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View of Beyond the Social Determinants of Health


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Beyond the Social Determinants of Health: Indigenous Women and Land- Based Wellbeing.

L. Hall, U. Pine, T. Shute DRHJ/RDRS 2020, 3, pp.1-11

Laura Hall, BAHon, MA, PhD

Assistant Professor, ljhall@laurentian.ca

School of Indigenous Relations - Laurentian University.

Urpi Pine, BAHon, M.Ed Culture based Therapist,

Land-based educator, artist and theatre performer, urpipine@gmail.com Indigenous community member.

Tanya Shute, Spec.HBA., MSW, PhD Assistant Professor, tg_shute@laurentian.ca School of Social work - Laurentian University.


This paper will reflect on key findings from a Summer 2017 initiative entitled The Role of Culture and Land-Based Healing in Addressing and Ending Violence against Indigenous Women and Two-Spirited People. The Indigenist and decolonizing methodological approach of this work ensured that all research was grounded in experiential and reciprocal ways of learning.

Two major findings guide the next phase of this research, complicating the premise that traditional economic activities are healing for Indigenous women and Two-Spirit people. First, the complexities of the mainstream labour force were raised numerous times. Traditional economies are pressured in ongoing ways through exploitative labour practices. Secondly, participants emphasized the importance of attending to the responsibility of nurturing, enriching, and sustaining the wellbeing of soil, water, and original seeds in the process of creating renewal gardens as a healing endeavour. In other words, we have an active role to play in healing the environment and not merely using the environment to heal ourselves. Gardening as research and embodied knowledge was stressed by extreme weather changes including hail in June, 2018, which meant that participants spent as much time talking about the healing of the earth and her systems as the healing of Indigenous women in a context of ongoing colonialism.

Keywords: Indigenous women, Wellbeing, Social Determinants of Health, Gender, Settler Colonialism.




Cet article porte sur les principales conclusions d'une initiative de l'été 2017 intitulée « Le rôle de la culture et de la guérison basée sur la terre pour lutter et mettre fin à la violence faite aux femmes autochtones et aux personnes bi-spirituelles ». L’approche méthodologique indigéniste et décolonisante de ce travail a permis d’assurer que toutes les recherches reposent sur des méthodes d’apprentissage expérientielles et réciproques. Deux conclusions principales guident la prochaine phase de cette recherche, ce qui complique le postulat selon lequel les activités économiques traditionnelles sont bénéfiques pour les femmes autochtones et les personnes bispirituelles. Premièrement, les complexités de la main-d'œuvre traditionnelle ont été soulevées à plusieurs reprises. Les économies traditionnelles subissent des pressions permanentes en raison de pratiques de travail abusives. Deuxièmement, les participants ont souligné l’importance de s’occuper de la responsabilité de nourrir, d’enrichir et de maintenir le bien-être du sol, de l’eau, des semences originales dans le processus de création de jardins de renouvellement en tant qu’effort de guérison. En d'autres termes, nous avons un rôle actif à jouer dans la guérison de l'environnement et non pas simplement en utilisant l'environnement pour nous soigner nous-mêmes. Le jardinage en tant que recherche et connaissance incarnée a été mis en évidence par les changements climatiques extrêmes, notamment la grêle en juin 2018, ce qui signifie que les participantes ont passé autant de temps à parler de la guérison de la terre et de ses systèmes que la guérison des femmes autochtones dans un contexte de colonialisme en cours.

Mots clés : Femmes autochtones, bien-être, déterminants sociaux de la santé, genre, colonialisme des colonisateurs.


This research initiative, involving researchers and community members associated with the 7 Directions Learning Centre, now known as the Painted Corn Collective (or PCC for the remainder of this paper), took place in the Summer of 2017 and focused on gardening as a way of addressing and resisting violence against Indigenous women and Two-Spirit people. While this research initiative started with an approach toward ending violence against Indigenous women and Two-Spirit people, we did not, in fact, engage with discussions about colonial violence as a central focus. Our work is part of a wave of Indigenous scholarship that deepens social determinants of health frameworks by moving beyond the context of trauma and resulting health effects toward utilizing Indigenous Knowledge and practices for healing and recovery. We argue two points: first, that Indigenous health and healing requires an approach that moves beyond the social determinants of health toward an understanding rooted in Indigenous Knowledge for which ‘social’ determinants are inclusive of environment (or Creation) and culturally rooted analysis of wellbeing. Second, ending violence against Indigenous women is essential to improving health for all Indigenous people, and that this conversation is one in need of expansion beyond the bounds of nation-state and settler colonial containment.

