A Rapid Evidence Review of stigma mitigation strategies during past outbreaks among Indigenous populations living in rural, remote and northern regions of Canada and what can be learned for COVID-19
COVID-19 and public health responses to the pandemic have the potential to prevent or generate stigma, a socially constructed phenomenon that has the potential to negatively impact health outcomes for Indigenous Peoples.
A new resource from the National Collaborating Centre for Indigenous Health (NCCIH) and Northern Health on evidence-based recommendations to counteract COVID-19 related stigma is now available1.
This Rapid Evidence Review was collaboratively developed with expert guidance from members of the COVID-19 Public Health Working Group on Remote and Isolated Communities. The document identifies and analyzes best practices for stigma mitigation strategies that have been used by Indigenous Peoples and communities during previous epidemics, pandemics, and infectious disease outbreaks.
The report also outlines considerations in developing and undertaking stigma mitigation strategies (e.g., developing context-specific strategies) within rural, remote, Northern and Indigenous communities. Knowledge gaps and opportunities for future research emerging from the evidence review are highlighted.
The search of academic and grey literature was conducted in May 2020 and repeated in October 2020 to include the most recent available evidence. The authors identified, gathered, and analyzed a total of 179 articles against inclusion criteria then synthesized findings from a total of 25 articles to answer the question, “What are the best practices for preventing and mitigating COVID-19 related stigma in Indigenous rural, remote and northern communities within Canada?”
This rapid review identified six broad themes emerging from the literature review which, taken together, explore the topic of best practices for stigma mitigation among Indigenous, rural, remote and Northern communities in the setting of an infectious disease outbreak such as COVID-19.
The themes include:
- Pathogen factors;
- Fear, anxiety and misinformation;
- Stigmatized identities;
- Structural and systemic drivers;
- Culture and community; and
- Public health and media.
Some stigma mitigation strategies identified in the literature include: providing education and information to address fear and anxiety; sharing personal stories to tackle stigma; and implementing systemic and structural plans to mitigate racism and stigma within workplaces (Ward & MacDonald, 2021).
The report concludes that there is a lack of literature in relation to stigma, COVID-19, and Indigenous communities. However, there is much to be learned from the available evidence related to other infectious diseases and prior epidemics including drivers and impacts of stigma. Eight broad recommendations are discussed including but not limited to developing context specific, strengths-based and resilience focused strategies; recognition of Indigenous People’s sovereign rights; and developing partnered approaches to create culturally specific strategies to mitigate stigma.
The full report is available on the NCCIH website.