Abstract
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.
Highlights
This paper introduces a community health evaluation methodology using a unique set of Indigenous Health Indicators (IHI), which focus on a range of health-based considerations that are often overlooked by health assessments conducted in Indigenous communities
For the “Where are we now?” health status questions, the collated10results depicted of 16 respondents’ views that each of the IHIs are in a unique position in on the continuum of poor health
Indigenous community health assessment methods have not included many of the “intangible” aspects of Indigenous community health (Objective a)
Summary
This paper introduces a community health evaluation methodology using a unique set of Indigenous Health Indicators (IHI), which focus on a range of health-based considerations that are often overlooked by health assessments conducted in Indigenous communities. Health indicators are measures or characteristics of the status of human health in a community. Many other types of health assessments exist, some pertinent to the work discussed here; these include: human health risk assessments (HHRA) such as those used to determine increased morbidity and mortality outcomes due to individual exposures to toxicants [4]; community health assessments (CHA) borne from the public health field, which employ definitions of health beyond the physiological, such as housing and education [5]; and, health impact assessments (HIA) that
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