Health (18-24): Background Content

Indigenous Health Surveys

Fed. Govt., ON

Our Health Counts

Our Health Counts: Urban Aboriginal Database Research Project

The “Our Health Counts” project will contribute to the priority area of Applying the “Two-Eyed Seeing” Model in Aboriginal Health, specifically utilizing “Two-Eyed Seeing” in assessing and improving the health of urban Aboriginal people. The study design provides an opportunity to address the broad gaps in urban Aboriginal health assessment across health domains and lifecycle stages with a focus on a key health care utilization indicator (ER use)

From a population and public health perspective, the near absence of population based health assessment data is extremely concerning, particularly given the known disparities in social determinants of health. This situation is unacceptable in a developed country such as Canada.

Our over-all goal is to improve urban Aboriginal health data by documenting many aspects of people’s health and well-being – as a baseline. At all stages of this project many and diverse partners work collaboratively to make health services effective, relevant and efficient for urban Aboriginal peoples. To date, the urban centres included in this project are Ottawa, Hamilton, Toronto, London, and Kenora. An urban Indigenous health information, knowledge, and evaluation (HIKE) network has formed. The HIKE network includes influential representatives from each urban community and members of the research team to share ideas, findings, tools, and resources.

April 1, 2011

Fed. Govt., ON

Our Health Counts: Hamilton

There were three project community sites for the Our Health Coiunts study: First Nations in Hamilton, Inuit in Ottawa, and Métis in Ottawa. This report focuses on the First Nations in Hamilton community site, which was chosen as the First Nations project community site because of its significant Aboriginal population (13,735) persons reporting Aboriginal ancestry according to the 2006 Census and strong infrastructure of Aboriginal community health and social services. This project was carried out using community based participatory research methods. Our approach promoted balance in the relationships between the Aboriginal organizational partners, academic research team members, Aboriginal community participants and collaborating Aboriginal and non-Aboriginal organizations throughout the health information adaptation process, from initiation to dissemination.

Key Project Findings and implications For Health Policy And Practice:

The “Our Health Counts” report presents their findings – 14 specific recommendations – under the following categories:

  1. Housing, services for low income and marginalized populations,and addressing inequities in the social determinants of Health
    • Housing (1)
    • Services for Low Income and Marginalized Populations (1)
    • Addressing Inequities in the Social Determinants of Health (1)
  2. Chronic Disease and Disability (1)
  3. Health Care Access (1)
  4. Aboriginal specific services, cultural safety, and Aboriginal self-determination of Health care delivery:
    • Aboriginal Specific Services for Family Treatment, Mental Health and Maternal Health (1)
    • Cultural Safety (1)
    • Aboriginal Self-Determination of Health Care Delivery (1)
  5. Children’s Health (3)
  6. Research (1)
  7. System Planning (2)

March 25, 2019

Fed. Govt., ON

Our Health Counts: Kenora

895 The Lake – A new “Our Health Counts” project is targeted at indigenous residents in the Kenora and surrounding first nation communities. Organizers says they hope to get as many as 900 surveys completed in the next year or so. It’s hoped the survey results will give a more accurate count of the aboriginal population in the Kenora area and find out what their specific health needs are. The Waasegiizhig Nanaandawe’iyewigamig Health Access Center is helping out with the survey

Fed. Govt., ON

Our Health Counts: London

Only 14% of Indigenous adults in London completed the 2011 Census. To obtain a representative sample, 80% of households should have completed the Census. Only 9% completed the 2011 National Household Survey (NHS). OHC London study findings indicate that there are 17,108-22,155 Indigenous adults in London. This is 3-4 times more than estimated by Statistics Canada. The 2011 NHS estimated that 5,165 Indigenous adults (15 years+) live in London. The 2016 Census indicated 8,410 Indigenous adults (18 years+) live in London.

