A conceptual framework to improve climate-resilient health among Indigenous communities

Climate change is affecting Indigenous communities’ well-being, especially health. The World Health Organization has introduced a climate-resilient health system approach to minimize climate-associated health risks. Indigenous communities are poorly served by this approach, given its limited recognition of Indigenous health practices compared to non-Indigenous practices. By conducting a global systematic literature review, we aim to identify opportunities to improve climate-resilient health system approaches among Indigenous communities. We analysed 137 peer-reviewed journal articles published between 2013 and 2023. The study is aimed at three objectives: i) to identify health drivers of Indigenous communities, ii) to develop a health drivers-based conceptual framework to improve climate-resilient health system approach among Indigenous communities, and iii) to apply the proposed framework in case studies. We applied latent and manifest content analyses to examine the data, capturing explicit meanings and underlying themes from the quotes we collected through the systematic literature review. First, we identified fifteen health drivers for Indigenous communities, which were categorized into three categories: i) risk (n = 6), ii) protective (n = 3), and iii) overlapping (n = 6). Second, we developed a conceptual framework with two main components: (i) a place-centered feedback loop and (ii) the shaping of health drivers. The place-centered feedback loop consists of five elements: (i) place, (ii) causations, (iii) infirmities, (iv) interventions, and (v) sustaining. The shaping of health drivers includes three aspects: (i) shaping types, (ii) shaping opportunities, and (iii) stakeholders. Third, the case study assessment affirmed the applicability of the conceptual framework in different geographic locations.