September 16, 2025

The term “Indigenous Peoples” is often used broadly, but it doesn’t reflect the diversity of cultures, languages, and histories it encompasses. Today, alongside a resurgence of cultural knowledge, First Nations, Inuit, and Métis communities are calling for a more distinctions-based approach to health care—one that honours their specific traditions, values, and healing practices.    

In this final story of our three-part series, Letitia Pokiak, an Inuit woman from Tuktoyaktuk in the Western Arctic region (Northwest Territories), shares aspects of her culture that are deeply tied to the land and discusses challenges around food security and access to health care in northern communities. 

Living in relationship with the land 

For Inuit living in remote Arctic regions, survival and well-being are intimately connected to the land and sea. Letitia Pokiak knows this well. She grew up in Tuktoyaktuk, one of the northernmost communities in the Western Arctic, where her ancestors have lived for generations. 

Living there means adapting to the seasons: hunting geese in spring, harvesting whale in summer, and spending fall at a remote cabin hunting caribou. Pokiak notes that hunting, camping, sewing parkas and maklaks, building or repairing equipment, as well as being connected closely with community, are not just cultural traditions—they are essential for physical, spiritual, emotional, and mental health.  

Food systems and health 

Because of its remoteness, Pokiak’s hometown was less immediately affected by colonial disruption than many communities further south. “We were fortunate in that there was very little outside influence, although there have been impacts due to colonization and government encroachment,” she says. 

Those impacts are now increasingly visible. Where Tuktoyaktuk was once accessible only by plane, ice road or boat, a paved road now connects the community to southern road networks. That shift has brought easier access to processed and packaged foods, but at a cost. 

“Our food systems … have been heavily eroded,” says Pokiak. “There are very few people who are able to access hunting or harvesting to incorporate into their daily practices, like [we did] a generation or two ago.” 

Patient partner Letitia Pokiak

Western food systems, combined with the high cost of hunting and fishing equipment—such as boats, rifles, and snowmobiles—act as major barriers to traditional harvesting in Inuit communities. The transition from a traditional, nutrient-rich diet to one high in sugars, saturated fats, and refined carbohydrates from processed foods has led to higher prevalence of obesity, diabetes, heart disease, and high cholesterol among Inuit communities—especially among women. It’s also eroding cultural continuity. 

“We’ve moved away from those healthy foods people would typically harvest off the land,” says Pokiak. “I think lack of access to traditional foods, whether it’s maktak or caribou or fish or berries or geese, has impacted our health—not only physically, but mentally, emotionally, socially, and spiritually.”  

Building distinctions-based care 

In addition to food insecurity, which Inuit Tapiriit Kanatami (ITK) reports has reached crisis levels in all four Inuit regions, Inuit communities face unique challenges in accessing health services. Pokiak notes that most communities have only a small health station, occasionally staffed by visiting doctors or nurses. In very remote areas, about 82 per cent of Inuit do not have a regular primary-care provider, underscoring the need for care closer to home. 

For the most part, any locals in need of care must travel further south to regional centres—or, in emergencies, be evacuated by air. This lack of consistent, culturally safe care contributes to health disparities.  

The Nunavut Network Environments for Indigenous Health Research (NEIHR) Centre takes a systems approach to Inuit health. This Inuit-led network applies Inuit knowledge (also known as Inuit Qaujimajatuqangit, or IQ) across counselling, land programs, arts, and research—treating culture and land as care. With the guidance of Elders and Inuit science at its core, NEIHR “bends the system” to Inuit worldviews. Evaluations show land-based mental-health programs can equal or outperform fly-in services—providing strong evidence in favour of distinctions-based models. 

Another example of distinctions-based health care designed by and for Inuit is the Qaujigiartiit Health Research Centre in Iqaluit, which supports community-led wellness research that blends IQ with Western methods—building local capacity for culturally sensitive health programming and research.  

Similarly, the Nunavik Regional Board of Health and Social Services has a dedicated Department of Inuit Values and Practices. It funds wellness committees and midwifery services embedded in Inuit values—programs built around birthing, emotional support, and community wellness planning that align with cultural norms and priorities. 

These examples highlight that distinctions-based approaches—when supported with funding and autonomy—can foster care and services that respect Inuit culture, language, values, and ways of knowing. 

Strengthening health through cultural continuity 

As this series has shown, First Nations, Métis, and Inuit Peoples each have distinct traditions, histories, and priorities that must be understood in health and research contexts. For Inuit, supporting cultural continuity, addressing food insecurity, and improving access to care are not just health priorities—they are matters of resilience and survival. 

The growing success of Inuit-led health initiatives demonstrates what is possible when care is grounded in local knowledge, language, and values. These distinctions-based approaches don’t just improve outcomes; they also affirm identity, restore trust, and strengthen community well-being for generations to come.  

“Inuit health, well-being, and culture are intimately connected with the health of the lands, waters, families, and communities,” says Pokiak.  “Inuit self-determination and sovereignty become important with Inuit on the frontlines of the climate crisis, where our land-based practices are slowly eroding away with various impacts.”   

Together, the stories in this series, Honouring the distinct cultures of Indigenous Peoples, highlight a shared truth: health research in Canada is strongest when it honours the knowledge, cultures, and voices of First Nations, Métis, and Inuit Peoples. If you missed the previous stories in this series, you can check them out here: Honouring First Nations Knowledge and Honouring Métis Knowledge.