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Health

Health is a key component of well-being. This section reviews self-rated health status, levels of chronic conditions and contact with health professionals to explore the health status of the non-reserve Aboriginal population as a component of well-being.

Self-rated health status
Chronic conditions
Contact with health professionals

Self-rated health status

Self-rated health status is considered a reliable indicator of health that successfully crosses cultural lines, and one that permits some assessment of positive health as opposed to just the absence of disease (Idler and Benyamini 1997; Shields and Shooshtari 2001). Previous studies have found that asking respondents to rate their own health status on a scale from poor to excellent is “as good or better than measures such as functional ability, chronic diseases and psychological well-being” (Shields and Shooshtari 2001:35).

Research has also shown that there are many factors that influence the way people rate their health status, including age, gender, and the presence of chronic conditions. In addition to other determinants of health such as maintaining a healthy weight and taking part in physical activity, there is a strong positive link between health status and socio-economic factors, such as having high levels of education and being employed (Shields and Shooshtari 2001; Health Canada 2003a).

Majority of non-reserve Aboriginal population reported excellent or very good health

In the 2001 APS, the majority of the non-reserve Aboriginal population aged 15 or older —56%—reported excellent or very good health. About 17% reported fair or poor health, and the remaining 26% described their health as good.

Men were somewhat more likely to rate their health as excellent or very good. The 2001 APS showed that 59% of Aboriginal men did so, compared with 54% of Aboriginal women. While differences between the sexes were smaller among older age groups, men in younger age groups were much more likely than women to rate their own health as very good or excellent.

About three-quarters (74%) of men aged 15 to 24 reported excellent or very good health status, compared with 65% of women in the same age group. Among individuals aged 25 to 34, 68% of men reported excellent or very good health status, as did 62% of women.

Not surprisingly, the likelihood of self-rating health as excellent or very good declined with each successive age group. The proportion of Aboriginal people rating their health as “excellent or very good” was highest among those aged 15-24 (69%), and lowest among those over 65 (24%). This pattern of declining health status among successive age groups is also found in the total Canadian population. (Table 1)

Table 1. Self-rated health status by age and sex, Aboriginal identity population, non-reserve, Canada, 2001. Opens a new window. Table 1. Self-rated health status by age and sex, Aboriginal identity population, non-reserve, Canada, 2001

Aboriginal youth report health status on par with other Canadian youth

Overall, the Aboriginal non-reserve population rated their health status lower than the total Canadian population. However, among young adults this gap was negligible.

About 69% of Aboriginal people aged 15-24 in non-reserve areas rated their health as very good or excellent, compared with 71% of the total population in the same age group. (Chart 1) As the Aboriginal population is the fastest growing component of the youth population, these young people will play a pivotal role in the future.

Chart 1. Excellent or very good self-rated health status, Canada, 2001.  Opens a new window. Chart 1. Excellent or very good self-rated health status, Canada, 2001

While Aboriginal young people report similar levels of health status to the total Canadian youth population, in general the health status of Aboriginal people declines more quickly than the total population with each successive age group. As a result, the gap between the health status of Aboriginal people and the total Canadian population widens in older age groups.

As Chart 2 illustrates, for every age group between 25 and 64, the proportion of Aboriginal people reporting fair or poor health is about double that of the total population.

The effect is even more pronounced among Aboriginal women. For example, 41% of Aboriginal women aged 55-64 reported fair or poor health, compared with 19% of women in the same age group in the total Canadian population. Among individuals aged 65 and over, 45% of Aboriginal women reported fair or poor health, compared with 29% in the total female population.

Chart 2. Fair or poor self-rated health status, Canada, 2001.  Opens a new window. Chart 2. Fair or poor self-rated health status, Canada, 2001

Chronic conditions

Arthritis or rheumatism most commonly reported chronic condition among Aboriginal adults

Differences in health ratings are also linked to the existence of chronic conditions. Individuals with chronic conditions rated their health as fair or poor more often than those without chronic conditions.

In the 2001 APS, 45% of the Aboriginal population aged 15 and over reported having one or more chronic conditions, that is, a health condition that had been diagnosed by a health-care professional and had lasted, or was expected to last, at least six months.

Arthritis or rheumatism, high blood pressure and asthma were the most commonly reported chronic conditions for the Aboriginal adult population (those aged 15 and over). Among Aboriginal children (those aged 14 and under) living in non-reserve areas, allergies, asthma and ear infections or ear problems were the most commonly reported chronic conditions. Allergies were reported by 15.5%, asthma by 12.1% and ear infections or ear problems by 9.8%.

Among the adult population, 19.3% of the non-reserve Aboriginal population reported arthritis or rheumatism, nearly twice the proportion of 11% among the total Canadian population. Similarly, 12.0% of the Aboriginal population reported high blood pressure, compared with 8.7% among the total population, while 11.6% of the Aboriginal population reported asthma, slightly higher than the 10.3% for the total population.5

Diabetes most prominent among older Aboriginal women

Rates of diabetes were considerably higher for the non-reserve Aboriginal population than for the total Canadian population, and were particularly high among older Aboriginal women. Seven percent of the Aboriginal non-reserve population reported diabetes, compared with 4.3% of the total Canadian population. If the different age structure of the Aboriginal population and the total population were taken into account through age standardization, the gap would be even larger: 7% compared with 2.9%.

