THE BUILT ENVIRONMENT: Understanding How Physical Environments Influence the Health and Well-Being of First Nations Peoples Living On-Reserve Roberta Stout

THE BUILT ENVIRONMENT: Understanding how physical environments influence the health and well-being of First Nations peoples living on-reserve Roberta Stout

EMERGING PRIORITIES © 2018 National Collaborating Centre This publication is available for Citation: Stout, R. (2018). The built for Aboriginal Health (NCCAH). This download at: nccah.ca. All NCCAH environment: Understanding how physical publication was funded by the NCCAH materials are available free and can environments influence the health and well- and made possible through a financial be reproduced in whole or in part being of First Nations peoples living on- contribution from the Public Health Agency with appropriate attribution and reserve. Prince George, BC: National of Canada. The views expressed herein do citation. All NCCAH materials are Collaborating Centre for Aboriginal not necessarily represent the views of the to be used solely for non-commercial Health. Public Health Agency of Canada. purposes. To measure the impact of these materials, please inform us of For further information or to obtain Acknowledgements their use. additional copies, please contact:

The NCCAH uses an external blind Une version française est également National Collaborating Centre for review process for documents that publiée sur le site ccnsa.ca, sous Aboriginal Health (NCCAH) are research based, involve literature le titre : Le milieu bâti : Comprendre 3333 University Way reviews or knowledge synthesis, l’influence de l’environnement physique Prince George, BC, V2N 4Z9 or undertake an assessment of sur la santé et le bien-être des Premières Tel: 250 960 5250 knowledge gaps. We would like to Nations vivant sur réserve. Fax: 250 960 5644 acknowledge our reviewers for their Email: [email protected] generous contributions of time and Web: nccah.ca expertise to this manuscript. ISBN (Print): 978-1-77368-179-5 ISBN (Online): 978-1-77368-180-1

Outer Cover Photo © Credit: iStockPhoto.com, ID 157562026 Inner Cover Photo © Credit: iStockPhoto.com, ID 469652271 CONTENTS

1.0 INTRODUCTION ------5 1.1 Demographics ------6

2.0 COMMUNITIES PLANNED THROUGH INDIGENOUS DESIGN AND KNOWLEDGE ------7 3.0 BUILDING ENVIRONMENTS ON-RESERVES – Download publications at FAILURES IN DESIGN ------13 nccah.ca/34/Publication_Search 3.1 The built environment and housing on reserve ------13 3.2 The built environment and water and sanitation on-reserve ------15 3.3 The built environment and challenges to accessing healthy foods on reserve ------17 3.4 The built environment and challenges to active living on-reserve ------19 3.5 The built environment, transportation, and road safety on reserve ------20 Télécharger des publications à ccnsa.ca/524/Recherche_de_publication 4.0 ADVANCES AND SUCCESSES IN IMPROVING THE BUILT ENVIRONMENTS OF ON-RESERVE COMMUNITIES ------23 issuu.com/nccah-ccnsa/stacks 4.1 Indigenous planning ------23 4.2 Addressing the housing crisis on-reserve ------24 4.3 Bringing home drinking water ------25 4.4 Countering Food Insecurity ------26 4.5 Improving on-reserve infrastructure to promote physical activity ------26 4.6 Improving road safety ------27

5.0 CONCLUDING REMARKS ------29

REFERENCES ------30 ...Indigenous peoples in Canada deliberately planned and designed their communities so as to thrive within their territories prior to colonization.

Every aspect of urban life has environments lead to increased vulnerable and rural populations, been designed to accommodate physical activity while lowering rates neither mentions how the built human needs. Cities and towns of obesity, asthma and respiratory environment influences the health are composed of neighbourhoods, infections, injuries and unintentional and well-being of Indigenous 1 homes, schools, businesses, shopping fatalities, and heat exposure (CMA, peoples living in urban, rural, districts, parks, recreation centres, 2013, pp. 2-3). For example, access remote, northern or isolated and transportation networks. All to local supermarkets can provide communities.2 This paper aims to fill of these places and spaces make residents with greater choice and this gap by describing how the built up the built environment, or the options around food and nutrition environment influences the health “human-made or modified physical (Hanson & Stout, 2011), and people and well-being of First Nations surroundings in which people live, are more likely to walk to purchase reserve communities. Although work and play” (Cheadle & Tugwell, groceries and other items (Heart the built environment is large in 2014, p. 2). Simply put, the built and Stroke Foundation, n.d.). scope (including health, business, environment includes surroundings Communities with designated bike education, recycling, and garbage “for humans, by humans, and to be lanes promote active transportation disposal facilities and infrastructure, used for human activity” (Visual and commuting which help lower to name a few), this paper focuses Arts and the Built Environment, levels of obesity, chronic diseases, specifically on only five elements of n.d., para. 1). and certain types of cancers the built environment: (Winnipeg Regional Health There is mounting evidence Authority, 2013). The Canadian 1) housing; and recognition that the built Journal of Public Health’s [CJPH] 2) water and wastewater environment influences the safety, Special Supplement on the built management; health and well-being of individuals environment and health in Canada 3) food security; and communities (Canadian Journal shows how built environments of 4) active living; and of Public Health [CJPH], 2012; neighbourhoods and schools can 5) transportation. Canadian Medical Association be drivers of childhood obesity, [CMA], 2013; Centers for Disease particularly in urban settings. Each of these elements, if poorly Control and Prevention, 2010; This can have detrimental health funded, maintained or absent, has an Heart and Stroke Foundation, n.d.; implications across the life course. impact on human safety, health and Jackson, 2003; Lees, Redman, & well-being. Berland, 2010; Muhajarine, 2012; While publications such as those of Williams, 2013). Healthy built the CMA and the CJPH touch upon

1 For this paper, the terms ‘Indigenous’ and ‘Indigenous peoples’ will be used to represent all First Nations, Inuit, and Métis peoples inclusively. ‘Aboriginal’ and ‘Aboriginal peoples’ are used when reflected in the literature under discussion. Wherever possible, culturally specific names are used. 2 We recognize that the built environment impacts Inuit and Métis communities as well; however, these impacts must be the focus of future papers.

The built environment: Understanding how physical environments influence the health 5 and well-being of First Nations peoples living on-reserve The paper begins by introducing human modified space.” Search considered rural, remote, isolated how Indigenous peoples in terms were expanded to include or northern. Indigenous and Canada deliberately planned and “housing/homes/households”, Northern Affairs Canada includes designed their communities so as “infrastructure”, “water”, “waste four geographic zones in which First to thrive within their territories management”, “food/food security/ Nations communities are located: prior to colonization. It will then food insecurity/nutrition”, “physical turn to how colonization altered activity/inactivity/recreation/ ∙∙ Urban (Zone 1): within 50 km Indigenous peoples’ home and obesity”, “transportation/roads/ of the nearest service centre community environments. As will winter roads”/ “Indigenous with a year-round road access be shown, present-day First Nations architecture”/ “design”/ “planning.” ∙∙ Rural (Zone 2): between 50-350 communities across Canada are Additional literature was identified km from the nearest service rooted in colonial policies and from the bibliographies of relevant centre with a year-round road processes, and the imposition of publications. The search included access western built environments has peer and non-peer reviewed ∙∙ Remote (Zone 3): over 350 km contributed to many of the ongoing publications spanning from 1995 from the nearest service centre social and health inequities they to 2016. Publications were deemed with year-round road access currently experience. The paper relevant if they focused on First ∙∙ Special Access (Zone 4): no concludes with some possible Nations on-reserve communities year-round road access to a opportunities for action to counter and the impact of some element of service centre (Leclair, 2016). the present situations faced by many the built environment on health and communities. well-being. In a few cases, other Close to one fifth, or 17.3%, of relevant literature and examples First Nations communities are Publications included in this paper from Indigenous perspectives from considered to fall under “special were limited to those with multiple the United States were included as access”, while 3.7% are considered and overlapping aspects of the well. remote, 44% rural and 34.4% urban built environment in First Nations (Leclair, 2016, slide 11). As will be on-reserve communities falling 1.1 Demographics discussed in later sections of this within a determinants of health paper, the health and well-being of framework. Although this paper First Nations are one of the three communities considered “special did not include a systematic review Indigenous groups recognized access” are profoundly impacted by process, publications were initially under the Canadian Constitution housing, infrastructure, and food identified through a search of of 1982. According to the most security issues. CINAHL; Native Health Databases; recent data, Indigenous peoples MEDLINE; EMBASE; EBM comprise 1,673,785 or 4.9% of the Reviews (including Cochrane); total Canadian population (Statistics PubMed; PubMed Central, Google; Canada, 2017a). Of this total, 58.4% Google Scholar; OpenDOAR; (977,230) identify as First Nations. Health Sciences Online; Turning Almost a half (44.2%) of registered Research into Practice; OAISter; First Nations people reside on National Aboriginal Health reserve (Statistics Canada, 2017a). Organization; National Aboriginal There are 617 First Nation Bands/ Community Controlled Health communities recognized by the Organization; and Indigenous and federal government (Indigenous Northern Affairs. Terms utilized and Northern Affairs Canada included “Aboriginal/First Nation/ [INAC], 2014). Amongst these Indigenous/Indians/ native peoples/ communities is great cultural, + “built environment/ supportive linguistic, economic, infrastructural, environment/health/environment/ and geographic diversity. Many ecological survey/man-made space/ First Nations reserves are small and

