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First Nations Taking Action on the SDH: Reflections from CPHA 2017

First Nations Taking Action on the SDH: Reflections from CPHA 2017

By Lesley Dyck on October 25, 2017

This blog post has been written as part of a three-part series on Indigenous KT in response to the NCCDH’s attendance at the Public Health 2017 conference in Halifax, NS, in June 2017. It is also intended to build on the NCCDH’s ongoing work to be an anti-racist organization.

The author, Lesley Dyck, is a white, non-Indigenous woman based out of Summerland, BC, in the traditional territory of the Okanagan Nation. Her professional background includes health promotion and community development with a focus on public health capacity for health equity and population health.

When I attended the Public Health 2017 conference this past summer in Halifax, NS, (in Mi’kmaki, the ancestral and unceded territory of the Mi’kmaq People), there were multiple resources from the First Nations Health Directors Association (FNHDA) of British Columbia that I found very interesting.

Some were specifically tailored to how to address lateral violence, as discussed in another NCCDH blog post about the conference (“Symposium: Decolonizing Our Relationships through Lateral Kindness”). For more information about the FNHDA’s Lateral Kindness Train-the-Trainer sessions, visit their website (in English only).

One of the other resources the FNHDA shared that caught my attention was the Social Determinants of Health Discussion Guide, created by the First Nations Health Council (FNHC) in BC. 

The SDH Discussion Guide

In May 2011, BC First Nations presented the FNHC with an ambitious mandate. In addition to the expectation of providing dedicated political leadership for the implementation of the health plans and agreements — as well as supporting health systems transformation — leaders called upon the FNHC to build partnerships to make progress on the social determinants of health (SDH). This mandate required the FNHC to build new partnerships within Canada and British Columbia. Moreover, it also required them to engage First Nations on ways to improve the health and well-being of children, families and communities.

In response, the FNHC developed the Social Determinants of Health Discussion Guide, designed to support discussions on the SDH at Sub-Regional and Regional Caucuses. The purpose of the guide is to demonstrate the link between specific issues and health outcomes, serving as a tool with specific information on children and family well-being, early childhood experiences and poverty — a reflection of the three main themes of the Regional Caucus. Each theme has a selection of discussion questions, including questions meant to draw feedback on the 10-year plan to set priorities and build consensus.

A question of mandate

What is perhaps most fascinating about the publication, however, is the necessity for the FNHC’s guide to clearly state the innocuous intent of the guide. More specifically, the resource includes a specific passage indicating that, despite its contribution to the field via the guide, the organization “is not assuming new authority for children and family services” (Discussion Guide, p. 21).

The statement was perhaps included in anticipation of potential backlash, which appears to have been warranted: During the discussions to start the work of supporting action on the SDH, the FNHC was challenged by their own members, and other Indigenous and non-Indigenous organizations, on whether they were reaching beyond their mandate. As a result, the FNHC found it necessary to request a legal opinion to clarify whether it is acting appropriately in pursuing agreements with British Columbia and Canada to create a platform for collaboration with First Nations on broader issues that influence health and well-being. They received a legal opinion (which can be found on their website, dated June 7, 2017) that they are acting within the mandate set out by BC First Nations in the Consensus Papers.

Benefits of the guide

One of the Discussion Guide’s strengths is that it does a good job of simply laying out the importance of an intersectoral approach to supporting Indigenous families and children. The FNHC will be developing a discussion document to be shared with First Nations prior to the Regional Caucuses in Fall 2017, which will support the decision about a long-term strategy related to the SDH that First Nations Chiefs will be asked to make at Gathering Wisdom for a Shared Journey IX in May 2018.

For more information see the Summer 2017 Update on the FNHC website (in English only).


Cultural SafetyIndigenous healthRacism/racialization