Geography as a Determinant of Health: Health Services Utilization of Pediatric Respiratory Illness in a Canadian Province

Kassam, Shehzad; Serrano-Lomelin, Jesús; Hicks, Anne; Crawford, Susan; Bakal, Jeffrey A.; Ospina, Maria

doi:10.3390/ijerph18168347

Cited by 3 publications

(1 citation statement)

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“…This is a truism that many Indigenous peoples and communities have asserted for decades. People from coast to coast to coast across so-called Canada are also and increasingly documenting ways that rural, remote, and especially northern geographies-along with places more broadly falling outside of the 100-kilometre radius of the United States/Canada border where 90% of inhabitants of Canada now live-are experiencing poorer health outcomes as compared with our urban metropolitan neighbours [31,32]. In other words, the specificity of places, including local lands, and the muck, the weeds, and the unique ecologies, matter.…”

Section: Grounding Ourselves: a Geo-eco-placed Introductionmentioning

confidence: 99%

Grounding Wellness: Coloniality, Placeism, Land, and a Critique of “Social” Determinants of Indigenous Mental Health in the Canadian Context

Josewski

Leeuw

Greenwood

2023

IJERPH

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Authored by a small team of settler and Indigenous researchers, all of whom are deeply involved in scholarship and activism interrogating ongoing processes of coloniality in lands now known to many as Canada, this paper critically examines “social” and grounded determinants of Indigenous mental health and wellness. After placing ourselves on the grounds from which we write, we begin by providing an overview of the social determinants of health (SDOH), a conceptual framework with deep roots in colonial Canada. Though important in pushing against biomedical framings of Indigenous health and wellness, we argue that the SDOH framework nevertheless risks re-entrenching deeply colonial ways of thinking about and providing health services for Indigenous people: SDOH, we suggest, do not ultimately reckon with ecological, environmental, place-based, or geographic determinants of health in colonial states that continue to occupy stolen land. These theoretical interrogations of SDOH provide an entry point to, first, an overview of Indigenous ways of understanding mental wellness as tethered to ecology and physical geography, and second, a collection of narrative articulations from across British Columbia: these sets of knowledge offer clear and unequivocal evidence, in the form of Indigenous voices and perspectives, about the direct link between land, place, and mental wellness (or a lack thereof). We conclude with suggestions for future research, policy, and health practice actions that move beyond the current SDOH model of Indigenous health to account for and address the grounded, land-based, and ecologically self-determining nature of Indigenous mental health and wellness.

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Section: Grounding Ourselves: a Geo-eco-placed Introductionmentioning

confidence: 99%