Indigenous Knowledge Systems

Purpose of Indigenous Knowledge Systems

This section helps to connect concepts of health, healing, and wellbeing with ancestral and traditional knowledge of Indigenous cultures and languages. It is rare in Public Health to encounter a grounding in Indigenous health perspectives and the connections embedded in our cultures, languages, and worldviews.

This page provides some of these connections to help clarify how we can utilize these strengths and cultural assets to improve our community and population health.

What is Health Equity? 

• Health equity is the attainment of the highest level of health for all people (US DDHS, 2022).
• Health status was once believed to be the results of genetic factors and individual behaviors (i.e. smoking, exercise) 
• Since 2005, there has been increased attention to understand the role social and economic conditions have in health outcomes. 
• Health equity acknowledges not all people have the same opportunities to achieve optimal levels of health. 
• Associations between social factors and health outcomes have revealed experiencing economic, social, or economic disadvantage can adversely affect groups of people, thus creating disparities in health. 

What are Social Determinants of Health (SDOH)? 

• Social Determinants of health reflect the social, political, and environmental conditions and contexts that people live in. 
• The Center for Disease and Prevention (CDC) defines SDOH as “the non-medical factors and conditions in the places where people live, work, learn, and play that affect a wide range of health and quality-of-life-risks and outcomes. 
• Further, the CDC has identified five domains to measure SDOH, which includes 1) economic stability, 2) access and quality education, 3) access and quality healthcare, 4) Neighborhood and built environment and 5) social and community context.
• SDOH approaches seek to address the social and systemic barriers to reach health equity. 

What are Indigenous Social Determinants of Health? 

• Seven Directions defines ISDOH as those aspects of American Indian and Alaska Native social and political existence in the United States that create conditions that influence the health and wellbeing of the peoples beyond those determinants in mainstream populations.

Why is an IDOH framework important? 

• In 2019, Seven Directions completed an exploratory scoping review and environmental scan to assess the landscape of literature and web-based content on social determinants as it relates to Indigenous Peoples’ health in the United States. Results from this review revealed the shortage of SDOH models and frameworks that represented the unique contexts and aspects of Indigenous Peoples’ health and community characteristics.  
• Further, the landscape of Indigenous Peoples’ health reveals health disparities (i.e. diabetes, mental health) are well-documented in health literature. This is a direct reflection of SDOH frameworks and models following biomedical models that are disease-specific and individual-focused – which often fail to acknowledge and include the strength and resilience of Indigenous communities. This lack of a holistic approach to health and wellness does a disservice to our peoples, narrowly defining health and ignoring important community characteristics that support our health, our connections to one another and our land and cultures, and represent the essence of who we are. 

Intentions to develop a IDOH framework 

• This project focuses on an Indigenous-centered social determinants of health framework that acknowledges the values and principles of Indigenous health, healing, and wellbeing that stems of Indigenous worldviews and epistemologies.
• Developing a comprehensive framework that is applicable to the diversity of Indigenous Peoples and tribal communities across the United States represents an ongoing effort. 
• The framework importantly includes a spotlight and celebration of Indigenous knowledge and worldviews.
• Our goal has been to identify areas that contribute to healing, health, and wellbeing from an Indigenous lens and develop a framework that is strength-based and community-centered.

Discourse around rethinking social determinants of health from Indigenous perspectives have started to receive attention

• In the seminal article, Reclaiming Indigenous Health in the United States: Moving Beyond the Social Determinants, a panel of experts begins to conceptualize Indigenous health and wellbeing  into three categories of determinants of health and wellbeing are defined 1) broad determinants that affect non-Indigenous and Indigenous communities, 2) shared determinants of health among Indigenous communities or among communities that share a certain geography or culture. 3) unique Indigenous determinants that are evident in one Indigenous or a few communities. 

The IDOH project team recognizes the diversity of tribal nations and Indigenous communities. Therefore, uplifting Indigenous ways of knowing, being, and doing represented a critical component of the development of this framework. We invited community members to attend facilitated discussions and activities to have conversations about the forces and factors that influence community health. Further, we have coordinated an advisory council to provide guidance and feedback on our approach to develop content and material. This is an iterative process, and will hopefully support your conversations and further inquiry into how Indigenous Social Determinants are important in your work.