Indigenous Elders' voices on health-systems change informed by planetary health: a qualitative and relational systems mapping inquiry

Indigenous Peoples and their knowledge systems are increasingly being looked to for solutions regarding climate change, including within clinical health-care settings. Indigenous Elders specifically are noted knowledge keepers within their communities and are often looked to with great respect for their Land-based knowledges as they pertain to planetary health approaches. We sought to explore the views of health-systems change informed by planetary health within the circumpolar north from the perspective of Indigenous Elders. We held a sharing circle, in which Elders identified four interconnected themes following a cyclical pattern that were also depicted with relational systems mapping, including the past and how we got here, where we are now, where we need to go in the future, and our reflections. Our findings showed that any concepts related to planetary health that are discussed within health systems cannot be disconnected from the context around them. Overall, health systems were stated to be currently devoid of any environmental context or consideration.