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Note: This content may be emotionally difficult. The Hope For Wellness help line is 1-855-242-3310 or via online chat, Additional supports are available through We Matter.

A new report on Indigenous suicide in Canada has generated the most comprehensive picture of the crisis to date, despite health authorities continuing not to collect data about the problem.

Released at the end of June, the Statistics Canada report titled " Suicide among First Nations people, Métis and Inuit (2011-2016)" found that, overall, Indigenous people in Canada die by suicide at a rate three times as high as non-Indigenous Canadians.

While comprehensive, the report acknowledges there are limitations to the findings that likely result in underestimations of the actual rates. The report's analysis includes a number of socio-economic factors, as well as comparative differences based on age, sex and location - on or off reserve.

The lead researcher of the report, Mohan Kumar, said he wants readers to remember that for each of the numbers in the report "there is a person behind them, and their deaths meant an incredible loss to family, friends, community and the society at large."

He also contextualizes the findings in light of existing research that shows how aspects of colonization contribute to the Indigenous suicide crisis. So that the high rates, he says, shouldn't be taken as indicative of personal, community or cultural failings.

Canada doesn't track suicides specifically by Indigenous identity, and the process that Kumar and co-researcher Michael Tjepkema used to overcome this is important to look at, as are the limitations inherent to these findings. The findings are estimations not full counts, as they're based on only a sample portion of the full population, and there are some population groups not surveyed.

But as Indigenous researchers Roland Chrisjohn and Shaunessy McKay wrote in Dying To Please You: Indigenous Suicide in Contemporary Canada, their 2017 book on the suicide crisis, discourse about the problem and solutions is often unhelpful and not evidence-based: "It sounds like drumbeats of a PR bandwagon, like Native people are being recruited to a mainstream viewpoint rather than being convinced with real data; with all parties repeating a mantra over and over again until they parrot it without any real understanding."

Thus, the Statistics Canada report's contributions in terms of new, fuller data analysis are important.

The report's central finding - that First Nations people die by suicide at three times the rate of non-Indigenous Canadians, Inuit at nine times the rate, and Métis at two times - illustrates a crisis but is not likely to surprise those familiar with previous statistics. For those unfamiliar, it puts Inuit among the people with the highest rates of suicide anywhere in the world.

The report examines each of the three groups separately, and is based on 2011 populations, when the census had 851,560 people self-identify as First Nations, 59,445 as Inuit and 451,795 as Métis .

The report estimates that there were 1,845 total deaths by suicide of the Indigenous population in Canada from May 10, 2011, through Dec. 31, 2016. This total consists of 1,180 First Nations people, 250 Inuit and 415 Métis.

Looking at it side by side with murder data can help contextualize the scale of the problem.

For the five years since StatCan started tracking homicides by Indigenous identity, there have been 710 recorded Indigenous victims of homicide. The number of estimated suicides from the StatCan report is approximately two and a half times larger, though it applies to a slightly longer period.

The public interest in addressing the problem of missing and murdered Indigenous women and girls (MMIWG) in Canada illustrates the scale of the energy that could be mustered in service of a similar reckoning with the suicide crisis.

A Statistics Canada report found that Indigenous people die by suicide at a rate three times as high as non-Indigenous Canadians. But the report acknowledges there are limitations to the findings that likely result in underestimations of actual rates

Younger Indigenous people suffer higher rates of suicide

When comparing overall populations of the identity groups, the report uses age-standardized suicide rates to account for the groups' different age distributions - the 2011 census shows median age was 26 for First Nations, 23 for Inuit, 31 for Métis and 41 for non-Indigenous. Kumar said the approach ensured that the findings were in the form of "the rate that would be expected if the age structures of the populations were the same."

The highest rates of Indigenous suicide are seen in youth and young adults, between the ages of 15 and 24, Kumar told National Observer. For First Nations people, the rate for these ages is 6.2 times higher than for non-Indigenous population in the same age range; for Inuit people, the rate is 23.9 times higher. (There wasn't enough data to generate accurate rates for Métis by age range.)

Not all communities are equally affected by the suicide crisis

For the First Nations population, the suicide rate was two times as high for those living on-reserve as those living off-reserve.

