International Journal of Environmental Research and Public Health

Research

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15 pages, 888 KiB

Open AccessArticle

“In Their Own Voice”—Incorporating Underlying Social Determinants into Aboriginal Health Promotion Programs

by Shannen Vallesi, Lisa Wood, Lyn Dimer and Michelle Zada

Int. J. Environ. Res. Public Health 2018, 15(7), 1514; https://doi.org/10.3390/ijerph15071514 - 18 Jul 2018

Cited by 26 | Viewed by 25084

Abstract

Despite growing acknowledgement of the socially determined nature of health disparities among Aboriginal people, how to respond to this within health promotion programs can be challenging. The legacy of Australia’s assimilation policies have left profound consequences, including social marginalisation, limited educational opportunities, normalisation [...] Read more.

Despite growing acknowledgement of the socially determined nature of health disparities among Aboriginal people, how to respond to this within health promotion programs can be challenging. The legacy of Australia’s assimilation policies have left profound consequences, including social marginalisation, limited educational opportunities, normalisation of premature death, and entrenched trauma. These social determinants, in conjunction with a reluctance to trust authorities, create barriers to accessing healthcare services for the prevention, treatment, and rehabilitation of chronic disease. The Heart Health program is a culturally sensitive cardiac rehabilitation program run at the local Aboriginal Medical Service in Perth, Western Australia that has since moved beyond cardiac education to provide a holistic approach to chronic disease management. A participatory action research framework was used to explore Heart Health participant and service provider perspectives on the barriers, enablers, and critical success factors to program participation and behaviour change. Thematic analysis of interview transcripts was undertaken, and through yarning (Aboriginal storytelling) sessions, many participants made unprompted reference to the impacts of white settlement, discrimination, and the forced fracturing of Aboriginal families, which have been explored in this paper reiterating the need for a social determinants lens to be taken when planning and implementing Aboriginal health promotion programs. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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13 pages, 876 KiB

Open AccessArticle

Associations between Participation in a Ranger Program and Health and Wellbeing Outcomes among Aboriginal and Torres Strait Islander People in Central Australia: A Proof of Concept Study

by Roxanne Jones, Katherine A. Thurber, Alyson Wright, Jan Chapman, Peter Donohoe, Vanessa Davis and Raymond Lovett

Int. J. Environ. Res. Public Health 2018, 15(7), 1478; https://doi.org/10.3390/ijerph15071478 - 12 Jul 2018

Cited by 14 | Viewed by 7872

Abstract

Culture can be viewed as an integral part of Aboriginal and Torres Strait Islander health and wellbeing. This study explores the association between caring for country, through participation in a Ranger program, and wellbeing. We analyzed cross-sectional data collected in Central Australia in [...] Read more.

Culture can be viewed as an integral part of Aboriginal and Torres Strait Islander health and wellbeing. This study explores the association between caring for country, through participation in a Ranger program, and wellbeing. We analyzed cross-sectional data collected in Central Australia in 2017, comparing health and wellbeing (life satisfaction, general health, psychological wellbeing and family wellbeing) among Aboriginal and Torres Strait Islander peoples employed as Rangers (n = 43) versus not employed as Rangers (n = 160). We tested if any differences in outcomes were explained by differences in key demographic or health factors. Ranger participation was significantly associated with very high life satisfaction (PR = 1.69, 95% CI: 1.29, 2.20) and high family wellbeing (PR = 1.47, 95% CI: 1.13, 1.90); associations remained significant after individual adjustment for education, income, employment, health risk factors and health conditions. The magnitude and direction of associations were similar for very good general health, but results were not significant. We did not identify an association between Ranger participation and psychological wellbeing. While based on a small sample, these findings support the assertion that participation in the Ranger program is associated with positive health and wellbeing outcomes. This supports the continuation of cultural participation and practice through the Ranger program and has implications for funding, program and policy development. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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18 pages, 589 KiB

Open AccessArticle

Using the Healthy Community Assessment Tool: Applicability and Adaptation in the Midwest of Western Australia

by Christina Tsou, Charmaine Green, Gordon Gray and Sandra Claire Thompson

Int. J. Environ. Res. Public Health 2018, 15(6), 1159; https://doi.org/10.3390/ijerph15061159 - 2 Jun 2018

Cited by 4 | Viewed by 4865

Abstract

Population-based studies have associated poor living conditions with the persistent disparity in the health of Aboriginal and non-Aboriginal Australians. This project assesses the applicability of the Health Community Assessment Tool and its role in improving the environment of a small community in the [...] Read more.

