Promoting health and wellness through Indigenous sacred sites,ceremony grounds,and land-based learning: a scoping review

Abstract

This study analyzes the literature on Indigenous sacred sites within the larger topic areas of land-based education and healing, as per the guidance of Anishinaabe (a group of Indigenous Peoples from the Great Lakes and the Great Plains areas of contemporary Canada and USA) Elders and community leaders in eastern Manitoba, Canada. A scoping review was conducted to identify the size, scope, nature, and key themes of existing research in seven databases, inclusive of gray literature which is a key source for Indigenous organizations. In total, we analyzed 35 articles and documents. The emerging themes included: (1) sacred sites and the promotion of health and wellness; (2) sacred sites as places of knowledge; (3) the desecration and protection of sacred sites; and (4) legal battles between Indigenous Peoples and the state. Recommendations to advance understandings and correct colonially imposed imbalances are discussed, and health and legal implications are outlined.

Introduction

Sacred sites are often understood as physical locations or spaces where humans gather and intentionally engage with natural environments for spiritual purposes, and where relationships with—and value and knowledge of—the land is built, renewed, and maintained. We, the authors, are living and working on Treaty 1 land in Winnipeg, Manitoba, Canada, which is the home of Anishinaabe (a group of Indigenous Peoples from the Great Lakes and the Great Plains areas of contemporary Canada and USA), Nehiyawak (a group of Indigenous Peoples from across multiple contemporary Canadian provinces from Alberta to Quebec), also known as Cree, Dakhóta (a group of Indigenous Peoples from the Great Plains of contemporary Canada and USA), and Métis (a group of Indigenous Peoples from the prairies of contemporary Canada). Inspired by our location within and relationships to these lands, the purpose of this article is to build on research frameworks that include connections with the land and sacred sites as important determinants of health and wellness.

Sacred sites include ancient petroglyphs, petroforms, buffalo jumps, whaling shrines, birthing alcoves, burial sites, places where spiritual visions have been received, ceremony grounds, medicine gathering places, certain spaces in forests and fields used for fasting practices, other significant locations where ancestors have gathered, and places that are historically revered. These also include places where unique land formations are conducive to precipitating spiritual experiences; for example, Manitou Api (where the Creator sits) in Manitoba, Canada, that is a sacred creation site of Anishinaabe People where it is taught that the original instructions for living in a good way and for understanding of the universe were received (Christensen & Poupart, 2012).

Across the diversity of Indigenous Peoples globally, sacred sites hold significance and often inspire dedicated reverence. As they are key access points for transmitting worldview, knowledge, and cosmology that transcend everyday human experience, sacred sites are unique pathways to intangible cultural heritage (Bakht & Collins, 2016; Blair, 2020; Christensen & Poupart, 2012). Although in many colonial countries like Canada, Australia, New Zealand, and the USA, there are ongoing legal battles over the right to own, access, regulate, and protect sacred sites, Indigenous Peoples continue to gather and hold ceremonies that encourage and engender spiritual relationships with the land of and around these spaces (Bakht & Collins, 2016; Blair, 2020; Christensen & Poupart, 2012). The right to do so is protected via freedom of religion enshrined in the Canadian Charter of Rights and Freedoms and internationally by the Universal Declaration of Human Rights and the United Nations Declaration on the Rights of Indigenous Peoples, among other legislation (Bakht and Collins, 2018), yet sacred sites have not been adequately protected by federal governments, and too many have been desecrated, dismantled, denigrated, and polluted (Bakht & Collins, 2016; Barclay & Steele, 2021; Blair, 2020; Gottardi, 2020; Looking Horse, 2016). Indeed, Stelkia and colleagues (2020) affirmed what scholars have evidenced regarding the vital interconnections: “The wholistic, interconnected, spiritual, and sacred relationship that many Indigenous Peoples have with the land is an integral part of strengthening physical, spiritual, mental, and emotional health and wellbeing” (p. 356). Unfortunately many Indigenous Peoples are excluded from exercising judicial license, control, or legal rights to protect sacred sites, despite these places being important Indigenous social or relational determinants of health (Blair, 2020).