While a critique of much of the general discourse around Indigenous issues is that it is negative or problem-focused, this report did aim to "to look at it from the perspective of resiliency (instead) of having a deficiency-based estimate," according to Kumar.

In conversation, he highlighted that the report's findings show that of "close to 600 bands ... 60% of those FN bands had not experienced suicides (of any people in the sampled population), so they have a zero suicide rate."

For Inuit Nunangat, "11 out of 50 Inuit communites had a zero suicide rate."

These numbers do need qualifying, as these zero suicide rates don't necessarily mean there were no deaths by suicide from these bands and Inuit communities over the roughly five-and-a-half-year period covered by the report. This is due to the methodology.

How to count Indigenous suicides when the government doesn't track Indigenous suicides

This research is based on the 2011 National Household Survey (NHS), which replaced the long-form census, and was based on voluntary responses. These responses accounted for a total of just over six million of the Canadian population, including what was then approximately a third (466,000) of self-identified Indigenous people in the country.

For the First Nations communities that participated in the NHS (over 90 per cent of the over 600 in Canada), all households on reserve received the survey while First Nations people living off-reserve were, like those in the general population, selected to receive the survey at random. All Métis living in households in surveyed areas, including the Métis Settlements of Alberta, received the survey while Métis living outside of survey areas were part of the random selection process to receive the survey.

For Inuit, every household in Inuit Nunangat (spanning parts of Northwest Territories, Quebec, and Labrador as well as all of Nunavut) received the survey, but individuals outside of the territory were selected for the NHS at random as part of the general population.

The NHS was used as a way to determine who among the suicide deaths were Indigenous, because the Canadian government doesn't track that in its records of health statistics.

"In the Canadian Vital Statistics Database (CVSD), there are no Indigenous identifiers, so you can't say if a death that occurred is of a First Nations person or a Métis or Inuit," Kumar explained.

"So the only way we can do that is we link the mortality records (from the CVSD) to the National Household Survey records, and in the NHS people self-identified as either a First Nations person, Inuit or Métis, or they didn't identify as Indigenous and so they would be considered non-Indigenous."

He noted a small percentage identify as belonging to more than one of the three Indigenous groups, about 0.8 per cent of the 2011 Indigenous population, though there is no separate analysis of their data in this report.

The report uses the deaths by suicide recorded in the CVSD starting from the day the NHS was collected, May 10, 2011, through the end of December 2016 - the period of 5.6 years.

Who - and what - was and wasn't counted

The NHS is a survey of private dwellings that omits people living in institutions (jails, medical facilities, etc.), collective dwellings (group homes, hostels, etc.), and many of those who are homeless.

These unmeasured groups may have higher rates of death by suicide compared with those who were surveyed; also, a higher proportion of the Indigenous population may be in those unmeasured groups than of the non-Indigenous population. It is for these reasons, and other less specific factors relating to the counting of deaths by suicide, that the report states "suicide rates presented (here) may underestimate the true rates."

The NHS also doesn't include data on gender or sexual identity, so there are no specific suicide rates in this report for two-spirit people or by sexual orientation or trans and non-binary gender identities - though these individuals are part of the overall statistics, except for those who are part of the unmeasured groups.

Kumar said the government is looking at having gender identity and sexual orientation identification included for the 2021 long-form census in consultation with Indigenous organizations.

"There are so many other factors that are behind the suicide rate we couldn't look into because we were restricted to what was collected in the NHS," Kumar said. The report itself identified some of these factors: "historical and intergenerational trauma, community distress, cultural continuity, family strength and mental wellness were not explored here."

Socio-economic factors

The report was able to do an analysis based on five socio-economic factors contained in the NHS: household income, level of education, labour force status, marital status, and, for First Nations, on- or off-reserve, while for Métis and Inuit, the size of the community in which they lived.

This itself, may be a unique contribution to the knowledge base of research on Indigenous suicide, especially with the large population range covered in this research.

But there were limitations to this too: only individuals 25 and older could be included to accurately analyze the roles of education, labour and marital status. This is a problem, because suicide rates for Indigenous youths and young adults are disproportionately high, and they are not reflected in this part of the report's analysis.

