A framework to improve climate-resilient health among Indigenous communities

Abstract

Climate change has severely impacted Indigenous communities' health. Many global strategies aimed at addressing climate-related health risks assume all populations face the same challenges and can adapt equally, overlooking the specific needs of groups such as Indigenous communities. Adopting generalized global approaches can unintentionally harm Indigenous communities and worsen their climate health risks. In this context, my study explores how the World Health Organization's climate-resilience health systems approach can be tailored for Indigenous communities. Two objectives guide the study: i) to develop a conceptual framework to improve climate resilience health among Indigenous communities, ii) to identify the capacities of Indigenous communities that can serve as transformative pathways in safely adopting global climate-resilient health approaches. To achieve these objectives, I followed a two-step methodology. First, I conducted a systematic literature review encompassing 137 peer-reviewed articles from Web of Science, PubMed, and Medline by ProQuest databases. Second, I collaborated with the Indigenous Peoples' Observatory Network and conducted 17 key informant interviews. In the first objective, I identified fifteen Indigenous health drivers, categorized into risk, protective, and overlapping categories. I developed a conceptual framework based on identified health drivers. The conceptual framework comprises two components: i) a place-based feedback loop and ii) the shaping of health drivers. The feedback loop comprises five elements: i) place, ii) causations, iii) infirmities, iv) interventions, and v) sustaining. The shaping of health drivers is designed as a collaborative process involving governance-level officers and Indigenous communities. Applying the framework to case studies confirmed its adaptability across various locations. In the second objective, I identified five transformative pathways: i) government community interactions, ii) traditional medicine and spiritual beliefs, iii) experience-based practices, iv) community-based collective actions, and v) community-based policies. I developed evidence-based narratives to explain how transformative pathways support resilience consideration of the World Health Organization's climate-resilient health systems. Based on insights from key informants, I proposed three recommendations to strengthen transformative pathways: i) Indigenous mentorship in knowledge, health education, and research, ii) identifying opportunities to develop Indigenous inclusive health workforce, and iii) enhancing indigeneity in health policies. This study provides valuable insights to researchers, policymakers, and health professionals on enhancing Indigenous communities' resilience to climate-linked health risks by developing a conceptual framework and identifying transformative pathways.