Indigenous perspectives on health

Indigenous perspectives on health

Dr. Trevor Hancock

19 June 2019

701 words

Friday was National Indigenous People’s Day, a good time to reflect on Indigenous perspectives on health. There is much there that can be helpful in these challenging times.

A good place to start is the First Nations Perspective on Health and Wellness, a model developed by the First Nations Health Authority (FNHA) in BC. For those not familiar with it, the FNHA was established through a series of agreements between the First Nations Leadership Council and the federal and provincial governments, starting in 2005. In 2013, after a long process of transition, BC’s First Nations assumed the programs, services, and responsibilities in BC formerly handled by Health Canada’s First Nations Inuit Health Branch. It thus became the first and still the only such provincial First Nations Health Authority in Canada.

The roots of the agreements that led to the creation of the FNHA lie in the recognition by all three parties of the large and unacceptable inequalities in health experienced by First Nations people in BC. Those inequalities are in part due to inequalities in the provision of health services, but are more deeply rooted in unhealthy living conditions and inadequate economic and educational opportunities. But the real roots lie in the couple of hundred years of colonialism, oppression, racism and displacement from their traditional lands since European settlers arrived in what is now BC.

The settlers also brought with them a range of infectious diseases to which Indigenous people had little or no resistance, resulting in a massive loss of life, which inevitably meant a loss of knowledge, wisdom, history, tradition and culture. The combination of loss of land, culture and self-governance experienced by BC’s First Nations, and by many other Indigenous people around the world, lies at the heart of the health inequalities that were observed.

But while there is a dark past, this column is not simply about how bad things were, and in many respects still are, but about the strength and resilience of Indigenous people and the resurgence of their communities, culture and self-governance. Which brings me to the Indigenous approach to health and wellbeing.

The FNHA’s model has five circles, starting with the human being at the centre. Human wellbeing has four facets – mental, emotional, spiritual and physical – that make up the second circle. The third circle represents the values that support wellness: Respect for First Nations culture and traditions and for other people; the ancestral wisdom found in language, traditions, culture, and medicine; the responsibility “we all have to ourselves, our families, our communities, and the land”, and the relationships we have with others that sustains us. Surrounding these, the fourth circle “depicts the people that surround us and the places from which we come: Nations, family, community, and land”, while the fifth circle includes “the social, cultural, economic and environmental determinants of our health and well-being”.

We find similar understandings of health in many other Indigenous societies. At a recent international health conference we heard from a distinguished Maori physician, educator and leader, Sir Mason Durie. In it he talked about the Maori approach to wellbeing, which includes endorsing Indigenous rights, enabling whānau (extended families) to flourish, supporting community initiatives, protecting the air, lands, rivers, oceans and forests, and restoring the balance of nature.

The protection and restoration of the land, and of responsibility for the land by Indigenous people, has perhaps gone furthest in New Zealand. At the same event I heard Tāmati Kruger, a leader of the Tūhoe, describe how the Te Urewera region – previously a national park – has been granted legal recognition as a person, protected by a Board, which he chairs. “We do not own the land,” he said, “but we belong with it, we live with it . . . that is where we have come from” And, he added, “If you detach yourself from nature, you are lost”.

These and other Indigenous approaches to health are holistic, an understanding of health that we have largely forsaken in the mistaken belief that health comes from health care and personal lifestyles and choices alone. If governments in Canada and around the world would recognise and adopt such an holistic approach we would all be a lot healthier.

© Trevor Hancock, 2019


Daunting challenges, endless opportunities

Daunting challenges, endless opportunities

Dr. Trevor Hancock

12 June 2019

701 words

A few years ago Naomi Klein wrote a book about climate change titled “This changes everything”. Her point was that climate change was a crisis of capitalism and that we would need to radically rethink our society and our economy if we are to deal with it.

But she was only discussing climate change; we face a far greater challenge because in addition to changing the climate we are also massively polluting the Earth, acidifying the oceans, depleting vital resources and causing a sixth great extinction. So if climate change alone changes everything, what does all of this mean?

The bad news is that if we don’t change everything, and quickly, it may mean massive environmental, social, cultural and economic disruption within the lifetime of many alive today, and with it traumatic change, disease, injury and death for millions.

But the good news is that avoiding these outcomes will require massive environmental, social, cultural and economic disruption within the lifetime of many alive today – yes, you did read that correctly! Let me explain what I mean.

Last week, I joined a number of my colleagues from UVic on a panel to answer questions about climate change from 150 high school students from Claremont Secondary School. At my suggestion, the session was called ‘Daunting challenges, endless opportunities’. The students’ questions, and the discussions that followed, were interesting, thoughtful and lively. It was clear they understand the situation and are looking for answers.

