INHS 100
Indigenous health impacts of development and resource extraction
-indig people in very developed lands lost access to their traditional lands -in northern BC, more access to the land
Indigenous
-A term considered more acceptable as a generalizing term -it signifies that people have inhabited a particular territory for millennia and because it connects common experience across the globe. -not used in legislation
What makes canadians sick model
-50%: your life (income, childhood development, education, gender, race, etc) -25%: your health care -15%: your biology -10%: your environment (air quality, infrastructure)
Post colonization
- middle of 20th century -refers to after colonialism -was created as colonial countries became independent
Language rights
english and french
Mobility rights
right to enter, leave and remain in Canada
English language
-indig language was considered pagan -learning english was an assimilation tool -was taught through methods of punishment and humiliation
RCAP's central question
"What are the foundations of a fair and honorable relationship between Aboriginal and non-Aboriginal people of Canada?"
Cultural safety takes us beyond
-cultural awareness, cultural sensitivity, and cultural competence -cultural safety is inclusive of these characteristics and also idea of it is grounded in cultural humility
Historical trauma healing needs to include:
-aboriginal worldviews -personal cultural safety -capacity to heal
What did the cultural safety committee identify the institutional barriers for indig people were
- lack of acknowledgment of the impact of colonization and assimilation policies; - lack of programs to meet the length of time required to address historical trauma and reconciliation needs -lack of respect for Indigenous healing ways
Indian acts twist on words
-"the descent provisions in the Act are essentially blood quantum formulas that perpetuate colonial, racist ideologies about what it meant to be a "real" Indian." -The use of different wording does not cover up what Canada is doing - it is requiring that all status Indians be "real" Indians as viewed from Eurocentric ideologies around blood purity and race.
Fundamental freedoms
-8 of them Freedom of: -Consciousness -Religion -Thought -Belief -Expression -Press -Peaceful Assembly -Association
Access to health care
-Aboriginal People are less likely to seek help when symptoms are present -Aboriginal People are more likely to be diagnosed at a later stage of disease than non-Aboriginal people -Many Indigenous people don't trust mainstream health care services because they don't feel safe from stereotyping and racism
Acculturation
-continuous and intense contact between two previously autonomous cultural traditions
Chandler and Lalonde study found
-Aboriginal people account for 3% of the total population in BC -Aboriginal people account for 9% of all suicides in BC -Aboriginal youth account for 23% of all youth suicides in BC
Who was an indian
-Aboriginal women who married non-Aboriginal men in the past lost their status under the Act, but Aboriginal men who married non-Aboriginal women did not. -women were not allowed to vote in Band elections or participate in public meetings until 1951. -Men and women were not granted the federal vote until 1960. -Indian men could not lose status through marriage, in fact, if they married non-status women, those women GAINED status under the Act.
Language and culture and TRC
-Acknowledge that Indigenous rights include Indigenous language rights -Enact an Indigenous Languages Act -Appoint Languages Commissioner -Post-secondary degree and diploma programs in Indigenous languages -Enable Survivors and their families to reclaim names changed by residential school system
Health and TRC
-Acknowledge that the current state of Aboriginal health is a direct result of previous Canadian government policies, including residential schools -Implement health-care rights of Indigenous people -Recognize, respect and address distinct health needs of the Metis, Inuit, and off-reserve Indigenous peoples -Provide sustainable funding for healing centres -Recognize the value of Indigenous healing practices and use them in treatment of Aboriginal patients -Increase the number of Indigenous professionals working in the health-care field -Provide cultural competency training for all health-care providers -Require all health-care students to take a course dealing with Indigenous health issues
What the TRC wants
-Adequate resources -Cultural competency training -Accountability -Consultation -Respect and self-determination -Legislation that protects Aboriginal way of life -Adopting and implementing United -Nations Declaration on the Rights of Indigenous Peoples
Higher education
-Any Indian person wishing to pursue higher education risked losing his/her status as an Indian, including all benefits such as living on the reservation, inheriting property, or even being buried on the reservation. -cant obtain any degree, become a doctor, lawyer or clergy member
Cultural continuity as a determinant of indig peoples health (pt.2)
-Barriers to cultural continuity were specific to single studies and included youth apathy, community toxicity such as gossip and addiction, lack of funding for programming, or acculturative pressure from western institutions. -Auger offers that it is important to understand challenges it is more important to focus on strength-based interpretations of cultural continuity. -Promoting community empowerment is a shift away from deficit-based models of Indigenous health.
Aboriginal peoples and historical trauma
-Bellamy and Hardy (2015) argue that Indigenous people are at higher risk for Post Traumatic Stress Disorder (PTSD) however, the prevalence rates are low in community. -They admit that cultural biased diagnostic criteria is one factor. -But, another factor is that a PTSD diagnosis does not adequately address Indigenous trauma.
Healing historical trauma overview of research
-Castellano & Archibald (2013) -"historic trauma transmission" explains the origins of social unease in Indigenous communities and the dynamics of interventions. -Research draws on historical, social science, and therapeutic sources to develop core concepts.
Johann Blumenbach five major racial divisions
-Caucasoid (White) -Mongoloid (Asian) -Ethiopian (later Negroid) -American Indian -Malayan (South American)
Other theories
-Coastal Theory: Indigenous people arrived on the west coast travelling by boat or foot (arriving when the glaciers had pulled back from the shoreline). -Pacific Crossing Theory: Indigenous people came across the ocean in some type of boat from Australia. -Atlantic Crossing Theory: Indigenous people came across the ocean in a skin and wood boat. -Pangaea Theory: The theory that the earth was once one supercontinent and broke up into smaller continents supports this theory.