The Our Health Counts London report presents detailed findings in all of the following categores:

  • Adult Demographics Findings & Community Priorities
  • Child Demographics Findings & Community Priorities
  • Housing and Mobility Findings & Community Priorities
  • Nutrition and Food Security Findings & Community Priorities
  • Adult Health Findings & Community Priorities
  • Child Health Findings & Community Priorities
  • Adult Chronic Conditions Findings & Community Priorities
  • Child Chronic Conditions Findings & Community Priorities
  • Oral Health Findings & Community Priorities
  • Ability, Pain, and Prescription Medication Findings & Community Priorities
  • Reproductive and Sexual Health Findings & Community Priorities
  • Access to Health Care Findings & Community Priorities
  • Parenting and Child Protection Agency (CPA) Involvement Findings & Community Priorities
  • Residential School Findings & Community Priorities
  • Missing Persons Findings & Community Priorities
  • Criminal Justice Findings & Community Priorities
  • Violence and Abuse Findings & Community Priorities
  • Discrimination Findings & Community Priorities
  • Mental Health Findings & Community Priorities
  • Substance Use Findings & Community Priorities
  • Adult-Culture and Identity Findings & Community Priorities
  • Child-Culture and Identity Findings & Community Priorities
  • Community Resource Needs Findings & Community Priorities
  • School Experience and Performance Findings & Community Priorities

July 1, 2017

Fed. Govt., ON

Our Health Counts: Ottawa

Key Findings:

“Inuit in Ottawa have experienced very high levels of historical trauma due to colonial policies such as residential schools and forced relocation. Current discriminatory practices, including racism in social services, health care and high levels of child protection agency involvement contribute to an ongoing cycle of poverty and trauma. Additional barriers to health care, documented in this report, contribute to a high burden of chronic disease and physical and emotional pain.

These factors both help to contextualize the Our Health Counts findings, and to contribute to what is likely a significant under-reporting of hardship, from physical pain to socio-economic conditions. In addition, there may be cultural norms that discourage direct verbal expression of complaint. As a result, it is likely findings related to rates of chronic disease, mental health and socio-economic hardships are underestimated.”

This report focuses on health, wellbeing and access to health services for the adult Inuit population in Ottawa. The OHC study of Inuit in Ottawa was led by Tungasuvvingat Inuit (TI), who worked with a research team led by Indigenous physician, Dr. Janet Smylie from the Well Living House at the Centre for Urban Health Solutions at St. Michael’s Hospital in Toronto. TI’s work is grounded in the traditional principles of Inuit Qaujimajatuqangit (IQ), the Inuit way of ‘knowing’.

Highlighted Findings with 22 specific recommendations directed to federal, provincial, municipal and local policy-makers:

  1. Large, youthful and majority permanent resident Inuit population with close connections and strong retention of Inuktitut (3)
  2. Striking barriers to income, education, employment, stable housing and food security
    • Striking poverty, food insecurity, and housing vulnerability (3)
    • Barriers in access to education and employment (2)
  3. Disproportionate burden of chronic disease, barriers in access to health care and high rates of Emergency Department admissions
    • Disproportionate burden of chronic health conditions and barriers in access to preventative screening and primary health care health services (3)
    • High rates of emergency room admission (1)
  4. Striking burden of trauma, family disruption, discrimination and violence (3)
  5. Disproportionate burden of mental health challenges (1)
  6. Strength of Inuktitut language and Inuit community networking (3)
  7. Opportunities for further Inuit community-directed health assessment and response (3)

November 30, 2020

Fed. Govt., ON

Our Health Counts: Thunder Bay

NetNewsLedger – Participants were selected using respondent-driven sampling, a statistical method that uses social networks to recruit Indigenous people living in the city.

Data released from the survey focused on Indigenous adults’ and children’s experiences with the health care system in Thunder Bay show communities deeply rooted in their cultural traditions and identities, while facing several systemic barriers that adversely impact their health and wellbeing. “Specifically, the results of the Our Health Counts Thunder Bay study highlight the gap in access to culturally safe care for Indigenous peoples within public health, primary health, mental health, acute and long-term care. These results clarify the overall healthcare priorities of Indigenous people and specifically the need for Aboriginal Health Access Centres (AHAC) and centres of excellence in diabetes and mental health.

The survey found that the size of the Indigenous population in the Thunder Bay Census Metropolitan Area (CMA) is far larger than the previous figures released by Census Canada. The survey results summarized in a set fact sheets, calculated the size of the FNIM (First Nations, Métis, Inuit) adult population of Thunder Bay to be 29,778 (estimated range is 23,080-42,641).
These survey number are more than three times higher than the FNIM population size estimate of 9,780 reported by the 2016 census, which most FNIM in Thunder Bay reported they did not complete.