6 2.0 COMMUNITIES PLANNED THROUGH INDIGENOUS DESIGN AND KNOWLEDGE

This section will provide a brief overview of the continuum of how Indigenous peoples planned, designed and modified their local landscapes and communities for millennia. It will then discuss how, through colonization and forced relocation to reserves, the federal government imposed western-based designs and planning by way of built environments.

Prior to colonization, it is estimated that anywhere between 500,000 and 2 million First Nations peoples lived across Canada (Dickason, 2002). As in other parts of the Americas, First Nations peoples thrived in territories where communities and community structures were ingeniously planned and designed to be responsive to local geographies and climates (Nabokov & Easton, 1989). Architectural structures throughout the Americas, too varied and numerous to list in full, included long, plank or pit houses, wigwams, temple-pyramids, igloos, earthlodges, and tipis. All of these reflected the needs of diverse practical, social and ceremonial activities, such as “sleeping, working, worshipping, meditating, playing, dancing, lounging, giving birth, decision-making, cleansing, storing or preparing food, caring for animals and honoring the dead” (Nabakov & Easton, 1989, p. 12).

© Credit: iStockPhoto.com The built environment: Understanding how physical environments influence the health 7 ID 589097066 and well-being of First Nations peoples living on-reserve © Credit: iStockPhoto.com, ID 526491015 how communities came to be, where to be, came how communities for told example, place-naming, and 10). stories world” (p. Oral natural for and the within of planning importance the and environment, their and humans between “interconnections involved planning (2013), pre-colonial to Matunga According fires. controlled using or through agriculture, slash-burn practicing communities, settled building as such means through needed, as environments their altered actively and materials local used elsewhere, as Canada, in peoplessimple decisions. Indigenous or were not arbitrary dwellings how to and build on where to live words, 12). decisions other In (p. from generation to generation” on passed principles and patterns to singular according settlements their arranged homes and their built arrived Columbus Christopher when America North in who lived groups or so tribal hundred “three to Nabokov Easton (1989), and the According Canada. across observed be can of location communities and organization design, deliberate The 8 (p. 29). (p. same” the one and are –they other do not to correspond each simply land of the history peopleof and the history words, the other In spot. that took on place event that supernatural or or for aspecial there, or died for someonenamed who born was may be or area wooded “hilltop a that ofNation Whapmagoostui Cree the her work with in found 101-102). Adelson (2002) Similarly, (pp. them” in to dwell said be can people dwell the which in landscape –the lives of their actualities on the bearing its practical and imagination moral forreference the points symbolic peopleApache with provide authority… place-names and of ancestral vehicles as upon to serve called are “place-names He states, spaces. and knowledge ethical and social, ecological, to ancestral link as a of place-naming significance (1996)Basso profound explores the of Apache Mexico, New the with work his In of communities. survival and well-being uphold collective the how to and were found, to be of medicines sources water, food and Teegee (2015) writes: (2015) Teegee (Adelson, 2002). climates warmer or to follow food sources seasonally moved and were seminomadic Nations First notMany, all, though practice of clam gardening. Dating Dating gardening. of clam practice the through ecosystems marine of their management traditional practiced communities coastal these to how points research addition, In climate. damp the in longevity and straight-grain, firmness, characteristic its particular given west coast Canadian the along for structures choice material the 1989, was Easton, Cedar p. 227). & (Nabokov America” North in sophisticated wood architecture “most the as were described Coast Northwest the along houses plank cedar imposing the 18th century, late the In villages. coastal sedentary establish forest could resources, and marine due to plentiful which, by communities populated was for example, Columbia, of British Coast Northwest The available. were resources natural and sources where food places were in located villages and camps sedentary semi- and sedentary that and communities of their establishment the in knowledge ecosystem sophisticated used Nations First that wrote (2002) Dickason sustained ourselves.” (p. 122) andthisishow weEarth Mother lives, thisisthecycleof our years thatthisisthecycleof thousands andof ancestors knew, through by design.We knew, our had norealhome.’ To us, itwas was, ‘[o]h,they’re nomadic, they Western society’s interpretation access fishinthe waterways. areas toaccessthecaribouor territories. We travelled inthose Our peoplehadtraditional back between 1,000 to 3,000 years, tipi rings can still be observed [t]hey were ancient architects of the this gardening is one example throughout Alberta. In particular, landscape” (p. 79). Impounding, from the region of environmental many of these are found at lookouts corralling, and the use of controlled modification to meet human where buffalo would have been fire were also noted as means by nutritional needs (Lepofsky et al., hunted (Dickason, 2002). which the First Nations modified 2015). landscapes to gain access to food First Nations who depended on resources, such as buffalo. The Siouan word “tipi” translates as buffalo for nutrition and resources “used to dwell” (Nabokov & Easton, used the existing geography to Further east, however, agriculture, 1989). When the Spanish explorer practice the highly organized buffalo in addition to hunting and gathering, Don Juan de Oñate first saw these drives and jumps such as Heads- was well underway amongst the structures in the southern United Smashed-In in southern Alberta Huron and Iroquois nations around States, he described them as being (Dickason, 2002). As part of this the Great Lakes region. The climate “built as skillfully as any house in practice, hunters purposefully built permitted for the practice of large Italy” (Nabakov & Easton, 1989, p. rock drive lanes in which sticks scale slash-burn agriculture to 150). Like cedar structures of the and other organic matter would be flourish. Dickason (2002) noted west coast of Canada, tipis were placed to appear human-like. These that by the 17th century the Huron designed of local materials, including lanes would funnel the buffalo had 7,000 acres under cultivation wood and multiple buffalo hides. towards the jumps or pounds for producing the “three sisters” of These portable dwellings included slaughter. According to archaeologist corn, beans and squash, as well as systems for heating, cooling, Jack Brink (2008), “those who tobacco. Successful food production ventilation and insulation (Nabakov manufactured this arrangement allowed for the development of & Easton, 1989). Hundreds of were not simple buffalo hunters… larger sedentary communities with

In the late 18th century, the imposing cedar plank houses along the Northwest Coast were described as © Credit: iStockPhoto.com, ID 458600373 © Credit: iStockPhoto.com, the “most sophisticated wood architecture in North America” (Nabokov & Easton, 1989, p. 227)

