I ndigenous people around the globe have suffered from the impacts of colonization to various ext... more I ndigenous people around the globe have suffered from the impacts of colonization to various extents and often share similar historical and ongoing collective adversities that negatively affect well-being. 1,2 Of particular concern is the disproportionate burden of mental health issues among Indigenous people. 3-5 A growing number of studies demonstrate the extent of inequality in physical health and mental health between non-Indigenous and Indigenous populations. 6-10 For example, just under one-quarter of Inuit (23.5%) and First Nations adults living off-reserve (24.0%) and 1 in 5 Métis (19.6%) reported lifetime suicidal ideation, compared with just over 1 in 10 non-Indigenous adults. 11 Furthermore, a recent study 12 shows inequalities in mental health outcomes within Indigenous populations in Canada. To assist effective policy-making based on the emerging evidence of the extent of inequalities, it is critical to understand what explains these inequalities. Recent studies 12,13 highlighted the importance of social determinants of health in inequalities in health and mental health outcomes within Indigenous populations in Canada. These studies show, for example, that policies designed to address food insecurity may help reduce mental health issues among Indigenous people living off-reserve in Canada. Our study objective was to quantify the extent of, and explain various demographic, socioeconomic and geographical factors that account for, inequalities in psychological distress, suicidal ideation and suicide plans between non-Indigenous and Indigenous populations living off-reserve in Canada. Methods Data source, design and study population This is a cross-sectional analysis using the most recent Canadian Community Health Survey-Mental Health (2012 CCHS-MH). 15 This survey was designed to collect information on mental health and health care services, lifestyle and social conditions, and prevention and detection of disease from both non-Indigenous and Indigenous populations living off-reserve (79.7% of the total Indigenous population 14) in Canada.
Background Addressing the Truth and Reconciliation Calls to Action on including anti-racism and c... more Background Addressing the Truth and Reconciliation Calls to Action on including anti-racism and cultural competency education is acknowledged within many health professional programs. However, little is known about the effects of a course related to Indigenous Peoples and colonialism on learners’ beliefs about the causes of inequities and intergroup attitudes. Methods A total of 335 learners across three course cohorts (in 2019, 2020, 2022) of health professional programs (e.g., Dentistry/Dental Hygiene, Medicine, Nursing, and Pharmacy) at a Canadian university completed a survey prior to and 3 months following an educational intervention. The survey assessed gender, age, cultural identity, political ideology, and health professional program along with learners’ causal beliefs, blaming attitudes, support for social action and perceived professional responsibility to address inequities. Pre-post changes were assessed using mixed measures (Cohort x Time of measurement) analyses of var...
International Journal of Environmental Research and Public Health
First Nations children are over 17 times more likely to be removed from their families and placed... more First Nations children are over 17 times more likely to be removed from their families and placed in the child welfare system (CWS) than non-Indigenous children in Canada. The high rates of parent-child separation have been linked to discriminatory public services and the Indian Residential School (IRS) system, which instigated a multi-generational cycle of family disruption. However, limited empirical evidence exists linking the IRS to subsequent parent-child separations, the CWS, and mental health outcomes among First Nations, Inuit, and Métis populations in Canada. The current studies examine these relationships using a nationally representative sample of First Nations youth (ages 12–17 years) living in communities across Canada (Study 1), and among First Nations and Métis adults (ages 18+ years) in Canada (Study 2). Study 1 revealed that First Nations youth with a parent who attended IRS had increased odds of not living with either of their biological parents, and both IRS and n...
Pain and culture are complex and multifactorial phenomena. The concepts are difficult to define a... more Pain and culture are complex and multifactorial phenomena. The concepts are difficult to define and measure since they intersect with the biological, psychological, and social realms. Considering the intrinsic multidimensionality of each phenomenon, we are only beginning to understand the myriad ways in which culture may influence pain. Consequently, (1) the study of the relationship between culture and pain has been fraught with methodological and theoretical challenges; and (2) there is little evidence to support specific guidelines on how to assess and treat pain of specific cultural groups. Therefore, researchers face challenges in conducting research on pain with indigenous populations.
