1. In the Steps of Children: Reducing Health Inequalities of Indigenous Peoples in Canada by Refocusing on the Social Determinants of Health and Holistic Approaches and the Wellness of Generations Margo Greenwood, Sarah de Leeuw, and Bernice Downey The National Collaborating Centre for Aboriginal Health, UNBC Prince George, BC

2. In the Steps of Children What We’re Speaking About Today What are the social determinants of health? Indigenous ways of knowing and being: linkages to health The specificity of social determinants and Aboriginal people’s health Aboriginal early childhood The generations of today, the communities of tomorrow

3. In the Steps of Children Social Determinants of Health To consider health from a social determinants perspective requires shifting considerations away from individual subjects (susceptible to factors such as disease or at risk of unhealthy behaviours such as smoking and poor diet) to both the social contexts in which that subject works, plays, loves, and experiences life and to the social factors which impact that subject, including (amongst other things) economics, education, early childhood development, and housing. (see for instance Anderson et al 2002; Marmot 2005)

4. In the Steps of Children Indigenous Epistemologies Healing means mending bodies and souls. It also means rekindling the flames that strengthen our Native spirituality. It means physical, mental, psychological and emotional well-being. This is known in Native healing circles as the holistic approach to healing. (Elder Byron Stiles, 1993: Quoted in The Royal Commission on Aboriginal Peoples 1996: n.p.)

5. In the Steps of Children Unique Social Determinants that Affect Indigenous Health Colonization and colonialism Relationship to the land Racism Cultural subjugation Isolation

6. In the Steps of Children The Status of Indigenous People’s Health Data collected at the national and provincial/territorial levels indicate that the health status of First Nations, Inuit and Métis is well below that of the non- Aboriginal population of Canada. Significant gap between Aboriginal and non-Aboriginal life expectancy and chronic diseases. High rates of: –births –suicide –diabetes –heart and circulatory disease –fetal alcohol spectrum disorder –infant mortality –injury –tuberculosis

7. In the Steps of Children Social Determinants of Health and Indigenous Peoples In 1996, the Royal Commission on Aboriginal Peoples (RCAP) report noted that socio-economic factors are important health determinants, but criticized the “individual level” analyses of socio- economic variables (such as income and employment) found in most health studies

8. In the Steps of Children Social Determinants of Health and Indigenous Peoples A 2003 report on Public Health suggested that a “wide-angle approach for health determinants and community development that is clearly supported and guided by the affected Aboriginal communities is what is needed.”

9. In the Steps of Children The Next Seven Generations “If you heal a child, you will heal a family. If you heal a family, you will heal a community. And if you heal a community, you will heal a Nation.” Ovid Mercredi

10. In the Steps of Children Early Childhood and Aboriginal Health “I am reminded of a teaching common to many First Nations – that being, in whatever we say and do, we need to be mindful of the effects it will have on children today and for generations to come. In short, if our reality is such that we are lacking in the health of Indigenous children today, those children are going to grow up and continue to contribute to the negative realities of First Nations people in the future… If we look at healthy development from an Indigenous perspective, we are looking at the whole child – the social, physical and mental development, and also more importantly, spiritual development. A really solid connection to language and culture is most important so that our kids know where they come from, who they are, as citizens of this world.” (Key Informant D 2008)

11. In the Steps of Children Questions? We can be contacted at: University of Northern British Columbia 3333 University Way Prince George, BC V2N 4Z9 Canada Tel: 250.960.5986 Fax: 250.960.5644 E-mail: nccah@unbc.ca