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Cancer incidence rates have been shown to vary by ethnicity, and the increasing awareness of and interest in reporting ethnic health inequalities have been growing internationally. The objective of this study was to assess cancer incidence and mortality rates by ethnicity in Canada.The study used the 2006 Canadian Census Health and Environment Cohort, linked to the Canadian Cancer Registry and the Canadian Vital Statistics-Death Database, to determine cancer cases and mortality from 2006 to 2016. Ethnicity was categorized as non-Indigenous North American (NINA); European; Caribbean; Latin, Central and South American (LCSA); African; East Asian; South Asian; and West Central Asian and Middle Eastern.Europeans had the highest standardized incidence rates, while NINA had the highest mortality rates. Rates varied substantially by ethnicity and immigrant status. The top three cancers accounted for 46.5% to 61.9% of all new cancers, while the top three cancer deaths accounted for 36.1% to 61.9% of all deaths. The distribution of cancers within the top 10 cancers and the top 10 cancer deaths also differed; e.g., stomach cancer was found to be more prevalent in the East Asian, LCSA, African and Caribbean groups. Non-immigrant African males had the highest cancer incidence rates, and non-immigrant South Asian females had the highest mortality rates.There is considerable variability in cancer incidence and cancer mortality rates by ethnicity, and this study addresses the knowledge gap in Canada in this area. Establishing baseline indicators, such as cancer rates by ethnicity, is essential to understanding the differences within the diverse Canadian population and to informing targeted interventions that may help reduce health inequalities.

The objective of this study was to describe sex-specific hospitalization rates among Indigenous people in Canada (excluding Quebec), separately for First Nations people living on and off reserve, Inuit living in Inuit Nunangat (excluding Nunavik), Métis, and the non-Indigenous population.The 2006 and 2011 Canadian Census Health and Environment Cohorts (CanCHECs) were used, allowing hospital records to be examined by Indigenous identity as reported on the census. Five years of hospitalization data were used for each CanCHEC. Causes of hospitalization were based on the most responsible diagnosis and coded at the chapter level according to the International Classification of Diseases (ICD-10-CA). Age-standardized hospitalization rates (ASHRs) were calculated per 100,000 population, and rate ratios (RRs) were calculated for each Indigenous group relative to non-Indigenous people.ASHRs were higher among Indigenous people than among non-Indigenous people; this was true for females and males from both the 2006 and the 2011 cohorts. Hospitalization patterns varied by sex and Indigenous group. The greatest disparities with the non-Indigenous population were observed among on-reserve First Nations females and males from both cohorts. Elevated RRs were observed for diseases of the endocrine, nutritional and metabolic system among First Nations females and males living on reserve; hospitalizations for mental health among First Nations females and males living off reserve and Inuit males; and diseases of the respiratory system among Inuit females. For Métis females and males, equally elevated RRs were observed for diseases of the endocrine system and mental health. ASHRs for most causes decreased between the 2006 and 2011 cohorts, with the exception of ASHRs for mental health among First Nations females and males living on reserve, which increased.Findings are consistent with recognized health disparities between Indigenous and non-Indigenous people. Further research is warranted to understand reported differences in hospitalization patterns.

This study described perceptions of bullying as a school characteristic and associations with school, academic, and health characteristics among a representative sample of First Nations high school students living off reserve in Canada using data from the 2012 Aboriginal Peoples Survey. Almost 4 in 10 of First Nations youth living off reserve perceived bullying as a problem at their schools. A perceived climate of bullying co-occurred with other negative school climate characteristics such as racism, violence, and the presence of alcohol and drugs. First Nations youth living off reserve who perceived bullying as a problem at school reported higher psychological distress and a higher prevalence of suicidal ideation, even after controlling for the effects of youth sex, age, and household income. These findings highlight the need to focus on school characteristics as perceived by youth to improve school climate and youth health.