The current paper reviews research that has explored the intergenerational effects of the Indian ... more The current paper reviews research that has explored the intergenerational effects of the Indian Residential School (IRS) system in Canada, in which Aboriginal children were forced to live at schools where various forms of neglect and abuse were common. Intergenerational IRS trauma continues to undermine the well-being of today’s Aboriginal population, and having a familial history of IRS attendance has also been linked with more frequent contemporary stressor experiences and relatively greater effects of stressors on well-being. It is also suggested that familial IRS attendance across several generations within a family appears to have cumulative effects. Together, these findings provide empirical support for the concept of historical trauma, which takes the perspective that the consequences of numerous and sustained attacks against a group may accumulate over generations and interact with proximal stressors to undermine collective well-being. As much as historical trauma might be linked to pathology, it is not possible to go back in time to assess how previous traumas endured by Aboriginal peoples might be related to subsequent responses to IRS trauma. Nonetheless, the currently available research demonstrating the intergenerational effects of IRSs provides support for the enduring negative consequences of these experiences and the role of historical trauma in contributing to present day disparities in well-being.
Journal of developmental origins of health and disease, Jan 20, 2018
The Indian residential school (IRS) system in Canada ran for over a century until the last school... more The Indian residential school (IRS) system in Canada ran for over a century until the last school closed in 1996. Conditions in the IRSs resulted in generations of Indigenous children being exposed to chronic childhood adversity. The current investigation used data from the 2008-2010 First Nations Regional Health Survey to explore whether parental IRS attendance was associated with suicidal thoughts and attempts in childhood, adolescence and in adulthood among a representative sample of First Nations peoples living on-reserve across Canada. Analyses of the adult sample in Study 1 (unweighted n=7716; weighted n=186,830) revealed that having a parent who attended IRS was linked with increased risk for suicidal thoughts and attempts in adolescence and adulthood. Although females were negatively affected by having a parent who attended IRS, the link with suicidal ideation in adulthood was greater for males. Analyses of the youth sample in Study 2 (unweighted n=2883; weighted n=30,190) c...
Limited studies have assessed how parent and/or grandparent attendance at residential schools is ... more Limited studies have assessed how parent and/or grandparent attendance at residential schools is associated with mental health and substance use among First Nations peoples living off reserve, while also considering how cultural dimensions relate to these outcomes. Analyses of the 2017 Aboriginal Peoples Survey revealed that the odds of self-reported diagnosed mood and anxiety disorders, past-year heavy drinking, and frequent marijuana use were significantly higher among First Nations adults living off reserve who had either a parent and/or grandparent who attended residential schools, even when controlling for covariates. In predicting diagnosed mood disorder, positive cultural identity affect and cultural engagement moderated the effect of parent residential school attendance while cultural exploration moderated the effect of two generations of attendance. Cultural exploration was a protective factor for grandparent residential school attendance in relation to past-year frequent m...
Canadian Journal of Education/Revue canadienne de l'éducation
Indigenous peoples in Canada continue to face health care inequities despite their increased risk... more Indigenous peoples in Canada continue to face health care inequities despite their increased risk for various negative health outcomes. Evidence suggests that health professions students and faculty do not feel their curriculum adequately prepares learners to address these inequities. The aim of this study was to identify barriers that hinder the inclusion of adequate Indigenous content in curricula across health professions programs. Semi-structured interviews were conducted with 33 faculty members at a university in Canada from various health disciplines. Employing thematic analysis, four principal barriers were identified: (1) the limited number and overburdening of Indigenous faculty, (2) the need for non-Indigenous faculty training and capacity, (3) the lack of oversight and direction regarding curricular content and training approaches, and (4) the limited amount of time in curriculum and competing priorities. Addressing these barriers is necessary to prepare learners to provi...
