Written by KRISTA MAXWELL
Published: 29 November -0001
The past is increasingly invoked in contemporary Indigenous health scholarship, reflecting the growing interest of health professionals and others in how colonial histories have shaped Indigenous health and illness in the present. What opportunities and challenges does this trend present for the critical analysis of Indigenous peoples’ historical relations with the health care systems of settler states? What is at stake in health professionals’ invocations of history in present-day debates about Indigenous health inequities? How can critical scholars best advance rigorous understandings of settler-colonial health care systems as sites of assimilation and coercion (Mosby 2013, Daschuk 2013), but also as sites of Indigenous activism, employment, identity-making, assertions of sovereignty, and other forms of creative and constructive engagement (Kelm, 1999; Lux, 2001, McCallum, 2014, Drees, 2013)? This panel casts a critical gaze over the relationship between Indigenous health and Indigenous histories.
The current literature in Indigenous health acknowledges the importance of the past to understanding present-day system and structures inflencing Indigenous health and Indigenous health services. Yet narrow analysis of limited historical topics (in particular, a focus on Indian Residential Schools, the Child Welfare System and the Indian Act, see for example Smylie, 2015) has resulted in the sense both that these histories are adequately known and fully understood and that they capture the full extent of Indigenous experience. Moreover, the application of Indigenous health history in Indigenous health research is limited to particular kinds of histories and particular kinds of uses. Due in part to the current political and economic climate of Indigenous health research funding in Canada and perhaps also internationally, Indigenous histories of medicine, health, and health service are pressed into existing and problematic assumptions in population health work; health research methodologies including clinical trial and data analysis techniques which leave little room for critical and theoretical engagement; and narrow and instrumentalist research objectives that favour projects that measure and directly aim to improve contemporary health status, propose direct changes to current health systems and policy; and develop tools and content for educating health care professionals.
Aboriginal health research and the writing of Aboriginal history in Canada most often proceed in radically different spaces and conditions. Yet Indigenous health research is often premised on an implicit understanding of historical Aboriginal decline over time. How to gage, prevent or address decline is the central question of community health sciences. Decline is so thoroughly immersed in our knowledge about Aboriginal people’s health that we often appear as best as known, medicalized and numbered bodies – “at risk populations” compelling regulation. While the premise of change over time is so important to Indigenous health research, it is remarkable that current invocations of history in Indigenous health discourse reflect little critical involvement of people who analyze the past. At the same time, as a result of their methodological separation from contemporary Indigenous commnities, the work of many historians who study Indigenous health often misrepresents Aboriginal peple as fixed and passive objects that historical colonial policies and systems processed and exceeded, and their work rarely engages with the contemporary priorities of Indigenous health researchers.
This panel provides examples of such critical involvement, including analyses of how history is invoked in health research, historical relations of power in Indigenous health research and health care instituitons, and studies which show the importance of rigorous and nuanced historical understandings to Indigenous health research. By “critical” we mean analyses which are attentive to both historical and contemporary relations of power permeating health care systems, including Indigenous health research, which include but are not limited to (often narrowly-defined) colonial relations. For example, this may manifest in attention to how the political economy of healthcare shapes when and how history becomes meaningful to Indigenous health researchers; the social and political implications of health research discourse which repeatedly foregrounds Indigenous people as victims of history requiring professional interventions; the ways in which “knowing our history” is invoked as a powerful antidote to or prescription for poor health; and the use of certain understandings of history in trauma discourse (Maxwell, 2014).