Grant: Project Grant

If you go to the doctor with a problem and the doctor tells you there is nothing wrong, you might feel rejected and misunderstood. Maybe in your community there is no other doctor to go to, so next time you are ill you decide not to go to the doctor at all, making things worse. Unfortunately, this situation is common in many parts of Canada. Our health care systems assume disease is the cause of illness. However, there is more than one way to understand health and health care. This study will help to build a health care system that learns from our different understandings, and constantly improves to provide better care. Many Indigenous peoples do not see health as an absence of disease, but as the result of good relationships with their family, community, environment, and spirit. The differences between these beliefs and the beliefs of our health care system mean that Indigenous patients often receive unhelpful, and even harmful, care. One idea is to build "learning health systems" that continuously improve care by learning from a variety of information sources, including patients. To improve care for Indigenous patients, learning health systems must know what to learn, how, and from whom. This research will take place over four years in Northwest Territories, where 51% of the population is Indigenous. Working with Indigenous and territorial governments, we will review literature and documents and speak with community members to answer three questions. First, how is health system learning understood from different cultural and academic perspectives? Second, how do health systems learn from the Indigenous communities they serve? Third, what should a comprehensive conception of health system learning look like? Our results will suggest what and how health systems must learn to improve care for Indigenous patients and all Canadians.