Background University students belonging to various ethnic groups have specific health needs that... more Background University students belonging to various ethnic groups have specific health needs that influence their self-rated health and health service use. Purpose To examine which determinants of health serve as key predictors of self-rated health and health service use in a sample of ethnically diverse undergraduate students. Methods Data were abstracted from the 2012 Maritime Undergraduate Student Sexual Health Services Survey (N = 10,512). Logistic regression was used to explore the predictors of self-rated health and use of university-based health services according to ethnicity. Results Social support (Caucasian: odds ratio (OR) = 1.018; 95% confidence interval (CI) [1.008, 1.028]; African: OR = 1.890; 95% CI [1.022, 1.160]; Other: OR = 1.096; 95% CI [1.023, 1.175]), and depression risk (Caucasian: OR = .899; 95% CI [.844, .914]; Indigenous: OR = .904; 95% CI [.844, .969]; Asian: OR = .894; 95% CI [.839, .953]; Multiracial: OR = .892; 95% CI [.812, .980]) were the most frequen...
Background: Including content on Indigenous health in medical school curricula has become a widel... more Background: Including content on Indigenous health in medical school curricula has become a widelyacknowledged prerequisite to reducing the health disparities experienced by Indigenous peoples in Canada. However, little is known about what levels of awareness and interest medical students have about Indigenous peoples when they enter medical school. Additionally, it is unclear whether current Indigenous health curricula ultimately improve students' beliefs and behaviours. Methods: A total of 129 students completed a 43-item questionnaire that was sent to three cohorts of first-year medical students (in 2013, 2014, 2015) at one undergraduate medical school in Canada. This survey included items to evaluate students' sociopolitical attitudes towards Indigenous people, knowledge of colonization and its links to Indigenous health inequities, knowledge of Indigenous health inequities, and self-rated educational preparedness to work with Indigenous patients. The survey also assessed students' perceived importance of learning about Indigenous peoples in medical school, and their interest in working in an Indigenous community, which were examined as outcomes. Using principal component analysis, survey items were grouped into five independent factors and outcomes were modelled using staged multivariate regression analyses.
W orldwide, Indigenous populations have high rates of suicide and psychological distress, the lat... more W orldwide, Indigenous populations have high rates of suicide and psychological distress, the latter characterized by psychological and physiologic symptoms of anxiety and depression. 1-3 Suicide is a major cause of death among First Nations, Métis and Inuit peoples, 4 the 3 distinct Indigenous groups in Canada. Suicide rates among Indigenous peoples, when considered collectively, are 2 to 3 times higher than among non-Indigenous Canadians. 5 Rates of suicide and distress vary considerably across the Indigenous groups. During the period between 1991 and 2001, the Indigenous to non-Indigenous suicide mortality rate ratio was 1.60 for Métis men, 0.85 for Métis women, 1.66 for status First Nations men and 1.86 for status First Nations women. 6 Suicide rates among the Inuit, which are among the highest in the world, are up to 10 times higher than the overall rate for Canada. 5,7,8 Suicide led to life expectancy losses of 4.8 years for men and 1.2 years for women in Inuit Nunangat in 1999-2003. 9 Suicide rates are higher among First Nations peoples living on-reserve than among Indigenous peoples living offreserve. 10 The rate ratios for potential years of life lost owing to suicide among status First Nation men living on-and off-reserve compared with non-Indigenous men (women) were 2.88 (3.71) and 1.11 (0.76), respectively. 11 Furthermore, except for Métis men, suicidal thoughts among Indigenous peoples are more common than among non-Indigenous Canadians. 12 Historical and ongoing experiences associated with col onization accompanied by inequities in income, employment opportunities, housing and food security, among other factors, have resulted in pervasive health problems among Indigenous peoples. 4,13-21 Indigenous populations have the poorest health outcomes in Canada, often similar to those of populations in developing countries. 18 RESEARCH MENTAL HEALTH
Two studies assessed the nature of parental communication about the trauma of Indian Residential ... more Two studies assessed the nature of parental communication about the trauma of Indian Residential Schools (IRSs) in relation to the psychological distress of their adult offspring, and whether the link between parental communication and distress was mediated by offsprings’ greater awareness of collective discrimination or sense of pride in cultural identity. In Study 1, an online survey of Indigenous participants from across Canada ( N = 498) demonstrated a curvilinear relation between the extent to which parents talked about their negative IRS experiences and the severity of depressive symptoms among offspring, among whom symptoms were particularly pronounced with more frequent communication. This relation was mediated by greater perceived discrimination. A similar, but inverse, association was found when parental communications conveyed positive construals of their IRS experiences. Study 2 ( N = 134) further demonstrated an association between direct communications from IRS survivo...