Adjusting for these socio-economic factors found that for the applicable age groups, 78 per cent of the difference in suicide rates disappears when the five factors are controlled for between First Nations and non-Indigenous; for Métis, 37 per cent of the difference disappears; and for Inuit, 40 per cent disappears (and closer to 50 per cent when household income was factored with the northern higher costs of living).

To illustrate what this adjustment means (in statistical terms, 'controlling for' these variables), is that First Nations median income in 2011 was $15,615 compared to $28,239 for non-Indigenous, but this part of the analysis compared the rates of suicide for First Nations and non-Indigenous who have similar incomes (and similarly adjusts for the other four factors), and found rates that were only 22% different. This also implies that for the non-Indigenous population in and of itself, suicide rates are not uniform, but vary corresponding with these socio-economic factors.

Kumar commented on the differing percentages of difference (i.e. the 78, 37, and 40 per cents, respectively) that disappeared for First Nations, Métis, or Inuit: "There are so many other things that are going on ... probably the better answer is that we don't quite understand why there is a difference."

It's also important to note the difference between causation and correlation: this analysis doesn't necessarily mean these factors are the cause of the different suicide rates, but that they are occurring together, which may be indicative of what is behind the problem.

Where to go from here

This analysis indicates that widespread societal imbalances between Indigenous and non-Indigenous populations are a large aspect of the Indigenous suicide crisis. Thus, individual-focused suicide-prevention programs are not a full solution.

That idea is parallel to how the Calls For Justice from the MMIWG inquiry final report do not solely focus on directly stopping murderers or murders, nor say that the murders and disappearances are the genocide itself, but look more to changing the current conditions that result from the continuity of genocidal practices and that cause Indigenous victimization.

Three of the five socio-economic factors - the areas of education, employment and poverty - are included in parts of the MMIWG inquiry Calls For Justice ( pages 170-221), as well as in the " Master List of Report Recommendations" that the inquiry compiled from 100 previous reports they reviewed during their process.

The need for repair, to create equitable conditions and treatment, was also recognized recently when the Canadian government was ordered by the Canadian Human Rights Tribunal to pay $40,000 each to all individual First Nations children and some parents/grandparents who were affected by the government's discriminatory practices in child welfare and service provision, including in the area of suicide-prevention services, as part of an ongoing tribunal case to end discriminatory policies.

The Statistics Canada report findings may help shape future research on Indigenous suicide, "There are lots of questions that probably come up (based on this report), which need to be addressed in future research," Kumar said. "I think it's up to other researchers to come up with questions or what sort of direction other research should go."

Kumar, who previously worked at the National Aboriginal Health Organization, also noted the importance of the involvement of national Indigenous organizations, including Inuit Tapiriit Kanatami, the Métis National Council, and the National Association of Friendship Centres, and their contributions to the research process: it's important that Indigenous peoples do have a leading role in such knowledge production, and in developing approaches to these problems.

​​What people, communities, organizations, and governments do about the continuing suicide crises is crucial. It is a long-term problem that hasn't been adequately addressed, often only appearing in the general public consciousness when a specific community is forced to declare a state of emergency - as God's Lake First Nation, about 1,000 kilometres northwest of Winnipeg, did at the end of August.

International Suicide Awareness Day was marked on Sept. 10, with the annual Celebrate Life event hosted by Inuit at Canada's Parliament Hill and other events across the country. The report's findings will add to these discussions, as well as those at the bi-annual World International Suicide Prevention Conference, being held next Aug. 25-27 in Winnipeg, an opportunity for all working on this problem.

But perhaps the most important part of the report may be its affirmation, with the best quantitative evidence currently available, that there continues to be a crisis and that the approaches used to address it have not been sufficient.

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Canada's Indigenous suicide crisis is worse than we thought

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A Statistics Canada report's central finding - that First Nations people die by suicide at three times the rate of non-Indigenous Canadians, Inuit at nine times the rate, and Métis at two times - illustrates a crisis but is not likely to surprise those familiar with previous statistics.

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The suicide rate among First Nations people was three times higher than in non-Indigenous populations between 2011 and 2016 in Canada, according to Statistics Canada.

