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Developing Responsive Indicators of Indigenous Community Health

View Article: PubMed Central - PubMed

ABSTRACT

How health is defined and assessed is a priority concern for Indigenous peoples due to considerable health risks faced from environmental impacts to homelands, and because what is “at risk” is often determined without their input or approval. Many health assessments by government agencies, industry, and researchers from outside the communities fail to include Indigenous definitions of health and omit basic methodological guidance on how to evaluate Indigenous health, thus compromising the quality and consistency of results. Native Coast Salish communities (Washington State, USA) developed and pilot-tested a set of Indigenous Health Indicators (IHI) that reflect non-physiological aspects of health (community connection, natural resources security, cultural use, education, self-determination, resilience) on a community scale, using constructed measures that allow for concerns and priorities to be clearly articulated without releasing proprietary knowledge. Based on initial results from pilot-tests of the IHI with the Swinomish Indian Tribal Community (Washington State, USA), we argue that incorporation of IHIs into health assessments will provide a more comprehensive understanding of Indigenous health concerns, and assist Indigenous peoples to control their own health evaluations.

No MeSH data available.


Scenario 2 (river clean up) results (At the time of the workshops, the “Resilience” indicator was called “Well-Being”.).
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ijerph-13-00899-f004: Scenario 2 (river clean up) results (At the time of the workshops, the “Resilience” indicator was called “Well-Being”.).

Mentions: The fourth and final part of the workshop—ranking and weighting the scenarios—proved to be the most arduous. Several participants verbally commented that it was difficult for them to understand the swing weighting concept. Other participants noted that ranking and weighting indicators are cognitively and emotionally challenging tasks, yet understood that if ranking and weighting are not done, then by default all 18 measures across the six different indicators are assumed to have equal importance. Figure 3 shows results across all participants for Scenario 1 (beach cleanup), including the scenario-specific range of weights across all participants for the six IHI indicators along with the median values (depicted by the diamond shapes) and the weights assigned by one (anonymous) individual. Several indicators, such as natural resources security, varied substantially across participants in terms of assigned importance; other indicators, such as community connections, were assessed more similarly by participants. Figure 4 presents the summary results for Scenario 2 (river cleanup). As is clearly shown, the fourth indicator—education—varied considerably in how it was valued by participants relative to the other indicators: on average it was rated slightly higher than any other indicator but the range of responses is high. There was substantial agreement, on the other hand, with respect to the relative importance placed on ceremonial uses of resources and concerns related to resources security.


Developing Responsive Indicators of Indigenous Community Health
Scenario 2 (river clean up) results (At the time of the workshops, the “Resilience” indicator was called “Well-Being”.).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036732&req=5

ijerph-13-00899-f004: Scenario 2 (river clean up) results (At the time of the workshops, the “Resilience” indicator was called “Well-Being”.).
Mentions: The fourth and final part of the workshop—ranking and weighting the scenarios—proved to be the most arduous. Several participants verbally commented that it was difficult for them to understand the swing weighting concept. Other participants noted that ranking and weighting indicators are cognitively and emotionally challenging tasks, yet understood that if ranking and weighting are not done, then by default all 18 measures across the six different indicators are assumed to have equal importance. Figure 3 shows results across all participants for Scenario 1 (beach cleanup), including the scenario-specific range of weights across all participants for the six IHI indicators along with the median values (depicted by the diamond shapes) and the weights assigned by one (anonymous) individual. Several indicators, such as natural resources security, varied substantially across participants in terms of assigned importance; other indicators, such as community connections, were assessed more similarly by participants. Figure 4 presents the summary results for Scenario 2 (river cleanup). As is clearly shown, the fourth indicator—education—varied considerably in how it was valued by participants relative to the other indicators: on average it was rated slightly higher than any other indicator but the range of responses is high. There was substantial agreement, on the other hand, with respect to the relative importance placed on ceremonial uses of resources and concerns related to resources security.

View Article: PubMed Central - PubMed

ABSTRACT

How health is defined and assessed is a priority concern for Indigenous peoples due to considerable health risks faced from environmental impacts to homelands, and because what is “at risk” is often determined without their input or approval. Many health assessments by government agencies, industry, and researchers from outside the communities fail to include Indigenous definitions of health and omit basic methodological guidance on how to evaluate Indigenous health, thus compromising the quality and consistency of results. Native Coast Salish communities (Washington State, USA) developed and pilot-tested a set of Indigenous Health Indicators (IHI) that reflect non-physiological aspects of health (community connection, natural resources security, cultural use, education, self-determination, resilience) on a community scale, using constructed measures that allow for concerns and priorities to be clearly articulated without releasing proprietary knowledge. Based on initial results from pilot-tests of the IHI with the Swinomish Indian Tribal Community (Washington State, USA), we argue that incorporation of IHIs into health assessments will provide a more comprehensive understanding of Indigenous health concerns, and assist Indigenous peoples to control their own health evaluations.

No MeSH data available.