Embed Size (px)
Citation preview
INDIGENOUS HEALTH CONDITIONS AND EXPERIENCES
SOURCES, PATTERNS, EXPLANATIONS & SOLUTIONS
© Dr. Francis Adu-Febiri, 2020
24/02/2020 1
24/02/2020 2
• MOTIVATE:
– Why we should be interested in the social indicators of indigenous health
Introduction: The Health Status of Indigenous Peoples in Canada
• The marking of Indigenous peoples as diseased, addicted, and unworthy of care—along with the deaths attached to them—are deeply historical. Kelm (1998) wrote of the discursive construction of Indigenous peoples as sick and vulnerable, arguing that it has worked under Settler colonialism to construct a population of peoples believed incapable of governing themselves ( Cannon and Sunseri, 2018, pp. 205-206).
24/02/2020 3
24/02/2020 4
INTRODUCTION: Main Theme, Central Question and Main Thesis
• MAIN THEME:
• Indigenous health and well-being in a settler colony
• CENTRAL QUESTION: • What are the sources of the patterns of Indigenous health
conditions/experiences and well-being in Canada, the impacts of these patterns, and strategies to sustainably transform them?
• MAIN THESIS: • The patterns of Indigenous health conditions/experiences and well-being in
Canada are socially constructed. The devastating patterns of settler colonial violence and their consequences will continue until effective sustainable decolonizing and indigenizing strategies are designed and implemented to deconstruct these patterns and socially reconstruct sustainable Indigenous healing and well-being.
INTRODUCTION: Main Argument
• The imperial violence of settler colonialism embedded in the evolution of the capitalist political economy underlies the patterns and impacts of indigenous health conditions/experiences and well-being in Canada. This pattern would not fundamentally change until the human agency of Indigenous peoples is transformed to use sustainable decolonizing and indigenizing strategies to diminish/eliminate the core of imperial violence such as ideology of scarcity of resources, centered power, oppressions, racisms, cultural hegemony, new poverty, and white patriarchy. Until then, the patterns of deteriorating Indigenous health and well-being will continue with tragic consequences.
24/02/2020 5
24/02/2020 6
Introduction: The Imperial Root of Indigenous Health
Conditions/Experiences
• http://www.youtube.com/watch?v=Iv-dG8XH_8A
25/02/2020 7
INTRODUCTION: Main Argument Illustrated:The Imperial Root of Indigenous Health
Conditions/Experiences
• Through stories handed down over many generations, it is well known that pre-contact Indigenous peoples had effective infrastructures, upheld traditional values and beliefs, followed customs and traditions, and were in fact very healthy people (Fox and Long 2000: 288)
25/02/2020 8
INTRODUCTION: Main Argument Illustrated:The Imperial Root of Indigenous Health
Conditions/Experiences
• However, it is false to think that “Aboriginal People had no diseases and health problems prior to contact. Aboriginal people did suffer from disorders such as arthritis and rye problems caused by too much smoke in enclosed spaces, for example. It is just that the big-killer communicable diseases were not a problem.” (Steckley and Cummins 2008, p. 187).
24/02/2020 9
• EXPLORE:
• To know and understand the major concepts related to Indigenous health and well-being
Major Concepts• Imperialism
– Settler Colonialism
– Imperial Violence: Aggressive, Peaceful, and Lateral
– Racisms: Individual, Institutional, Systematics, Systemic
– Oppression
• Socially Constructed Indigenous health and well-being
• Political Economy– Capitalist Political Economy
– Ideology of scarcity of resources
– New poverty
• Human Agency• Human Capital
• Human Factor• Hu
• White Patriarchy
• Cultural Hegemony:
– Pathological Indigenous Culture
– Assimilation
– Multiculturalism
• Centered Power
• Decolonization and Indigenization 10
Major Concepts
• IMPERIALISM:
• Systemic and systematic subordination of the culture, discourse, theories, knowledges, governance system of Indigenous groups by Western capitalist countries for economic purposes. Colonialism is a weapon of this imperialism.
