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Objective Data linkage and secondary use of routinely collected quantitative health data is ubiquitous. In recent years, the volume and breadth of routinely collected qualitative health data has grown. These data sources provide rich narrative information that could enable a broader understanding of healthcare challenges at scale, however linkage and secondary use of this qualitative health information is not common. This study explores the potential of linkage and secondary use of qualitative patient reported experience measure (PREM) data to understand the impact of digital hospitals on patients. Approach In Queensland, Australia, PREM surveys are distributed to most public hospital patient. Patient responses will be linked to the hospital and ward attended; qualitative comments will be extracted from two large hospitals: a digital hospital and non-digital hospital. Comments will be compared between the hospitals, focusing on factors which relate to experience of a digital hospital, either directly (e.g. computerised workstations), or indirectly (e.g. communication). Results & Conclusions Currently under ethics review – one challenge identified is that deidentification of free-text qualitative data at this scale is not feasible. Ethics committees may not have experience with this type of study and may require education on using qualitative health data at scale. Implications Linkage and secondary use of routinely collected qualitative PREMs data has the potential to reduce participant burden in research, by utilising existing data sources to answer research questions. It can also broaden the scope of research by utilising data collected across multiple hospitals or jurisdictions, without significantly increasing the resources required.

A two-eyed seeing approach considered Indigenous knowledge and Western science towards eco–health, reconciliation and land back with Fort William First Nation (FWFN) in Ontario, Canada. To map traditional land use, occupancy, and ecological knowledge, we interviewed 49 FWFN members about their hunting, fishing, trapping, plant harvesting, cultural sites, and sacred gatherings on their ancestral land. Their traditional land use and occupancy includes more than 7.5 million ha of their ancestral land. The FWFN members reported many industrial impacts on their reserve and ancestral land. We analyzed the normalized difference vegetation index (NDVI) change over time on FWFN’s ancestral land and the Thunder Bay Pulp and Paper Mill (TBPP)’s National Pollutant Release Inventory data to investigate the FWFN members’ ecohealth concerns. The NDVI analysis revealed large tracts of degraded FWFN’s ancestral land due to logging areas, mining claims, settlements, and paper mills. Mining claims and greenstone belts occupy a quarter of the FWFN members’ ancestral land. The TBPP mill dumped pollution into the Kaministiquia River upstream and upwind of the FWFN community, exposing FWFN members to kilotons of cancerous and other toxic chemicals each year for over a century. Resource extraction and pollution in Northwestern Ontario negatively impacted the human health and ecosystem integrity of FWFN, requiring reconciliation by restoring damaged land and preventing pollution as the starting point for land back. The first step to land back is ending the environmental racism of the TBPP’s pollution directed downstream and downwind of FWFN and protecting ancestral land against logging, mining, and other extractive industries.

Wasagamack and Garden Hill First Nations in Island Lake, Manitoba, are experiencing a housing crisis, with severe overcrowding. This article describes a research analysis of local materials, building skill levels, environment, demographics, and cultural aspects completed by graduate students in interior design as part of collaborative design/build activities, training programs, and community workshops. This study is part of a First Nation community/university partnership. Healthy, culturally appropriate, resilient single- and extended-family homes were designed using local materials and labour. This pilot project offers a pathway to build capacity to fill the gap of 150,000 homes in a way that advances cultural, health, social, and economic development. Further, a decolonizing policy and the provision of adequate infrastructure, such as access roads, in Indigenous reserves are needed to create a sustainable home-building ecosystem.