Population-based studies have associated poor living conditions with the persistent disparity in the health of Aboriginal and non-Aboriginal Australians. This project assesses the applicability of the Health Community Assessment Tool and its role in improving the environment of a small community in the Midwest of Western Australia (WA). The action research cycles started with the initial reflection on the suitability of the HCAT version 2 for the local community context and whether it was fit-for-purpose. The researcher provided ‘critical companionship’, while the participants of the study were invited to be co-researchers (the Assessors) who critically examined the HCAT and assess the community. The relevant domains to the serviced town (an outer regional community) were pest control and animal management; healthy housing; food supply; community vibrancy, pride and safety; reducing environmental tobacco smoke; and promoting physical activity. The Assessors found the HCAT descriptors mostly aligned with their community context but found some of the items difficult to apply. Based on participant’s suggestions, some of the original scoring scales were reformatted. School attendance and illicit drug use were identified as a key outcome indicator for youth but were missing from the HCAT. The HCAT domains applied helped streamlining core business of agencies in the local community. The face validity of HCAT items were confirmed in this research with minor adjustments to reflect local context. Youth engagement to education is of high community concern and the development of an item would create similar interagency collaborative dialogues. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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16 pages, 516 KiB

Open AccessArticle

Development of a National Aboriginal and Torres Strait Islander Cancer Framework: A Shared Process to Guide Effective Policy and Practice

by Jenny Brands, Gail Garvey, Kate Anderson, Joan Cunningham, Jennifer Chynoweth, Isabella Wallington, Bronwyn Morris, Vikki Knott, Samantha Webster, Lauren Kinsella, John Condon and Helen Zorbas

Int. J. Environ. Res. Public Health 2018, 15(5), 942; https://doi.org/10.3390/ijerph15050942 - 9 May 2018

Cited by 9 | Viewed by 5759

Abstract

Indigenous Australians experience a substantially higher cancer mortality rate than non-Indigenous Australians. While cancer outcomes are improving for non-Indigenous Australians, they are worsening for Indigenous Australians. Reducing this disparity requires evidence-based and culturally-appropriate guidance. The purpose of this paper is to describe an [...] Read more.

Indigenous Australians experience a substantially higher cancer mortality rate than non-Indigenous Australians. While cancer outcomes are improving for non-Indigenous Australians, they are worsening for Indigenous Australians. Reducing this disparity requires evidence-based and culturally-appropriate guidance. The purpose of this paper is to describe an initiative by Cancer Australia and Menzies School of Health Research (Menzies) to develop Australia’s first National Aboriginal and Torres Strait Islander Cancer Framework using a process of co-design with relevant stakeholders. The initiative was guided by three core principles: achieving policy-relevant evidence-based outcomes; engaging and maintaining trust with Indigenous Australians at every phase; and employing best-practice and appropriate research methods. Four components of research comprised the Framework development: evidence review; multifaceted stakeholder consultation and input; triangulation of findings; and direct stakeholder input in drafting and refining the Framework. The evidence review confirmed the increasing burden of cancer on Indigenous Australians, while stakeholder consultations facilitated comprehensive input from those with lived experience. The consultations revealed issues not identified in existing literature, and gave different emphases of priority, thus reinforcing the value of including stakeholder perspectives. This paper focuses primarily on documenting the methods used; findings are presented only in order to illustrate the results of the process. The published Framework is available at www.canceraustralia.gov.au; further description and analyses of findings from the consultations will be published elsewhere. The logistics inherent in large-scale consultation are considerable. However, the quality of data and the foundation for sustained partnership with stakeholders and knowledge translation vastly outweighed the challenges. The process of wide-ranging stakeholder consultation described in this paper offers a model for other areas of national and international Indigenous priority setting and policy and practice development that meets the needs of those most affected. The Framework, through the establishment of an agreed, shared and evidence-based agenda, provides guidance for jurisdictional cancer plans, optimal care pathways, and program and service planning for the multiple players across all levels of the health system. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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23 pages, 409 KiB

