Pregnant First Nations women who live on reserves in rural and remote regions of Canada are routinely evacuated to urban cities to await labour and birth; this is commonly referred to as Health Canada’s evacuation policy. I produced two stand alone papers to investigate this policy. In the first, I investigated the development and implementation of the Canadian government’s evacuation policy. Archival research showed that the evacuation policy began to take shape in 1892 and was founded on Canada’s goals to assimilate and civilize First Nations. My second paper employed First Nations feminist theory to understand why the evacuation policy does not result in good health, especially for First Nations women. Because the evacuation policy is incongruent with First Nations’ epistemologies, it compromises First Nations’ health. I offer policy recommendations to promote First Nations health in a way that is consistent with First Nations’ epistemologies and goals towards self-determination and self-governance.

This thesis quantified risks of lead (Pb), cadmium (Cd), and mercury (Hg) in the diet of First Nations peoples residing on-reserve in the province of Ontario, Canada. Data was obtained from the 2011-2012 First Nations Food, Nutrition, and Environment Study (FNFNES) and Health Canada to construct total diet studies and probabilistic assessments. Results indicated that the majority of the population is at low risk of exceeding the reference values for these contaminants. Average exposures of Pb and Hg were higher than the general Canadian population (1.7 and 1.6 times greater, respectively), whereas Cd was 59% lower than the Canadian average. The upper percentiles of the population exposure distributions were characterized for contributing food items to assist risk management strategies. For cadmium exposures, smokers had elevated exposures compared to non-smokers. Women of childbearing age had lower dietary MeHg exposures than the total population and were largely below the reference value.

First Nations women who live on reserves receive maternity care from a variety of government health care systems: Federal, provincial, and municipal. At first glance, this seems like an abundant amount of health care; however, the lack of coordination has led to poorer outcomes as demonstrated for example by the twofold IMR for First Nations on reserves compared to that of non-Aboriginal populations. To inform discussions and changes to health care policy and programming for maternity care for First Nations on reserves, my dissertation focuses on Health Canada’s evacuation policy within the province of Manitoba. It describes how First Nations women journey among these three health care systems in the provision of that care. This federal policy instructs federally employed nurses to arrange for the transfer of pregnant First Nations women who live on rural and remote reserves to an urban – and usually southern – location so that the women can receive labour and birthing services. Women are evacuated out of their home communities between 36 and 38 weeks gestational age and wait in the city, often alone, for labour to start. While there is a general understanding of how different elements of this federal policy work, there is no literature that describes its execution in detail nor in full. To address this critical knowledge gap, my dissertation consists of three stand-alone papers. For the first paper, “‘This Policy Sucks and It’s Stupid:’ Mapping Maternity Care for First Nations Women on Reserves in Manitoba,” I used intersectionality, institutional ethnography, and semi-structured interviews to produce a descriptive and visual map of the evacuation policy. Using intersectionality and a case study approach, the second paper, “Health Canada’s Evacuation Policy for Pregnant First Nations Women in Manitoba: Resignation, Resilience, and Resistance,” semi-structured interview data are analyzed through a thematic analysis to understand the experiences and perspectives of First Nations women, family, and community members. I argue for the development of a specific theoretical framework that makes explicit the specific legal and policy influences particular to First Nations women who live on reserves in the third paper, “The Legal Categorization of First Nations Women in Health: The Need for a First Nations Feminist Theory.” Taken as a whole, these three papers address some of the knowledge gaps related to maternity care services for First Nations women once they are evacuated. They also situate these gaps within the legal context of health care for First Nations women so that tangible improvements can be made.

First Nations foodways have been altered through systemized efforts of colonization and were effectively reduced in part from the creation of stores and through limiting reserve systems. The current research seeks to understand the dietary choices and changes among three generations of Fist Nations women. Research takes place in a remote First Nation community in Northern Ontario. The differing food practices among the three generations of women highlight transformations resulting from a traumatic history. Decreases in the consumption of traditional, land based foods, as well as the practices around these foods (procurement, preparation, knowledge exchange and social engagement) alter the experiences of the younger generations. The conversations/exchanges around food take place within the culturally significant space of the teepee. The teepee is a core element. These exchanges have a tremendous bearing on the overall wellness of these women and their efforts to reclaim and remain culturally resilient.

