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1.
Proc Natl Acad Sci U S A ; 121(7): e2311703121, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38315863

RESUMO

Global polls have shown that people in high-income countries generally report being more satisfied with their lives than people in low-income countries. The persistence of this correlation, and its similarity to correlations between income and life satisfaction within countries, could lead to the impression that high levels of life satisfaction can only be achieved in wealthy societies. However, global polls have typically overlooked small-scale, nonindustrialized societies, which can provide an alternative test of the consistency of this relationship. Here, we present results from a survey of 2,966 members of Indigenous Peoples and local communities among 19 globally distributed sites. We find that high average levels of life satisfaction, comparable to those of wealthy countries, are reported for numerous populations that have very low monetary incomes. Our results are consistent with the notion that human societies can support very satisfying lives for their members without necessarily requiring high degrees of monetary wealth.


Assuntos
Renda , Satisfação Pessoal , Humanos , Pobreza , Sociedades , Problemas Sociais
2.
Proc Natl Acad Sci U S A ; 119(4)2022 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-35042810

RESUMO

The field of genomics has benefited greatly from its "openness" approach to data sharing. However, with the increasing volume of sequence information being created and stored and the growing number of international genomics efforts, the equity of openness is under question. The United Nations Convention of Biodiversity aims to develop and adopt a standard policy on access and benefit-sharing for sequence information across signatory parties. This standardization will have profound implications on genomics research, requiring a new definition of open data sharing. The redefinition of openness is not unwarranted, as its limitations have unintentionally introduced barriers of engagement to some, including Indigenous Peoples. This commentary provides an insight into the key challenges of openness faced by the researchers who aspire to protect and conserve global biodiversity, including Indigenous flora and fauna, and presents immediate, practical solutions that, if implemented, will equip the genomics community with both the diversity and inclusivity required to respectfully protect global biodiversity.


Assuntos
Povos Indígenas/genética , Disseminação de Informação/ética , Biodiversidade , Genômica/métodos , Humanos , Povos Indígenas/psicologia , Povos Indígenas/estatística & dados numéricos , Disseminação de Informação/métodos , Grupos Populacionais/genética
3.
J Med Virol ; 96(7): e29795, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39007429

RESUMO

Despite increased risk of severe acute respiratory syndrome coronavirus 2 infections and higher rates of COVID-19-related complications, racialized and Indigenous communities in Canada have lower immunization uptake compared to White individuals. However, there is woeful lack of data on predictors of COVID-19 vaccine mistrust (VM) that accounts for diverse social and cultural contexts within specific racialized and Indigenous communities. Therefore, we sought to characterize COVID-19 VM among Arab, Asian, Black, and Indigenous communities in Canada. An online survey was administered to a nationally representative, ethnically diverse panel of participants in October 2023. Arabic, Asian, Indigenous, and Black respondents were enriched in the sampling panel. Data were collected on demographics, COVID-19 VM, experience of racial discrimination, health literacy, and conspiracy beliefs. We used descriptive and regression analyses to determine the extent and predictors of COVID-19 VM among racialized and Indigenous individuals. All racialized respondents had higher VM score compared to White participants. Among 4220 respondents, we observed highest VM among Black individuals (12.18; ±4.24), followed by Arabic (12.12; ±4.60), Indigenous (11.84; ±5.18), Asian (10.61; ±4.28), and White (9.58; ±5.00) participants. In the hierarchical linear regression analyses, Black participants, women, everyday racial discrimination, and major experience of discrimination were positively associated with COVID-19 VM. Effects of racial discrimination were mediated by addition of conspiracy beliefs to the model. Racialized and Indigenous communities experience varying levels of COVID-19 VM and carry specific predictors and mediators to development of VM. This underscores the intricate interaction between race, gender, discrimination, and VM that need to be considered in future vaccination campaigns.