The renewal and return of Indigenous women and Two-Spirit people to land and culture is an ongoing push-back against the structures of settler colonialism that maintain Euro-Canadian



dominance over land. Violence upholds that dominance (Wolf, 2006), leading to the health effects that stem from trauma. Trauma-rooted illnesses are understood in Indigenous Knowledge systems to be rooted in stress and grief, combining mental, physical, emotional and spiritual health with intergenerational and life-long effects of ongoing colonization (Cook, 2015). Gender based violence has remained essential to the project of colonization as a direct assault on the power and responsibilities of Indigenous women and Two-Spirit people.

The interconnection of human health with all of Creation is well understood in Indigenous scholarship. While environmental colonialism and toxification impacts Indigenous bodies in innumerable ways, an Indigenous response among participants in our research would say, in turn, that it is our responsibility to heal with the environment—to change as the world changes, and to create a good pathway for future generations. The understanding that our lives and our wellbeing is intertwined with environmental wellbeing is embedded in Indigenous Knowledge systems and ways of life. Deloria Jr. (2001) writes that there is a,

…realization that the world, and all its possible experiences, constituted a social reality, a fabric of life in which everything had the possibility of intimate knowing relationships because, ultimately, everything was related…The Indian world can be said to consist of two basic experiential dimensions that, taken together, provided a sufficient means of making sense of the world. These two concepts were place and power, the latter perhaps better defined as spiritual power or life force. (p. 2)

Land itself is complex and embodied in human being (physically, mentally, emotionally and spiritually) while reflecting all elements of Creation in reciprocity and relationality. Mohawk midwife and scholar Katsi Cook (2015) speaks to these interconnections, linking health and environment as well as intergenerational trauma—written on our cells as Indigenous people—

speaking thus to the vital importance of ceremonial and cultural healing. The air we breathe is part of land-based return, as is the water we drink and the fat upon our bodies.


In this project, we explored the concept of Indigenous research as practice and as cultural renewal. Research methods and methodological choices in this project flowed from cultural protocols and an Indigenist framing of knowledge and evidence. An Indigenist or decolonizing research methodology sees cultural responsibility as central to the work itself. Nerida Blair (2015) writes “Indigenous voices are centring themselves in the research process and in the stories told as a result of more than two centuries of research that has defined, categorised, and castigated us as peoples (p.463).” Though Blair writes from an Indigenous context in Australia, the same might be said in Canada, where Indigenous Peoples are reclaiming the tools of research, leading in research endeavors, and reclaiming health research that has too often been dominated by pathologizing discourses. Evidence and ‘what counts’ as knowledge, is understood in our presentation of findings from a perspective that fully validates Indigenous Knowledge systems.



Evidence is in experience and therefore experience was a necessary part of better understanding the links between cultural activities such as gardening—with Indigenous seeds and methods—or maple tapping, two specializations of the PCC and the overall wellbeing and healing of Indigenous women and Two-Spirit people. Gardening with Indigenous methods included lighting fires of thanksgiving, putting down tobacco to ask permission before beginning, using Indigenous seeds (old seeds, prior to the genetic alteration of similar seeds of corn, beans, and squash) and other ceremonies and practices. Talking circles were informal;

taking place in the evenings after the work was completed, or in the mornings as dreams and breakfast was shared. An Indigenous worldview was understood throughout as framing and grounding our inherent responsibilities.

Anishinaabe elder Jim Dumont (2005) speaks to the elements of an Indigenous worldview through a concept he calls Indigenous intelligence, which is about the “legacy of our ancestors and of what our ancestors are waiting for us to do. Our thoughts also include the future generations. It is a living past, a living future, and we are the living connection in between” (p.

