A Reclamation of Well Being: Visioning a Thriving and Healthy Urban Indigenous Community

8/16/2019 A Reclamation of Well Being: Visioning a Thriving and Healthy Urban Indigenous Community

1/36

"UUBDINFOU

A RECLAMATIONOF WELL BEING:Visioning a Thrivingand Healthy UrbanIndigenous Community

Toronto’s First Indigenous Health Strategy

20162021

Toronto IndigenousHealth Advisory Circle


2/36


3/36

HEALTH STATUS AND SOCIO-DEMOGRAPHIC INFORMATION6GATHERING THE CIRCLE8

CONCEIVING THE TIHS18

TIHAC ADVISORS16

STRATEGIC ALIGNMENT11VISION WHEEL13

OVERARCHING THEMES20

STRATEGIC DIRECTION 124STRATEGIC DIRECTION 226STRATEGIC DIRECTION 330CONCLUSION/NEXT STEPS32

TIMELINE OF INDIGENOUSHEALTH PLANNING IN TORONTO15

ARTISTS’ INSIGHT34

VISION, MISSION ANDOPERATING PRINCIPLES23

INTRODUCTION4CONTENTS


4/36


5/36

INDIGENOUSHEALTHIN

INDIGENOUSHANDSThe principle of self-determination has

informed every step in the creation of A

Reclamation of Well Being: Visioning a

Thriving and Healthy Urban Indigenous

Community – Toronto’s first Indigenous

Health Strategy, 2016 – 2021.

Thisstrategywasconceivedbythe

TorontoIndigenousHealthAdvisoryCircle(TIHAC).Asacircleofdedicatedcommunityleaders,TIHACprovidesrecommendationstotheTorontoCentralLHIN(TCLHIN)andTorontoPublicHealth(TPH)onimprovinghealthoutcomesforIndigenouspeopleinToronto.Inaddition,TIHACprovidesbroaderpolicyandadvocacy

directiononimprovingthesocialdeterminantsofIndigenoushealth.InthisfirstIndigenousHealthStrategyforToronto,TIHACrecommendsa

numberofstrategicactivitiesthatwillimpactwhatandhowhealthprogramsandservicesareprovidedinadditiontoaddressinghealthinfluencerssuchastheeducation,housing,foodand justicesystems.

Context

Torontohasthelargestandmost

diverseurbanIndigenouspopulationinOntario(EnvironicsInstitute,2010).ThereislittlelocaldataonIndigenoushealth.However,nationalandFirstNationsdatabasesindicatethatIndigenouspeoplefareworsethanthenon-Indigenouspopulationonamyriadofhealthindicators(Gionet&Roshanasfshar,2013;Oldingetal., 2014).

Indigenous people living in Toronto

face a disproportionate burden of

challenges across the known social

determinants of health, as well as

barriers in accessing health services.Indigenous people experience higher

rates of poverty, unemployment,

homelessness, involvement with

child welfare, food insecurity and

challenges within the education

system – all contributing to poor

health outcomes (McCaskill et al.,

2011; NCCAB, 2013; Olding et al.,

2014; Steward et al., 2013). Despite

these health inequities and hardships,Toronto’s Indigenous community has

tremendous strength and resilience.

Improving Indigenous health

outcomes falls within the mandates

of both TC LHIN and TPH. While both

organizations fund Indigenous health,

TPH also provides various programs

and services accessed by community

members. There are also a number

of health services provided by

Indigenous and other non-Indigenous

organizations in Toronto. However,

much more is needed. Reducinghealth inequities experienced by

Toronto’s Indigenous community

requires a coordinated and wholistic

approach – one that harmonizes

traditional and mainstream health

programs and services.

On December 9th, 2013, Anishnawbe

Health Toronto (AHT) presented

the alarming results of their study,Premature and Preventable Death

Among Members of Toronto’s

Aboriginal Community: Walking in

Their Shoes to Toronto’s Board of

Health. This presentation reinforced

the need for TPH, TC LHIN and

AHT to continue partnering in the

establishment of TIHAC, a permanent,

community-led health advisory circle.

Toronto’s First Indigenous Health Strategy 20162021 5


6/36

HEALTH STATUS AND SOCIO-DEMOGRAPHIC INFORMATION

POPULATION HOMELESSNESS

SIZE OF TORONTO’S INDIGENOUS POPULATION

AccordingtoStatisticCanada’s2011National

HouseholdSurvey:19,265

OurHealthCountsToronto:34,000 to 69,0001

OurHealthCountsstudydocumentshighratesofnon-participationintheNHS.

17.5%GENERAL

POPULATION12

EDUCATION

TorontorespondentsinUrban

AboriginalPeoplesStudywhoreportednegativeexperienceswithelementaryand

secondaryschools:26%10

25% ABORIGINAL

COMMUNITY*11

PERCENTAGEOVERTHE AGEOF15WITHOUTA

CERTIFICATE,DIPLOMAORDEGREEINTORONTO

*OurHealthCountsTorontonotesthatthispercentagemay

besignificantlyhigher.

TARPFOUNDTHAT

19%OFITSRESPONDENTS

COULDSPEAK ANINDIGENOUS

LANGUAGE14

LANGUAGE

1.3%to 2.7%

TOTALPOPULATIONOFTORONTO

MIGRATION AND MOBILITY

PERCENTAGEOFTORONTO’S

INDIGENOUSCOMMUNITYBORNOUTSIDE

OFCITY:

73%13

16%OFHOMELESS

POPULATIONIDENTIFY

ASABORIGINAL2

INCOME(BEFORETAXES)–PERCENTAGEOFINDIGENOUSPOPULATIONLIVINGUNDERLOWINCOMECUTOFF

OurHealthCountsnotesthatthemajorityofIndigenousPeople

livinginTorontodidnotparticipateinthe2011NHSandthosewhodidparticipatehadhigherincomes.ThisparticipationbiasiscreatedbecausethemainNHSrecruitmentmethodistosendmailtofixedaddressesusingthevotingregistrar.Peoplewith

lowincomesaremorelikelytomovefrequentlyorbehomeless,andthereforemaynotreceivethismail.

OurHealthCountsToronto:90%3

AccordingtoStatisticCanada’s2011NationalHouseholdSurvey:26%

4

AGE

39MEDIANAGEIN TORONTO

32MEDIAN AGE

OF ABORIGINALIDENTITY INTORONTO

15%GENERAL

POPULATIONUNDER155

22% ABORIGINALPOPULATIONUNDER156

IDENTITY2011NATIONALHOUSEHOLDSURVEY:

65%

27%1.7%

1.3%

5.2%

First Nations

Multiple Aboriginal Identities

Inuit

Métis

Aboriginal Identities not

included elsewhere 8

DIVERSITYPARTICIPANTSINTHE2010TORONTO

ABORIGINALRESEARCHPROJECTIDENTIFIED AS:

48%

15%10%

11%

5%

10%

Anishnawbe

Métis

Cree

Haudenosaunee

Mi’kimaq

Other 9

TheseestimatesarefromtheNationalHouseholdSurveyandrepresentasocioeconomicallyprivilegedminoritysubpopulationofthetotalIndigenouspopulationofToronto.

