Diaspora Health Literacy: reclaiming and restoring Nibwaakaawin (wisdom) and mending broken hearts.

Abstract

Cardiovascular diseases are major causes of mortality and hospitalization for adult Indigenous peoples. Historical, socio-economic, environmental and cultural risk factors have been identified in the literature and new evidence is emerging regarding culturally relevant health promotion approaches for Indigenous peoples at risk of developing or currently experiencing cardiovascular disease. Self-management of care is considered a central component to effective cardiovascular disease management. This approach requires a working knowledge and understanding of cardiovascular disease medications, and an ability to effectively communicate with healthcare practitioners. Another important associated risk factor for Indigenous peoples with heart disease, is the gap between patient - practitioner understanding of heart disease. The biomedical perspective supported by Western scientific evidence, makes little room for Indigenous knowledge. Indigenous peoples may wish to include Indigenous knowledge and/or Traditional Medicine in their self-care approach. The findings of this research demonstrates that Indigenous peoples primarily have a biomedical understanding of their heart disease and most are unaware of how various socio-historical and socio-cultural factors such as the negative inter-generational impact of residential school and contemporary experiences of oppression and discrimination are linked to their heart disease. This situation can be attributed to an Indigenous knowledge diaspora experience that includes the severance of access to Indigenous knowledge and Indigenous languages during the residential school period and the dominance of biomedicine in health care delivery. The concept of ‘diaspora health literacy’ is critically discussed as a potential tool to address the Indigenous knowledge diaspora barrier. It is proposed that Indigenous peoples with heart disease can enhance their self-care when culturally relevant health literacy approaches are available to them. In turn, healthcare practitioners can broker an ‘Indigenous therapeutic relational space’ with their Indigenous patients by initiating a culturally relevant health literacy assessment and a harmonized implementation model.