Environmental factors play a critical role in the health and well-being of people worldwide and the distribution of the burden of disease associated with environmental causes is disproportionately high in marginalized populations, including First Nations. In this way, environmental health problems are as much social and political problems as environmental and must be addressed as such. In Canada, the division of responsibilities for environmental health, in combination with the jurisdictional complexities of health and environment regulation and service provision on-reserve creates a First Nations environmental health management system with significant gaps. This research set out to explore the question: What are the current strengths and challenges in First Nations environmental health policy and management? A qualitative exploratory design organized in two stages and employing key informant interviews, document review and a community case study was used to examine this topic. In the first stage a review of existing programs and policies applicable to Ontario First Nations and a series of interviews with key experts on the topic in the province were conducted. A conceptual framework of the core elements affecting environmental health management in First Nations communities was developed and then applied to a case study with Mississauga First Nation in Northern Ontario. The framework included five core elements: Environmental Health Jurisdiction and Responsibility; Participation in Environmental Health Decision-Making; Access to Environmental Health Resources, Communication of Environmental Health Information; and, Role and Influence of Leadership. The findings indicate that "internal" issues, like community-based decision-making and support for environmental health initiatives seem to be least affected by the "external" issues such as access to federal funding. The "internal" issues were also shown to be critically important factors having impacts on environmental health management practices and policies in Mississauga First Nation. While there are countless barriers associated with the "external" factors that have significant impacts on environmental health management practices and policies, this research suggest that the "internal" factors can potentially be the most important factors in creating positive change in this area and as a result warrant further study in order to improve the state of environmental health issues in First Nations.
Author Keywords: Community, Environmental Health, First Nations, Framework, Policy