Introduction
In the Canadian health arena, filling the gaps and defining health inequities among women representing various groups is not just important but necessary. This paper provides an explanation of a critical evaluation of cisgender Indigenous women as a population that lives in cities and faces various health challenges in the Canadian nursing practice. This paper will attempt to unravel through a critical lens the complexities of social determinants of health rooted in history and defy the structure of society to gain the health forefront of the marginalized population. This report was prepared by going through the never-ending loop of barriers and inequity in healthcare and, as a result, the accrual of poor health results. Furthermore, the paper seeks to address this complexity proactively to get specific measures that facilitate the inclusivity of not only cis persons but also focus on transgender and non-binary people who also have gendered identities and unique healthcare needs. Finally, such an effort portends a multipronged and intersecting type of nursing practice that gives prominence to social justice, orientation to culture, and work on equity to curb health inequalities disadvantaged communities face.
Choosing a Specific Diverse Group
This paper will focus on the health experiences of cisgender Indigenous women living in urban settings in Canada. At the same time, it is established that poor health, along with a variety of health issues or problems, will remain among Indigenous people in both the reserve and urban settings; some unique challenges in the health of Indigenous people need focused attention. That is further compounded by the poor delivery of health care services, the increasing gap between the haves and the have-nots, and a feeling of cultural alienation faced by many Indigenous women who live in urban centers (Paul & Chouhan, 2020). It will, therefore, focus the inquiry through the lens of urban settings onto the unique intersectionality of challenges this population faces. It will be critical insight toward understanding multifaceted factors influencing their health and well-being. The reason for this is the fact that urban cisgender indigenous women are even more vulnerable in comparison to the rural setup. However, because of the diversity in their identity and existence, these women usually experience the intersectionality of their marginality, which includes gender-based discrimination, racial-ethnic stereotyping, and socioeconomic backwardness (Monchalin et al., 2019). This paper seeks to focus on the stories and experiences of these people while simultaneously bringing to light the compounding barriers they face in urban settings. Such focused examination will, in this case, hopefully enable the drawing of nuanced understandings regarding structural, systemic, and interpersonal influences shaping the health outcomes for urban-residing cisgender Indigenous women within the Canadian nursing context.
Situating Myself concerning the Chosen Community
As a nursing professional, positionality reflection is critical in the chosen qualitative research within the community of cisgender indigenous women living in the city. All these lived experiences, though essential to display their experiences, may be quite different from mine. I will Centre on these lived experiences in the paper while taking and acknowledging the voices and perspectives of these women as paramount. I would apply cultural humility and reflexive practice to understand the always-existing power dynamics between the researcher and the researcher. This shows how I, as a non-Indigenous person, enjoy a privileged position, and this very fact has informed my understanding of health issues among Indigenous peoples. In the process, I self-reflect and am open to learning, seeking to walk through this with the utmost sensitivity and respect for the lived experience of cisgender Indigenous women living in an urban context to be researched. In so doing, this inquiry will need to be located within the much broader—historical and contemporary—problem of colonization and systemic racism in Canada. Even where such legibly drafted legislative objectives are absent, elements of a decolonizing agenda are dismantled in this document (Cannon et al., 2019). As a nursing professional committed to social justice and equity, I can never really see myself being able to practice my profession without diving deep into the pervasive impacts of colonization on Indigenous people’s health and well-being. I thus get to approach this topic with the most profound appreciation of the resilience and strength of urban dwelling and cisgender Indigenous women, understanding so well the kind of profound resilience that indeed they do show in the face of systematic oppression.
To a large extent, such understanding would require an intersectional lens—one that would acknowledge how various dimensions interplay and provide shape to the health of cisgender urban Indigenous women. This considers an individual’s gender and all of the intersections of race, class, sexuality, and ability that come together to make a unique experience of being marginalized and showing resilience. Building from the voices and experiences of cisgender Indigenous women living in the city, this paper locates explicitly the colonial continuities on how health and well-being are unfolded (Varcoe et al., 2019). With critical examination, I hope to shine more light on some of these systemic barriers with the intention that this will contribute to the ongoing efforts within nursing practice and with their interdisciplinary partners to dismantle these injustices and promote health equity for all individuals, regardless of where they may be situated in social location.
