Abstract

Despite the health improvements afforded to non-Indigenous peoples in Canada, Aotearoa (New Zealand) and the United States, the Indigenous peoples in these countries continue to endure disproportionately high rates of mortality and morbidity. Indigenous peoples’ concepts and understanding of health and wellbeing are holistic; however, due to their diverse social, political, cultural, environmental and economic contexts within and across countries, wellbeing is not experienced uniformly across all Indigenous populations. We aim to identify aspects of wellbeing important to the Indigenous people in Canada, Aotearoa and the United States. We searched CINAHL, Embase, PsycINFO and PubMed databases for papers that included key Indigenous and wellbeing search terms from database inception to April 2020. Papers that included a focus on Indigenous adults residing in Canada, Aotearoa and the United States, and that included empirical qualitative data that described at least one aspect of wellbeing were eligible. Data were analysed using the stages of thematic development recommended by Thomas and Harden for thematic synthesis of qualitative research. Our search resulted in 2669 papers being screened for eligibility. Following full-text screening, 100 papers were deemed eligible for inclusion (Aotearoa (New Zealand) n = 16, Canada n = 43, United States n = 41). Themes varied across countries; however, identity, connection, balance and self-determination were common aspects of wellbeing. Having this broader understanding of wellbeing across these cultures can inform decisions made about public health actions and resources.

Highlights

  • Across Canada, Aotearoa (New Zealand) and the United States, different words are used in the included papers to describe wellbeing such as wellness and well-being, as well as specific Indigenous language words

  • To account for the complexities associated with these circumstances, we have looked at the similarities in wellbeing between countries, which may in part be driven by some of these inconsistencies between Indigenous cultural groups and Western borders

  • Our analysis revealed seven interrelated aspects of life as being centrally important to the Indigenous peoples in Canada’s wellbeing: Holism/Wholism (n = 15 papers); Culture (n = 33); Community and Family (n = 31); Land and Sea (n = 27); Resilience (n = 21); Spirituality and Cultural Medicine (n = 18); Physical, Mental and Emotional Wellbeing (n = 26)

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Summary

Introduction

Aotearoa (New Zealand) and the United States are all highly developed countries [1], yet the benefits of their development are not shared across all members of these societies. Disparities experienced by Indigenous people are underpinned by the unequal distribution of social, political and economic determinants of health and wellbeing [2]. Indigenous peoples’ personal and collective experiences of disempowerment, marginalisation, loss of land, and racism have adversely impacted their health and wellbeing [1,3,4,5]. These factors are exacerbated by institutional systems, including health 4.0/).

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