Developing Responsive Indicators of Indigenous Community Health.
How health is defined and assessed is a priority concern for Indigenous peoples due to considerable health risks faced from environmental impacts to homelands, and because what is "at risk" is often determined without their input or approval. Many health assessments by government agencies, industry, and researchers from outside the communities fail to include Indigenous definitions of health and omit basic methodological guidance on how to evaluate Indigenous health, thus compromising the quality and consistency of results. Native Coast Salish communities (Washington State, USA) developed and pilot-tested a set of Indigenous Health Indicators (IHI) that reflect non-physiological aspects of health (community connection, natural resources security, cultural use, education, self-determination, resilience) on a community scale, using constructed measures that allow for concerns and priorities to be clearly articulated without releasing proprietary knowledge. Based on initial results from pilot-tests of the IHI with the Swinomish Indian Tribal Community (Washington State, USA), we argue that incorporation of IHIs into health assessments will provide a more comprehensive understanding of Indigenous health concerns, and assist Indigenous peoples to control their own health evaluations.
Swinomish Indian Tribal Community, 11404 Moorage Way, La Conner, WA 98257, USA. jdonatuto@swinomish.nsn.us.
Jamie
J
Donatuto
Swinomish Indian Tribal Community, 11404 Moorage Way, La Conner, WA 98257, USA. lcampbell@swinomish.nsn.us.
Larry
L
Campbell
Institute for Resources, Environment and Sustainability, The University of British Columbia, Vancouver Campus, Vancouver, BC V6T 1Z4, Canada. robin.gregory@ires.ubc.ca.
Robin
R
Gregory
D054521:Cultural Competency; D003695:Delivery of Health Care / Q000208:ethnology / Q000458:organization & administration* / Q000592:standards; D004777:Environment; D006077:Government Agencies; D006303:Health Services, Indigenous / Q000458:organization & administration / Q000592:standards; D006801:Humans; D007221:Industry; D044382:Population Groups; D011634:Public Health / Q000592:standards; D058996:Quality Improvement; D014861:Washington / Q000208:ethnology
Indigenous health; cultural competency; environmental health justice; evaluation; health assessment; indicators