Commemortion
-Commission -install a publicly accessible, highly visible, Residential Schools National Monument in the city of Ottawa and in each capital city
Community resilience and health research
-Community-based participatory research (CBPR)—research relationships based on trust, reciprocity, and shared understanding of research problem and outcomes -Shifting from a deficits-based to a resource-centred model of Indigenous health research
How does worldveiws and culture affect the health of indigenous people
-Culture concerns patterns of behaviors and values. -First Indigenous worldviews and culture is an inclusive, collectivist society -Values of sharing, group or family solidarity, emotional interdependence -Emphasize duties and mutual obligations -Group decision-making
Importance of cultural continuity
-Culture is linked through processes of historical transformation (Kirmayer) -Cultural Continuity is the present preservation of traditional culture (Chandler and Lalonde) -foundational to health in successful First Nations. -is an expression of self-determination.
Current treatment and symptoms for PTSD
-Current treatment for PTSD approaches tend to pathologize the victim and incarcerate the perpetrator. -Symptoms are reduced by controlling surroundings and blaming the affected. -The current approach is not effective.
Self determination as a determinant of health
-Distal determinants of health: They represent the political, economic, and social contexts that construct both intermediate and proximal determinants. -Self-Determination has been cited as the most important determinant of health among Aboriginal people: a. it influences all other determinants -must have equal participation in political decision making, control over lands etc. It is the degree to which one feels in control of their life
Connectedness to land as a determinant of health
-Environmental dispossession must be considered as a fundamental cause of poor health in Indigenous communities
Additional sections in the TRC
-Equity for Indigenous People in the Legal System -Professional Development and Training for public servants -Education for Reconciliation -Youth Programs -Museums and Archives
10 strategies to guide organizations in enhancing capacity for equity-oriented services
-Explicitly commit to equity -Develop supportive organizational structures, policies, and processes -Re-vision the use of time -Attend to power differentials -Tailor care, programs and services to local contexts -Actively counter racism and discrimination -Promote meaningful community + patient engagement -Tailor care to address inter-related forms of violence -Enhance access to the social determinants of health -Optimize use of place and space
The Truth and Reconciliation Commission (TRC)
-From the RCAP action plan, the Office of Indian Residential Schools Resolution Canada was created -Measures to address the legacy of the Indian Residential School system were identified -The TRC was one of those measures
DNA testing
-Geneticists now calculate, based on mutation rates in human DNA, that the ancestors of the Native Americans parted from their kin in their East Asian homeland -DNA testing also suggests there is no link between some North American Indigenous people and Mongolia. -The Initial belief was that they found tools the same down south as in the north. There assumption was migration not evolution. And nothing else similar was found. No art, no stories, why only tools and not keep any other cultural artifacts.
Dislocation
-Government policies had disastrous consequences for Indigenous people. The most fertile land was given to white settlers, the government took control over water, and the environment was altered to the disadvantage of Indigenous peoples.
Aquiar and Halseth explanation on how historic trauma distinguishes from PTSD
-HT is more complex -HT is a collective phenomenon -HT is accumulative -HT is intergenerational -Past HT creates conditions of disadvantage -Results in perpetuate traumas for subsequent generations -Contemporary traumas (racism and discrimination) perpetuate colonialism -Direct experience of the trauma is not required. -The trauma experience is passed down to close family members.
Health trends of indigenous people vs non indigenous people
-Have lower median after-tax income; -Are more likely to experience unemployment; -Are more likely to collect employment insurance and social assistance; -Are more likely to live in housing in need of major repairs; -Are more likely to experience physical, emotional or sexual abuse; -Are more likely to be victims of violent crimes; and -Are more likely to be incarcerated and less likely to be granted parole.
The need for healing
-Healing needs to include: a. aboriginal worldviews b. personal cultural safety c. capacity to heal -Pillars of healing a. reclaiming history b. cultural interventions c. therapeutic healing
Health transfer
-Health Transfer allows for some administrative flexibilities and control over funding, however, it still exists within a larger system that has significant restraints. -Throughout the country, communities are at varying levels of health transfer
Recommendations of the RCAP
-Housing; -Education; -Art and Heritage; -It also included recommendations developed through a focus on certain perspectives (women, Elders, youth, 'The North', Métis, urban); -Reconciliation of Treaties; -Negotiating land bases; -Resources; -Economic Development; -Child welfare; -Restoring family and community health; -Health and Health Care.
Various shortfalls in government commitment to indig peoples' health funding
-Inadequate funding growth for health programs (capped at 3% for ten years). -New health program funding, such as Maternal Child Health, is often inadequate and only selected communities can benefit from the funds. -A health-funding shortfall of close to $2 billion is expected over the next five years (2006-2011). -Over the next two years, individual communities will experience an average gap of 9% in 2006/07 and 14% in 2007/08 between what they will receive in health funding and what is actually needed.
Genocide
-Killing members of the group; -Causing serious bodily or mental harm - prevent births -Forcibly transferring children of the group to another group -all of these conditions are met through Canada's assimilation policy
Six factors associated with cultural continuity
-Land claims; -Self-government; -Education services; -Police and fire services; -Health services; -Cultural facilities.
Major contributors to spread of disease
-Large, sedentary populations -Over-crowding and poor hygiene -Poor nutrition -Close contact with animals (they are reservoirs for microorganisms).
Additional sections in the TRC continued
-Missing Children and Burial Information -National Centre for Truth and Reconciliation -Media and Reconciliation -Sports and Reconciliation -Business and Reconciliation -Newcomers to Canada
Indigenous relationship to land
-Multifaceted, health-supporting, deep spiritual relatedness -Central to acquisition, transmission, and practice of Indigenous knowledge -Disrupted by colonialism
Why is equity oriented care important
-Patients experiencing equity-oriented care showed higher levels of comfort and confidence about the care they received -Increased levels of comfort and confidence predicted increased confidence to manage their health issues -Over time, as confidence increased, patients' self reported quality of life improved, and symptoms of chronic pain, depression and PTSD decreased
Purpose of residential schools
-Pedagogy - Change learning and education from holistic to western -Paganism - needed to be Christianized -Culture - needed to take on "White-Western" values -Appearance - Needed to "look" more like white people
Environmental dispossession
-Process through which Indigenous peoples' access to the land and resources of their traditional environments is reduced or fundamentally altered -had cascading effects
Health services
-Provincial systems provide most acute and intensive services for ALL Indigenous populations (i.e.: hospital services) -The Federal government provides some health services for on-reserve status First Nations and Inuit communities as well as Non-Insured Health Benefits (NIHB) -This funding is not provided for non-status or Métis populations
Cultural continuity and the study
-RCAP addressed youth suicide in the recommendations for change -Study took place in British Columbia -Suicide rates 5 -20 x higher than non-Indigenous population -200 Indigenous communities studied/outcomes varied per community -The primary focus of the study was to try and work out why it should happen that some Indigenous communities experience epidemic rates of youth suicide, while in others such deaths are largely unknown or absent.
