These determinants, among others, include peace, income, shelter, education, food, a stable ecosystem, sustainable resources, and social justice and equity 3. Essentially, a social determinant of health lens considers both the causes of the causes of disparities 5 and the causes that underlie the causes of the causes 6.
Such a framework is imperative to understanding the enduring health inequities between Indigenous and non-Indigenous peoples. In Canada, Aboriginal children experience higher rates of infant mortality 8 , tuberculosis 9 , injuries and deaths 10 , youth suicide 11 , middle ear infections 12 — 14 , childhood obesity and diabetes 15 , dental caries 16 and increased exposure to environmental contaminants including tobacco smoke 12 , 14 , Immunization rates for Aboriginal children are lower than those of non-Aboriginal children 18 , 19 , as are rates of accessing a doctor These health inequities can only be understood and intervened upon if understood as holistic challenges.
Such an understanding requires moving beyond the physical realm, or the absence of disease, to include the social, spiritual and emotional realms. Aboriginal children are born into a colonial legacy that results in low socioeconomic status 21 , high rates of substance abuse 22 and increased incidents of interaction with the criminal justice system These are linked with intergenerational trauma associated with residential schooling 24 and the extensive loss of language and culture The basis of adult health and health inequity begin in early childhood First, there are proximal determinants of health.
These have a direct impact on the physical, emotional, mental and or spiritual health of an individual, and include employment, income and education. Second are intermediate determinants, the origin of proximal determinants, inclusive of community infrastructure, cultural continuity and health care systems. Third are the distal determinants, which include colonialism, racism, social exclusion and self-determination; these comprise the context in which intermediate and proximal determinants are constructed and are the most difficult to change. However, if transformed, distal determinants may yield the greatest health impacts and, thus, long-term change to Aboriginal child health inequities Figure 1.
Adapted from reference Colonial legislation and policies continue to influence the health of Aboriginal children and their families, explicit, for instance, in Indian reserves that have unique jurisdictional complexities that result in disparities of service access and ongoing dislocation of people from traditional lands, fishing and hunting sites, and water rights.
The reserve system precipitated great and sudden changes in lifestyle and patterns of settlement The Indian Act also governed the Indian Residential Schools, institutions that operated for more than years, with the last school in Canada closing in This experience resulted in collective trauma, consisting of… the structural effects of disrupting families and communities; the loss of parenting skills as a result of institutionalization; patterns of emotional response resulting from the absence of warmth and intimacy in childhood; the carryover of physical and sexual abuse; the loss of Indigenous knowledges, languages, and traditions; and the systematic devaluing of Indigenous identity Child welfare systems continue to intervene in the lives of Aboriginal families in Canada at a rate greater than any other population in the country 33 , and currently more Aboriginal children live as governmental wards than were ever in residential schools.
Social determinants of health and the future well-being of Aboriginal children in Canada
Both colonization and colonialism are more than economic or material structures. Colonialism results in multiple forms of discrimination. Stemming from racism are microaggressions, which are often very subtle. Racism, along with these microaggressions, is evidence of advanced colonization 39 and has become entrenched in society. Taken together, these realities can be considered Aboriginal-specific determinants of health in that they result in a disproportionate experience with socioeconomic inequities that are rooted in a particular socio-historical context.
A sense of cultural continuity for First Nations individuals and communities, and likely for Indigenous peoples more broadly, builds resiliency and reduces negative health outcomes, particularly youth suicide For Aboriginal people, the right to identify as an Indigenous person, the right to practice Indigenous ceremonies, and the right to speak an Indigenous language, are all crucial to identity and health, both of which are also especially linked to spirituality Language and cultural revitalization are viewed as health promotion strategies If Aboriginal children are provided opportunity for growth and development that fosters and promotes cultural strengths and citizenship, health disparities resulting from the impacts of colonialism may be lessened.
Interventions and practices designed to foster and enhance the health and well-being of Aboriginal children require holistic concepts of health that move beyond biomedical realms and, instead, address and focus upon social determinants.
best Book Lists images on Pinterest | Books to Read, Book club books and Book worms
Approaches must be flexible, while also addressing historical and contemporary determinants and should include decolonizing strategies. Interventions should not target individual behavioural change or focus solely on proximal determinants of child health.
