title: A holistic model for the selection of environmental assessment indicators to assess the impact of industrialization on indigenous health.
abstract: OBJECTIVE
  Mainstream environmental assessment (EA) methodologies often inadequately address health, social and cultural impacts of concern for Canadian indigenous communities affected by industrialization. Our objective is to present a holistic, culturally-appropriate framework for the selection of indigenous health indicators for baseline health assessment, impact prediction, or monitoring of impacts over time.
  
  
  METHODS
  We used a critical population health approach to explore the determinants of health and health inequities in indigenous communities and conceptualize the pathways by which industrialization affects these determinants. We integrated and extended key elements from three indigenous health frameworks into a new holistic model for the selection of indigenous EA indicators.
  
  
  RESULTS
  The holistic model conceptualizes individual and community determinants of health within external social, economic and political contexts and thus provides a comprehensive framework for selecting indicators of indigenous health. Indigenous health is the product of interactions among multiple determinants of health and contexts. Potential applications are discussed using case study examples involving indigenous communities affected by industrialization.
  
  
  CONCLUSIONS
  Industrialization can worsen indigenous health inequities by perpetuating the health, social and cultural impacts of historic environmental dispossession. To mitigate impacts, EA should explicitly recognize linkages between environmental dispossession and the determinants of health and health inequities and meaningfully involve indigenous communities in the process.
authors: Department of Community Health Sciences, University of Calgary, 3rd Floor, TRW Building, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6. jakryzan@ucalgary.ca
authors: Julie A
authors: JA
authors: Kryzanowski
authors: Lynn
authors: L
authors: McIntyre
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