Relational Theory, Indigenous Peoples and Health Laws and Policies
Relational Theory, Indigenous Health, Canada, Health Law and Policies, Conceptual Frameworks, Inequality
In relational theory, the self is seen as fundamentally constituted in terms of its relations to others: it not only lives in relationship with and to others, but also owes its very existence to such relationships. Being Relational explores core moral and metaphysical concepts through a relational-theory lens and analyzes how such considerations might apply to more practical areas of concern in health law and policy. Innovative and self-reflexive, this groundbreaking collection will appeal to a broad range of thinkers, especially those who seek to understand the complex ways in which power is created and sustained relationally.
This chapter considers the potential of relational theory for improving the conceptualization and treatment of Indigenous health matters. Indigenous health is a particularly pressing matter, given that Indigenous peoples have carried a disproportionate burden of ill health for decades in Canada. The chapter specifically considers how relational theory could inform health laws and policies. It illustrates how relational theory provides a conceptual framework that addresses some of the shortcomings of the social determinants approach to health, which is the approach that currently informs much of Indigenous health policy planning. While the social determinants approach is helpful for identifying elements of the context that informs Indigenous health, and identifying inequalities, its utility is weakened by the fact that it tends to take the individual as its subject and focus upon that which can be expressed in statistical form. Relational theory enables a recasting of the social determinants approach, a route for dislodging it from these constraining tenets. It succeeds in this respect because relational theory is grounded, in part, in the recognition of the co-constitutive nature of community and individuals, which has several important consequences. One of these consequences is that relational theory offers an approach to understanding health determinants that resonates better with Indigenous theories of health. Another is that relational theory enables the identification of relational dimensions of inequality, which may be invisible from a traditional social determinants approach but which are essential for understanding what sort of change is necessary to improve the health and well-being of Indigenous peoples.
Constance MacIntosh, "Relational Theory, Indigenous Peoples and Health Laws and Policies" in Jocelyn Downie &Jennifer Llewellyn, eds, Being Relational: Reflections on Relational Theory and Health Law (Vancouver: UBC Press 2011) 230.