The purpose of this scoping review is to examine how sacred sites—as a key impulse within the emerging literature on land-based education and land-based healing—can promote the health and wellness of Indigenous people, with a primary focus on Canada, Turtle Island—known more widely as North America. This review makes the specific contribution of centering sacred sites within the other aspects of land-based relationships and activities, while building connections to legal and political movements for Indigenous self-determination and self-governance, as well as issues of environmental justice and climate change.

Materials and methods

This study was led by the first author, Moneca Sinclaire, a member of the Cree Nation in northern Manitoba, Canada, who is living in Winnipeg, Manitoba, with guidance from First Nation Elders, community leaders, and community members who shared their input into the research priorities and goals. A process of community engagement was started with ceremony and setting intentions, by offering tobacco to Elders, who wish to remain collectively acknowledged rather than individually named, to ask for direction, within a larger and ongoing research relationship. Community leaders and community members who wished to participate in the ceremony and meetings were welcomed and invited to share their input after the Elders had spoken. A consensus was built with all those who were involved by hearing from everyone until the direction for the study became clear.

More comprehensive than a literature review, a scoping review is useful for identifying the size, scope, nature, and key themes of existing research (Tuck & McKenzie, 2015). Scoping review methodology is well-suited to achieve the aims of mapping the state of knowledge in the literature area, providing an overview of the range of current evidence, and informing future work in this area (Tuck & McKenzie, 2015). We followed the process that Arksey and O’Malley (2005) outlined—and Levac and colleagues (2010) detailed and refined—for conducting a scoping review in a comprehensive and systematic way, namely by: (1) identifying the research question; (2) identifying the relevant studies; (3) applying inclusion and exclusion criteria for study selection purposes; (4) organizing the data into tables and themes; and (5) synthesizing and reporting on the state of research. The research question was formulated as: What is the state of knowledge on how sacred sites specifically—and land-based healing and education more broadly—promote the health and wellbeing of Indigenous Peoples in Canada—Turtle Island, and other comparable settings? The search terms are provided in Supplementary Material 1.

A search of titles and abstracts was conducted in the following databases: Scopus, EBSCOhost, CINAHL, OVID, Medline, Embase, and Google scholar. We did not impose limitations on publication dates to capture the most comprehensive data possible. After de-duplication, the first author screened study titles, abstracts, and keywords for adherence to the inclusion criteria (Arksey & O’Malley, 2005; Levac et al., 2010). Only articles written in English were included for pragmatic reasons, but there were very few documents lost to these exclusion criteria. Exclusion criteria eliminated research protocols, conference proceedings, lists of land-based programs, quantitative evaluations of land-based interventions, power point presentations, and entire books. Inclusion criteria defined that articles had to contain information about land-based activities and pertain to Indigenous Peoples in Canada and on Turtle Island or to those with similar colonial history. Full-text peer-reviewed articles, gray literature, and additional documents identified via ancestry referencing and suggestions from topic experts were amalgamated, and after screening, there were 35 articles eligible for review (Arksey & O’Malley, 2005; Levac et al., 2010; Russell et al., 2016). These were incorporated into a table, and pertinent data were inputted about each source (Arksey & O’Malley, 2005; Levac et al., 2010). Articles that discussed sacred sites to any degree were highlighted. See Supplemental Material 2 for the data flowchart.

Results

To summarize the results by categories, 16 of the articles were qualitative analyses of Indigenous land-based health and education initiatives. There were five qualitative studies on Indigenous lived experiences and perceptions of land and health, including two with urban Cree and Métis youth, two with Anishinaabe Elders, and one with Innu people in subarctic Labrador. Another qualitative study inquired specifically into the impact of sacred site desecration on Indigenous health (Cooper et al., 2019). There were seven reviews, with three pertaining to land-based learning, three about the importance of land to Indigenous knowledge, health, and spirituality, and one synthesizing models into a wellness framework. Three articles delved into analysis of legal protections for Indigenous sacred sites. There was one case study on Indigenous women’s leadership in land protection activism. Finally, there was a position paper on Indigenous Natural Law for planetary health and survival. A subset of articles pertained directly to Indigenous sacred sites (Supplemental Material 3; Supplementary Material 4). The emerging themes from this analysis included: (1) sacred sites and the promotion of health and wellness; (2) sacred sites as places of knowledge; (3) the desecration and protection of sacred sites; and (4) legal battles between Indigenous Peoples and the state. All but one of the studies on land-based healing and education programs have been published within the past decade since 2014, with one 2005 exception. This recent and emerging literature area emphasizes that land and health are so closely intertwined for many Indigenous Peoples that they must not be considered in isolation.

