Center for World Indigenous Studies, Olympia, Washington, USA.
Am J Community Psychol. 2024 Mar;73(1-2):216-233. doi: 10.1002/ajcp.12670. Epub 2023 Apr 14.
Indigenous peoples around the world suffer from health disparities attributed to a plethora of risk factors and social determinants of health stemming from colonialism and systemic oppression. Community-based health interventions have been identified as a means for addressing and reducing Indigenous health disparities by allowing for Indigenous sovereignty to be respected and centered. However, sovereignty relating to Indigenous health and well-being is underresearched. The present article explores the role of sovereignty in Indigenous community-based health interventions. A qualitative metasynthesis was conducted among 14 primary research studies co-authored by Indigenous people describing and evaluating Indigenous community-based health interventions. Five conceptual themes emerged as aspects of sovereignty which benefit Indigenous health and well-being outcomes: integration of culture; relocation of knowledge; connectedness; self-actualization; and stewardship. Implications are discussed, with the goal of creating a decolonial framework rooted in Indigenous epistemologies and perspectives for how sovereignty impacts Indigenous health, as well as strengthening a clear need for further research on and praxis of sovereignty in Indigenous healthcare.
世界各地的土著人民因殖民主义和系统性压迫造成的大量健康风险因素和社会决定因素而遭受健康差距的困扰。基于社区的健康干预措施已被确定为解决和减少土著人民健康差距的一种手段,因为它允许尊重和以土著人民的主权为中心。然而,与土著人民健康和福祉有关的主权问题研究还很不足。本文探讨了主权在土著社区为基础的健康干预措施中的作用。在 14 项由土著人民共同撰写的描述和评估土著社区为基础的健康干预措施的主要研究中进行了定性元分析。出现了五个主权概念主题,这些主题有益于土著人民的健康和福祉结果:文化的融合;知识的迁移;联系;自我实现;和管理。本文讨论了这些影响,其目的是建立一个基于土著认识论和观点的去殖民框架,了解主权如何影响土著人民的健康,并强烈需要进一步研究和实践土著人民医疗保健中的主权问题。