Instead, interventions should account for broader contexts and distal determinants that continue to influence the context and, thus, the health of the child. These broad contexts require collaborations across and between sectors and disciplines; medical or even health sectors alone cannot address or influence these determinants of health and must work in concert with other sectors such as education, child welfare, housing and justice, among others.
A critical starting point is to create awareness of the social and historical context in which Aboriginal peoples find themselves. This begins with the education and training of professionals that interact with Aboriginal people on a daily basis. Students in the health professions who are not trained to understand socioeconomic and historical contexts may be vulnerable to adopting common, social stereotypes about Indigenous peoples Concentrated effort is required to include the knowledge and strengths held by Aboriginal peoples into the curriculum.
Elliott and de Leeuw 44 write that:.
- Many Waters (The Stones of Song Book 2).
- Murder in Noir: A Max, Brad, and Maisie Mystery #3.
- A View from Aggieland.
- Toward Nights End!
- Steps on the Stone Path: Working with Crystals and Minerals as a Spiritual Practice.
This type of education opens opportunities for transmission of knowledge to other disciplines and even broader society. These individuals provide relational bridges of understanding between the health care system and the Aboriginal children and their families interfacing with it. While much baseline data about Indigenous peoples are needed, intervention research aimed at improving the lives of Aboriginal children is also necessary.
This type of research demands collaborative partnerships with Aboriginal communities based on respectful, equitable relationships. Recognizing multiple ways of knowing and being in the world is fundamental to effective research and effective health care practice, with and for Aboriginal peoples. Because the Angels are incorporeal beings, though they nevertheless take on human form when appearing to mankind, it can be difficult to differentiate one from another in icons.
However, Gabriel is usually portrayed with certain distinguishing characteristics. He should not be confused with the Archangel Michael, who carries a sword, shield, date-tree branch, and in the other hand a spear, white banner possibly with scarlet cross and tends to wear red. Michael's specific mission is to suppress enemies of the true Church hence the military theme , while Gabriel's is to announce mankind's salvation.
Artists like to show Gabriel carrying a lily Mary's flower , a scroll and a scepter. Encyclopedia of Angels 2nd ed. Facts on File, Inc. He is the patron saint to telecommunication workers, radio broadcasters, messengers, postal workers, clerics, diplomats, and stamp collectors. Legends of the Jews Vol I: The Religion of Islam.
Retrieved December 2, Archived from the original on April 28, The Mythology of Judaism". Archived from the original on Retrieved 15 June Pentecost is a one-day observance, which would have come before Zacharias' the 8th course began, or at the latest, the 1st day of his course, which was from 12 thru 18 Sivan, or noon on the 19th, if Josephus is correct that courses changed at noon on the sabbaths. Archived from the original on 7 July Retrieved 6 July Retrieved April 29, Imprenta de Isidro Aguasvivas. Browne and Nolan, Retrieved April 30, The Holy Archangel Gabriel".
An Ethiopian Childhood New York: Picador, , p. Macmillan Publishing , pp. The Holy Spirit in the Quran. Retrieved 11 August The Concise Encyclopedia of Islam. Face to Face with Angels: Christopher Evan Longhurst Translated by Toby McCormick. Angels An Endangered Species. But Gabri-el is unique amongst an otherwise male or androgynous host, for it is almost certain that this great Archangel is the only female in the higher echelons. The Text This Week. Links to related articles. Stephen's Day Sol Invictus Yule. Nicholas " Television specials Yule Log. Daniel 1 2 3 4 5 6 7 8 9 10 11 12 Additions to Daniel.
People and things in the Quran. The names are sorted alphabetically. Angels in Abrahamic religions.
Saints of the Catholic Church. Matthew Mark Luke John. Military saints Virtuous pagan. Catholicism portal Saints portal.
- Associated Data.
- 19 best Baron Arild Rosenkrantz images on Pinterest in | Baron, Catholic art and Prayers.