Sacred sites and the promotion of health and wellness

A major theme that emerged is that health and wellness are inseparable from land, and more specifically, from ceremonies carried out on sacred sites. In their research uniting scholars of Tewa (an Indigenous people from the contemporary New Mexico, USA), Diné (a group of Indigenous Peoples from contemporary New Mexico, Arizona, and Utah, USA), Muscogee Creek (a group of Indigenous Peoples from the southeastern woodlands of contemporary USA), Kanien’kehá: ka (a group of Indigenous People from contemporary southeastern Canada and New York State, USA), and Kānaka Maoli (Indigenous People of Hawaii) ancestry, Cooper and colleagues (2019) describe sacred sites as particularly charged with profound spiritual power. Sacred sites are critical to cultural survival, they are akin to family, and they are felt within the self (Cooper et al., 2019). These authors clearly state that “when sacred spaces are thriving, people are healthy” (Cooper et al., 2019, p. 6). The purpose of protecting sacred sites extends benefit to all humanity because, as a Hopi (an Indigenous People from Arizona, USA) study participant shared:

It’s never an individual thing when you go to these locations. It’s always for a purpose. There’s always a reason for these places that we go to for different offerings.. . . These places that are identified as sacred spaces . . .[must] be maintained so that we can continue to offer our prayers as Hopi People to that one location, and our prayers in turn are going to help in the wellbeing of everybody as whole, not just Hopi, but everybody. (Cooper et al., 2019, p. 15)

The opposite holds true, they contend, that desecration of sacred sites harms everyone, though it is often felt most acutely and painfully in the bodies, minds, and spirits of Indigenous Peoples whose identities are embedded there (Cooper et al., 2019). The grief for sacred spaces is extended to include entire mountaintops desecrated by mining, mothers’ wombs impacted by paper mill toxins in the community water supply, and burial grounds bulldozed for golf course developments (Bonspille-Boileau, 2015; Cooper et al., 2019; Richmond & Ross, 2009). The pain of such desecration compounds inside Indigenous bodies, a reality that can lead to solastalgia—distress and inability to experience solace because one’s environment and one’s identity is under assault, somaterratic illnesses—physical illnesses from environmental toxins, and psychoterratic illnesses—mental illness arising from threats to one’s land and to one’s connection its power (Cooper et al., 2019).

Bowers (2010) similarly described sacred sites as places where sacred business is carried out, such as where sacred medicines are harvested. Medicine picking sites are sacred and of multiple layered medicinal worth, as an Anishinaabe plant medicine expert shared in a study about therapeutic landscapes: “I came up with a phrase the other day that describes how I feel, ‘Harvesting medicine is medicine’” (Wilson, 2003, p. 90). Bowers (2010) further wrote of sacred space as places where a circle is formed and where a community is formed in ceremony. When people enter sacred ceremony grounds, they have the opportunity to transcend individual experiences into oneness with others in the circle and the world around them: “these ritual spaces are where people find silence and peace, can reflect on their experiences and gain a new insight, or seek awareness of ways to change or find new directions for the future” (Bowers, 2010, p. 210). Bowra and colleagues (2021) added that sacred sites are also animate, dynamic, spiritual beings.

