Forging partnerships

Forging partnerships

Community approach transforms aboriginal health research
May 6, 2002

They call it "helicopter research." Academics drop in to First Nations communities, research projects on traditional practices, the residential school effect, or oral history, and then leave. Taking along the knowledge they've gained in their visit. The process often leaves the people under the microscope feeling overwhelmed and breathless.

Often, the First Nations communities never hear from the researchers again—and never learn the results of their studies.

The Manitoba First Nations Centre for Aboriginal Health Research is putting an end to helicopter research. The new centre, financed in part by the Assembly of Manitoba Chiefs, is conducting innovative, collaborative health research in partnership and consultation with First Nations communities. And this new approach to solving difficult health problems is serving as a model for other aboriginal health institutes across the country.

"They're doing unbelievable work," Jeff Reading, the scientific director of the Institute of Aboriginal Peoples Health, says of the centre. "We're starting to make significant progress on health issues that most affect native communities—issues that they have identified as important to them. This development in Manitoba and across the country has inspired people to take a much closer look at the potential of First Nations communities, and what they can accomplish when they work in partnerships."

One of the centre's major projects is a study of the way health surveys are conducted in First Nations communities, an investigation led by John O'Neil, the centre's director. His goal is to improve the information that forms the basis of governments' health policy. The project involves developing new ways to measure the social factors that influence health in First Nations communities.

For instance, poverty affects health, but aboriginal Canadians define poverty differently than non-aboriginals, O'Neil says. Poverty is not just a lack of income. "Quite often you hear from elders and older people who live way below the poverty line but have fairly traditional lifestyles, are still active in hunting and trapping, and are still fairly connected to traditions in a spiritual way," says O'Neil, "They'll say 'I'm not poor.'"

In fact, in First Nations communities, people with higher incomes are more at risk for heart disease and diabetes than people with lower incomes, a fact that contradicts conventional medical wisdom, O'Neil says.

Health surveys in aboriginal communities need this information so policymakers don't assume that raising income alone is enough to improve health, O'Neil says. He hopes the study will influence an improved health policy that recognizes the link between wellness and the role of tradition, spirituality, and ties to the land.

In addition, other researchers at the centre are examining the reasons behind a high rate of hip fractures among aboriginal women, and are investigating ways to prevent and treat diabetes. They also hope to work with traditional healers, to study the impact that traditional knowledge and spirituality have on health.

Benefits

The Manitoba First Nations Centre for Aboriginal Health Research is conducting critically important research to address the prevalence of disease such as diabetes, HIV, and AIDS, and the high rate of youth suicide in First Nations communities.

But the centre's approach to the process of research is just as critical as the individual projects, says Doreen Sanderson, health advisor to the Assembly of Manitoba Chiefs. For the first time, researchers at the centre are consistently incorporating traditional and cultural values into their work. They consult First Nations communities on which health issues are a priority, and what is relevant to the community.

Research is conducted with the goal of improving aboriginal people's health as they define health, says John Neil, the centre's director. "In the aboriginal context, people talk about the medicine wheel—a more holistic notion of health that includes spiritual, emotional, physical, and social well-being."

Involving the communities promotes co-operation and innovative solutions. "We want to feel a sense of control over research that's traditionally been initiated by outsiders," says Sanderson.

The centre also pairs communities with the best researchers in the field, so the brightest minds direct their energies toward solving these problems, says Jeff Reading, scientific director of the Institute of Aboriginal Peoples Health.

The Manitoba centre is a model for the virtual institute, which is setting up a network of training centres to lead the way in addressing indigenous health issues around the world, says Reading. "It's a very good step and it's a model for the other centres to aspire to."

One of the Manitoba centre's major accomplishments is building a critical mass of expertise in the area of aboriginal peoples' health. The centre is training aboriginal graduate and post-graduate students, and hiring aboriginal researchers when possible. It's also the flagship institution for the Aboriginal Capacity and Development Research Environments (ACADRE) program of the Institute of Aboriginal Peoples Health.

The ACADRE program is developing a network of linked research environments across Canada to tackle aboriginal health issues. The Manitoba centre is already attracting interest from countries with large aboriginal populations, including New Zealand and Australia.

Partners

A Unique Relationship

Officially opened in March 2001, the Manitoba First Nations Centre for Aboriginal Health Research is building bridges among First Nations communities and Canada's research community. Partners in the centre include the Assembly of Manitoba Chiefs, the University of Manitoba, the Winnipeg Health Sciences Research Foundation, and the Government of Manitoba. The centre is also assisted by contributions from the Canada Foundation for Innovation and the Canadian Institutes of Health Research.

The bridges among the academic and aboriginal communities are being built step by step, as they work together in each stage of a research project and on all aspects of the centre's administration. The result is that research is no longer being done on aboriginal people. It's now done with aboriginal people, and by them.

Representatives from the Assembly of Manitoba Chiefs sit on the centre's board of directors. The assembly's Health Information and Research Committee, composed of representatives from seven tribal councils and non-affiliate bands, reviews proposed research projects. Once a First Nation decides to participate in a project, members of that nation join the research team.

The presence of band members on a research team ensures that the centre is as accountable to the First Nation as it is to the University of Manitoba, says Doreen Sanderson, health advisor to the Assembly of Manitoba Chiefs. Communities also know that they'll get the benefit of the study's results because they are part of the planning on how the information will be shared.

Researchers also agree to return to each of the communities where they conducted their study.

Bill Leslie, an osteoporosis expert, is involved in a study to find out why there is a higher-than-average rate of hip fractures in some First Nations communities. He says the partnership among team members is important and critical to his study's success.