The front door of the Lower Similkameen Indian Band office swings open every few minutes with a visitor or a band member. Nestled in the middle of the main street of the dry, mountainous town of Keremeos, B.C, the band council and Chief are always busy handling issues of health, education, culture and language preservation, social well-being, and the environment. All of these issues are complicated further by an expanding population. The Okanagan-Similkameen region of B.C. has the highest rate of migration in the province, so it has become important to both band leadership and community health planners to consider what effects these activities have on the health and well-being of the Similkameen people of the Okanagan Territory. Like many of their Indigenous counterparts in Canada, Indigenous peoples of B.C.’s Southern Interior are struggling to keep their way of life and their health intact in the face of these changes.
Growing populations, industrial development, resource extraction, housing, and municipal boundary expansion have put extreme pressures on the water and terrestrial resources of the Okanagan-Similkameen. And for the Similkameen People, the health of the land and the health of the people are inextricably linked. The ability to move freely within the territory to gather medicines and food, and to hunt, pray, and live has been profoundly restricted by the tourism industry in the Okanagan-Similkameen Valleys.
To live in a healthy way, Indigenous people, and arguably all people, need access to the land. Yet much of the health policy debate in Canada is categorical, separating health, the environment, family, food, and recreation into isolated entities. The Indigenous perspective tends to be more holistic or community-based, incorporating all these entities into a broader concept of health. Currently, the Similkameen people are working to translate ancient teachings into contemporary community plans for improved health. In the past, the sustainable management of the environment was necessary and vital since it functioned as both the grocery store and the pharmacy. Today, indigenous communities don’t have sufficient access to today’s costly organic foods because of high poverty and unemployment rates.
Aboriginal people have three times the national average of diabetes, and are more likely to have heart disease than their non-Indigenous counterparts. What’s more, Aboriginal men can be expected to live 8.1 years less, and Aboriginal women 5.5 years less, than their non-Aboriginal counterparts. This is despite the fact that both Aboriginal and non-Aboriginal communities may be physically located in the same proximity to conventional health care facilities, such as in the case of the Similkameen People. However, unemployment, poverty, and continued health care coverage cuts by Health Canada’s non-insured health benefits program is a large part of what creates this inequality. Differences in mental health are prominent as well: tragically, suicide by First Nations people is nearly three times the 2001 Canadian rate. While there are many causal factors that can be attributed to these differences, food and lifestyle are one part of that equation. Food was once solely hunted and gathered, and healthy diets were drawn from fish, plants, and animals from the land. This stands in contrast to contemporary society’s sedentary lifestyle with high-calorie and low-quality foods making up a large part of the diet–which is indeed true for many Canadians. Most Indigenous people still supplement their livelihoods with hunting and gathering despite contemporary contexts and confines.
Community policymakers, take note: First Nations peoples are creating their own community health plans that incorporate local knowledge and understanding. Using Indigenous ways of knowing and doing, and considering this in all health policy creation, is an important way forward in moving from the categorical to the holistic. Given the ever-heated debate on health policy reform, this Indigenous perspective serves to deconstruct the way “Westerners” view health and should inform all Canadian community health policies, specifically where they affect Indigenous people.