The purpose of this study was to interview elite First Nations, Inuit, and Métis athletes to gain an in-depth understanding of their personal journeys to excellence. Semi-structured interviews were conducted and a narrative analysis was used to analyze the research findings. The three objectives were to find success strategies, obstacles and advice the elite athletes would provide to Aboriginal youth. The main success strategies were found to be Aboriginal elements, focus, mental preparation for competition, parental support, passion, and positive self-talk. Multiple obstacles were faced by the athletes in this study, with racism and leaving home being the commonalities. The advice they provided for young First Nations, Inuit, and Métis athletes was rich and inspiring. The findings of this study provide useful information for aspiring Aboriginal athletes, and for future ongoing meaningful research, that may lead to reducing the gaps in the literature.

Although the Indian infant mortality rate has dropped from 66 deaths per 1000 live births in 1960 to 24.6 deaths per 1000 live births in 1980, considerable discrepancies continue to exist between the Indian and Non-Indian population in British Columbia. The high incidence of Indian infant mortality is an important issue to B.C.'s native population. While governments have instituted programs in an effort to improve the health status of Indian infants, no studies have been undertaken in British Columbia to identify those factors which influence Indian infant mortality. This study examines the theoretical and empirical relationship between Indian infant mortality and a variety of socio-economic and health care factors. Using data derived from matched birth and death certificates and information acquired from the Department of Indian Affairs, this study assesses the effects of the following variables on neonatal and post neonatal mortality: 1. Maternal Age/Live Birth Order, 2. Marital Status, 3. Place of Delivery, 4. Region, 5. Welfare Dependency, and 6. Health Jurisdiction. Tests of partial and marginal association were performed initially to identify those variables which were not significantly related to the Birth Outcome. As the results of these tests revealed that Place of Delivery was the only significant variable, various regression models were constructed to estimate the effects of non-hospitalization and hospitalization on neonatal and postneonatal mortality. The findings a from these tests indicated that when non-significant factors were eliminated from the regression model, the variable, Place of Delivery, was not significantly related to the Birth Outcome. Factors to account for these results were then discussed. In particular, consideration was given to the extent to which shortcomings in the data and study methodology may have affected the results of statistical tests. To develop a better understanding about the nature of Indian infant mortality, the major causes of Indian infant deaths were examined over various historical periods. After reviewing changes in the distribution of deaths this study described, theoretically, how changes in the social and economic structure in Indian communities affected Indian health and more specifically Indian infant health. It was argued that while life style factors and certain aspects of the physical environment may affect infant mortality, these factors should not be viewed in isolation. Changes in Indian economic and social systems have had direct and indirect consequences on the physical and mental health of native people. To the extent that these changes are on-going they still may have some bearing on Indian infant health problems today. Based on this theoretical perspective this study examined the adequacy of past and present health programs and described some of the limitations of government intervention strategies. The concluding section argues that self-help preventive programs and medical/technical solutions are of limited utility in terms of reducing infant morbidity and mortality. Furthermore, while it may be possible to improve the standard of living of Indian people through transfer payments or other social welfare schemes, these strategies may provide only partial solutions if broader social problems are direct and indirect causal factors of ill-health. To the extent that social problems may be related to certain aspects of their psycho-social environment, it is essential that governments adopt strategies which provide the opportunities for Indians to regain self-respect and control over the institutions which affect their daily lives. / Applied Science, Faculty of / Community and Regional Planning (SCARP), School of / Graduate

In 2014, the legal landscape shifted in British Columbia with the unanimous Supreme Court decision, Tsilhqot’in Nation v. British Columbia. The case resulted in a recognition of Aboriginal title, and real and substantial Aboriginal authority over large tracts of land in the province. According to legal analysts, the most significant element is the requirement for stronger consultation with First Nations and – in many cases – consent that needs to be pursued by the province’s resource extraction industries prior to development. British Columbia’s community forest sector is unlikely to be immune to this shift. A baseline for First Nations involvement in community forestry – both in terms of breadth and depth – has not yet been established. While Tsilhqot’in is expected to dramatically impact stakeholder engagement, to what degree and in which locales this change will occur is not well known. Through a series of semi-formal interviews conducted with people in a leadership position in 19 of the province’s community forests, this paper establishes this baseline, as well as considers the potential impact of the Tsilhqot’in decision for the province’s community forest sector.