6 Toronto’s First Indigenous Health Strategy 20162021


7/36

PARENTING AND CHILDREN

PERCENTAGEOFLONEPARENTSWHO

WEREWOMEN:

84%15

SELF-RATED HEALTH

HAVINGLOWHOUSEHOLDINCOMEWAS A SIGNIFICANT

PREDICTOR OF‘POOR’SELFRATEDHEALTH16

I N T E R G E N E

R A TIO N A L T

R A

U M A

TWO-THIRDSofurbanAboriginalpeoplein

Torontosaythattheyhavebeenaffectedbyresidentialschools,eitherpersonallyorthrougha

familymember17

CHRONIC DISEASE

Aboriginal people with lowincome, less than high school

education or were unemployedhad higher percentages of

being diagnosed with chronicconditions 18

MENTAL HEALTH

14%OFINDIGENOUSMENTAL

HEALTHPATIENTSINHOSPITALSREPORTED

BEINGHOMELESS

8%OFPATIENTSFROMTHEGENERALPOPULATION 19

IN CONTRAST TO

REHABILITATION

Average time in rehabilitationslightly longer for Aboriginal

patients in Toronto thangeneral population

Larger proportion of Aboriginal patients in

rehabilitation for medicallycomplex condition 20

Theserateslikelyunderestimate Aboriginalpatientssinceit

wouldonlyincludeAboriginalpatientswhowereidentifiedinthehospital.SomeAboriginal

patientswillnotdiscloseidentityand/orhealthcareproviderswillnotrecognizeAboriginal

identity.Thisdependsonwhoisgatheringtheinformation.

1RotondiM.EstimationoftheSizeoftheUrban AboriginalPopulationinToronto,ONInterim Analysis–January26,2016

2

StatisticsCanada.(2013).NationalHouseholdSurvey(NHS)AboriginalPopulationProfile(pp.1–95).Ottawa.doi:99-011-X2011007

3SmylieJ.OurHealthCountsTorontoInterim

AnalysisMay3,2016.

4City of Toronto (2013). 2011 National Household

Survey (NHS): Income and Shelter Costs. Toronto, ON.

5CityofToronto(2013).Backgrounder2011Census:AgeandSexCounts.

6StatisticsCanada.(2013).NationalHousehold

Survey(NHS)AboriginalPopulationProfile(pp.1–95).Ottawa.doi:99-011-X2011007

7EnvironicsInstute.(2010).UrbanAboriginal

PeoplesStudy:TorontoReport(pp.1–82).Toronto, ON.

8StatisticsCanada.(2013).NationalHousehold

Survey(NHS)AboriginalPopulationProfile(pp.1–95).Ottawa.doi:99-011-X2011007

9McCaskill,D.,FitzMaurice,K.,&Cidro,J.(2011).TorontoAboriginalResearchProject:FinalReport

(pp.I–XV,17–398).Toronto,ON.10EnvironicsInsitute.(2010).UrbanAboriginalPeoplesStudy:TorontoReport(pp.1–82).Toronto, ON.

11StatisticsCanada.(2013).NationalHouseholdSurvey(NHS)AboriginalPopulationProfile(pp.1–95).Ottawa.doi:99-011-X2011007

12CityofToronto(2013).Backgrounder:2011NationalHouseholdSurvey:LabourForce,Education,PlaceofWork,Commutingand

Mobility.Toronto,ON.

13McCaskill,D.,FitzMaurice,K.,&Cidro,J.(2011).TorontoAboriginalResearchProject:FinalReport(pp.I–XV,17–398).Toronto,ON.

14McCaskill,D.,FitzMaurice,K.,&Cidro,J.(2011).TorontoAboriginalResearchProject:FinalReport(pp.I–XV,17–398).Toronto,ON.

15McCaskill,D.,FitzMaurice,K.,&Cidro,J.(2011).

TorontoAboriginalResearchProject:FinalReport(pp.I–XV,17–398).Toronto,ON.

16

Mehdipanah,R.(2011).UrbanAboriginalHealth:Usingindividualandcontextualapproaches

tobetterunderstandthehealthofAboriginalpopulationslivinginToronto.Waterloo,ON.

17EnvironicsInstute.(2010).UrbanAboriginal

PeoplesStudy:TorontoReport(pp.1–82).Toronto.

18Mehdipanah,R.(2011).UrbanAboriginalHealth:UsingindividualandcontextualapproachestobetterunderstandthehealthofAboriginal

populationslivinginToronto.Waterloo,ON.

19TorontoCentralLHIN.(2011).Profileof AboriginalPatientsfromHospitalsintheToronto

CentralLHIN(Vol.2011,pp.1–12).Toronto,ON.

20TorontoCentralLHIN.(2011).Profileof AboriginalPatientsfromHospitalsintheTorontoCentralLHIN(Vol.2011,pp.1–12).Toronto,ON.



8/36

Gatheringthe Circle“Thebestwayforthecircletoworktogetheristhroughaharmonizedapproach.ThismeansthatallmeetingsandthewaysweworktogetherareguidedbyEldersandinvolveyouth.Itisintergenerational,involves

healersanddifferentwaysofknowing.”

LeilaMonib,HealthEquitySpecialist,CircleSecretariat,TorontoPublicHealth



9/36

CREATIONOFTHETORONTOINDIGENOUSHEALTHADVISORY

CIRCLE(TIHAC) TheTIHACwasestablishedwitharecognitionthattheTIHSmustbeledby

communitymembersthemselves.

Thisisinlinewiththeprinciple

ofself-determinationandechoesrecommendationsrecentlyreleasedinTruth and ReconciliationCommission of Canada: Calls to

Action (2015)andintheCityofToronto’sStatement of Commitmentto Aboriginal Communities (2010).

ASteeringCommitteecomprisedof AnishnawbeHealthToronto,TPHand

TCLHINoversawthecreationoftheTIHACthroughacommunicationsandoutreachstrategyinformedbytheVisionWheel,astrategicplanningtooladaptedfromthetraditionalMedicineWheel.

AnumberofsourceswereconsultedtodeveloptheTIHACstructure.

GovernancestructuresofsimilarIndigenoushealthinitiativesacrossCanadawerereviewed.Furthermore,communitystakeholderswithinTorontoandOntariowereengaged.



10/36

In2014,TPHandTCLHINmetwiththeleadershipofover15Toronto-based

IndigenousorganizationstogatherrecommendationsonTIHACmembership,

governance,rolesandresponsibilities.

TIHAC is structuredaccording to

community stakeholderrecommendations:

• MeetingsareguidedbyanIndigenousfacilitatorwithextensiveknowledgeofIndigenouscommunitygovernanceandfacilitationbothlocally,provinciallyandnationally.

• Asmall,agilecircleofIndigenous Advisors.

• MembershiprepresentsthediversitywithinToronto’s

Indigenouscommunity.• Advisorsrepresentthemselves

ratherthanthemandatesoftheorganizationstheyworkfor.

