How designers can plan healthier communities, together with Indigenous families

Parent uplifting ceremony at Squamish Nation’s Totem Hall. (Nadia Beyzaei), Author provided

How designers can plan healthier communities, together with Indigenous families

We know that there is a vast gap between the health of Indigenous peoples and non-Indigenous Canadians; in fact Indigenous children fall well below national health averages for Canadian children.

Indigenous advocates and researchers have extensively documented causes contributing to this inequality. They include many social determinants of health and cultural factors — foremost, the colonial legacy of dispossession from lands, intergenerational trauma and infrastructure underfunding.

Research also shows that strong community ties and connections to culture and spirituality have measurable impacts on well-being, particularly for youth.

But what are the strongest kinds of community supports, the ones that allow families and children to thrive? That’s a question our team at the Health Design Lab at Emily Carr University has been trying to answer, through our work with United Way of the Lower Mainland and the Social Planning and Research Council of B.C. (SPARC B.C.) on the Squamish Avenues of Change project.

Pop-up community engagement session with families at a drop-in playgroup in Squamish. (Nadia Beyzaei), Author provided

This project aims to create healthy environments that support the development of children up to the age of six. The city of Squamish was selected as a project site due to its high number of young families, and a high rate of developmental vulnerability (35 per cent) among kindergarten-aged children.

Our lab works with partner organizations like United Way to address challenges in health and health care through a human-centred design approach.

To do this, we offer participatory design research methods that engage the experts — the people who will be affected by the solution or outcome.

For this project, we wanted to reach out to families in Squamish, a growing community located north of Vancouver, in order to understand what social and community supports they needed. Squamish is a diverse city that has a large Indigenous population (five per cent); our focus neighbourhoods within the community had a slightly larger Indigenous population (6.4 per cent), with many families living on reserve. In particular, we focused on the needs of people from the Sḵwx̱wú7mesh (Squamish) Nation.

Guests on Sḵwx̱wú7mesh territory

But how could we reach the Sḵwx̱wú7mesh families? We understood we would have to be invited into their spaces or invite them to meet us where they felt comfortable.

We were fortunate to connect with Joy Joseph-Mccullough, association education director, and Charlene Williams, cultural language worker, who enabled us to invite Sḵwx̱wú7mesh families to share what they needed for their community.

Joy and Charlene’s warm welcome was especially meaningful for one of us. Nicole is a member of the Sto:lo Nation and was raised in Burnaby, B.C., but her great grandmother was from Capilano Band of Squamish Nation. Never having felt comfortable claiming any Squamish roots because her family isn’t connected anymore, Nicole has now been inspired to go back to the community and find her roots there.

Community stakeholders reviewing insights gathered from families during community engagement sessions. (Nadia Beyzaei), Author provided

With these community members we both visited the A’yas Lam’ Family Program and Totem Hall.

While entering this territory as guests, we were aware of the significance of honouring the lived experiences of families. We wanted to offer the opportunity to share struggles and challenges as well as hopes and dreams.

Community-guided design research

We developed a series of hands-on design activities that would let participants creatively express their thoughts and ideas.

These activities were used in two key engagement sessions organized for Sḵwx̱wú7mesh families, in collaboration with Joy, Charlene and Roseanne George, the A’yas Lam’ Family Program coordinator.

This is a key difference between design research and traditional academic research. Rather than follow a strict methodology, we had to step back and let the community guide the process and create a safe space for themselves.

For instance, our first session included a Talking Circle that lasted most of the morning — much longer than planned — but it built trust between participants, allowing them to be honest and candid during subsequent activities. We also closed our events with an Uplifting Ceremony to give thanks to participating families.

Language programs and acceptance

We led two activities after the Talking Circle: Hopes and Dreams, and Wishes for Our Community. The first asked parents to identify high-level aspirations, while the second was grounded in important needs — like safety, transportation and nutrition — and possible solutions.

Sḵwx̱wú7mesh parents voiced that they wanted their children to have language programs, and be accepted by the wider community. These needs, focused on inclusion and culture, were strikingly different from the desires expressed by non-Indigenous families in Squamish.

Community engagement session with families at A’yas Lam’ Family Program. (Nadia Beyzaei), Author provided

Our second session invited young families to name strengths and challenges of the community aloud with one another, to build trust and solidarity. Through sharing, families realized that they shared similar challenges and struggles.

Next, they participated in an activity called Places I Go and Places I Wish For, which invited them to map community services and resources that they use as well as ones that they wished existed.

The insights from both sessions were summarized into key findings and recommended action strategies, which were taken back to the Squamish Nation for validation.

A report comprising the full findings from all participating families in the Squamish community will be released, leading to phase three of the Avenues of Change project which will include implementing several strategies identified through this collaborative process.

This project provides one model of how design methods can be used effectively to gather information and insights. Our model is still not widely used in academic research, but offers real advantages in building trust with participants and understanding complex problems.


We would like to acknowledge the contributions of: Sarah Hay (Adjunct Research Associate — Health Design Lab, Emily Carr University), Nadia Beyzaei (Coordinator — Health Design Lab, Emily Carr University), Lara Therrien Boulos (Researcher — SPARC B.C.), Eirikka Brandson (Planner, Community Impact & Investment — United Way of the Lower Mainland) to this project, as well as families from the Squamish Nation and community who participated in our engagement workshops and shared their insights for how to build healthy futures for their children and the community.