2). This approach to research as practice means that there is a temporal element of Indigenous culture that can be understood through gender-based teachings about life-making, fluidity of existence, freedom of choice, and responsibilities to enact peace—stretching back simultaneously into forever and into the present and future, resistant to Eurocentric notions of colonialism’s permanent presence. This is an approach that Indigenous women and Two-Spirit communities know well and embody through daily renewals, resistances, and re-stor(y)ing Creation (Author, 2017. Participants were keen on taking part in a research initiative that honored their perspectives and their experiences as Indigenous women and Two-Spirit/LGBTQ people. Settler colonialism has created particular kinds of struggles for women and Two- Spirit/LGBTQ Indigenous folks, as gender-based oppression has remained central to the suppression of land rights and wellbeing.

The temporal and spatial responsibilities of Indigenous women are deliberately undermined by ongoing colonial occupation, ownership, and control of Indigenous lands.

Land—understood as interconnected Creation, with all of life interrelated to human beings who are the youngest of Creation—is indeed central to the renewal of wellbeing for Indigenous women and Two-Spirit/LGBTQ Indigenous folks. The labour of birthing is a crucial entry-point into understanding and supporting Indigenous knowledge and ways of life, not specifically always of human-birthing creative work, but also of all creative responsibilities for new life- giving, seeding, and visioning. Ending violence against Indigenous women requires a whole understanding of the ways that the state enacts violence through deliberate ecological interruptions and eradications, through normalizing bodies that have not been shaped by trauma and resilience. Ending violence against Indigenous women and youth means unpacking the ways that the colonial system has targeted Indigenous people differently according to gender, class, ability, age and so on. Violence against Indigenous women is as central to the colonial project as violence against the land, waters, and complex relational ecologies remains.



Canada’s Residential School system has exposed Indigenous people to the intergenerational and ongoing effects of living in a system that wants to exterminate our existence, our family structures, our cultures, and ways of life. Participants in the Summer 2017 garden project spoke to healing and wellbeing as daily enactment, through healthy parenting and other expansions on the concept of nurturing.

The idea of Indigenous mothering signals an Indigenous understanding of mutual care and reciprocity in all parts of life. Parenting very broadly, inclusive of uncles, aunties, grandparents, siblings, cousins and parents as well as Elders and Knowledge Keepers, is about bringing healing back to the whole family of Creation, including the very soil we depend upon to grow our foods. Indeed, a central finding in this research was that in order to create wellbeing for the people, the wellbeing of the earth has to be tended to. This includes the work of feeding microbes in the soil, of praying for the water, and of creating a peaceful environment for children who were part of the garden project.


Participants spoke often about two major themes. The first—reciprocity—embeds the work of gardening as research, renewal, and ending violence, in ongoing responsibilities and interconnections with the land. The second theme—honouring Indigenous women’s economic renewal and empowerment—remains central to undoing the legacy of colonial dispossession.


Our work is contextualized by the ongoing guidance of Indigenous scholars, writers, and teachers who continue to weave decolonizing discourses on health and wellbeing with environmental and land-based learning. Themes that emerged in this work included Culture as economic renewal, environmental health and human health, and Indigenous mothering as deeply informing fields of health research and gender-based analysis. Culture is also encompassing of original, land-based Indigenous economies. For Indigenous families, the destruction of local economies and the deliberate underdevelopment of their traditional economies is a basis for the colonial project. A major finding of this research has been that healing and wellbeing cannot be constructed as solely a human-centered activity. The waters need healing. The weather is changing. Indigenous scholar Vine Deloria Jr.’s (2003) words on the future of human belonging, is a warning that environmental restoration has to be a part of all that we do as Indigenous health, social service and community advocates. In his words “ It is becoming increasingly apparent that we shall not have the benefits of this world for much longer. The imminent and expected destruction of the life cycle of world ecology can be prevented by a radical shift in outlook from our present native conception of this world as a testing ground of abstract morality to a more mature view of the universe as a compressive matrix of life forms.” (p. 283).