Child welfare and the TRC
-Reduce the number of Indigenous Children in care -Fully implement Jordan's Principle -Enact legislation that establishes national standards for Indigenous child apprehension -Develop culturally appropriate parenting programs
Community involvement
-Strengthen communities and deepen the connection to the environment -Restore cultural activities and lead to the reestablishment of a communities sense of place. -This can lead to a communities sense of control, self-efficacy and self-determination
Study in the NW territories, yukon and nunavut
-Summary: describes some fo the health benefits that come from spending time out on the land -sound that land based practice is a highly effective way of supporting reconciliation, their identity and culture
What the different committees recommend for indig healing
-The Mental Health Commission of Canada (2012) recommends combining traditional and mainstream approaches, such as engaging Elders as service providers. -The CSWG (2013) urges a balance between western and traditional approaches. -A balance is not augmentation nor is it complementary; it is a reworking of what is currently available by co-constructing a new way. -One theory in progress is the Indigenous Cultural Responsiveness Framework.
What concepts used to justify European sovereignty over Indigenous lands and people, such as the Doctrine of Discovery and terra nullius means
-The TRC asked that work be done to deny the validity of the beliefs that allowed paternalistic policies and racial stereotyping. These beliefs were supported by the doctrine of discovery and terra nullius
Chandler and Lalonde study
-The province-wide rate of Indigenous youth suicide (which was 5x the national average) was not capturing the reality of the province's communities -1 out of every 5 tribal councils did not recorded suicides -In the period covered by the study, 90% of suicides were in less then 10% of the bands -Youth suicide is not an 'Indigenous' issue - but it is an issue in some Indigenous communities
Third interpretation of the medicine wheel
-The wheel can also represent values and decisions. -values (drawn in the East, where the sun rises) influence decisions taken in the mental realm (drawn in the North, at the top). Then, decisions are implemented in the physical realm (West), and actions produce reactions in the emotional realm (South). Finally, these reactions provide feedback into the value system, completing the circle of value - action - evaluation.
Factors that heighten intimidation and alienation for indig populations
-There is a higher value placed on Western educational credentials; -A lack of respect for traditional Indigenous approaches to healing; -Use of complicated medical terminology instead of conversational language; -The rapid pace that health care professionals work within; -Western focus on disease rather than on the whole person and life circumstances; -Lack of 'space' for ceremonies and traditional healing.
Cultural responsiveness framework
-This framework was developed through an initiative led by the Federation of Sovereign Indigenous Nations and the Saskatchewan Ministry of Health (FSIN, 2013). -The framework offers a model for client-centered care that engages community and Elders. -Stemming from cultural safety, Cultural Responsiveness creates a middle ground that unites Indigenous and western ways of responding.
Understanding trauma theory
-Understanding the nature of trauma -Understanding goes beyond western conception -Understanding the relationship between contemporary and historical manifestations of trauma is required to disrupt the cycle. -Interrupting the cycle requires healing and rebuilding individuals, families, and communities.
Traditional healing
-When Indigenous people refer to traditional healing, they are speaking of the use of herbal remedies as well as specific ceremonies and rituals to promote spiritual, mental, physical and psychological well-being
Holistic models
-a change in one aspect of yourself is likely to affect all others -models of holistic health takes various elements into consideration
Bill C-31
-act to amend the indian act -restored indian status and band membership rights -had a huge impact on registered indian pop. Estimated to have increased by 19% -debate continues whether it benefits families and women -many believe it continues to marginalize indig people and have a negative effect on health
Health practices in ancient civilization
-all utilize various health practices -ancient civilizations were aware that: -environment affects health -used plants -hygiene affects health -Certain foods kept our bodies more healthy than others
Indian act
-allowed government to control: -identity (who was or was not an indian) -The way the community was governed -land and resources -education -the ability to retain a lawyer and defend their rights -what professions they could have -spiritual practices
Self determination and self government
-allows FN people to make decisions regarding health care etc -Under this policy, First Nations may be entitled to make certain laws governing their community with respect to health.
Types of contact: partial diffusion
-an idea or tool is borrowed and partially integrated into a way of life but does not include the resources/ technology or background knowledge for reproduction of the idea or tool
Creation stories
-an origin or conception story to explain how people and the world came into existence
Words from the elders
-anishinabe of lake superior -preserving indig knowledge- interviews with 46 elders from two communities the batchewana first nation and pic river first nation -focused on meanings associated with the land
Cultural unsafe practice definition
-any actions that diminish, demean or disempower the cultural identity and well being of an individual -analyzes power imbalances -addresses institutional discrimination, colonization and relationships with colonizers as they apply to health care
Cultural awareness
-awareness of your own, and other, cultures -identifying and understanding that differences exist -a continual and evolving process that examines cultures to garner a better understanding and awareness of them
Medical model
-based on the absence of illness -uses physical diagnosis for treatment -focuses of western ways of knowing -model deals with illness, the negative, the absence of health and functions from a deficit approach
Places of interface: where two worlds meet
-becoming bi-cultural: indig children must learn to 'code switch' between indig and mainstream cultures -two eyed seeing and the story of coyotes eyes: recognizing that there are different systems of knowledge -taking the best from two (or more) ways of knowing -ethical space: interface of diverse ways of knowing and cultures
pre-colonial history
-before europeans came to north america, indigenous people were healthy, diverse and strong -women were valued, children were raised according to values, resource rich environments provided abundant, healthy food
Doctrine of discovery
-bill issued by the Vatican that said that when European nations "discovered" non-European lands, they gained special rights over that land
Another interpretation of the medicine wheel
-can also represent the balance between spiritual (East), mental (North), physical (West) and emotional (South) aspects of health. -Spirit has needs of love, belonging, purpose, meaning, creativity, hope, and forgiveness. -Mental encompasses cognitive ability, thinking, learning, beliefs about self. -Emotional holds affect, behaviour, and self-expression. -Physical explores health and wellness of body.