The agency reported Friday on the rates of death by suicide for self-identifying First Nations people, Metis and Inuit from 2011 to 2016, compared to non-Indigenous people.

The suicide rate among First Nations people was 24.3 deaths per 100,000 person-years at risk, which StatsCan says is "roughly understood as number of deaths per persons per year." That is compared to eight deaths per 100,000 person-years at risk for non-Indigenous people.

The suicide rate for First Nations people living on a reserve was twice as high than those living off reserve, according to the agency.

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WATCH: Indigenous leader says he's waiting for a national strategy around issue of suicides
Indigenous leader says he's waiting for a national strategy around issue of suicides

For those who self-identify as Metis, their suicide rate was around twice as high as the rate of non-Indigenous people, at 14.7 deaths per 100,000 person-years at risk.

For Inuit, the rate was around nine times higher than non-Indigenous, at 72.3 deaths per 100,000 person-years at risk.

Suicide rates were highest for youth and young adults aged 15 to 24 years old among First Nations men and Inuit men and women.

However, StatsCan did point out that there is a high level of variability for suicide rates "at the community level" for Indigenous people.

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"When examined by First Nations band, just over 60 per cent of bands had a suicide rate of zero," the agency reported.

Statistics Canada says the higher risk of suicide for Indigenous people compared to non-Indigenous is due to "socioeconomic characteristics," such as household income, labour force status, level of education, marital status, as well as whether they live on or off a reserve and the community size.
WATCH: Cape Breton's Eskasoni First Nation experiencing mental health crisis
Cape Breton's Eskasoni First Nation experiencing mental health crisis

"Among First Nations people, 78 per cent of the higher risk of death by suicide was accounted for by these characteristics, while it was 37 per cent among Metis and 40 per cent among Inuit adults aged 25 years and older," the report stated.
If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help. The Canadian Association for Suicide Prevention, Depression Hurts and Kids Help Phone 1-800-668-6868 all offer ways of getting help if you, or someone you know, may be suffering from mental health issues.

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First Nations suicide rate 3 times higher than for non-Indigenous people: StatsCan | Globalnews.ca

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The suicide rate among First Nations people was three times higher than in non-Indigenous populations between 2011 and 2016 in Canada, according to Statistics Canada. The agency reported Friday on the rates of death by suicide for self-identifying First Nations people, Metis and Inuit from 2011 to 2016, compared to non-Indigenous people.

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Statistics Canada's report on suicide among First Nations people, Métis and Inuit (2011-2016) released June, 2019, found that Indigenous people in Canada die by suicide at a rate three times higher than that for non-Indigenous Canadians. The preamble starts by noting:

"Suicide rates have consistently been shown to be higher among First Nations people, Métis and Inuit in Canada than the rate among non-Indigenous people; however, suicide rates vary by community, Indigenous group, age group and sex. The historical and ongoing impacts of colonization, forced placement of Indigenous children in residential schools in the 19 th and 20 th centuries, removal of Indigenous children from their families and communities during the "Sixties scoop" and the forced relocation of communities has been well documented. These resulted in the breakdown of families, communities, political and economic structures; loss of language, culture and traditions; exposure to abuse; intergenerational transmission of trauma; and marginalization, which are suggested to be associated with the high rates of suicide."

An important recognition is the historical conditions that contribute to fractures of self-worth, opportunities, and alienation driving too many young people to the depths of depression, even a half century after the well documented injustices. Impacts of which continue to be transmitted and inherited by young people who were not even living then.

Yet, once again, the systemic reaction to failed futures and the resulting consequences continue to rely too heavily on institutionalized responses, rather than on humanitarian ones; responses that rely too highly on effective jails, corrections systems, and legislation for control.

Highly effective institutional systems that gobble up huge amounts of revenues for policing, social workers, probation officers, nurses, and teachers; each adept and replete with quantitative justifications for their effective and efficient management of resources. But in spite of the effectiveness and efficiency, too many lives continue to be marginalized, warehoused and lost.

And in many cases, the cost of issuing an apology and paying compensation after the fact are far less costly than actually instituting the more intensive application of social care and accountability necessary to mitigate ongoing cycles of crime, violence, neglect and marginalization.