– “Imperialism is the highest state of capitalism” (V.I. Lenin)
24/02/2020 11
Major Concepts
24/02/2020 12
• INSTITUTIONAL RACISM
• Policies, procedures, and practices– in institutions and organizations that consciously or
unwittingly promote, sustain, or entrench differential advantage or privilege for the dominant group at disadvantage/disprivilege to racialized groups:
• e.g. word -of-mouth recruitment, discriminatory hiring based upon employer’s bias, union policy of internal job posting, lack of recognition of foreign credentials and Indigenous knowledges.
Major Concepts
24/02/2020 13
• SYSTEMIC/SYSTEMATIC RACISM • Laws, rules, and other norms woven into the social system
– that result in an unequal distribution of economic, political, and social resources and rewards among various racial groups (Henry et al, 2000: 56).
• E.g. Denial of access, participation and equity to racial minorities for services such as education, housing, employment
• E.G. Negative representation of people of color, the erasure of their voices and experiences, and the repetition of racist images in the media.
• When these allocation of resources are backed up by legislation, they constitute SYSTEMATIC RACISM.
Major Concepts
•VIOLENCE
24/02/2020 14
PATTERNS OF INDIGENOUS HEALTH:AGGRESSIVE VIOLENCE
• Aggressive violence, the “guns, germs and steel invasion” ( Jared Diamond, 1998) that accompanied the European imperial domination of the Turtle Island
24/02/2020 15
PATTERNS OF INDIGENOUS HEALTH:PEACEFUL VIOLENCE
• Haunani Kay-Trask (2000) invokes Frantz Fanon’s notion of a “peaceful violence” to emphasize that not only is imperial violence carried out through aggressive invasions and occupations or physical warfare, but that it also consists of the “ordered realities of confinement, degradation, ill-health and early death” (p. 118).
24/02/2020 16
PATTERNS OF INDIGENOUS HEALTH:VERTICAL VIOLENCE
• Indigenous Infants/Children:• Infant mortality rate, especially for reserve
Indians, is considerably higher than for the general population.
• The chance of an Aboriginal child developing pneumonia is about 17 times that of other Canadian Children.
• Indigenous children have more ear infections, meningitis, and hepatitis
• Indigenous experience the highest incidence of fetal alcoholic syndrome. – Sources: Absolon 2011, Ahenakew 2012, Daschuk 2013, Frideres, James and Rene R. Gadacz.
2001:Chapter 3; Wotherspoon, Terry and Vic Satzewic. 2000: Chapter 6; Bolaria, Singh B. and Rosemary Bolaria (ed.). 1994: Chapters 13-16.
24/02/2020 17
PATTERNS OF INDIGENOUS HEALTH:LATERAL VIOLENCE
• Indigenous Adults:• Life expectancy rates remain an average of 10 years behind the rates of
the general population.• The incidence of diabetes is 10 times the general Canadian rate; cervical
cancer 6 times higher.• Indigenous adults in Canada have a 20.8 percent higher rate of cancer
than the general population. • Suicide and self-inflicted injuries are three times higher (six times higher
for the 15-24 age group).• Homicide rates are 2 times as high, congenital anomalies are 1.5 times
higher, tuberculosis is over 9 times higher, and pneumonia over 3 times higher.
• The overall rate of violent deaths is between 3-4 times the general Canadian rate.
• The death rate for the Aboriginal population ages 15-44 is more than three times of the general Canadian population. – Sources: Greenwood et al (2015), Absolon 2011, Ahenakew 2012,
Daschuk 2013, Frideres, James and Rene R. Gadacz. 2001:Chapter 3; Wotherspoon, Terry and Vic Satzewic. 2000: Chapter 6; Bolaria, Singh B. and Rosemary Bolaria (ed.). 1994: Chapters 13-16, Assembly of First Nations 2007, Mensah and Williams 2017, p. 3. 24/02/2020 18
PATTERNS OF INDIGENOUS HEALTH:VERTICAL & LATERAL VIOLENCE
• "One-third of HIV-positive Canadians are Aboriginal."