The built environment: Understanding how physical environments influence the health 9 and well-being of First Nations peoples living on-reserve © Credit: iStockPhoto.com, ID 468009506 well-being is “synonymous with the the “synonymous is with well-being one community, Cree in (2002) by Adelson observed As upon well. to live exploit aplace as but rather not was to aspace as seen land The needs. to meet their environments their modified to and adapted communities Nations First which to of sophistication degree the it shows landscapes, of precolonial sampling and introduction basic avery provided section this While 1989, &Easton, (Nabakov p. 81). streets” rows like houses,“36 in its with community Oneida and of aMohawk characteristics like town- the observed visitor Dutch 1634, longhouses. In a multiple in of residents residing upwards 1,500 10 making’…or institutional ‘islands’ ‘islands’ institutional making’…or ‘‘place- as Reserves refers to Indian (2011) Patrick communities. reserve for present foundation day the laid Act (1876) Indian of the policies assimilationist and Colonization system. reserve of the imposition the following disrupted completely was planning and design over community self-determination Nations’ First 97). (p. illnesses” and foods, whiteman’s interferences, by “unencumbered are when they It achieved is (p.97). others” and provide for and oneself warm, keep foods, right eat the bush, the in well live activities, traditional able pursue to hunt, being from inseparable is and wayCree of life, (p. 11).(p. displacement, Territorial its beneficiaries” and state settler the of gaze away the from wastelands or urban herded to rural survived, out they or, of if existence structured peoples were either “Indigenous that (2013) expresses peoples. Matunga Nations of First relocation and forced removal the possible through developmenteconomic made was western and farming communities, of settler expansion The spaces. of allotted these marginalization the to speak and reference to areserve words common Cree in used are lot) and terms the to Dion Stout (2012),According 387). (p. of forced settlement” First Nations peoples. removal and relocation of possible through the forced development was made economic western and communities, farming The of settler expansion of these allotted spaces. to the marginalization and speak to areserve words used in reference plot) common are Cree and iskonikun (leftover tipahaskan (measured lot) Stout (2012), the terms According to Dion dispossession, environmental iskonikun tipahaskan (leftover plot) (leftover (measured (measured © Credit: iStockPhoto.com, ID 174865276 cultural, psychological, and spiritual spiritual and psychological, cultural, p. 410).Ross, 2012, cumulative The & rates” (Richmond epidemic near at members community plague… that diseases chronic other many and of obesity, diabetes determinants “pivotal are poor diets to nutrient rich nutrient from transition the and lifestyles to sedentary active from shift The profound ongoing. and are colonization from resulting inequities and impacts health The 2005). &Peters, 2012; Wilson &Delormier, Hanley, Willows, 2007; &Mumtaz, Williams Ross, 2009; & Richmond 2007; Mascarenhas, 2011; (Bickford, communications relationshipsintergenerational and and systems, governance and ceremonial practices, and activities harvesting and hunting traditional practices, and knowledge based land- mobility, peoples’ Nations First disrupted policies, colonial other and schooling, residential Provincial Health Officer, 2009; 2009; Officer, Health Provincial Columbia (British rise on the are many and population, Indigenous non- to the compared Indigenous the amongst greater are obesity and diabetes, disease, of cardiovascular Rates 2009). (Reading, countries of those developing mirror that diseases of rates chronic epidemic to experience found have been Canada peoples in Indigenous fact, 2015). In (Reading, Canadians non-Indigenous to comparison in health poorer suffer and Canada in expectancy lowesthave the life peoples Indigenous Currently, 2011, (Bickford, p. 2). identity” loss of a self- and suicide abuse, drug alcohol and dysfunction, and violence of family poverty, a “legacy in resulted has communities reserve of imposition the Furthermore, 44). 2013, p. home” (Boutilier, their from “expulsion including assimilation, rapid with associated is stress The built environment: Understanding how physical environments influence the health health the influence environments physical how Understanding environment: built The and well-being of First Nations peoples living on-reserve living peoples Nations First of well-being and at near epidemic rates”at near epidemic plague… community members that diseases chronic other obesity, diabetes and many determinants of “pivotal are poor diets to nutrient rich the nutrient transition from and lifestyles to sedentary ongoing. The active shift from colonization profound are and inequities resulting from The health impacts and people live. Reading (2015) states: Reading people live. Indigenous which in environments physical and geographic social, economic, the within situated as outcomes understood to need be health Indigenous sum, In 2011). of Canada, Agency Health 2013; Public Gionet &Roshanafsha, p. 410) 2012, &Ross, (Richmond Aboriginal communities.” (p. 11) economic development for or private investment in public market, aswell aslack of environments andthelabour discrimination insocial residential schools, racial of Act, thedamaginglegacy theIndian oppressive natureof communities andreserves, the Aboriginal peoplesintoremote from thecentralizationof – fashioned – acolonialstructure theproblem discover therootof shaping theseconditions, we responsible for determinants we search stillforthe deeper if 11 Euro-centric housing designs and materials do not take into account the diversity of cultural activities or the climates in which First Nations people live (Dawson, 1995; Lee & Morris, 2005).

The following sections provide Nations reserves. Their 2015 interim more than two-thirds (70.8%) of all a snapshot of several aspects report concluded that First Nations on-reserve homes need some level of of the built environment and housing is in a “state of crisis” (p. 3). repair. how these have impacted the Similarly MacTavish and colleagues health and well-being of First (2012) note that First Nations Exacerbating these shortfalls Nations living on reserve, namely homes are, “severely inadequate in and disrepairs are the “culturally housing, water and wastewater both quantity and quality” and that inappropriate housing designs” management, food security, this is attributable to a number of which were imposed upon First active living, and transportation. intersecting factors, namely “rapid Nations communities (MacTavish, There is a general absence of population growth, inadequate et al., 2012, p. 208). Euro-centric information specific to First funding, restrictive government housing designs and materials Nations priorities and perspectives policies, lack of home ownership, do not take into account the on the built environments of and culturally inappropriate housing diversity of cultural activities or reserve communities. However, the designs” (p. 208). While the exact the climates in which First Nations literature points out how on-reserve figures are unknown, it is estimated people live (Dawson, 1995; Lee & infrastructure, or lack thereof, that anywhere between 35,000 to Morris, 2005). As Moffat (2013) is associated with poorer health 85,000 new homes on reserve are writes, “houses are often federally outcomes. needed to meet the current shortfalls designed and constructed, which (SSCAP, 2015). In addition to these has resulted in cookie-cutter homes 3.1 The built environment shortfalls, close to half (44.2%) of which may not be appropriate for 3 on-reserve homes are currently in all Canadian climates” (p. 37). and housing on reserve need of major repairs, in contrast Adelson (2002) notes that the Cree to 6% of Canadian households of Whapmagoostui viewed the The Standing Senate Committee (Statistics Canada, 2017b). The First imposition of housing as an example on Aboriginal Peoples (SSCAP) Nations Information Governance of “whiteman’s encroachment” conducted a cross-Canada study of Centre [FNIGC] (2012) adds that and that “despite the conveniences housing and infrastructure on First

3 For an in-depth discussion on Indigenous housing as a determinant of health, see https://www.ccnsa-nccah.ca/docs/determinants/FS- Housing-SDOH2017-EN.pdf