Residential schools
-catholic, anglican, presbyterian and methodist churches pressured federal government to fulfill the educational clauses in the treaties asap -children taken from age 7 until 16 -schools were secluded -wanted to maintain separation from families for as long as possible and visitations were limited and they got 2 months summer holidays -prairie province has high numbers of attendees
Role of the church
-christian duty and self interest were foundations of residential schools -church/government parternship until 1969 -after, schools on reserves were largely transformed into day schools -last school closed in 1996 (gordons in sask) -under the partnerships, churches earned grants through how many children attended
Christianization
-church played big role in colonization -attempted systematic assimilation -believed it was their duty to help lift them from 'inferior state' -used coercion like promises of food and medicine
study suggests
-clinicians associate symptoms from residential school survivors with PTSD -little was known about the extent of trauma from res schools. -less was known about interventions that would promote healing
Royal Commission on Aboriginal Peoples (RCAP)
-commission appointed in 1991 -final report 1996 -5 volumes and over 4000 pages -19 recommendations
RCAP and the past
-commission concludes that the relationships between aboriginal people and non aboriginal people has been built on 'false premises' -result was policies that removed aboriginal people from their homelands and tried to get rid of their culture
Health transfer
-complex process with opportunities and limitation that shift varying levels of control from FNIHB to FN commjunities regarding administration of health services -throughout the country, communities are at varying levels of health transfer -allows for some administrative flexibility and control over funding -movement towards self government that would allow for better self determination
Compulsory attendance
-compulsory attendance in 1894 -before FN families had the choice of sending their child to school or not
Recognizing the churches role and TRC
-congregations learn about the role the churches had in colonization -history and legacy of residential schools -why apologies are necessary
Anishinabe
-consider themselves to be part of the land -symbiotic relationship to the land based on responsibility -spiritual connection through ceremony and is foundational strength to build and sustain social relationships
Documenting indigenous culture and heritage
-defense of indig territories through government impact assessment process -government approval of mining, pipeline and other projects requires indig use of traditional territories -strain on limited FN resources also builds community capacity -environemntal assessment system gutted by provincial liberal government and led to discussion about indigenous environmental assessment process
Storytelling and healing
-demonstrates cultural pride for children -connection with ancestors and brings immense love for self and others
Relational racism
-discriminatory encounters in daily life. -Being followed in stores, ignored, denied promotions. -Name calling, sexual or physical assaults.
Identity development
-due to the historical trauma experienced, identity has become clouded by western expectations and assimilation practices -cultural continuity creates values, identity, norms and meaning -shapes we we are in the world
Clovis model/ land bridge theory
-early humans came from Siberia on foot and had followed mammoths and caribou across a land bridge where the Bering Sea is now located -hunters found a way through the ice sheets that covered what is known as Canada -moved to pursue animals and fanned out to the pacific and atlantic coasts -process of cultural differentiation began and produced a wide array of aboriginal languages, cultures etc.
Structural racism
-economic, social, and political institutions and processes. Inequitable laws, policies, rules, regulations, and access to resources. -structural practices create dominance without Indigenous input, such as reserve size, etc.
Truth and reconcilliation
-established by indian residential school settlement agreement -response to class action lawsuits brought on my res school attendees
Indian Hospitals
-established to treat infectious diseases -intention was to keep interracial pathogens from spreading -some had positive and some had negative experiences -records of treatments that occurred in these hospitals are scarce
Disease in indig people
-europeans brought diseases the aboriginal people had no resistance to (small pox, TB, influenza, scarlet fever measles) -reduced pop. drastially -pop of 500,000 declined to 102,000
Linnaeus construction of race
-europeans, asians, americans and africans differed in mood -europeans as cheerful, asians as meloncholy, americans as aggressive and africans as sluggish
What does cultural safety require
-examination of how personal biases, authority, privilege and territorial history can influence the relationships between health care providers and indig people -self relfection and critical reflection are key and being able to establish trust with the patient
Engaging the collective in an early childhood setting
-families and communities as partners in developing early programs with a focus on language and culture as well as decision making and administration -knowledge holders in the community must be supported and strengthened to teach and share -education cirriculum should be culturally relevent and locally supported -requires partnership between education institutions and indig communities.
21st century resource rush
-first it was the fur trade and timber and now its pipelines and mining -FN people are using the courts and international pressure to defend indigenous territories.
Cultural competency
-focuses on acquiring an adequate and appropriate set of skills, knowledge, attitudes, protocols, approaches, language and experiences for working with people of other cultures such as indig cultures -culturally competent health care providers have the tool kit needed for building trusting health care relationships with culturally different people
Cultural sensitivity
-focuses on difference and on being sensitive and respectful towards the worldviews, principles and practices of people from other cultures such as indig cultures -involves learning about these cultures through cultural awareness. -culturally sensitive aware and apply that awareness when working with culturally different people
Balance
-for a traditional healer, an imbalance (loss of values etc) may affect health decisions
Stressors of contact
-forced migration -violence -destruction, depletion, or reduced access to traditional subsistence sources (food, shelter, clothing) -enslavement -epidemics
What are the quadrants of the medicine wheel
-four points and symbolizes stages in the life journey -east (suns daily birth) represents a persons birth and early years -south relates to childhood and intellectual growth -west represents adulthood and introspection -north represents old age, wisdom and the spiritual aspects of life -center is symbolic to mother earth and the creator and their role in the beginning and continuation of life
To establish permanent funding for community controlled:
-healing and reconciliation projects -Culture and language projects -Education and relationship-building projects -And regional dialogues for Indigenous spiritual leaders and youth to discuss Indigenous spirituality, self-determination and reconciliation
What do multiple definitions of health show?