• Recommendationsareissuedthroughaconsensusdecision-makingmodel.

• TwoIndigenousEldersareintegraltotheCircleandusecultural

elementssuchasmedicines,ceremonyandtraditionalguidanceatallmeetings.

• Largercommunitymeetingsalwaysincorporateasacredfirefortheduration.

• TIHACisguidedbyanEldersCouncil.

• Youthparticipatethroughanactive YouthCouncil.

• Indigenousworldviewsareintegratedthroughout.

• TPHandTCLHINleadershipparticipateatmeetingsinaconsultativeandlisteningcapacity,notasAdvisors;theyalsoensureactiononrecommendations.

• ReferencegroupsareestablishedtoaddressspecificsocialdeterminantsofIndigenoushealth,asnecessary.

•PTOs(ProvincialTerritorialOrganizations)areconsulted,whenrequired.

TheSteeringCommitteealsometwiththeMinistryofHealthandLong-TermCare,MinistryofAboriginal AffairsandProvincialTerritorialOrganizationstodiscussIndigenous

healthplanninginTorontoandfutureopportunitiesforcollaboration.

TIHAC’smandateisalignedwiththestrategicprioritiesofboththeMinistry

ofHealthandLong-TermCareandtheMinistryofAboriginalAffairsasoutlinedinthe2014mandateletterssenttoeachministrybyPremierKathleenWynne.

Strategic Alignment

ThischartdetailshowtheTIHSisinalignmentwiththeprioritiesidentified

byinternational,national,provincialandlocalstakeholders.

Photo(lefttoright):TroyObed,

KaitlynAdams-Lewis,Sam

Kloetstra,MylesJacko,Connor

PionanndAkeeshaFootman



11/36

STRATEGIC ALIGNMENTSTAKEHOLDER ALIGNMENT WITH TIHS

International

UnitedNationsDeclarationontheRightsofIndigenousPeoples

Indigenousself-determinationandgovernanceintheplanninganddeliveryofculturallysafeprogramsandservices

Federal

Truth and Reconciliation CommissionTo respect Indigenous health care rights, increase access to traditional healing, improve health outcomes, cultural competency training

for health care providers and ensure community engagement in the planning, delivery and evaluation of health programs

To ensure the availability of, or access to, health services for First Nations and Inuit communitiesFirst Nations and Inuit Health Branch

Provincial

Ministry of Health and Long-Term CareEfficient coordination between LHINs and public health, greater access to high quality, client-centred and culturally appropriate

services in line with Excellent Care for All Act , focus on seniors, mental health and addictions

Cross-government coordination, increase in Indigenous decision-making, focus on socio-economic influencers – particularly

education and through Walking Together: Ontario’s Strategy to End Violence Against Aboriginal Women

Focus on equity: closing achievement gap between Aboriginal and non-Aboriginal students

Aboriginal Children and Youth Strategy will guide system transformation of services for Aboriginal children and youth including mental

health, suicide prevention, child welfare and youth justice

Aboriginal component of Ontario’s Long-Term Affordable Housing Strategy

Mandatory Indigenous cultural competency training for all public servants

Advancing cultural competency training, palliative care, mental health & addictions and Indigenous engagement in diabetes

Political Accord with the Premier of Ontario’s office

Delivers programs and services in the area of health, signed an Ontario Metis nation framework agreement with the province in 2008

Ministry of Aboriginal Affairs

Ministry of Education

Ministry of Children and Youth Services

Ministry of Municipal Affairs and Housing

Public Service of Ontario

Provincial Indigenous Health Leads Network

of the LHINS

Chiefs of Ontario

Metis Nation of Ontario

LocalToronto Aboriginal Support Services Council Advancing Indigenous Health issues through policy, advocacy and research

Implementation of Indigenous Health Strategy part of TPH’s Strategic Plan and in line with foundational principles of community

engagement and health equity

Aligns with TC LHIN goal and strategic priorities of a healthier Toronto with positive patient experiences, a population health

approach, health and community care transformation, health equity, Citizens’ Panel and Patients First Indigenous consultations

Statement of Commitment to Aboriginal Communities in Toronto (2010)

Provides advice to Mayor and Council to promote interests of Toronto’s diverse Indigenous community

TPH

TC LHIN

City of Toronto

Aboriginal Affairs Committee of Toronto City

Council



12/36

VISIONINGTHEINDIGENOUSHEALTHSTRATEGY

TheVisionWheelwaskeytothedevelopmentoftheTorontoIndigenousHealthStrategy(TIHS)and

willcontinue toactasroadmapforimplementation,evaluation andrenewal.

TheVisionWheelisadaptedfromthetraditionalMedicineWheelandbasedonteachingsVanessaAmbtman-Smith(formerlyoftheTCLHIN)

receivedfromCreeandOji-CreeElders.

ThereisnoonesymbolorteachingthatrepresentsthediversityacrossIndigenouspeoples.VisioningthroughtheMedicineWheeldoesnotrepresentauniversal“pan-Indigenous

approach.”ThisisaspecificchallengeintheurbanIndigenousenvironmentwherealargenumberofIndigenouspeoplecometogether

frommanydifferentnations.

TheMedicineWheelisbasedonIndigenousculturalvalues,traditionandspirituality.Itsfourdirections(East,South,WestandNorth)symbolizecompleteness,wholeness,connectednessandstrength.In

ordertoachieveoptimalhealthandwellnesstheMedicineWheel’selementsmustbeinbalance–thePhysical,Emotional,Mentaland

Spiritual.TheTIHSVisionWheelbeginsattheeasterndoorwiththevisiontocreateacommunity-drivenandwholisticstrategythatwillimprovehealthservices,qualityofcareandaddressthesocialdeterminantsofIndigenoushealthwiththegoalofimprovinghealthoutcomes.

Meaningfulandrespectfulrelationshipsarethefocusofthesoutherndirection.Inthisphase,TIHACwasdeveloped,aswererelationshipswithvariousstakeholderssuchastheMinistryofHealthandLong-TermCare,MinistryofAboriginalAffairs,Provincial

TerritorialOrganizations,aswellasIndigenousandnon-Indigenousserviceproviders.

Knowledgeisthefocusofthe

westerndirection.NumeroussourcesofevidenceinformedthedevelopmentoftheTIHS:Indigenoushealthdata(andgaps),literature,livedexperience,traditionalteachings,evaluationsandcommunityinput.

Actionisthecentralfeatureofthenortherndirection.Itisthroughactionthatthestrategicdirectionsofthe

TIHSwillberealized.



13/36



14/36

HARMONIZEDGOVERNANCE:

TIHAC’STERMSOFREFERENCETIHACisguidedbytheconceptofharmonizedgovernance.ThisreferstotheblendingoftraditionalIndigenouswaysofbeingwithwesternsystems.ThiscommitmentisengrainedinTIHAC’sTermsofReference.

AnElderopensandcloseseachmeetinginatraditionalway.AnEthicalCodeguidesallmeetingsandincludestheroleofElders,how Advisorsworktogether,aswellastraditionalmodestoaddressconflict.