Indigenous traditional land uses, including hunting, fishing, sacred activities, and land-based education at the Red Sucker Lake First Nation (RSLFN) in Manitoba, Canada, are impacted by mining. The Red Sucker Lake First Nation (RSLFN) people want their territories’ land and water to be protected for traditional uses, culture, and ecological integrity. Towards this goal, their Island Lake Tribal Council sought support for an Indigenous-protected and conserved area (IPCA) in their territory, outside of existing mining claims, but without success. The two-eyed seeing approach was adopted in this study. Traditional land use mapping and interviews were undertaken with 21 Indigenous people from the RSLFN, showing that many traditional land uses are concentrated on greenstone belts. The interviews revealed that mining exploration has resulted in large petroleum spills, noise distress, private property destruction, wildlife die-offs, and animal population declines. These issues negatively impact RSLFN’s traditional land use practices, ecosystem integrity, and community health. Governments need to partner with Indigenous communities to reach their biodiversity targets, particularly considering northern Canada’s peatlands, including those in the RSLFN territory, surpassing Amazon forests for carbon storage. The role of critical minerals in renewable energy and geopolitics has colonial governments undermining Indigenous rights, climate stabilization, and biodiversity to prioritize extractivism. Mining at the RSLFN has environmental impacts from exploration to decommissioning and after, as well as the massive infrastructure required that includes roads, hydro, and massive energy supplies, with a proposed multimedia national Northern Corridor to export RSLFN’s resources and other resources to six ports.

Food insecurity rates for Canada’s Indigenous people are the worst among developed nations, demanding immediate action to prevent an impending health crisis. Food insecurity in Canada is widespread across most First Nations households (51 per cent). The highest food insecurity rates are experienced by the Inuit in Nunavut (63 per cent), First Nations without access roads (65 per cent), and Alberta First Nations (60 per cent). Indigenous peoples’ food insecurity is associated with a shorter life expectancy and higher rates of physical and mental illnesses, including four times the diabetes incidence of Canada’s non-Indigenous populations. This paper analyzes the impact on food insecurity of a notional trade northern corridor to reach local and global markets, considering case studies of resource and utility corridors. This research found that, rather than improving food security and providing benefits, trade corridors typically bring a resource curse to Indigenous communities. Also called the ‘paradox of plenty,’ a resource curse occurs when Indigenous communities, particularly First Nation reserves, experience mainly negative economic impacts when their resources are extracted. A resource curse on Indigenous communities is apparent across Canada, including at Norman Wells in the Northwest Territories and Shoal Lake 40 in Ontario, where oil and water pipelines have resulted in negative environmental, health and socio-cultural impacts without providing permanent road access or long-term jobs, and without reducing high food prices. Also, the resource curse is evident for Alberta’s First Nations, which have the highest food insecurity rate of the country’s First Nations, despite being covered in pipelines and extractive industries. To explore the food security impacts of the notional northern corridor, we spatially analyzed its route’s proximity to mineral-rich greenstone belts, roads, and Indigenous communities without all-weather road access. The notional northern corridor route transects many rich mineral deposits to reveal a focus on resource extraction. This notional route appears to prioritize the transport of resources to global markets over Indigenous communities’ needs. The notional route has six ports traversing First Nation territories under the Indian Act but is nearby to only seven of the 122 Indigenous communities lacking road access. This notional route, thus, is linked to Indigenous-specific systemic racist legislation of the Indian Act to bypass Inuit lands in Nunavut, Quebec and Labrador, where communities all lack roads but do not fall under the Indian Act. The Crown’s Indian Act trusteeship over First Nations gives a legal right to usurp reserve or Crown land for any corridor or development. The Indian Act benefits industry, settler and state to access and own Native land and resources, but not First Nations except regarding sustenance activities. The Federal Crown’s trusteeship over First Nations’ land and resources makes First Nations’ people legal “wards of the state,” which has led to inequitable planning control, infrastructure and services. Signs of economic poverty are that most Indigenous communities lack food infrastructure, hospitals, and post-secondary education facilities, with 122 First Nation communities lacking all-season access roads. This inequity indicts Canada for colonialism, racism and failure to uphold the equality clause in its constitution. The notional route to Hudson Bay indicates that First Nations and food security were not fully included in the conception phase of the Northern Corridor. The notional route cuts through the Indigenous-led protected area proposed in the Seal River Watershed to reach Hudson Bay via Churchill rather than Port Nelson. This notional route would undermine the Indigenous-led protected area and the migration of the threatened Caribou population. Oppositely, the NeeStaNan corridor proposed by Fox Lake, York Factory and other First Nations goes to Port Nelson and avoids the Seal River Watershed. Free, prior and informed consent should start at the conception phase to include Indigenous interests. In Northern Canada, where Indigenous people comprise the vast majority, infrastructure development should be Indigenous-led to prioritize Indigenous food security. An Indigenous-led, adequately funded strategy to end food insecurity in Canada’s Indigenous communities within the next decade is needed to turn around a health and human rights crisis. Removing Indigenous-specific systemic racist barriers to Indigenous control over Native land and adequate funding for infrastructure and services will attain Indigenous food security within a decade.

