An allied research paradigm for epidemiology research with Indigenous peoples

There is no shortage of epidemiology research describing the ill health of Indigenous peoples in Canada and globally and many of these studies have had negative repercussions on Indigenous communities. However, epidemiology can also be a helpful tool for supporting the health and health services of communities. This paper challenges the reader to consider the harms of epidemiology which essentialize Indigenous communities as sick and in need of help. It then discusses, from the perspective of a settler physician and clinical epidemiology student, how we may be able reconcile the field of epidemiology research with the needs of Indigenous communities. In doing so, it describes an allied research paradigm for epidemiology.

Although qualitative research has been substantially informed by critical feminist theories, uptake in quantitative research has been sparser. It is even more rare for Indigenous methodologies to be used to inform quantitative research. This paper is written from a personal perspective, reflecting on the author’s prior experiences as well as existing literature on critical feminist theory and Indigenous methodologies, to describe an allied research paradigm. This allied research paradigm follows an ontology that explores the subjectivity within epidemiology and the influence of the positionality of the researcher. It follows an epistemology that understands that knowledge can be generated through many ways including, but not limited to statistical analyses. It follows an axiology that research aims to affect social change and improve the lives of the communities participating in the research. It follows a methodology that is participatory and empowers community partners to meaningfully contribute to statistical research. This allied research paradigm, which makes no claims to universality, describes several important principles: reconciliation, relationships, perspective, positionality, self-determination and accountability.

Researchers who wish to engage in research in allyship with Indigenous communities must understand the colonial history embedded in health research, commit to a process that honours meaningful relationships with community partners, and carefully consider the implications of their work.