ADVISINGANDINFLUENCING:

TIHAC’SMANDATETIHAChasbeenmeetingregularlysinceMarch,2015.Theirmandateistwofold:

1.Provideoversight,guidanceandadvicetotheTCLHINandTPHintheidentification,planning,implementation,funding,researchandevaluationofculturallybased,culturallysecurehealthprogramsandservicesforthediverseIndigenouscommunityinToronto.

2.ToinfluencepublicpolicythatimpactsIndigenoushealthoutcomes.

ROLEOFSPONSORS

AT TIHACMEETINGSTPHandTCLHINleadershipattendsCirclemeetingsto:

1. ActivelylistentoTIHACdiscussions.

2. ProvideinformationandcontexttoinformTIHACrecommendations.

3. Reportbackonorganizationalfollow-through.

4. BuildtrustandstrongrelationshipswithTIHAC.

5. Shareinformationfromothercommunity/organizationalinitiativestoensurealignmentwithTIHACrecommendations.



15/36

TIMELINE OFINDIGENOUS HEALTH

PLANNING IN TORONTO

INTERNATIONAL

NATIONAL

LOCAL

2008

FirstRoundtableonUrban

AboriginalHealth

Between

2008-2010Four

RoundtablesonUrban

AboriginalHealthin

Torontowereheld

2010

TheGovernmentofCanadaagrees

topay$145Millionvialand

claimtotheMississaugasofNewCredittorectifythe1787 Toronto

Purchase

2010

TorontoCityCouncil

adoptsStatement of

Commitment

to Aboriginal

Communities

in Toronto

2007

2007

UnitedNationsDeclarationoftheRightsofIndigenous

People

2008

TCLHINandTPHcombineIndigenous

engagement

2011

Interim AdvisoryCircle

wascreatedtoprovide

guidanceon

fundingforyouthmentalhealthand

additionsandactivitiesofthe

Roundtable

2012

Youthmentalhealthandaddictions

programmingfunded

2011

Toronto AboriginalResearch

Project(TARP)reportreleased

2012

CreationoftheWell

LivingHouse–anaction

researchcentre

focusedonIndigenoushealthandwell-being

2013

SeventhGenerationMidwivesofToronto

movesintothenewlyopened

TorontoBirthCentrewith

anIndigenousfocusonhealthy

maternalandchildoutcomes

2014

Stakeholderengagementtoinformthe

creationofthepermanent

healthadvisoryCircleandplanning

processfortheTorontoIndigenous

HealthStrategy

2014

Eldersand YouthCouncils

established

2015

MandateofTorontoIndigenous

HealthAdvisoryCirclefinalized

2011

NationalUrban

AboriginalPeoplesStudy

released

2011

Toronto Aboriginal

SocialServicesCouncil(TASSC)

incorporated

2013

AnishnawbeHealthToronto

reportonpremature

andpreventableIndigenous

deathsbrought

toTorontoBoardofHealth

2014

Extensivecommunity

engagementprocess

completedbytheNative

CanadianCentreofTorontotoinformthe

TIHACstrategicplanningprocess

2014

Knowledgeproducts

anddataon Aboriginal

healthcreatedtoguidethe

Circle

2015

TorontoIndigenous

Health Advisory

Circlelaunchandcommunity

feast

2015

TruthandReconciliationCommission-finalreportandcallsto

action

2016

LaunchofToronto

IndigenousHealth

Strategy



16/36

CEREMONIALLAUNCHOFTIHACOn January 23rd, 2015 the TIHAC was officially launched at the Native Canadian

Centre of Toronto. The day was facilitated by Michelle Sault and included a sacred

fire, sunrise ceremony, pipe ceremony and community feast. Elder Kahontakwas

(Diane) Longboat gave each Advisor a symbolic element and cardinal directionto represent their TIHAC role and responsibilities which carries throughout each

meeting and all of the work that the TIHAC does on behalf of the community.

Photos(lefttorightbyrowstartingattop):SaraWolfe,

SarahMidanik,Kenn Richard,Akeesha Footman,

SamKloetstra,Myles Jacko,Joe Hester,Larry Frost,

Kahontakwas(Diane)Longboat,Kawennanoron

(Cindy)White,Amy Desjarlais,Dr. JanetSmylie,Dr. David McKeown,SusanFitzpatrick,EllenBlais,

Leila Monib,MichelleSaultand Dr.Bernice Downey.


17/36

TIHAC ADVISORS: SKILLS, DIRECTIONS AND ELEMENTSNAME DIRECTION ELEMENT

Sara Wolfe, RM

Representsfamilies,mothers,childrenandtheunbornEAST Seedsofanewgenerationinanewera

Sarah Midanik

RepresentsthefoundationalelementsofIndigenouslanguages,culturesandknowledge

systemsthatareessentialtohealthandwellbeing

EAST Basketholdingthosethingsmostsacredtoourfuture

Kenn Richard

Representsadvocacy,heartofthepeople,andthefulfillmentofurbancommunityneedsSOUTH

EaglefeathercarryingtheprayersofthepeopletotheCreatorforabalancedlife

Youth Council: Akeesha Footman, Myles Jacko, Sam Kloetstra, Devin Trottier,

Kaitlyn Adams-Lewis, Daniella Robinson, Connor Pion, Cedar Landon

Carriesthenewgeneration’swishesanddreamsforthefulfillmentofthe8thFireProphecy:theriseofIndigenousNations

SOUTH Fireinthecandle

Larry Frost

CarriesmessagesfromtheTorontoAboriginalSocialServicesCommitteetoTIHACandbackagain;aidedbytheguidanceoftheAncestors’sacreddirection

WEST Blackandwhiteflagsrepresentingtheancestors

Joe HesterUsestoolsleftbytheAncestorsonthepathwayforustopickuptobecomewellandbalancedinourrelationshipswitheachotherandCreation

WESTPipebundleholdingsacredguidancefromthespirit,traditionalknowledgesystemsandsacredceremonies

Elders Council: Kahontakwas (Diane) Longboat, Kawennanoron (Cindy) White,

Amy Desjarlais

Holds the sacred connection to the Spirit during meetings to ensure integrity and transparency

in all relationships and issues, as well as sharing wisdom and teachings to guide the work

NORTH Turtleshellrattlerepresentingtruth

Dr. Janet Smylie

Usesthebestofresearchanddatato“seefarahead”inmeetingtheneedsofToronto’semergingIndigenouspopulation

NORTHGuswenthabelt(tworowwampum)todepictourrolesasIndigenousnationsandCanadiansmutuallysupportingoneanotherbutnotinterferingorseekingtochangeoneanother

TIHAC SUPPORT

Dr David McKeown Ex-OfficioTIHACmember,MedicalOfficerofHealthfortheCityofToronto

Susan Fitzpatrick Ex-OfficioTIHACMember,TCLHINChiefExecutiveOfficer

Ellen Blais TIHAC Secretariat, TC LHIN Aboriginal Health Consultant and Communications Lead

Leila Monib TIHAC Secretariat, TPHHealthEquitySpecialist

Michelle Sault TIHAC Facilitator,PrincipalConsultant,CornerstoneConcepts

Dr. Bernice Downey TIHAC Indigenous Health Governance Consultant Principal, Minoayawin Consulting



18/36

Conceiving the TIHS

“TherehavealwaysbeensystemsofIndigenousgovernance.Weneedtounderstandthatwecangovernourselvessuccessfullyandthatwealwayshave.Wehavestrongsystemicwaysoffiguringoutanswersthatour

communityneeds.”