As part of that notion of reciprocity, participants told stories—and spoke to the importance of stories as creating and Creation—and reflected on teachings throughout the process. The theme of returning to our understandings of Indigenous Creation stories as a verb-



based responsibility—as a project of storytelling toward renewal—was a key finding in this research. Indigenous women’s value in our families can be seen as rooted in Creation/ing responsibilities, inclusive of birth (the birthing of humans) and nurturance in broader ways—of gardens, of community, of extended family. The boundaries of state colonialism and enforced dispossession of Indigenous lands are at the roots of genocide (attempted) in Canada. These roots are obscured by calls for better health, lessened poverty, and environmentally sustainable development as sanitizing movements that rarely—unless they are articulated by Indigenous people for Indigenous people—touch upon the roots of ongoing colonization.

Quill Christie-Peters (2018) writes eloquently about how Indigenous women and Two- Spirit folks embody resistance and love for community inclusive of all of Creation. Creation’ing, as a verb-based practice of renewal, is central to undoing or moving around systems that seek to undermine Indigenous women and Two-Spirit belonging. This understanding of belonging has been under attack as,

…since contact, the settler state has recognized how Indigenous women, Two-spirit, queer, trans, and non-binary relatives are the ones that so beautifully weave our bodies within our homelands, seamlessly connecting our communities to all of creation. The state has watched these people—the ways they tended to the waters, articulated power, and upheld our communities—and has responded by explicitly targeting these community members….Many of our bodies have been, and continue to be, taken from this earth through colonial violence. Many of our bodies have been, and continue to be, found in our waterways. (par. 12)

Indigenous women’s and Two-Spirit Creation’ing understandings of renewal and wellbeing, are similarly marginalized in state-centric approaches to understanding environmental or more- than-human relationships. Literatures on the environment as central to human wellbeing do not always deal well enough with the ways that settler-colonialism has cut off Indigenous people from a healthy and abundant land base. Environmental belonging has been siphoned off from Indigenous nationhood by Eurocentric writers (author, 2017), and has created a gap in understanding around land-based and environmental learning.

This gap in environmental theorizing was reflected upon throughout our Summer, 2018 research, as participants expressed frustration with Euro-Western scientific supremacy in any and all conversations about addressing environmental relationships. For Indigenous women and Two-Spirit participants in traditional Indigenous economies and environmental restoration projects, storytelling arose as a method of healing for both human and environmental bodies, as the enactment of Indigenous stories creates real-world shifts. Indigenous writers like Waaseyaasin Christine Sy, present us with an in-depth and growing understanding of the interconnections between storytelling, human and environmental interweavings. Indigenous literatures and storytelling traditions have been and continue to be many things for Indigenous peoples and Nations, but have recently become a method to document, name, and transform colonial reality, as well as provide a persistent means to re-generate Indigenous reality and Indigenous life (Sy, 2014, par. 3).



Participants in this research spoke to the interconnections between violence against women and Two-Spirit bodies frequently throughout our research interactions. This theme also arises in the works of many Indigenous Peoples, as Martin Lukacs (2016) reminds us,

Indigenous rights stand in the way of pipelines, mega-dams like Site C, giant fracked gas terminals—and $650bn in resource projects over the next ten years that the Liberals are trumpeting as much as the Conservatives did. Never mind that recent Supreme Court decisions, and the Royal Commission on Aboriginal Peoples before them, call for shared sovereignty or management over these lands. Or that many more Canadians are realizing that Indigenous stewardship of large swathes of territory—instead of its mismanagement by multi-national corporations—would be to the benefit of everyone...Trudeau may indeed want to do right by Indigenous peoples, but the government is locked into a logic of its own: quietly maintaining exclusive control over Indigenous peoples’ lands and resources. (par. 7)