-health can't be adequately captured through illness and death -it is a state that people can attempt, maintain or regain -changing force -it is influenced by our social, economic, political and cultural environments
Terra Nullius
-historical principle that refers to land belonging to 'no one' and there for can be acquired through occupation
Cultural humility
-humility helps us to understand the obvious truth -many indig cultures teach humility as one of their core principles for being in good relationships. Humility reminds us that we are part of creation -in terms of patient provider relationships, cultural humility reminds us to humbly acknowledge our culture in relation to others -reminds us that everyone has knowledge that they bring to the relationship
land covering info
-in 1800 European powers held 35% of the earths surface -in 1914, europe held approx. 85%
Aboriginal
-indian, inuit and metis people of Canada -these people are very diverse
Indigenous vs western worldveiw on society
-indigenous people believe society operates in a state of relatedness and that everything and everyone is related. -law kinship and spirituality reinforce this connectedness. -identity comes from connections -western people believed in a compartmentalized society
Indigenous vs western worldveiw on wealth
-indigenous people believe that buildup of wealth is important for the good of the community. -western people believe that amassing wealth is for personal gain
Indigenous vs western worldveiw on feeling comfortable
-indigenous people believe that feeling comfortable is measured by the quality of your relationships with people. -western people believe that feeling comfortable is related to how successful you feel you have been in achieving your goals. -western people also use intrinsic values vs extrinsic values
Indigenous vs western worldveiw on human beings
-indigenous people believe that human beings are not the most important in the world -western people believe that human beings are most important in the world
Indigenous vs western worldveiw on land
-indigenous people believe that the land is sacred and usually given by a creator or supreme being and if it's respected, the land will provide what is needed. -western people believe that the land and its resources should be available for development and extraction for the benefit of humans.
Indigenous vs western worldveiw on time
-indigenous people believe that time is non-linear and cyclical in nature. Its measures in cyclical events and the seasons are central to this cyclical concept -western people believe that time is usually linearly structured and future orientated and the framework of months, years and days reinforces the linear structure
Indigenous vs western worldveiw on truths
-indigenous people believe there can be many truths and that truths are dependent upon individual experiences. -western people believe there is only one truth, based on western science of western style law.
Indigenous vs western worldveiw on beliefs
-indigenous people have a spiritually orientated society. Their system is based on belief and spiritual world (regional science) -western people believe in empirical science and they are skeptical. They require proof as a basis of belief.
Fur trade
-initially was a mutually beneficial thing -had impacts on traditional indig economies and environment -diffusion of euro goods into indig communities -as time went on, there was less demand for fur, depletion of game and a desire to settle the west. Fur trade eventually died off
Sterilization (1973-1976)
-involuntary sterilization in 3 indian health hospitals in US -1/3 to 1/2 of aborig women sterilzed -women in canada also targeted -FN and metis people were given diagnosis saying they were 'mentally deficient' which made them eligible for sterilization without consent
Status or treaty indian
-legal term embedded within the indian act -refers to all Indigenous people who are the descendants of the Nations that entered into Treaty with the (British) "Crown"
Health of Indigenous Populations Prior to Contact
-lived healthy lifestyles and did not suffer from infectious disease -only biological weapons indig people had were forms of intestinal parasites -Common ailments included pyhorrea (disease of the gums), arthritis, venereal disease, broken bones but were well adapated to deal with these ailments. They used plants and herbs as medicines and many modern drugs are derived from these
Assimilation or segregation?
-loss of land and changing rules limited choices and health opportunities of indig people -travel was limited leading to intermarriage -trade was limited between communities
Impacts on families, culture and language
-lost language, identity, culture, basic skills such as parenting -res. school mission was to acculturate the children into mainstream society -loss of familial connections -shame -not worthy of love
Terra nullius
-means nobody's land. Settlers coming to Canada believed that Indigenous people never owned the land therefore, Europeans were able to settle on the land and make it there own.
Community and health
-medicine wheel describes the interconnectedness between health and well being of the individual, family and community -a problem can only be resolved when the entire community is in balance -the health of indigenous people is connected to the economic, environmental and cultural wellness
Metis people in residential schools
-metis people were excluded except their is some evidence that metis people did attend -9% of people who went to res schools identified as metis
Pagans and Indians
-missionaries taught the children to live in fear of god -all FN culture and beliefs were seen as pagan and morally wrong -anyone who practiced these would go to hell -
Relocation and reserve system
-moved away from desirable lands -FN groups were joined together that were rivals -coercion tactics used by missionaries to force assimilation became more effective
Fourth interpretation of the medicine wheel
-north (white): air, animals, receive energy, mental, wisdom and logic -east (yellow): sun, fire, determine energy, spiritual, illumination -south (red): water, plants, gives energy, emotional, trust and innocence -west (black): earth, physical, holds energy, introspection and insight -centre (green): learning self, balance, beauty and harmony
Collectivist culture effects on health
-often people feel isolated and find the way western practitioners expect people to take responsibility for their own health is difficult to understand -generally expect families to provide strong mutual support. Decisions concerning treatment will often be made by the group
Epistemic racism
-one race's knowledge is preferred over others. It is not identified by race but as science or fact.
Inuit
-people living in the Arctic regions.
First nations
-people who are members to one or more of the First Nation communities in Canada, and who may be Status or non-Status Indians. -more than 50% of FN people no longer live on reserves -term widely used in 1980's in place of 'indian' or 'band'
Changes in diet
-pre contact: small size, relative isolation, mobility on land and water, seasonal excursions, knowledge of environment, enviro friendly subsistence practices and the variety of foods -post contact: increased saturated fats, sugars, alcohol, salt etc -loss of cultural knowledge about foods and medicines has resulted in family violence and health problems
Symbolic racism
-prejudices are revealed in less direct ways such as disagreeing with affirmative action, or benefits provided to Indigenous people. -Racism is usually not discussed in relation to the meritocracy myth. If people do not have access to the same social goods or production there is no equal approach to success.