XVI International AIDS Conference in TorontoTo Address HIV Among Aboriginals
August 13-18, 2006
• “With the highest HIV rates in Canada, Saskatchewan’s epidemic is uniquely Indigenized”(Dr. Pamela Downe, Associate Professor, College of Arts and Science, University of Saskatchewan).
24/02/2020 19
IMPACT OF MARGINAL INDIGENOUS HEALTH
• Reinforcement of:
–Low economic status
–Low educational achievement/attainment
–Negative racial stereotypes
24/02/2020 20
EXPLANATIONS FOR AND SOLUTIONS TO THE INDIGENOUS HEALTH CRISIS
• The disparity between the health status of Indigenous people in pre-contact and the post-contact periods renders the biomedical theory and genetic deficiencies less convincing in explaining the contemporary marginal health and wellness status of Indigenous people. The Biomedical Model is therefore unable to resolve the Indigenous health crisis on its own. This is because the biomedical health care system of Canada “does not, has not, and cannot meet their needs [health and wellness needs of Indigenous peoples of Canada]” (Loppie-Reading et al 2009, HFNC 2011).
• What then explains and can resolve the Indigenous health crisis?
24/02/2020 21
Sociological Perspectives of the Indigenous Health Crisis
• Major Concept: Social Construction: Health is socially constructed.
• That is, it is, “ a product of social circumstances” (Wotherspoon and Satzewich 2000: 176).
• Health is dependent very much on “socially determined ways of life” beyond the individual’s control (Bolaria 1988: 135) that prevent Indigenous people to eat well, rest well, exercise well, and connect well with community/society.
• “Of course, the causes of such socioeconomic and health disparities are never easy to pin down. Yet, the salience of racism in all this cannot be easily discounted (McGibbon and Etowa 2009,; Raphael 2009)” (Mensah and Williams 2017, p. 3).
• Solutions to the Indigenous health challenge therefore lie more in change of social conditions than in utilization of Western biomedical health care services. Increase in the human factor competency (HFC) of Indigenous communities could facilitate this transformation of the Indigenous social conditions. High HFC could transform Indigenous communities/peoples to transform their access to valued resources (Adu-Febiri 2017) that would make them “eat well, rest well, exercise well, and connect well with community/society” (Bolaria 1988, p. 135)24/02/2020 22
Sociological Perspectives of the Indigenous Health Crisis
• Major Concept: Oppression—Restrictions on Indigenous lives: Fragile freedoms; lack of real choices
• Oppression is a Social Determinant of health(Greenwood et al 2015, Elizabeth McGibbon, 2012).
• Oppression and health are intricately connected. A recent emphasis on the social determinants of health has focused attention on the “causes of the causes” of ill health, including systemic forces such as capitalism, globalization, imperialism, medicalization, neo-colonialism and neoliberalism. If we are to change the oppressive practices that cause ill health our analysis must consistently and explicitly integrate these systemic forces and thus reframe growing health inequities within the scope of moral responsibility and social justice (McGibbon, 2012)
24/02/2020 23
24/02/2020 24
Sociological Perspectives of the Indigenous Health Crisis
• “The Story of Minnie Sutherland:Death By Stereotype?”
• http://afternoonsncoffeespoons.wordpress.com/2011/04/28/aboriginal-canada-the-story-of-minnie-sutherland/
Indigenous Perspectives of the Indigenous Health Crisis
• “…colonialism is indeed the broadest and most fundamental determinant of Indigenous health and well-being in countries where settler-colonial power continues to dominate” (De Leeuw et al, 2015, p. xii).– Existing literature focused on determinants of health has
been primarily concerned with how the “social” determines human (ill) health or lack of well-being, often to the exclusion of other forces that may not be considered strictly “social” in nature, including colonialism—historical and contemporary colonialisms—that continue to bear down on all aspects of Indigenous peoples’ lives (ibid.)24/02/2020 --25
24/02/2020 26
• CREATE:
• Be a Changemaker; be a Gamechanger
CREATIVITY & INNOVATION EXERCISE
• Critically review the explanations and suggested solution strategies in the rest of the slides.
