In order to improve health outcomes for Indigenous people they must be involved in the creation and implementation of policies, this means a commitment to indigenous languages, say Summer Finlay and Kate Armstrong

According to the UN, Indigenous languages are “at risk of disappearing” prompting the UN General Assembly to declare 2019 the International Year of Indigenous Languages (IYIL). [1] However, the IYIL should be about more than just language revival. It should also be embraced as a platform for promoting and protecting Indigenous peoples’ health and wellbeing, specifically regarding the prevention and management of noncommunicable diseases (NCDs).

It is well documented that Indigenous people (estimated to number 370 million in over 90 countries) often have poorer health outcomes than other people within their respective countries with NCDs contributing significantly to the morbidity and mortality of Indigenous people. [2-6] The drivers of health disparity are complex and include social determinants of health; the conditions within which “people live, work and age.” [7] The solutions required to address inequalities are equally as complex. Culture should be a constant in the attempt to tackle the unacceptable health disparity for Indigenous peoples.

Indigenous Peoples globally enjoy rich and diverse cultures, but many of these are under threat. Colonisation and globalisation continue to undermine Indigenous peoples’ cultures and languages, and create a situation where Indigenous people are very often living in poverty and experiencing poorer health outcomes and higher rates of preventable NCDs than their non-Indigenous counterparts. [8-16] 

To address the health disparity, solutions at a global and state level need to go beyond the social determinants of health and address cultural determinants as well. Cultural connectedness and continuity have been demonstrated as having a positive impact on Indigenous peoples’ health and wellbeing. [17] Including cultural determinants in policy, and programs targeting Indigenous people, would both support Indigenous peoples’ health and wellbeing and help maintain their cultures.

Indigenous languages, as a key expression of culture, have a vital role to play in the health and wellbeing of Indigenous peoples. The action plan for the 2019 IYIL calls for a “Synergy among different international development frameworks” including the sustainable development goals (SDGs). [18-19] The SDGs recognise the role of Indigenous peoples and cultures in achieving the goals. 

If the UN, and its member states, are serious about promoting and protecting Indigenous languages then the promotion and implementation of the SDGs plans should be communicated in Indigenous languages. Communicating in Indigenous languages would also acknowledge the importance of culture and language to Indigenous people, promote health and wellbeing, assist in the success of the SDGs, and play a role in preventing and managing NCDs (SDG 3.4). [20]

Good communication meets the needs of the listener and moves beyond superficial messaging⁠— particularly when it comes to complex health concepts. NCD health literacy in the numerous Indigenous languages globally must extend beyond verbatim translations, and be informed by Indigenous knowledge systems and worldviews. A truly decolonised approach is required; one that respects the rights of Indigenous peoples to revitalise, use, develop and transmit their languages to future generations. [21] This is particularly important for Indigenous people whose first language is their traditional language. [22,23] 

This approach cannot be achieved without Indigenous people leading the process, and they need to be appropriately resourced to do so. 

To see a genuine and substantial improvement in Indigenous peoples’ morbidity and mortality there needs to be a shift in the way we approach the prevention and management of NCDs. Incorporating Indigenous languages into the implementation of the SDGs and other global mechanisms, and integrating them within multi-faceted policies and programmes will improve the health and wellbeing of Indigenous peoples and demonstrate to the world that they are truly valued and celebrated. 

Summer May Finlay is a Yorta Yorta woman who grew up in Lake Macquarie near Newcastle, Australia. She is currently undertaking a PhD with the University of South Australia, is a lecturer at the University of Wollongong and is a National Health and Medical Research Institute Postdoctoral Fellow at the University of Canberra. She is the Aboriginal & Torres Strait Islander Vice President of the Public Health Association of Australia, co-vice chair of the Indigenous Working Group for the World Federation of Public Health Associations, and a co-chair of the #IndigenousNCD movement.
Twitter: @SummerMayFinlay
Competing interests: None declared. 

Kate Armstrong is a public health physician, and the founder & president of CLAN (Caring & Living As Neighbours), an Australian-based NGO that is committed to a rights-based, community development approach to improving health outcomes for children who are living with chronic health conditions in resource-poor countries. Kate is a co-chair of the #IndigenousNCD movement and founding chair of NCD Child.
Twitter: @K8_Armstrong
Competing interests: None declared. 

