyday life ○ Forgiveness plays role in cultural continuity ○ Journeys of connection or disconnection were independent and variable based on individual Barriers to cultural continuity ○ Historical trauma ○ Racism, ignorance, microaggressions in society and media Discussion ○ Cultural continuity shapes determinants of health ○ Distal determinants shape cultural continuity ○ All social determinants of health are interconnected ○ Colonization is considered in historical context, but continues to impact indigenous today ○ Ongoing oppression has lead to colonial mentalities Mental state that blocks recognition of existing traditional perspectives, preventing people from seeing beyond conditions created by white society ○ Conceptualizations of cultural continuity are more complex than what is offered by mainstream definitions Indigenous Knowledge to Close Gaps in Indigenous Health------------------------------------------------------- Manitoba first nations have 4 times more diabetes than non-indigenous Gaps because of poverty, child welfare, overcrowded housing ○ Not addressed because of racism Institutional racism = differential access to goods by race ○ Ex. nurses don't complete training required in remote areas vs nurses in urban contexts more prepared Epistemic racism = one group people superior to another Historical Health Inequities ○ Indigenous communities face health disparities due to colonization, residential schools, and systemic racism. Indigenous Worldview on Health ○ Emphasizes holistic health—physical, mental, emotional, and spiritual aspects interconnected with land, culture, and identity. Community-Driven Solutions ○ Indigenous-led initiatives improve health by integrating cultural practices and community values (e.g., community-based health centers). Call for Systemic Change ○ Advocates for structural changes to allow Indigenous governance in health services, addressing racism, and supporting Indigenous healthcare professionals. 7 grandfather teachings are what the women’s clinic are based on Lecture 10 October 22nd What is Cultural Continuity?—---------------------------------------------------------------------------------------- “Being who we are” Ongoing/sustained/passed on forms of culture that are linked to an identifiable tradition from the past ○ Can change over the years, but still has a link to the past Chandler & Lalonde studied cultural continuity in relation to community self-determination ○ Where the local indigenous language was practiced widely, there were fewer youth suicides ○ Looked for: speak the local language? How much self-governance? ○ Communites with more autonomy = lesser suicide rates  ○ Linked strong cultural continuity as protective factor against suicide A& B--------------------------------------------------------------------------------------------------------------- Which is more effective? ○ A = harm reduction Ex. safe injection sites ○ B = health/life promotion Debate ○ Side A ○ Side B Video-------------------------------------------------------------------------------------------------------------- - For suicide, people question why they should continue to live in bad environment? ○ Getting them out of that environment gives them a reason to live Suicide rates in indigneous people can be attributed to consequences of colonization ○ Colonization is not in past, still exists today Focus should be on creating better living conditions ○ Goal should be life promotion Forces of assimilation still exist, as seen by child welfare system Connections to land important, can’t practice way of life without it ○ Highlighted importance of cultural continuity Efforts need to be made to preserve land and give indigenous self-governance over education system Language is investment in reconnecting young people with their worldview Sense of identity gives meaning to live = reason to live = less suicide Ex. opioid intervention is effective because its a community-based intervention Wellness should be considered throughout lifespan ○ Spiritual journey should be at every stage of live Indigenous practices have gone away because of colonization ○ Before birth, there used to be traditional practices but now women have to deal with intergenerational trauma instead of doing practices There are more neurological disorders because of constant stress during pregnancy