– a) If you agree that any of the strategies are sustainable, provide an innovative design (provide a brief description and also a clear diagram connecting processes/steps, tasks, people, and resources) to successfully implement it/them.
– b) If you question the sustainability of the suggested strategies, provide creative ideas that could inform sustainable strategies and innovative designs to implement them.
• Submit your designs and ideas for 2 bonus marks.24/02/2020 27
24/02/2020 28
• APPLICATION OF SOCIOLOGICAL PARADIGMS
THE FUNCTIONALIST PERSPECTIVE OF THE INDIGENOUS HEALTH CRISIS
• Explanation: “PATHOLOGICAL” INDIGENOUS CULTURE
• Indigenous traditional medicine is disappearing but Indigenous Canadians are unable to adequately access/utilize advanced medicine (the biomedical health care services) because of their traditional cultures, according to Brant (1990: Clare Brant. “Native Ethics and Rules of Behaviour.” Canadian Journal of Psychiatry, 35: 534-539).
24/02/2020 29
THE FUNCTIONALIST PERSPECTIVE OF THE INDIGENOUS HEALTH CRISIS
• 1. Indigenous people prefer intimate contacts with physicians, as they do with traditional healers, and therefore find de-personalized biomedical services unacceptable.
• 2. Indigenous people are more likely to utilize hospital emergency departments for non-emergency treatment, because they culturally blind to the purpose of emergency departments.
• 3. Indigenous people are less likely to make appointments, and to show up for appointments, because they are past- and present-oriented, and not future oriented.– Clare Brant. “Native Ethics and Rules of Behaviour.” Canadian Journal
of Psychiatry, 35: 534-539).
• Stereotypes?
24/02/2020 30
THE FUNCTIONALIST PERSPECTIVE OF THE INDIGENOUS HEALTH CRISIS
• Major Concept: Assimilation
• Solution: ASSIMILATION:– Must abandon Indigenous cultures and immerse in the
mainstream Canadian culture so as to properly utilize the biomedical Canadian health care services
• Critique:• “Few Aboriginals are unicultural (many have already lost
their traditional cultures and are assimilated into Euro-Canadian culture) and most Aboriginals are bicultural, able to live adequately in both Aboriginal and Euro-Canadian cultural milieux” (Waldram 1994: 326).
24/02/2020 31
SOCIAL CONFLICT PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Explanation: POVERTY:• Major Concepts: Political Economy: The intersection of power and wealth
driven by the ideology of scarcity of resources.
• New Poverty: New poverty is extreme poverty resulting from the introduction of the
cash economy (through macroglobalization processes) to Indigenous people without providing them with access to Welfare State services and without empowering them to access the formal economic sector. These conditions make new poverty an issue more prevalent in underdeveloped countries and communities (Adu-Febiri 2016, p. 30).
• Capitalist Political Economy: Colonization and Social Class:
– Indigenous Poverty Produced by Capitalist Exploitation through colonization:
• New Poverty leads to very high rates of suicide and violent death, alcohol abuse, and domestic violence, areas in which biomedical health care services have had little effect (Waldram 1994: 328).
24/02/2020 32
SOCIAL CONFLICT PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• 1. Poor housing conditions result in high incidences of infectious diseases, such as scabies and tuberculosis (Ibid.).
• 2. Low incomes also affect diet: Indigenous peoples have in recent years developed very high rates of nutritional disorders, such as diabetes, lung cancer, and cardiovascular disease (Feather 1991)
• 3. Poverty and low level of education reduce health care utilization of lower/under class people, Aboriginals not excepted (Waldram 1994: 329-21).
24/02/2020 33
SOCIAL CONFLICT PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Solution: Establish Self-government and Eliminate Poverty:
• “…effective changes in health status require major transformations in the organization of social life that go beyond what native peoples can achieve on their own” (Wotherspoon and Satzewich 2000: 176).