Gendered analyses are vital to renewal in Indigenous thought and practice as colonial thinking sought so consistently to overturn or subsume Indigenous women’s governance and economic power (Hall, 2016) and the gendered fluidity and sexual freedoms of Indigenous societies. Heterosexist and patriarchal Eurocentric thought is a building block of the imperial and colonial systems. The heterosexual, patriarchal family is a reflection of this ideological building block in large part because this is also the family model that must consume and produce in privatized settler colonial parcels of land, maintaining colonial dominance. According to Rifkin (2011) “compulsory heterosexuality can be conceptualized as an ensemble of imperatives that includes family formation, homemaking, private property holding, and the allocation of citizenship, a series of potential ‘detachable parts’ fused to each other through discourses of sexuality” (p. 37). Roots of colonial violence are intertwined thoroughly with gender-based and heterosexist discourses. Participant provided examples of these poisoned roots, speaking to the ways that Canada’s education and child-welfare systems have pressured non-violent extended- family wellbeing through the mass removal of Indigenous children who are in turn vulnerable to sexual abuse and other forms of state violence. Participants also spoke to the ways that Indigenous family structures are pressured to conform to the kinds of heterosexism that characterize settler-colonial society.

Economic Renewal

Indigenous women and Two-Spirit participants spoke to the need for economic empowerment as part of overall wellbeing. This research raised important issues that are seemingly new but also generations old and rooted in colonialism. Forms of surveillance in the lives of Indigenous women, including surveillance in the workplace, came up more than once as an issue. Examples of stressful work environments included non-unionized workplaces (where unionizing is verbally discouraged), toxic behaviors from management in the workplace.

Surveillance and safety: endangering Indigenous women with incarceration, impoverishment, and the reinforcement of the land and culture loss that underlies these systems. Indigenous women’s scholarship, resistance and renewal—the voices and voicing of our mothers and aunties



and grandmothers, our nieces and daughters—speak clearly to the ways that state, corporate, and settler colonialism have undermined our wellbeing through environmental contamination and medicalized practices such as sterilization (Stote, 2012).

Participants in the garden project spoke to the idea that some amount of economic underdevelopment is tied to the processes of Indigenous birthing in modern colonial Canada as mothers are forced to leave communities to give birth. Participants discussed the ways that personal lifestyle concerns (ie. smoking, alcohol consumption), tied to historic and ongoing colonization, are listed as factors in poor health outcomes for Indigenous people. Lifestyle choices are not necessarily a good starting point for understanding the challenges that the ongoing system of colonialism in Canada has presented for Indigenous mothers—and mothering as a paradigm.

These findings weave well together with the literature of Indigenous Knowledge Keepers.

The centrality of gendered violence to mainstream or colonial economic development is understood by scholars like Winona LaDuke (2017) as interconnecting human and environmental impact. Recent oil spills after the colonially enforced Keystone Pipeline development project moved ahead speak to “Wiindigoo Economics—Cannibal or Wasichu economics...an economic system that destroys the source of its wealth, Mother Earth” (LaDuke, par. 4). Just as Indigenous thinkers identify the gendered nature of colonial oppression, so too does resistance become rooted in the renewal of knowledge about the sacred feminine in Creation.

Overall, participants in this initiative wanted to challenge the ways that ‘traditional’

economies are frozen in the past. Cultural practices such as maple-tapping (undertaken in the Spring of 2018), gardening heirloom/Indigenous seeds, gathering natural medicines from the forest, and processing and storing seeds and foods, are all part of the PCC’s yearly workshops and land-based learning activities. When non-Indigenous or dominant society undertakes these activities, it becomes seen as ‘productive’, as ‘innovative’, as permaculture and sustainability studies—rewarded and privileged according to settler colonial narratives. For Indigenous women, youth, and Two-Spirit participants in land-based learning, it was important to remember that these innovations and original seeds are rooted in ancestral wisdom and in the wisdom of the land. Understanding these things maintains and encourages mental and emotional wellbeing as Indigenous women, youth, and Two-Spirit participants lead and innovate. The prevailing notion that Indigenous economies were simply doomed to failure underscores a reluctance to actively engage with Indigenous economic renewal and wellbeing. The Royal Commission on Aboriginal Peoples final report (1994) contains important information about these underdevelopment strategies, for example in research about Indigenous men in Saguenay where,

…development centred on a few primary resources generates harmful effects on development of the regional economy which fails to achieve diversification, and this has consequences on the local ability to retain population. While the economic system defends its prerogatives in the name of profit, the political system in turn justifies its action with national objectives which themselves are based on a liberal development



philosophy. Yet national projects form part of a perspective that is not always interested in regional self-affirmation. (Girard et al. p. 5)