Indigenous Peoples often have little to no room to separate themselves from the impacts of destructive land practices, given that profound spiritual interconnections have been built over thousands of generations, including the traditional Indigenous knowledges (TIK) and inherent responsibilities attached to its preservation and management (Nightingale & Richmond, 2022). Violence against the land is violence against Indigenous Peoples because, as Blair (2020) explained, Indigenous spiritualities are primarily rooted in the land, and to hurt one is to hurt both. This was affirmed by a Nehiyawak Elder who described sacred sites her grandfather would take her to visit as a child:

Spirituality is the essence of the being, the being that comes from your environment . . . When you’re so dependent on the land like we were, then the land had to be a part of every decision because that’s what sustained us, so protecting the land and protecting the hunting areas, the trapping areas, and all of the water areas, it had to be above all protected from any damage. (Hansen, 2018, pp. 84–85)

To be denied access to one’s sacred sites and ways of experiencing the divine—along with integral access to traditional sustenance, foods, waters, and medicines—is to suffer spiritual violence and spiritual abuse (Truth and Reconciliation Commission of Canada [TRC], 2015).

In a similar way, Hatala and colleagues (2020) found that urban youth understood nature as a spiritual force that could guide people away from harmful directions in life; without access to sacred spaces, transmission of spiritual guidance can be obscured or harder to find. When participants in land-based healing and education programs interact with sacred spaces, they report feeling greater responsibility toward the land, which often comes with the desire to renew and pass on their knowledge to the next generations, an impulse which when violated, can have devastating consequences on the health of entire communities and Nations (Cooper et al., 2019; Corntassel & Hardbarger, 2019; Danto et al., 2021; Fast et al., 2021; Hansen, 2018; Lines & Jardine, 2019).

Indigenous Peoples are more likely to experience minority stress and sequalae health repercussions in colonized spaces, but the opposite is true of Indigenous protected sacred spaces (Aamar et al., 2015; Bowra et al., 2021; Cooper et al., 2019; Fast et al., 2021). Fast and colleagues (2021), for example, extended sacred sites to mean ceremonial space and community space that is accessible, safe, free from violence, and inclusive for those who identify as Two-Spirit, non-binary, and/or LGBTQIA+. Fast and colleagues (2021) explored how ceremony retreat space activated and affirmed positive feelings, including community spirit, solidarity, belonging, identity, and purpose for youth participants. Youth participants reflected on this distinct positivity in sharp contrast to being in typical academic space, institutional space, and colonial space (Fast et al., 2021). Participants discovered that sacred spaces enabled them to be taught directly from the land, that sacred sites are in fact teachers, and that sacred sites empowered new-ancient Indigenous ways of thinking and being with the land (Fast et al., 2021).

Sacred sites as places of knowledge

For TIK to flourish, sacred sites need to be protected for continued capacity to share the culture, customs, values, ceremonies, spirituality, language, ways of knowing and being, health, wellness, and relationships with the land (Corntassel & Hardbarger, 2019; Danto et al., 2021; Fast et al., 2021; Johnson-Jennings et al., 2020; Kingsley et al., 2013; Lines & Jardine, 2019; Stelkia et al., 2020; Ward et al., 2021).

Sacred sites are embedded with Indigenous languages and cultures, each site with their own unique ceremonial names, songs, and strengths; protecting sacred sites then is akin to protecting TIK and its transmission (Danto et al., 2021; Hatala et al., 2020; Mikraszewicz & Richmond, 2019; Priest, 2022).

The work of Elders and Knowledge Keepers empowers community members’ connections and re-connections with sacred spaces through hosting cultural gatherings, pow-wows, retreats, hunting trips, canoeing journeys, survival skill building activities, harvesting traditional medicines, healing ceremonies, naming ceremonies, vision quest ceremonies, traditional teachings, and much more–all for the purposes of protecting the capacity for living in a good and balanced way on earth (Ambtman-Smith & Richmond, 2020; Big-Canoe & Richmond, 2014; Bowra et al., 2021; Hickey et al., 2021; Johnson & Ali, 2020; Redvers, 2020; White, 2000). Danto and colleagues (2021) describe how Elder-youth dyads in land-based healing and education programs foster a special personal warming and spiritual openness that occurs in ceremonial spaces and sacred sites, including for urban youth who otherwise face multiple, compounding sites of oppression on a daily basis. Lines and Jardine (2019) and other scholars demonstrated how access to sacred land and cultural activities, such as fishing and harvesting medicines, allowed youth to transform internalized racism and shame into feelings of pride, happiness, satisfaction, capacity, and self-esteem—all of which are needed for continuing a learning journey.