Equity rights
-protection and benefits
Chandler and Lalonde study told us
-province wide rate of abor. youth suicide rate was not capturing the reality -there were no recorded suicides in 1 of every 5 reserves -90% of suicides were in less than 10% of bands -youth suicide is not an 'abor.' issue
Self determination and health services
-provinces and territories must be involved in negotiations where matters affecting their jurisdiction are being discussed -collaboration amongst federal, provincial, territorial, and Indigenous governments are required to effectively work within the current system
Health services (prov and federal)
-provincial government provides most extensive care for ALL abor. people -federal government provides some health services for on reserve FN and Inuit communities -no funding is provided for non status or metis populations
What is an individual culture influenced by
-race, gender, religion, ethnicity, socio-economic status, sexual orientation and life experience
Result of classifications and hierarchies
-racial differences originate in biology and physical characteristics and behaviors are good indicators of race -each race has a distinct culture that is linked to biology -racial differences are unchangeable -racial categories should be written into political, legal and social system
Six R's of assimilation
-racism, religion, relocation, residential schools, reserves, RCMP (supervised the removal of indig children to residential schools)
Raven: haida creation story
-raven helped in the beginning -gave them each gifts to be shared with the world -each are unique but have similarities -telling stories helps overcome racism, reminds them who they are -human connection
Historical trauma pillars of healing
-reclaiming history -cultural interventions -therapeutic healing
Geographers
-recognize cyclical and dynamic relationships between humans and spaces/places
Common colours of the medicine wheel
-red, yellow, black, white, blue or green
Health inequities
-refers to socially constructed, unjust and avoidable differences in health and healthcare between and within groups of people
Metis
-refers to the mixed blood descendants of European and Indigenous people. -language is michif -developed from the people of mixed ancestry descent from the French and Cree families living in the Red River valley.
Nutritional expirements
-researchers traveled to northern Cree communities in manitoba to study their nutrition state -team quickly observed extreme malnutrition and health issues -researchers were interested in impacts of vitamin therapies instead of giving nourishment -vitamin issues werent the number one issues in these communities, it was hunger
Social determinants of health
-resulting from social constructions and situations -provide us with a framework for understanding health and what influences it
Revisiting indian act
-revised because Indian act contradicted with the Charter of Rights and Freedoms -Bill C-31 -did not eliminate sexism -took until 2019 for gender equity in the Indian Act to be effective
Apology and response
-scott moe issued an apology for the 60s scoop -FSIN chief bobby cameron said the apology is welcomes but children are still being stripped from their families, communities and culture and the apology is empty if it is not followed through by action
Wellness and illness
-separate but related dimensions -lack of illness is not enough to assume a state of health -presence of illness or disease does not mean that people aren't experiencing aspects of health -health plays a role in how disease and illness is experienced
Worldveiw
-set of beliefs about fundamental aspects of Reality that influence one's thinking, knowing, and doing. -we should respect and learn from others worldveiws
New direction in social policy
-social issues (poverty, health, housing, family violence); -cultural issues (language, spirituality, child care and traditional ways of life); and -educational issues
What is health equity?
-social justice goal focused on pursuing the highest possible standard of health and health care for all people paying special attention to those in the context of greater risk of poor health, and taking into account broad social, political and economic influences and access to care
Historical trauma theory
-studies show an association between secure infant attachment and children's well being -children who experienced chronic childhood trauma are negatively affected -Epigenetics may explain the way genes alter and can perpetuate intergenerational impairments. -Adverse childhood experiences in the first generation create increased stress on the next generation and thus perpetuates the cycle of trauma. -Indigenous cultures value clan and kinship systems. -Incorporating cultural context into attachment theory models honours the Indigenous ways of being prior colonization.
Department of indian affairs
-supposed to be a temporary department to assimilate FN people into mainstream society -Once the Department realized that First Nations people did not want to become brown skinned white people, they increased their efforts of assimilation through various policies.
Culturally safe care requires
-that the patient's way of knowing and being is respected as valid -that the patient is a partner in the health care decision-making process -that the patient determines whether or not the care received is culturally safe. -As Canadians and as health practitioners, we need to be self-reflexive regarding our own biases and stereotypes. This is a core skill that can be learned and facilitates the development of culturally secure relationships.
Aboriginal healing foundation
-the aboriginal healing foundation was created to oversee community healing projects addressing the negative residential school experiences
Four sacred medicines (tobacco)
-the east -Tobacco connects us to the spirit world. If a request is accompanied by an offer of tobacco that is accepted, the promise must be honoured. -Tobacco can also be used to thank the Creator for his gifts -Tobacco is generally not smoked, except on special ceremonial occasions
Develop and teach cirrculum on
-the need to respect Indigenous spirituality -the history and legacy of residential schools and the role of the church in that system -the history and legacy of religious conflict in Aboriginal families and communities, -and the responsibility that churches have reduce conflicts and prevent spiritual violence.
Four sacred medicines (sweetgrass)
-the north -used by almost all Aboriginal peoples in North America for ritual cleansing. -When Sweetgrass is walked on, it bends but does not break. Hence, it has been associated with virtue: an injustice can be returned by a kindness, by bending, not breaking.
Ecological restoration definition
-the process of assisting the recovery of an ecosystem that has been degraded, damaged, or destroyed -The science of ecological restoration is devoted to: returning damaged ecosystems to a condition that is structurally and functionally similar to the pre-disturbed state
Types of contact: diffusion
-the process of people borrowing an idea and incorporating it into their way of life, complete with reproduction of the idea or tool
UN declaration on the rights of indigenous people (2010)
-the right to the full enjoyment of all human rights and fundamental freedoms; -the right to be free from any kind of discrimination; -the right to self-determination, autonomy or self-government; and -the right to life, physical and mental integrity, liberty and security of the person.
