Research priorities in the NWT include priorities of the GNWT, Indigenous Governments and organizations, and communities. Information can be found on the web pages of those organizations; Indigenous and community governments also have wellness plans that indicate priorities. When conducting health research in the NWT, researchers should take the time to understand that history in a context that promotes improvement of the survival, dignity and well-being of Indigenous peoples. Hotıì ts’eeda recommends that researchers undertake cultural competency training and be prepared to learn about, and adapt their research plans to fit, local Indigenous priorities.
The NWT is more than one million square kilometers, with a population of 45,000 people spread among 33 mostly remote communities, many without all-season road access. Indigenous people (First Nations Dene, Métis and Inuvialuit) are 50% of the NWT population, with nine recognized Indigenous official languages alongside English and French.
The transition from nomadic land-based cultures to permanent settlement took place during the 1800s - 1900s. Disease epidemics and the introduction of the fur trade into the NWT disrupted migratory and cultural practices. Indigenous children were removed from families to attend church- and state-run residential schools. This forced dislocation deepened colonization’s traumatic impacts, disrupting psychological, environmental, social, and family health. This experience continues to have a profound impact on well-being. Since the 1970’s, the political landscape of the NWT has been transformed by the negotiation of Indigenous land and self-government agreements with the federal and territorial governments. These agreements recognize Indigenous peoples’ authorities over lands, resources, and social programs, including health and well-being.
Due to this history, there are sharp differences in social determinants of health outcomes between Indigenous and non-Indigenous residents of the NWT. These indicators show that ignoring those differences is not enough to address many of the specific needs of Indigenous people. Without cultural understanding and approaches informed by addressing impacts of ongoing colonization and the multi-generational trauma of residential schooling, the health system has failed to connect with many Indigenous residents. In recent years this has become an area of focus for the GNWT, and in 2019, a Cultural Safety in the NWT Health and Social Services System plan was developed, marking a start toward normalizing culturally safe health care provision in the NWT.
Effective and culturally safe health research is critical to improving the NWT health system, however there are many research gaps which limit our understanding of Indigenous health disparities and potential remedies (Young, 2003). Communities tend to have low trust levels in relation to the health system and research, due to a colonial legacy of vulnerable Indigenous adults and children being subjected to experimental, outmoded, and degrading health research and treatment (Mosby, 2013; Drees, 2013). While some negative experiences occurred years ago, there continue to be recent examples of culturally unsafe care, including in the NWT, that support an ongoing widespread distrust among Indigenous peoples in health systems (Smylie, 2015; Hildebrandt, 2015).
United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP)
UNDRIP was adopted by the UN General Assembly in 2007 and has been fully supported by Canada since 2016. Both the Truth and Reconciliation Commission of Canada (2015) and the final report of the Missing and Murdered Indigenous Women and Girls Inquiry (2019) have called for implementing UNDRIP as a basis for institutionalizing practices in Canada that promote cultural safety and ensure legal and human rights of Indigenous peoples are respected. In 2019, the GNWT identified implementing UNDRIP as one of its top priorities. These calls include specific measures relating to health, health research, and cultural competency and safety. The declaration describes standards for the survival, dignity and well-being of Indigenous peoples. Specific articles of UNDRIP apply to Hotıì ts'eeda's work and the research priorities set by Hotıì ts'eeda.
Indigenous communities and governments in the NWT have expressed the need to ground health and wellness programs in community priorities, Indigenous culture, and land-based traditions. Incorporating this wisdom into the design and delivery of programs and services is vital, especially acknowledging the importance that the land and land-based traditional activities plays in health and well-being. Hotıì ts’eeda strives to assist in research that uses approaches based in local culture and priorities, and is conducted in partnership with Indigenous communities and governments. Hotıì ts’eeda's also focuses on building cultural competence among NWT health and social services professionals, ensuring a culturally-safe environment for Indigenous patients and clients.
Health research has the ability to create transformative partnerships with communities to understand and communicate root causes, risks, protective factors and programming ideas to improve health and well-being. Specifically, patient-oriented research, grounded in approaches that meaningfully and respectfully engage with communities, including knowledge translation and capacity building, is critical. While the NWT has a vibrant health research landscape, Hotıì ts'eeda's is committed the standards outlined in UNDRIP and to the need for meaningful community engagement and collaboration from the outset of projects, so that the knowledge created by research can truly benefit NWT communities and residents.
The overarching principles outlined in the UNDRIP are reflected in the priorities set around health research in the NWT.
Territorial health and social service research priorities
The GNWT Department of Health and Social Services (GNWT-HSS) has defined its priority research areas in health and wellness in its research agenda. Researchers should familiarize themselves with these priorities.
- Improving the Health Status of the Population Through Prevention and Education
- Access to Primary Care and Public Health Services
- Mental Health and Addictions
- Child and Family Services
- Disparities in Aboriginal health
- Implementation, Knowledge Translation and Capacity Building
Priorities of community partners
When Hotıì ts’eeda began as an organization in 2017, community partners gathered to discuss northern health research and the role of a SPOR Support Unit. In addition to priorities already described by the GNWT, partners identified additional research priorities:
- Housing and Homelessness
- Indigenous Knowledge and Healing
- Cultural Safety and Competency
- Health Promotion
Since 2017, Hotıì ts'eeda partners have been gathering yearly at the annual Ełèts’ehdèe where priorities continue to be updated.
While the NWT does not have a university, there are several research and educational institutions that can provide institutional homes and supports for health research projects:
- Aurora College and the Aurora Research Institute (ARI)
- Institute for Circumpolar Health Research (ICHR)
- Inuvialuit Cultural Resource Centre (ICRC)
- Gwich’in Department of Culture and Heritage
- Dedats'eetsaa: Tłı̨chǫ Research and Training Institute (TRTI)
In addition, Indigenous governments have ongoing research programs and projects within their organizations. Individual communities, Indigenous governments and organizations, and regional health authorities review research license applications and often partner with researchers as they conduct their studies.