The survey also captured FNIM communities’ challenges with access to health care and institutionalized racism.

  • Fifty per cent of adults surveyed in Thunder Bay have a primary care practitioner, compared to 90 per cent of adults in Ontario.
  • Almost half of the adults surveyed reported accessing emergency care in the past 12 months, compared to only 19 per cent of Ontarians.
  • Over two-thirds of participants reported experiencing racism.
  • One in three adults reported that they were treated unfairly by health care professionals because of their Indigenous identity.

The survey was co-led by Well Living House, an Indigenous health research unit at St. Michael’s Hospital, and Anishnawbe Mushkiki Aboriginal Health Access Centre.

The “Our Health Counts Thunder Bay” report presents detailed findings in the following categoroies:

  • Demographics
  • Access to Health Care Services
  • Culture and Identity
  • Criminal Justice
  • Mental Health
  • Discrimination
  • Diabetes
  • Chronic Health Conditions

March, 2018

Fed. Govt., ON

Our Health Counts: Toronto

The study was based on Toronto’s indigenous population that – based on preliminary findings – is approximately 2-4Xs larger that what Statistics Canada reported (2011 NHS). Why the difference? Many indigenous people move frequently or are homeless and the study did not require a fixed address (unlike the National Household Survey (NHS) that uses mailing addresses from a voting registrar. “While attempts at assimilation have not been successful, the implementation of these policies has negatively influenced structural determinants of health, such as housing, income, employment and land ties,” said the 70-page study. “They also undermined language, cultural expression, and family systems. The result is a continued negative impact on the health of Indigenous peoples — including mental and emotional health and well-being.”

The study had four primary objectives:

  1. Understanding the health and health service needs of indigenous peoples in City of Toronto by including a sample that included everyone, NOT just those who use programs and services
  2. Asking participants about their holistic health, health determinants and health needs
  3. Understanding the key factors linked to emergency room use over time
  4. Research done by indigenous people FOR indigenous people…”nothing about us without us”.

The “Our Health Counts Toronto” report presents detailed findings in all of the following categories:

  • 2016 OHC Toronto Population Estimate
  • Project Overview and Methods Factsheet
  • Demographics Factsheet
  • General Health Factsheet
  • Housing and Mobility Factsheet
  • Nutrition & Food Security Factsheet
  • Chronic Health Conditions Factsheet
  • Oral Health Factsheet
  • Reproductive & Sexual Health Factsheet
  • Parenting & Child Protection Agency Involvement Factsheet
  • Residential Schools Factsheet
  • Missing Persons Factsheet
  • Criminal Justice Factsheet
  • Violence & Abuse Factsheet
  • Discrimination Factsheet
  • Mental Health Factsheet
  • Two-Spirit Mental Health Factsheet
  • Substance Use Factsheet
  • Culture & Identity Factsheet
  • Community Resource Needs Factsheet
  • School Experiences Factsheet
  • Child Development Factsheet
  • Immunization Factsheet
  • Neonatal Health Factsheet
  • Perinatal and Infant Feeding Factsheet
  • Access to Health Care – OHC Toronto

Fed. Govt.

Regional Health Survey

The First Nations Information Governance Centre is an independent, apolitical, and technical non-profit organization operating with a special mandate from the Assembly of First Nations’ Chiefs-in-Assembly (Resolution #48, December 2009)


With First Nations, we assert data sovereignty and support the development of information governance and management at the community level through regional and national partnerships. We adhere to free, prior and informed consent, respect nation-to-nation relationships, and recognize the distinct customs of nations.

Core Strategic Objectives

Our Vision and Mission are guided by our Core Strategic Objectives:

  1. Our approach is Community-driven and Nation-based
  2. Our data are inclusive, meaningful, and relevant to First Nations
  3. Our tools are effective, adaptable, and accessible
  4. Our partnerships connect regions to strengthen data sovereignty

The RHS has earned its place as the reliable source of information about life in First Nations communities, with its data being used to support policy and programming at community, regional, and federal levels. And it is still the only First Nations survey of its kind, with its social, cultural, and political impact now widely acknowledged. The RHS National Team is located at the First Nations Information Governance Centre in Ottawa and coordinates the RHS on a national level. Our activities include preparing reports, serving as the data steward, and engaging in partnerships. In addition, ten independent, RHS Regional Partners coordinate the RHS in their respective regions. The National Team and Regional Partners collaborate on collective issues as well as share ideas and knowledge.