If this were not the case we would not be repeating the same policies, guised in politics of law and order, entitlements and rights, and the otherization of peoples and issues that have so clearly failed in the past; and systems that seem to thrive on their ability for self perpetuation.

The late auditor general Michael Ferguson warned and cautioned as far back as 2015 that Correctional Service of Canada officials (CSC) were failing to prepare offenders for parole in a timely fashion, driving up prison costs by nearly $100 million a year and undermining efforts to prepare offenders to re-enter society without committing more crimes.

Three years later the Auditor General again reported in Report 6: Community Supervision-Correctional Service Canada , of the deteriorating support for those subject to the corrections system. Amongst his findings:

That CSC did not properly manage offenders under community supervision, did not give parole officers all the information they needed to help offenders with their health needs, and that parole officers did not meet with offenders as often as they should have.

That CSC was not able to properly monitor many offenders under community supervision.

That the number of offenders released into community supervision had grown and was expected to keep growing.

That CSC had reached the limit of the numbers of offenders it could house in the community, and that it did not have a long-term plan to respond to its housing pressures.

That it could take CSC more than two years from the time a site was selected with a community partner to the time an offender was placed at a facility, and that these shortages were likely to get worse.

How much has really changed since Michael Ferguson's report, and how much money has been spent on a system that has deteriorated and continues to deteriorate remains unclear.

According to The Office of the Parliamentary Budget Officer: Update on Costs of Incarceration 22 March 2018, CSC's expenditures associated with custody centers in 2016-17 alone totaled $1.63 billion ($114,587 per inmate) of which $1.57 billion ($109,971 per inmate or ninety-six percent) was attributable to CSC custody program.

And as to the effectiveness of CSC, despite research and performance measurement in the field of corrections and criminal justice, CSC still lacks a regularly maintained, national recidivism database- a valuable indicator of the effectiveness of "corrections". According to reports the last time CSC fully measured its two-year reconviction rate in 1995, it stood at forty-one percent, compared to 20 percent for Norway.

This, despite what some in frustration have called, a tinkering with the system - changes to the Criminal Code requiring judges to consider sanctions other than incarceration, for all offenders but particular attention to the circumstances of Indigenous offenders, following the 1999 decision by the Supreme Court of Canada in Regina vs. Gladue; a decision that should have changed incarceration patterns.

It is considered tinkering because it would again require the Supreme Court, in 2012, through the decision on Regina vs. Ipeelee, to remind the judiciary that they were mandated to follow the legislation and decision in Gladue.

Among the provinces in 2016/2017, Aboriginal adults accounted for the largest proportion of admissions to custody in Saskatchewan (seventy-six percent) and Manitoba (seventy-four percent).

These are the cold impersonal numbers of broken and failed lives that contribute to, and conceal far more tragic consequences. They are the mathematical impersonalization of systemic institutionalization.

Statistics can impersonalize even the worst human tragedies, and news reports have not been short on the tragic consequences of desperation reflected in instances of First Nations suicides.

For decades the suicide rates among First Nations, Inuit, and Métis people in Canada have been alarmingly higher than for the rest of Canadians. These suicides, in small and closed knit communities with close family ties, result in immense grief, bereavement, stigmatization and despair, particularly when the loss is of a young person.

In the spring of 2016 the remote Manitoba community of Pimicikamak Cree Nation, known as Cross Lake declared a state of emergency after six suicides within two months and 140 attempts within a two weeks period.

During the summer of 2019 the God's Lake First Nation, about 550 kilometres northeast of Winnipeg, experienced a rash of suicides that left four young people dead, twenty-two attempted suicides, and an epidemic of meth and alcohol addictions.

While these statistics may come as a surprise to some, they have been the tragic reality faced by First Nations communities across Canada for decades. There is a sense of helplessness in the statements of chiefs and elders struggling to alleviate the deep pain and isolation felt by their young peoples. There is a sense of deep caring and desperation in their calls for help, repeated across the country.

The new report on Indigenous suicide in Canada, released at the end of June, is aimed at providing a comprehensive picture of the crisis, unfortunately limited to the data collected during as part of the 2016 census and, therefore, is already four years and many lives short.

