Advertisement

Canadian Journal of Public Health

, Volume 98, Issue 4, pp 347–351 | Cite as

Narratives of Social Support and Health in Aboriginal Communities

  • Chantelle A. M. RichmondEmail author
Article
  • 1 Downloads

Abstract

Objective

Societies that foster high-quality social relationships and social support seemingly produce healthier populations. Existing research identifies social support as a significant dimension and determinant of Canadian Aboriginal health, yet patterns of morbidity and mortality overwhelmingly reflect social causes (e.g., violence, suicide), thereby suggesting that social support may not be widely accessible within this population. This paper seeks to understand how broader societal factors (e.g., colonialism) work to influence access to social support in the everyday social environments of Aboriginal communities.

Method

Narrative analysis of interviews with 26 Aboriginal Community Health Representatives (CHRs) from across Canada.

Results

Sources of social support are institutional (e.g., those employed to provide support) and intimate (e.g., family). In terms of access to social support, CHRs’ stories reflected a narrative detailing the post-colonial context. Key elements of this narrative include the child-parent relationship, group-belonging, trust, socio-economic dependence, and the changing nature of help. Findings suggest that features of the broader societal context (e.g., poverty) have manifested as local social conditions (e.g., providing help has come to be seen as a possible source of income), thereby reducing access to social support. Access to this resource is also affected as institutional and intimate supports tend to overlap in Aboriginal communities, many of which are small in terms of size and population.

Conclusion

Research and policy options must recognize the post-colonial influences that affect the everyday realities of Aboriginal communities and study the complex interactions between these influences, and how health determinants–like social support–play out in local places as a result of this legacy.

MeSH terms

Aboriginal health social support social environment colonialism community health representatives narrative analysis 

Résumé

Objectif

Les sociétés qui encouragent des relations sociales et un soutien social de grande qualité semblent produire des populations plus saines. Les recherches déjà réalisées définissent le soutien social comme une dimension importante et un déterminant de la santé des Autochtones canadiens, mais les modèles de morbidité et de mortalité reflètent essentiellement des causes sociales (p. ex., violence, suicide), ce qui semble indiquer que cette population n’aurait pas suffisamment accès à un soutien social. L’objectif de cet article est donc de comprendre la façon dont les facteurs sociétaux plus larges (p. ex., système colonial) influent sur l’accès au soutien social dans les environnements sociaux quotidiens des communautés autochtones.

Méthodologie

Analyse narrative d’entrevues réalisées auprès de 26 représentants autochtones en santé communautaire (RSC) de partout au Canada.

Résultats

Les sources de soutien social sont institutionnelles (p. ex., les personnes embauchées pour fournir un soutien) et intimes (p. ex., la famille). En matière d’accès au soutien social, les propos des RSC prenaient la forme d’un exposé des faits dans un contexte postcolonial. Les éléments clés de ce récit comprenaient la relation parent-enfant, le sentiment d’appartenance au groupe, la confiance, la dépendance socio-économique et la nature changeante de l’aide. Les observations laissent supposer que les caractéristiques du contexte sociétal plus large (p. ex., la pauvreté) se sont manifestées en tant que conditions sociales locales (p. ex., l’offre d’aide est désormais perçue comme une source possible de revenus), réduisant ainsi l’accès au soutien social. L’accès à cette ressource est également touché puisque les soutiens institutionnels et intimes ont tendance à se chevaucher dans les communautés autochtones, dont bon nombre sont petites sur les plans de la superficie et de la population.

