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Self-determination is on the agenda of Indigenous peoples all over the world. This analysis by an Indigenous feminist scholar challenges the United Nations-based human rights agendas and colonial theory that until now have shaped Indigenous models of self-determination. Gender inequality and gender violence, Dian Million argues, are critically important elements in the process of self-determination.Million contends that nation-state relations are influenced by a theory of trauma ascendant with the rise of neoliberalism. Such use of trauma theory regarding human rights corresponds to a therapeutic narrative by Western governments negotiating with Indigenous nations as they seek self-determination.Focusing on Canada and drawing comparisons with the United States and Australia, Million brings a genealogical understanding of trauma against a historical filter. Illustrating how Indigenous people are positioned differently in Canada, Australia, and the United States in their articulation of trauma, the author particularly addresses the violence against women as a language within a greater politic. The book introduces an Indigenous feminist critique of this violence against the medicalized framework of addressing trauma and looks to the larger goals of decolonization. Noting the influence of humanitarian psychiatry, Million goes on to confront the implications of simply dismissing Indigenous healing and storytelling traditions.Therapeutic Nationsis the first book to demonstrate affect and trauma's wide-ranging historical origins in an Indigenous setting, offering insights into community healing programs. The author's theoretical sophistication and original research make the book relevant across a range of disciplines as it challenges key concepts of American Indian and Indigenous studies.

Ruth Phillips argues that these practices are \"indigenous\" not only because they originate in Aboriginal activism but because they draw on a distinctively Canadian preference for compromise and tolerance for ambiguity. Phillips dissects seminal exhibitions of Indigenous art to show how changes in display, curatorial voice, and authority stem from broad social, economic, and political forces outside the museum and moves beyond Canadian institutions and practices to discuss historically interrelated developments and exhibitions in the United States, Britain, Australia, and elsewhere. Drawing on forty years of experience as an art historian, curator, exhibition critic, and museum director, she emphasizes the complex and situated nature of the problems that face museums, introducing new perspectives on controversial exhibitions and moments of contestation. A manifesto that calls on us to re-imagine the museum as a place to embrace global interconnectedness, Museum Pieces emphasizes the transformative power of museum controversy and analyses shifting ideas about art, authenticity, and power in the modern museum.

Background Household food insecurity is a potent social determinant of health and health care costs in Canada, but understanding of the social and economic conditions that underlie households’ vulnerability to food insecurity is limited. Methods Data from the 2011–12 Canadian Community Health Survey were used to determine predictors of household food insecurity among a nationally-representative sample of 120,909 households. Household food insecurity over the past 12 months was assessed using the 18-item Household Food Security Survey Module. Households were classified as food secure or marginally, moderately, or severely food insecure based on the number of affirmative responses. Multivariable binary and multinomial logistic regression analyses were used to determine geographic and socio-demographic predictors of presence and severity of household food insecurity. Results The prevalence of household food insecurity ranged from 11.8% in Ontario to 41.0% in Nunavut. After adjusting for socio-demographic factors, households’ odds of food insecurity were lower in Quebec and higher in the Maritimes, territories, and Alberta, compared to Ontario. The adjusted odds of food insecurity were also higher among households reliant on social assistance, Employment Insurance or workers’ compensation, those without a university degree, those with children under 18, unattached individuals, renters, and those with an Aboriginal respondent. Higher income, immigration, and reliance on seniors’ income sources were protective against food insecurity. Living in Nunavut and relying on social assistance were the strongest predictors of severe food insecurity, but severity was also associated with income, education, household composition, Aboriginal status, immigration status, and place of residence. The relation between income and food insecurity status was graded, with every $1000 increase in income associated with 2% lower odds of marginal food insecurity, 4% lower odds of moderate food insecurity, and 5% lower odds of severe food insecurity. Conclusions The probability of household food insecurity in Canada and the severity of the experience depends on a household’s province or territory of residence, income, main source of income, housing tenure, education, Aboriginal status, and household structure. Our findings highlight the intersection of household food insecurity with public policy decisions in Canada and the disproportionate burden of food insecurity among Indigenous peoples.

Active surveillance of invasive group A Streptococcus (iGAS) disease indicates that its incidence in the US general population is low, but limited studies show rates for American Indians and Alaska Natives (AI/AN) are severalfold higher. Major disparities in rates of iGAS exist between Indigenous and non-Indigenous populations of Australia, New Zealand, and Canada, but much less is understood about iGAS among AI/AN in the United States. Although complex host-pathogen interactions influence the rates of iGAS, including strain variation and virulence, the number and type of concurrent conditions, and socioeconomic status, the relative contribution of each remains unclear. We highlight the poor correlation between the substantial effect of iGAS among Indigenous persons in industrialized countries and the current understanding of factors that influence iGAS disease in these populations. Prospective, large-scale, population-based studies of iGAS are needed that include AI/AN as a necessary first step to understanding the effects of iGAS.

Revealing how Canada's first Prime Minister used a policy of starvation against Indigenous people to clear the way for settlement, the multiple award-winning Clearing the Plains sparked widespread debate about genocide in Canada.