Although rates of daily smoking among Inuit have been decreasing since 1991, Inuit are still much more likely to smoke relative to the Canadian population as a whole. However, little population-based empirical research has identified characteristics associated with cigarette use among this population.Based on data from the 2012 Aboriginal Peoples Survey, sex-specific logistic regression analyses, informed by an Inuit social determinants of health framework, described associations between current smoking and selected socio-demographic characteristics among Inuit men and women aged 18 or older who resided in Inuit Nunangat.In 2012, 75% of Inuit men and 74% of Inuit women reported that they smoked cigarettes either daily or occasionally. Inuit men and women had lower odds of smoking if they were high school graduates. Among Inuit men, the odds of smoking were lower for those in higher-income households. Among Inuit women, the odds of smoking were lower for those who had postsecondary education or lived in food-secure households; odds were higher for women who had attended a residential school. Inuit of both sexes had significantly higher odds of smoking if they lived in crowded conditions or in homes where a regular smoker was present.Some correlates of smoking among Inuit in Inuit Nunangat appear to be sex-specific. Findings from this study identify some of the protective and risk factors for smoking among this population and can help inform smoking prevention and cessation programs.

Social networks are important for promoting and maintaining health and well-being. Social networks, including family and friendship ties, are sources of emotional, practical and other support that enhance social participation and help combat isolation and loneliness. Aboriginal seniors have been identified as a population at risk of social isolation.The data are from the 2012 Aboriginal Peoples Survey, a national survey of First Nations people living off reserve, Métis, and Inuit. Frequencies, cross-tabulations, and logistic regression models were used to look at family networks and self-perceived general and mental health among Métis aged 45 or older.An estimated 48% of Métis men and 60% of Métis women aged 45 or older had strong family networks. Older age, lower education, and non-participation in the labour force were associated with strong networks. Métis men and women with strong family networks had higher odds than did those with weak networks of reporting positive mental health, even when potential confounders were taken into account. Among Métis men, a relationship between strong family networks and positive general health was also observed.Strong family networks are associated with positive self-perceived general and mental health among Métis adults. In addition to individual behaviours, family well-being is important for general health promotion.

Research that has examined Aboriginal children's hospitalization rates at the national level has been limited to analyses of areas with large percentages of Aboriginal residents, rather than of Aboriginal individuals. This study uses linked census and administrative data to describe hospitalization patterns among children and youth aged 0 to 19, by Aboriginal identity, for all provinces and territories except Quebec.The 2006 Census was linked to the 2006/2007-to-2008/2009 Discharge Abstract Database, which contains hospital records from all acute care facilities (except Quebec). Hospital records were examined by Aboriginal identity, as reported to the census, according to International Classification of Diseases chapters based on "the most responsible diagnosis." Age-standardized hospitalization rates (ASHRs) were calculated per 100,000 population, and age-standardized rate ratios (RRs) were calculated for Aboriginal groups relative to non-Aboriginal people.ASHRs were consistently higher among Aboriginal children and youth relative to their non-Aboriginal counterparts; rates for children aged 0 to 9 were 1.4 to 1.8 times higher; for youth aged 10 to 19, 2.0 to 3.8 times higher. For all children aged 0 to 9, the leading cause of hospitalization was "diseases of the respiratory system," but RRs for Aboriginal children ranged from 1.7 to 2.5, compared with non-Aboriginal children. Disparities between Aboriginal and non-Aboriginal 10- to 19-year-olds were pronounced for injuries due to assaults (RRs from 4.8 to 10.0), self-inflicted injuries (RRs from 2.7 to 14.2), and pregnancy, childbirth and the puerperium (RRs from 4.1 to 9.8).Additional research is needed to examine reasons for the disparities in hospitalization rates between Aboriginal and non-Aboriginal children and youth.

Using data from the 1991, 2001 and 2012 Aboriginal Peoples Survey, this study examines the prevalence of smoking among Inuit aged 15 or older, by location of residence, sex and age group. Overall, the prevalence of daily smoking was significantly lower in 2012 than in 1991; this was true for Inuit living inside and outside Inuit Nunangat, for men and women, for most age groups, and for those in all Inuit regions except Nunavik. The average number of cigarettes smoked per day by daily smokers decreased steadily and significantly over time, except among those living outside Inuit Nunangat or in Nunavik, and those aged 55 or older. The average age of daily smoking initiation remained stable at 15.