There are numerous factors at play for where any given Indigenous person may be at in terms of knowledge and access to TIK, including the status of their connection to their original land and family, residential school survivorship, or that of a family member, mobility, and urbanization (Big-Canoe & Richmond, 2014; Bombay et al., 2014; Snyder & Wilson, 2012). There were 11 articles that focused on engagement with the land in urban contexts to support health and wellness in different ways (Hatala et al., 2019, 2020; Landry et al., 2019). Participants here expressed they still felt the connection to the sacred land under and around the constructed aspects of cityscapes, that the land is still alive, that the land still has a spirit, and that access to rivers, trees, and green spaces within cities was crucial to feeling well (Hatala et al., 2019, 2020; Landry et al., 2019). Landry and colleagues (2019) noted the importance of creating small-scale Indigenous-safe spaces in private backyards and in public parks, practicing cultural traditions such as laying tobacco by a tree in an urban park, holding public demonstrations for land rights and protections, and honoring the need to visit sacred land beyond the city limits at times.

A theme of the 16 studies around land-based healing and education programs was how consistently participants expressed that they not only learned directly from sacred sites but that they also deepened their sense of belonging, while experiencing overall health and wellness improvements in holistic ways. Several studies, for example, clearly stated that TIK transmission leads to identity reclamation—and the healing that comes with that—which is anchored in the land and ceremonies (Big-Canoe & Richmond, 2014; Greenwood & Lindsay, 2019; Hickey et al., 2021; Johnson & Ali, 2020; Mikraszewicz & Richmond, 2019; Stelkia et al., 2020). King and colleagues (2009) also described how “many Indigenous Peoples have an idea of the person that can be characterized as community-centered, since other people belonging to one’s own community, the land, and its animals are all viewed inherently as part of the self” (p. 77). Thus, the actions of collectively generating and shielding sacred sites support TIK transmission and healing, as well as the interactions between them.

The desecration and protection of sacred sites

The desecration of sacred sites is a part of the long history of government and colonial violence against Indigenous people which has been ongoing since before the formal establishment of the state (Barclay & Steele, 2021). In several articles, authors gave historical accounts of how sacred land has been lost through theft (Fast et al., 2021; Gottardi, 2020), by historical and current colonial laws (Bakht & Collins, 2016; Blair, 2020; Corntassel & Hardbarger, 2019; Fast et al., 2021), by assimilation and dispossession (Cooper et al., 2019; Danto et al., 2021; Greenwood & Lindsay, 2019), and desecration through climate and environment changes (Christensen & Poupart, 2012; Gottardi, 2020).

There is agreement in the literature that around the world, historically and in ongoing ways, colonialism has disrupted Indigenous Peoples’ access to sacred lands, and it has excluded Indigenous Peoples from decision-making in land utilization, resulting in the loss and desecration of sacred sites which are clearly and inextricably entwined with Indigenous cultural survival and health (Bakht & Collins, 2016; Blair, 2020; Cooper et al., 2019). Tuck and McKenzie (2015) described how the destructive actions toward land, such as tar sands, toxic waste, oil spills, and hyper-development, expose the deep ignorance of the interconnectivities of health and environment, indicative of colonizer thinking. Richmond and Ross (2009) similarly noted the destructiveness of environmental dispossession, where Indigenous Peoples have been denied access to the material and spiritual resources of traditional environments through years of colonial state oppression. Robbins and Dewar (2011) stressed that protection of sacred sites and healing spaces is more pressing than ever before due to the rapid and unprecedented rate of loss of land, urbanization, resource mining, and climate fluctuations and disasters. These authors highlighted the contributions of traditional peacemaker Arvol Looking Horse, the Lakota (a group of Indigenous Peoples from contemporary North Dakota and South Dakota, USA) 19th Generation Keeper of the White Buffalo Calf Sacred Pipe, who “likens Indigenous sacred sites to the equivalent of hospitals and educational institutions” (Robbins & Dewar, 2011, p. 7). Sacred sites can be understood as culturally safe universities, hospitals, and medical schools, all of which are in high demand (Robbins & Dewar, 2011).

