2026 / Health and well-being, Indigenous knowledge, Land-based healing, Reciprocal healing

A Systematic Scoping Review for Decolonial Public and Global Health: Indigenous Frameworks and Models of Wellbeing From Turtle Island and MoananuiāKea

Citation

Qina‘au, J., Yanger Mariano, A., Kahili-Heede, M. K., Kone, S. Q., Rivera, C., Rapadas, C., Chatto, S., Clack, V. J., Johnson, F. N., Johnson-Jennings, M., & Antonio, M. C. K. (2026). A systematic scoping review for decolonial public and global health: Indigenous frameworks and models of wellbeing from Turtle Island and Moananuiākea. Frontiers in Public Health, 14. doi.org/10.3389/fpubh.2026.1809539

Link to file

This scoping review looked at how Indigenous communities and scholars from Turtle Island (North America) and Moananuiākea (the Pacific) have defined well-being in their own models, frameworks, and theories. The authors argue that equitable public and global health needs to draw on diverse ways of understanding well-being, including decolonial perspectives. Indigenous frameworks tend to be holistic and tied to ecological health, while Western approaches often treat well-being as an individual, compartmentalized issue — which can narrow health practice and reinforce disparities. Until now, no review had brought together the growing body of Indigenous-developed frameworks in this area.

The review followed the PRISMA-ScR guidelines and searched five databases plus grey literature and hand-sourced articles. To be included, a study had to present an original model, framework, or theory of well-being developed by Indigenous authors for Indigenous people, families, or communities from Turtle Island or Moananuiākea.

Out of 1,473 database records and 89 additional references, 61 full-text articles were reviewed and 33 were ultimately included. Most of the publications (64%) came from Moananuiākea, and 36% came from Turtle Island. Qualitative methods were the most common approach used to develop the frameworks (52%). Across all the included work, seven major themes emerged:

Well-being involves a holistic integration of all life domains;
Spirituality and the ongoing presence of ancestors matter;
Culture and the preservation of tradition are central;
Well-being is collective and relational;
People have a reciprocal relationship with the land, which serves as a source of identity, health, and responsibility;
Place-specific Indigenous metaphors and language are important; and
Empowerment and self-determination are key.

The authors conclude that Indigenous communities worldwide are pushing for these frameworks to move beyond conceptual discussion and into real application within public and global health systems. The findings have implications for developing decolonial theory and building more equitable health systems. Future research should focus on putting Indigenous well-being frameworks into practice.

Abstract

Background

Equitable approaches to public and global health require grounding in diverse ontologies of wellbeing and decolonial theory. Indigenous wellbeing models and frameworks embed holistic values that support ecological thriving. In contrast, Western approaches often individualize and compartmentalize wellbeing, narrowing public and global health practice and contributing to persistent disparities. Despite the proliferation of Indigenous-developed frameworks, no scoping review has synthesized contributions in this area. This review aimed to identify models, frameworks, and theories of wellbeing developed by Indigenous communities and scholars from Turtle Island (North America) and Moananuiākea (the Pacific) to inform more culturally safe and decolonial approaches to public and global health.

Methods

Guided by the PRISMA-ScR framework, both peer-reviewed publications and grey literature were sourced from five databases (PubMed, Web of Science, EBSCO Academic Search Complete, CINAHL, and ProQuest). Additional articles were hand-sourced. Included articles posed an original model, framework, or theory of wellbeing, developed for Indigenous people, families, or communities, by Indigenous authors from those respective lands in Turtle Island or Moananuiākea.

Results

A total of 1,473 database references and 89 additional references were identified for screening. After 61 full-text reviews, 33 manuscripts were included for analysis. Twenty-one publications originated from Moananuiākea (64%) and 12 originated from Turtle Island (36%). The most common method used to develop the models and frameworks was qualitative (52%). Synthesis of the data yielded seven themes: (1) holistic integration of all life domains; (2) spirituality and the ongoing presence of ancestors; (3) culture and preservation of tradition; (4) collective wellbeing and relationality; (5) reciprocal relationship with land as a source of identity, health, and responsibility; (6) use of place-specific Indigenous metaphors and language; and (7) empowerment and self-determination.

Conclusion

Indigenous communities globally are calling for a shift from conceptual discussion of wellbeing toward tangible application in public and global health systems. These findings hold several implications for decolonial theory-development and more equitable health systems. Future research should build on work which moves Indigenous wellbeing frameworks from theory to action.