COVID-19 and Indigenous public health sovereignty in British Columbia: Addressing systemic inequity through community-driven solutions

Indigenous peoples in the Western hemisphere have a tragic history with communicable disease. In the aftermath of contact, smallpox devastated Indigenous peoples. This project examines Indigenous community-driven solutions to COVID-19. Narratives of disease among First Nations are often deficit-based, aligning with patterns of systemic racism. This work challenges racist narratives, through an examination of community-driven health sovereignty-based solutions, to COVID-19. In British Columbia (BC) government responses to COVID recognized Indigenous peoples are vulnerable due to several factors: lack of access to healthcare, socioeconomics, and numerous comorbidities. Factors dovetail with vulnerabilities experienced in the aftermath of major climate events including wildfires. In BC, First Nations have begun to take greater control over their health care services. Though the pandemic exacerbated challenges, this research examines how health sovereignty was maintained and amplified amid the crisis. Such evidence is crucial to how First Nations successfully managed COVID-19. Of significance is how First Nations struggled to assert jurisdictional authority and maintain territorial integrity in protecting community. As communities went through restrictions, examples emerged where First Nations reinforced nation-based territorial boundaries to promote health sovereignty. This project explores Indigenous health protocols used to create health security, and measures success in amplifying health sovereignty. This work uses a mixed methods approach to examine territorial health sovereignty, drawing on OCAP® principles, interviews and community-based research methods. The main objective of this research is to produce and mobilize knowledge - applying the learnings from successful First Nations COVID-19 responses to mitigate the spread of COVID-19 and improve detection and management for self-determined First Nation communities and populations.