Integrating Indigenous and Western Scientific Approaches in Community-Based Participatory Research to Reduce the Health Inequities of First Nations, Inuit, and Métis Peoples in Canada

In Canada, no population is in a more disadvantaged health position than Indigenous peoples. Despite decades of biomedical research, their health outcomes have seen little improvement, largely because researchers have focused on pathology and dysfunction, not on understanding the social determinants of health or Indigenous experiences. For example, only recently have we recognized that the health of their land is intimately tied to the health of Indigenous peoples. We also know that industry is degrading the environment and impacting human health to such an extent and at such a rate that there is cause for serious concern. Worse, disproportionate exposures to pollutants are impacting Indigenous peoples, especially given their close proximity to and interdependent relationship on the land around them. We have a reasonable understanding of the historical, cultural, and epidemiological perspectives concerning Indigenous health in Canada. But we do not have an adequate understanding of their health concerns, changes to their health status over time, or the factors that contribute to their health status from their perspectives. Community-based participatory research is a philosophical and methodological approach that characterizes the traits that CIHR's Institute of Aboriginal Peoples' Health espouses: "to carry out sound and ethical research together in ways that respect community values and allow communities to stand as true partners in the research process". By integrating Indigenous and Western scientific approaches in community-based participatory research - exemplified in the accompanying (funded) operating grant - this research program, unified by a number of interrelated and complementary projects, will offer recommendations for practice, program and policy domains that will ultimately reduce health disparities and work towards health equity by involving Indigenous peoples in Canada in the research enterprise.