December 2010 - A new report by the NCCAH maps the current research landscape in Canada on Aboriginal health and provides a comprehensive picture of existing knowledge and current directions in the field.
Landscapes of First Nations, Inuit, and Métis Health: An Updated Environmental Scan, released in December 2010, identifies the current health priorities of national organizations working in Aboriginal peoples' health, assesses recent literature and research, and makes observations on changes in focus in Aboriginal health in Canada.
In addition, the report assesses the funding patterns of the Canadian Institutes of Health Research, the major source of federal funding for work in health-related fields. The document details 151 grants totaling $66.5 million for projects relating to First Nations, Inuit and/or Métis health that received funding in 2007 and 2008. A key finding is that one in four grants and awards is now addressing health promotion and prevention.
Positive Changes and Remaining Gaps in Aboriginal Health in Canada
Landscapes of First Nations, Inuit, and Métis Health finds that a “positive” shift is occurring in the research landscape in Canada, with indications that leading national organizations in Aboriginal peoples' health are emphasizing a more holistic approach to health.
As well, topics such as social determinants of health – which explore the role of broader social, economic and contextual issues in health and well-being – are making strong appearances in the peer-reviewed literature and research, as are topics related to health promotion and prevention, and chronic and infectious diseases. The report finds that mental health and addictions – both key issues identified by a number of national organizations – are beginning to receive increased attention.
A list of studies, reports and documents published between January 1, 2007 and December 31 2008 is included, grouped by topic, and serves as a supplementary resource for general interest. An introduction to national organizations working in Aboriginal, First Nations, Inuit and Métis public health in Canada is also included.
The earlier 2006 edition of the NCCAH environmental scan assessed the health landscape from 2001 to mid-2006 and located 649 peer-reviewed documents – an average of 118 documents a year for the period under study. This updated report identified peer-reviewed 384 studies and documents for the years 2007 and 2008 – an average of 192 per year.
As report author Carmen Ellison notes, this could indicate that Aboriginal health research is increasing – or that the concept of 'health' has become more inclusive and journals increasingly open to publishing articles addressing more holistic views of health.
"Regardless of the cause, one finding is very clear: more research on First Nations, Inuit and Métis is being disseminated," the report states.
A Closer Look at Priorities
Peer-reviewed studies
More specifically, the newly released Landscapes of First Nations, Inuit, and Métis Health environmental scan found the following research priorities to be most prevalent among the 384 peer-reviewed documents identified for the period 2007-2008:
- 32.8% addressed the social determinants of health
- 32.3% addressed health care research policy, human resources, programming, and delivery
- 26.3% addressed maternal, child, and youth health
- 19.8% addressed chronic disease
- 14.6% addressed infectious disease
- 8.9% addressed mental health
- 7.6% addressed gender
- 6.3% addressed genetics
- 3.9% addressed environment/toxicology
- 3.6% injury/violence
'Grey' literature
The report identifies similarities and differences in priorities based on assessment of the 84 non peer-reviewed reports, studies and discussion papers published since 2007 by Aboriginal organizations, governments, professional organizations and other non-governmental organizations. The scan notes less emphasis in this literature on chronic and infectious diseases (3.6% and 4.8% respectively), and more emphasis on policy (14.3%), social determinants of health (14.3%), general topics such as a population's health status (13.1%), and health care services and programs (11.9%).
Canadian Institutes of Health Research studies, grants and awards
An assessment of topics related to First Nations, Inuit, and Métis health addressed in the current research undertaken by the Canadian Institutes of Health Research indicates a strong emphasis on health promotion/prevention (24.8%) and chronic disease (24.2%), each of which make up nearly one-quarter of funded projects. As well, there is a stronger emphasis in the CIHR on mental health and addictions than is evident in the peer-reviewed and non-peer reviewed literature. A breakdown of other topic categories follows:
- 22.1% addressed mental health and addictions
- 22.1% addressed health care access and/or services
- 18.1% addressed infectious disease
- 12.8% addressed health research infrastructure
- 12.8% addressed environment, toxicology and food
- 8.7% addressed maternal/child health
- 7.4% addressed social determinants of health
- 2.7% addressed genetics
- 4.0% addressed injury (accidental) and violence
Getting Started - establishing priorities in 2005
When the NCCAH was initially established in 2005, it undertook two projects to guide its work - an environmental scan of the current work performed in the field of Aboriginal peoples' health in Canada, and a survey of who was doing what in Aboriginal health research.
The Centre's original report, “Landscapes of Indigenous Health” similarly provided an overview of organizations involved in Aboriginal health, an evaluation of related research and literature, and the results of consultations with key informants in the field. The document, released in 2007, assessed 649 peer-reviewed documents and 242 reports, studies and discussion papers published since 2001 by Aboriginal organizations, federal and provincial governments, health regions, professional organizations, and other non-governmental organizations (NGOs).
The scan also assessed 243 projects undertaken by the Canadian Institutes of Health Research (CIHR) that were devoted to the study of Aboriginal health. Together, these assessments pointed to key themes in the field.
Among the many recommendations, the NCCAH was advised to:
- emphasize community collaboration,
- foster culturally appropriate research, programs, policies and collaborations that show tangible results for individuals and communities,
- foreground Indigenous knowledge in the field of public health in Canada,
- facilitate a transition to Aboriginal responsibility for public health,
- balance diversity with commonality, the local with the national.
Some of the issues raised included a call for evaluation processes for public health programs and applied research, as well as for data specific to First Nations, Inuit and Métis peoples. Key informants emphasized the social determinants of health as a strong priority, particularly relating to issues of culture and equity, including issues of race, power, systemic inequalities, and social justice.
In sum, all aspects of the environmental scan pointed to the importance of community and culture to Aboriginal public health in Canada.
In 2007, the NCCAH also undertook a "Who's Who in Aboriginal Health" survey that included academics (123), organizations and service providers (96), government bodies (6), and research centres (24) active in the area of Aboriginal health. In the course of the data collection, the NCCAH found that the top five focus areas of research amongst academics were: social determinants of health, diabetes, wellness, resilience and strength, women's health and mother-child health.
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