Open AccessArticle

Indigenous Health and Human Rights: A Reflection on Law and Culture

by Odette Mazel

Int. J. Environ. Res. Public Health 2018, 15(4), 789; https://doi.org/10.3390/ijerph15040789 - 18 Apr 2018

Cited by 13 | Viewed by 10790

Abstract

In Australia, Aboriginal and Torres Strait Islander peoples bear a greater burden of disease and have lower life expectancy than their non-Indigenous counterparts. These combined indicators are evidence of an entrenched health crisis in the Indigenous population that is linked to systemic disadvantage [...] Read more.

In Australia, Aboriginal and Torres Strait Islander peoples bear a greater burden of disease and have lower life expectancy than their non-Indigenous counterparts. These combined indicators are evidence of an entrenched health crisis in the Indigenous population that is linked to systemic disadvantage over many decades. In an effort to improve life expectancy and lessen the burden of disease, a number of strategies and national frameworks now embed a human rights-based approach to achieving health equality. This paper explores the application of human rights to Indigenous health and examines the inherent tensions that exist in engaging a system of law based on universal assumptions of the Enlightenment to advance Indigenous rights. What becomes apparent through this exploration is that the strategic approach of Indigenous peoples’ use of human rights, despite its genesis in a system of law that justified colonisation, has opened up opportunities to reframe fixed ideas of law and culture. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

16 pages, 348 KiB

Open AccessArticle

Cancer Services and Their Initiatives to Improve the Care of Indigenous Australians

by Emma V. Taylor, Margaret M. Haigh, Shaouli Shahid, Gail Garvey, Joan Cunningham and Sandra C. Thompson

Int. J. Environ. Res. Public Health 2018, 15(4), 717; https://doi.org/10.3390/ijerph15040717 - 11 Apr 2018

Cited by 16 | Viewed by 5960

Abstract

Indigenous Australians continue to experience significantly poorer outcomes from cancer than non-Indigenous Australians. Despite the importance of culturally appropriate cancer services in improving outcomes, there is a lack of awareness of current programs and initiatives that are aimed at meeting the needs of [...] Read more.

Indigenous Australians continue to experience significantly poorer outcomes from cancer than non-Indigenous Australians. Despite the importance of culturally appropriate cancer services in improving outcomes, there is a lack of awareness of current programs and initiatives that are aimed at meeting the needs of Indigenous patients. Telephone interviews were used to identify and describe the Indigenous-specific programs and initiatives that are implemented in a subset of the services that participated in a larger national online survey of cancer treatment services. Fourteen services located across Australia participated in the interviews. Participants identified a number of factors that were seen as critical to delivering culturally appropriate treatment and support, including having a trained workforce with effective cross-cultural communication skills, providing best practice care, and improving the knowledge, attitudes, and understanding of cancer by Indigenous people. However, over a third of participants were not sure how their service compared with others, indicating that they were not aware of how other services are doing in this field. There are currently many Indigenous-specific programs and initiatives that are aimed at providing culturally appropriate treatment and supporting Indigenous people affected by cancer across Australia. However, details of these initiatives are not widely known and barriers to information sharing exist. Further research in this area is needed to evaluate programs and initiatives and showcase the effective approaches to Indigenous cancer care. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

11 pages, 292 KiB

Open AccessFeature PaperArticle

Demonstrating Impact: Lessons Learned from the Queensland Aboriginal and Islander Health Council’s AOD-Our-Way Program

by Kimberly Cartwright, Dennis Gray and Eddie Fewings

Int. J. Environ. Res. Public Health 2018, 15(3), 450; https://doi.org/10.3390/ijerph15030450 - 5 Mar 2018

Cited by 2 | Viewed by 4097

Abstract

In this paper, we describe the innovative way in which the Queensland Aboriginal and Islander Health Council uses “clicker technology” to gather data to report on the key performance indicators of its “AOD-our-way” program, and how, with the subsequent combination of those data [...] Read more.