The ongoing impacts of disproportionate sentencing, forced placement of children in foster care, removal of young men and women from healthy social development, and deprival of employable skills and opportunities today continues to perpetuate the impact of the "Sixties scoop" and forced relocation of communities of the past. Impacts of which will continue to be transmitted and inherited by young people not yet living.

Given these statistics, how can one possibly be surprised with disproportionately higher suicide rates among First Nations peoples?

The Assembly of First Nations National Chief, Perry Bellegarde, notes: "The time is now for bold vision and decisive action." Perhaps it is not asking too much to expect the religious institutions that so energetically took to saving souls through assimilation to now respond as energetically to saving lives. A new bold vision must focus our gaze towards countries like the Netherlands where since 2014, twenty-three prisons have been shut, turning into temporary asylum centres, housing and hotels.

Big bureaucracy and billions spent on corrections has not offered the solutions other jurisdictions have achieved.

Michael Ferguson's report in 2016, four years ago referenced to an additional ten-year period prior to that during which little or no progress had been achieved with regards to First Nations issues:

There is nothing that should be more important to a society than the care and safety of its children; a universal value across race, class, religion or status. The reality is that this value has been conditional on those children being of ones' own community. Children of others should not seem to mean less.

More than ever we need a problem-solving mindset to develop solutions built around people instead of defaulting to litigation, institutionalization, and simply spending more money without meaningful outcomes.

Federal, provincial, and local governments need to strengthen partnership with Indigenous organizations to develop strategies to recruit, retain and train Indigenous partners to support wider access to mental health services. At the same time communities themselves need to widen support and long-term capacity, building in health and mental health responses and to expect meaningful and transformative change.

There can be no solution without federal and provincial departments, and the Assembly of First Nations working together to bring about meaningful educational, healthcare, and social support systems that provide support on a per community based approach; for developing strategies that recognize different needs for different communities and for distinct measures.

Perhaps most crucially, communities also need to look for a helping hand at the end of their arms, grass roots movements, that are no longer willing to let governments and politicians get away with the easy solutions - payouts and promises without real solutions and outcomes.
Anil Anand is a research associate with the Frontier Centre for Public Policy. Anil served as a police officer for 29 years; during his career some of his assignments included divisional officer, undercover narcotics officer, and intelligence officer. He has worked in Professional Standards, Business Intelligence, Corporate Communications, the Ipperwash Inquiry (judicial public inquiry), and Interpol.
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Mental wellness resources available for First Nations people, Métis and Inuit:
Hope for Wellness: Help Line: 1-855-242-3310

Live chat: www.hopeforwellness.ca

Kamatsiaqtut Help Line

Toll Free 1-800-265-3333

In Iqaluit 1-867-979-3333

Kids Help Phone

Toll Free 1-800-668-6868

Text 686868 (no data plan, internet connection, or app required)

Live chat: www.kidshelpphone.ca

Indian Residential Schools Crisis Line: 1-866-925-4419

Additional resources: Suicide prevention www.canada.ca/en/public-health/services/suicide-prevention.html

See Endnotes

Close Endnotes

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The Institutionalization and Suicide Crisis Among Indigenous Youth

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Statistics Canada's report on suicide among First Nations people, Métis and Inuit (2011-2016) released June, 2019, found that Indigenous people in Canada die by suicide at a rate three times higher than that for non-Indigenous Canadians.

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Missing and Murdered Indigenous Women and Girls
PDF Version
July 2017

Research and Statistics Division

Indigenous women represent 10% of the total population of missing women in Canada

According to the Missing and Murdered Aboriginal Women: 2015 Update to the National Operational Overview report by the Royal Canadian Mounted Police (RCMP), Indigenous women represent 10% (174) of the total population of women in Canada missing for at least 30 days reported by the Canadian Police Information Centre (CPIC) (1,750). Of these, 111 women were identified as missing due to "unknown" circumstances or foul play was suspected.