• 1.Create Indigenous self-government• 2. Eliminate Poverty by
• Destroying capitalism and introducing socialism/communism.
• Critique:• Complete Indigenous independent state is not feasible in a settler colony
where the indigenous population is small.
• The project of replacing capitalism with socialism/communism is overwhelming, and so far has not worked anywhere.
24/02/2020 34
INTERACTIONIST PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Explanation: DEFINITION OF HEALTH & HEALTH CARE
• Major Concept: Human Agency: Peoples’ capability/ability to define situations and make choices with their human capital and human factorthrough the looking-glass self process
• Human Agency: Definition of Clinical Reality:
• 1. Define health or healing as total well being and to include whole communities or families.
• 2. Perceptions of racism in the biomedically-based health services delivered by EuroCanadians, especially in the absence of formal means to discuss them with the others involved (medical employees and employers), condition the negative response of Indigenous people to the Canadian health care system (Waldram 1994: 333, Alan and Smylie 2018, pp. 214-223).
24/02/2020 35
INTERACTIONIST PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Solution: RE-DEFINITION OF HEALTH AND HEALTH CARE– Change in the perception that the EuroCanadian biomedically-
based health care service is racist would influence Indigenous people to access and utilize the biomedical services to heal their diseases.
• Critique:
• Given that many Indigenous people define health or healing as total well-being (World Health Organization’s definition) and to include whole communities or families, increased utilization of the EuroCanadian biomeddically-based health care system won’t resolve the health crisis. 24/02/2020 36
FEMINIST PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Major Concept: White Patriarchy: European sexist ideology and structures of male dominance
• Explanation: White Patriarchal Health Care System.• Lack of consultation and participation of Indigenous women
in the major decisions affecting Indigenous health in post-contact Canada is a major factor in Indigenous health crisis.
• Women are the main care givers in Indigenous communities but unlike in the pre-contact period, they don’t participate in health policy making.
• Solution:
• Make Indigenous women major participants in health policy and decision making processes of Indigenous health care system.
24/02/2020 37
FEMINIST PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Critique:
– Indigenous women’s participation in the major decision-making processes in a colonial biomedical health care system is not likely to totally resolve the Indigenous health crisis because gender is only one dimension of the Indigenous health crisis.
24/02/2020 38
POSTMODERN PERSPECTIVES OF INDIGENOUS HEALTH CRISIS
• Major Concept: Politics of culture creates a Cultural Hegemony—a vertical cultural mosaic with one culture as the most dominant.
• Explanation: Cultural Hegemony
• Mono-cultural (Eurocentric) Health Care System:
• Culturally insensitive and inappropriate health care services (Waldram 1994, Allan and Smylie 2018).
• Language barriers
• Disrespect for Indigenous health values and beliefs.
• Lack of consideration of the unique life circumstances and living conditions of Indigenous peoples.
• Lack of Indigenous care services provided in Indigenous cultural context by
Indigenous health care deliverers.24/02/2020 39
POSTMODERN PERSPECTIVES OF INDIGENOUS HEALTH CRISIS
• Major Concept: Multiculturalism—horizontal cultural mosaic or cultural equality
• Solution: Multiculturalize the Health Care system• Provision of health services in Indigenous languages or language
interpretation services in situations where clients are not fluent in EuroCanadian language.
• Sensitivity to Indigenous health beliefs and values.
• Health care services provided in proper Indigenous cultural contexts by Indigenous health care providers.
• Critique:– Culturally sensitive and appropriate health care services in
Contemporary Canada would not necessarily eliminate the fundamental structural inequalities of racism, sexism, and classism from the health care system.24/02/2020 40
POSTSTRUCTURALIST PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Major Concept: Centered Power—concentration of decision-making resources in the hands of a selected few
• Explanation: Centralized Power Structures– Racism, sexism, and classism, as intersected centralized
power structure, disempower Indigenous people and thus unable them to control Indigenous health care services.
– Thus lower class Indigenous women experience the blunt of Indigenous health crisis.
