Indigenous Health Research

The Need

Indigenous Peoples in Canada – First Nations, Metis and Inuit – have historically been under-represented in health research. Not only have they not been included in the existing types of diseases and conditions being studied by Canadian researchers, Indigenous Peoples’ own specific health concerns have not been adressed or, in fact, asked of them.

An effort is underway by research organizations, including PHRI, to amend these errors and oversights, using – among other Indigenous-led values and principles – the concept of “nothing about us without us.”

Starting around 2013, PHRI has worked alongside eight First Nations communities across Canada to collect information to:

Better understand the contextual, environmental, socioeconomic, and biological determinants of differences in health status in harmony with First Nations ways of knowing.
Assist communities to develop local management strategies for chronic disease
Investigate how the community-level environment is associated with individual health behaviours and the presence and progression of chronic disease risk factors and chronic diseases such as cardiovascular disease (CVD) and cancer.

CAHHM-First Nations study

The Canadian Alliance for Healthy Hearts and Minds First Nations (CAHHM-FN) study involves First Nations communities in several provinces, and is led by PHRI Senior Scientist Sonia Anand.

Indigenous data workshops have been held in 2019, 2021, and 2022 by and for this cohort, focused on sharing data and how best for Indigenous researchers and communities to access and lead in data sovereignty.

Partners in this initiative include: Silent Genomes; researchers from Six Nations of the Grand River (Ontario) Lac La Ronge Indian Band (Saskatchewan), Fort McKay First Nation (Alberta), Nation Huronne-Wendat (Quebec) and Oneida Nation of the Thames (Ont) communities; and many other partners across Canada.

COVID and Indigenous communities

Six Nations of the Grand River (Ontario), Wendat Huronne (Quebec), and Lac La Ronge Indian Band (Saskatchewan), and academic institutions in each of those provinces, are working with PHRI to investigate their access to COVID-19 vaccines, their immunogenicity, effectiveness and safety among First Nations Peoples, who are high-risk populations in Canada.

The ongoing study also aims to understand why some Indigenous Peoples are not as confident in the COVID-19 vaccine as others, and to document the overall impact of COVID in these communities. The study will also provide insight into how a pandemic of this scale can be prevented in these communities and other vulnerable populations.

COVID CommUNITY-First Nations

Predicting heart failure in Indigenous populations

Within the CHF Alliance, a pan-Canadian network of researchers and patient-partners focused on heart failure (HF) founded in 2022, a team led by PHRI’s Sonia Anand and Russell De Souza are working with Indigenous Peoples, who may have a unique risk factor profile for developing HF.

They aim to identify key traditional (e.g. diabetes) and non-traditional risk factors (e.g. air pollution, social support) for cardiac dysfunction leading to HF among 2,500 Indigenous people enrolled in two cohort studies (CAHHM First Nations cohort and CLSA) with detailed clinical and community-level risk factors, and cardiac MRIs. They will use supervised machine learning methods to identify factors associated with changes in cardiac structure and function on cardiac MRI, and with incidence HF (during follow-up) in CAHHM-FN.

Inclusion of Indigenous Peoples in clinical trials

The Accelerating Clinical Trials (ACT) Canada consortium, launched in early 2023, is a pan-Canadian group of hundreds of researchers, patient-partners, communities, biotechnology industry, and government across the country that includes inclusion of and consultation with Indigenous Peoples as a key component.

Wayne Clark , Director of the Wapanachakos Indigenous Health Program at the University of Alberta, is the Indigenous Health Champion of ACT as well as co-chair of ACT’s Indigenous Health Committee along with co-chair Wanda Phillips-Beck, First Nations, Canada Research Chair in Indigenous Nursing at the University of Manitoba.

The ACT consortium – for which PHRI is the coordinating centre and the grant host institution led by PHRI Senior Scientist PJ Devereaux – has an objective of ‘democratizing’ clinical trial participation into under-represented populations, including the Indigenous, as well as Canadians in remote and rural areas, sex and genders, and ethnicities beyond who is currently participating in clinical trials.

The Need

CAHHM-First Nations study

COVID and Indigenous communities

Predicting heart failure in Indigenous populations

Inclusion of Indigenous Peoples in clinical trials

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