The Power of Family in Indigenous Communities

family with women, men and children in bright colors

Elissa Noah, BHSc, MPH(c), Schulich Medicine & Dentistry


I am currently completing the 12-month Master of Public Health program at Western University. As a requirement in the case-based learning program, I was enrolled in a social cultural determinants of health course last semester. This course explored behavioural, social, and cultural factors and their impacts on individual and community health. A particular deliverable in the course has stuck with me since being assigned. For this assignment, we were instructed to keep a daily log of all the activities we engaged in for one whole week. We then had to reflect on our log and observe the various social determinants of health factors that are prominent in our lives, and their implications: how these contribute to our well-being. Income and education were factors that would be expected in the life of a master’s student. However, the most prominent social determinant of health factors that I was able to identify in my log, was culture.

I identify as an Indigenous woman, Lunaapeew from Eelūnaapéewi Lahkéewiit (Delaware Nation) of the Turtle Clan. My culture is valuable to me, and it has shaped me into the person I am today. However, in a short one-week log, I was shocked to observe the amount of influence it had in my everyday life.

I am living with and through my Indigenous community as I attend university. Rendering culture so prominent in my day-to-day life are my relationships with my community and family. Culture strongly influences these relationships and how I view them. It creates a sense of belonging and connection, attributed to factors such as shared values, beliefs, and experiences. With the reflection ignited by this assignment, I could see that my culturally shaped community and family relationships clearly contribute to my overall well-being. I regularly contact family members and visit my community, drawing on both as essential support systems while dealing with the stresses of post-secondary school. I experience better mental and emotional health when I maintained these relationships.

Physical environments are commonly viewed as factors that influence individuals' and populations' health. While this is true, research on the social aspects of an individual's life has become increasingly recognized as additional influential factors to health. A particular branch of epidemiology, called social epidemiology, was developed in the 1980s that identifies how social factors affect and contribute to health (Honjo, 2004). Many studies have been conducted using the social epidemiological approach to demonstrate the beneficial influence of social support. Franks et al. (1992) study, for instance, found an association between social relationships, including social support and family functioning, and health behaviours. Results of another study revealed that individuals with social ties and relationships have lower rates of mortality in comparison to individuals without similar relationships (Berkman & Syme, 2017). A study by Ristevski et al. (2020) reports that cultural connections and family were invaluable resources during cancer journey and understanding the significance of Indigenous cultural and family connections can aid in the creation of culturally acceptable models of care.

Family relations are critical to Indigenous communities and our culture. For many Indigenous peoples, including myself, families define our identity and provide us with a sense of belonging.

Mainstream health services frequently fail to recognize the strength that Indigenous people acquire from their community and a supportive family network (Ristevski, 2020). With growing evidence of social relationships’ impact on individuals' health and well-being, but also as Canada and the world aim to translate commitments to anti-colonial health promotion strategies, it is vital to acknowledge the influence that culture and social relationships has on Indigenous peoples’ health.

Indigenous family and social relationships during COVID-19

As family and social relationships are essential components to maintaining a healthy Indigenous community, a recent global health issue has affected this. COVID-19 has disrupted the dynamics in many communities, including Indigenous communities. Due to social distancing and lockdown mandates, the COVID-19 pandemic has unprecedentedly disrupted cultural practices within Indigenous communities, including my own (Power, 2020). Ceremonies were heavily restricted during the first wave of COVID-19, and in some cases, public health urged to stop participating in traditions such as sweat lodges due to uncertainty of transmission (PHAC, 2021). These practices often are associated with cultural connectedness and social relationships with community and extended family. Another challenge experienced in Indigenous communities that COVID-19 further exacerbated was mental health in the population. Indigenous people are more vulnerable to experiencing mental health problems due to a lack of accessing cultural practices, the shutdown of cultural gatherings, and disruptions of external relationships (PHAC, 2021).

There is a need to adopt evidence-based strategies that promote health equity for Indigenous populations moving forward. It is essential to be aware of Indigenous cultures and how cultural practices, beliefs, and feelings of belonging can affect health. Providing health care tailored to Indigenous people and funding to Indigenous-led partnerships cannot afford to ignore the role of culture in Indigenous well-being. If we are serious about addressing the health and social inequities that Indigenous people experience, recognizing the ways in which possibilities to renew Indigenous values and beliefs through family and community relations can play a crucial role in maintaining Indigenous well-being.



Berkman, L., & Syme, L. (2017). Social networks, host resistance, and mortality: a nine-year follow-up study of alameda county residents. American Journal of Epidemiology, 185(11), 1070-1088.

Franks, P., Campbell, T., & Shields, C. (1992). Social relationships and health: the relative roles of family functioning and social support. Social Science & Medicine, 34(7), 779-788.

Honjo, K. (2004). Social epidemiology: definition, history, and research examples. Environmental Health and Preventive Medicine, 9(5), 193-199.

Power, T., Wilson, D., Best, O., Brockie, T., Bearskil, L., Millender, E., & Lowe, J. (2020). Covid-19 and indigenous peoples: an imperative for action. Journal of Clinical Nursing, 29(15-16), 2737-2741.

Public Health Agency of Canada. (2021, March 03). What we heard: indigenous peoples and COVID-19: public health agency of Canada’s companion report. Government of Canada.

Ristevski, E., Thompson, S., Kingaby, S., Nightingale, C., & Iddawela, M. (2020). Understanding aboriginal peoples’ cultural and family connections can help inform the development of culturally appropriate cancer survivorship models of care. JCO Global Oncology, 6(1), 124-132.



Photo by Elissa Noah