EllenBlais,AboriginalHealthConsultantLead,TorontoCentralLocalHealthIntegrationNetwork,

andCircleSecretariat



19/36


20/36

Overarching Themes

“Youneedtolookatallsocialdeterminantsofhealth.

Youneedtosomehowaffectthoseareasandsectorstorecognizeandcontributetoahealthycommunity.”

JoeHester,ExecutiveDirector,AnishnawbeHealthToronto Photo:NicolePenak,communitymember



21/36

InformedbytheworkofIndigenoushealthspecialist, Dr. BerniceDowney,TIHACwovethreeoverarchingthemesthroughouttheTorontoIndigenousHealthStrategy:

RECLAMATION OFWELLBEING Well-beingwillbereclaimedthroughIndigenous-centricgovernance(selfdetermination)andimprovedaccesstoIndigenoushealingknowledgeandpractice,asarticulatedintheUnited

NationsDeclarationontheRightsofIndigenousPeoples(2007).

BasedonHaudenosauneeand Anishnawbeteachings,theTIHACEthicalCodeofBehaviourforCircleMemberswasdevelopedbytheEldersCouncilandembedsthereclamationoftheserights.

TheEthicalCodeandTIHACTermsofReferenceguideTIHACAdvisorsinhowtointeractwithoneanotherandmakedecisions.

TheVisionWheel(anadaptationofthetraditionalMedicineWheel)hasservedasawell-beingroadmaptodeveloptheTIHS.

SPIRITOFRECONCILIATION:MAKINGITRIGHTIn2015,theTruthandReconciliationCommissionofCanadareleasedtheirfinalreportandCallstoAction

toredressthelegacyofresidentialschoolsandtoadvancetheprocessofCanadianreconciliation.

The Calls to Action for the health

system call upon all levels ofgovernment to:

• Recognizeandimplementthehealth-carerightsofAboriginalpeople.

• Recognize,respectandaddressthedistincthealthneedsoftheMétis,Inuit,andoff-reserve Aboriginalpeoples.

• Recognize the value of Aboriginalhealing practices and use them in

the treatment of Aboriginal patients

in collaboration with Aboriginal

healers and Elders where

requested by Aboriginal patients.

• ConsultwithAboriginalpeoplestoestablishmeasurablegoalsto

identifyandclosehealthoutcomegapsbetweenAboriginalandnon-Aboriginalcommunities,andtopublishannualprogressreports

andassesslong-termtrends.Healthoutcomeindicatorsinclude:infantmortality,maternalhealth,suicide,mentalhealth,addictions,lifeexpectancy,birthrates,infantandchildhealthissues,chronicdiseases,illnessandinjuryindicatorsandtheavailabilityofappropriatehealthservices.OurHealthCounts:UrbanAboriginalHealthDatabaseProjectwillbeaninvaluableresourceasTIHACmeasuresandevaluatesTIHS progress.

TheTIHACGuswenthabelt(alsoknownasthetworowwampum)representstheoriginaltreatiesbetweensettlersandIndigenous



22/36

people.Itservesasareminderthatwearealltreatypeople–withrights,rolesandresponsibilitiesregardingreconciliationandthewell-beingofIndigenouspeople.

REINFORCEAPOPULATIONHEALTHAPPROACH Apopulationhealthapproachexaminesandrespondstohealth

inequitiesamonggroupsinordertoimprovethehealthofthewholepopulation.TIHACreviewedthefindingsofcommunityengagementsessionsledbytheNativeCanadianCentreofTorontoinadditiontoavarietyofWellLivingHouseknowledgeproducts.(Pleaseseetable:WellLivingHouseKnowledgeProducts.)

TheTorontoIndigenousHealthStrategyusesapopulationhealthapproachto:

• AddressthesocialdeterminantsofurbanIndigenoushealththroughactionstoinfluencethehealth, justice,education,housingandfoodsystems.

• Reducehealthinequities–differencesinhealththatareavoidable,unfairandunjust–throughprogramsandservicesthatareculturallysecure,accessibleandaddresshistoricandcurrentwrongs.

WELL LIVING HOUSE KNOWLEDGE PRODUCTS

TIHAC reviewed the following Well Living House documents as part of its priority setting process:

• TheAboriginalPopulationinToronto:ExistingSocio-DemographicandHealthInformation.

• AComparisonofGovernanceStructureswithinAboriginalHealthStrategies:BackgroundandGovernanceConsiderationsintheContextoftheToronto AboriginalHealthStrategy.

• AboriginalHealthProgramsandServicesintheCityofToronto.

• AMapandaComprehensiveListofServiceOrganizations.

• ProgramFundingStreams:TorontoAboriginalHealthandSocialServices.

• BriefingSynthesisofProgramandServiceGapsforAboriginalPopulationsinToronto.

• OurHealthCountsToronto:UrbanAboriginalHealthDatabaseProject,preliminaryfindings.



23/36

MissionToleadtransformationinhealthprogramsandservicestowardwell-beingforIndigenouspeopleinToronto.

VisionWeenvisionathrivingandhealthyIndigenouscommunityinTorontothroughtherespectfulharmonizingofpractices,policiesandresourceallocation.

Operating Principles1. HealthplansaredevelopedwithIndigenousPeoplesasfullpartners.

2. WhereverIndigenousPeoplesgotoaccessprogramsandservices,theyreceiveculturallyappropriate,safeandproficientcare,andallbarrierstooptimalcarehavebeenremoved.

3. Careisplannedtoberesponsivetocommunityneedsandisappropriate,efficient,effectiveandhighqualityatbothsystemsandinterpersonallevels.

4. DedicatedresourcesandfundingforIndigenousHealthprogramsandserviceswillsupportacoordinatedandcollaborativesystem.

5. LeverageandbuildthecapacityofIndigenousleadershipandIndigenouscommunitiestocare

forthemselves.


