CIEDAR fills critical gaps in health research by ensuring Indigenous voices are being heard

“Indigenous voices are generally not being heard in research because the data are not being collected,” says Dr. Kimberly R. Huyser, Lead of CoVaRR-Net’s Indigenous Engagement, Development and Research (CIEDAR) Pillar 7 and Associate Professor, University of British Columbia. “At CIEDAR, we’re aiming to fill those research gaps by leveraging public data as well as directly through community-based studies, such as our “Hearing Indigenous Voices in the COVID-19 Pandemic” project.”

Indigenous Peoples in Canada have been disproportionately impacted by the pandemic. “The rate of COVID-19 in First Nations People living on a reserve was significantly higher than in the general Canadian population early in the pandemic and Indigenous Peoples were also more likely to experience hospitalization from COVID-19 than other racial and ethnic groups. These elevated rates were the result of factors stemming from structural racism and settler-colonialism, creating critical gaps in health research about Indigenous Peoples’ experiences, needs, and effective solutions,” adds Dr, Huyser.

Addressing social vulnerabilities that increase COVID-19 health risks

In their study, “Understanding the Associations among Social Vulnerabilities, Indigenous Peoples, and COVID-19 Cases within Canadian Health Regions,” published in 2022 in the International Journal of Environmental Research and Public Health, CIEDAR researchers found that social indicators of structural racism and settler-colonialism such as substandard housing, higher unemployment rates, and longer commuting time were associated with higher rates of COVID-19.

“We leveraged public data from 99 Canadian health regions to investigate how key social determinants of health contribute to COVID-19 impacts on Indigenous health. Some key implications from this research are that systemic support must be provided for Indigenous Peoples to address challenges related to social factors such as unemployment, transportation needs, and housing to mitigate the health impacts of COVID-19 and future pandemics,” says Dr. Huyser. “The Canadian government should collect accurate and reliable data on COVID-19 cases that distinguish between different Indigenous identities (disaggregated data),” says Tamara Chavez CIEDAR’s project manager.

Increase access to vaccination clinics and minimize feelings of distrust

In their study, “Understanding Indigenous Peoples’ Relationship to Vaccines,” presented as an award-wining poster at the CoVaRR-Net Spring 2023 Meeting, CIEDAR researchers identified and ranked different reasons for vaccine motivation and vaccine hesitancy among Indigenous Peoples, and where they are most likely to access vaccines. They found strong motivations for vaccination to protect personal, family, and Elder health. The top reasons for not receiving the vaccine included distrust towards the safety and effectiveness of COVID-19 vaccines. Vaccination clinics were by far the most popular location to access vaccines, compared to pharmacies, public health clinics, medical clinics, or a doctor’s office.

“Our findings suggest access to vaccination clinics should be prioritized for any future infectious outbreaks. Policymakers and researchers should also continue to work alongside Indigenous communities to minimize feelings of distrust towards medical interventions like vaccines,” says Dr. Huyser.

The vaccine study is one example of the research being done through CIEDAR’s large-scale Hearing Indigenous Voices survey. The project allows CIEDAR researchers to assess Indigenous Peoples’ experience in the pandemic, investigate the social factors that may protect or increase their vulnerability to COVID-19 and variants of concern, resources used for mental health concerns, and willingness to engage with research.

Boosting Indigenous health through land-based healing camps and beading

CIEDAR partnered with the Taché Waters Healing Society to co-develop a land-based healing camp for facilitators, which was grounded in Indigenous culture to promote healing from the ongoing impacts of settler-colonialism — health disparities, isolation, and lack of services – exacerbated by the pandemic. “The camp was in an extremely remote setting and included traditional activities such as berry picking, canoeing, fishing, putting up tents and teepees, and making drums around a fire. Land-based healing camps have many documented benefits, such as helping reduce substance abuse and improving physical and mental health,” says Mary Jessome, CIEDAR research manager and PhD candidate at UBC.

“The land was also a catalyst for a process of reconciliation between Indigenous and non-Indigenous facilitators in this pilot study. The experience allowed camp facilitators to shift their narrative about health and well-being from one that was Westernized towards one that sees well-being as a holistic process,” adds Mary Jessome. “We’re excited to be piloting a land-based healing camp for participants next summer.”

Cultural skills and ancestral teachings, such as beading, are other ways Indigenous Peoples have found to thrive, improve well-being, and reduce stress levels during and through the pandemic. “Our social media campaign, #BeadAndThrive, was an effective way to get people in diverse Indigenous communities to start beading. We held online workshops and classes to increase community engagement when in-person events were held. More than 700 beading kits were distributed to Indigenous Peoples and organizations across the country,” says Dr. Huyser.

Amplifying Indigenous voices through diverse research initiatives

To amplify Indigenous voices in research, CIEDAR also plays an important role in educating and sharing guidance with CoVaRR-Net on the principles for successfully engaging with Indigenous communities on research projects. “Researchers need to get Indigenous communities involved as partners in designing and conducting the research well before they start collecting data,” says Dr. Huyser.

An Indigenous Advisory Council of Elders, knowledge keepers, and other key stakeholders provides guidance and feedback on all CIEDAR’s diverse research projects. These include a four-part podcast series on Indigenous thriving and (re)storying the COVID-19 Pandemic. The (Re)Story Podcast involves returning to Indigenous knowledge and narratives regarding our connection to land, others, and self. “It’s a way for Indigenous voices to be heard using their own voices and sharing stories of how they thrived and overcame the challenges of COVID-19 over the past three years,” she says.

CIEDAR has also been active internationally, liaising with other Indigenous groups around the world to share, among other things, lessons learned. This CoVaRR-Net Pillar facilitated a hybrid symposium called “Hearing Indigenous Voices During the COVID-19 Pandemic Symposium” in collaboration with UBC Health in June 2023. Indigenous scholars from Canada, US, and New Zealand participated and discussed lessons learned about conducting research and Indigenous resilience during the pandemic.

Both Dr. Huyser and CIEDAR Project Manager Tamara Chavez believe that some key lessons learned from all their research activities are that Indigenous Peoples need to be partners in community-based research in order for their voices to be heard and be much more involved in leading their own public health initiatives.

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