Urban Land-based Healing: A Northern Intervention Strategy

Urban Indigenous populations face significant health and social disparities across Canada. With high rates of homelessness and substance abuse, there are often few options for urban Indigenous Peoples to access land-based healing programs despite the increasingly known and appreciated benefits. In May 2018, the first urban land-based healing camp opened in Yellowknife, Northwest Territories, Canada, one of the first to our knowledge in Canada or the United States. This camp may serve as a potential model for an Indigenous-led and Indigenous-based healing camp in an urban setting. We seek to present preliminary outcome data from the healing camp in a setting with a high-risk population struggling with substance use and homelessness. Reflections are presented for challenging logistical and methodological considerations for applications elsewhere. This northern based effort affords us ample opportunity for expanding the existing knowledge base for land-based healing applied to an urban Indigenous high-risk setting

Nature Prescriptions and Indigenous Peoples: A Qualitative Inquiry in the Northwest Territories, Canada

Nature prescription programs have become more common within healthcare settings. Despite the health benefits of being in nature, nature prescriptions within the context of Indigenous Peoples have received little attention. We therefore sought to answer the following question: What are circumpolar-based physicians’ and Indigenous Elders’ views on nature prescribing in the Northwest Territories, Canada? We carried out thirteen semi-structured interviews with physicians between May 2022 and March 2023, and one sharing circle with Indigenous Elders in February 2023. Separate reflexive thematic analysis was carried out to generate key themes through inductive coding of the data. The main themes identified from the physician interviews included the importance of cultural context; barriers with nature prescriptions in the region; and the potential for nature prescriptions in the North. Reflections shared by the Elders included the need for things to be done in the right way; the sentiment that the Land is not just an experience but a way of life; and the importance of traditional food as a connection with Nature. With expanding nature prescription programs, key considerations are needed when serving Indigenous communities. Further investigation is warranted to ensure that nature prescriptions are appropriate within a given context, are inclusive of supporting Land-based approaches to health and wellbeing, and are considered within the context of Indigenous self-determination

Physicians’ views of patient–planetary health co-benefit prescribing: a mixed methods systematic review

Health professionals are increasingly called to become partners in planetary health. Using patient–planetary health (P–PH) co-benefit prescribing framing, we did a mixed methods systematic review to identify barriers and facilitators to adopting P–PH co-benefit prescribing by physicians and mapped these onto the Capability, Opportunity, Motivation, and Behaviour (COM-B) model and Theoretical Domains Framework (TDF). We searched electronic databases from inception until October, 2022, and did a content analysis of the included articles (n=12). Relevant categories were matched to items in the COM-B model and TDF. Nine barriers and eight facilitators were identified. Barriers included an absence of, or little, knowledge of how to change practice and time to implement change; facilitators included having policy statements and guidelines from respected associations. More diverse study designs that include health professionals, patients, and health-care system stakeholders are needed to ensure a more holistic understanding of the individual, system, and policy levers involved in implementing clinical work informed by planetary health

Truth and Reconcilition Commissions and Health Care System Responses for Indigenous Peoples: A Scoping Review

Grounded in human rights approaches, truth and reconciliation commissions (TRCs) explore an event or process that did widespread and systematic intentional harm to a group of people. Health as a fundamental right is an important component addressed by TRCs. Yet despite TRCs often having recommendations for health care systems, it is unknown how well these recommendations are being translated within health care settings. Therefore, the overarching purpose of our scoping review was to identify academic articles that discussed health care system discourse or responses to TRCs in the context of Indigenous Peoples. Our thematic analysis of the included articles identified three main themes for health care system responses to TRCs: (1) the acknowledgment of multiple ways of knowing, being, and doing in health systems; (2) current interventions as responses within health systems; and (3) suggestions for change within health systems. Although a TRC may create a specific road map and mandate for health care systems, we found considerable variability in the uptake of these actions across institutions. Concerted efforts within and around health care systems and across sectors are therefore necessary to achieve large-scale, meaningful change for Indigenous Peoples post-TRCs and to maintain accountability as a foundational human rights principle