24/36

STRATEGIC DIRECTION #1 REDUCE HEALTH INEQUITIES FOR INDIGENOUS PEOPLES

Goal: To address barriers, gaps and access to health programs and services for Indigenous people in Toronto

Strategy: How will we do this? Deliverables: How will we know we have been successful? Partners/Stakeholders

Betterintegrationandcollaborationbetweenpreventative,primary,specialtyandacutecaresystemsandIndigenousorganizationsthroughthecreationofnetworksandpathwaysforpersonsneedingcareandserviceproviders

1. Developed/measuredpatientexperiencesthroughapeople’ssurvey.Timelyaccesstoservicesandclient-patientsatisfactionmeasured

2. Statisticallyclinicalsignificantimprovementinaccesstoprimarycare

3. Statisticallyclinicalsignificantimprovementinaccesstomentalhealthandaddictionsservices

4. Establishedandimplementedastandardreferralmechanism.Developedstandarddocumentforreferralandacceptanceofpatients

5. CommunityHealthCentresacceptreferralsfromemergencydepartments

6. Indigenouspopulationidentifiedasapriorityinthestrategic/programplans

offundedorganizations

• TorontoCentralLocalIntegrationNetwork(TCLHIN)

• TorontoPublicHealth(TPH)• OurHealthCounts(OHC)• HealthServiceProviders(HSPs)• HealthQualityOntario(HQO)• MentalHealthandAddictions

ReferenceTable

IncreaseinvestmentinIndigenousculturalproficiencycontinuumandlearningopportunities

1. Arangeoflearningopportunitiesareavailableandarecommensuratewithwhoisbeingtrainedandwithoptionsforincreasedlevelsoflearningbeyondfoundationallearning

2. Measuredtraineeexperience,traineesatisfactionresponseindicatesacceptanceofculturalproficiency

3. Capturednumberofindividualsthatgothroughthetraining

4. Demonstratedincreaseinculturalproficiencyasmeasuredthroughevaluations

5. Devisedsupportsandprogramstointegrateculturalproficiencytrainingforhealthprofessionalsandstudents(nurses,midwives,physicians)

• Non-Indigenouscommunity• TPH• TCLHIN• Relevantuniversitiesandcollegesin

Toronto• HSPs• nonHSPswhohavehealthcarestaff• SouthernOntarioAboriginalHealth

AccessCentre• OntarioAssociationofCommunity

HealthAccessCentres• Relevanthospitalspilotingcultural

proficiencyinitiatives

Increaseinvestmentinculturallysafeprimarycareforchronicdiseases

1. Documentedneedsandunmetneeds

2. Trackedthecurrentinvestmentandreportedonincreasesininvestmentforculturallysafeprimarycareforchronicdiseases

3. Accessmeasuresareinplace

• TCLHIN• HQO• HSPs• OHC



25/36

4. SamestandardofcareforIndigenouspatientsasmainstreamisevidenced

5. Indigenouspopulationidentifiedasapriorityinthestrategic/programplansoffundedorganizations

Developmentofa1-800Indigenoushealingand

caringlineinconjunctionwithaknowledgehubandclearinghouseforprovidersandpatients

1. Completedaneedsassessment

2. Completedanenvironmentalscan

3. Developedalistofresources

4. DevelopedadatabaseofmapsofservicesandAboriginalhealthpractitionersandsensitivedoctors

5. 1-800callcentreestablished

6. Devisedanevaluationmechanismthatincludesfeedbackfromclients/serviceprovidersthatservicesareimprovingandmeetingneeds

• TCLHIN

• TPH

• Indigenouscommunityorganizations

• Non-Indigenouscommunityorganizationsprovidinghealthprogramsandservices

IntegratemoreIndigenoussystemnavigatorsintothe

existingsystem

1. IncreasednumberofIndigenousSystemNavigators

2. Aminimumnumberofemployeesineachfundedagencyareidentifiedand

trainedasaculturallycompetentnavigatorofthehealthsystem3. Aminimumnumberofstaffateachhospitalaretrainedandidentifiedas

culturallysafeandsecurenavigatorsofthehealthcaresystem

4. AminimumofstaffatTorontoPublicHealthareidentifiedasculturallycompetentsystemnavigatorsforIndigenousclients

• TPH

• TCLHIN

• HSPs• HQO

Ensurehealthcarespacesarewelcoming,accessibleandinclusiveofIndigenouspeople

1. Completedabaselinestudytodeterminenumberofwelcoming,accessibleandculturallyinclusivespaces

2. Measuredanincreaseinspacesthatallowforculturalpractices(e.g.smudging)


• TCLHIN

• TPH

• HQO

• HSPs

Deviseorsupportexistingprogramsforseniorsandfamiliesimpactedbyresidentialschools

1. SupportedtheCallstoActionfoundintheTruthandReconciliationReport

2. Increasednumberofprogramsforfamiliesimpactedbyresidentialschools

• TCLHIN

• TPH


• OrganizationsworkingwithIndigenouscommunitymembers



26/36

STRATEGIC DIRECTION #2 INFLUENCE THE SOCIAL DETERMINANTS OF INDIGENOUS HEALTH

Goal: To influence systems that impact the health of Indigenous people in Toronto

Strategy: How will we do this? Deliverables: How will we know we have been successful? Partners/Stakeholders

HOUSING SYSTEM

AdvocateforlandlordracismtowardIndigenoustenantsbeaddressed

1. Advocacyworkisunderwayanddemonstrable

2. Policyhasbeendevisedandimplementedtoaddressracismwithlandlords

• TPH• BoardofHealth• RelevantCityofTorontodepartments• Landlordandtenantorganizations

InfluencesupportivehousingpolicyforthebenefitofIndigenousyouth,2Spiritandseniorsthatissecure,safeand

addressesrisks

1. Policyhasbeendevelopedandimplementedtoaddresshousing issuesrelatedtotwo-spiritedpeoples,Indigenousyouthandseniors

2. SupportedtherecommendationsintheTruthandReconciliationReport1

• TCLHIN• TorontoCommunityHousing

Corporation(TCHC)• Housingsectororganizations

• TPH• BoardofHealth• HQO• RelevantCitydepartments• RelevantProvincialMinistries• MinistryofCommunityandSocial

Services

InfluencesupportivehousingpolicyforthebenefitofpregnantIndigenouswomenandIndigenouswomeninvolvedwiththechildwelfaresystem

1. PolicyhasbeendevelopedandimplementedtoaddressissuesofIndigenouspregnantwomenandaccesstosupportivehousing,especiallywhileinvolvedwithchildwelfare

2. SupportedtherecommendationsintheTruthandReconciliationReport2

3. Advocacyworkunderwayanddemonstrableregardingthe inclusionaryzoninglawstodedicatehousingunitsfortheIndigenouscommunity

4. SamestandardofcareforIndigenouspatientsasmainstreamisevidenced


• TCLHIN• TCHC• TPH• Housingsectororganizations• BoardofHealth• HQO• RelevantCitydepartments• RelevantProvincialMinistries• MinistryofCommunityandSocial

Services• NationalAboriginalCouncilof

Midwives(NACM)



27/36

FOOD SYSTEM

Advocateforaffordable,healthyfoodforIndigenouspeopleinTorontousinganIndigenouslens(including

throughtheTorontoFoodStrategy)

