Academic journal article Canadian Journal of Public Health

The Health of Ontario First Nations People

Academic journal article Canadian Journal of Public Health

The Health of Ontario First Nations People

Article excerpt

Results from the Ontario First Nations Regional Health Survey

ABSTRACT

Objective: To describe the health of First Nations adults residing on Ontario reserves using data from the Ontario First Nations Regional Health Survey (OFNRHS).

Method: Communities were randomly selected; individuals were systematically selected based on gender and age. Health questions were parallel to those used in the National Population Health Survey (NPHS) and included general health, chronic conditions, substance use, and health service utilization.

Results: Response rate was 86% (N=1094) in participating communities; 23 of 30 selected communities participated. Most OFNRHS respondents reported that their health was good or better. Comparisons of OFNRHS participants with NPHS Ontario respondents showed: some chronic health conditions (including diabetes, high blood pressure) were more common; a greater proportion reported smoking; and a substantially lower proportion indicated that they consumed alcohol in the past year.

Conclusions: The OFNRHS provides important province-wide data to inform decisions by the First Nations people about how to intervene effectively to improve their health status.

Over the past several decades, many studies have examined the health of Canada's Aboriginal people,1 but few have involved province-wide community-based samples; fewer still have been conducted using a process directed by a First Nations steering committee. The largest population survey to date, the national Aboriginal Peoples Survey (1991), was conducted without First Nations direction; further, 181 reserves opted out of the APS.2 The purpose of this article is to provide an overview of chronic health conditions reported by Ontario First Nations people living on reserve, as well as information about specific risk behaviours and health service contact, using data from the Ontario First Nations Regional Health Survey (OFNRHS). Where possible, this information is compared to findings from the National Population Health Survey (NPHS).3 These results are intended to inform First Nations communities about the health status of their people, both problem areas and strengths, in order to aid their decisions about how to intervene effectively.

METHODS

First Nations communities in Ontario were randomly selected within urban, rural, special access and remote strata. In each community, individuals were systematically selected from six strata based on gender and age (child: newborn to age 11, youth: age 12-17 and adult: age 18+). Females are over-represented in the adult sample: when a child or youth was selected to participate, the "person most knowledgeable" provided information on that child; this person (usually the mother) was also interviewed about her health. Health questions were parallel to those used in the NPHS3 and included general health, chronic conditions, tobacco and alcohol use, and health service utilization.

The NPHS had a stratified two-stage design whose sampling unit was the household.3 However, the data presented here derive from the health portion of the interview; only one member of the household responded to this section. Respondents aged 18 and over from Ontario were selected for comparisons here (NPHS-O).

All analyses were run in SUDAAN (Version 7.5.3) on weighted data. Prevalence estimates and standard errors were calculated. Because the OFNRHS and the NPHS-O had different sampling designs, t-values were calculated with the standard error of the difference equal to the square root of the sum of the squared standard errors. Health conditions and risk factors vary by gender, so males and females were tested separately. Because of the number of tests done, alpha was set at 0.001; using a conservative estimate of degrees of freedom (df = 100), the critical t value was 3.39. Significant differences noted in tables are based on this value.

RESULTS

Sample

Of the 30 communities randomly selected, 23 participated in the survey and 1 was ineligible, for a response rate of 79. …

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