• Solution: De-centralized Power• Indigenous health crisis will be resolved only when
Indigenous Canadians have equal access to and participation in a decentralized power.
24/02/2020 41
POSTSTRUCTURALIST PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Critique:– Indigenous local control of Indigenous health care seems to be
working for Aboriginals in The William Charles Band located in the Montreal Lake in Saskatchewan (Waldram 1994). This is in spite of the fact that Canadian State is still a centralized structure of racism, classism and sexism.
• When the band gained control of health care delivery in 1988, there was a dramatic change in attitude.
• Immunization rates increased.
• Home management improved.
• Elders began to see the nurses on a regular basis.
• After-hours visits to the nursing stations decreased.
• Health care services was accompanied by new educational and outreach initiatives.
24/02/2020 42
POST-COLONIAL PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Explanation: Imperialism• Imperialist interaction and social practices in the
health care institution systematically excludes Indigenous peoples from equal participation and treatment (Reid 1994).
• Indigenous perception that the predominantly EuroCanadian health care staff are imperialistic: treating the EuroCanadian patients better than the Indigenous peoples (Waldram 1994).
• Health care deliverers tend to hold imperialistic stereotypes of Indigenous peoples as inferior: drunks, incompetent parents, etc. (Sherley-Spiers 1989, Alan and Smylie 2018).
24/02/2020 43
POST-COLONIAL PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Major Concept: Decolonization—returning economic and political power to dominated people
• Solution: Indigenous Control; Decolonization
• Indigenous Control of Indigenous Health Care system:
– Indigenous health care personnel delivering health care to Indigenous patients in Indigenous cultural context.
• Structural change [Indigenous Self-government] is required to reduce the pervading impact of systemic, systematic and institutional racism on the health of Indigenous people in Canada (Allan and Smylie 2018)
24/02/2020
POST-COLONIAL PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Critique:– 1. This perspective doesn’t discuss how such a structural
change would come about in a White settler colonial state like Canada.
– 2. Indigenous control may mean Indigenous elite control of Indigenous health care that marginally benefits or even works against lower class Indigenous people, particularly poor Indigenous women.
24/02/2020 45
INDIGENOUS PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Explanation #2: Systemic, Systematic and Institutional Racisms emerging from settler-colonialism
• Racist social structure [of the White settler colonial state] rather than cultures of Aboriginal society generates sickness and premature death in Aboriginal society (Fox and Long 2000: 298, Allan and Smylie 2018). 24/02/2020 46
Explanation #1: Dominance of the
Western Biomedical System that
disregards Indigenous Medicine Wheel
INDIGENOUS PERSPECTIVE OF INDIGENOUS HEALTH CRISIS
• Major Concept: Indigenization—making Indigenous philosophies, knowledges, cultures, and imaginations the base for constructing a sustainable health and well-being of Indigenous peoples.
• SOLUTION: “…any solution will have to be based on cultural and spiritual revival in the native community” (Greenwood et al 2015, Fox and Long 2000: 290).– Any solutions will have to reflect the holistic health and wellness system informed by
the Indigenous medicine wheel.
• Critique:
– Fails to articulate that effective and sustainable revival should be based on total empowerment of Indigenous people. That is, not only the revival of cultural and spiritual capital, but also human capital, social capital, emotional capital, moral capital, and aesthetic capital (Adjibolosoo 1995, Adu-Febiri 2016). In other words, high human factor competency (HFC) in Indigenous communities could lower the health risks and increase the well-being in Indigenous communities.24/02/2020 47
CONCLUSION
• The Indigenous health conditions and experiences, are intricately connected to social, cultural, spiritual, political, and economic marginalization that present a formidable challenge to Indigenous communities rather than biological and cultural deficiencies.
• Three general trends are required if the health care situation of Indigenous people is to improve sustainably (Waldram 1994: 336-7):
– 1) A greater cultural sensitivity in the health care system on the part of non-Indigenous biomedical practitioners.
– 2) A continuing process of acquisition of Indigenous control of health at the community level.
– 3) An overall general improvement in the socio-economic status of Indigenous Canadians.