Assuntos
Árabes , Vacinas contra COVID-19 , COVID-19 , Letramento em Saúde , Povos Indígenas , Racismo , Humanos , Feminino , Masculino , Adulto , COVID-19/prevenção & controle , COVID-19/etnologia , Canadá/epidemiologia , Vacinas contra COVID-19/administração & dosagem , Pessoa de Meia-Idade , Povos Indígenas/estatística & dados numéricos , Confiança , Adulto Jovem , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde , Idoso , Povo Asiático , População Negra/estatística & dados numéricos , População Negra/psicologia , SARS-CoV-2/imunologia , Vacinação/psicologia , Vacinação/estatística & dados numéricos , Adolescente , Etnicidade
4.
Glob Chang Biol ; 30(1): e16981, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37888836

RESUMO

Indigenous Peoples are long-term custodians of their lands, but only recently are their contributions to conservation starting to be recognized in biodiversity policy and practice. Tropical forest loss and degradation are lower in Indigenous lands than unprotected areas, yet the role of Indigenous Peoples' Lands (IPL) in biodiversity conservation has not been properly assessed from regional to global scales. Using species distribution ranges of 11,872 tropical forest-dependent vertebrates to create area of habitat maps, we identified the overlap of these species ranges with IPL and then compared values inside and outside of IPL for species richness, extinction vulnerability, and range-size rarity. Of assessed vertebrates, at least 76.8% had range overlaps with IPL, on average overlapping ~25% of their ranges; at least 120 species were found only within IPL. Species richness within IPL was highest in South America, while IPL in Southeast Asia had highest extinction vulnerability, and IPL in Dominica and New Caledonia were important for range-size rarity. Most countries in the Americas had higher species richness within IPL than outside, whereas most countries in Asia had lower extinction vulnerability scores inside IPL and more countries in Africa and Asia had slightly higher range-size rarity in IPL. Our findings suggest that IPL provide critical support for tropical forest-dependent vertebrates, highlighting the need for greater inclusion of Indigenous Peoples in conservation target-setting and program implementation, and stronger upholding of Indigenous Peoples' rights in conservation policy.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Humanos , Animais , Vertebrados , Biodiversidade , Povos Indígenas
5.
BMC Cancer ; 24(1): 882, 2024 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-39039483

RESUMO

BACKGROUND: Indigenous peoples worldwide experience inequitable cancer outcomes, and it is unclear if this is underpinned by differences in or inadequate use of endocrine treatment (ET), often used in conjunction with other cancer treatments. Previous studies examining ET use in Indigenous peoples have predominately focused on the sub-national level, often resulting in small sample sizes with limited statistical power. This systematic review aimed to collate the findings ofarticles on ET utilisation for Indigenous cancer patients and describe relevant factors that may influence ET use. METHODS: We conducted a systematic review and meta-analysis of studies reporting ET use for cancer among Indigenous populations worldwide. PubMed, Scopus, CINAHL, Web of Science, and Embase were searched for relevant articles. A random-effect meta-analysis was used to pool proportions of ET use. We also performed a subgroup analysis (such as with sample sizes) and a meta-regression to explore the potential sources of heterogeneity. A socio-ecological model was used to present relevant factors that could impact ET use. RESULTS: Thirteen articles reported ET utilisation among Indigenous populations, yielding a pooled estimate of 67% (95% CI:54 - 80), which is comparable to that of Indigenous populations 67% (95% CI: 53 - 81). However, among studies with sufficiently sized study sample/cohorts (≥ 500), Indigenous populations had a 14% (62%; 95% CI:43 - 82) lower ET utilisation than non-Indigenous populations (76%; 95% CI: 60 - 92). The ET rate in Indigenous peoples of the USA (e.g., American Indian) and New Zealand (e.g., Maori) was 72% (95% CI:56-88) and 60% (95% CI:49-71), respectively. Compared to non-Indigenous populations, a higher proportion of Indigenous populations were diagnosed with advanced cancer, at younger age, had limited access to health services, lower socio-economic status, and a higher prevalence of comorbidities. CONCLUSIONS: Indigenous cancer patients have lower ET utilisation than non-Indigenous cancer patients, despite the higher rate of advanced cancer at diagnosis. While reasons for these disparities are unclear, they are likely reflecting, at least to some degree, inequitable access to cancer treatment services. Strengthening the provision of and access to culturally appropriate cancer care and treatment services may enhance ET utilisation in Indigenous population. This study protocol was registered on Prospero (CRD42023403562).