Tobias and Richmond (2014) documented how dispossession and a rise in resource extraction in Northern Ontario, Canada, not only negatively impacted traditional ceremonial grounds but also led to a surge of vandalism in the area and the need for protective enclosures. The disruptions of sacred sites are many and resented, as one Elder shared:

There are some places that we can’t go. With the gates. Our forefathers never had gates. There is a place that’s so important for our people. Our people used to go there and do ceremony. And now, any of you ever been there? Spray painted all inside (Pic River Elder, Male, as cited in Tobias & Richmond, 2014, p. 29).

These authors also found that while sacred sites for traditional healing are essential for Indigenous cultural and personal health, they have also suffered demonization via forces of Christianization, rebranding of their names and reputations—the equivalent of changing God’s Lake to Devil’s Lake or other names to Devil’s Tower, Devil’s Narrows, or Devil’s Creek. Colonial powers have long-funded evangelization missionaries into Indigenous communities with catastrophic effects (Barclay & Steele, 2021; TRC, 2015). A Batchewana (an Anishinaabe First Nation in Northern Ontario, Canada) Elder equated sacred healing sites to resilience, strength, and resistance of colonization:

We talk about these sacred places . . . and how those places were so beautiful and what they called them and then it was Christianized and made to be an evil place, a bad place and the devil something or the devil this or the devil that. But when you look behind that curtain that the crown placed, you see the beauty of our culture and the spirituality and the ceremony that is in those places (Tobias & Richmond, 2014, p. 29).

Gottardi (2020) documented the role of Indigenous sovereignty and sacred sites protection, calling for policy reform that honors Indigenous Peoples’ rights to full participation in decision-making. This author highlighted Indigenous women’s leadership in grassroots movements to protect sacred lands, and contributes to the expanding definition of sacred space to include public protest and demonstration spaces (Gottardi, 2020).

Legal battles between Indigenous Peoples and the state

A final theme that emerged from this review was the legal protection of sacred sites, including the right to participate in cultural life and freedom of religion legislation. There are deep existential harms to Indigenous Peoples committed by governments in the despoiling of burial sites and ancient altars, for example, the US border wall in 2020 for highway expansion, as acts of cultural genocide (Bakht & Collins, 2016; Barclay & Steele, 2021). Particular geographical places in Indigenous homelands are inextricably bound to Indigenous identities and Peoplehood, and these practices are not portable to just anywhere, thus access is essential (Barclay & Steele, 2021). The Rainbow Bridge, Utah, USA, which is central to Diné religious practice provides one example among many; Barclay and Steele (2021, p. 1305) cited McDonald (2004), who quoted Badoni v. Higginson (1980) that “if humans alter the earth in the area of the Bridge, [their] [additional material in original work] prayers will not be heard by gods and their ceremonies will be ineffective to prevent evil and disease.” Similarly, the Black Hills are the sacred heart and womb of everything to the Lakota People but are currently and harmfully titled to various private landowners, as well as the US government (Barclay & Steele, 2021).

Blair (2020) wrote that holistic health and spirituality must factor into the contestations about who has the rights to decide what constitutes a sacred site and what protections it will be afforded. Currently, according to Blair (2020), “Indigenous conceptions of land and spirituality do not translate neatly into terms understandable to most lawyers and adjudicators” (p. 10). Sheridan and Longboat (2006) write that from a Haudenosaunee (a group of Indigenous Peoples from the Great Lakes area of contemporary Canada and USA) point of view, minds and legal systems must be decolonized to understand that sacred land “possesses sentience that is manifest in the consciousness of that territory, and that same consciousness is formalized in and as Haudenosaunee consciousness” (p. 366).