Health policy (Amsterdam, Netherlands), Aug 1, 2018
Using three nationally representative Aboriginal Peoples Surveys (2001, 2006 and 2012, n = 68,040... more Using three nationally representative Aboriginal Peoples Surveys (2001, 2006 and 2012, n = 68,040), we examined income-related inequalities in self-perceived poor/fair general health status among Indigenous adults (18+) living off-reserve in Canada. We used the relative and absolute concentration indices (RC and AC, respectively) to quantify income-related inequalities in health for men and women, within the three Indigenous populations (First Nations, Métis, and Inuit), and in different geographic regions. Moreover, we performed decomposition analysis to determine factors that explain income-related inequality in health within the Indigenous peoples living off-reserve in Canada. The prevalence of poor/fair health status among the Indigenous population living off-reserve increased from 18% in 2001 to 22% in 2012. The extent of pro-rich relative (absolute) income-related inequalities in health increased by 23% (42%) from 2001 to 2012. Income-related inequalities in health increased s...
Embracing a shared social identity typically serves to protect group members in the face of threa... more Embracing a shared social identity typically serves to protect group members in the face of threats. However, under some conditions, intragroup dynamics are diverted so that instead, they contribute to disturbances in collective well-being. The present analysis applies a social identity framework to understand how intragroup processes elicited in Indian Residential Schools (IRS) altered the capacity of Indigenous peoples to overcome damage to their identity and collective functioning. With the alleged goal of assimilating the Indigenous population, residential schools in Canada entailed the forced removal of Indigenous children from their communities. A Truth and Reconciliation Commission established in 2008 confirmed the extensive abuse perpetrated by IRS staff, but also raised awareness of the pervasiveness of student-to-student abuse. Supported by qualitative analyses of the reports of social service providers working with IRS survivors (N = 43), it is argued that a key part of ...
I ndigenous people around the globe have suffered from the impacts of colonization to various ext... more I ndigenous people around the globe have suffered from the impacts of colonization to various extents and often share similar historical and ongoing collective adversities that negatively affect well-being. 1,2 Of particular concern is the disproportionate burden of mental health issues among Indigenous people. 3-5 A growing number of studies demonstrate the extent of inequality in physical health and mental health between non-Indigenous and Indigenous populations. 6-10 For example, just under one-quarter of Inuit (23.5%) and First Nations adults living off-reserve (24.0%) and 1 in 5 Métis (19.6%) reported lifetime suicidal ideation, compared with just over 1 in 10 non-Indigenous adults. 11 Furthermore, a recent study 12 shows inequalities in mental health outcomes within Indigenous populations in Canada. To assist effective policy-making based on the emerging evidence of the extent of inequalities, it is critical to understand what explains these inequalities. Recent studies 12,13 highlighted the importance of social determinants of health in inequalities in health and mental health outcomes within Indigenous populations in Canada. These studies show, for example, that policies designed to address food insecurity may help reduce mental health issues among Indigenous people living off-reserve in Canada. Our study objective was to quantify the extent of, and explain various demographic, socioeconomic and geographical factors that account for, inequalities in psychological distress, suicidal ideation and suicide plans between non-Indigenous and Indigenous populations living off-reserve in Canada. Methods Data source, design and study population This is a cross-sectional analysis using the most recent Canadian Community Health Survey-Mental Health (2012 CCHS-MH). 15 This survey was designed to collect information on mental health and health care services, lifestyle and social conditions, and prevention and detection of disease from both non-Indigenous and Indigenous populations living off-reserve (79.7% of the total Indigenous population 14) in Canada.
