Community Journey of Change Through Relational Determinants of Health

What is the research about?

This research concerns developing a model that maps Indigenous communities’ journeys from the cycle of violence arising through relational determinants of health. This project involved the study of community mobilization processes to highlight pathways for moving away from historical harm and systemic violence and approach a place of wellness that is relational.

Previous programs had a focus on building awareness and capacity to promote safe environments for the healthy development of children and youth. Adult programs focused on the view that adults in the community have a responsibility to create safety for children and youth. Feedback from communities signaled that the workshops alone did not contribute to reduced violence within the community. This feedback led to the development of community mobilization process.

Programs seldom offered the advocacy and allyship needed to move beyond the harms and systemic barriers to enable communities to connect to living in a healthy manner in cultural wellness. Additionally, a healthy relational environment means the wellbeing of the whole community whether the members are urban, rural, or remote.

Research on the determinants of Indigenous Peoples’ health needs to extend beyond purely social determinants of health. In current literature there are 3 shortcomings: 1) colonialism is not accounted for as a determinant of Indigenous health, 2) Indigenous health should be examined as an unique area requiring different perspectives, and 3) literature on social determinants of Indigenous health has been primarily written by non-Indigenous authors.

What did the researchers do?

Community mobilization processes were studied in 5 Indigenous communities across 8 years. First, respectful partnerships were created with each community. The communities guided the research team in recognizing their need for sharing understanding, and self-documentation of experienced harms. To support, this a compilation of over 1,000 sources from across Canada were utilized to create a timeline of harmful historical experiences. From these sources a Community Journey of Change (CJC) model was developed as a guide to travel away from 15 layers of harm and towards a journey of wellness. The timeline of harmful historical experiences was further utilized to depict 3 categories that form the CJC: 1) the Cycle of Violence, 2) the Circle of Wellness, and 3) the Relational Determinants of Health. Each category was subdivided into 4 domains: physical, mental, spiritual, and emotional.   

What do you need to know?

Relational Determinants of Health include foundational relationships with the land, culture, ceremony, and language. The CJC model highlights the relational processes that can be constructive for recovery from the harms and disruptions of colonization. Historical traumas for Indigenous peoples include: displacement from Traditional lands, devastation by disease, subjugation under the Indian Act, banning of cultural practices, forced attendance at residential schools, the Sixties Scoop, and racist and systemic harms across generations. 

What did the researchers find?

This research identified 6 considerations for creating an ethical space to develop policies, programs, and services that support communities in their journeys of change: 1) Look to Indigenous leaders for organizational alignment and Indigenous program development, 2) Respect self-determination and support community vision and actions, 3) Ensure safety at all levels and for all participants, 4) Work to re-integrate culture, 5) Promote cohesion and culture within the community, and 6) Leads systems change.

How can you use this research?

The Community Journey of Change model provides guidance for researchers working with Indigenous communities to attend to the layers of harm from colonization. This can help create culturally relevant pathways to restore the relational determinants of health. This model will inform policy, programs and services for Indigenous communities. It is also a step forward for Truth and Reconciliation in Canada.

About the researchers

S. Cardinal, MAL, Director of Indigenous Relations, Canadian Red Cross.

D. Pepler, O.C., Ph.D., C. Psych., Distinguished Research Professor of Psychology, Department of Psychology, LaMarsh Centre for Child and Youth Research, York University, Toronto, Canada.

Citation

Cardinal, S., & Pepler, D. (2021). Community journey of change through relational determinants of health. The International Indigenous Policy Journal, 12(3), 1-16.

Keywords

Violence prevention, Indigenous wellness, relational determinants of health, Indigenous communities