This article is aligned with the USask College of Medicine's strategic directions.
Dosman, widely regarded as the “father of agricultural medicine,” was invited to present on this work at Farm and Home Week, an annual event the University of Saskatchewan (USask) once hosted each spring; people living in rural areas visited the campus to hear lectures from faculty and learn about the latest research on agriculture.
After Dosman spoke, then-USask President Leo Kristjanson – who had listened intently to the new faculty member’s presentation – delivered his own address.
Later that afternoon, Dosman received a message requesting that he come to the president’s office. “For a faculty member, that's sort of like being called on the carpet,” recalls Dosman. “When I got there, President Kristjanson said, ‘You know, Jim, you gave a good talk. Probably better than most. Ninety per cent.’
‘But,’ he said, ‘you missed a point. You said that we were solving the problems of the people of Saskatchewan. I would've loved you to have said that when we're solving the problems of the people of Saskatchewan, we're solving the problems of the people of the world.’”
That idea – that knowledge is universal – has stayed with Dosman through his decades-long research career at the U of S. “It gave me a new understanding of what we were doing,” says Dosman, a member of the Canadian Medical Hall of Fame and founder of USask’s Canadian Centre for Health and Safety in Agriculture (CCHSA). “It sounds simple but it was quite profound.”
Fast forward to February 2022: Earlier this spring Dosman and a team comprising USask researchers and community partners was awarded $1.4 million in CIHR funding to study the connections between housing, home, and mental health in two First Nations communities in rural Saskatchewan. The group will explore the relationships between the physical structure (the house), what goes on within its four walls (the home) and the mental health of the people who live there. While the study is based in these communities, Dosman hopes what they learn will benefit Indigenous people elsewhere in this province and beyond.
This new work will build on the relationships Dosman and colleagues have built and nurtured with the two communities over more than 10 years. Their first CIHR-funded project – completed in 2018 – looked at the connection between housing and respiratory health. The second – which will wrap up in 2023 – has been studying the link between housing and sleep. “That (relationship) has really been key to the success,” says Dosman. “It’s been a partnership with the communities.”
The new project is based on the Cree people’s traditional Tipi Teachings. The 15 poles that provide the internal structure of the tipi represent a set of universal values, according to USask researcher Kathleen McMullin, who is a member of the project team.
“When you look at it across humanity, we're always looking at things like good child rearing and love and kindness and obedience – the kinds of values that keep a society strong,” says McMullin. “The Tipi Teachings are a form of self-government. It's a way of governing one's household, it's a way of governing one's community, and it's a healthy way of living.”
As part of this work, the team is exploring whether colonization has affected the relationship between the individual and the concept that the dwelling is a sacred space.
“One of our theories is that if you revitalize the cultural teachings that go with the tipi, you’re revitalizing mental health,” says McMullin. “It (a person’s home) is not just a place that you live in. It carries all these other values and teaching which promote good mental health. If you have strong values that are being taught and practised, then you’re going to have healthy home structures again, regardless of the shape, whether it’s round like a tipi, or rectangular or square.”
The team is using the Tipi Teachings as their framework for the new project. Dosman says the modern theory of Indigenous mental health published in the research literature maps quite closely to the Tipi Teachings, which were developed hundreds – possibly thousands – of years ago. “If we can do this, it will be a wonderful model to join the historic teachings with the modern theory,” says Dosman. “Isn't it exciting that the age-old Tipi Teachings are as applicable today as the modern theory?”
That initial project involving the two First Nations communities – the First Nations Lung Health Study – flowed from the Saskatchewan Rural Health Study. “We always thought that the Indigenous people living in rural areas would have many of the same health risks and difficulties accessing health care as did people who lived in small rural communities,” says Dosman.
A key finding that emerged from the first collaboration was that Status Indians – whose health care is the responsibility of the federal government’s Non-Insured Health Benefits program, or NIHB – did not have the same access to at-home testing for sleep apnea as non-First Nations Saskatchewan residents. That meant they faced long waits – and potentially long drives – to spend a night in a sleep lab in Saskatoon or Regina.
A pair of policy papers written by researcher Dr. Greg Marchildon (PhD) calling attention to this inequity, and some strategic in-person discussions with Indigenous Services Canada policy analysts led by Dr. Mark Fenton (MD) in 2019 resulted in policy change – first provincially, then nationally – giving Indigenous people all across Canada better access to this medical service. It was a major breakthrough for First Nations people in Canada. And it demonstrated that solving problems in Saskatchewan can indeed benefit others outside the province.
Marchildon says the key informant interviews the team did with federal (NIHB) and provincial (Saskatchewan Aids to Independent Living) policy-program administrators was key to unravelling the policy problem.
“Seldom in the life of a researcher does something that matters to thousands of people happen in such a short time-frame,” says Dosman. “That was an outstanding example of, yeah, the research we do here matters,” says Dosman. “It isn't always that fast. Sometimes change is slow – it can take many years. But that is a very dramatic example of how change can happen quickly.”
One of the things that’s brought Dosman immense satisfaction over the years has been shining a spotlight on the unique health care challenges faced by people living in rural areas. “These were groups that were underrecognized and underserved, but by doing the research and outreach and prevention and policy change, the issues they face have become more mainstream,” he says. “It's a voyage from being unrecognized to being legitimate.”
Dr. Malcolm King (PhD), an eminent Indigenous scholar and member of the research team, thinks that if the project is successful, the results should be instructive for not only Indigenous people, but all people. “This would be the other side of Two-Eyed Seeing, whereby non-Indigenous people could learn from and benefit from the good experience of Indigenous people,” says King.
Just how broad an impact does Dosman think this latest study on housing and Indigenous mental health could have?
“It's like throwing a stone in the water,” says Dosman. “You never know where the ripples will hit the shore.”
The Research Team
Co-investigators: Elder Suzanne Seeseequasis, Elder Raymond Mandes Sr, Jeremy Seeseequasis, Marie Neubuhr, Warren Seesequasis, Delano Mike, Carol Naytayhow, Larry Burgess, Chandima Karunanayake, Kathleen McMullin, Bonnie Janzen, Vivian Ramsden, Josh Lawson, Mark Fenton, Niels Koehncke, Elisa Halkett
Collaborators: Donna Rennie, Thomas Smith-Windsor, Greg Marchildon
Principal Investigators: James A. Dosman (Nominated PI), Punam Pahwa, Sylvia Abonyi, Malcolm King, Marilyn Baetz, Shelley Kirychuk