Abraham Isaac Jacob Joseph. Retrieved from " https: Views Read Edit View history. In other projects Wikimedia Commons Wikiquote. Additional research to examine cultural beliefs, behaviour and expression surrounding pain and the utility of established pain scales in this population is warranted. For reviewer comments and the original submission of this manuscript, please see www. The authors thank the children, youth and community members for sharing their perspectives.
They also acknowledge the assistance of advanced practice nurse, Melissa Devine, in the preparation of the manuscript. National Center for Biotechnology Information , U. Published online Jul Author information Copyright and License information Disclaimer. No other competing interests declared. Margot Latimer, Sharon Rudderham and Allen Finley made a substantial contribution to the conception and design of the study. All authors revised the article critically for important intellectual content, approved the version submitted for publication and have agreed to act as guarantors of the work.
This article has been cited by other articles in PMC. Abstract Background First Nation children have the highest rates of pain-related conditions among Canadian children, yet there is little research on how this population expresses its pain or how and whether the pain is successfully treated. Results Interpretive descriptive analysis was used and themes regarding pain expression, care seeking and pain management were identified.
Design For this qualitative investigation, we used a community-based participatory action method, consisting of ethnographic techniques 14 including interviews and focus group conversation sessions. Data collection and analysis The conversation sessions included small groups of 4—6 children, youth, parents, teachers or health care professionals; the 5 elders were interviewed individually. Sample of semi-structured interview questions.
Expression of pain among Mi’kmaq children in one Atlantic Canadian community: a qualitative study
Results Of the community participants in this study, 76 were children and youth: Pain experiences The experiences of pain were categorized as medical or nonmedical. Open in a separate window. Pain expression, interpretation and seeking care Participants from all groups most commonly reported that children and youth were stoic in their pain expression and often hid their pain.
Comments on their perceptions of health care discrimination made by community members and youth during individual interviews and conversation sessions. Remarks on the use of pain scales made by health care professionals and parents during conversation sessions. Comments made by health care professionals during conversation sessions on how Aboriginal patients respond when asked about their pain. Pain management Self-management was the most common strategy described by community members for treating their pain, and it included both pharmacologic and nonpharmacologic techniques.
Strategies for pain self-management described by youth during conversation sessions. Conclusion Aboriginal children represent the fastest growing group of Canadian children and have the highest rates of pain conditions, which likely interfere with their development and academic achievement. Supplemental information For reviewer comments and the original submission of this manuscript, please see www.
Supplementary Material Online Appendices: Click here to view. Aust Fam Physician ; Canadian community health survey — annual component Ottawa: First Nations Information Governance Centre; A review of the experience, epidemiology, and management of pain among American Indian, Alaska Native, and Aboriginal Canadian peoples. J Pain ; Severe dental caries, impacts and determinants among children years of age in in Inuvik Region, Northwest Territories, Canada.
J Can Dent Assoc ; Chronic arthritis in children and adolescents in two Indian health service user populations. BMC Musculoskelet Disord ; 5: Prevalence and predictors of headaches in US adolescents. First Nations Centre; Relationship between post-traumatic stress disorder and pain in two American Indian tribes. Pain Med ; 6: Pain Res Manag ; Population projections by Aboriginal identity in Canada. Roper JM, Shapira J. Ethnography in nursing research. Res Nurs Health ; Health care communication issues in multiple sclerosis: Qual Health Res ; Assessing pain across the cultural gap: Central Australian Indigenous peoples pain assessment.
Contemp Nurse ; Legacy of Hope Foundation; J Cancer Educ ; Arthritis beliefs and self-care in an urban American Indian population.
Arthritis Rheum ; Our voices, our stories: Library and Archives Canada; The American Indian mind in a linear world: American Indian studies and traditional knowledge New York: Reducing racial disparities in pain treatment: The role of empathy and perspective-taking. Racial disparity in analgesic treatment for ED patients with abdominal or back pain. Am J Emerg Med ; Canadian Pain Society; Evidence-based assessment of pediatric pain.