Extended abstract— Poisoning the body to nourish the soul: Prioritising health risks and impacts in a Native American community

Current United States government human health risk assessment and management regulations use physiological health outcome-oriented indicators for individuals to define and evaluate health risks and impacts. Yet many indigenous peoples view health on a community-wide scale rather than the individual, and consider social, environmental and cultural aspects of health to be equally important and fundamentally inter-linked with physical health (Harris and Harper 1997, Wolfley 1998, Garrett 1999, Arquette et al. 2002).  How health is defined and assessed is a high priority for indigenous communities because of the considerable health risks faced due to contamination of the natural resources on which community members have depended since ‘time out of mind’ and continue to depend on today (Harris and Harper 2001, USEPA 2002, van Oostdam et al. 2005).

This paper is motivated by the need to develop a more multi-dimensional and culturally meaningful definition of health in indigenous communities in North America.  We consider how to identify, measure and evaluate dimensions of health in the context of environmental changes experienced by the Swinomish Indian Tribal Community, a fishing community in western Washington State. The proposed health measures are inclusive of, yet differ from, conventional risk-based measures primarily because they reclassify the constituent components of ‘health’ and incorporate measures or scales that better reflect community concerns.

Results demonstrate how resident members of the Swinomish community face adverse health impacts from the harvest and consumption of culturally important traditional foods, primarily salmon and shellfish that have been contaminated by anthropogenic sources (view photos of a Swinomish community shellfish harvest). These traditional foods, and the acts of harvesting, preparing, storing and consuming them, are central to the Swinomish cultural practices and way of life.  Traditional foods are connected to other key facets of the community such as education and ceremonies, all of which play important roles in creating and maintaining the health of the community.

We describe a health evaluation tool devised using descriptive scaled rankings to clarify non-physiological health risks and impacts in relation to contaminated seafood. By using Swinomish meanings of health in reference to seafood where contamination of aquatic natural resources has been found, we illustrate that seafood represents much more than a caloric food source; seafood is a symbolic, deeply meaningful source of nourishment that feeds the spirit as well as the body. Food security, ceremonial use, knowledge transmission, and community cohesion all play primary roles in Swinomish definitions of individual and community health, and complement physical indicators of health. Thus, to eat less seafood—as prescribed on the basis of current physiological measures—may actually be detrimental to the Swinomish concept of health. 

In the US context, treaty status entitles the right to health for indigenous people and their natural resources.  Inherent in this right is the ability to define, prioritize, and assess health; rights heretofore acknowledged by the treaty parties (NCAI 2004, USEPA 2006).  Failing to recognize Swinomish health risks transgresses legal recognition of the right to self-define and protect health in both international protocol and nation state interpretations of treaty rights (O’Neill 2007).

References:

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NCAI (National Congress of American Indians), 2004. Use of tribal fish consumption rates by USEPA. Resolution MOH-04-023. June 21.

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