In this paper, we describe the innovative way in which the Queensland Aboriginal and Islander Health Council uses “clicker technology” to gather data to report on the key performance indicators of its “AOD-our-way” program, and how, with the subsequent combination of those data with other performance measures, it was possible to go beyond the initial evaluation. The paper also illustrates how the application of survey research methods could further enable enhanced reporting of program outcomes and impacts in an Indigenous context where Indigenous community controlled organisations want to build the evidence base for the issues they care about and ultimately drive their own research agendas. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

14 pages, 967 KiB

Open AccessArticle

Depression, Suicidal Behaviour, and Mental Disorders in Older Aboriginal Australians

by Yu-Tang Shen, Kylie Radford, Gail Daylight, Robert Cumming, Tony G. A. Broe and Brian Draper

Int. J. Environ. Res. Public Health 2018, 15(3), 447; https://doi.org/10.3390/ijerph15030447 - 4 Mar 2018

Cited by 18 | Viewed by 13030

Abstract

Aboriginal Australians experience higher levels of psychological distress, which may develop from the long-term sequelae of social determinants and adversities in early and mid-life. There is little evidence available on the impact of these on the mental health of older Aboriginal Australians. This [...] Read more.

Aboriginal Australians experience higher levels of psychological distress, which may develop from the long-term sequelae of social determinants and adversities in early and mid-life. There is little evidence available on the impact of these on the mental health of older Aboriginal Australians. This study enrolled 336 Aboriginal Australian participants over 60 years from 5 major urban and regional areas in NSW, utilizing a structured interview on social determinants, and life-time history of physical and mental conditions; current psychosocial determinants and mental health. Univariate and multivariate analyses were utilized to examine the link between these determinants and current depressive scores and suicidality. There was a high rate of life-time depression (33.3%), current late-life depression (18.1%), and suicidal ideation (11.1%). Risk factors strongly associated with late-life depression included sleep disturbances, a history of suicidal behaviour, suicidal ideation in late-life and living in a regional location. This study supports certain historical and psychosocial factors predicting later depression in old age, and highlights areas to target for prevention strategies. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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13 pages, 289 KiB

Open AccessArticle

An Exploration of Underrepresentation of Aboriginal Cancer Patients Attending a Regional Radiotherapy Service in Western Australia

by Marilyn Lyford, Margaret M. Haigh, Siddhartha Baxi, Shelley Cheetham, Shaouli Shahid and Sandra C. Thompson

Int. J. Environ. Res. Public Health 2018, 15(2), 337; https://doi.org/10.3390/ijerph15020337 - 14 Feb 2018

Cited by 12 | Viewed by 5314

Abstract

Travel logistics impede Aboriginal patients’ uptake of cancer treatments and is one reason for the poorer outcomes of Aboriginal people with cancer. This research examined benefits of a newly established rurally based radiotherapy unit in southwest Western Australia (WA), and included exploring the [...] Read more.

Travel logistics impede Aboriginal patients’ uptake of cancer treatments and is one reason for the poorer outcomes of Aboriginal people with cancer. This research examined benefits of a newly established rurally based radiotherapy unit in southwest Western Australia (WA), and included exploring the experience of Aboriginal patients and possible reasons for Aboriginal people’s underrepresentation in treatment. Semi-structured in-depth interviews with 21 service providers involved in the treatment and care of people with cancer, and 3 Aboriginal patients with cancer who undertook radiotherapy at the Service were undertaken. Data were subject to thematic analysis involving immersion in the data for familiarization, inductive coding, investigator discussion and refining of emerging themes and triangulation of patient and provider interviews. Aboriginal cancer patients were positive about the treatment and support they had received, highlighting the often complex challenges faced by rural Aboriginal cancer patients in accessing and maintaining treatment. Service providers offered suggestions for small numbers presenting to the Service, including late presentation, potential perceptions of cultural insensitivity on the part of service providers, out-of-pocket costs and under-ascertainment of Aboriginal status. The Service has put in place practices and initiatives to support patient health and wellbeing, including making the facility more welcoming towards Aboriginal people and ensuring culturally appropriate care. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

