Wellbeing of Indigenous Peoples in Canada, Aotearoa (New Zealand) and the United States: A Systematic Review

Abstract

Despite the health improvements afforded to non-Indigenous peoples in Canada, Aotearoa (New Zealand) and the United States, the Indigenous peoples in these countries continue to endure disproportionately high rates of mortality and morbidity. Indigenous peoples’ concepts and understanding of health and wellbeing are holistic; however, due to their diverse social, political, cultural, environmental and economic contexts within and across countries, wellbeing is not experienced uniformly across all Indigenous populations. We aim to identify aspects of wellbeing important to the Indigenous people in Canada, Aotearoa and the United States. We searched CINAHL, Embase, PsycINFO and PubMed databases for papers that included key Indigenous and wellbeing search terms from database inception to April 2020. Papers that included a focus on Indigenous adults residing in Canada, Aotearoa and the United States, and that included empirical qualitative data that described at least one aspect of wellbeing were eligible. Data were analysed using the stages of thematic development recommended by Thomas and Harden for thematic synthesis of qualitative research. Our search resulted in 2669 papers being screened for eligibility. Following full-text screening, 100 papers were deemed eligible for inclusion (Aotearoa (New Zealand) n = 16, Canada n = 43, United States n = 41). Themes varied across countries; however, identity, connection, balance and self-determination were common aspects of wellbeing. Having this broader understanding of wellbeing across these cultures can inform decisions made about public health actions and resources.

An exploration of the sociodemographic and health conditions associated with self-rated wellbeing for Aboriginal and Torres Strait Islander adults

“…Family, kinships and community connections are important to the wellbeing of Indigenous peoples in Australia [ 6 , 10 , 11 ], and globally [ 21 ]. In this study, wellbeing was lowest among those without partners or living on their own.…”

The Fabric of Aboriginal and Torres Strait Islander Wellbeing: A Conceptual Model

“…Conceptions of wellbeing are culturally bound and shaped by a person's experiences, beliefs and values [5]. Whilst understandings do vary across cultural groups, Indigenous peoples globally commonly hold holistic and collectivist worldviews that prioritise the wellbeing of the group above one's own individual needs [6][7][8], differing markedly from the dominant Western individual-centric worldview. Furthermore, many Indigenous peoples share similar histories of colonisation and trauma [9].…”

“…The ongoing intergenerational legacies of colonisation, including the disruption of family and kinship networks, loss of language and culture, and social marginalisation, impact the experience and conception of wellbeing for Indigenous peoples [9]. Many parts of life influence Indigenous peoples' wellbeing, and these parts are often described by Indigenous people, globally, as being deeply and inextricably interconnected [8,10]. For example, Kilcullen et al (2016) identified connectedness to country, family and kinship, cultural knowledge and social networks as contributing to the health and wellbeing of Aboriginal and Torres Strait Islander people in Australia [11].…”

“…Despite the significant literature supporting the importance of the interconnection of dimensions of wellbeing for Aboriginal and Torres Strait Islander people, existing measures [8,10] and indicators do not adequately capture these holistic and collectivist aspects. For example, while successive Australian governments have committed to improving the health and wellbeing of Aboriginal and Torres Strait Islander people, to date, wellbeing has not been captured using measures that are based on the values and preferences of Aboriginal and Torres Strait Islander people [4,19].…”

The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe: Ensuring and Promoting Best Practice in Research

“…The resulting Special Issue includes 31 papers in total, with 21 from Australia [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ], 4 from the United States [ 28 , 29 , 30 , 31 ], 3 from Aotearoa/New Zealand [ 32 , 33 , 34 ], 1 from Canada [ 35 ], and 2 from authors in multiple countries [ 36 , 37 ]. This represents a substantial body of research on the health and wellbeing of Indigenous and Tribal peoples, possibly the largest collection ever published.…”