The built environment: Understanding how physical environments influence the health 13 and well-being of First Nations peoples living on-reserve associated with them, some decades, fails to meet infrastructure individuals consider[ed] the new needs like housing, as well as rising dwelling completely unsatisfactory” costs associated with inflation (p. 104). Durbin (2009) remarks that (SSCAP, 2015). The literature makes the “high prevalence of mould on clear that the built environment reserves is likely because between on reserve includes substandard the 1960s and 1980s most reserve housing, which leads to poor health housing was centrally designed outcomes (Durbin, 2009; FNIGC, and delivered by the federal 2012; MacTavish et al., 2012; Office government. Many of the houses, of the Auditor General of Canada, schools, and workplaces were built 2011; Palmater, 2011). on wood frames which are prone to mould” (p.186). On-reserve houses, Some potential health especially in northern regions, implications often lack appropriate and effective heating and ventilation systems, and Overcrowding, combined with poor are too small to accommodate the ventilation and the growth of mold size and structure of Indigenous and mildew, may lead to elevated families (Clark, Riben, & Nowgesic, levels of pulmonary diseases, 2002; Kovesi, 2012; Larcombe et such as tuberculosis, pneumonia, al., 2011; MacTavish et al., 2012; bronchitis, and asthma (Boutilier, Osterberg, 2009; Weichenthal et al., 2013; Clark et al., 2002; Durbin, 2013). An argument can be made 2009; FNIGC, 2012; Kovesi, 2012; that the lack of cultural elements is a Larcombe et al., 2011; MacDonald, “potential cause of housing failures, Hébert, & Stanbrook, 2011; Moffatt, undermining sense of ownership Long, & Mayan, 2013; Office of the and subsequent responsibility for the Auditor General of Canada, 2011; home” (Kyser, 2011, p. 6). Weichenthal et al., 2013). As well, overcrowding has been linked to The 2011 Report of the Office of sleep disruption and deprivation, and the Auditor General showed that weakened immune system response homes on reserve deteriorate at when exposed to airborne pathogens a faster rate than other Canadian and illnesses like influenza (Moffatt homes. This was based in large et al., 2013). part on “substandard construction practices or materials” used for Studies show that a lack of autonomy building the homes and a “lack and control over housing, coupled of proper maintenance” once the with the imposed western-centric homes were built (p. 18). With an housing design, contributes to increasing population and housing psychological stress (Dawson, 1995; supply not meeting the current need, Moffatt et al., 2013). Similarly, the many households are overcrowded lack of home ownership has been (Durbin, 2009; FNIGC, 2012; linked to a lowered incentive to MacTavish et al., 2012; Office of maintain or repair the structure the Auditor General of Canada, (National Association of Realtors 2011). Furthermore, the federal [NAR], 2012), which can lead to government’s funding cap of 2% for an increased “prevalence of mold, on-reserve programs and services, dust, water intrusion and dampness, which has been in place for two or poor ventilation…all conditions

© Credit: iStockPhoto.com ID 506610454 which have been linked directly are “preventive measures put in (Quebec), God’s Lake First Nation or indirectly to [tuberculosis], or place to protect public health (Manitoba), Pinaymootang First have been shown to decrease the from drinking water that could be Nation (Manitoba), Kahkewistahaw body’s immune response to TB” contaminated” (Health Canada, (Saskatchewan), and Shoal Lake First (Moffatt et al., 2013, p. 560). There 2016, What is a drinking water Nation (Saskatchewan) are under is also strong evidence that home advisory?, para. 1). The majority of “do not consume” orders (Lui, ownership fosters individual well- drinking water advisories for First 2015). Kitigan Zibi and Shoal Lake being, through increased self-esteem Nations communities are located in First Nations have been under these and control over one’s life, and Ontario, some of which have been orders since 1999 (Lui, 2015). provides positive social benefits, under these advisories for years or including “boost[ing] the educational even decades (Lui, 2015). A “do not consume” order is put performance of children, induc[ing] in place by Health Canada when higher participation in civic and Boil water advisories are issued boiling water will not remove volunteering activity …, [and] when there are “disease-causing contaminants, such as uranium, lower[ing] crime rates and lessen[ing] bacteria, viruses or parasites gasoline or Trihalomethane, from welfare dependency.” (NAR, 2012) … found in the drinking water tap water (Health Canada, 2016). In These benefits, in turn, contribute to system” (Health Canada, 2016, these cases, the federal government community health and well-being. Types of drinking water advisories, urges the discontinuation of using para. 1). According to Patrick tap water for “drinking; brushing … 3.2 The built environment (2011), boil water advisories are teeth; cooking; washing fruits and “2.5 times more frequent” for vegetables; making infant formula and water and sanitation First Nations communities than or other drinks, soups or ice cubes; on-reserve for other Canadians (p. 386). As for bathing infants and toddlers or well, unlike urban boil advisories feeding pets” (Health Canada, 2016, The vast majority of urban such as that issued for the City Types of drinking water advisories, populations across Canada enjoy of Winnipeg in January 2015, para. 2). Nevertheless, despite the access to clean and safe drinking which lasted three days, the fact that First Nations may perceive water and sanitation. This is not average length of boil advisories tap water as being unsafe, a 2007 the case for all First Nations living for First Nations communities survey found they may continue on reserve throughout Canada, between 1995 and 2007 was 343 to use the water for a “wide range especially for First Nations living days (Patrick, 2011). By way of of everyday applications, such as in more remote communities. As example, the Ontario communities toothbrushing, food preparation recently as January 31, 2018, there of Neskantaga First Nation and and cooking” (EKOS Research were approximately 137 drinking Shoal Lake 40 First Nation have Associates, Inc., 2007, p. 6). water advisories in effect in First been under boil water advisories Nations communities across since 1995 and 1997 respectively In addition to drinking water Canada.4 According to Health (Human Rights Watch, 2016), while advisories, a small yet unacceptable Canada, drinking water advisories the communities of Kitigan Zibi number of First Nations continue

4 The Government of Canada does not report on all drinking water advisories in First Nations communities across Canada in the same location. As a result, the total number of drinking water advisories were calculated by the author using data derived from three sources. The First Nations Health Authority [FNHA] reports on the number of boil water and do not consume advisories for First Nations communities in British Columbia. As of February 28, 2018, there were 19 drinking water advisories and 3 do not consume advisories for a total of 19 advisories in effect in 17 First Nations communities in BC (FNHA, n.d.). The Government of Canada (2018) reports on short term drinking water advisories in First Nations communities south of 60 degrees. As of January 31, 2018, there were 37 short-term drinking water advisories in place in First Nations communities south of 60 degrees. The Department of Indigenous and Northern Affairs reports on the number of long-term drinking water advisories. As of January 23, 2018, there were 81 long-term drinking water advisories in effect in First Nations communities (Indigenous and Northern Affairs Canada, 2018).

The built environment: Understanding how physical environments influence the health 15 and well-being of First Nations peoples living on-reserve to lack some level of water in their in 2014-2015 indicated that while Ltd., 2011). A more recent federal households “such as hot running improvements have been made since report on 446 First Nations water (3.4%), cold running water the previous assessment, 18% of wastewater systems requiring (2.1%), and flush toilets (2.7%)” the water systems continue to be inspections in 2014-2015 shows that (FNIGC, 2012, p. 50). Furthermore, classified at high risk of producing despite considerable improvements a 2011 national assessment of First unsafe drinking water in the since the last assessment, 6% of First Nations water systems found that event of a problem, and a further Nations wastewater systems continue of 807 systems serving 560 First 37% are classified as medium risk to be at high risk of releasing poorly Nations communities, 72% of (Environment and Climate Change treated wastewater in the event of households had their water piped, Canada, 2016). a problem, and a further 41% are 13.5% were on truck delivery, 13% considered to be at medium risk were serviced by individual wells, Wastewater systems are also often (Environment and Climate Change and 1.5% had no water service inadequate in First Nations on- Canada, 2016) provision (Neegan Burnside Ltd., reserve communities. The 2011 2011). As Boutilier (2013) states, National Assessment of First Because First Nations communities “[t]hat Canada continues to remain Nations Water and Wastewater fall under the jurisdiction of home to people who do not have Systems found that of the 532 the Department of Indigenous running water – no longer a privilege wastewater systems serving 418 and Northern Affairs, the strict but a universal human right [United First Nations communities, 54% of provincial and territorial regulations, Nations General Assembly, 2010] the households had access to piped laws and protections that ensure – is an alarming reality entirely on wastewater systems, 8% were on safe drinking water and wastewater its own” (p. 117). A more recent truck haul, 36% were serviced by management for all Canadians do federal report on 699 First Nations individual water systems, and 2% not apply to on-reserve communities water systems requiring inspections had no service (Neegan Burnside (Human Rights Watch, 2016).

...Human Rights Watch (2016) and the 2011 Report of the Office of the Auditor General have strongly criticized the lack of legislation for drinking water on-reserves. Human Rights

Watch (2016) has stated that ID 491823922 © Credit: iStockPhoto.com, there is a “water crisis” in First Nations communities (p. 29). This crisis has resulted in poor health outcomes experienced by on-reserve communities.