 

References:

[1] International Year of Indigenous Languages. Background. https://en.iyil2019.org/about/#1531098956940-22e4535d-4346. Last viewed 3 June 2019.
[2] United Nations Global Compact, n.d. Indigenous Peoples. https://www.unglobalcompact.org/what-is-gc/our-work/social/indigenous-people. Last viewed 3 June 2019.
[3] Anderson I, Robson B, Connolly M. et al. Indigenous and tribal peoples’ health (The Lancet-Lowitja Institute Global Collaboration): a population study, 2016. Lancet, 388(10040):131–157. doi: 10.1016/s0140-6736(16)00345-7
[4] United Nations, NA. United Nations Indigenous Peoples: Health. https://www.un.org/development/desa/indigenouspeoples/mandated-areas1/health.html. Last viewed 3 June 2019.
[5]  Cunningham M., 2009. “Health” in State of the World’s Indigenous Peoples. New York, NY: United Nations.
[6] NCD Alliance, 2012. Health Inequalities and Indigenous People. https://ncdalliance.org/sites/default/files/rfiles/Health%20inequalities_indigenous_11Dec12_NCDA.pdf. Last viewed 4 June 2019.
[7] World Health Organisation, 2019. Social Determinants of health. https://www.who.int/social_determinants/sdh_definition/en/. Last viewed 3 June 2019.
[8] Burke Smith, H., C. and. Ward, G. K, 2001. “Globalisation and Indigenous Peoples: Threats or Empowerment?” Indigenous Cultures in an Interconnected World Chapter: 1. Allen and Unwin, St Leonards (NSW) / UBC Press, Vancouver Editors: Claire Smith, Graeme K Ward.
[9] Paradies, Y. J Pop Research (2016) 33: 83. https://doi.org/10.1007/s12546-016-9159-y
[10] Bell, A. (2014). Relating indigenous and settler identities: Beyond domination. New York: Palgrave Macmillan.
[11] O’Laoire, M., 2008. Indigenous Language Revitalisation and Globalisation. Te  Kaharoa, vol. 1. DOI: https://doi.org/10.24135/tekaharoa.v1i1.143
[12] Australian Human Rights Commission, 2004. The impact of globalization on Indigenous Intellectual Property and Cultures: Professor Dr. Erica-Irene A. Daes, 25 May 2004, Museum of Sydney, Sydney Australia. https://www.humanrights.gov.au/about/news/speeches/impact-globalization-indigenous-intellectual-property-and-cultures. Last viewed 3 June 2019.
[13] Lucas, K., 2001 Defending Indigenous Cultures. https://www.globalpolicy.org/component/content/article/162/27558.html . Last viewed 3 June 2019.
[14] O’Laoire, M., 2008. Indigenous Language Revitalisation and Globalisation. Te  Kaharoa, vol. 1. DOI: https://doi.org/10.24135/tekaharoa.v1i1.143
[15] United Nations, NA. United Nations Indigenous Peoples: Health. https://www.un.org/development/desa/indigenouspeoples/mandated-areas1/health.html. Last viewed 3 June 2019.
[16] United Nations, NA. United Nations Indigenous Peoples: Health. https://www.un.org/development/desa/indigenouspeoples/mandated-areas1/health.html. Last viewed 3 June 2019.
[17] Auger, M. D. (2016). Cultural Continuity as a Determinant of Indigenous Peoples’ Health: A Metasynthesis of Qualitative Research in Canada and the United States. The International Indigenous Policy Journal, 7(4) . Retrieved from: https://ir.lib.uwo.ca/iipj/vol7/iss4/3 DOI: 10.18584/iipj.2016.7.4.3
[18] United Nations, 2018. Action plan for organizing the 2019 International Year of Indigenous Languages. New York. https://en.iyil2019.org/wp-content/uploads/2018/09/N1804802.pdf
[19] United Nations, 2015. Transforming our world: the 2030 Agenda for Sustainable Development
[20] United Nations, NA. Indigenous Peoples and the 2030 Agenda. United Nations. https://www.un.org/development/desa/indigenouspeoples/focus-areas/post-2015-agenda/the-sustainable-development-goals-sdgs-and-indigenous.html. Last cited 3 June 2019.
[21] United Nations, 2015. Transforming our world: the 2030 Agenda for Sustainable Development.
[22] Vass, A., Mitchell, A. and Dhurrkay, Y., 2011. Health literacy and Australian Indigenous peoples: an analysis of the role of language and worldview. Health Promotion Journal of Australia 22(1) 33 – 37
[23] Singleton, K., Krause, E., 2009. “Understanding Cultural and Linguistic Barriers to Health Literacy” OJIN: The Online Journal of Issues in Nursing. Vol. 14, No. 3.