The health and well-being of Indigenous Peoples, including their nutritional status, is poor compared to the general Canadian population. There are many causes of these disparities, including racism, poor access to health resources, and the nutrition transition. Before colonization, most First Nations across Canada consumed diets purely composed of Traditional Foods (TF) that were hunted or collected from the natural environment. TF are important for their nutritional quality, food security, and culture. However, rates of TF consumption have decreased in recent years contributing to poor dietary outcomes. The diversity and quantity of TF consumed is thought to be primarily dictated by the ecological biodiversity in the surrounding environment; however, this relationship remains untested in Canada. The objective of this study was to gain a better understanding of First Nations modern food systems by evaluating the relationship between ecozone biodiversity and nutritional outcomes in the form of dietary diversity in First Nations individuals across Canada. We used dietary data and household data collected by the First Nations Food, Nutrition and Environment Study and multiple biodiversity databases for analyses. Spearman’s correlations were used to investigate the relationship between dietary diversity and nutrition. A statistical model was used to evaluate the relative predictive power of biodiversity and multiple other predictive variables in determining dietary diversity. We found that individuals who consume more TF have more nutrient rich diets, and therefore, dietary diversity is a good indicator of nutrition outcomes. We also found that in contrast to previous research and assumptions, in the context of First Nations living in Canada, biodiversity has a negative relationship to dietary species richness. It was also determined that variables related to culture, and accessibility of TF were the most important factors in predicting positive nutritional outcomes. These preliminary results provide key areas for interventions essential for increasing access to TF.

Indigenous people in Canada have suffered through immense trauma since colonization, and child welfare agencies have contributed to the assimilation of Indigenous children. This research explores the stories of Indigenous people who have been in the care of Children’s Aid Society in Ontario and how they have experienced their plan of care. Every child in the child welfare system has a plan of care completed by their worker at regular intervals. This document is intended to review the child’s progress in various dimensions of their lives and facilitate goal-setting for the future. The plan of care is a standardized document that is created from a Western perspective and thus does not necessarily reflect Indigenous culture or the child’s true self. Using a mixed methods approach with a strong emphasis on Indigenous Methodologies, two Indigenous young adults shared their stories about their experiences with plans of care. In addition, an Indigenous key informant provided context from an Indigenous perspective on how plans of care can be improved for Indigenous children in care. To understand the plan of care document from a child/youth’s perspective, the author of this research asked a co-worker to complete a plan of care on their life. A critique of this experience is shared in this study. Findings suggest that experiences with plans of care can vary significantly, and depend greatly on the relationship between the young person and their child welfare worker. The two Indigenous young adults valued participation in their plan of care and found the goal setting to be useful when they were consulted. However, it is determined that the child welfare worker can bring Indigenous culture into the document in creative ways. These findings lead to recommendations for change at the micro and macro levels involving greater opportunities for relationship-building, space for young people to participate, and including Indigenous knowledge in child welfare practice. / Thesis / Master of Social Work (MSW)

First Nations communities in northern Ontario continue to grapple with food insecurity despite community leaders, social justice activists, reporters, and scholars drawing attention to this multi-faceted issue for decades. Improving food security has been approached by many different actors and directions, such as neo-liberal initiatives to make market food more financially accessible, alternative food procurement programs such as incorporating greenhouses and gardening, and food system resurgent efforts such as increasing funding and training for land-based harvesting practices. Compared to food security, which focuses on access to affordable and nutritious food, food sovereignty offers a more compelling framework to understand food shortages in the settler-colonial context of northern Ontario as it emphasizes the roots of that insecurity, specifically at the way that colonial impositions disrupted Indigenous food systems. Using a community-based participatory methodology within a decolonial feminist theoretical lens and a community of practice of political ecology, this thesis will explore the ways that First Nations communities in northern Ontario are working against and within colonial impositions to improve access to traditional foods in their communities. I will examine some of the tensions and opportunities community members experience and the various approaches they are using or imagining for the future. Lastly, I will explore the ways that the concept of food sovereignty risks becoming symbolic in northern Ontario unless it is accompanied by movements towards land restitution. At the same time, I will argue that food and land sovereignty are inextricably linked, and that practicing Indigenous food systems can lead to food sovereignty with or without government approved land restitution. Finally, I will suggest that sovereignty of and through food may be a more appropriate voicing or inversion of the term to more explicitly acknowledge that food sovereignty and land restitution are inherently and intimately tied.