16 Indeed, Human Rights Watch (2016) ready access to grocery stores. While management practices, and personal and the 2011 Report of the Office of it would be reasonable to assume beliefs and attitudes about stocking the Auditor General have strongly that those located closer to southern healthful foods may be major criticized the lack of legislation for or urban centres would have better determinants of the availability of drinking water on-reserves. Human access than those living in rural and nutritious foods” (p. S34). Such was Rights Watch (2016) has stated that remote locations, this is not always the finding in a study of a northern there is a “water crisis” in First the case. For example, a 2012 survey Saskatchewan First Nation, where Nations communities (p. 29). This of food costs in Saskatchewan found fresh and nutrient rich foods, such crisis has resulted in poor health there were “no on-reserve stores in as vegetables, fruit and meat, were outcomes experienced by on-reserve the southern part of the province often more expensive and therefore communities. that qualified as grocery stores,” and purchased less often than processed these communities “appear[ed] to foods, like macaroni and cheese, Some potential health rely on food available at gas stations, chips, and pop (Bruner, & Chad, implications convenience stores or local general 2014). In this community, the stores” (Saskatchewan Food Costing costs of fresh produce at the local The lack of adequate, accessible, Task Group, 2012, p. 16). Of the 14 community grocery store were available, and safe water systems northern Manitoban communities double that of the closest urban puts First Nations at increased studied by Thompson, Gulrukh, centre, 500 kilometers to the south. risk for developing infectious Alam, and Wiebe (2012), “13… ha[d] diseases and illnesses, including either no grocery store or [had] only Limited access to grocery stores and community-acquired Methicillin- one grocery store that stocks mainly high costs for local groceries have resistant Staphylococcus aureus high-calorie, high-fat, low-nutrient meant that some First Nations must (MRSA), shigellosis, Hepatitis food” (p. 57). The authors noted that travel to and from the nearest urban A, Helicobacter pylori, whooping only Berens River First Nation was centre for their groceries. In some cough, skin infections (such as equipped with three grocers due to a cases, this is not only dangerous but impetigo), and gastrointestinal and year round barge. also very costly. For example, the urinary infections, to name a few two northern Manitoba communities (Boutilier, 2013; Boyd, 2011; Harden Grocery and convenience stores in of Garden Hill and Wasagamack & Levalliant, 2008). There is also many rural, remote, northern and First Nations must cross open water evidence of elevated stress when isolated First Nations communities to reach the adjacent community First Nations communities are faced depend largely on costly food for their groceries. This trip is with hardships in meeting basic shipments by road, ice-road, train, particularly perilous in the fall and requirements for hygiene and food waterways or by air (Enrg Research spring when ice is either forming or preparation, either through the use Group, 2015; Manitoba Food breaking up. During these periods, of contaminated water or costly Charter, 2009; Thompson et al., people must charter helicopters or bottled sources (Human Rights 2012). Long distance shipping often rent boat taxis (Thompson et al., Watch, 2016). decreases the quality and quantity 2012). of fresh, perishable items while 3.3 The built environment the cost of these and other market The transition from nutrient and foods, with the exception of high protein rich traditional foods, found and challenges to accessing sugar and high fat foods and drinks, within the surrounding territories, healthy foods on reserve are markedly higher (Fieldhouse & to a dependency on imported, often Thompson, 2012; FNIGC, 2012; high-cost, nutritionally poor market First Nations communities vary Joseph et al., 2012; Rudolph & foods, affects the “health, social, across Canada in size, location, McLachlan, 2013; Skinner, Hanning, economic and cultural wellbeing” economic development and Desjardins, & Tsuji, 2013a; Stroink, of First Nations (Lees et al.; Power, infrastructure across Canada. There & Nelson, 2012). Willows (2005) 2008; Stroink & Nelson, 2012; is no definitive data on how many notes that in remote First Nations, Willows, 2011). It also disables prior First Nations communities have an “individual store manager’s stock land and food-based economies

The built environment: Understanding how physical environments influence the health 17 and well-being of First Nations peoples living on-reserve and knowledges where gathering Pal, Haman, & Robidoux, 2013; insecurity at a rate of 73% compared and harvesting traditional foods for Thompson et al., 2012). to national Canadian rate of 8% shared meals and feasts connected (Fieldhouse & Thompson, 2012). families and communities to one Canada has endorsed the World Fieldhouse and Thompson (2012) another and their environment Food Summit Plan of Action’s point out that food security is part (Food Matters Manitoba, 2013). definition of food security which of a larger crisis of disadvantage in Indeed, as Stroink and Nelson (2012) states that “all people, at all times, on-reserve communities. They state, note, there are “spiritual aspects of have physical and economic access “First Nations reserves are typically food gathering, preparation, and to sufficient, safe, nutritious food” Canada’s most remote and poorest ceremony” amongst First Nations (Food and Agriculture Organization communities. They are frequently communities and cultures (p.66). [FAO] of the United Nations, 1996, economically marginalised, Willows (2011) extends this view para. 1). Yet there is a growing and commonly lack adequate by stating that traditional diets not body of evidence of elevated food infrastructure for food processing, only provide “sufficient energy and insecurity amongst First Nations food production and safe drinking micronutrients” but also nourish peoples (Egeland, Pacey, Cao, & water, as well as poor transport “the mind and spirit,” all of which Sobol, 2010; Elliott et al., 2012; networks all of which are factors that contribute to the promotion of FNIGC, 2012; Kerpan, Humbert, & make these communities vulnerable holistic health (p. 6). Yet the Henry, 2015; Rudolph & McLachlan, to food insecurity” (p. 218). consumption of traditional foods has 2013; Skinner, Hanning, & Tsuji, been threatened in some regions due 2013b; Power, 2008). While rates Some potential health to a growing preference for western of food insecurity vary among implications foods, concerns over environmental First Nation communities, the contamination of traditional food incidence and severity of food There is ample evidence that food sources, and climate change (Bruner insecurity increases for remote insecurity and inadequate nutrition & Chad, 2014; Elliott, Jayatilaka, communities (Thompson et al., are linked to poor health outcomes Brown, Varley, & Corbett, 2012; 2012; Veeraraghavan et al., 2016). including diabetes, obesity and Jacobs et al., 2010; Power, 2008; On average, the FNIGC (2012) heart disease (Elliott et al., 2012; Socha, Zahaf, Chambers, Abraham, reports that 54.2% of First Nation Fieldhouse & Thompson, 2012; Lees & Fiddler, 2012; Willows, 2005). It households on reserve experience et al.; Pal et al., 2013; Rudolph & is also hindered by the high cost of moderate to severe food insecurity. McLachlan, 2013; Willows, 2011). hunting equipment and fuel, food These rates can be even higher In addition, research shows that processing and storage, and skills in different parts of the country. food insecurity lowers immunity development across the generations For example, some First Nations while increasing the incidence of (Food Matters Manitoba, 2013; in Manitoba experience food dental caries and anemia (Fieldhouse

