Developing community-defined indicators of Indigenous health: Practical guidance from the Ahtna approach to wildfire resilience

Indigenous communities have sought health assessment models that reflect holistic concepts of well-being, yet Western frameworks often overlook relational, cultural, spiritual, and environmental dimensions. The Indigenous Health Indicators (IHIs) framework addresses this gap by centering community-defined values in locally driven, adaptable ways. This paper illustrates a flexible, community-led approach to developing and applying IHIs, using the experience of communities in Alaska’s Copper River region, home of the Ahtna people, linking Ahtna values to wildfire resilience as an example. The process highlights key components of IHI practice: identifying locally meaningful values, determining which values are affected by the issue of interest, prioritizing health concerns, and identifying strategies to address the risk. Reflections from regional environmental program staff who led this work emphasize the importance of grounding IHIs in cultural principles, leveraging community events to reduce participation burden, ensuring facilitation is rooted in trust, and designing IHIs to inform concrete decision-making related to adaptation, resource allocation, and program development. The IHI approach provides a model for other communities seeking to integrate Indigenous knowledge and values into public health, resource management, and climate adaptation planning, offering locally relevant metrics while preserving the relational and cultural foundations of well-being.