From Coffee and Eggs to the First of its Kind in Canada

A Story of Determinants of Indigenous Health In Canada

Sometimes really good things happen over a conference breakfast.

On a late autumn morning in 2011, Drs. Margo Greenwood and Charlotte Reading, both leading Indigenous women scholars working broadly in the area of Aboriginal health and well-being, sat down with Dr. Sarah de Leeuw, a creative writer and geographer working in a faculty of medicine. Coffee was ordered. Sessions from the previous day were discussed. Decisions were made about omelets versus oatmeal, toast as opposed to hash browns.

And it was casually observed that a book written by Indigenous people about determinants of health was very much needed in Canada.

That breakfast, during which the conversation meandered from shopping for shoes to children and families, from too much work through to court cases being waged about the rights of Indigenous peoples across the country, was the genesis of the recently published Determinants of Indigenous Health In Canada: Beyond the Social, edited by Greenwood, de Leeuw, Reading and Lindsay (Canadian Scholars’ Press, 2015).

What the genesis conversation importantly did was establish both an idea and a need: although by 2011 a social determinants of health (SDOH) framework was becoming increasingly well-established as a means of understanding health inequalities in Canada, and while SDOH frameworks solidified colonialism as perhaps the most significant driver of poor health amongst Indigenous people in the country, almost nothing was written by Indigenous peoples about the topic and the literature was almost entirely silent on limits to the concept ‘social’.

A blank sheet of paper was passed between Greenwood, Reading and de Leeuw; lists were made of leading Indigenous scholars, activists, clinicians, and community leaders who would likely have something to say about First Nation, Metis and Inuit well-being in Canada. Sometime later, after chapters from people from coast to coast to coast had begun to pour in, Indigenous artists were also invited to contribute works that sought to creatively illuminate questions about Indigenous health. There were poems and short stories, reproductions of contemporary totem poles, all weaving through research contributions by Indigenous language theorists, two-spirited scholars, First Nations physicians and health policy leaders, and Metis genealogists, and genetic researchers.

The final outcome is a book that, according to one reviewer, “provides a welcome corrective to mainstream writings that present simplistic and essentialist views of both culture and Indigenous status….;” this is important because the health disparities affecting Indigenous peoples in Canada might well be understood as a national epidemic, something that must be understood, discussed, and taught with the complexity and nuance granted to other pressing contemporary challenges. Most importantly, Determinants of Indigenous Health In Canada: Beyond the Social addresses the disparities by placing front and center the voices and experiences of Indigenous peoples.

In some ways it was fortuitous the conversation that started the book began over breakfast: Dr. Greenwood has long observed that one of the best ways to generate and disseminate knowledge about Indigenous peoples is to “set a table, to invite people to sit down around it, to share, to visit.” The book Determinants of Indigenous Health In Canada: Beyond the Social is an invitation to share, to think about knowledge about Indigenous people as written by Indigenous people. As Javier Mignone, with the University of Manitoba, says: “This book offers new lights, questioning our views about social determinants of health among Indigenous peoples in Canada. It is a creative text that I highly recommend.”

Determinants of Indigenous Health In Canada: Beyond the Social can be ordered through your local bookstore or online through Canadian Scholars’ Press:http://www.cspi.org/books/determinants-of-indigenous-peoples-health-in-canada. The book was supported through the National Collaborating Centre for Aboriginal Health (NCCAH) with funding from The Public Health Agency of Canada.

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