Health Promotion and Socio-behavioural Sciences PhD Student, School of Public Health, University of Alberta, Edmonton, Canada.
Tier 1 Canada Research Chair in Health and Community, Faculty of Health Sciences, University of the Fraser Valley, Chilliwack, Canada.
BMC Public Health. 2019 Feb 11;19(1):176. doi: 10.1186/s12889-018-6383-8.
Social determinants of Indigenous health are known to include structural determinants such as history, political climate, and social contexts. Relationships, interconnectivity, and community are fundamental to these determinants. Understanding these determinants from the perspective of Indigenous youth is vital to identifying means of alleviating future inequities.
In 2016, fifteen Yellowknives Dene First Nation (YKDFN) youth in the Canadian Northwest Territories participated in the 'On-the-Land Health Leadership Camp'. Using a strength- and community-based participatory approach through an Indigenous research lens, the YKDFN Wellness Division and university researchers crafted the workshop to provide opportunities for youth to practice cultural skills, and to capture the youth's perspectives of health and health agency. Perspectives of a healthy community, health issues, and health priorities were collected from youth through sharing circles, PhotoVoice, mural art, and surveys.
The overall emerging theme was that a connection to the land is an imperative determinant of YKDFN health. Youth identified the importance of a relationship to land including practicing cultural skills, Elders passing on traditional knowledge, and surviving off the land. The youth framed future health research to include roles for youth and an on-the-land component that builds YKDFN culture, community relations, and traditional knowledge transfer. Youth felt that a symbiotic relationship between land, environment, and people is fundamental to building a healthy community.
Our research confirmed there is a direct and critical relationship between structural context and determinants of Indigenous Peoples' health, and that this should be incorporated into health research and interventions.
众所周知，影响原住民健康的社会决定因素包括历史、政治气候和社会背景等结构性决定因素。关系、相互联系和社区是这些决定因素的基础。从原住民青年的角度理解这些决定因素对于确定缓解未来不平等现象的方法至关重要。
2016 年，加拿大西北地区的 15 名 Yellowknives Dene 第一民族（YKDFN）青年参加了“实地健康领导力营”。通过以社区为基础的参与式方法和原住民研究视角，YKDFN 健康部门和大学研究人员精心设计了该研讨会，为青年提供实践文化技能的机会，并捕捉青年对健康和健康代理的看法。通过分享圈、照片声音、壁画艺术和调查，从青年那里收集了关于健康社区、健康问题和健康优先事项的观点。
总体上出现的主题是，与土地的联系是 YKDFN 健康的必要决定因素。青年确定了与土地的关系的重要性，包括实践文化技能、长辈传授传统知识以及从土地上生存。青年们为未来的健康研究设定了框架，包括青年的角色和实地考察部分，这将建立 YKDFN 文化、社区关系和传统知识的传承。青年们认为，土地、环境和人民之间的共生关系是建设健康社区的基础。
我们的研究证实，结构性背景与原住民人民健康的决定因素之间存在直接和关键的关系，这应该纳入健康研究和干预措施中。