18 Lévesque, &Wabano, p.Lévesque, 11). 2007a, (Kirby, it survival” meant exertion; just physical more to people than meant activity Physical it. demanded lifestyle “as their active physically people Nations were First that meant land off the living communities, Nations of First settlement to the Prior 2007). on Health, Committee 2011;& Maddison, Standing Pearce 2007b; Robertson-Wilson, Wabano, Lévesque, 2012; & Kirby, al., et (Joseph of activity physical to levels contribute of communities environments physical and built The living on-reserve challengesand to active 3.4 The built environment 3). (p. peoples” of Aboriginal lives improve the to “necessary foods are nutritious accessible affordable and that argue they issues, health to these cure-all not is a food security while that recognize They 7). (p. suicide” and depression, anxiety, weights, birth low delays, development outcomes, “poor learning with nutrition inadequate between linkages on the (2012) report colleagues’ and 2012).& Thompson, Socha al., 2013). Rural First Nations may Nations First 2013).al., Rural et (Barnidge traffic over human traffic to vehicular given priority greater residents contend with rural p. 4). 2012, Likewise, al., et (Joseph concerns” safety traffic and crime for potential ahigher and aesthetics, poor connectivity, low street having to walking… “unfavorable as perceived was environment built the Nations, of Six community the in surveyed Ofsafe those or desirable. not is always forroadways walking 2012). on-reserve Using (FNIGC, adults Nations First amongst most activity common physical the as identified been has 3). Walking (p. activity” to physical barriers potential as of lack facilities, and safety poorroads, loosesuch as dogs, factors, environmental identified has research formative communities, Aboriginal “[i]n that for example, (2012) indicate, colleagues and Joseph living. conducive to active are that environments not have built may communities Nations First that suggest studies 2007a).al., Existing et 2013; 2012; Kirby Joseph al., et al., et (Barnidge literature the in explored have yet fully to be they centres, urban from greatly vary communities on-reserve and rural of environments built the While The built environment: Understanding how physical environments influence the health health the influence environments physical how Understanding environment: built The and well-being of First Nations peoples living on-reserve living peoples Nations First of well-being and conducive to pedestrian traffic due traffic conducive to pedestrian not is highway, which beyond arural for options walking have limited mapping with children and youth and children with mapping Asset 2004). Centre, Nations (First community their within needs facility most important the as equipment playground and rink outdoor centre, drop-in arena, pool, swimming a community identified Survey Health 1997 the Regional in Youth participating Ontario from field. or outdoor playing playground equipped (37%) afully had still fewer and gym equipped afully had (46%) 515 of the schools on reserve half less than that (2012) reported Assembly on Education Chiefs The environments. physical schools and local within oflack infrastructure by the hampered is activity physical in to participate ability the youth, and children For Nations First 2007a/b).al., et (Kirby Moosewomen Factory in for Cree to walking barriers as cited were factors, other among bears, or dogs aggressive with run-ins potential and safety road addition, 2015). In &Ksaibati, Denzer, (Shinstine, poor lighting and roadways, on the shoulders adequate of lack of speed vehicles, high to the 19

© Credit: iStockPhoto.com, ID 147772948 © Credit: iStockPhoto.com, ID 173620801 of obesity and obesity-related obesity-related and of obesity epidemic to agrowing contributed has lifestyles and diets traditional away from rapid transition The implications potential health Some opportunities. and centres not have access to such recreational do communities remote reserve and rural many that to state astretch be it not would 6). Certainly, room.” (p. exercise and rink, rollerblading rink, ice hockey gym, pool, room, weight rink, indoor an with centre leisure “a include would community their 2013). ideally For them, & Willows, Holt, Ball, (DyckFehderau, spaces and structures vandalized and broken and down maintenance, ofdue to lack a safety, poor hampered was playgrounds and courts basketball outdoor ice rinks, at activity physical that indicated Manitoba Alexander, Fort from 20 physical inactivity increases with age. age. with increases inactivity physical 2012). Furthermore, &Gilbert, Aziz, de Groh, Shields, (Roberts, Survey Measures Health 2011 Canadian 2009- the obese in and overweight who were considered to be range age same this youth in and children 30.1%the of Nations non-First with contrasts 2012). This (FNIGC, or obese overweight reportedly (42.7%) half almost are old, years 12-17 youth, Nations First Amongst 2008/10). 2002/03 in in to 62.5% (from rise 58.5% on the are of age 2-11 years children Nations First obese and forrates overweight (2012), FNIGC to the According 2). (p. crisis” blown cardiovascular a“full- in people are Indigenous (2010) that Foundation cautions Stroke and Heart the fact, In 2007b). al., et 2012; Kirby (FNIGC, Canada in populations Nations First among disease, cardiovascular and diabetes such as diseases, physical inactivity and obesity have obesity and inactivity physical children, Nations First Amongst 2012). (FNIGC, tension and depression stress, oflevels anxiety, to lower linked is activity 5). Physical 2011, depression”and (Bickford, p. problems low such as self-esteem, health mental cancer… [and] colon endometrial breast, and apnea, “sleep obese include and overweight being with associated risks Elevated 2012). 2011; al., et Willows, Willows Fehderau, & Ball, Sanou, Pigford, 2011; 2012; (Bickford, FNIGC, cancer and disease, cardiovascular osteoporosis, hypertension, diabetes, of levels epidemic including outcomes, health negative long-term of to anumber lead can Obesity southern communities. Garden Hill Hill Garden communities. southern and access to neighbouring road by of lack impacted profoundly access” are “special as categorized access zones. Communities special remote and rural, in located are communities Nations of First majority the notedAs earlier, communities. on-reserve for networks transportation and conditions, road on roads, information little relatively 2015, is p. 100). there Currently, (Marr, services” social other and healthcare or accessing inclusion, or social entertainment seeking functions, or civic community in participating supplies, and groceries getting to “work, getting such as for activities day-to-day critical are networks Transportation safety on reserve transportation, and road 3.5 The built environment, 2012). al., et (Skinner diabetes 2 onset type to early linked been First Nation, located in northern difficult for those without vehicles to (Desapriya et al., 2011; Short et al., Manitoba, is an example of a “special get to them. 2014). Shinstine et al. (2015) and access” community. For a short Desapriya et al. (2011) advocate for span of ninety days over the winter Lack of public transportation can alternative road use which would months, community members are lead to increased hitchhiking, with include the development of public able to use winter roads to connect its associated safety issues,5 be a transportation systems or roadway to Thompson, Nelson House and barrier to receiving appropriate infrastructures to encourage walking Winnipeg, in addition to having a health care and, coupled with the and cycling. One U.S. example of years’ worth of supplies delivered need to travel long distances on a successful partnership for rural/ via semi-trailers. Roads within the high speed roads, increase the risk on-reserve transportation is between community are bumpy and often of injury or mortality resulting from the Menominee Indian Reservation muddy, and could benefit from motor vehicle collisions (MVCs). (Wisconsin), the College of the regular maintenance (Collinson, This latter issue has received Menominee Nation, and local Hildebrand, & Rempel, 2011). some recent attention as a public schools and services. This alternative health issue (Desapriya, Fujiwara, rural transit system assists those Because of their rural, remote, or Verma, Babul, & Pike, 2011; Short, without vehicles and “makes over isolated locations, most on-reserve Mushquash, & Bédard., 2014). 80,000 trips a year” (Shinstine et al., residents, like their non-Indigenous Desapriya and colleagues (2011) 2015, p. 29). It meets the needs of counterparts in similar geographic looked at on-reserve MVCs that over 90% of the Menominee Indian regions, must rely primarily on had occurred in Saskatchewan. Reservation, many of whom do not personal vehicles, including cars, Their study showed that most have their own vehicle. trucks, snowmobiles and all-terrain MVCs happened between 8:00 a.m. vehicles. In the general context and 4:00 p.m. and that poor road Some potential health of rural Ontario, Marr (2015) surfaces, such as “loose snow, slush, implications describes individuals without packed snow/ ice, loose gravel/sand, access to personal transportation and muddy road[s]” (p. 1009) posed While not all on-reserve roads as “‘transportation’ disadvantaged additional risks, as did “intersections are the same, collision rates are as they lack the mobility necessary with rural roads, streets, private reportedly higher for on-reserve to access the activities and services roads, or alleys… and domestic roads versus off-reserve roads and essential for their quality of life” animal interaction” (p. 1011). on roads in the territories over (p. 100). According to a U.S. study those of the provinces (Desapriya on livability and transportation Relatively small improvements to et al., 2011; Short et al., 2014). First on American Indian reservations, on-reserve roads can significantly Nations people living on reserve are Shinstine and colleagues improve transportation safety twice as likely as non-First Nations (2015) indicate that the lack of (Desapriya et al, 2011; Short, people to be injured, hospitalized or transportation choices and options Mushquash, & Bédard, 2014). die as a result of MVCs (Desapriya is commonplace, making travel Resurfacing and filling potholes et al., 2011; Short et al., 2014). both within and beyond Indigenous to improve road conditions and Poor maintenance, conditions, and communities a challenge. The increasing visibility through signage location of on-reserve roadways are authors speak indirectly to the built at high risk intersections (i.e. rural/ major contributing factors to these environment of many reservations as private roads/streets/alleys) could rates (Desapriya, et al., 2011; Short et having dispersed and disconnected result in lower MVCs and reduced al., 2014). centres and services, which make it rates of premature loss of life

5 See for example the Highway of Tears, a notorious stretch of highway in northern British Columbia, stretching from Prince Rupert to Prince George, which has seen a series of murders and disappearances of mainly Indigenous women who turned to hitchhiking as a form of transit due to poverty and a lack of public transportation. For more information, please refer to the Highway of Tears Symposium Recommendations Report, http://www.turtleisland.org/healing/highwayoftears.pdf.