14 pages, 1145 KiB

Open AccessArticle

Conceptualizing and Managing Medical Emergencies Where No Formal Paramedical System Exists: Perspectives from a Remote Indigenous Community in Canada

by Jeffrey Curran, Stephen D. Ritchie, Jackson Beardy, David VanderBurgh, Karen Born, John Lewko and Aaron M. Orkin

Int. J. Environ. Res. Public Health 2018, 15(2), 267; https://doi.org/10.3390/ijerph15020267 - 4 Feb 2018

Cited by 5 | Viewed by 6387

Abstract

(1) Background: Remote communities in Canada lack an equitable emergency medical response capacity compared to other communities. Community-based emergency care (CBEC) training for laypeople is a model that has the potential to enhance the medical emergency response capacity in isolated and resource-limited contexts. [...] Read more.

(1) Background: Remote communities in Canada lack an equitable emergency medical response capacity compared to other communities. Community-based emergency care (CBEC) training for laypeople is a model that has the potential to enhance the medical emergency response capacity in isolated and resource-limited contexts. The purpose of this study was to understand the characteristics of medical emergencies and to conceptualize and present a framework for what a medical emergency is for one remote Indigenous community in northwestern Ontario, in order to inform the development of CBEC training. (2) Methods: This study adhered to the principles of community-based participatory research and realist evaluation; it was an integrated component of the formative evaluation of the second Sachigo Lake Wilderness Emergency Response Education Initiative (SLWEREI) training course in 2012. Twelve members of Sachigo Lake First Nation participated in the training course, along with local nursing staff, police officers, community Elders, and course instructors (n = 24 total), who participated in interviews, focus groups, and a collaborative discussion of local health issues in the development of the SLWEREI. (3) Results: The qualitative results are organized into sections that describe the types of local health emergencies and the informal response system of community members in addressing these emergencies. Prominent themes of health adversity that emerged were an inability to manage chronic conditions and fears of exacerbations, the lack of capacity for addressing mental illness, and the high prevalence of injury for community members. (4) Discussion: A three-point framework of what constitutes local perceptions of an emergency emerged from the findings in this study: (1) a sense of isolation; (2) a condition with a potentially adverse outcome; and (3) a need for help. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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12 pages, 281 KiB

Open AccessFeature PaperArticle

Exploring Positive Survivorship Experiences of Indigenous Australian Cancer Patients

by Laura Tam, Gail Garvey, Judith Meiklejohn, Jennifer Martin, Jon Adams, Euan Walpole, Michael Fay and Patricia Valery

Int. J. Environ. Res. Public Health 2018, 15(1), 135; https://doi.org/10.3390/ijerph15010135 - 15 Jan 2018

Cited by 13 | Viewed by 5080

Abstract

Amongst Indigenous Australians, “cancer” has negative connotations that detrimentally impact upon access to cancer care services. Barriers to accessing cancer services amongst Indigenous Australians are widely reported. In contrast, factors that facilitate this cohort to successfully navigate cancer care services (“enablers”) are scarcely [...] Read more.

Amongst Indigenous Australians, “cancer” has negative connotations that detrimentally impact upon access to cancer care services. Barriers to accessing cancer services amongst Indigenous Australians are widely reported. In contrast, factors that facilitate this cohort to successfully navigate cancer care services (“enablers”) are scarcely reported in the literature. Through qualitative interviews, this article examines factors that assist Indigenous Australians to have positive cancer experiences. Semi-structured interviews were conducted with twelve adult Indigenous oncology patients recruited from a tertiary hospital in Queensland, Australia during 2012–2014. Data generated from the interviews were independently reviewed by two researchers via inductive thematic analytical processes. Discussions followed by consensus on the major categories allowed conclusions to be drawn on potential enablers. Two major categories of enablers were identified by the researchers: resilience and communication. Individual’s intrinsic strength, their coping strategies, and receipt of support improved participant’s resilience and consequently supported a positive experience. Communication methods and an effective patient-provider relationship facilitated positive experiences for participants. Despite potential barriers to access of care for Indigenous cancer patients, participants in the study demonstrated that it was still possible to focus on the positive aspects of their cancer experiences. Many participants explained how cancer changed their outlook on life, often for the better, with many feeling empowered as they progressed through their cancer diagnosis and treatment processes. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