Assuntos
Povos Indígenas , Neoplasias , Humanos , Neoplasias/tratamento farmacológico , Neoplasias/etnologia , Neoplasias/epidemiologia , Povos Indígenas/estatística & dados numéricos , Antineoplásicos Hormonais/uso terapêutico
6.
Int J Equity Health ; 23(1): 28, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38347516

RESUMO

BACKGROUND: Despite considerable investment in maternal-child programs in Canada, there has been little positive impact on the health of Indigenous mothers and their children. The reasons for this are unclear and there is a need to identify how such programs can be successfully implemented. Community input is essential for successful programs; however, it is unclear what the contributions of frontline workers have been in the health program process, i.e., program development, delivery, and evaluation. Based on these identified gaps, this scoping review aimed to: (1) identify factors of success and barriers to successful Indigenous maternal-child community health programs for mothers and their children aged 0-6 years; and (2) explore how frontline workers are included in the program process. METHODS: This scoping review was completed using the Arksey and O'Malley framework, informed by Levac et al. Four data bases (Medline, CINAHL, Embase, and Scopus), grey literature, and reference lists were searched for relevant materials from 1990-2019. Data was extracted from included articles and analysed using descriptive statistics, thematic analysis with the Braun and Clarke framework, and a Principal Component Analysis. RESULTS: Forty-five peer-reviewed and grey articles were included in the review. Factors of program success included: relationship building; cultural inclusion; knowledge transmission styles; community collaboration; client-centred approaches; Indigenous staff; and operational considerations. Barriers included: impacts of colonization; power structure and governance; client and community barriers to program access; physical and geographical challenges; lack of staff; and operational deficits. Frontline workers were found to have a role in program delivery (n = 45) and development (n = 25). Few (n = 6) had a role in program evaluation. CONCLUSION: Although a better understanding of the frontline worker role in maternal-child health programs was obtained from the review, in a large proportion of literature the authors could not determine if the role went beyond program delivery. In addition, no direct input from frontline workers and their perspectives on program success or barriers were identified, suggesting areas to explore in future research. This review's findings have been applied to inform a community-based participatory research project and may also help improve the development, delivery, and evaluation of Indigenous maternal-child health programs.


Assuntos
Saúde da Criança , Humanos , Criança , Canadá
7.
Int J Equity Health ; 23(1): 11, 2024 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-38254148

RESUMO

BACKGROUND: Cancer is a major global health concern. Unfortunately, Indigenous populations such as Greenlanders living in Denmark, face significant disparities in cancer risk, incidence, diagnosis, care quality, and outcomes. In Denmark, vulnerable Greenlanders face challenges accessing cancer screening. The aim of this study was to explore their perceptions of cancer, barriers to participation in cancer screening, and potential for developing a tailored intervention. METHODS: This qualitative study was based on participant observations and qualitative interviews. The sample comprised 46 participants from four distinct drop-in centres. Of these, 28 were vulnerable Greenlanders (19 women and 9 men), 9 were staff members (6 women and 3 men), and 6 were relatives (4 women and 2 men). The data were analysed through inductive content analysis. RESULTS: Vulnerable Greenlanders in Denmark believed they were responsible for their own health and were generally satisfied with the healthcare system. However, they found it challenging to manage their own health and many depended on support from others. Fear of cancer and death shaped their attitudes towards screening. CONCLUSION: For vulnerable Greenlanders in Denmark participation in cancer screening programmes was positively viewed for most but could be challenging. Different intervention ideas raised by the vulnerable Greenlanders, relatives and staff members could guide the development of strategies to increase participation rates.