In my remarks, while not sugar-coating the severity of the situation – they know, they can read and follow the media – I stressed that while indeed we face daunting challenges, the fact that everything has to change also presents endless opportunities; their generation will be the one that has to re-invent almost everything.

Albert Einstein told us “We can’t solve problems by using the same kind of thinking we used when we created them”. ‘Business as usual’ is what has got us into this situation, so continuing to pursue ‘business as usual’ will not fix the problems, it will only make them worse.

So the economic, social, legal, political, technological, cultural and philosophical approaches that got us here – in short, our current form of civilisation – has to be changed, and this is good news. It is also where the endless opportunities come in. Reinventing everything is going to require massive, rapid and widespread invention and innovation across all fields of human endeavour.

Our thoughts somewhat naturally tend to look to scientific and technological innovation, hoping for technical fixes – and perhaps hoping they will save us from having to undertake the more challenging civilisational changes we need. And indeed, there are plenty of scientific and technological innovations that are needed, from clean energy to non-polluting products, healthy low-meat diets to recyclable materials, innovative ways of cleaning up the environmental mess we have created and many others.

Taking all these new technologies and creating new entrepreneurial solutions will help create the new economy we need, providing new jobs while improving human and social development and ecosystem health. But beyond this, we also need social innovators, and the philosophers, artists and social activists who can express and communicate new values in appealing ways.

We see some of those new values emerging in the idea of the ‘sharing economy’; we don’t need to own a car, a boat, a lawnmower and so on, we can share them. This idea may be expanding to the housing sector, where there is some renewed interest in various forms of co-living – be it with parents, other families or friends. There is also a renewed interest in old ways of relating to nature with reverence, respect and love, whether expressed spiritually or otherwise.

As I noted two weeks ago, we are beginning to see young leaders emerging to confront and address this situation, both globally and locally, including leading the ‘climate strikes’ and the work of creating a Green New Deal. Some of them will be leading a discussion on youth leadership and intergenerational action at the next ‘Conversation for a One Planet Region’, June 20th, 5 – 7 PM at the Central Branch of the Public Library on Broughton St., Victoria. It should be an interesting dialogue.

© Trevor Hancock, 2019


At last – a Wellbeing Budget

At last – a Wellbeing Budget

Published as ‘New Zealand leads the way by focusing on quality of life’

Dr. Trevor Hancock

5 June 2019

701 words

One of the central themes in my columns, and in my academic and professional writing and presentations, is that as a society we have got our priorities wrong. We have focused on economic growth and increase in material wealth rather than on increased human and social development and the quality of life. So it is heartening to see that at least one government is making the shift to these broader objectives.

Don’t get too excited – it’s not happening here in Canada, more’s the pity. But in New Zealand, they have a different outlook. On May 30th the New Zealand Government delivered what is surely the world’s first Wellbeing Budget. But what exactly is a Wellbeing Budget and what makes it different?

In her Budget message Prime Minister Jacinda Ardern commented “while economic growth is important – and something we will continue to pursue – it alone does not guarantee improvements to our living standards”. She went on to note “Nor does it measure the quality of economic activity or take into account who benefits and who is left out or left behind”.

So here we have a government that understands that not all growth is good, and even more important, that the purpose of the economy is not simply to grow, but to improve our living standards, without leaving people out or leaving them behind.

According to Grant Robertson, the Minister of Finance, the approach the government is taking “signals a new approach to how government works, by placing the wellbeing of New Zealanders at the heart of what we do”. Instead of focusing on “a limited set of economic data”, with success defined by “a narrow range of indicators, like GDP growth”, this new approach measures success in line with New Zealanders’ values – “fairness, the protection of the environment, the strength of our communities”.

To do so, the government has built on 30 years of work in New Zealand and internationally to create a Living Standards Framework that considers “the intergenerational wellbeing impacts of policies and proposals”. Importantly, it recognizes four forms of capital – natural, human, social and the combination of financial and physical capital.

These are then linked to twelve domains of wellbeing that include civic engagement, cultural identity, safety and security and subjective wellbeing. These are similar to the domains in the Canadian Index of Wellbeing, which was initiated by the Atkinson Foundation in 1999 and has been housed at the University of Waterloo since 2010. But to my knowledge, regrettably, no federal or provincial government has yet adopted it.

The Wellbeing Budget “focuses on five priority areas where evidence tells us there are the greatest opportunities to make real differences to the lives of New Zealanders”: Support mental wellbeing, especially for those under 24; improve child wellbeing and reduce child poverty; increase incomes, skills and opportunities for Maori and Pacific Islanders; support a thriving digital age economy, and create opportunities for organisations and communities to transition to a sustainable and low-emissions economy.

