Weaving Promising Practices to Transform Indigenous Population Health and Wellness Reporting by Indigenizing Indicators in First Nations Health

Abstract

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.

Best Practices to Support the Self-Determination of Indigenous Communities, Collectives, and Organizations in Health Research through a Provincial Health Research Network Environment in British Columbia, Canada

“…Once a culturally safe and capacity-bridging environment that encourages Indigenous ways of knowing and being is established, we can then support ICCO self-determination and introduce them to other research partners with whom we are working, such as the health authorities or BC SUPPORT Units. Positive research experiences and relationships have the power to connect individuals, groups, organizations, and institutions and transform the health research environment into one that is more inclusive; it has a positive compounding and spiraling effect [35]. In our experience, health research networks have proven to be a way to build beneficial research experiences and relationships.…”

Indigenous Health Research Mentorship within Post-Secondary Institutions in Canada, the United States, Australia, and New Zealand: A Scoping Review

“…However, Indigenous peoples and communities carry deep roots of mistrust of health research and refer to research as the "dirtiest" word due to historical and ongoing negative and exploitative experiences with Western-based researchers that have resulted in stolen intellectual property, harm, and unethical experiments being conducted without consent [3,4]. Further, researchers have often been criticized for culturally unsafe research practices including: (1) unethical research engagement; (2) reporting on the health of Indigenous populations from a deficit-based perspective by highlighting negative health outcomes over strengths-and rights-based approaches; (3) lack of Indigenous representation and input in validating research findings and knowledge translation; and lastly, (4) failing to return research findings to the community(ies) [1,5,6]. Moreover, Indigenous knowledges, perspectives, and community-driven research practices in health research have not prominently been honored or respected in a culturally safe manner within Western-based research environments, including academic institutions [7].…”