Introduction Cette étude décrit les taux d'hospitalisation pour blessures auto-infligées et pour blessures par agression dans les régions à pourcentage relativement élevé de résidents s'identifiant comme membres des Premières nations, Métis ou Inuits, par cause de blessure, par tranche d'âge et par sexe. Méthodologie Tous les dossiers de sortie des hôpitaux de soins de courte durée des provinces et territoires du Canada hors Québec ont été tirés de la Base de données sur les congés des patients. Les aires de diffusion où plus de 33 % des résidents ont déclaré appartenir à un groupe autochtone au recensement de 2006 ont été classées comme « régions à fort pourcentage d'Autochtones ». Résultats Dans l'ensemble, dans les régions à fort pourcentage d'Autochtones, les taux d'hospitalisation normalisés selon l'âge (THNA) pour blessures auto-infligées étaient plus élevés chez les femmes, tandis que les THNA pour blessures par agression étaient plus élevés chez les hommes. Comparativement aux résidents des régions à faible pourcentage d'Autochtones, les résidents des régions à fort pourcentage d'Autochtones étaient au moins trois fois plus susceptibles d'avoir été hospitalisés pour blessures auto-infligées et au moins cinq fois plus susceptibles d'avoir été hospitalisés pour blessures par agression. Conclusion Les recherches à venir devraient analyser les comorbidités et les conditions socioéconomiques ainsi que les comportements à risque individuels comme facteurs associés à l'hospitalisation pour blessures auto-infligées.

Introduction This study describes rates of self-inflicted and assault-related injury hospitalizations in areas with a relatively high percentage of residents identifying as First Nations, Métis and Inuit, by injury cause, age group and sex. Methods All separation records from acute in-patient hospitals for Canadian provinces and territories excluding Quebec were obtained from the Discharge Abstract Database. Dissemination areas with more than 33% of residents reporting an Aboriginal identity in the 2006 Census were categorized as high-percentage Aboriginal-identity areas. Results Overall, in high-percentage Aboriginal-identity areas, age-standardized hospitalization rates (ASHRs) for self-inflicted injuries were higher among females, while ASHRs for assault-related injuries were higher among males. Residents of high-percentage Aboriginal-identity areas were at least three times more likely to be hospitalized due to a self-inflicted injury and at least five times more likely to be hospitalized due to an assault-related injury compared with those living in low-percentage Aboriginal-identity areas. Conclusion Future research should examine co-morbidities, socio-economic conditions and individual risk behaviours as factors associated with intentional injury hospitalizations.

Introduction Injuries are a leading cause of death and morbidity. While individual Aboriginal identifiers are not routinely available on national administrative databases, this study examines unintentional injury hospitalization, by cause, in areas with a high percentage of Aboriginal-identity residents. Methods Age-standardized hospitalization rates (ASHRs) and rate ratios were calculated based on 2004/2005-2009/2010 data from the Discharge Abstract Database. Results Responses from parents living in provinces with legislation (n = 640) and without legislation (n = 362) were as follows: concern for injury (63% vs. 68%, nonsignificant [NS]); believe helmets are effective (98% vs. 98%, NS); child always wears a helmet (74% vs. 69%, NS); support legislation for children (95% vs. 83%, p $lt; .001); support legislation for all ages (85% vs. 75%, p $lt; .001); support police enforcement (83% vs. 76%, p = .003); believe legislation decreases the amount of time their child bicycles (5% vs. 8%, NS). Conclusion Residents of high-percentage Aboriginal-identity areas also live in areas of lower socio-economic conditions, suggesting that the causes for rate differences among areas require further investigation.