Background Addressing the Truth and Reconciliation Calls to Action on including anti-racism and c... more Background Addressing the Truth and Reconciliation Calls to Action on including anti-racism and cultural competency education is acknowledged within many health professional programs. However, little is known about the effects of a course related to Indigenous Peoples and colonialism on learners’ beliefs about the causes of inequities and intergroup attitudes. Methods A total of 335 learners across three course cohorts (in 2019, 2020, 2022) of health professional programs (e.g., Dentistry/Dental Hygiene, Medicine, Nursing, and Pharmacy) at a Canadian university completed a survey prior to and 3 months following an educational intervention. The survey assessed gender, age, cultural identity, political ideology, and health professional program along with learners’ causal beliefs, blaming attitudes, support for social action and perceived professional responsibility to address inequities. Pre-post changes were assessed using mixed measures (Cohort x Time of measurement) analyses of var...
International Journal of Environmental Research and Public Health
First Nations children are over 17 times more likely to be removed from their families and placed... more First Nations children are over 17 times more likely to be removed from their families and placed in the child welfare system (CWS) than non-Indigenous children in Canada. The high rates of parent-child separation have been linked to discriminatory public services and the Indian Residential School (IRS) system, which instigated a multi-generational cycle of family disruption. However, limited empirical evidence exists linking the IRS to subsequent parent-child separations, the CWS, and mental health outcomes among First Nations, Inuit, and Métis populations in Canada. The current studies examine these relationships using a nationally representative sample of First Nations youth (ages 12–17 years) living in communities across Canada (Study 1), and among First Nations and Métis adults (ages 18+ years) in Canada (Study 2). Study 1 revealed that First Nations youth with a parent who attended IRS had increased odds of not living with either of their biological parents, and both IRS and n...
Pain and culture are complex and multifactorial phenomena. The concepts are difficult to define a... more Pain and culture are complex and multifactorial phenomena. The concepts are difficult to define and measure since they intersect with the biological, psychological, and social realms. Considering the intrinsic multidimensionality of each phenomenon, we are only beginning to understand the myriad ways in which culture may influence pain. Consequently, (1) the study of the relationship between culture and pain has been fraught with methodological and theoretical challenges; and (2) there is little evidence to support specific guidelines on how to assess and treat pain of specific cultural groups. Therefore, researchers face challenges in conducting research on pain with indigenous populations.
The current paper reviews research that has explored the intergenerational effects of the Indian ... more The current paper reviews research that has explored the intergenerational effects of the Indian Residential School (IRS) system in Canada, in which Aboriginal children were forced to live at schools where various forms of neglect and abuse were common. Intergenerational IRS trauma continues to undermine the well-being of today’s Aboriginal population, and having a familial history of IRS attendance has also been linked with more frequent contemporary stressor experiences and relatively greater effects of stressors on well-being. It is also suggested that familial IRS attendance across several generations within a family appears to have cumulative effects. Together, these findings provide empirical support for the concept of historical trauma, which takes the perspective that the consequences of numerous and sustained attacks against a group may accumulate over generations and interact with proximal stressors to undermine collective well-being. As much as historical trauma might be linked to pathology, it is not possible to go back in time to assess how previous traumas endured by Aboriginal peoples might be related to subsequent responses to IRS trauma. Nonetheless, the currently available research demonstrating the intergenerational effects of IRSs provides support for the enduring negative consequences of these experiences and the role of historical trauma in contributing to present day disparities in well-being.
Journal of developmental origins of health and disease, Jan 20, 2018
The Indian residential school (IRS) system in Canada ran for over a century until the last school... more The Indian residential school (IRS) system in Canada ran for over a century until the last school closed in 1996. Conditions in the IRSs resulted in generations of Indigenous children being exposed to chronic childhood adversity. The current investigation used data from the 2008-2010 First Nations Regional Health Survey to explore whether parental IRS attendance was associated with suicidal thoughts and attempts in childhood, adolescence and in adulthood among a representative sample of First Nations peoples living on-reserve across Canada. Analyses of the adult sample in Study 1 (unweighted n=7716; weighted n=186,830) revealed that having a parent who attended IRS was linked with increased risk for suicidal thoughts and attempts in adolescence and adulthood. Although females were negatively affected by having a parent who attended IRS, the link with suicidal ideation in adulthood was greater for males. Analyses of the youth sample in Study 2 (unweighted n=2883; weighted n=30,190) c...