350 KiB

Open AccessArticle

Stimulating Parenting Practices in Indigenous and Non-Indigenous Mexican Communities

by Heather A. Knauer, Emily J. Ozer, William Dow and Lia C. H. Fernald

Int. J. Environ. Res. Public Health 2018, 15(1), 29; https://doi.org/10.3390/ijerph15010029 - 25 Dec 2017

Cited by 7 | Viewed by 5960

Abstract

Parenting may be influenced by ethnicity; marginalization; education; and poverty. A critical but unexamined question is how these factors may interact to compromise or support parenting practices in ethnic minority communities. This analysis examined associations between mothers’ stimulating parenting practices and a range [...] Read more.

Parenting may be influenced by ethnicity; marginalization; education; and poverty. A critical but unexamined question is how these factors may interact to compromise or support parenting practices in ethnic minority communities. This analysis examined associations between mothers’ stimulating parenting practices and a range of child-level (age; sex; and cognitive and socio-emotional development); household-level (indigenous ethnicity; poverty; and parental education); and community-level (economic marginalization and majority indigenous population) variables among 1893 children ages 4–18 months in poor; rural communities in Mexico. We also explored modifiers of associations between living in an indigenous community and parenting. Key findings were that stimulating parenting was negatively associated with living in an indigenous community or family self-identification as indigenous (β = −4.25; SE (Standard Error) = 0.98; β = −1.58; SE = 0.83 respectively). However; living in an indigenous community was associated with significantly more stimulating parenting among indigenous families than living in a non-indigenous community (β = 2.96; SE = 1.25). Maternal education was positively associated with stimulating parenting only in indigenous communities; and household crowding was negatively associated with stimulating parenting only in non-indigenous communities. Mothers’ parenting practices were not associated with child sex; father’s residential status; education; or community marginalization. Our findings demonstrate that despite greater community marginalization; living in an indigenous community is protective for stimulating parenting practices of indigenous mothers. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

1639 KiB

Open AccessArticle

Indigenous Infant Mortality by Age and Season of Birth, 1800–1899: Did Season of Birth Affect Children’s Chances for Survival?

by Lena Karlsson

Int. J. Environ. Res. Public Health 2018, 15(1), 18; https://doi.org/10.3390/ijerph15010018 - 23 Dec 2017

Cited by 10 | Viewed by 4361

Abstract

This paper focuses on the influence of season of birth on infant mortality among the Sami and non-Sami populations in northern Sweden during the nineteenth century. The source material is a set of data files from the Demographic Data Base at Umeå University, [...] Read more.

This paper focuses on the influence of season of birth on infant mortality among the Sami and non-Sami populations in northern Sweden during the nineteenth century. The source material is a set of data files from the Demographic Data Base at Umeå University, making it possible to combine age at death (in days), month of death, and month of birth over the course of the entire century. Cox regression models reveal that for the first week of life, season of birth had no influence on the risk of mortality. For the Sami, the results showed that being born during winter was related to a higher risk of neonatal mortality, and being born during summer was related to a higher risk of mortality after six months of age. Furthermore, for the Sami, the neonatal mortality showed a U-shaped pattern with a minimum in June–August, whereas the corresponding pattern among the non-Sami was flatter. The findings shed light on vulnerability in two populations sharing the same environment, but diverging in terms of social, economic, and cultural factors. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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565 KiB

Open AccessArticle

Indigenous Values and Health Systems Stewardship in Circumpolar Countries

by Susan Chatwood, Francois Paulette, G. Ross Baker, Astrid M. A. Eriksen, Ketil Lenert Hansen, Heidi Eriksen, Vanessa Hiratsuka, Josée Lavoie, Wendy Lou, Ian Mauro, James Orbinski, Nathalie Pambrun, Hanna Retallack and Adalsteinn Brown

Int. J. Environ. Res. Public Health 2017, 14(12), 1462; https://doi.org/10.3390/ijerph14121462 - 27 Nov 2017

Cited by 29 | Viewed by 7987

Abstract

Circumpolar regions, and the nations within which they reside, have recently gained international attention because of shared and pressing public policy issues such as climate change, resource development, endangered wildlife and sovereignty disputes. In a call for national and circumpolar action on shared [...] Read more.