1. Creationofcommunitygardeninitiativesaresupported

2. Policiesforgreenspacesforfoodsustainabilityareresearchedandreported

3. Strategiestoincreaseaccesstoaffordable,healthyfooddevelopedand

implemented4. Advocacyworkunderwayanddemonstrableregardingfreeaccessto

prenatalvitamins

• TCLHIN

• HSPs

• SouthernOntarioAboriginalDiabetesInitiative

• TPH-TorontoFoodStrategy,ChronicDiseaseandInjuryPrevention

• HQO

• NekenaanHouse

• CityofTorontoPlanning

EDUCATION SYSTEM

AdvocateforagreaternumberofIndigenousteachers,professorsinthe

educationsystem

1. Advocacyworkisunderwayanddemonstrable • MinistryofEducation

• AllGTAcollegesanduniversities

Advocateforstudentsintheeducationsystemtohaveexperientiallearningopportunities(inadditiontoculturalcompetencytraining)regardingIndigenousceremoniesand/orceremonial

teachings

1. Advocacyworkisunderwayanddemonstrable • TorontoDistrictSchoolBoard(TDSB)

• TorontoCatholicDistrictSchoolBoard(TCDSB)

• MinistryofEducation

• AllGTAcollegesanduniversities

• ConseilscolairededistrictcatholiqueCentre-Sud(CSDCCS)

AdvocateforIndigenous-specificadultlearningcentres

1. Advocacyworkisunderwayanddemonstrable • TDSB

• TCDSB

1http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf 2http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf


http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdfhttp://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdfhttp://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdfhttp://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf


28/36

EDUCATION SYSTEM (CONTINUED)

Advocate for the development

of a state of the art,

well-equipped, centre of

excellence that prepares

Indigenous youth for entranceinto post-secondary programs

that includes housing,

financial and transportation

support and is infused with

Indigenous world view

1. Advocacyworkisunderwayanddemonstrable • TDSC

• TCDSB

• MinistryofTraining,CollegesandUniversities(MTCU)


AdvocatefortargetedprogrammingforIndigenousstudentsto

becomepartofschoolbasedsportsteams

1. Advocacyworkisunderwayanddemonstrable • TDSB

• TCDSB

• MTCU

•

RighttoPlay• CanadianLacrosseAssociation


JUSTICE SYSTEM

AdvocatewithinjusticesystemforculturallyappropriatecourtprocessesforIndigenouswomen

attendingfamilycourt

1. Advocacyworkisunderwayanddemonstrable • MinistryoftheAttorneyGeneral

• Ministry of Child and Youth Services (MCYS)

• ChildProtectionAgencies

• HealthandSocialServiceAgencies

•

AboriginalLegalServicesHUMAN RIGHTS

City-wide campaign to

address the role of racism

with an anti-oppression,

social justice framework

1. Demonstratedsupporttoothersdoingtheworkofaddressingnon-healthrelatedcampaignstoaddressracism

2. Demonstratedsupportforaproposalforprovincewidemandatoryculturalcompetencytraining

• TCLHIN

• TPH

• BoardofHealth

• MOHLTC

• Anti-Racism/HumanRightsorganizationsandinitiatives



29/36

3. ProvidedadvicetotheMinisterofHealthonimpactofracismonthehealthofIndigenouspeople

4. Supportedchallengestotargetseniorleadershiptotakeculturalcompetencylearningopportunities

VIOLENCE

Support programs that

address violence in Toronto

Indigenous community

1. Advocacyworkisunderwayanddemonstrable

2. SupportgiventoagenciesthathaveamandateonviolenceagainstIndigenouswomen&families

3. SupportedthecallstoactionsintheTruthandReconciliationReport3

• TCLHIN

• TPH

• RelevantMinistries

• CommunitygroupsdedicatedtosupportingMissingandMurderedIndigenousWomen(MMIW)

EARLY CHILDHOOD

Expansion of culturally

secure parenting support

programs

1. IncreasednumberandsizeofculturallysecureparentingprogramsforIndigenouscommunity

• TPH

• Indigenousorganizations

• MCYS

3http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf


http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdfhttp://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf


30/36

STRATEGIC DIRECTION #3 HARMONIZE INDIGENOUS AND MAINSTREAM HEALTH PROGRAMS AND SERVICES

Goal: To close the institutional care gap through harmonized healing spaces and frontline services

Strategy: How will we do this? Deliverables: How will we know we have been successful? Partners/StakeholdersSupportnewandexistingpublichealthpromotionprogramsfocusingonphysicalactivity,healthyeating,mentalhealthpromotion,healthyparenting,youthresilienceandchronicdiseasepreventiontobeculturallyappropriate.

1. BaselinestudytodeterminewhatprogramshavebeentargetedtotheIndigenouscommunity

2. Researchintodataandqualitymeasurementsofexistingprogramsrevealed:

• Improvedaccesstohealthpromotionprograms

• Increasedphysicalactivityforparticipants

• Increasedknowledgeofculturallyappropriatehealthpromotionmessaging

•

Improvedqualityofprograms• Improvedincreaseinself-reportedhealthstatus

• Investmentsinexistingandnewprogramsaddressingchronicdiseaseprevention,mentalhealthpromotion,healthparentingandyouthresiliencefortheIndigenouspopulationareinplace

• TPH


• MOHLTC

• PublicHealthOntario(PHO)

• SOADI(SouthernOntarioAboriginalDiabetesInitiative)

• TorontoCancerPreventionCoalition

• Mentalhealthandaddictionsreferencetable

SupportnewandexistingpalliativecareprogramsforIndigenouspeoplesthatintegrateIndigenousworldview.

1. ImplementedtheTCLHINPalliativeCareStrategy(PCS),whichincludedaspecificAboriginalpalliativecarestrategy

2. Identificationofemergingopportunitiestodevisestrategies

3. Evidenceofco-designofstrategybyIndigenouscommunity

4. Determinedtheproportionofpeoplewhoaredyingwithpalliativecaresupport

5. IncreasedproportionofIndigenouspatientsreceivingculturallysafepalliativecaresupport

6. PalliativeCarestrategiesareinalignmentwithIndigenousmidwiferypractices

7. Identificationoftraditionalresourcescompleted,implementationoffamilygriefpractices

• TCLHIN

• HSPs

• NationalAboriginalCouncilofMidwives(NACM)



31/36


32/36


33/36

REALIZINGTHE VISION AReclamationofWellBeing:VisioningaThrivingHealthyUrbanIndigenousCommunity:Toronto’sFirstIndigenous

HealthStrategyaffirmsTIHAC’sbeliefthatself-determination

isatthecoreofbuildingastrong,healthy,andresilientIndigenouscommunity.

Toronto’s Indigenous population

is incredibly diverse. There are

Indigenous people who call Toronto

their permanent home and others

who travel between this city and

Indigenous communities to have

their health needs met. As such, thisstrategy recognizes that improving the

health of Indigenous people in Toronto

will require a coordinated effort

between diverse Indigenous leadership

and all levels of government.

TIHAC acknowledges that the legacy

of colonial trauma has resulted

in significant health inequities for

Indigenous people in Toronto. Some

of these inequities stem from the

intergenerational effects of residential

schools, as well as systemic

discrimination and service gaps in the

health care and public health systems.

TIHAC commends TC LHIN and TPH for

working with the community to improve

Indigenous health through culturally

competent services and strategies to

stimulate systemic change.

