Landscapes of First Nations, Inuit, and Métis Health: An Environmental Scan of Organizations, Literature and Research, 3rd Edition.
This resource, released in 2014, provides a comprehensive picture of existing knowledge and current directions in Aboriginal peoples' health in Canada.
Landscapes of First Nations, Inuit and Métis Health: An Updated Environmental Scan
The second edition of the environmental scan was released in 2010.
Landscapes of Indigenous Health - an environmental scan of work in the field of Indigenous peoples' health in Canada, originally released in 2007.
Update: December 2014
The National Collaborating Centre for Aboriginal Health (NCCAH) is pleased to present Landscapes of First Nations, Inuit, and Métis Health: An Environmental Scan of Organizations, Literature and Research, 3rd Edition. Similar to previous environmental scans produced by the NCCAH in 2006 and 2010, this publication sets out to review the current knowledge production on First Nations, Inuit, and Métis health and health priorities in Canada. The Landscapes 3rd Edition report includes:
A Changing Landscape
Aboriginal health-related organizations saw dramatic changes in 2012. Deep cuts in health funding devastated the health departments at the Assembly of First Nations (AFN), Inuit Tapiriit Kanatami (ITK), Pauktuutit, and the Native Women’s Association of Canada (NWAC). The National Aboriginal Health Organization (NAHO) was eliminated completely. At the same time, several new Aboriginal-controlled organizations emerged focusing on specific aspects of health and health care, including information governance, physical activity, environmental health, sexual health, midwifery, and health management professionals.
Summary of Findings of Health Priorities: Commonalities and Gaps
There continues to be considerable research undertaken in Aboriginal health. The scan also revealed that despite a decline in funding for health research during the 2011-12 fiscal year, there continues to be high levels of funding for CIHR research related to Aboriginal health, suggesting that more published research will be forthcoming.
The scan also showed some similarities between the health priorities of Aboriginal organizations and the primary focuses identified in both peer and non-peer reviewed literature and funded research. Topics of health care (including research, policy, human resources, programming, and delivery) and socio-economic and cultural determinants are the top priorities across all sectors reviewed. Several other topics are stronger concerns for organizations but receive less emphasis in literature and research, including: lifestyle and healthy living (especially smoking cessation, sexual health, and diet and nutrition); child and youth health; chronic disease (especially diabetes); maternal, fetal, and infant health; mental health and wellness; and violence, injury, and abuse. All of these gaps indicate areas where the existing and forthcoming knowledge may not be adequately addressing the concerns of the organizations that represent the needs of communities.
Health Research Priorities
National Aboriginal/Health Organizations
Health care including research, policy, human resources, programming, and delivery
Socio-economic and cultural determinants of health
Mental health and wellness
Child and youth health
Maternal, fetal, and infant health
Violence, injury, and abuse
General health status
To round out the picture of current Aboriginal health research priorities, a detailed analysis by topic was conducted for all 416 CIHR funded projects related to Aboriginal health. Most projects fit within the ‘Social/Cultural/Environmental/Population Health’ theme, and the most common focus was on health care (70.2%). This was followed by:
Themes represented in the literature and research indicate the need for more consistent and clear disaggregation of population data, including gender, life stage, geography and the use of the term ‘Aboriginal’. Additionally, the scan revealed a continued under-representation of infants and children, males, urban, off reserve Aboriginal populations, and Métis people generally in health research.
Emerging knowledge: Making a difference through translation and exchange
As noted through the Landscapes 3rd Edition, serious health disparities continue to affect First Nations, Inuit, and Métis communities and people. The challenge now is to ensure that the emerging knowledge documented in this report is disseminated to communities and front line practitioners. New research also needs to be readily accessible to public health decision makers at all levels so that high quality, informed, evidence-based policies can assist First Nations, Inuit, and Métis peoples to achieve their public health goals and optimum health and well-being.
Update: December 2010
This 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 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
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:
'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:
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:
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.
Our database is constantly evolving to provide us with the names of experts who generously provide their time and insights to support our peer-review process, helping ensure our reports, fact sheets, and knowledge-sharing materials meet a high standard of acceptance as viable sources of knowledge in Aboriginal public health. Our approach includes a rigorous double-blind peer review process that includes both academic as well as community expertise.