Rather than focus on what has become an implicated truism that Indigenous forms of spirituality are too different than Western religions and thus not protectable under the same legal system, Barclay and Steele (2021) demonstrated how the colonial state has unjustly treated Indigenous spiritualities—and rights to exercise religion—in similarly unjust ways to other Indigenous non-religious rights, particularly those involving land use. Barclay and Steele (2021) pointed out the systemic racism at play, reviewed legal pathways that have been attempted, and provided alternative approaches to protecting sacred sites within the existing laws. These scholars argued that government misunderstanding of Indigenous spiritualities is too often used as an excuse to destroy sacred sites when in fact the legislation has expansive definitions of religion that apply to non-Indigenous people (Barclay & Steele, 2021).

Bakht and Collins (2016) expounded international and Canadian law, with special emphasis on the case of Ktunaxa (an Indigenous group from contemporary British Columbia, Canada) Nation versus the province of British Columbia which was the Supreme Court of Canada’s first opportunity to rule on whether the demolition of an Indigenous sacred site counted as freedom of religion violation under the Canadian Charter of Rights and Freedoms. The case and its appeal were both dismissed, and a proposed ski resort development was prioritized over the Ktunaxa People whose identity and culture are profoundly intertwined with the contested lands of Qat’muk in the southeast corner of British Columbia, thus endangering the home of the Grizzly Bear Spirit (Gailus & Devlin, 2017).

The literature cites numerous legal and institutional barriers that continue to take away land from Indigenous Peoples, and it goes further into how environmental issues, such as climate change, oil spills, and mercury poisonings are also hindering Indigenous Peoples access to sacred sites, lands, and resources (Big-Canoe & Richmond, 2014; Gottardi, 2020; Richmond & Ross, 2009). These examples are also seen as a form of environmental dispossession that occurs in direct and indirect forms, the former involves processes that physically disable land use, for example, contamination of traditional medicine sites, and the latter occur via legislation and development that severs Indigenous People’s links to their lands, resources, and knowledge (Richmond & Ross, 2009).

Discussion

This review explores how sacred sites are crucial for Indigenous health and wellness, while also attending more generally at the relationships between land, health, and wellness for diverse Indigenous People within Canada and similar settings. We found many gaps in written knowledge regarding land and healing, which is even more true regarding sacred sites specifically. There are numerous geographical gaps within Canada, and there is very little from beyond Canada; there are many unrepresented and underrepresented distinct Indigenous Peoples in the literature on sacred sites as well.

While sacred sites have been conceptualized as hospitals and schools, more research is needed to expand on these ideas and experiences. The definitions and outcomes of what constitutes health and wellness are increasingly complex. The World Health Organization’s (WHO, 2023) definition of health outlines a state of physical, mental, and social wellbeing, not merely the absence of disease of infirmity (Fast et al., 2021; Johnson & Ali, 2020). WHO’s definition considers all aspects of health; however, several scholars have recognized that Indigenous populations in Canada and beyond continue to have additional sociocultural or relational factors that influence their health or wellness, including colonially imposed economic and policy conditions that produce inequitable and impoverished education, employment security, housing, childhood development, and health care, as well as exclusion from land-based resources (Johnson & Ali, 2020; Landry et al., 2019; Lines & Jardine, 2019; Stelkia et al., 2020). Mitchell and colleagues (2019) described how the social determinants of health in an Indigenous context must also include unique structural determinants, such as the oppressions of living under colonial legacy, political and economic exclusion, systemic racism, socially disadvantaged conditions, and fundamentally access to and control over the land. Intergenerational trauma must be considered as well, given that Indigenous Peoples’ experiences are rooted in multigenerational, cumulative, and chronic trauma, injustices, and oppression from generations of land removal and dispossession (Aguiar & Halseth, 2015). We found that for Indigenous People, renewing access and connections to the land—and specifically the protection of sacred sites—in rural, remote, and urban communities through fostering cultural revitalization, TIK transmission, spiritual practices, and intergenerational connections are vital for health and wellness. Thus, access and protection of sacred sites and the land should be included in definitions and social, relational, or structural determinants of health and wellness going forward.