Assuntos
Detecção Precoce de Câncer , Neoplasias , Feminino , Humanos , Masculino , Medo , Groenlândia , Neoplasias/diagnóstico , Pesquisa Qualitativa
8.
Public Health Nutr ; 27(1): e147, 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38804085

RESUMO

OBJECTIVE: Invasive colonial influences and continuing neoliberal policies have a detrimental impact on Land, health, food and culture for Indigenous Communities. Food security and sovereignty have significant impacts on Indigenous well-being and, specifically, oral health. Aspects relating to food security, such as availability of nutritious foods, are a common risk factor of oral diseases. This scoping review aimed to collate existing evidence regarding the relationship between food sovereignty and/or food security and oral health for Indigenous Communities, globally. DESIGN: Four databases were searched using keywords related to 'Food security' or 'Food sovereignty,' 'Indigenous Peoples' and 'Oral health.' Duplicates were removed, and two independent reviewers screened the titles and abstracts to identify articles for full-text review. Extracted data were summarised narratively, presenting a conceptual model which illustrates the findings and relationships between food security and/or food sovereignty and oral health. RESULTS: The search identified 369 articles, with forty-one suitable for full-text review and a final nine that met inclusion criteria. The impact of food security and food sovereignty on oral health was discussed across different populations and sample sizes, ranging from eighteen Kichwa families in Brazil to 533 First Nations and Metis households in Canada. Pathways of influence between food sovereignty and/or food security are explored clinically, quantitatively and qualitatively across oral health outcomes, including early childhood caries, dental caries and oral health-related quality of life for Indigenous Communities. CONCLUSIONS: Innovative strategies underpinned by concepts of Indigenous food sovereignty are needed to promote oral health equity for Indigenous Communities. The nexus between oral health and Indigenous food sovereignty remains largely unexplored, but has immense potential for empowering Indigenous rights to self-determination of health that honour Indigenous ways of knowing, being and doing.


Assuntos
Segurança Alimentar , Povos Indígenas , Saúde Bucal , Humanos , Abastecimento de Alimentos , Saúde Global
9.
J Water Health ; 22(5): 797-810, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38822460

RESUMO

Municipal water supply through truck-to-cistern systems is common in northern Canada. Household satisfaction and concerns about water services likely impact user preferences and practices. This case study explores household perspectives and challenges with regard to domestic access to water in a decentralized truck-to-cistern system. A case study was conducted in the Northern Village of Kangiqsualujjuaq, Nunavik (Quebec, Canada). A paper-based questionnaire was completed by 65 households (one quarter of the population). Many households (37%) reported not drinking tap water from the truck-to-cistern system. Chlorine taste was a frequently reported concern, with those households being significantly less likely to drink water directly from the tap (p = 0.002). Similarly, households that reported a water shortage in the previous week (i.e., no water from the tap at least once) (33%) were more likely to express dissatisfaction with delivered water quantity (rs = 0.395, p = 0.004). Interestingly, 77% of households preferred using alternative drinking water sources for drinking purposes, such as public tap at the water treatment plant, natural sources or bottled water. The study underscores the importance of considering household perspectives to mitigate the risks associated with service disruptions and the use of alternative sources for drinking purposes.


Assuntos
Água Potável , Abastecimento de Água , Água Potável/análise , Humanos , Quebeque , Características da Família , Inquéritos e Questionários , Feminino , Masculino , Veículos Automotores , Pessoa de Meia-Idade , Adulto
10.
BMC Public Health ; 24(1): 129, 2024 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-38195478

RESUMO

OBJECTIVE: Cultural adaptation of the Patient Health Questionnaire-PHQ-9 to Bolivian Quechua and analysis of the internal structure validity, reliability, and measurement invariance by sociodemographic variables. METHODS: The PHQ-9 was translated and back-translated (English-Quechua-English) to optimise translation. For the cultural adaptation, experts, and people from the target population (e.g., in focus groups) verified the suitability of the translated PHQ-9. For the psychometric analysis, we performed a Confirmatory Factor Analysis (CFA) to evaluate internal validity, calculated α and ω indices to assess reliability, and performed a Multiple Indicator, Multiple Cause (MIMIC) model for evaluating measurement invariance by sex, age, marital status, educational level and residence. We used standard goodness-of-fit indices to interpret both CFA results. RESULTS: The experts and focus groups improved the translated PHQ-9, making it clear and culturally equivalent. For the psychometric analysis, we included data from 397 participants, from which 73.3% were female, 33.0% were 18-30 years old, 56.7% reported primary school studies, 63.2% were single, and 62.0% resided in urban areas. In the CFA, the single-factor model showed adequate fit (Comparative Fit Index = 0.983; Tucker-Lewis Index = 0.977; Standardized Root Mean Squared Residual = 0.046; Root Mean Squared Error of Approximation = 0.069), while the reliability was optimal (α = 0.869-0.877; ω = 0.874-0.885). The invariance was confirmed across all sociodemographic variables (Change in Comparative Fit Index (delta) or Root Mean Square Error of Approximation (delta) < 0.01). CONCLUSIONS: The PHQ-9 adapted to Bolivian Quechua offers a valid, reliable and invariant unidimensional measurement across groups by sex, age, marital status, educational level and residence.