Limited studies have assessed how parent and/or grandparent attendance at residential schools is ... more Limited studies have assessed how parent and/or grandparent attendance at residential schools is associated with mental health and substance use among First Nations peoples living off reserve, while also considering how cultural dimensions relate to these outcomes. Analyses of the 2017 Aboriginal Peoples Survey revealed that the odds of self-reported diagnosed mood and anxiety disorders, past-year heavy drinking, and frequent marijuana use were significantly higher among First Nations adults living off reserve who had either a parent and/or grandparent who attended residential schools, even when controlling for covariates. In predicting diagnosed mood disorder, positive cultural identity affect and cultural engagement moderated the effect of parent residential school attendance while cultural exploration moderated the effect of two generations of attendance. Cultural exploration was a protective factor for grandparent residential school attendance in relation to past-year frequent m...
Canadian Journal of Education/Revue canadienne de l'éducation
Indigenous peoples in Canada continue to face health care inequities despite their increased risk... more Indigenous peoples in Canada continue to face health care inequities despite their increased risk for various negative health outcomes. Evidence suggests that health professions students and faculty do not feel their curriculum adequately prepares learners to address these inequities. The aim of this study was to identify barriers that hinder the inclusion of adequate Indigenous content in curricula across health professions programs. Semi-structured interviews were conducted with 33 faculty members at a university in Canada from various health disciplines. Employing thematic analysis, four principal barriers were identified: (1) the limited number and overburdening of Indigenous faculty, (2) the need for non-Indigenous faculty training and capacity, (3) the lack of oversight and direction regarding curricular content and training approaches, and (4) the limited amount of time in curriculum and competing priorities. Addressing these barriers is necessary to prepare learners to provi...
Background University students belonging to various ethnic groups have specific health needs that... more Background University students belonging to various ethnic groups have specific health needs that influence their self-rated health and health service use. Purpose To examine which determinants of health serve as key predictors of self-rated health and health service use in a sample of ethnically diverse undergraduate students. Methods Data were abstracted from the 2012 Maritime Undergraduate Student Sexual Health Services Survey (N = 10,512). Logistic regression was used to explore the predictors of self-rated health and use of university-based health services according to ethnicity. Results Social support (Caucasian: odds ratio (OR) = 1.018; 95% confidence interval (CI) [1.008, 1.028]; African: OR = 1.890; 95% CI [1.022, 1.160]; Other: OR = 1.096; 95% CI [1.023, 1.175]), and depression risk (Caucasian: OR = .899; 95% CI [.844, .914]; Indigenous: OR = .904; 95% CI [.844, .969]; Asian: OR = .894; 95% CI [.839, .953]; Multiracial: OR = .892; 95% CI [.812, .980]) were the most frequen...
Background: Including content on Indigenous health in medical school curricula has become a widel... more Background: Including content on Indigenous health in medical school curricula has become a widelyacknowledged prerequisite to reducing the health disparities experienced by Indigenous peoples in Canada. However, little is known about what levels of awareness and interest medical students have about Indigenous peoples when they enter medical school. Additionally, it is unclear whether current Indigenous health curricula ultimately improve students' beliefs and behaviours. Methods: A total of 129 students completed a 43-item questionnaire that was sent to three cohorts of first-year medical students (in 2013, 2014, 2015) at one undergraduate medical school in Canada. This survey included items to evaluate students' sociopolitical attitudes towards Indigenous people, knowledge of colonization and its links to Indigenous health inequities, knowledge of Indigenous health inequities, and self-rated educational preparedness to work with Indigenous patients. The survey also assessed students' perceived importance of learning about Indigenous peoples in medical school, and their interest in working in an Indigenous community, which were examined as outcomes. Using principal component analysis, survey items were grouped into five independent factors and outcomes were modelled using staged multivariate regression analyses.