Familiarizing with Foundational Documents and Research
The critical analysis presented in this paper is grounded in a rigorous engagement with primary documents from the Canadian Schools of Nursing (CASN) and scholarship relevant to Canadian nursing. They are, therefore, a rich source of information on issues surrounding the provision of health care and disparities among indigenous communities, including cisgender indigenous women living in urban localities (Suarez‐Balcazar et al., 2020). I searched through different CASN publications, including position statements, guidelines, and even scholarly articles, to grasp the position taken by the nursing profession regarding Indigenous health and cultural competence. It is also excellent to look into Canadian nursing scholars working closely with indigenous communities and their contributions. This paper aims to provide a more holistic analysis, contextualizing theoretical frameworks and practical insights synthesized from the real world in working with Indigenous communities.
In addition to the above, this paper shall draw on the critical resources of the CASN and Canadian nursing scholarship. Equally, it shall include vital aspects of working with the Indigenous Communities as outlined in Strategies of Truth and Reconciliation Commission (TRC) (Tremblay & Echaquan, 2022). TRC Calls to Action highlight an emphasis on reconciliation with the colonial legacy in the delivery system of health and, more precisely, an outcome associated with the Indigenous people. Accordingly, this paper aims to be culturally sensitive, accepting colonization’s historical and ongoing effects on Indigenous health throughout its analysis, which aligns with TRC principles. This paper contributes by focusing on TRC recommendations that outline the necessity of a culturally safe healthcare environment that needs more Indigenous representation in the health professions. This paper contributes to the broader discussion of Indigenous health equity and reconciliation within nursing. It focuses on the TRC recommendations that speak to the need for a healthy atmosphere that ensures cultural safety.
The further inclusion of TRC strategies in this paper is unwavering evidence of a commitment to the cultural responsiveness of nursing practice and research. This paper recognizes TRC’s centrality of partnership and collaboration with Indigenous communities; therefore, within this framework, it tries to uphold respect and mutual benefit in addressing health disparities among cisgender Indigenous women living in urban areas. In addition, foregrounding the TRC recommendation in this analysis seeks to underline the urgency the recommendation makes for systemic changes within the nursing profession and healthcare systems at large for more effective responsiveness to the needs of the Indigenous people (Njeze et al., 2020). It intends to use this paper to advance the dialogue on Indigenous health equity and reconciliation by considering the TRC’s calls to action and strategies as fully integrated into all collective efforts of decolonizing nursing practice and research.
Utilizing a Critical Lens
In the best critical light, this paper describes the dynamics of nursing practice and research related to urban-dwelling cisgender indigenous women. Developing a decolonizing approach to health, critically investigate power relations in the system to understand how the colonial past and present affect care and access resources. This paper, therefore, tries to explain how these power relations oppress and exclude from the health care setting a marginalized group, such as cisgender Indigenous women (Hu & Hajizadeh, 2022). Through critical examination, the present paper scrutinizes the underlying assumptions of dominant discussion discourses that unwillingly support the continuance of systemic injustices.
The critical lens will question the paradigms and frameworks that are currently in place and ruling the conducting of nursing practice and research with/for urban-cisgender Indigenous women. This might involve some open questioning of conventional assumptions and searching for other perspectives that would enable a better understanding of the complexities of Indigenous health experiences (Thummapol et al., 2018). The following paper, therefore, is critical in providing interrogation of the dominant discourses regarding Indigenous health, intending to deconstruct such misrepresentations and stereotypes that injure and lend to the continued marginalization of Indigenous women within the discourse of health care. This seeks to highlight that critical drivers of health inequities have been identified as including, but not limited to, structural barriers, cultural insensitivity, and institutionalized racism that conspire to inhibit equal access and equal outcomes from healthcare for urban-dwelling cisgender Indigenous women.