Assuntos
Questionário de Saúde do Paciente , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Masculino , Bolívia , Peru , Psicometria , Reprodutibilidade dos Testes
11.
Aust N Z J Psychiatry ; : 48674241267238, 2024 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-39086119

RESUMO

OBJECTIVES: Indigenous people experience poorer mental health compared to the general population. Socioeconomic gaps partly explain these disparities. However, there is variability between populations and French overseas territories are understudied. This study examines the prevalence of mental health problems among Indigenous people in New Caledonia and French Polynesia, describing and comparing it with that of their counterparts while considering associated factors. METHODS: We used the data from the cross-sectional Mental Health in the General Population survey in the only 3 sites for which information on indigenous status was available: Noumea (2006) and the 'Bush' (2008) in New Caledonia, and French Polynesia (2015-2017). Current mental health issues were screened using the Mini-International Neuropsychiatric Interview. In multivariable analyses, we considered the following factors: gender, age, education level, marital status, occupational activity and monthly income. RESULTS: Overall, 2294 participants were analysed. Among the 1379 indigenous participants, 52.3% had at least one mental health issue. The prevalence of depressive disorder (18.0% vs 11.7%), alcohol use disorder (16.7% vs 11.7%) and suicide risk (22.3% vs 16.7%) were higher among indigenous participants compared to non-indigenous participants. After adjustment, the association between indigenous status and these mental health issues did not persist, except for alcohol use disorder. CONCLUSION: We found higher prevalence of depressive disorder, alcohol use disorder and suicide risk among indigenous people of French Polynesia and New Caledonia compared to their counterparts. These differences seemed largely explained by socioeconomic disparities. Future studies could explore the use of and access to healthcare by indigenous populations.

12.
Am J Primatol ; 86(3): e23523, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37221905

RESUMO

Primates are facing an impending extinction crisis. Here, we examine the set of conservation challenges faced by the 100 primate species that inhabit the Brazilian Amazon, the largest remaining area of primary tropical rainforest in the world. The vast majority (86%) of Brazil's Amazonian primate species have declining populations. Primate population decline in Amazonia has been driven principally by deforestation related to the production of forest-risk commodities including soy and cattle ranching, the illegal logging and setting of fires, dam building, road and rail construction, hunting, mining, and the confiscation and conversion of Indigenous Peoples' traditional lands. In a spatial analysis of the Brazilian Amazon, we found that 75% of Indigenous Peoples' lands (IPLs) remained forested compared with 64% of Conservation Units (CUs) and 56% of other lands (OLs). In addition, primate species richness was significantly higher on IPLs than on CUs and OLs. Thus, safeguarding Indigenous Peoples' land rights, systems of knowledge, and human rights is one of the most effective ways to protect Amazonian primates and the conservation value of the ecosystems they inhabit. Intense public and political pressure is required and a global call-to-action is needed to encourage all Amazonian countries, especially Brazil, as well as citizens of consumer nations, to actively commit to changing business as usual, living more sustainably, and doing all they can to protect the Amazon. We end with a set of actions one can take to promote primate conservation in the Brazilian Amazon.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Humanos , Animais , Bovinos , Brasil , Primatas , Povos Indígenas
13.
BMC Health Serv Res ; 24(1): 553, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38693527

