Speaking at the Northern Exposures conference on Manitoulin Island, in October, 2015, scholars Harlan Pruden and Margaret Robinson discuss syndemics, culture as treatment and prevention, the impact of culture on health and need to invest in strong communities.
My name is Harlan Pruden. I am First Nations Cree.
Syndemics is that perfect storm where there’s interlocking and interrelated social as well as health issues that are impacting. And when I looked at the syndemics, I became like really kind of hopeful, in that we have to start looking at the context in which the disease is happening, or how the context is allowing the spread of the disease.
And the context is like a— what I’m saying is an overall picture right — and so what I was also talking about is our interventions cannot just be singly in focus right. So you can’t just talk about homelessness, without talking about education and employment and addictions. Nor can you talk about addictions without talking about employment, education housing security or insecurity as well as other things. And so it’s this addressing and looking at kind of like a holistic approach.
And so we’ve been hearing concepts from speakers, like this morning at the plenary, of talking about peer-based or peer-driven services. And I know that there is historical trauma-informed care, is also doing this holistic kind of approach, that you’re not triggering. But it’s the entire context that we’re in so it’s like it’s this overall theme of looking at the context. And what it makes very hopeful is that we can start a way of talking about and a framework of addressing those big huge issues of racism and systemic and institutional racism that exists for many people of color, and particularly in Canada for the Aboriginal and First Nations, Indigenous and Métis. Racism was well alive right. Or the big issues around colonization for us as native people, in that that’s the context, and once we start looking at the healing around that is then I think that we’re actually getting more at the question of addressing social determinants of health. But it’s that syndemics, so it’s not just one thing and it’s also this acknowledgement that everything is interconnected. And as a native person you know we we we know that everything is connected and because we’re whole people and so that’s what I’m like really hopeful around this conversation because it’s not like just looking at one thing it’s looking at everything . Which makes it incredibly challenging. But syndemics and that research and discussion is the opening up of that and so I’m very hopeful around that.
Culture is treatment and culture is prevention, you know, and that again it goes back to that larger framework that anything that instills greater cultural pride increases self-esteem. When you have an increased self-esteem better decision-making processes happen and it’s a holistic approach to health and well-being.
And so that’s a new sort of sort of like we’re actually articulating it that culture is prevention and culture is treatment. And that’s where I’m focusing my attention on. But again it’s difficult because those folks that are disconnected, that are internalized their living and breathing— what I would say is internalized colonization—and are so dislocated from their from their ways right, by the choice or by stigma or because they’re on what we would say is the Black Road you know. They’re coping the best way that they know and that often is through drugs and alcohol. And I think what we just have to do is stay the course continue on doing it because I know that once people said that so bring up looking at those issues they find it back to the Red Road.
And I think that what I consistently do is drop little tobacco and pray for those people, that are on that journey and on that that road, that that one day that they can find the Red Road, and once they find the Red Road that there is programming and spaces for them to say, “come and celebrate your Indianess,” “come and celebrate your two-spiritness,” and that there is that support there for them.
I’m Margaret Robinson, I’m a researcher in residence at the Ontario HIV Treatment Network, and my focus is on Aboriginal health.
What they found in BC is that when there were particular elements present in an Indigenous culture—like self government for instance, or control over police, fire department, health services, people speaking their Indigenous language—that suicide rates just plummeted. They identified a number of key markers, and if these things are present in the community then they have very little suicide, in part because it enables young people and other people as well, to imagine a future for themselves as an Indigenous person in the community they live in.
If as the study suggests, that having strong Indigenous communities keeps people healthy and lowers rates of diabetes, lowers rates of suicide, lowers people’s issues with mental health or substance use, then I think we need to be investing in strong Indigenous communities, we need to be helping people get access to their culture, and helping people stay connected with it. Because not only is it the right thing to do, and it helps create healthier people, but it’s actually cheaper in the long run to keep people healthy than it is to treat people who are sick.
I was lead on the Two-Spirit roundtable which examined mental health and substance use among Two-Spirit people in Timmins and in Ottawa. And we interviewed people there in a round circle, and it was amazing when people started talking about the impact that cultural connection and tradition and involvement in ceremony had had on their lives. It changed the way that they felt about their own mental health and well-being it, changed the way that they dealt with stigma, and helped them move through trauma and grief, and all those issues of violence that we face as Indigenous people in our daily lives.