W orldwide, Indigenous populations have high rates of suicide and psychological distress, the lat... more W orldwide, Indigenous populations have high rates of suicide and psychological distress, the latter characterized by psychological and physiologic symptoms of anxiety and depression. 1-3 Suicide is a major cause of death among First Nations, Métis and Inuit peoples, 4 the 3 distinct Indigenous groups in Canada. Suicide rates among Indigenous peoples, when considered collectively, are 2 to 3 times higher than among non-Indigenous Canadians. 5 Rates of suicide and distress vary considerably across the Indigenous groups. During the period between 1991 and 2001, the Indigenous to non-Indigenous suicide mortality rate ratio was 1.60 for Métis men, 0.85 for Métis women, 1.66 for status First Nations men and 1.86 for status First Nations women. 6 Suicide rates among the Inuit, which are among the highest in the world, are up to 10 times higher than the overall rate for Canada. 5,7,8 Suicide led to life expectancy losses of 4.8 years for men and 1.2 years for women in Inuit Nunangat in 1999-2003. 9 Suicide rates are higher among First Nations peoples living on-reserve than among Indigenous peoples living offreserve. 10 The rate ratios for potential years of life lost owing to suicide among status First Nation men living on-and off-reserve compared with non-Indigenous men (women) were 2.88 (3.71) and 1.11 (0.76), respectively. 11 Furthermore, except for Métis men, suicidal thoughts among Indigenous peoples are more common than among non-Indigenous Canadians. 12 Historical and ongoing experiences associated with col onization accompanied by inequities in income, employment opportunities, housing and food security, among other factors, have resulted in pervasive health problems among Indigenous peoples. 4,13-21 Indigenous populations have the poorest health outcomes in Canada, often similar to those of populations in developing countries. 18 RESEARCH MENTAL HEALTH
Two studies assessed the nature of parental communication about the trauma of Indian Residential ... more Two studies assessed the nature of parental communication about the trauma of Indian Residential Schools (IRSs) in relation to the psychological distress of their adult offspring, and whether the link between parental communication and distress was mediated by offsprings’ greater awareness of collective discrimination or sense of pride in cultural identity. In Study 1, an online survey of Indigenous participants from across Canada ( N = 498) demonstrated a curvilinear relation between the extent to which parents talked about their negative IRS experiences and the severity of depressive symptoms among offspring, among whom symptoms were particularly pronounced with more frequent communication. This relation was mediated by greater perceived discrimination. A similar, but inverse, association was found when parental communications conveyed positive construals of their IRS experiences. Study 2 ( N = 134) further demonstrated an association between direct communications from IRS survivo...
Health policy (Amsterdam, Netherlands), Aug 1, 2018
Using three nationally representative Aboriginal Peoples Surveys (2001, 2006 and 2012, n = 68,040... more Using three nationally representative Aboriginal Peoples Surveys (2001, 2006 and 2012, n = 68,040), we examined income-related inequalities in self-perceived poor/fair general health status among Indigenous adults (18+) living off-reserve in Canada. We used the relative and absolute concentration indices (RC and AC, respectively) to quantify income-related inequalities in health for men and women, within the three Indigenous populations (First Nations, Métis, and Inuit), and in different geographic regions. Moreover, we performed decomposition analysis to determine factors that explain income-related inequality in health within the Indigenous peoples living off-reserve in Canada. The prevalence of poor/fair health status among the Indigenous population living off-reserve increased from 18% in 2001 to 22% in 2012. The extent of pro-rich relative (absolute) income-related inequalities in health increased by 23% (42%) from 2001 to 2012. Income-related inequalities in health increased s...
Embracing a shared social identity typically serves to protect group members in the face of threa... more Embracing a shared social identity typically serves to protect group members in the face of threats. However, under some conditions, intragroup dynamics are diverted so that instead, they contribute to disturbances in collective well-being. The present analysis applies a social identity framework to understand how intragroup processes elicited in Indian Residential Schools (IRS) altered the capacity of Indigenous peoples to overcome damage to their identity and collective functioning. With the alleged goal of assimilating the Indigenous population, residential schools in Canada entailed the forced removal of Indigenous children from their communities. A Truth and Reconciliation Commission established in 2008 confirmed the extensive abuse perpetrated by IRS staff, but also raised awareness of the pervasiveness of student-to-student abuse. Supported by qualitative analyses of the reports of social service providers working with IRS survivors (N = 43), it is argued that a key part of ...
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Papers by Amy Bombay