Introduction
Both health equity research and Indigenous health research are driven by
the goal of promoting equitable health outcomes among marginalized and underserved
populations. However, the two fields often operate independently, without collaboration.
As a result, Indigenous populations are underrepresented in health equity research
relative to the disproportionate burden of health inequities they experience. In this
methodological article, we present Xpey’ Relational Environments, an analytic framework
that maps some of the barriers and facilitators to health equity for Indigenous
peoples.
Methods
Health equity research needs to include a focus on Indigenous populations
and Indigenized methodologies, a shift that could fill gaps in knowledge with the potential
to contribute to ‘closing the gap’ in Indigenous health. With this in mind, the Equity
Lens in Public Health (ELPH) research program adopted the Xpey’ Relational
Environments framework to add a focus on Indigenous populations to our research on
the prioritization and implementation of health equity. The analytic framework introduced
an Indigenized health equity lens to our methodology, which facilitated the identification
of social, structural and systemic determinants of Indigenous health. To test
the framework, we conducted a pilot case study of one of British Columbia’s regional
health authorities, which included a review of core policies and plans as well as interviews
and focus groups with frontline staff, managers and senior executives.
Conclusion
ELPH’s application of Xpey’ Relational Environments serves as an example
of the analytic framework’s utility for exploring and conceptualizing Indigenous health
equity in BC’s public health system. Future applications of the framework should be
embedded in Indigenous research methodologies.
A New Title, a New Focus: Community Health Equity Research and Policy
