Oct. 26, 2020

Medical school’s Indigenous Health Dialogue defines directions to move Indigenous health forward

Report serves as a stimulus and resource for the Cumming School of Medicine to take action
An  illustration of a group of tipis

When it comes to advancing health equity with Indigenous people and their communities, the Cumming School of Medicine (CSM) aims to be a leader through excellence in health research and education. The medical school is releasing a report with a series of recommendations and actions to move that vision forward.

The report, written by Drs. Lynden Crowshoe, MD, Rita Henderson, PhD, and Cheryl Barnabe, MD, describes the process and outcomes of the Indigenous Health Dialogue (IHD) that focused on enhancing existing Indigenous health initiatives and creating new opportunities within the CSM which align with the University of Calgary’s Indigenous Strategy, ii’ taa’poh’to’p .

Over four years the IHD engaged with community, students, faculty and leadership to define direction for the CSM grounded in responding to the Truth and Reconciliation Commission of Canada’s (TRC) Health Legacy Calls to Action.

While many good things are being done to facilitate positive Indigenous health outcomes within the CSM, the authors noted gaps and disconnected efforts among the school’s various units, some two dozen clinical and research departments, institutes and offices.

“We envisioned there needed to be a process to bring people together to identify what the strengths are, what the gaps are, and to find strategic ways to move Indigenous health forward,” says Crowshoe.

That vision, facilitated by the CSM’s Indigenous, Local and Global Health Office, materialized into the Indigenous Health Dialogue report. The report and a presentation that provides an in-depth overview of the process and recommendations, are available here.

Understanding the Calls to Action for the CSM

The authors knew it was critical to engage with the seven Health Legacy Calls to Action (#18-24 of 94) because they reflect the voices of Indigenous people. The IHD is an effort to frame the calls in the CSM context.

“We needed to have a first step of understanding what the calls to action were saying for us as a medical school,” says Crowshoe.

Through a series of 25 events, more than 500 individuals from within the CSM and Indigenous communities gathered to identify key directions. Using Indigenous methodologies, including engaging with and listening to members of the community, disseminating information equally and working to improve the situation if deemed appropriate while respecting Indigenous ways of knowing, the group looked at each of the seven calls to action to understand what they meant for leadership, education and research within the CSM.

Critical Reflective Framework

The group identified five themes, and several truths and actions to move Indigenous health forward within the CSM. Together they became the Critical Reflective Framework. It was important for the group to identify the truths, because as Henderson stresses, there cannot be reconciliation without sharing of truth.

Because the authors are not involved in each institute, office and department within UCalgary, the purpose of the framework is to enable individuals to apply the recommendations to their workplace while being guided by a common vision.

“The action themes are to target key investment to develop a group of people to work together to advance this agenda,” says Henderson.

Recommendations for a path forward

The report includes five recommendations for a path forward.

“These recommendations are interconnected. They’re not about one person doing all these things. This is about many people sharing the load with specific responsibilities to be able to achieve these recommendations,” says Crowshoe.

“The CSM has a responsibility to promote a health professional workforce and a future of health that is equitable for all,” says Henderson.

When asked what the next steps for the CSM are, Crowshoe says, “I would ask each department, institute and office within our institution to formally explore the report and begin to define how they may act on any or all of the five directions. I suggest that there are opportunities for collaboration across units. Also, we are positioning the Indigenous, Local and Global Health Office to be a central resource that will broadly support our institution.”

“I’d like to thank Drs. Crowshoe, Barnabe and Henderson for their leadership and the hundreds of others who participated in the development of the Indigenous Health Dialogue,” says CSM Dean, Dr. Jon Meddings. “The recommendations represent an important opportunity for the CSM to move the calls to action in the Truth and Reconciliation report forward, to reduce barriers for Indigenous learners and those seeking health care. I look forward to seeing meaningful progress on the recommendations throughout our programs in the years to come.”

For institutes, offices and departments wishing to apply these recommendations to advance Indigenous health within their area, the Indigenous, Local & Global Health Office is available to support the process. Questions can be emailed to abhealth@ucalgary.ca.

Lynden (Lindsay) Crowshoe, co-chair of the Indigenous Health Dialogue, and Indigenous Health program director, is a member of the Piikani Nation, Treaty 7 Region of Alberta. He is an associate professor in the Department of Family Medicine, and member of the O’Brien Institute for Public Health at the CSM.

Rita Henderson, co-chair of the Indigenous Health Dialogue, is a models of care scientist and assistant professor in the departments of Family Medicine and Community Health Sciences, and a member of the Hotchkiss Brain Institute, and the O’Brien Institute for Public Health at the CSM.

Cheryl Barnabe is a Métis rheumatologist whose health services research program is focused on identifying and resolving health system care gaps for Indigenous patients. She is the vice-chair of Indigenous health, Department of Medicine, and an associate professor in the departments of Medicine and Community Health Sciences at the CSM. She is the Nominated PI of the Alberta Indigenous Mentorship in Health Innovation (AIM-HI) Network, funded by the CIHR Indigenous Mentorship Network Program. She is a member of the McCaig Institute for Bone and Joint Health, and the O’Brien Institute for Public Health, and at the CSM.

ii’ taa’poh’to’p, the University of Calgary’s Indigenous Strategy, is a commitment to deep evolutionary transformation by reimagining ways of knowing, doing, connecting, and being. Walking parallel paths together, ‘in a good way,’ UCalgary is moving toward genuine reconciliation and Indigenization.