Work that addresses the cumulative impacts of resource extraction on environment, community, and health is necessarily large in scope. This paper presents experiences from initiating research at this intersection and explores implications for the ambitious, integrative agenda of planetary health. The purpose is to outline origins, design features, and preliminary insights from our intersectoral and international project, based in Canada and titled the “Environment, Community, Health Observatory” (ECHO) Network. With a clear emphasis on rural, remote, and Indigenous communities, environments, and health, the ECHO Network is designed to answer the question: How can an Environment, Community, Health Observatory Network support the integrative tools and processes required to improve understanding and response to the cumulative health impacts of resource development? The Network is informed by four regional cases across Canada where we employ a framework and an approach grounded in observation, “taking notice for action”, and collective learning. Sharing insights from the foundational phase of this five-year project, we reflect on the hidden and obvious challenges of working across scales, sectors, and sites, and the overlap of generative and uncomfortable entanglements associated with health and resource development. Yet, although intersectoral work addressing the cumulative impacts of resource extraction presents uncertainty and unresolved tensions, ultimately we argue that it is worth staying with the trouble.
In Canada and across the globe, indicators play a fundamental role in measuring, tracking, and reporting on the overall health of the population. Mainstream population health indicators used to measure the health and well-being of First Nations peoples are constrained by the Western biomedical paradigm which focuses solely on illness and disease. These indicators are limited and fail to capture aspects of cultural, spiritual, and interconnected aspects of Indigenous health such as spirit, ceremony, and the connection to land. To advance First Nations self-determination in the healthcare system, it is essential for Indigenous narratives and knowledges to thrive in population health data and reporting. Five promising practices are shared to guide the development of First Nations health and wellness indicators and reporting: (1) be culturally relevant and centred on First Nations worldviews on health and wellness (2) must honour Indigenous knowledges and methods; (3) must involve respectful relationships & meaningful engagement with Indigenous peoples’; (4) “Nothing about us, without us”- Indigenous leadership and self-determination at all stages of indicator development; and (5) taking a strength-based approach & contextualizing indicators within historical, socio-political contexts. The co-development of indicators between the [First Nations Health Organization] and the [Office of the Executive Health Officer] in the Province of [Name of Canadian Province] are discussed as promising practices in action. Celebrating the strength and resilience of First Nations health which is required to pave a new way forward in Indigenous grounded population health.
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