Indigenous Health Part 2: The Underlying Causes of the Health Gap

Department of Medicine, University of Alberta, Edmonton, AB, Canada.
The Lancet (Impact Factor: 45.22). 08/2009; 374(9683):76-85. DOI: 10.1016/S0140-6736(09)60827-8
Source: PubMed


In this Review we delve into the underlying causes of health disparities between Indigenous and non-Indigenous people and provide an Indigenous perspective to understanding these inequalities. We are able to present only a snapshot of the many research publications about Indigenous health. Our aim is to provide clinicians with a framework to better understand such matters. Applying this lens, placed in context for each patient, will promote more culturally appropriate ways to interact with, to assess, and to treat Indigenous peoples. The topics covered include Indigenous notions of health and identity; mental health and addictions; urbanisation and environmental stresses; whole health and healing; and reconciliation.

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Available from: Malcolm King,
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    • "So, what can history teach us about where social change comes from? Indigenous populations such as the New Zealand Maori suffered serious negative consequences of colonization, the ramifications of which continue today (King et al. 2009). However, for colonizing, predominantly European populations in countries like Canada, the United States, Australia, and New Zealand, colonization appears to be an example, based on the thesis of Gelfand et al. (2011), of looser norms resulting in countries with more resources. "
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    ABSTRACT: The long-standing debate in public health and the wider society concerning the implications of structure and agency for health and well-being generally concludes that structure powerfully influences agency, and does so unequally, exacerbating social and health inequities. In this article, we review this debate in the context of increasing environmental degradation and resource depletion. As the global population rises and environmental resources per person shrink, conflicts over the underlying factors contributing to human health and well-being may intensify. A likely result of nearing limits is a further constraint of agency, for both rich and poor, and greater social and health inequities, including gender inequities.
    International Journal of Feminist Approaches to Bioethics 09/2015; 8(2):47-69.
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    • "Past segregationist practices of the Big Event have led to existing structural violence. For instance, Indigenous peoples receive inequitable funding for mental health and other social services on-reserve, have insufficient housing and experience home overcrowding , have fewer educational and economic opportunities , and have lost traditional patterns of subsistence (Gracey & King, 2009; King, Smith, & Gracey, 2009; Kirmayer et al., 2014; Richardson & Nelson, 2007; US Commission on Civil Rights, 2004). "

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    • "The participants in this study described the importance of the land for youth resilience, and research with people of all ages in Rigolet, Nunatsiavut supports this finding and has shown a deep connection to place and nature held by people in the community nurtured by spending time on the land (Cunsolo Willox et al., 2012, 2013a, b). Indeed, access to and connection with the land is a critical component of understandings and perspectives of health and well-being in general held by Indigenous populations globally (Burgess et al., 2009; Gracey and King, 2009; King et al., 2009; Carnie et al., 2011; Kirmayer et al., 2011; Rigby et al., 2011). "
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    ABSTRACT: The Canadian Arctic is experiencing rapid changes in climatic conditions, with implications for Inuit communities widely documented. Youth have been identified as an at-risk population, with likely impacts on mental health and well-being. This study identifies and characterizes youth-specific protective factors that enhance well-being in light of a rapidly changing climate, and examines how climatic and environmental change challenges these. In-depth conversational interviews were conducted with youth aged 15-25 from the five communities of the Nunatsiavut region of Labrador, Canada: Nain, Hopedale, Postville, Makkovik, and Rigolet. Five key protective factors were identified as enhancing their mental health and well-being: being on the land; connecting to Inuit culture; strong communities; relationships with family and friends; and staying busy. Changing sea ice and weather conditions were widely reported to be compromising these protective factors by reducing access to the land, and increasing the danger of land-based activities. This study contributes to existing work on Northern climate change adaptation by identifying factors that enhance youth resilience and, if incorporated into adaptation strategies, may contribute to creating successful and effective adaptation responses. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Social Science [?] Medicine 07/2015; 141:133-141. DOI:10.1016/j.socscimed.2015.07.017 · 2.89 Impact Factor
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