Equity From the Ground Up: How embedding Indigenous knowledge systems in a medical school can improve health outcomes
When Dr. Evan Adams, a member of the Tla’amin First Nation in Powell River, was doing his medical training, he was taught to look at patients through a very specific lens.
“In school, we were taught to deal with ‘the kidney disease in bed four,’” he remembers. “Instead, we need to see a seven-year-old girl, who is Indigenous and from a rural area and feeling very frightened right now. Along with her kidney issues.”
In late 2023, Dr. Adams, a visiting professor in the Faculty of Health Sciences and Deputy Chief Medical Health Officer at First Nations Health Authority (FNHA), was named Acting Associate Dean of Indigenous Health for the School of Medicine at SFU. Through the role, he will help SFU’s new school enhance its focus on patient-centred care that sees more than the disease.
A key piece of this shift is to embed Indigenous knowledge systems within the school’s curriculum for all students—one of the pillars of the new school.
With the start of a new medical school comes the opportunity to rethink medical care from the ground up. This is especially important after the pandemic exposed longstanding inequality in the healthcare system, including a lack of culturally safe care for Indigenous British Columbians.
“We are supposed to look after everyone, and we're definitely seeing that some are being looked after better than others,” said Dr. Adams. “Particularly with certain populations. We can do better. Equity should be one of the pursuits of healthcare workers, and part of what we’re doing is seeking equity.”
According to Dr. Adams, a focus on Indigenous knowledge systems can help bridge these gaps.
“By prioritizing and creating space for Indigenous knowledge and peoples, the health system becomes more inclusive and holistic,” he said. “It also allows for other values, like equity of service and equity of outcomes to be part of what we’re reaching for.”
The school also aims to train doctors to provide culturally safe care for marginalized communities to improve health outcomes.
Marie Hooper is an Elder from the kʷikʷəƛ̓əm (Kwikwetlem) First Nation and an Elder-in-Residence with the SFU Indigenous Student Centre. She has high hopes for what this new approach could mean for Indigenous people in BC.
“It will bring about trust, improved health care, one-on-one relationships, cultural safety free of racism and discrimination, and help give Indigenous patients a greater strength from their identity,” she said. Elder Marie noted that she wants to see health care rooted in holistic approaches to well-being that balance physical, emotional, mental, and spiritual health, which Indigenous ways of knowing prioritize.
These are goals Dr. Adams is enthusiastic about helping put in place.
“We have the opportunity. Why not go big?” he said. “If we create a system that is more responsive to Indigenous people, it will be more responsive to everyone. It will be more inclusive, safer, and have better accountability.
Social accountability, the social determinants of health, and other things that make people well, like equal access to justice and opportunity, are all connected," he added. "The inclusion of Indigenous knowledge systems allows us to break down silos and centre more equitable care for everyone.”