The Mino Bimaadiziwin Homebuilders postsecondary education pilot project built Indigenous youth capacity and houses in two remote Anishinini reserves—Garden Hill and Wasagamack. To evaluate this community-led project, a sustainable livelihood assessment holistically measured the impact on 45 of the 70 (64%) Homebuilder students and the community. The community benefited by gaining three culturally appropriate houses built from local lumber and employment opportunities for Anishinini instructors. A longitudinal survey found five of the six livelihood assets improved statistically and significantly, including satisfaction with social relationships, cultural awareness, income and ability to pay bills, housing safety, and human development. Students reported better relations with their families and neighbourhood. Most (85%) of the 70 Homebuilder students earned postsecondary certificates either in forestry, homebuilding or both while obtaining a training stipend, which elevated their incomes. These positive outcomes occurred despite project underfunding, the COVID-19 pandemic lockdown, climate change events, and inequitable housing policies under the Indian Act. Based on this project’s success, we recommend investing in Indigenous-led postsecondary education in community homebuilding projects. However, to attain equitable housing and human rights, a plan is needed to overturn the Indian Act, which keeps Indigenous people as “wards of the state” and their land in trust.

Most Indigenous women in Canada (61%) experience intimate partner violence (IPV), which is significantly worse than the high rate of 44 percent for other women in Canada. Despite the great risk for IPV, only three unfunded second-stage shelters for more than 600 First Nation reserves exist in Canada to provide First Nation women and their children a safe home. Second-stage housing offers IPV survivors transitional homes for an extended period that provide safety and renewal after their initial emergency shelter stays. This article documents the need for safe, nurturing, and culturally appropriate second-stage shelters for Indigenous women and their families to heal and rebuild. The authors provide two second-stage prototype designs based on domestic environmental analysis and concepts of houselessness, home, and co-housing. We discuss how these designs are one step in an action plan to protect Indigenous women and stop the genocide of Indigenous Peoples by supporting cultural, economic, health, and social development. The literature review and design concepts form an agenda to have design goals for housing IPV survivors that answers the “Calls to Justice for Murdered and Missing Women” and expands this needed service to every reserve.

This paper explores the role of electricity in the transition to renewable energy to mitigate climate change. A systematic literature review with the Scopus database identified 92 papers relevant to the renewable electricity transition. A PESTLE (Political, Economic, Sociological, Technological, Legal, and Environmental) review of the papers provided a multidisciplinary analysis. The Paris Agreement created a global movement for carbon neutrality to address the threats of climate change, calling for a transition to renewable electricity to lead the way and expand into new sectors and regions. Although smaller renewable technologies are ramping up, complexities thwarting the transition include locked-in assets, high upfront costs, variability of solar and wind energy, infrastructure, difficulty in decarbonizing transportation and industry, material resource constraints, and fossil fuel support. This research found that renewables are not replacing fossil fuels to date but adding further energy demands, so that greenhouse gas emissions rose in 2021 despite an increased renewable electricity share. Without a major shift in the trillions of dollars of subsidies and investment away from fossil fuels to renewables, catastrophic climate change is predicted. This paper found that the Paris Agreement’s commitment to net-zero carbon and the transition to renewable electricity are undermined by record-high levels of subsidies and financing for fossil fuel industry expansion. Transitioning to a climate-neutral economy requires an investment away from fossil fuels into renewable energy ecosystems. Renewable electricity provides possibilities to realize sustainable development goals, climate stabilization, job creation, a green economy, and energy security with careful planning.