The heteropatriarchal limit of thinking around family bonds and bodily autonomy, intertwines with violence against land defined in terms of development and extraction rather than relationship and responsibility. Waaseyaa’sin Christine Sy (2017) speaks to Indigenous feminism and a need to go deeper, to transform “the gendered ways settler colonial structural, ideological, and social power impact Indigenous peoples; and, in practicing/restoring/regenerating Anishinaabe life-ways through Anishinaabe philosophies” (par. 4). Toxification and environmental degradation have had particular impacts—perhaps deliberately so—on the bodies of Indigenous women and children. As Sarah Hunt (2016) points out, the impacts of this boundaried development also needs to be understood from the vantage points of Two-Spirit people who may be exiled from their Nations and families, who may experience homelessness and landlessness, and who also have responsibilities that need to be woven back in with community in order to address changes to the land and waters.

Finally, the topic of mothering arose in this project as a weaving of the work that we do to ensure safety and care for children with care for Creation. As young Indigenous participants in a research initiative, with small children participating in every moment that we do our work, we often spoke of renewing healthy parenting and creating safety and wellbeing for young people.

Interconnecting environmental wellbeing and mothering has meant looking at small and large ways that Indigenous bodies are affected by environmental colonialism. For example, Mohawk midwife Katsi Cook’s activism and research on the subject of contaminants in the breastmilk of Mohawk women affected by General Motors chemical dumping in local waterways, led to the creation of the Akwesasne Mother’s Milk Project in the mid-1980s (LaDuke, 1999). Indigenous women’s scholarship, in Cook and LaDuke’s works—reflected upon throughout this research project—connects deep understandings of Creation and Creating, wellbeing and culture, while mainstream health research has remained focused on essentializing aspects of those broad relationships. Rather than focus on the context of an issue from within an Indigenous worldview, and rather than focus on the inherent knowledge of societies who have always practiced effective birthing and parenting, health research in this area tends to focus on deficits while rooting those deficits in poor personal choices (McGuire-Adams, 2018). It is impossible to write about Indigenous women’s breastfeeding patterns without first speaking to environmental toxicity and the deliberateness of colonial interruptions of Indigenous ways of life. However, what is even more important to the work of Katsi Cook among many others, is that the knowledge of breastfeeding and its interconnections with a whole system of healthy, attached, and ecologically embedded community parenting, is knowledge inherent to Indigenous cultures and knowledge that is needed. Breastfeeding is but one example of the ways that Indigenous women weave Creation.




Creating spaces of safety and cultural renewal for Indigenous women and Two-Spirit people who are affected by gender-based violence as well as colonial violence contributes to overall wellbeing and to furthering our understandings of what challenges face Indigenous communities. Ending violence against Indigenous women should be a priority for all who are concerned with health equity and healing and wellness. This re-centering would speak to the profoundly gendered nature of the colonial system—a system that harms land, water, and human health alike. This re-centering of Indigenous women’s voices also speaks to the ways that Indigenous community-based solutions unfold through cultural and kinship healing. In Canada, an interest in wellbeing related to ending violence against Indigenous women and Two-Spirit people led to a national Inquiry into Missing and Murdered Indigenous Women and Girls (MMIWG). Activists and allies all worked hard to make the Inquiry into MMIWG a reality, and as findings are set to be published this coming year, it is vital that we continue to delve into the ways that communities themselves see new challenges and new possibilities moving forward.

The origins and ongoing nature of this movement is inclusive and reflective of an ongoing movement to protect and care for the land and waters. This movement originally and continually, de-centers the state, re-centers Indigenous governance and worldview, and works to recenter the culturally based and diverse family structures (families including sex worker families and street involved families, Two-Spirit/Queer/Trans families and other forms of chosen family) of Indigenous women, girls, and Two-Spirit people. The missing pieces, when the nation-state’s Inquiry unfolds, are the very elements that save Indigenous lives. Those elements are culture, a land base, and healthy relationships.


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