Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Epidemiology and Biostatistics

Abstract

We adopted a Medicine Wheel framework to assess the countervailing associations of stressors stemming from colonialism and cultural resilience resources on wellness-oriented measures of physical, mental, emotional, and spiritual health in a First Nations community. Additionally, we assessed the mechanisms under which cultural resilience resources promoted better health across these outcomes. A series of modified Poisson regression models were fit to assess the study objectives. We found that increasing frequency of thoughts of historical losses were associated with decreases in the likelihood of reporting better physical, emotional, and spiritual health. We found only limited evidence of a protective association for cultural resilience resources, where use of traditional healers had a modest protective association with men’s spiritual health (PR: 1.44, 95% CI: 1.11 to 1.85). Our findings suggest that stressors stemming from colonialism and cultural resilience resources may be important targets for intervention in Indigenous wellness-oriented health programming.

Summary for Lay Audience

Much of the research concerning the Indigenous peoples of North America has overwhelmingly concerned negative health outcomes such as substance use and depression, focusing on disparities in these outcomes that exist between Indigenous and non-Indigenous populations. This has resulted in a tendency to view Indigenous peoples and communities as diseased, which has obscured the larger social context behind these health inequities. More recently, Indigenous health research has begun to examine the effects of social factors on Indigenous health, including the historical and ongoing impacts of colonialism, and the protective effects that practice of Indigenous culture can have on health, rather than on disparities. However, there remains a lack of epidemiologic research on outcomes that reflect Indigenous conceptualizations of health.

In the present study we assessed the health of a First Nations community in Southern Ontario using a culturally congruent Medicine Wheel framework. In the Medicine Wheel, health encompasses multiple domains, including physical, mental, emotional, and spiritual domains. We assessed the relationships between health status across these four domains and known determinants of Indigenous health, including the harmful impacts of stressors stemming from colonialism (i.e., racial discrimination, residential school attendance, and thoughts of historical losses associated with colonialism [e.g losses of land; of culture]) and the protective impacts of participation in cultural practices (i.e., use of traditional healing practices). Further, we assessed how use of traditional healing practices promote better physical, mental, emotional, and spiritual health by examining whether use of these practices promoted health directly or reduced the negative impacts that the stressors had on these four outcomes.

We found that thoughts of historical losses were associated with poorer physical, emotional and spiritual health. We failed to find evidence that use of traditional healing practices mitigated the impacts of the stressors on the four health outcomes, though we found some evidence that use of traditional healers was directly associated with better spiritual health for men. Our findings suggest that stressors stemming from colonialism and cultural practices may have an important relationship with the wellness-oriented health outcomes included in the Medicine Wheel.

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