Actualizing the vision for a healthy

urban Indigenous community requires

a cross-sectoral approach. Along with

TC LHIN and TPH, TIHAC looks forward

to working with provincial ministries,

municipal divisions and Indigenous

Provincial Territorial Organizations.TIHAC will also work with experts

in the fields of education, housing,

justice, child welfare, food security,

human rights, family violence and

early childhood development. Together

we can make it happen.

There is a lot of exciting work

ahead – including the development

of a comprehensive implementation

framework, a communications

strategy and an Indigenized evaluation

plan that will measure our success.

TIHAC expresses gratitude to all of the

community members, agencies and

stakeholders who were instrumental

in creating Toronto’s First Indigenous

Health Strategy 2016-2021.

What is your vision of a healthy and thrivingIndigenous community in Toronto in 2050?

“Iamhopingthatpeoplewillenjoyequity,makealivingandenjoytheirrights.Ihopetheyhaveaccessto

servicesandmostimportantly,toeducation.TheCirclecanlooktotheyouthtoguideourfuture.”

RuthAnneCyr,CommunityElder

“It’salivingprocess,andsoitmoveswiththetime.ThereisacontinualdialogueinthecommunityaboutwhatahealthyIndigenouscommunitycanlooklike.”

JoeHester,ExecutiveDirector,AnishnawbeHealthToronto

“IseeathrivingandhealthyIndigenouscommunitywhereIndigenouspatientscanmoveseamlesslythroughthehealthcaresystem,whereculturalelementsofcareareofferedasachoicewitheveryinteraction,andwhereIndigenouspeoplearedeterminingtheirownpathwaystohealththataremeaningfultothem.”

SusanFitzpatrick,ChiefExecutiveOfficer,TorontoCentralLocal

HealthIntegrationNetwork

“ThisisamodelofIndigenoushealthinIndigenoushands.Wecanonlybesuccessfulwiththecommunity.IthinkthatthisisparticularlytrueoftheIndigenouscommunityifweworkinpartnershipandtakeourleadfrommembersoftheIndigenouscommunitythemselves.”

Dr.DavidMcKeown,MedicalOfficerofHealth,CityofToronto



34/36

TIHACCOMMUNITYLAUNCHAND FEASTPOSTER

ThisposterwasdevelopedbyElder Diane LongboatandtwoIndigenousartists:Joseph Sagaj and Holly Fisher.

GuidedbytheElder’steachings,thecolourfulandcompleximageryreflectsthediversityofToronto’sIndigenouscommunity.TheElderandartistsvisuallydepictedTIHAC’sworkincommunityhealing:spiritually,emotionally,mentallyandphysically.

Moon and StarsThemoonandstarsdepictthevastuniverse.ThisiswhereTIHAC Advisorssituatetheirmindstodocreativeandinnovativework.GrandmotherMoonrepresentstheSacredFeminine,thehealingpowersofwaterandthecycleoffertility.ThesolidyellowlineinvokesGrandfatherSunandrepresentsastrong

commitmenttocommunitywellbeing.

Moon

The TIHAC Community Launch and

Feast fell on the January 23, 2015

new moon. This is when people’s

minds come together in a peaceful and

measured way. New projects grow in

abundance and efficacy, like the face

of Grandmother Moon as she becomes

full. The bright, eclipse-like sliver of

moon represents the brightness of the

Advisors. Many Indigenous Nations

begin midwinter ceremonies on the

January new moon to give thanks for

last year’s abundance and pray thatthe upcoming cycle be just as good.

Stars

Thesestarstaketheshapeofthe‘BigDipper’.ThisformationrepresentstheManandWoman’spipe,inbalancewitheachother.ThesepipesareconnectedtotheNorthStar.TherearesevenstarsinlinewiththeSeven

GrandfatherteachingsandtheSevenGenerationsteachingwhichasksthatweconsiderhowouractionswillimpactthenextsevengenerations.ManyIndigenousbeliefsystemsviewstarsasAncestorswhohavegonetothespiritworld. T

O R O N T O A

B O R I G I N A L

H E

A L T H S

T R A T E G Y

You are invited to the

Community Launch

& Feast of the

Toronto Aboriginal

Health Advisory Circle

on January 23rd at

the Native Canadian

Centre of Toronto.A Celebration of the

Creation of the

Toronto Aboriginal

Health Strategy

7:30 - 8:30 am Sunrise Ceremony and Sacred Fire - James Carpenter

2:00 - 4:00 pm Community Ceremony and Launch - Diane Longboat

with Eagle Staf, Drumming, Singing, Pipe ceremony

4:30 - 6:30 pm Community Feast

6: 30 pm Cl os ing Ce rem on y

COMMUNITY LAUNCH & FEAST

FULL DAY

SCHEDULE

For more info please contact:

Ellen Blais: [email protected] Leila Monib: [email protected]



35/36

Star Blanket Logo

ThestarblanketrepresentstheSevenSacredLawswiththeeighthpointrepresentingAncestralwisdomand

guidance.EachAdvisorsitsatastarpoint;theirdirectionreflectstheskillsandgiftstheybring.Theswirlingcoloursdepictthedynamicnatureoflifeandtheinterconnectionoflife’sessentialelements:earth,fire,airandwater.TheredringaroundthestarsymbolizestheconnectionbetweentheAdvisorswhoworkcollaborativelytogetherandsitwithinthelarger

community.

The Woman on the Cliff

ThiswomanhonourstheimportanceofMotherEarthandwomenasthecreatorsoflifeandcarriersofwater. Asshegazesoffintothesky,shedrums(theheartbeatofMotherEarth)andsingstogivethanks.

Background Colours

Red depicts protection for the Circle’s

work and the community. The red

curve symbolizes Mother Earth – the

sacred land we depend and walk upon.

Purpleisthecolourofpeace.ItrepresentsIndigenouscommunity

leaders.Historically,purplewasreservedforroyalty.

Two Purple Wavy Lines

ThetwopurplelinesatthebottomsymbolizetheGuswenthaBeltof1613.AlsoknownastheTwoRowWampumBelt,thiswastheearliesttreatybetweentheDutchandtheHaudenosaunee,andwastheunderlyingbasisforallfutureHaudenosauneerelationshipswithEuropeanpowers.Theselinesrepresentrespectforthewaysin

whichIndigenousandnon-Indigenouspeopletravelontheriveroflife:Indigenousinacanoeandnon-Indigenousinaship.Ithonourstheprinciplesofnon-interference,peace,friendshipandrespect.

Thebeltendsareunfinishedtosignifyatreatywithoutend.Theresponsibilitiesofthisbeltare

meanttobesharedbyIndigenousandnon-Indigenouspeoples.TIHACrecognizestheTwoRowWampumBeltasrepresentingaharmonizedgovernanceprocessthatincludesIndigenousandnon-Indigenousleadership.



36/36

For more information:

[email protected]

A Reclamation of Well Being: Visioning a Thriving and Healthy Urban Indigenous Community

Documents

Transcript of A Reclamation of Well Being: Visioning a Thriving and Healthy Urban Indigenous Community