RESUMO

BACKGROUND: Indigenous adolescents access primary health care services at lower rates, despite their greater health needs and experience of disadvantage. This systematic review identifies the enablers and barriers to primary health care access for Indigenous adolescents to inform service and policy improvements. METHODS: We systematically searched databases for publications reporting enablers or barriers to primary health care access for Indigenous adolescents from the perspective of adolescents, their parents and health care providers, and included studies focused on Indigenous adolescents aged 10-24 years from Australia, Canada, New Zealand, and United States of America. Results were analyzed against the WHO Global standards for quality health-care services for adolescents. An additional ninth standard was added which focused on cultural safety. RESULTS: A total of 41 studies were included. More barriers were identified than enablers, and against the WHO Global standards most enablers and barriers related to supply factors - providers' competencies, appropriate package of services, and cultural safety. Providers who built trust, respect, and relationships; appropriate package of service; and culturally safe environments and care were enablers to care reported by adolescents, and health care providers and parents. Embarrassment, shame, or fear; a lack of culturally appropriate services; and privacy and confidentiality were common barriers identified by both adolescent and health care providers and parents. Cultural safety was identified as a key issue among Indigenous adolescents. Enablers and barriers related to cultural safety included culturally appropriate services, culturally safe environment and care, traditional and cultural practices, cultural protocols, Indigenous health care providers, cultural training for health care providers, and colonization, intergenerational trauma, and racism. Nine recommendations were identified which aim to address the enablers and barriers associated with primary health care access for Indigenous adolescents. CONCLUSION: This review provides important evidence to inform how services, organizations and governments can create accessible primary health care services that specifically meet the needs of Indigenous adolescents. We identify nine recommendations for improving the accessibility of primary health care services for Indigenous adolescents.


Assuntos
Acessibilidade aos Serviços de Saúde , Serviços de Saúde do Indígena , Povos Indígenas , Atenção Primária à Saúde , Adolescente , Humanos , Austrália , Canadá , Nova Zelândia , Atenção Primária à Saúde/normas , Estados Unidos
14.
BMC Health Serv Res ; 24(1): 266, 2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38429744

RESUMO

INTRODUCTION: Indigenous people who use unregulated drugs (IPWUD) face significant barriers to care, including sparse availability of culturally safe health services. Integrating Indigenous traditional and cultural treatments (TCT) into health service delivery is one way to enhance culturally safe care. In a Canadian setting that implemented cultural safety reforms, we sought to examine the prevalence and correlates of client perceptions of primary care provider awareness of TCT among IPWUD. METHODS: Data were derived from two prospective cohort studies of PWUD in Vancouver, Canada between December 2017 and March 2020. A generalized linear mixed model with logit-link function was used to identify longitudinal factors associated with perceived provider awareness of TCT. RESULTS: Among a sample of 507 IPWUD who provided 1200 survey responses, a majority (n = 285, 56%) reported their primary care provider was aware of TCT. In multiple regression analyses, involvement in treatment decisions always (Adjusted Odds Ratio [AOR] = 3.6; 95% confidence interval [CI]: 1.6-7.8), involvement in treatment decisions most or some of the time (AOR = 3.3; 95% CI: 1.4-7.7), comfort with provider or clinic (AOR = 2.7; 95% CI: 1.5-5.0), and receiving care from a social support worker (AOR = 1.5; 95% CI: 1.0-2.1) were positively associated with provider awareness of TCT. CONCLUSION: We found high levels of perceived provider awareness of TCT and other domains of culturally safe care within a cohort of urban IPWUD. However, targeted initiatives that advance culturally safe care are required to improve healthcare and health outcomes for IPWUD, who continue to bear a disproportionate burden of substance use harms.


