Health promotion, community development, and participation: an approach to native health education.

Health-care parameters for Natives living in isolated northern areas of Canada show rates of life expectancy, morbidity, and infant mortality far worse than the Canadian average. Improving access to medical facilities has not affected these statistics. Socioeconomic factors such as inadequate housing and lack of sewage systems are likely contributors to poor health, as is an attitude of hopelessness and impotence on the part of Native people. Health-care providers have recognized the need for health promotion as well as treatment, but have often instituted programs that blame the victim. An approach to health education that embodies community development, participation, and the fostering of a positive self-image is discussed. The implication of this approach is that when Native Canadian groups can identify their own health problems, have access to the information needed for their solution, and develop the confidence and assertiveness to act, change may occur at a community, as well as an individual, level.