Just as interesting as the Budget is the process used to create it. Rather than the usual silo’ed approach, where each Ministry just considers its own issues and concerns, “Ministers had to show how their bids would achieve the wellbeing priorities”. Cabinet Committees then worked to create collaborative approaches across Ministries, supporting collective approaches to the Wellbeing priorities.

New Zealand is very similar in many ways to BC – nearly 5 million people, a resource-rich country with a long coast line, a significant and increasingly assertive Indigenous population and a British colonial history. But it also has a history of democratic innovation; in 1867 it created four Parliamentary seats for Maori and in 1893 it became the first country in the world to give women – including Maori women – the right to vote in Parliamentary elections.

It is also noteworthy that New Zealand has had proportional representation since 1996, which resulted in no party having a clear majority in the 2017 election; as a result, the government that introduced the Wellbeing Budget is a Coalition led by the Labour party. Clearly Coalition governments can take bold initiatives.

If they can do it in New Zealand, there is no reason why we cannot have a Wellbeing Budget in BC.

© Trevor Hancock, 2019

This is what hope looks like

This is what hope looks like

(Published as ‘Green New Deal a pact for the future’)

Dr. Trevor Hancock

28 May 2019

702 words

A remarkable event happened in Victoria ten days ago. At short notice some 300 people crowded into the gym of the Fernwood Community Centre to discuss the Green New Deal (which I wrote about in my 30 December 2018 column). They came from all walks of life: Indigenous leaders, farmers from Sooke, social justice activists, high school student leaders of the climate strikes, local clean energy pioneers, retired government lawyers, urban development experts, union leaders, local politicians and many others.

Inspired by the Green New Deal proposal in the USA and Le Pacte in Quebec, the Pact for a Green New Deal for Canada “rests on two fundamental principles: 1. It must meet the demands of Indigenous knowledge and science and cut Canada’s [carbon dioxide] emissions in half in 11 years while protecting cultural and biological diversity, and 2. It must leave no one behind and build a better present and future for all of us” (see

Nationally, as of 5th May 2019, the Pact is endorsed by some 70 organizations from different sectors across the country – with at least 9 in BC, including the Union of BC Indian Chiefs – and many individuals, a high proportion of whom, interestingly, are leading musicians and actors.

The Victoria event was put together by a group of remarkable young leaders, mostly in their twenties, and it filled me with hope in these challenging times. The local sponsoring organisations included Rise and Resist, the Social Environmental Alliance, Canadian Union of Postal Workers 850, First Metropolitan United Church, Rethinking Economics Victoria and the Women’s March – Victoria Chapter.

Even more remarkable, this is one of some 200 public meetings taking place across Canada between late May and late June, all put together in just a couple of months. In this region alone there are townhalls planned or already taken place in Brentwood Bay, Surrey, Coquitlam, Nanaimo, Burnaby, Vancouver, New Westminster and Ganges.

The Green New Deal addresses both the need for what, many years ago, I called ecological sanity and also the need for social justice. Thus the Pact notes: “Many of us are struggling to find an affordable place to live, or a decent job to support our families. Hate crimes and racism are on the rise. And promises to Indigenous peoples have yet to be implemented.” And it goes on to say “We need an ambitious plan to deal with multiple crises at the same time.”

This is one of the keys to understanding our present situation; we must recognise both that these ecological and social crises are happening simultaneously and that they are interlinked. We have lost our sense of connection to nature, rooted in Indigenous and long-neglected European and other systems of knowledge and belief. As a result we treat the Earth as separate from us, something to be exploited to meet people’s needs and make them rich, regardless of the consequences.

But as William Leiss noted in his 1972 book The Domination of Nature: “If the idea of domination of nature has any meaning at all, it is that by such means . . . some men attempt to dominate and control other men (sic)”. The underlying values of acquisitiveness, enrichment, greed and domination that lead to ecological insanity also lead to social injustice. We cannot solve one without solving the other. This is what the Green New Deal recognises and seeks to address.

It is hard to tell where this will go, it’s all very new – although there are some clear parallels to the Green Party’s approach. The Party’s recent successes in the Nanaimo by-election, in PEI – where the Greens form the Official Opposition, and – last week – in the European elections, suggest the mainstream parties should be concerned. People – especially young people – do not believe these mainstream parties either understand the problems nor have the solutions. This is clear when one considers the ongoing support for further expanding fossil fuel exploitation from the federal Liberals and Conservatives, the NDP in BC and Conservative governments in many provinces.

So stay tuned. The next local meeting of the Green New Deal will be Wednesday June 19, 6.30 PM, at the First Metropolitan United Church, 932 Balmoral Road in Victoria.

© Trevor Hancock, 2019