Four sacred medicines (cedar)
-the south -used for purification and (taken as a tea) to attract positive energy, feelings, emotions and for balance. Its vitamin C content helped prevent scurvy when fruits and vegetables were unavailable during the winter months. Considered by some as a man's medicine. Cedar may be used to bring balance to ceremony.
Four sacred medicines (sage)
-the west -is a women's medicine, conferring strength, wisdom, and clarity of purpose. It is a powerful purifying medicine that drives away negative energies. Sage can be found braided and hung in people's homes, perhaps tied with a ribbon in one of the colours of the medicine wheel. The threefold braid represents body, mind and spirit.
Five influential characteristics of transmission of trauma
-they present five influential characteristics that perpetuate intergenerational transmission of trauma 1. Traumatic bonding 2. Trauma re-enactment 3. Anxiety 4. Hyper-vigilance 5. Depression
Sixties scoop
-through the indian act, social workers received a legal mandate to enter reserves and remove indig children from their parents -they were put into european- canadian residences and communities as well as into adaptive homes abroad -placed with white middle class christian families -this was justified as in the childs best interest -justification to removed the child from the aboriginal home were based on income and christian beliefs
Decolonization
-transfers independence of former colonial countries into peoples minds -basic idea of this process is the deconstruction of old fashioned perceptions and attitudes of power and opression
Intergenerational outcome of historical transmission
-traumatic events have implications on how indig peoples function both culturally and socially -In this model (Castellano & Archibald, 2013), symptoms of social disorders exhibited in the present are not only caused by immediate trauma - the memories and images of past traumatic events are being passed, from generation to generation, disrupting adaptive patterns of behaviour and diminishing social efficacy.
Difference in worldviews and culture of the west
-western worldviews are individualistic -value autonomy -individual initiative emotional independence -privacy -seeking financial security
imperialism and colonization
-when discussing european colonization of north america, we refer to colonization within the context of imperialism -imperialism refers to an extension of a nations power (which can occur through colonization, military force or other means)
Assimilation Policies and their connection to economic deprivation, starvation, and disease
-when the indian act came into play, their was a hunger crisis that impacted indigenous population -lower nutritional resources and wide spread epidemics
Justice and TRC and criminal system
1. Collect and publish data on the criminal victimization of Indigenous people 2. Create adequately funded and accessible Indigenous-specific victim programs 3. Appoint a public inquiry into the causes of, and remedies for, the disproportionate victimization of Indigenous women and girls 4. Recognize and implement Indigenous justice systems
TRC recommendation
1. Education 2. Child Welfare 3. Health 4. Culture and Language 5. Justice -promotes self-determination as key. Working toward self-determination within each of these recommendations is the goal.
Justice and TRC
1. Ensure lawyers and law students receive appropriate cultural competency training 2. Eliminate the overrepresentation of Indigenous people in custody over the next decade 3. Provide sufficient and stable funding to implement and evaluate community sanctions that will provide realistic alternatives to imprisonment 4. Recognize as a high priority the need to address and prevent Fetal Alcohol Spectrum Disorder 5. Eliminate barriers to the creation of additional Indigenous healing lodges 6. Work with Indigenous communities to provide culturally relevant services to inmates
Twelve key determinants of health
1. Income and social status 2. social support networks 3. education and literacy 4. employment/ working conditions 5. social environments 6. physical environments 7. personal health practices and coping skills 8. healthy child development 9. biology and genetics 10. health services 11. gender 12. culture
The strategy: four principles of RCAP
1. Mutual recognition (three facets of which are equality, co-existence and self-government); 2. Mutual respect; 3. Mutual sharing (based on the long overdue recognition that Canada's past and present prosperity rests on a relationship of sharing extended by Aboriginal peoples); 4. Mutual responsibility (involving the transformation of a colonial relationship into a partnership with joint responsibility for the land).
New treaty negotiations would be implemented by the adoption of:
1. New Royal Proclamation (Government and Crown) 2. Enabling federal legislation; 3. A national framework agreement to cover such topics as the scope of self-government agreements, the principles of land and resource sharing and fiscal arrangements to finance Indigenous nations
Traumatic events
1. Physical impacts (diseases and their consequences) 2. Economic impacts (forced removal of people) 3. Cultural/ social impacts (such as changes brought by religion, changes in social structures and cultural norms) 4. Psychological impacts (changed in perceived locus of social control- lost control of lives, livelihoods, territories etc)
Education and the TRC
1. Repeal section 43 of the Criminal Code (corporal Punishment): legal for teacher and parent to use force in the way of correction of a child in their care 2. Joint strategy to eliminate education and employment gaps between aboriginal and non aboriginal people 3. Eliminate discrepancy in education funding 4. Draft new Aboriginal education legislation with the full participation of aboriginal people 5. Provide adequate funding for First Nations students seeking post-secondary education 6. Develop culturally appropriate early childhood education programs for Aboriginal families
Reports perspectives
1. The commission identified many of the things that matter most to Indigenous people. 2. But it is misleading to imply that all Indigenous people share identical concerns and priorities. 3. Some groups have concerns that cut across cultural and nation lines. 4. Women, youth, elders, people living in cities and those living in the North have specific concerns and proposals for change, many of which they presented to the Commission.
Reconciliation
1. To adopt the United Nations Declaration on the Rights of Indigenous Peoples 2. Develop and sign a Covenant of Reconciliation 3. Support the renewal of Treaty relationships that would advance reconciliation in canada
Economic development and RCAP
1. building institutions; 2. lands and resources; 3. employment development; 4. education and training; 5. business development; and 6. innovative use of income support alternatives
Three directions initiated by FSIN
1. restoring First Nations community-based health, wellness, and education systems; 2. establishing a "middle ground" for engagement between mainstream and First Nations systems and worldviews; and 3. transforming mainstream health and education delivery so it becomes culturally responsive.