Assuntos
Atenção à Saúde , Povos Indígenas , Humanos , Canadá/epidemiologia , Estudos Prospectivos , Inquéritos e Questionários
15.
Ethn Health ; 29(3): 371-394, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38297918

RESUMO

OBJECTIVES: Despite growing interest in the health disparities associated with food insecurity, research focusing on Indigenous peoples has been limited, especially in studies using nationally representative samples. This study investigates the association between food insecurity and various health outcomes - self-rated general and mental health, chronic health conditions, suicidal ideation, and obesity - among Indigenous peoples in Canada. It also explores the potential moderating effects of culture-based resources, which include cultural identity affect, cultural group belonging, cultural engagement, and cultural exploration. DESIGN: The study utilized data from the 2017 Aboriginal Peoples Survey, a nationally representative sample of First Nations individuals living off-reserve, Métis, and Inuit across Canada (N = 15,533). Logistic regression models were used to analyze the data. RESULTS: Food insecurity was negatively associated with all examined health outcomes. Culture-based resources demonstrated a mixture of anticipated and unexpected effects on these relationships. Consistent with the stress process model, cultural group belonging mitigated the negative impact of food insecurity on all health outcomes. A similar pattern was observed for cultural engagement. However, contrary to expectations from the stress-buffering perspective, little evidence was found to support the moderating effects of cultural identity affect and cultural exploration. CONCLUSION: The results underscore the detrimental effects of food insecurity on the health of Indigenous peoples in Canada and suggest that culture-based resources, particularly cultural group belonging, play a crucial role in mitigating health disparities.


Assuntos
Insegurança Alimentar , Povos Indígenas , Humanos , Fatores Socioeconômicos , Inquéritos e Questionários , Avaliação de Resultados em Cuidados de Saúde , Canadá/epidemiologia
16.
BMC Med Ethics ; 25(1): 3, 2024 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-38172914

RESUMO

BACKGROUND: Current requirements for ethical research in Canada, specifically the standard of active or signed parental consent, can leave Indigenous children and youth with inequitable access to research opportunities or health screening. Our objective was to examine the literature to identify culturally safe research consent processes that respect the rights of Indigenous children, the rights and responsibilities of parents or caregivers, and community protocols. METHODS: We followed PRISMA guidelines and Arksey and O'Malley's approach for charting and synthesizing evidence. We searched MEDLINE, PsycINFO, ERIC, CINAHL, Google Scholar, Web of Science, Informit Indigenous Collection, Bibliography of Native North Americans, and Sociological Abstracts. We included peer-reviewed primary and theoretical research articles written in English from January 1, 2000, to March 31, 2022, examining Indigenous approaches for obtaining informed consent from parents, families, children, or youth. Eligible records were uploaded to Covidence for title and abstract screening. We appraised the findings using a Two-Eyed Seeing approach. These findings were inductively coded using NVivo 12 and analyzed thematically. RESULTS: We identified 2,984 records and 11 eligible studies were included after screening. Three key recommendations emerged: addressing tensions in the ethics of consent, embracing wise practices, and using relational approaches to consent. Tensions in consent concerned Research Ethics Board consent requirements that fall short of protecting Indigenous children and communities when culturally incongruent. Wise practices included allowing parents and children to consent together, land-based consenting, and involving communities in decision-making. Using relational approaches to consent embodied community engagement and relationship building while acknowledging consent for Indigenous children cannot be obtained in isolation from family and community. CONCLUSIONS: Very few studies discussed obtaining child consent in Indigenous communities. While Indigenous communities are not a monolith, the literature identified a need for community-driven, decolonized consent processes prioritizing Indigenous values and protocols. Further research is needed to examine nuances of Indigenized consent processes and determine how to operationalize them, enabling culturally appropriate, equitable access to research and services for all Indigenous children.


Assuntos
Saúde da Criança , Pesquisa , Adolescente , Criança , Humanos , Canadá , Ética em Pesquisa , Consentimento dos Pais , Pais
17.
Int J Nurs Pract ; 30(1): e13159, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37142278

RESUMO

AIM: This study aims to map intimate partner violence evidence among indigenous women and explore the prevalence, social and systemic factors contributing to this occurrence. METHODS: This is a scoping review following the steps recommended by the JBI. We searched the MEDLINE/PubMed®, Web of Science™, Embase, CINAHL and LILACS databases on March 2023. Studies that addressed the intimate partner violence topic among indigenous women and risk factors, without time and language limitations, were included. Detailed information was extracted, standardized by JBI. RESULTS: Twenty studies of different designs were included, all published in English, between 2004 and 2022. A high intimate partner violence prevalence among indigenous women was identified, associated with a great diversity of risk factors. CONCLUSION: The great diversity of identified factors associated with its occurrence shows the complexity of this problem and the vulnerability of indigenous women.


