Abstract

BackgroundSocial determinants of Indigenous health are known to include structural determinants such as history, political climate, and social contexts. Relationships, interconnectivity, and community are fundamental to these determinants. Understanding these determinants from the perspective of Indigenous youth is vital to identifying means of alleviating future inequities.MethodsIn 2016, fifteen Yellowknives Dene First Nation (YKDFN) youth in the Canadian Northwest Territories participated in the 'On-the-Land Health Leadership Camp'. Using a strength- and community-based participatory approach through an Indigenous research lens, the YKDFN Wellness Division and university researchers crafted the workshop to provide opportunities for youth to practice cultural skills, and to capture the youth’s perspectives of health and health agency. Perspectives of a healthy community, health issues, and health priorities were collected from youth through sharing circles, PhotoVoice, mural art, and surveys.ResultsThe overall emerging theme was that a connection to the land is an imperative determinant of YKDFN health. Youth identified the importance of a relationship to land including practicing cultural skills, Elders passing on traditional knowledge, and surviving off the land. The youth framed future health research to include roles for youth and an on-the-land component that builds YKDFN culture, community relations, and traditional knowledge transfer. Youth felt that a symbiotic relationship between land, environment, and people is fundamental to building a healthy community.ConclusionOur research confirmed there is a direct and critical relationship between structural context and determinants of Indigenous Peoples’ health, and that this should be incorporated into health research and interventions.

Highlights

  • Social determinants of Indigenous health are known to include structural determinants such as history, political climate, and social contexts

  • Yellowknives Dene First Nation (YKDFN) youth provided invaluable insights on their perspectives of the important social and structural determinants of health. The youth highlighted their role in influencing future health research and agency to address issues

  • Youth participants identified health issues and priorities that extended beyond community life and incorporated cultural components linked to the land

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Summary

Introduction

Social determinants of Indigenous health are known to include structural determinants such as history, political climate, and social contexts. In recent years there has been growing recognition that ‘health’ is more than an individualistic, biomedical concept - it is determined by social circumstances and contexts These ‘social determinants of health’ involve the conditions under which people live and work, and include diverse factors such as income, education, stress, social marginalization, racism and food security [1]. Because they influence the health status of individuals and groups, deficits in the social determinants of health are considered the major underlying reasons for health inequities and inequalities between populations [2]. Social determinants of health in an Indigenous context include unique structural (or foundational) determinants such as history, political climate, economics and social contexts.

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