This paper analyzes the community health of the Wikwemikong Unceded Indian Reserve (WUIR), Ontario, Canada. Results are reported from fieldwork including participant observation, key informant interviewing and self-reported data measuring health status, risk behaviour, place of residence, self-identity, and personal history extracted from 350 interviews conducted during a community-wide needs assessment. The research aimed to create a health plan for the community; however, subsequent analysis of the needs assessment results indicates that internal diversity exists in health status and needs between the seven villages that comprise WUIR. The analysis suggests variation in health status and risk-taking behaviour among community members may be related to varying colonial histories among the villages. The implications of intra-community variation in health status in First Nations are discussed in relation to influential health policy theories such as the determinants of health and health transfer policy in Canada.
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I am indebted to the residents of the Wikwemikong Unceded Indian Reserve for the knowledge and information they have shared with me. I am grateful to community leaders and managers at the Wikwemikong Health Centre for their review of this work and their continued support. Thank you to Wayne Warry, Ann Herring, Tina Moffat and Harriet MacMillan for their thoughtful comments on the various drafts of this paper and to Tricia Larose for her help with the final revisions. I appreciated very much the thoughtful and constructive feedback I received from the reviewers of the manuscript. This research was supported by the Social Sciences and Humanities Research Council of Canada and the School of Graduate Studies at McMaster University.
- Determinants of health
- First Nations
- Health disparities
- Needs assessment