Conclusion

Les options en matière de recherche et de politique doivent tenir compte des influences postcoloniales qui ont des répercussions sur les réalités quotidiennes des communautés autochtones et des interactions complexes entre ces influences ainsi que du rôle joué par les déterminants de la santé–comme le soutien social–dans les communautés locales en conséquence de cet héritage.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Berkman LF. The role of social relations in health promotion. Psych Med 1995;57:245–54.CrossRefGoogle Scholar
  2. 2.
    House JS, Landis KR, Umberson D. Social relationships and health. Science 1988;241(4865):540–45.CrossRefGoogle Scholar
  3. 3.
    Richmond C, Ross NA, Bernier J. Exploring Indigenous concepts of health: The dimensions of Métis and Inuit health. In: White J, Beavon D, Wingert S, Maxim P (Eds.), Aboriginal Policy Research: Directions and Outcomes Volume 4. Toronto, ON: Thompson Educational Publishing, 2007;3–13.Google Scholar
  4. 4.
    Richmond CAM, Ross NA, Egeland GM. Societal resources and thriving health: A new approach for understanding the health of Indigenous Canadians. Am J Public Health in press.Google Scholar
  5. 5.
    Adelson N. The embodiment of inequity: Health disparities in Aboriginal Canada. Can J Public Health 2005;96(Suppl. 2):S45–S61.PubMedGoogle Scholar
  6. 6.
    Barsh L. Canada’s Aboriginal peoples: Social integration or disintegration. Can J Native Stud 1994;XIV(1):1–46.Google Scholar
  7. 7.
    Wheatley MA. Social and cultural impacts of environmental change on aboriginal peoples in Canada. Int J Circumpolar Health 1998;57(Suppl 1):537–42.PubMedGoogle Scholar
  8. 8.
    Karmali S, Laupland K, Harrop RA, Findlay C, Kirkpatrick AM, Winston B, et al. Epidemiology of severe trauma among status Aboriginal Canadians: A population-based study. CMAJ 2005;172(8):1007–11.CrossRefGoogle Scholar
  9. 9.
    Richmond C, Elliott SJ, Matthews R, Elliott B. The political ecology of health: Perceptions of environment, economy, health and well-being among ‘Namgis First Nation. Health Place 2005;11(5):349–65.CrossRefGoogle Scholar
  10. 10.
    Waldram JB, Herring DA, Young TK. Aboriginal Health in Canada: Historical, Cultural and Epidemiological Perspectives, 2nd Edition. Toronto: University of Toronto Press, 2006.Google Scholar
  11. 11.
    Conrad P, Kern R. The Sociology of Health and Illness: Critical Perspectives, Third Edition. New York, NY: St. Marten’s Press, 1990.Google Scholar
  12. 12.
    Marmot M. Inequalities in health. N Engl J Med 2001;345(2):134–36.CrossRefGoogle Scholar
  13. 13.
    Link BG, Phelan J. Social conditions and fundamental causes of disease. J Health Soc Behav 1995;35:80–94.CrossRefGoogle Scholar
  14. 14.
    McCulla K. A comparative review of Community Health Representatives’ scope of practice in international Indigenous communities. Kahnawake, QC: National Indian and Inuit Community Health Representatives Organization, 2004.Google Scholar
  15. 15.
    Newbold B. Problems in search of solutions: Health and Canadian Aboriginals. J Community Health 1998;23(1):59–73.CrossRefGoogle Scholar
  16. 16.
    Browne A, Smye V. A post-colonial analysis of healthcare discourses addressing aboriginal women. Nurs Res 2004;9(3):28–41.CrossRefGoogle Scholar
  17. 17.
    Frohlich KL, Ross N, Richmond C. Health disparities in Canada today: Some evidence and a theoretical framework. Health Policy 2006;79(2-3):132–43.CrossRefGoogle Scholar
  18. 18.
    MacMillan HL, MacMillan AB, Offord DR, Dingle JL. Aboriginal health. CMAJ 1996;155(11):1569–78.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Warry W. Unfinished Dreams and the Reality of Aboriginal Self-Government. Toronto: University of Toronto Press, 1998.CrossRefGoogle Scholar
  20. 20.
    House JS. Work, Stress and Social support. Reading, MA: Addison-Wesley, 1981.Google Scholar
  21. 21.
    Thoits PA. Stress, coping and social support processes: Where are we? What next? J Health Soc Behav 1995;35:53–79.CrossRefGoogle Scholar
  22. 22.
    Felton BJ, Shinn M. Social integration and social support: Moving ‘social support’ beyond the individual level. J Community Psychol 1992;20(2):103–15.CrossRefGoogle Scholar
  23. 23.
    Turner RJ, Marino F. Social support and social structure: A descriptive epidemiology. J Health Soc Behav 1994;35(3):193–212.CrossRefGoogle Scholar
  24. 24.
    Wiles JL, Rosenberg MW, Kearns RA. Narrative analysis as a strategy for understanding interview talk in geographic research. Area 2005;37(1):89–99.CrossRefGoogle Scholar
  25. 25.
    Kearns R. Narrative and metaphor in health geographies. Prog Hum Geogr 1997;21(2):269–77.CrossRefGoogle Scholar
  26. 26.
    Knowles JH. The responsibility of the individual. In: Conrad P, Kern R (Eds.), The Sociology of Health and Illness: Critical Perspectives, Third Edition. New York: St. Marten’s Press, 1990.Google Scholar
  27. 27.
    McKinlay JB. A case for refocusing upstream: The political economy of illness. In: Conrad P, Kern R (Eds.), The Sociology of Health and Illness: Critical Perspectives, Third Edition. New York: St. Marten’s Press, 1990.Google Scholar
  28. 28.
    Kenny C. A Holistic Framework for Aboriginal Policy Research. Available online at: https://doi.org/www.swc-cfc.gc.ca/pubs/pub-spr/0662379594/200410_0662379594_e.pdf (Accessed January 12, 2007).

Copyright information

© The Canadian Public Health Association 2007

Authors and Affiliations

  1. 1.Department of GeographyMcGill UniversityMontrealCanada

Personalised recommendations