24/02/2020 48
CONCLUSION• In effect, the focus of resolving health and well-being issues in Indigenous
communities should not be on just culture. The insight of Allan and Smylie(2018) is worth taking seriously. We should be:
– “…concerned with culturalist solutions to problems involving racism and colonialism in the context of health care services delivery. It is important to draw a distinction between culturalist and anti-colonial approaches to health care delivery…cultural sensitivity training actively prevents health care practitioners from dealing effectively with issues of racism, and from producing scholarly epidemiological research illuminating the social determinants of health…Indigenous peoples are impacted by poverty, poor water quality, stress, and identity-related issues, and that this impacts health and health outcomes…the focus of research…ought to be on health outcomes and on remedying disparate and negative health indicators (Cannon and Sunseri 2018, p. 206)
Under the constraints of internal or settler colonialism, the health and well-being outcomes and indicators about Indigenous peoples would be changed mainly through changed Indigenous peoples, that is, human factor competent Indigenous leadership at all levels. 49
CONCLUSION
• Conventional efforts at resolving the health crisis will make little headway. The point is that it will take decolonization and indigenization of health and well-being to overcome the Indigenous health crisis. Increases in the human factor competency (HFC) of Indigenous communities could provide the “quiet revolution” or the effective lever or the tipping point to facilitate these processes.
24/02/2020 50
REFERENCES• Adjibolosoo, Senyo B-S. K. 1995. The Human Factor in Developing Africa,
Westport, Conn.: Praeger.
• Adu-Febiri, Francis. 2016. “Microglobalization Pardox: Encounters of Indigenous Poor Micro-entrepreneurs with Microfinance”. Review of Human Factor Studies, Volume 22, Number 1, pp. 27-63.
• Allan, Billie and Symilie, Janet. 2018. “The Role of Racism in the Health and Well-being of Indigenous Peoples in Canada”. In Martin J. Cannon and Linda Sunseri (Eds.). 2018, Racism, Colonialism, and Indigeneity in Canada: A Reader. Second Edition. Don Mills: Oxford University Press.
• Anderson, Alan A. 1994. “The Health of Aboriginal People in Saskatchewan: Resent Trends and Policy Implications.” In B. Singh Bolaria and Rosemary Bolaria (eds.). Racial Minorities, Medicine and Health. Halifax: Fernwood Publishing.
• Brant, Clare .1990. “Native Ethics and Rules of Behaviour.” Canadian Journal of Psychiatry, 35: 534-539.
• Cannon. Martin J. and Sunseri, Linda (Eds.). 2018, Racism, Colonialism, and Indigeneity in Canada: A Reader. Second Edition. Don Mills: Oxford University Press.
51
REFERENCES• Greenwood, Margo, Sarah de Leeuw, Nicole Marie Lindsay and Charlotte
Reading (ed.). 2015. Determinants of Indigenous Peoples’ Health in Canada: Beyond the Social. Toronto: Canadian Scholars’ Press
• McGibbon, Elizaberth (ed.). 2012. Oppression: A Social Determinant of Health. Halifax: Fernwood Publishing
• Mensah, Joseph and Williams, Christopher J. 2017. Boomerang Ethics: How Racism Affects Us All. Halifax and Winnipeg: Fernwood Publishing.
• Reid, Carol. 1994. “Sick to Death: The Health of Aboriginal People in Australia and Canada.” In B. Singh Bolaria and Rosemary Bolaria (eds.).
• Sherley-Spiers, S.K. 1989. “Dakota Perceptions of Clinical Encounters with Western Health Care Providers.” Native Studies Review, 5(1):41-51.
• Waldram, James B. 1994. “Cultural and Socio-Economic Factors in the Delivery of Health Care Services to Aboriginal People.” In B. Singh Bolaria and Rosemary Bolaria (eds.).
• Wotherspoon, Terry and Vic Satzewich. 2000. First Nations: Race, Class and Gender Relations. Regina: Canadian Plains Research Center.
24/02/2020 52