Circumpolar regions, and the nations within which they reside, have recently gained international attention because of shared and pressing public policy issues such as climate change, resource development, endangered wildlife and sovereignty disputes. In a call for national and circumpolar action on shared areas of concern, the Arctic states health ministers recently met and signed a declaration that identified shared priorities for international cooperation. Among the areas for collaboration raised, the declaration highlighted the importance of enhancing intercultural understanding, promoting culturally appropriate health care delivery and strengthening circumpolar collaboration in culturally appropriate health care delivery. This paper responds to the opportunity for further study to fully understand indigenous values and contexts, and presents these as they may apply to a framework that will support international comparisons and systems improvements within circumpolar regions. We explored the value base of indigenous peoples and provide considerations on how these values might interface with national values, health systems values and value bases between indigenous nations particularly in the context of health system policy-making that is inevitably shared between indigenous communities and jurisdictional or federal governments. Through a mixed methods nominal consensus process, nine values were identified and described: humanity, cultural responsiveness, teaching, nourishment, community voice, kinship, respect, holism and empowerment. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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1421 KiB

Open AccessArticle

Self-Determination in Health Research: An Alaska Native Example of Tribal Ownership and Research Regulation

by Vanessa Y. Hiratsuka, Julie A. Beans, Renee F. Robinson, Jennifer L. Shaw, Ileen Sylvester and Denise A. Dillard

Int. J. Environ. Res. Public Health 2017, 14(11), 1324; https://doi.org/10.3390/ijerph14111324 - 31 Oct 2017

Cited by 53 | Viewed by 6401

Abstract

Alaska Native (AN) and American Indian (AI) people are underrepresented in health research, yet many decline to participate in studies due to past researcher misconduct. Southcentral Foundation (SCF), an Alaska Native-owned and operated health care organization, is transforming the relationship between researchers and [...] Read more.

Alaska Native (AN) and American Indian (AI) people are underrepresented in health research, yet many decline to participate in studies due to past researcher misconduct. Southcentral Foundation (SCF), an Alaska Native-owned and operated health care organization, is transforming the relationship between researchers and the tribal community by making trust and accountability required features of health research in AN/AI communities. In 1998, SCF assumed ownership from the federal government of health services for AN/AI people in south central Alaska and transformed the health system into a relationship-based model of care. This change reimagines how researchers interact with tribal communities and established community oversight of all health research conducted with AN/AI people in the region. We describe the SCF research review process, which requires tribal approval of the research concept, full proposal, and dissemination products, as well as local institutional review board approval, and a researcher-signed contract. This review evaluates research through the lens of tribal principles, practices, and priorities. The SCF example provides a framework for other tribes and organizations seeking to reshape the future of health research in AN/AI communities. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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Review

Jump to: Research

17 pages, 737 KiB

Open AccessReview

The Influence of Markets on the Nutrition Transition of Hunter-Gatherers: Lessons from the Western Amazon

by Isabella Donders and Carles Barriocanal

Int. J. Environ. Res. Public Health 2020, 17(17), 6307; https://doi.org/10.3390/ijerph17176307 - 30 Aug 2020

Cited by 12 | Viewed by 3524

Abstract

For many centuries, hunter-gatherer societies relied on subsistence practices and traditional diets. However, forces of globalization have increased market involvement, thereby fueling the nutrition transition of hunter-gatherer societies. We review the academic literature on market involvement of hunter-gatherer societies in the Western Amazon [...] Read more.