Assuntos
Violência por Parceiro Íntimo , Feminino , Humanos , Prevalência , Fatores de Risco
18.
Med Anthropol Q ; 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38773774

RESUMO

Recent research has unveiled the pervasiveness with which Indigenous patients are subjected to racialized stereotypes within the Canadian health system. Because discrimination in health care is associated with poor health outcomes and undertreated illness, there is a need to better understand how racism is perpetuated systemically in order to rectify the policies, practices, and attitudes that enable it. This article outlines a moral economy of care in emergency departments in western Canada by exploring the discourses that medical professionals employ when discussing cases of medical racism. While these discourses respond to the everyday realities of working in hospitals, they are also rooted in the colonial genealogy of health care in Canada and perpetuated by neoliberal shifts in health care services. By exploring the moral economy of care, this article sheds light on the way pervasive discourses contribute to reproducing and circulating Indigenous-specific racism and its role in decision-making.

19.
Environ Manage ; 74(3): 564-589, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38960921

RESUMO

Parks Canada, in response to commitments undertaken towards reconciliation, has signaled its readiness to reassess the participation of Indigenous peoples in the co-management of national parks, national park reserves, and national marine conservation areas (NMCAs). However, the effectiveness of co-management, as the established framework underpinning these and other longstanding partnerships between the state and Indigenous groups, has been disputed, based on an uneven track record in meeting the needs, interests, and aspirations of Indigenous communities. This paper explores the potential of co-management to facilitate reconciliation within national parks, reserves and NMCAs by developing a typology of various types of co-management agreements. Addressing a critical knowledge gap in co-management governance, we provide a comprehensive review of 23 negotiated co-management agreements involving the state and Indigenous groups in a national park context. The resulting typology categorizes these agreements according to contextual factors and governance arrangements, offering insights into the feasibility of shared governance approaches with Parks Canada. Moreover, it identifies the strengths and weaknesses of co-management agreements in fulfilling reconciliation commitments. Our findings indicate that, although Parks Canada has implemented innovative approaches to co-management and shown a willingness to support Indigenous-led conservation efforts, true shared governance with Indigenous groups, as defined by international standards, is limited by the Canadian government's evident reluctance to amend the foundational legislation to effectively share authority in national parks.


Assuntos
Conservação dos Recursos Naturais , Parques Recreativos , Conservação dos Recursos Naturais/métodos , Canadá , Humanos , Povos Indígenas
20.
Environ Manage ; 73(5): 946-961, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38446188

RESUMO

This Special Section explores the interplay between Indigenous peoples, industry, and the state in five proposed and active mining projects in Canada and Sweden. The overall aim is to identify factors shaping the quality of Indigenous community-industry-state interactions in mining and mine development. An ambition underlying the research is to develop knowledge to help manage mining related land-use conflicts in Sweden by drawing on Canadian comparisons and experience. This paper synthesizes the comparative research that has been conducted across jurisdictions in three Canadian provinces and Sweden. It focuses on the interplay between the properties of the governance system, the quality of interaction and governance outcomes. We combine institutional and interactive governance theory and use the concept of governability to assess how and why specific outcomes, such as mutually beneficial interaction, collaboration, or opposition, occurred. The analysis suggests there are measures that can be taken by the Swedish Government to improve the governability of mining related issues, by developing alternative, and more effective, avenues to recognize, and protect, Sámi rights and culture, to broaden the scope and increase the legitimacy and transparency of the EIAs, to raise the quality of interaction and consultation, and to develop tools to actively stimulate and support collaboration and partnerships on equal terms. Generally, we argue that Indigenous community responses to mining must be understood within a larger framework of Indigenous self-determination, in particular the communities' own assessments of their opportunities to achieve their long-term objectives using alternative governing modes and types of interactions.


Assuntos
Governo , Mineração , Canadá , Suécia , Conhecimento
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