A limitation of this study is that it is not inclusive of studies in lower- and middle-income countries despite that many Indigenous Peoples face similar land struggles in low resource settings that are more likely to be undocumented–an omission that also represents further geo-political gaps in knowledge. Another consideration is that while we used numerous search terms, these do not represent an exhaustive list of potential search terms; in retrospect, we could have added more terms, such as specific “Nations”, “Tribes”, and “American Indian” at the beginning stages which would likely have yielded additional results. Furthermore, going forward, as described by Mikraszewicz and Richmond (2019), there is a need for the development of a research paradigm that can comprehensively account for land-based health and healing, including sacred sites, in its framework and underlying assumptions in a culturally safe and holistic manner. The same can be said of advancing the development of the legal system and paradigm.

Conclusion

Despite enduring settler colonialism and historically traumatic events, many Indigenous communities continue to maintain their teachings and connections to their land and to their sacred sites. For many Indigenous Peoples, in urban or non-urban contexts, land or nature in general—and Indigenous spaces, sacred sites, and ceremonial grounds specifically—remain central to healing, health, and wellness. A central theme that emerged in this review was that the sacredness of land and, conversely, how the loss and desecration of sacred land affects Indigenous People on many levels, including rights to, and barriers of health and religion (Blair, 2020; Christensen & Poupart, 2012; Hansen, 2018; Hatala et al., 2020).

This scoping review contributes to the growing body of literature examining not only the importance and spiritual significance of sacred sites for diverse Indigenous Peoples, but also uncovering how these spiritual relationships with the land and nature can promote health and wellness. This study contributes the specific dimension of sacred sites to the growing literature area of land-based education and land-based healing. Indigenous-led governance of sacred sites is supported by this review and numerous Elders. Indigenous knowledge and Indigenous health are both deeply rooted in the land, and in turn so are sacred sites, so much so that Indigenous health research must include a component of land and sacred sites. The protection of sacred sites is equivocal to the protection of Indigenous health, wellness, spirituality, identity, and freedom.

Supplemental Material

sj-docx-1-aln-10.1177_11771801241251411 – Supplemental material for Promoting health and wellness through Indigenous sacred sites, ceremony grounds, and land-based learning: a scoping review

Supplemental material, sj-docx-1-aln-10.1177_11771801241251411 for Promoting health and wellness through Indigenous sacred sites, ceremony grounds, and land-based learning: a scoping review by Moneca Sinclaire, Lindsay P Allen and Andrew R Hatala in AlterNative: An International Journal of Indigenous Peoples

Supplemental Material

sj-docx-2-aln-10.1177_11771801241251411 – Supplemental material for Promoting health and wellness through Indigenous sacred sites, ceremony grounds, and land-based learning: a scoping review

Supplemental material, sj-docx-2-aln-10.1177_11771801241251411 for Promoting health and wellness through Indigenous sacred sites, ceremony grounds, and land-based learning: a scoping review by Moneca Sinclaire, Lindsay P Allen and Andrew R Hatala in AlterNative: An International Journal of Indigenous Peoples

Supplemental Material

sj-docx-3-aln-10.1177_11771801241251411 – Supplemental material for Promoting health and wellness through Indigenous sacred sites, ceremony grounds, and land-based learning: a scoping review

Supplemental material, sj-docx-3-aln-10.1177_11771801241251411 for Promoting health and wellness through Indigenous sacred sites, ceremony grounds, and land-based learning: a scoping review by Moneca Sinclaire, Lindsay P Allen and Andrew R Hatala in AlterNative: An International Journal of Indigenous Peoples

Supplemental Material

sj-docx-4-aln-10.1177_11771801241251411 – Supplemental material for Promoting health and wellness through Indigenous sacred sites, ceremony grounds, and land-based learning: a scoping review

Supplemental material, sj-docx-4-aln-10.1177_11771801241251411 for Promoting health and wellness through Indigenous sacred sites, ceremony grounds, and land-based learning: a scoping review by Moneca Sinclaire, Lindsay P Allen and Andrew R Hatala in AlterNative: An International Journal of Indigenous Peoples