The built environment: Understanding how physical environments influence the health 21 and well-being of First Nations peoples living on-reserve Healthy built environments include, but are not limited to, access to and availability of quality housing, clean water, nutritious foods, safe neighbourhoods that promote physical activity, and convenient transportation networks.

The federal government primarily 4.1 Indigenous planning experiences of community members determines the built environment need to be front and center within of reserve communities. Funding While Indigenous planning is an any planning process (Albuquerque for built environment projects on emerging and growing field of et al., 2011). reserve, which has until recently study, the concepts and principles been capped at a 2% increase embedded in it, as was discussed in For over a decade, the Canadian annually, has been inadequate an earlier section of this paper, have Institute of Planners (CIP) has and has not kept pace with either been used by Indigenous peoples and actively supported and promoted the demographic realities of First communities for millennia (Jojola, Indigenous community planning Nations communities, nor the 2000; Matunga, 2013). Indigenous through the establishment of an costs of program delivery. Healthy planning is not only a method or Indigenous Peoples’ Planners (Sub) built environments include, but practice, but rather it is a “political Committee (IPPC). As a forward are not limited to, access to and strategy aimed at improving the lives looking practice, the IPPC has availability of quality housing, and environments of Indigenous signed land management agreements clean water, nutritious foods, safe peoples” (Matunga, 2013, p. 5). and memorandums, conducted neighbourhoods that promote As such, it encompasses collective, workshops on comprehensive physical activity, and convenient collaborative, cooperative, reciprocal, community planning, created a transportation networks. Many First iterative, and communal processes listing of Indigenous planners, Nations communities across Canada and worldviews. Furthermore, participated and presented in do not have these basic elements in according to Albuquerque and planner’s fora, and advanced place to make them healthy built colleagues (2011), “this approach research and knowledge on environments. This has contributed enables empowerment and opposes Indigenous planning. Most recently, to health and safety burdens notions of power over others” (p. the CIP/IPPC published a special disproportionately experienced by ii). Equally, Indigenous planners edition of their magazine, Plan many individuals and families living recognize that each community Canada (2013), on Indigenous on reserve. There are, however, is confronted with unique Planning/Planning to Indigenize. steps that can be taken to address circumstances, challenges and infrastructural inequities. opportunities, and that the distinct

The built environment: Understanding how physical environments influence the health 23 and well-being of First Nations peoples living on-reserve © Credit: iStockPhoto.com, ID 131972568 2013, p. 18). &Hemphill, (Erfan reconciliation” of and justice pursuit the in allies become “planners means this practice, processes. In of planning decolonization the entails planning Indigenous 6). Ultimately, para. 2016, (Monkman, land” the with rooted connections of deep these all people. It’s to ownership Indigenous as there still are that values our it’s it’s modern, is sustainable, design “Indigenous stated, garden work on the begun who has program design environmental of Manitoba’s University of the agraduate Thomas, Cheyenne Park. Assiniboine city’s of the part Peoples’ as Garden Indigenous new asked to developbeen the who have Winnipeg in designers Indigenous involves example One spaces. public redesign and upon to revitalize called being are planners Indigenous ground, the On 24 prefabricated housing to those built built to those prefabricated housing imposed move away federally from would housing on-reserve Ideally, 2016). (Morneau, Framework Housing development the of aNational supply within housing the address to plan long-term and a sustainable on communities Nations First with to work committed government federal the work, to this phase asecond As on reserve. housing existing and renovating retrofitting as well as needs housing to meeting committed was of $554.3 million investment atotal Budget, Federal 2016 of the part As Canada. in communities Nations across First crisis housing the for addressing urgency to the points evidence All on-reserve crisis 4.2 Addressing the housing which are designed as net-zero as or designed are which “passive homes” ten now built have They region. the in conditions wet weather particularly the not withstood have typically which box houses” “B.C. wood-frame the to housing to provide alternative company, order in building modular Britco, a with collaboration into entered for has example, BC, in SSCAP, 2015). Yale Nation The First 2013; (Boutilier, located are Nations First which in geographies and conditions weather specific meet the responsive to energy and sourced locally be should materials housing addition, In communities. Nations of First activities traditional and of cultural diversity to the according (Boutilier, 2013; SSCAP, 2015). 2013; SSCAP, (Boutilier, located are Nations which First in geographies weather conditionsandspecific to meet yresponsive the energ should be locally sourced and housingIn materials addition, communities. First Nations of and traditional activities of culturalto the diversity housing to those built according federally imposed prefabricated would move away from Ideally, housing on-reserve of example acommunity another provides Nations, First Fisher River at located Builders, Fisher River 2017). (Hyslop, costs by 80% utility cut will efficient homes, which high and maintenance, and end long term long term end and maintenance, and operation facility proper “ensure to of investment $1.8year million to afive committed has Budget 2016 the Nations, Federal First of well-being and safety, health the order to advance in a start, atravesty. As is Canada orders in do not and consume advisories water boil for under decades lived who have communities Nations First to be continue there That water drinking home Bringing 4.3 FNHMF. by the homes backed 5,500 approximately were there count, At last p.20). 2012, (FNHMF, communities” Nations First in renovation loans and rental access to homeownership, easier by providing on reserve housing market-based “supports and lands,” settlement and on reserve housing for arrangements financing support to created fund national first the “is FNHMF Accord, the Kelowna the of part as Originating (FNMHF). Fund Housing Market Nations First the called program for loans credit innovative an with have partnered who communities Nations First were 202 2015,December there of As well-being. community and individual to enhance potential offer home the Nations ownership promote First that Initiatives by 75% 2016, (Loney, p.44). costs cooling and heating reducing community, their homes within haveover now retrofitted They 175 2015). Energy, (Aki Western Canada in companies geothermal enterprise social residential one largest of the running independence, energy and self-sufficiency towards moving drinking water standards; recognize recognize water standards; drinking enforceable “national implement would elements other among that Waterto adopt aNational Policy government federal the pressured have advocates rights Human contaminants. offree environmental must and resources protected be food for traditional communities Nations by used or First are through pass that waterways well, As Canada. across communities Nations First to all management wastewater proper piped water and and clean to provide agencies government by responsible taken to be needs action Immediate eliminated. be must on reserves water quality to challenge continue that barriers structural and jurisdictional the barriers, funding may address this 2016, p. 144).(Morneau, While on reserves” water advisories boil The built environment: Understanding how physical environments influence the health health the influence environments physical how Understanding environment: built The and well-being of First Nations peoples living on-reserve living peoples Nations First of well-being and 10 homes with clean, potable water. 10 clean, homes with endeavor to retrofit will partnership The services. for these equipped structurally they nor are sanitation, 415 water or not with are supplied 450 homes Of the on reserve, 2006. since water advisory aboil under been has community the Ontario, northwestern in Located Nation. First of Pikangikum community in fly- for the conditions sanitation and poor water the to address (HFHM) Manitoba Habitat for Humanity with apartnership announced (PWRDF) DevelopmentWorld and Fund Relief 1, 2017 March On Primate’s the p. 20). 2015, (Lui, communities” Nations First in particularly infrastructure, wastewater water and in invest water rights…[and] Indigenous respect right; ahuman water as 25