The RHS is the only national First Nations health survey in Canada. It has produced important innovations in data sharing, research ethics, computer-assisted interviewing, sampling, field methods, training and culturally appropriate questionnaire content. Most significantly, the RHS process has invested in individual and organizational First Nations capacity at the community, regional and national levels. The RHS is a unique collaborative initiative of First Nations regional organizations across Canada.

Before the RHS, First Nations populations living on reserve and in northern communities had been excluded from national health surveys resulting in an information gap for many key socio-economic indicators to improve the lives of First Nations. The challenges First Nations face are multi-dimensional and require a collective response to promote well-being and to understand and reduce health disparities. The RHS is one such response that is filling this information void by generating regional and national evidence to improve the health care system and the determinants of health for First Nations.

July, 2018

Fed. Govt.

Regional Health Survey: Volume 1

Regional Health Survey: Volume 1
The meaning of First Nations health and well-being is defined as “the total health of the total person within the total environment.”

The concept of total health is defined as “all aspects and components of health and well-being seen as integrally interconnected with one another within an inclusive and inter-related and interactive web of life and living”.
The concept of total person is defined as all dimensions of personhood including body, mind, heart and spirit. These dimensions, when defined in such a way that can be practically measured in research as social determinants and outcomes, include:

  • physical health, mental health, emotional health, spiritual health;
  • healthy behaviour and lifestyle, healthy mental function, cultural continuity with the past and towards future opportunity;
  • healthy connection to culture and healthy spirituality as a First Nations person; and
  • healthy home life, community life and extended family connections.

Total environment is defined as “a healthy connection and relationship with the living environment – this being constituted of the land, natural environment, cultural environment, context of activity, community, family, and the everyday living environment.”

The National Report of the First Nations Regional Health Survey Phase 3: Volume One is intended to provide an overview of the national-level results from the survey, across children, youth and adult First Nations populations.

The data is presented in the following sections:

  • Socioeconomic Conditions
  • Chronic Health Conditions
  • Mental Health and Substance Abuse
  • Oral Health
  • Indian Residential Schools

Each of the above sections presents the following information:

  • Executive Summary
  • Key Findings
  • Introduction
  • Methods
  • Results
  • Discussion
  • Conclusions, and
  • References

July, 2018

Fed. Govt.

Regional Health Survey: Volume 2

Regional Health Survey: Volume 2
First Nations wellness encompasses Indigenous knowledge, culture, language, world view and spirituality as indicators of health. These indicators are core to an overall understanding of how we, as a people, keep ourselves “balanced” and therefore healthy. This reinforces the need for the RHS Cultural Framework to be used in interpreting the information collected by First Nations people. The model is important in explaining why certain questions, such as those relating to language and culture, are included in the context of a “health” survey. The First Nations Wellness model highlights the need for such questions. It illustrates that you cannot have an indicator of wellness for First Nations health without also discussing culture, language, world view and spirituality.

The RHS Phase 3 was made up of three specific surveys: the child, youth and adult. The child survey collected information on children between the ages of 0- and 11-years-old. (Child surveys were completed by the primary caregiver, usually a parent). The youth surveys were completed by First Nations youth between the ages of 12 and 17. The adult surveys were completed by those aged 18 years or older.

The National Report of the First Nations Regional Health Survey Phase 3: Volume Two is intended to provide an overview of the national-level results from the survey, across children, youth and adult First Nations populations.

The data is presented in the following sections:

  • Health – Care Access
  • Language and Culture
  • Nutrition and Food Security
  • Physical Activity and Sedentary Behaviours
  • Personal and Community Wellness

Each of the above sections presents the following information:

  • Executive Summary
  • Key Findings
  • Introduction
  • Methods
  • Results
  • Discussio
  • Conclusions, and
  • References

Other Background Content By Theme

Fundamental Systemic Issue

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Indigenous Health Organizations

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