The numerous health inequities among First Nations, Inuit and Métis and non-Aboriginal peoples in Canada have been well described and are an important focus for the Canadian Institutes of Health Research (CIHR). Poor health arises from a variety of factors including poverty, lack of education, culture loss, inadequate living conditions, exposure to trauma and violence, and lack of social support and resources. Many of these factors and conditions are particularly pronounced among Aboriginal peoples, and we must listen to and learn from their communities in order to improve things effectively.
To promote health equity among First Nations, Inuit and Métis and as part of its work to turn knowledge into improved health, CIHR has launched a signature initiative called Pathways to Health Equity for Aboriginal Peoples (Pathways). The overall goal of the Pathways initiative is to develop the evidence base in how to design, offer and implement programs and policies that promote health and health equity in four priority areas: suicide prevention, tuberculosis, diabetes/obesity and oral health.
Promising practices to address these health inequities are occurring today in urban settings, First Nations reserves, and Inuit and Métis communities across Canada. Through Pathways research, we will learn how best to have these promising approaches adopted by communities across the country. Through Pathways and related initiatives, CIHR and its partners will contribute to the creation of better preventive health services, and health equity for Aboriginal peoples.
Impacts of Pathways
By collaborating with First Nations, Inuit and Métis communities, CIHR and its partners will:
- improve health and health equity for Aboriginal peoples in priority areas;
- generate evidence to inform decision making;
- advance our understanding of how to reduce health inequities and how to apply this new knowledge more broadly; and
- increase research capacity for effective and evolving Aboriginal health programs and policies.
Partners for Engagement of Knowledge Exchange
In order to strengthen the impact of the Pathways initiative, CIHR launched its Partners for Engagement and Knowledge Exchange (PEKEs) funding opportunity. PEKEs will engage Aboriginal peoples', communities and organizations by incorporating Aboriginal voices, Ways of Knowing, and culture into the research. The PEKEs will play a central role in linking and facilitating interactions between researchers from Implementation Research Teams (IRTs) and Applied Public Health Chairs (Chairs), and Aboriginal communities. This will, in turn, help scale-up interventions that improve the health of residents in these communities.
Implementation Research Teams
Implementation Research Teams develop policies and programs that have the potential to improve health and health equity for the Aboriginal population in Pathways' four priority areas.
Applied Public Health Chairs
Applied Public Health Chairs build the knowledge base and mentoring for health interventions in Pathways' four priority areas, by considering the Aboriginal Ways of Knowing, the economics of implementing interventions in Aboriginal communities, whether the interventions are relevant to Pathways, understanding the role of gender and sex of Aboriginal men and women on health outcomes, and studying whether the interventions take into consideration Aboriginal concerns and ethics.
Population Health Intervention Research
Population Health Intervention Research evaluates the impact of health interventions regarding Pathways' four priority areas in First Nations, Métis and Inuit communities, by requiring close collaboration between researchers and policy-makers. Recipients of these grants will assess what interventions will help promote health and health equity for Aboriginals on the whole.
2014 PEKEs Recipients:
Through its network of 119 Aboriginal Friendship Centres and 7 Provincial Territorial Associations, the National Association of Friendship Centre (NAFC) plan to help demonstrate the benefits of new research to Aboriginals who live in urban centres across Canada. Established in 1972, NAFC has already reached Aboriginals of all genders, sexual orientations, ages, and socio-economic backgrounds regarding various concerns (such as tobacco cessation and identity/citizenship). In order for members of this community to work effectively with non-traditional researchers/clinicians, NAFC's PEKE will ensure that new implementation activities that show the merits of research in fighting suicide, diabetes and obesity, tuberculosis and oral health, are passed along in ways that are respectful of their traditions. NAFC, which is based in Ottawa, ON, will receive $999,965 in funding support over a five year period.
First Nations Health and Social Secretariat of Manitoba (FNHSSM), developed by the Assembly of Manitoba Chiefs, will forge a solid connection between non-traditional researchers and Indigenous communities that is based on knowledge translation, exchange and action (KTEA). In collaboration with the University of Manitoba, the University of Winnipeg, Diabetes Integration Project, the University of Victoria, Indigenous Physicians Association of Canada, Aboriginal Nurses Association of Canada, National Collaborating Centre for Aboriginal Health, Saint Elizabeth, National Aboriginal Council of Midwives, Aboriginal Midwives, Manitoba Health, Public Health Agency of Canada, First Nations Inuit and Health Branch, Te Atawhai o te Ao: Independent Maori Institute for Environment and Health and the Whakauae Research for Māori Health and Development, FNHSSM will engage Aboriginal community members as partners - not recipients - of health information. That way, the vast network of traditional knowledge, research, self-government and traditional practices in these communities can be shared and incorporated into the work of non-traditional scientists/clinicians. As a result, the implementation of new health practices to combat diabetes and obesity, tuberculosis, oral health and suicide will be seen as a natural progression. FNHSSM, which is based in Winnipeg, MB, will get $988,755 in funding over five years.
Native Women's Association of Canada (NWAC), in partnership with the Congress of Aboriginal Peoples, the Aboriginal Nurses Association of Canada, and the National Aboriginal Diabetes Association, will specifically focus on facilitating communication between the non-traditional scientific community and Aboriginal women. Founded in 1974, NWAC adheres to the concept that in most Aboriginal cultures women are the primary caretakers of the family. So the organization will try to engage mothers as participants in the PEKE. Mothers will likely adopt new methods to treat diabetes and obesity, tuberculosis, oral health and prevent suicide in their families if it's presented in a fashion that is respectful, relevant, responsible and reciprocal of their traditions. By following these wishes, NWAC will plan to provide residents in all Aboriginal communities with alternatives that can ultimately translate into a healthy future. NWAC, which is based in Ottawa ON, will receive $1 million in funding support over a five year period.