Introduction Les blessures constituent une cause importante de décès et de morbidité. Bien qu'aucun indicateur d'identité autochtone ne soit directement disponible dans les bases de données administratives nationales, cette étude porte sur les hospitalisations pour blessure non intentionnelle, selon la cause, dans les régions ayant un fort pourcentage de résidents d'identité autochtone. Méthodologie Nous avons calculé les taux d'hospitalisation normalisés selon l'âge (THNA) et les rapports de taux pour 2004-2005 à 2009-2010, à partir de la Base de données sur les congés des patients. Résultats Les chutes étaient la cause principale de blessure. Les THNA étaient plus élevés pour les hommes comme pour les femmes dans les régions ayant un fort pourcentage de membres des Premières nations; dans les régions ayant un fort pourcentage de Métis, c'est chez les hommes de 20 à 29 ans que le THNA global était le plus élevé, tandis qu'il était le plus bas chez les hommes de tous les groupes d'âge dans les régions à fort pourcentage d'Inuits. Certaines causes, telles que les chutes, étaient associées à un THNA élevé mais avec un rapport de taux semblable à celui observé pour toutes causes confondues; d'autres causes, comme les blessures par arme à feu chez les hommes dans les régions à fort pourcentage de membres des Premières nations, présentaient un THNA relativement faible mais un rapport de taux élevé. Les résidents des régions à fort pourcentage d'Autochtones présentaient un THNA pour blessure plus élevé que ceux des régions à faible pourcentage d'Autochtones. Conclusion Les résidents des régions à fort pourcentage d'Autochtones vivent dans des régions dont le statut socioéconomique était faible, ce qui invite à une recherche plus approfondie à propos des différences de taux entre régions.

National data about acute care hospitalization of Aboriginal people are scarce. This study addresses that information gap by describing patterns of hospitalization by Aboriginal identity for leading diagnoses for all provinces and territories except Quebec.The 2006 Census was linked to the 2006/2007-to-2008/2009 Discharge Abstract Database, which contains hospital records from all acute care facilities in Canada (excluding Quebec). With these linked data, hospital records could be examined by Aboriginal identity, as reported to the census. Hospitalizations were grouped by International Classification of Diseases (ICD-10) chapters based on "the most responsible diagnosis." Age-standardized hospitalization rates were calculated per 100,000 population, and rate ratios (RR) were calculated for Aboriginal groups relative to non-Aboriginal people.Hospitalization rates were almost invariably higher for First Nations living on and off reserve, Métis, and Inuit living in Inuit Nunangat than for the non-Aboriginal population, regardless of ICD diagnostic chapter. The ranking of age-standardized hospitalization rates by frequency of diagnoses varied slightly by Aboriginal identity. RRs were highest among First Nations living on reserve, especially for endocrine, nutritional and metabolic diseases (RR = 4.9), mental and behavioural disorders (RR = 3.6), diseases of the respiratory system (RR = 3.3), and injuries (RR = 3.2). As well, the rate for endocrine, nutritional and metabolic diseases was high among First Nations living off reserve (RR = 2.7). RRs were also high among Inuit for mental and behavioural disorders (RR = 3.3) and for diseases of the respiratory system (RR = 2.7).Hospitalization rates varied by Aboriginal identity, and were consistent with recognized health disparities between Aboriginal and non-Aboriginal people. Because many factors besides health affect hospital use, further research is required to understand differences in hospital use by Aboriginal identity. These national data are relevant to health policy formulation and service delivery planning.

Responding to calls to contextualize social psychological variables in history, the present research examines the relationship between collective relative deprivation and collective esteem using a historical perspective. We hypothesized that collective relative deprivation perceived to be experienced during an important low-point in a group's history serves to define the group's current collective identity, which is in turn associated with collective esteem. In Study 1, cultural narrative interviews were conducted with Francophone and Anglophone Quebecers in order to identify key historical chapters for these groups and to examine the extent to which historical low-points were identity-defining features of their narratives. In Study 2, using the information obtained from these narratives, collective relative deprivation was explored across group members' perceived histories and related to current in-group entitativity and collective esteem. The relationship between collective relative deprivation thought to be experienced by one's group during a historical low-point and collective esteem was positive for both Anglophone and Francophone Quebecers and was mediated by in-group entitativity. Collective relative deprivation perceived to be experienced during a historical low-point serves to define one's collective identity, which is in turn associated with greater collective esteem.

