Abstract:
How health is defined and assessed is a priority concern for Indigenous peoples due
to considerable health risks faced from environmental impacts to homelands, and because what is
“at risk” is often determined without their input or approval. Many health assessments by government
agencies, industry, and researchers from outside the communities fail to include Indigenous
definitions of health and omit basic methodological guidance on how to evaluate Indigenous
health, thus compromising the quality and consistency of results. Native Coast Salish communities
(Washington State, USA) developed and pilot-tested a set of Indigenous Health Indicators (IHI)
that reflect non-physiological aspects of health (community connection, natural resources security,
cultural use, education, self-determination, resilience) on a community scale, using constructed
measures that allow for concerns and priorities to be clearly articulated without releasing proprietary
knowledge. Based on initial results from pilot-tests of the IHI with the Swinomish Indian Tribal
Community (Washington State, USA), we argue that incorporation of IHIs into health assessments will
provide a more comprehensive understanding of Indigenous health concerns, and assist Indigenous
peoples to control their own health evaluations.