Structural violence shapes the health of Indigenous peoples globally, and is deeply embedded in history, individual and institutional racism, and inequitable social policies and practices. Many Indigenous communities have flourished, however, the impact of colonialism continues to have profound health effects for Indigenous peoples in Canada and internationally. Despite increasing evidence of health status inequities affecting Indigenous populations, health services often fail to address health and social inequities as routine aspects of health care delivery. In this paper, we discuss an evidence-based framework and specific strategies for promoting health care equity for Indigenous populations. Using an ethnographic design and mixed methods, this study was conducted at two Urban Aboriginal Health Centres located in two inner cities in Canada, which serve a combined patient population of 5,500. Data collection included in-depth interviews with a total of 114 patients and staff (n = 73 patients; n = 41 staff), and over 900 h of participant observation focused on staff members' interactions and patterns of relating with patients. Four key dimensions of equity-oriented health services are foundational to supporting the health and well-being of Indigenous peoples: inequity-responsive care, culturally safe care, trauma- and violence-informed care, and contextually tailored care. Partnerships with Indigenous leaders, agencies, and communities are required to operationalize and tailor these key dimensions to local contexts. We discuss 10 strategies that intersect to optimize effectiveness of health care services for Indigenous peoples, and provide examples of how they can be implemented in a variety of health care settings. While the key dimensions of equity-oriented care and 10 strategies may be most optimally operationalized in the context of interdisciplinary teamwork, they also serve as health equity guidelines for organizations and providers working in various settings, including individual primary care practices. These strategies provide a basis for organizational-level interventions to promote the provision of more equitable, responsive, and respectful PHC services for Indigenous populations. Given the similarities in colonizing processes and Indigenous peoples' experiences of such processes in many countries, these strategies have international applicability.

While Indigenous media have gained increasing prominence around the world, the vibrant Aboriginal media world on the Canadian West Coast has received little scholarly attention. As the first ethnography of the Aboriginal media community in Vancouver,Sovereign Screensreveals the various social forces shaping Aboriginal media production including community media organizations and avant-garde art centers, as well as the national spaces of cultural policy and media institutions. Kristin L. Dowell uses the concept of visual sovereignty to examine the practices, forms, and meanings through which Aboriginal filmmakers tell their individual stories and those of their Aboriginal nations and the intertribal urban communities in which they work. She explores the ongoing debates within the community about what constitutes Aboriginal media, how this work intervenes in the national Canadian mediascape, and how filmmakers use technology in a wide range of genres-including experimental media-to recuperate cultural traditions and reimagine Aboriginal kinship and sociality. Analyzing the interactive relations between this social community and the media forms it produces,Sovereign Screensoffers new insights into the on-screen and off-screen impacts of Aboriginal media.

Objectives Inequalities between Indigenous and non-Indigenous peoples in Canada persist. Despite the growth of Indigenous populations in urban settings, information on their health is scarce. The objective of this study is to assess the association between experience of discrimination by healthcare providers and having unmet health needs within the Indigenous population of Toronto. Methods The Our Health Counts Toronto (OHCT) database was generated using respondent-driven sampling (RDS) to recruit 917 self-identified Indigenous adults within Toronto for a comprehensive health assessment survey. This cross-sectional study draws on information from 836 OHCT participants with responses to all study variables. Odds ratios and 95% confidence intervals were estimated to examine the relationship between lifetime experience of discrimination by a healthcare provider and having an unmet health need in the 12 months prior to the study. Stratified analysis was conducted to understand how information on access to primary care and socio-demographic factors influenced this relationship. Results The RDS-adjusted prevalence of discrimination by a healthcare provider was 28.5% (95% CI 20.4–36.5) and of unmet health needs was 27.3% (95% CI 19.1–35.5). Discrimination by a healthcare provider was positively associated with unmet health needs (OR 3.1, 95% CI 1.3–7.3). Conclusion This analysis provides new evidence linking discrimination in healthcare settings to disparities in healthcare access among urban Indigenous people, reinforcing existing recommendations regarding Indigenous cultural safety training for healthcare providers. Our study further demonstrates Our Health Counts methodologies, which employ robust community partnerships and RDS to address gaps in health information for urban Indigenous populations.

Indigenous peoples of Canada, United States, Australia, and New Zealand experience disproportionately high rates of suicide as a result of the collective and shared trauma experienced with colonization and ongoing marginalization. Dominant, Western approaches to suicide prevention-typically involving individual-level efforts for behavioural change via mental health professional intervention-by themselves have largely failed at addressing suicide in Indigenous populations, possibly due to cultural misalignment with Indigenous paradigms. Consequently, many Indigenous communities, organizations and governments have been undertaking more cultural and community-based approaches to suicide prevention. To provide a foundation for future research and inform prevention efforts in this context, this critical scoping review summarizes how Indigenous approaches have been integrated in suicide prevention initiatives targeting Indigenous populations. A systematic search guided by a community-based participatory research (CBPR) approach was conducted in twelve electronic bibliographic databases for academic literature and six databases for grey literature to identify relevant articles. the reference lists of articles that were selected via the search strategy were hand-searched in order to include any further articles that may have been missed. Articles were screened and assessed for eligibility. From eligible articles, data including authors, year of publication, type of publication, objectives of the study, country, target population, type of suicide prevention strategy, description of suicide prevention strategy, and main outcomes of the study were extracted. A thematic analysis approach guided by Métis knowledge and practices was also applied to synthesize and summarize the findings. Fifty-six academic articles and 16 articles from the grey literature were examined. Four overarching and intersecting thematic areas emerged out of analysis of the academic and grey literature: (1) engaging culture and strengthening connectedness; (2) integrating Indigenous knowledge; (3) Indigenous self-determination; and (4) employing decolonial approaches. Findings demonstrate how centering Indigenous knowledge and approaches within suicide prevention positively contribute to suicide-related outcomes. Initiatives built upon comprehensive community engagement processes and which incorporate Indigenous culture, knowledge, and decolonizing methods have been shown to have substantial impact on suicide-related outcomes at the individual- and community-level. Indigenous approaches to suicide prevention are diverse, drawing on local culture, knowledge, need and priorities.