The objective of this study was to examine factors associated with school outcomes among elementary school-aged Inuit children in Inuit Nunangat through a socio-ecological framework. The associations among children’s school outcomes and various individual, family, and school factors were examined using the 2012 Aboriginal Peoples Survey. Logistic regression analyses suggest that an Inuk child who is healthy and not hungry, whose parents obtained a post-secondary education, who is attending a school with a climate conducive to learning and at which parents are given opportunities to be involved, and who is exposed daily to the Inuit language has better odds of succeeding at school.

First Nations children in Canada often experience poorer housing conditions than other Canadian children. This study used the 2006 Aboriginal Children’s Survey to examine the relationship between housing and physical and mental health for First Nations preschool-aged children living off-reserve. This study provides evidence that the physical, spatial, and psychological aspects of housing in which young off-reserve First Nations children live are associated with their physical and mental health, even after controlling for family socioeconomic factors, area of residence, and child’s age and sex (analyzed with regression models). In particular, homeownership, parental satisfaction with housing, and number of moves per year were all associated with multiple physical and mental health outcomes. Future research is needed to further investigate the mechanisms at play.

Housing conditions have been associated with child health. Inuit children are generally in poorer health than other Canadian children. They are also more likely to live in crowded households, in dwellings that need major repair, and to be exposed to second-hand smoke in the home.This study uses the 2006 Aboriginal Children's Survey to examine associations between physical and psychosocial housing characteristics and physical and mental health outcomes of Inuit children aged 2 to 5.Physical and psychosocial housing characteristics were associated with selected indicators of Inuit children's health. The presence of a smoker in the home, homeownership, and parental housing satisfaction were associated with specific physical and/or mental health outcomes, even after adjusting for other housing factors and family and child sociodemographic characteristics.Housing conditions were associated with the physical and mental health of young Inuit children, even when sociodemographic factors were taken into account. Homeownership and housing satisfaction appeared to be particularly important for young Inuit children's health.

The CWB Index has been developed to investigate well-being at the community level using census subdivisions to define the different types of communities. Because the basis for analysis is the entire population of a community, the presence of non-Aboriginal populations living in First Nations or Inuit communities, or of Aboriginal people living in “other” (non- Aboriginal) communities, has not yet been considered. Therefore, to date, the differences in well-being between Aboriginal and non-Aboriginal residents of the same areas have not been investigated at the community level. In addition, few (if any) CSDs identified as First Nations or Inuit are located in urban areas. There is a need to understand better the well-being of this segment of Canada’s population (Newhouse and Peters 2003). Thus the purpose of the present study was to apply the CWB Index to describe the socioeconomic well-being of Aboriginal and non-Aboriginal residents of the same urban centers. For this purpose, we use the city of Winnipeg in Manitoba, Canada as a “case study” because of its large Aboriginal population.

Few national studies of hospitalizations due to injuries among the First Nations population have been conducted.Based on 2004/2005 to 2009/2010 data from the Discharge Abstract Database, this study examines associations between unintentional injury hospitalizations, socio-economic status and location relative to an urban core in Dissemination Areas (DAs) with a high percentage of First Nations identity residents versus a low percentage of Aboriginal identity residents.Unintentional injury hospitalization rates were higher in the less affluent and the most remote DAs. When DAs with the same socio-economic status and location were compared, the risk of hospitalizations was greater in high-percentage First Nations identity DAs relative to low-percentage Aboriginal identity DAs.Socio-economic conditions and remote location accounted for some, but not all, of the differences in unintentional injury hospitalizations between high-percentage First Nations identity and low-percentage Aboriginal identity DAs. This suggests that characteristics not measured in this analysis--such as environmental, behavioural or other factors--play an additional role in DA-level unintentional injury hospitalization risk.