Indigenous Determinants of Health
Indigenous Determinants of Health (IDOH) encompass environmental, social, political, economic, and other factors that influence the health of Indigenous individuals, families, and communities. These factors must be considered when providing services to Indigenous people, and in developing policies or programs tailored to Indigenous populations.
Understanding Social Determinants of Health
Social Determinants of Health (SDOH) applicable to all populations typically include:
- Income
- Education
- Employment
- Housing
- Environment (recently highlighted due to the impact of climate change)
- Safety and Security (especially internationally and for many Indigenous communities)
Historical Context: The Impact of Colonization
To adopt a comprehensive view of health determinants from an Indigenous perspective, it is essential to acknowledge the history of colonization and its impact on First Nation, Inuit, and Métis peoples.
Colonial-based stressors include:
- Negative experiences with institutions (E.g., Residential School, hospitals, jails)
- Disruptions to families caused by child welfare interventions
- Childhood adversities
- Impacts on traditional economies and loss of access to land
- Federal and provincial/territorial policies impacting access to housing and employment
Cultural Resilience as a Determinant of Health
Cultural resilience factors include:
- Leveraging cultural strengths
- Access to and participation in traditional cultural and healing practices
- Strong social support and bonds among community members
The Ongoing Effects of Colonization
The legacy of colonialism has contributed to:
- Devaluation of Indigenous Knowledge, cultures, and practices
- Disruptions in cultural identity
- Loss of language and cultural practices
- Interruption of knowledge transmission between generations
- Fragmented family and community connections
- Racial discrimination
- Poverty and addiction issues
- Historical and ongoing intergenerational trauma
- Hindered access to essential services and healthcare
- Notably poorer health outcomes, with Indigenous Canadians having a life expectancy 12 years shorter than the national average.
Building a Foundation for Recovery and Reconciliation
Acknowledging how Indigenous Determinants of Health have adversely affected communities allows for a positive, strengths-based approach to form the basis for recovery, renewal, revitalization, and reconciliation.
Collective efforts to recover and rebuild can focus on:
- Strengthening cultural identities
- Promoting self-determination at individual, family, community, and national levels
- Recognizing Indigenous rights, title, and supporting the implementation of land claim and self-government agreements
- Building capacity for personal health and healing based on cultural strengths
- Enhancing family and community connectedness and mutual support
- Revitalizing cultural identity, knowledge, and skills
- Encouraging the learning and sharing of Indigenous languages
- Supporting local and regional economies with opportunities for traditional land-based activities as part of a diverse livelihood
- Applying Indigenous Knowledge and practices in land and water protection
Strengthening Partnerships for Health Equity
A renewed commitment to communication, collaboration, and accountability between government and non-government partners is essential. Working from a place of strength and investing in positive determinants of health can create an environment that supports health equity.
