National Collaborating Centre for Indigenous Health: Knowledge Resources & Publications

Understanding Indigenous Health Inequalities through a Social Determinants Model, written by Charlotte Loppie and Fred Wien, provides an update to the National Collaborating Centre for Indigenous Health’s popular 2009 report, Health Inequalities and Social Determinants of Indigenous Peoples’ Health. Drawing on recent literature, research and data, the authors utilize a tree metaphor to enhance our understanding of the underlying causes of Indigenous Peoples’ health inequalities.

The authors begin by providing a brief overview of Indigenous health inequalities, followed by a description of social determinants across the life course. They then explain how root (structural), core (systemic), and stem (immediate) environments influence Indigenous health at individual, community, and population levels. Loppie and Wien highlight the importance of Indigenous self-determination and cultural resurgence as vital pathways to wellness.

Visioning the Future: First Nations, Inuit, & Métis Population and Public Health is a collaborative report offering a vision for First Nations, Inuit, and Métis Peoples’ public health. The commissioned report not only complements the Chief Public Health Officer’s 2021 public health vision report but also privileges Indigenous knowledge(s). Visioning the Future represents a multi-faceted vision as articulated by Indigenous peoples from coast to coast to coast.

This Indigenous public health vision uses a determinants of health approach as a framework through which to address inequities experienced by Indigenous peoples across the spectrum of population and public health challenges: racism; infectious diseases; self-determination; data; governance; environment; urban Indigenous populations; mental well-being; and assessment of and response to First Nations, Inuit, and Métis Peoples’ well-being.

The report opens with public health visions articulated by the National Indigenous Organizations: The Assembly of First Nations; Métis National Council; and Inuit Tapiriit Kantami. Each subsequent section presents an overview of the current reality for Indigenous Peoples before considering how that reality should change and making recommendations for how to get to that change.

The report reveals the current inequities Indigenous Peoples experience every day but illuminates a path toward equity and wellness that acknowledges Indigenous peoples’ multiple systems for public health and ensures that Indigenous peoples’ knowledge(s) permeate the Canadian public health system. It lays out an achievable public health vision for a future characterized by equity, free of infectious diseases, and free of discrimination and racism.

The report, The treaty right to health: A sacred obligation responds to the Truth and Reconciliation Commission of Canada’s Call to Action 18, which among other things, calls on all levels of government to “recognize and implement the health-care rights of Aboriginal people as identified in international law, constitutional law, and under the Treaties.” The authors contribute to a deeper understanding of one piece of a much larger puzzle – the Treaty right to health.

The authors examine the Treaty right to health in the context of promises made by the federal government (both written and verbal) to First Nations peoples in relation to the historic numbered Treaties in Canada, including the “medicine chest clause.” A brief review of the concept of the Treaty right to health situates First Nations health in relation to wellness and well-being. Three critically important dimensions of the Treaty right to health are discussed including: promises made as part of the treaties, the constitutional protection of Treaty and Aboriginal Rights to health, and the ongoing denial of the Treaty right to health. Following this, the importance of the Treaty right to health and the implementation of Treaty promises for reconciliation, the implementation of the United Nations Declaration on the Rights of Indigenous Peoples, Indigenous self-determination, and the Nation-to-Nation relationship are each outlined.

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