Diabetes was particularly prevalent among older people in both the Aboriginal and total Canadian populations. However, rates of diabetes were higher in the Aboriginal population. Among the non-reserve Aboriginal population, the prevalence of diabetes increased in each successive age group. About 1%E of Aboriginal people aged 15-24 reported having been diagnosed with diabetes. This rose to a high of 22.2% for seniors aged 65 and over. (Chart 3)

There was little difference in the prevalence of diabetes between the sexes, except in the older age groups. Nearly one in four Aboriginal women aged 65 and over had been diagnosed with diabetes, compared with one in five Aboriginal men. The situation was opposite in the total population. About 15% of senior men aged 65 and over had been diagnosed with diabetes, as opposed to 11% of senior women.

In addition to high rates, according to Health Canada, diabetes is a significant concern for the Aboriginal population because of “early onset, greater severity at diagnosis, high rates of complications, lack of accessible services, increasing trends, and increasing prevalence of risk factors for a population already at risk.” (Health Canada 2000).

Chart 3. Percentage of population diagnosed with diabetes, Canada, 2001.  Opens a new window. Chart 3. Percentage of population diagnosed with diabetes, Canada, 2001

Diabetes most prevalent among North American Indian population

Diabetes among the non-reserve Aboriginal population was most prevalent in the North American Indian population, where 8.3% of the population age 15 and over was diagnosed with diabetes, as opposed to 6% of the Métis population and 2.3% of the Inuit population.

Rates of diabetes have risen for North American Indian adults not living on reserve since 1991 when the rate was 5.3%. Rates for the Métis and Inuit changed only slightly: 5.5% for Métis and 1.9% for Inuit adults in 1991.

According to Health Canada, there is evidence that the prevalence of diabetes is higher among the Aboriginal population living on-reserve. (Health Canada 2000) If this group were included, it is likely that the rate of diabetes for the total Aboriginal population (both those living in reserve and non-reserve areas combined) would be higher than 7%.

The six most prevalent chronic conditions for the North American Indian, Métis and Inuit populations were: arthritis or rheumatism; high blood pressure; asthma; stomach problems or intestinal ulcers; diabetes; and heart problems . The North American Indian and Métis populations reported similar levels for most of these chronic conditions, while the Inuit had lower rates.

Many factors may be contributing to the relatively lower levels of chronic conditions in the Inuit population. As there is less contact with health care professionals in the Canadian Arctic, where the majority of Inuit live, there may be many undiagnosed chronic conditions.6

In addition, the Inuit population is younger than the North American Indian and Métis populations; nearly half of Inuit are under the age of 20. Generally, those in younger age groups are less likely to report chronic conditions.

Chart 4. Percentage of population with selected chronic conditions, Aboriginal identity non-reserve population, 15 years and over, Canada, 2001.  Opens a new window. Chart 4. Percentage of population with selected chronic conditions, Aboriginal identity non-reserve population, 15 years and over, Canada, 2001

Contact with health professionals

In Canadian Arctic, Aboriginal people reported fewer contacts with health professionals

The 2001 APS showed that access to health care professionals remains an issue for Aboriginal people living in the Canadian Arctic. The Aboriginal population in the Far North had less contact with family doctors and general practitioners than Aboriginal people living in other regions. About 43% of the Aboriginal population in the Canadian Arctic had such contact, compared with 75% of those in urban areas and 69% in rural areas. In contrast, the 2000/01 Canadian Community Health Survey showed that 82% of the total Canadian population had seen a medical doctor in the 12 months prior to the survey.

The Aboriginal population living in the Canadian Arctic was more likely to have had contact with nurses – 58% – as opposed to other types of health professionals. These differences are likely due to the type of health care professionals available to people living in the Canadian Arctic.

Chart 5. Contact with health professionals, Aboriginal identity non-reserve population, 15 years and over, Canada, 2001.  Opens a new window. Chart 5. Contact with health professionals, Aboriginal identity non-reserve population, 15 years and over, Canada, 2001

One-third of Aboriginal people living in urban areas had access to traditional medicines

About 31% of the non-reserve Aboriginal population had access to First Nations, Métis or Inuit traditional medicines, healing or wellness practices in their city, town or community, according to the 2001 APS. The highest percentage was found in urban areas, where 34% of the population reported having access to traditional medicines, compared with 26% in rural areas and 14% in the Canadian Arctic.

While one-third of the urban Aboriginal population reported having access to traditional healing practices, just as many reported that they did not know if such health practices were available in their community.

About 7% of the urban Aboriginal population had contacted a traditional healer about their physical, emotional or mental health in the 12 months prior to the survey.



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Date Modified: 2004-03-04 Important Notices