Indigenous Natural or First Law in planetary health

Indigenous Peoples associate their own laws with the laws of the natural world, which are formally known as or translated as Natural or First Law. These laws come from the Creator and the Land through our ancestral stories and therefore, they are sacred. All aspects of life and existence depend on living and following these natural First Laws. Since colonization, Indigenous Peoples’ Natural Laws have been forcibly replaced by modern-day laws that do not take into account the sacred relationship between the Earth and all of her inhabitants. The force of societies who live outside of Natural Law has ensured the modern-day consequences of not living in balance with nature. Pandemics and global environmental change, including climate change, are all consequences of not following the Natural Laws that are encapsulated by the interconnected nature of the universe. Here we discuss Natural Law from an Indigenous paradigm and worldview which carries implications for planetary health and wider environmental movements around the globe

Exiting the Anthropocene : Achieving personal and planetary health in the 21st century

Planetary health provides a perspective of ecological interdependence that connects the health and vitality of individuals, communities, and Earth's natural systems. It includes the social, political, and economic ecosystems that influence both individuals and whole societies. In an era of interconnected grand challenges threatening health of all systems at all scales, planetary health provides a framework for cross-sectoral collaboration and unified systems approaches to solutions. The field of allergy is at the forefront of these efforts. Allergic conditions are a sentinel measure of environmental impact on human health in early life-illuminating how ecological changes affect immune development and predispose to a wider range of inflammatory noncommunicable diseases (NCDs). This shows how adverse macroscale ecology in the Anthropocene penetrates to the molecular level of personal and microscale ecology, including the microbial systems at the foundations of all ecosystems. It provides the basis for more integrated efforts to address widespread environmental degradation and adverse effects of maladaptive urbanization, food systems, lifestyle behaviors, and socioeconomic disadvantage. Nature-based solutions and efforts to improve nature-relatedness are crucial for restoring symbiosis, balance, and mutualism in every sense, recognizing that both personal lifestyle choices and collective structural actions are needed in tandem. Ultimately, meaningful ecological approaches will depend on placing greater emphasis on psychological and cultural dimensions such as mindfulness, values, and moral wisdom to ensure a sustainable and resilient future.Peer reviewe

The Value of Global Indigenous Knowledge in Planetary Health

In order to fulfill a broader vision of health and wellness, the World Health Organization (WHO) 2014–2023 strategy for global health has outlined a culturally sensitive blending of conventional biomedicine with traditional forms of healing. At the same time, scientists working in various fields—from anthropology and ecology to biology and climatology—are validating and demonstrating the utility of Indigenous knowledge. There is a misperception that Indigenous peoples are in need of Westernized science in order to “legitimize” our knowledge systems. The Lancet Planetary Health Commission report calls for the “training of indigenous and other local community members” in order to “help protect health and biodiversity” (p. 2007). Such calls have merit but appear authoritarian when they sit (unbalanced) without equally loud calls for the training of (socially dominant) westernized in-groups by Indigenous groups “in order to help protect health and biodiversity.” The problems of planetary health are both profound and complex; solutions can be found in a greater understanding of the self and the universe and the land as a medicine place. The following message was delivered as part of a keynote at the inVIVO Planetary Health Conference in Canmore, Alberta, Canada—20 points of consideration for a planetary health science in its pure, raw form, on behalf of the Indigenous elders

Traditional Indigenous medicine in North America: A scoping review.

BACKGROUND:Despite the documented continued use of traditional healing methods, modalities and its associated practitioners by Indigenous groups across North America, it is presumed that widespread knowledge is elusive amongst most Western trained health professionals and systems. This despite that the approximately 7.5 million Indigenous peoples who currently reside in Canada and the United States (US) are most often served by Western systems of medicine. A state of the literature is currently needed in this area to provide an accessible resource tool for medical practitioners, scholars, and communities to better understand Indigenous traditional medicine in the context of current clinical care delivery and future policy making. METHODS:A systematic search of multiple databases was performed utilizing an established scoping review framework. A consequent title and abstract review of articles published on traditional Indigenous medicine in the North American context was completed. FINDINGS:Of the 4,277 published studies identified, 249 met the inclusion criteria divided into the following five categorical themes: General traditional medicine, integration of traditional and Western medicine systems, ceremonial practice for healing, usage of traditional medicine, and traditional healer perspectives. CONCLUSIONS:This scoping review was an attempt to catalogue the wide array of published research in the peer-reviewed and online grey literature on traditional Indigenous medicine in North America in order to provide an accessible database for medical practitioners, scholars, and communities to better inform practice, policymaking, and research in Indigenous communities