© Credit: iStockPhoto.com, ID 139964230 4.4 Countering Food apple orchard and some grapes, and 4.5 Improving on-reserve Insecurity getting more customers off reserve, infrastructure to promote including custom growing for restaurants, and possibly even adding physical activity Continuing to gather baseline a greenhouse” (Chapin, 2016, para. evidence, through conversations 16). In the Northwest Territories, According to the federal and available data sources, will the Small Scale Foods Program, government, “cultural and show how the built environment initiated in 2006, has supported the recreational infrastructure can can be modified to improve food development of community garden provide an important focal point for security, food quality, and food sites across the Territory, some of community activities” on reserve options and choices in rural, remote, which have grown to incorporate (Morneau, 2016, p. 143). As such, northern, and isolated First Nations greenhouses (Northwest Territories they have earmarked $76.9 million communities. Advancing food Industry, Tourism and Investment over a two-year period for the security requires multiple levels and Health Canada, 2011). development of such infrastructure. of community and governmental action in areas including addressing First Nations communities are Asset mapping and comprehensive poverty; improving transportation also responding to food insecurity community planning are processes of perishable foods (including through innovative and traditional that bring to the fore the voices, the building of all-season roads); food projects. Food Matters perspectives and priorities of expanding current grocery stores (or Manitoba (2013) documented a populations. For First Nations creating alternative grocery options); number of such initiatives taking communities who have participated embracing food alternatives such place in northern First Nation in such processes, being able as greenhouses, agriculture, and communities. Their scan revealed to exercise in one’s community community gardens; promoting the how land-based, community-driven, may involve the renovation to, or revival of traditional food-based and multi-generational projects development of, safe environments practices and food sharing networks; help to ensure the maintenance and aesthetically pleasing indoor and ensuring that traditional food and survival of traditional food and outdoor spaces for playing, resources are protected from harvesting and skills. For example, tobogganing, hockey, basketball, environmental contaminants (Pal et the Northlands Community baseball, or dance and other aerobic al., 2013; Skinner et al., 2013a). Freezer Program, located in Lac activities etc. (Collinson et al., 2011). Brochet, Manitoba, ensures that For example, in an asset mapping First Nations on-reserve three full-sized freezers are filled exercise with Alexander First communities are responding to food with traditional meats like caribou, Nation, the youth shared the ways insecurity and the high costs of with the help of local hunters and they thought that: imported foods through community trappers. This meat is distributed garden projects. The Abegweit First to those in need but is also used for places and spaces could be Nation in Prince Edward Island has community feasts, cook-outs, and enhanced or used in different started a community garden, called ways to improve healthy living…. educational and nutritional programs Epekwitk Gardens and Preserves, The outdoor ice rink was one as part of the Aboriginal Diabetes in order to make fresh produce place that could be modified to Initiative (Food Matters Manitoba, available for community members increase physical activity. Youth 2013, p.12). Since 2014 Meechim suggested fixing the basketball through the local Epekwitk Gas Inc., a local social enterprise created nets located in the rink for use Bar. This project began through in Garden Hill First Nations, has over the summer months, a partnership with a local non- provided locally produced fruit, cleaning the surrounding area of Indigenous farmer who mentored glass and garbage, fencing the vegetables, poultry, and fish to community members on the rink to keep balls and pucks residents. As part of this innovative process of planting, maintaining inside, turning on the lights at project, the “market is held at the and harvesting a garden. There are night so the rink surface could local TV station with live Oji- be played on, flooding the now twenty community members Cree language broadcast of what is surface with water for skating working on the garden and they are available” (Loney, 2016, p. 33). and hockey in winter, [and] looking to expand to include “an opening the rink shack to keep

26 people warm during winter Community-based organizations, 4.6 Improving road safety activities.” (DyckFehderau et al., such as Sandy Lake Health and 2013, p. 5) Diabetes Project (SLHDP) and There is limited information about the Kahnawake Schools Diabetes roads, road conditions and the Similarly, developing hiking Prevention Project (KSDPP), have transportation challenges, needs and walking trails, along with been active in the promotion of and opportunities of First Nation establishing walking groups to physical activity to counter the high peoples living on reserve. What promote safety, have been identified rates of diabetes. For example, in is known is that there is a higher and/or instituted by communities addition to other localized health incidence of MVCs on reserve, to promote physical activity interventions, the SLHDP promoted and that there is an immediate (DyckFehderau et al., 2013; Joseph a community-wide walking trail. need for action to improve road et al., 2012; Kirby et al. 2007a/b). One of the health interventions conditions to curb the loss of life, Culturally-based physical activities made by the KSDPP was to alter the hospitalizations and injuries resulting already underway in First Nations physical environments of the school from MVCs. The Federal Budget communities across Canada include and community so as to promote 2016 acknowledges that investments traditional games and sports such better eating habits and lifestyles. need to be made to failing as lacrosse; powwow dancing; and Both of these programs have been infrastructures on reserve, including activities on the land such as berry longstanding and successful, likely roads. They have committed part of picking, hunting, fishing, gardening, given that they are community- the $255 million of the First Nation or harvesting traditional medicines. driven and controlled (Macaulay Infrastructure Fund to improving Cultural activities that involve the et al., 2006; Salsberg, et al., 2007). roads in First Nations communities whole family are not only ways of Without doubt, there is the need to over the next two years (Morneau, improving healthy physical activity, engage public health professionals, 2016). but are also “way[s] to spend time planners, educators, dieticians, and together and strengthen the family” community members of all ages According to Short and colleagues (Bickford, 2011, p. 52). in the development of long-term, (2014), an updated needs assessment culturally based, obesity prevention of on-reserve roads is due, given strategies, preventative health care that the last one was done over messages, pedestrian safety plans, a decade ago. They argue that exercise, fitness, and wellness interventions for road safety must opportunities, and activities around target four sets of factors including diet and nutrition. “human, vehicle/equipment, physical environment, [and] social environment… and should include outcome measures to evaluate changes in each” (Short et al., 2014, p. E304). This could include interventions which target vehicle/ equipment factors by promoting the maintenance of vehicles (providing service checks and repairs) and interventions which focus on the physical environment such as modifying road conditions (fixing potholes).

The built environment: Understanding how physical environments influence the health 27 and well-being of First Nations peoples living on-reserve Research highlighted through this paper suggests there are direct linkages between the health and well-being of First Nations peoples and their experiences with deterritorialization and imposed western development, which rapidly transitioned them away from traditional lifestyles and significantly altered their landscapes, foodscapes, and fitscapes.

This paper provides an overview of some of the elements of the built environment in First Nations communities, based on the current information available. While it began by showing how Indigenous peoples had mastered knowledge around the specific environments in which they lived and had designed sustainable communities, livelihoods, and harvesting practices, these ways of knowing and living were greatly altered through colonization. Research highlighted through this paper suggests there are direct linkages between the health and well-being of First Nations peoples and their experiences with deterritorialization and imposed western development, which rapidly transitioned them away from traditional lifestyles and significantly altered their landscapes, foodscapes, and fitscapes. Given the westernization of Indigenous communities, this paper has sought to understand some elements that define a healthy western built environment and whether the same standards are enjoyed by First Nations peoples living on reserve. The findings in this paper highlight that the built environment of First Nations communities falls well below these standards and, in fact, there is an on-going crisis in terms of housing shortfalls and disrepair, contaminated water systems, food insecurity, and challenges to active living and transportation.

These five areas of the built environment, coupled with the scope of the diversity of perspectives, experiences and priorities of the 600+ First Nations communities across Canada, have yet to be fully understood. Indeed, to garner a more complete understanding, First Nations peoples and communities from various regions need to be asked for their direct input on how the built environments of rural, remote, northern, isolated and urban environments impact their health and well-being. What are other areas of the built environment that affect them? There are other research gaps including the built environments of Inuit, off-reserve and Métis communities. For example, what does the built environment look like in urban centres where there is a high density of Indigenous peoples? Do they have access to affordable housing? Are they food secure? Are neighbourhoods walkable? Finally, though many communities are challenged with infrastructural inadequacies, it would also be worthwhile to hear how First Nations are modifying their environments to better meet their needs.

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