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.
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.
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Acknowledgements: This paper was made possible through the financial support of a research allowance from the Indigenous Health Research Development Program (CIHR-IAPH), and a doctoral fellowship from SSHRC (#752-2006-2137). My thanks to Dr. Nancy Ross for thoughtful comments on a previous draft. I acknowledge Debbie Dedam-Montour and her staff at the National Indian and Inuit Community Health Representatives Organization, and thank the Community Health Representatives who participated so willingly in this study. I also acknowledge the support of Ellen Gabriel and Quebec Native Women Inc.
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Richmond, C.A.M. Narratives of Social Support and Health in Aboriginal Communities. Can J Public Health 98, 347–351 (2007). https://doi.org/10.1007/BF03405416
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DOI: https://doi.org/10.1007/BF03405416