Proportion of Indigenous women homicide victims increased since 1991

Between 1980 and 2014, there were 6,849 police-reported female homicide cases in Canada. Among the total number of female victims, 16% were Indigenous women. Since 1991, the number of murdered non-Indigenous women has declined. In contrast, the number of murdered Indigenous women has remained relatively stable, thus accounting for an increasing proportion of Indigenous female homicide victims. For example, in 1980, Indigenous women accounted for 9% (18) of female homicide victims, whereas in 2014, they accounted for 21% (30) of female homicide victims. In 2014, the rate of homicide of Indigenous women (3.64 per 100,000) was almost six times higher than non-Indigenous women (0.65 per 100,000).

Higher homicide rate of Indigenous women in the territories

Between 2001 and 2014, the territories had a police-reported homicide rate for Indigenous women that was higher than the overall rate in Canada. The prairies also had a higher police-reported homicide rate of Indigenous women than the overall rate in Canada. The largest difference in police-reported homicide rates between Indigenous women and non-Indigenous women was in the Yukon (12 times higher for Indigenous women) and in Saskatchewan (11 times higher for Indigenous women).

Half of the homicides of Indigenous women were committed by a family member

Of the total solved homicide cases of Indigenous women between 1980 and 2014, half (53%) were committed by a family member, a quarter (26%) by an acquaintance and 8% by strangers. The 2014 homicide survey found that fewer homicides of Indigenous women occurred in a residence (66%) compared to non-Indigenous women (88%). In addition, 17% of homicides of Indigenous women occurred on a street, a road, or a highway compared to 1% of non-Indigenous women.

Footnotes

Footnote 1

Footnote 2

Miladinovic, Z., and Mulligan, L. Homicide in Canada, 2014. Juristat. Statistics Canada Catalogue no. 85-002-X. 2015.

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Department of Justice Canada's Internet site

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In Canada, official statistics have consistently documented at the national level what is highlighted above in the Intimate Femicide in Ontario study: Indigenous women are significantly more likely to be killed by male partners than non-Indigenous women in Canada. In fact, Indigenous women and girls are overrepresented as victims of femicide more generally. For example, about four percent of the Canadian population is Indigenous and female yet they represented 24 percent of homicide victims in 2015. Despite their higher risk of intimate femicide, however, some research shows that Indigenous women and girls are also often killed by male acquaintances and strangers.

This fact was brought to light by the Sisters in Spirit grassroots initiative launched in 2005 by the Native Women's Association of Canada (NWAC) who documented that, by 2010, over 580 Indigenous women and girls across Canada were murdered or went missing. Among the findings was that Indigenous women and girls were more often killed by male acquaintances or strangers than by male partners, although official statistics indicate that they remain eight times more likely to be killed by male partners than non-Indigenous women.

The initial estimate of femicide documented by the grassroots initiative has risen to almost 1,200 since the Royal Canadian Mounted Police (RCMP) began investigating the issue following the Sisters in Spirit campaign. After repeated calls for an inquiry into the treatment of Indigenous women and girls, the Canadian government launched the National Inquiry into Missing and Murdered Indigenous Women and Girls in 2016. The mandate is to report on systematic causes of all forms of violence against Indigenous women.

The Sisters in Spirit initiative highlighted various systemic issues including the impunity of many of the perpetrators, similar to what is being documented in other world regions. Their study found that nearly half of the cases involving indigenous women and girls remain unsolved and no charges were laid in about 40 percent of the cases. These figures continue to be contested and debated by others, including the RCMP, who reported clearance rates that were much higher, ranging from 80 to 100 percent. The proportion of those that resulted in charges or convictions is not currently known.

Regardless, it is now recognized, most recently in the inquiry's interim report, that the high risk of violence experienced by Indigenous women and girls stems, in large part, from a failure of police and others in the criminal justice system to adequately respond to, or provide for, the needs of Indigenous women and girls.

Femicide can be used to describe the killings of indigenous women and girls. Given the role of racialized violence and the documented impunity of some of the perpetrators, the term 'feminicide' which has become more common in Latin American countries may also be appropriate given that it is meant to capture the impunity of perpetrators and the inadequate state responses to these crimes. Because gender remains an important determinant of their risk of lethal violence in some contexts compared to Indigenous men, femicide has been used to describe these killings.