The critical perspective of each issue similarly explores where potential avenues of transformative change lie within the nursing profession. It means it helps find systemic barriers not within the whole mechanism that allow no positive health outcomes but present an actionable strategy to let the people challenge and tear them down. Such reflection and dialoguing will surely sensitize the nurses to develop alternative models of care for equity, cultural competence, and social justice (McGough et al., 2022). These activities could be policy advocacy, cultural care practice, and collaborative, meaningful work within and between the health division and the Indigenous societies. The critical approach, if embraced, might ultimately put the nurses at the forefront of dealing with the health disparities that the cisgender Indigenous women living in urban areas face and contribute to a larger collective towards health equity and social justice in the Canadian healthcare system.
Strategies for Inclusivity
These health disparities, therefore, need to be addressed to eliminate the disparities experienced by cisgender Indigenous women living in the cities. It should support healthcare environments that are welcomed, respected, and culturally safe for cisgender women, trans, and non-binary people alike in recognition of the plurality of identities and experiences among Indigenous communities. This calls, therefore, for the use of a holistic approach that recognizes the meshed identities and peculiar healthcare needs of the individual in such a way that healthcare is accessible to and affirming for all (Butkus et al., 2020). This paper aims to critically appraise, identify, and synthesize rigorous sources drawn from Canadian scholarly nursing references that will be applied to support the student’s evidence-informed and systematic understanding for fostering inclusivity within healthcare organizations, programs, services, and First, the development of cultural competency training should be given the utmost priority while developing professionals that are well versed with knowledge and skills to develop cultural sensitivity in dealing with the diversity of the population that includes cisgender Indigenous women residing in urban areas. It is now recommended that all such training programs be tailored to Indigenous perspectives, teachings, and protocols to enable clear information to participants regarding the views of Indigenous people and the practice of health (Burnett et al., 2020). In addition, Indigenous healthcare providers should be made compulsory in healthcare organizations through active recruitment and retention policies, which will promote and create space valuing Indigenous voices. Diversification within an organization’s healthcare workforce would assure them a much greater chance of meeting the needs of Indigenous communities and assurance of the provision to patients being cared for by a provider they can trust and relate to.
Such programs and services should further be tailored to meet the cultural, social, and economic health requirements of cisgender Indigenous women living in urban settings (Scrimshaw et al., 2021). These may involve culturally appropriate programs in health promotion, community-based outreach programs, and support services that enable Aboriginal women to be active in their health care (Marriott et al., 2020). Healthcare organizations should also develop policies and protocols that affirm the gender identity of each person so that trans and non-binary members can be assured of respect and support toward obtaining access to health (Morton Ninomiya et al., 2020). These, therefore, include a demeanor of ensuring that every individual feels appreciated, respected, and able to make choices that pertain to their health and overall body wellness in the highest position in the workplace.
In the end, this paper provides an in-depth explanation of the health challenges facing cisgender Indigenous women living in the urban areas of Canada through the perspective of nursing in Canada. Therefore, two critically purposive efforts in understanding the complex barriers to health equity for this population involved applying a critical lens and centering the voices of the community. These include the paper’s ability to interrogate power relations, question hegemonic narratives, and examine underlying assumptions to identify areas that need intervention, allowing it to propose concrete, actionable strategies to create more inclusive healthcare environments. In reality, it demands collective action toward the elimination of systemic discrepancies that focus on health disparities among different groups of women, such as urban-dwelling cisgender Indigenous women. This requires a commitment to cultural humility, ongoing education, and engagement with Indigenous communities. The goals of equity, cultural competence, and social justice in nursing practice would bring up a proper healthcare system that is inclusive, responsive, and equitable to all, irrespective of their cultural background or identity.
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Tremblay, M.-C., & Echaquan, S. (2022). Fostering Cultural Safety in Health Care Through a Decolonizing Approach to Research with, for and by Indigenous Communities. Global Handbook of Health Promotion Research, Vol. 1, 1, 115–126. https://doi.org/10.1007/978-3-030-97212-7_9
Varcoe, C., Ford-Gilboe, M., Browne, A. J., Perrin, N., Bungay, V., McKenzie, H., Smye, V., Price (Elder), R., Inyallie, J., Khan, K., & Dion Stout, M. (2019). The Efficacy of a Health Promotion Intervention for Indigenous Women: Reclaiming Our Spirits. Journal of Interpersonal Violence, 36(13-14), 088626051882081. https://doi.org/10.1177/0886260518820818
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