EXPLORING HOW CURRENT FEDERAL, PROVINCIAL, AND FIRST NATIONS GOVERNMENT POLICIES SUPPORT AND PROMOTE HEALTHY AGING AMONG OLDER MI’KMAQ IN ATLANTIC CANADA
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Older Indigenous peoples in Canada, including Mi’kmaq in the Atlantic region, face significant health disparities that occur earlier and more often than for non-Indigenous Canadians. These health disparities mask the unique and positive ways in which Elders and older Mi’kmaq can promote wellbeing within their communities in Atlantic Canada, introducing challenges to promoting health across the life course. As more Mi’kmaq reach older age, creating healthy aging policies that aim to promote health is essential. This study explored: 1) What are the current federal, provincial, and First Nations government policies that promote healthy aging among older Mi’kmaq living on-reserve in Atlantic Canada; and 2) a) how do policymakers integrate and reflect upon Mi’kmaq perspectives in the development, implementation, and evaluation process of healthy aging-related policies, and b) how can these policies support healthy aging of older Mi’kmaq living in their communities. A two-phase qualitative descriptive approach was used to answer these questions. First, a systematic search was conducted to locate 11 federal, provincial, and First Nation policies, strategies, frameworks, and action plans related to healthy aging and older Mi’kmaq on organizational and governmental websites. Second, nine interviews were conducted with individuals working in federal, provincial, and First Nations government departments, First Nations Health Organizations, First Nations Health Centres, and members of provincial aging policy development committees across the Atlantic region. Inductive content analysis generated four descriptive themes from the policy documents: a) Transparent Inclusion of Older First Nations During Policy Development, b) Engaging Elders and Older Mi’kmaq, c) Determinants of Health Approach, and d) Programs and Services; and three descriptive themes from the interviews: a) Government Relations and Communication, b) Current Healthy Aging Policies for First Nations, and c) Integrating Older First Nations Healthy Aging-Related Priorities in Health Policies. Findings indicated inconsistencies between First Nations and Canadian government policies related to service provision and programs intended to promote healthy aging among Elders and older Mi’kmaq on-reserve. In addition, priorities related to healthy aging identified in Mi’kmaq organization mandates have not been integrated into federal or provincial healthy aging policies. These findings highlight the urgent need for meaningful collaboration between First Nations and Canadian governments to co-create comprehensive, Indigenous-focused policies to promote healthy aging. It was also emphasized that Elders and older Mi’kmaq living on-reserve need to be meaningfully engaged to understand what each community wants to age well. Critically, a process for inclusive and comprehensive engagement with communities is needed to ensure healthy aging is supported and needs are being addressed.