For many centuries, hunter-gatherer societies relied on subsistence practices and traditional diets. However, forces of globalization have increased market involvement, thereby fueling the nutrition transition of hunter-gatherer societies. We review the academic literature on market involvement of hunter-gatherer societies in the Western Amazon and its consequences on diet, health and well-being. First, we elaborate on four main determinants of market involvement (accessibility, monetary income, wild meat trade and social capital), showing how each determinant draws individuals toward or away from markets. Thereafter, we discuss how these determinants alter diet, health and well-being. Our results add to the understanding of the complex relations between market involvement, dietary change, health and well-being of indigenous societies. Furthermore, they bring to light that additional research is needed on the topic to support decision-makers and help preserve indigenous values. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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13 pages, 704 KiB

Open AccessReview

Indigenous Australians Perceptions’ of Physical Activity: A Qualitative Systematic Review

by Emma E. Dahlberg, Sandra J. Hamilton, Fatuma Hamid and Sandra C. Thompson

Int. J. Environ. Res. Public Health 2018, 15(7), 1492; https://doi.org/10.3390/ijerph15071492 - 14 Jul 2018

Cited by 23 | Viewed by 9179

Abstract

Given poorer health and higher rates of chronic disease seen in Indigenous populations around the world and the evidence linking exercise with health and wellbeing, recommendations for encouraging and increasing Indigenous people’s participation in physical activity are needed. This paper systematically reviews published [...] Read more.

Given poorer health and higher rates of chronic disease seen in Indigenous populations around the world and the evidence linking exercise with health and wellbeing, recommendations for encouraging and increasing Indigenous people’s participation in physical activity are needed. This paper systematically reviews published qualitative research papers exploring issues related to the perspectives of Indigenous Australians around physical activity. Key terms relevant to attitudes, beliefs, and perceptions of Indigenous Australians on physical activity and sport were explored in 11 electronic bibliographic databases including EMBASE, Medline and Web of Science. Of the 783 studies screened, eight qualitative studies met the selection criteria; only one was exclusively undertaken in a rural setting. Four major themes emerged: family and community, culture and environment, sport, and gender differences. Men highlighted sport and going on walkabout as preferred types of physical activity while women preferred family-focused activities and activities and support for women's sport. Several studies found exercise was supported when in the context of family and community but was considered shameful when done only for oneself. Sport was regarded as playing an influential role in bringing communities together. Group, community, or family activities were desired forms of physical activity with the environment they are conducted in of high importance. These findings should inform future research and intervention programs aimed at addressing the physical activity levels of Indigenous Australians and may be relevant to other Indigenous populations. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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22 pages, 1124 KiB

Open AccessReview

Factors Affecting the Retention of Indigenous Australians in the Health Workforce: A Systematic Review

by Genevieve C. Lai, Emma V. Taylor, Margaret M. Haigh and Sandra C. Thompson

Int. J. Environ. Res. Public Health 2018, 15(5), 914; https://doi.org/10.3390/ijerph15050914 - 4 May 2018

Cited by 52 | Viewed by 18977

Abstract

Indigenous Australians are under-represented in the health workforce. The shortfall in the Indigenous health workforce compounds the health disparities experienced by Indigenous Australians and places pressure on Indigenous health professionals. This systematic review aims to identify enablers and barriers to the retention of [...] Read more.

Indigenous Australians are under-represented in the health workforce. The shortfall in the Indigenous health workforce compounds the health disparities experienced by Indigenous Australians and places pressure on Indigenous health professionals. This systematic review aims to identify enablers and barriers to the retention of Indigenous Australians within the health workforce and to describe strategies to assist with development and retention of Indigenous health professionals after qualification. Four electronic databases were systematically searched in August 2017. Supplementary searches of relevant websites were also undertaken. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool. Fifteen articles met the criteria for inclusion. Important factors affecting the retention of Indigenous health professionals included work environment, heavy workloads, poorly documented/understood roles and responsibilities, low salary and a perception of salary disparity, and the influence of community as both a strong personal motivator and source of stress when work/life boundaries could not be maintained. Evidence suggests that retention of Indigenous health professionals will be improved through building supportive and culturally safe workplaces; clearly documenting and communicating roles, scope of practice and responsibilities; and ensuring that employees are appropriately supported and remunerated. The absence of intervention studies highlights the need for deliberative interventions that rigorously evaluate all aspects of implementation of relevant workforce, health service policy, and practice change. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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