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News
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Indigenous
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Health
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Coronavirus

Charting a Post-Pandemic Path for Urban Indigenous People

It starts with listening, learning and looking at health data in a new way, says Brittany Bingham.

Moira Wyton 10 Sep 2020 | TheTyee.ca

Moira Wyton is The Tyee’s health reporter. Follow her @moirawyton or reach her here. This reporting beat is made possible by the Local Journalism Initiative.

Brittany Bingham was in a talking circle with several Indigenous women, gathering information for her PhD project, when a realization struck. For her, being a researcher comes second to honouring stories.

The women were sharing their experiences with Bingham and one of her advisors, Elder Roberta Price, in a session guided by traditional protocols.

The conversation had started around health, and eventually focused on the women’s challenges with housing and homelessness throughout their lives.

Bingham was blown away by the power of their stories — and by the strength and vulnerability they showed in sharing them with her. But she knew that achieving that level of comfort and trust didn’t happen by chance.

“When this work is done in a really culturally appropriate way that incorporates cultural traditions and protocols, the stories that are told are really profound,” said Bingham, who is a member of the Shíshálh Nation in Sechelt, B.C.

Honouring these kinds of stories and recognizing their importance is now guiding Bingham as she leads a project to respond to the needs of diverse urban Indigenous peoples in Vancouver’s pandemic recovery.

Bingham became the first Indigenous PhD student to graduate from the health sciences program at Simon Fraser University this summer. Her thesis examined gender and Indigenous-informed perspectives on mental health, addiction and homelessness.

But as she worked on the research, she noticed a lot of the health-care system’s information about Indigenous people wasn’t necessarily analyzed using an appropriate, contextualized Indigenous lens.

Even standard information, like hospital use data, can help increase understanding of the relationship between the system and an individual or a community. But only if it’s considered within the context of the harm done by colonialism and ongoing anti-Indigenous racism in B.C.’s health-care system.

“I think that part of this Indigenous health work is really standing back and looking at the big picture,” said Bingham, who earned a grant from the Michael Smith Foundation for Health Research to fund her project. “And that includes looking at all of the complexities of the structural impacts on health, the policy impacts on health.”

“We always are considering the historical context, and how that still is impacting people today.”

Bingham wants to work with community partner organizations to provide context to existing data and use the information to shape the COVID-19 response, so it builds on the strengths of the 59,000 diverse Indigenous people in Vancouver and helps them overcome the barriers they still face.

“There’s a gap in the research and the data that establishes the needs of the urban Indigenous population and also provides information around the needs for COVID-19 response,” said Bingham. While B.C. collects data about status First Nations people, those who are displaced from their homelands or who do not have status are not included in these measures.

“We have really amazing community-based services that are offering people cultural supports and are able to mobilize really quickly,” she added. “So it’s just a matter of breaking down some of the barriers to getting the adequate support to these agencies who are already doing all of this hard work.”

Many urban Indigenous people have been reporting that COVID-19 has limited their access to cultural supports and traditional medicines, said Bingham, which are more important than ever to maintain physical and mental well-being.

And Indigenous people were already more likely to have complex health needs due to lower incomes, challenges in access to housing and food insecurity — all determinants of health. The pandemic added to the problems.

“A key barrier that I always think will come up is access to safe and supportive housing,” said Bingham. “Especially in the times of COVID-19 when people are supposed to stay at home and stay safe and distance and all of those things.”

Bingham wants to look at the information the health system already has about key risk factors for COVID-19 with an Indigenous lens and explore where collecting new kinds of data and asking different questions could lead to more useful answers for Indigenous people.

That starts with building a dashboard of what is known and not known about urban Indigenous people seeking health care. The population’s diversity adds to the challenge.

While Indigenous people disproportionately experience homelessness and substance use disorders in Vancouver, many more are thriving. There are also three First Nations in the city itself and Indigenous people from across what is known as Canada and around the world make their home here.

Bingham wants to use interviews with community organizations and health service providers who work with urban Indigenous people to decolonize health data and centre the voices of Indigenous women in what gives them strength and keeps them well.

“Data tells people stories, and we have an obligation as researchers to have that data lead to action,” said Bingham, who was also recently appointed the first director of Indigenous research at both the Centre for Gender and Sexual Health Equity and Vancouver Coastal Health’s Aboriginal Health branch.

Bingham said she feels like a witness rather than a researcher when she works with community members. Tools like Drawing Change, which can capture people’s stories as they are shared, help her in ensuring they feel their stories are represented with integrity.

“I'm really just there to hold space,” she said. “It's an honour for people to share their story with us in the context of research and to make sure that we operate in a reciprocal way as researchers, and that we do our best with the story that they tell us.”  [Tyee]

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