Assembly of first nations resolution
1.Confirm that only First Nations can determine the path to decolonization and reconciliation 2. First Nations'' led process to draft a new Royal Proclamation binding on the Crown in right of Canada and all of the provinces and territories. -first nations no longer under the indian act
Charter of rights and freedom
1.Fundamental Freedoms 2.Democratic rights 3.Mobility rights 4.Legal rights 5.Equity rights 6.Language Rights 7.Other
The impact on self-determination and identity of Indigenous people is the result of:
1.The various (revisions) of the Indian Act, 2. Residential schools, 3. Community relocations, and 4. The treatment of Aboriginal veterans. 5. Attitudes of culture superiority
Church Parties to the Settlement Agreement
Formally adopt and comply with the United Nations Declaration on the Rights of Indigenous Peoples: -Ensuring policies, programs and practices comply -Respecting Indigenous peoples' right to self-determination in spiritual matters -Engaging in ongoing public dialogue and actions to support the Declaration -Issuing a statement, no later than March 31, 2016, as to how they will implement the Declaration -Repudiate concepts used to justify European sovereignty over Indigenous lands and people, such as the Doctrine of Discovery and terra nullius
Traditional ecological knowledge
Historically, Indigenous peoples practiced a harvest-based economy and manage resources based on knowledge of land and its patterns and processes. Example: Hunters & Gatherers: follow the herds for hunting
Doctrine of Discovery
International law that allowed Europeans to 'discover' or acquire land that did not belong to them. -Through this law, they gained sovereign rights and titles over the land and people. --This law ignored the rights of Indigenous people.
Land based activities
include going out berry or egg picking, hunting with family, trapping, fishing, picking traditional medicines, tanning hides etc.
Cultural responsiveness framework definition
The Cultural Responsiveness Framework (FSIN, 2013) is about restoring and enhancing First Nations' own health systems whereby the two systems could come together as equals to work together in a way that would be to the benefit of all -the theory braids tribal knowledge and theories that follow trauma-informed strengths, culture as intervention, and culture-based healing.
Cultural continuity as a determinant of indig peoples health (pt.1)
The findings across the synthesized research articles speak to the importance of cultural continuity in shaping positive health and wellness outcomes for Indigenous Peoples. It is also clear that intergenerational knowledge transmission is a central component of renewing and maintaining cultural continuity for Indigenous Peoples
Negotiations of the treaties
The primary means for renewing a treaty relationship are based on the principles of: a) self-government; b) the land and resources required to make self-government viable.
Chandler and Lalonde study: 6 factors
The six factors associated with cultural continuity include -Land claims; -Self-government; -Education services; -Police and fire services; -Health services; -Cultural facilities.
Sask provincial government definition of health
a dynamic process involving the harmony of physical, mental, emotional, social and spiritual well being. Health gives individuals and communities the power to adapt and function to the best of their ability.
World Health Organization definition of health
a state of complete physical, mental, or social well being, not merely an absence of illness or disease
Plains cree definition of health
a state of physical, mental (intellectual), emotional and spiritual wellness, that includes economic and political independence.
Social darwinism
a term commonly used to describe the idea that natural selection can be applied to rank different people or social groups (including races, nationalities, genders etc.) -misappropriation of the scientific theory
Land based programs
describe organized activities on the land. Formal Land-based programs can be organized through schools, justice, health, or other organizations and were noted as a relatively new phenomenon based in a present day reality and governance.
Land based
describes Indigenous ways of life rooted in Traditional Knowledge, where everything is connected and related to the land and water.
Land based healing
describes a set of culturally-defined healing practices, in which the land is a host and partner to the healing process.
Bruess and Richardson: physical health
efficient bodily functioning, resistance to disease and the ability to respond appropriately to events
Geography as a determinant of health
geographers understand that human activity is intrinsically linked to things like land, territory, ground, and the Earth
Bruess and Richardson: social health
good relations with others, the presence of supportive culture and successful adaptation to the environment
Bruess and Richardson: occupational health
having feelings of comfort and accomplishment related to your daily tasks
Medicine wheel
helps to understand what is means to be well, and how one maintains well being throughout life -assists in communicating perspectives of health that are consistent with indigenous worldviews
Land based education
is the traditional form of Indigenous education. It is based on learning from the land through observation, relationship, and experience
Legal rights
life, liberty and security, detention, unusual punishment
Why did contact happen?
occurred largely as a result of a desire for land and the resources associated with that land
Assimilation
occurs when one group seeks to dominate and absorb another group so completely that diverse world views and cultural differences disappear
Early childhood education
often creates 'mismatch' with indig communities and cultures -caregivers and teachers must have access to knowledge from the community as well as from mainstream early childhood development education
Social exclusion racism
physically and socially isolated racialized groups, unfair distribution such as housing, health care, education, employment. This pertains to access and consumption in four ways: 1. Social society - remote reserves, not voting rights etc. 2. Social goods- poor quality of housing, access to water 3. Social production- denying opportunities to contribute, arts, resource development 4. Social consumption- lack of education and employment opportunities
Cultural safety
process of looking at how ones culture influences ones biases and interactions with patients
Embodied racism
reactions of the body to the anxieties of discrimination, alienation, and social violence
Contact
refers to the meeting of two or more previously remote cultures or societies for the first time and the period of adjustment to each others presence
Colonization
refers to the process of establishing colonies or settlements in new lands, away from the sovereign nation of origin
Ecological restoration
sustainability of our earth's resources depends on the health of our ecosystem. -if our ecosystem is damaged, it needs to be repaired for the health of the earth and community members.
Bruess and Richardson: Spiritual health
the ability to discover and express your purpose in life; to learn how to experience love, joy, peace
Bruess and Richardson: emotional health
the ability to express emotions comfortable and appropriately
Bruess and Richardson: mental health
the capacity to cope with life situations, grow emotionally through them and develop to your fullest potential
Indigenous knowledge
the complex knowledge systems that have developed over time by a particular people in a particular area and that has been transmitted from generation to generation. It includes both ecological and scientific attributes.
WHO definition of social determinants of health
the conditions in which people are born, grow, live, work, and age, including the health system.
Colonialism
the policies, laws and systems associated with controlling people or geographic areas -smallpox had the most profound post contact negative effect due to colonialism