[For example, http://www.independent.co.uk/news/world/americas/canadas-femicide-epidemic-brings-calls-for-inquiry-9687855.html]

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Murdered and Missing Indigenous Women and Girls

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In Canada, official statistics have consistently documented at the national level what is highlighted above in the Intimate Femicide in Ontario study: Indigenous women are significantly more likely to be killed by male partners than non-Indigenous women in Canada. In fact, Indigenous women and girls are overrepresented as victims of femicide more generally.

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A United Nations report is highlighting the role "abhorrent" housing conditions play in the poverty and exploitation that Indigenous people face in Canada and around the world.

The report, presented to the UN General Assembly on Friday, examines the lack of access to secure housing both in cities and on reserves and its effect on the rights of Indigenous people in countries including Canada, Australia and Tanzania.

"The Special Rapporteur finds that housing conditions for Indigenous peoples around the world are overwhelmingly abhorrent and too often violate the right to adequate housing," the report reads.

"(Indigenous people) are more likely to suffer inadequate housing and negative health outcomes as a result, they have disproportionately high rates of homelessness and they are extremely vulnerable to forced evictions, land-grabbing and the effects of climate change."

Leilani Farha, the UN special rapporteur on adequate housing, noted that housing shortages are severe enough in Canada's North that some people in Indigenous communities are forced to sleep in shifts.

"There's 15 people living in a home that's the size of a trailer, so of course they have to sleep in shifts when there's only so much room," she said.

The report also highlights poor water systems on many Canadian reserves.

"In a country with more fresh water than anywhere else in the world, 75 per cent of the reserves in Canada have contaminated water, with communities such as Attawapiskat declaring a state of emergency," it reads.

The report also says Indigenous people in Canada and around the world who live in urban areas deal with racism from landlords, presenting another hurdle to accessing housing.

The report linked a lack of housing as a factor that exacerbates Canada's ongoing problem of missing and murdered Indigenous women.

"Lacking secure, adequate housing, Indigenous women often become the targets of further violence because of their gender and their Indigenous identity," it says.

Farha said one of the main goals of the report was to link the UN's Declaration on the Rights of Indigenous People (DRIP) to the UN's legislation on the right to adequate housing.

"The right to housing under international human rights law is something that is legally binding on governments in Canada," said Farha. "That's really important because the UN's DRIP isn't a legal instrument in the way that the treaty for the right to housing is."

She said she hopes making that connection will put more pressure on the Canadian government to act on issues that predominantly affect Aboriginal people.

Farha said Indigenous people -- and particularly Indigenous women -- should be involved in the development of strategies to tackle housing shortages.

"I think governments around the world need to completely alter their relationship with Indigenous peoples and really recognize their self-determination and admit that there are ongoing wrongs that needs to be addressed," she said.

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An abandoned house is shown on the Pikangikum First Nation, Friday, January 5, 2007. THE CANADIAN PRESS/John Woods

United Nations human rights experts Leilani Farha (left) and Catarina de Albuquerque listen to questions during a news conference in Detroit, Monday, Oct. 20, 2014. THE CANADIAN PRESS/AP/Paul Sancya

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UN report highlights 'abhorrent' housing conditions for Indigenous people

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A United Nations report is highlighting the role "abhorrent" housing conditions play in the poverty and exploitation that Indigenous people face in Canada and around the world. The report, presented to the UN General Assembly on Friday, examines the lack of access to secure housing both in cities and on reserves and its effect on the rights of Indigenous people in countries including Canada, Australia and Tanzania.

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Funding for Social Services

Historically, the federal government has been responsible and provided funding for nearly all the social programs and services provided to Indigenous peoples in Canada. First Nations peoples registered with Indian status receive federal funds for social programs on reserves through the . The funding is directed to First Nations band administrations. In the past, discriminatory sections in the Indian Act have prohibited some people, particularly women who married non-status men, from accessing social services. ( See also Women and the Indian Act.) Inuit, Métis and non-status First Nations peoples receive funding through the department of Indigenous Services Canada, created in 2017.

National, provincial and territorial Indigenous representative organizations such as the Assembly of First Nations, Métis National Council, Congress of Aboriginal Peoples and the Inuit Tapiriit Kanatami often have mandates that include the improvement of social conditions and represent or advocate for the interests of their members. Many of these organizations receive funding from the federal government. Friendship Centres (non-governmental agencies) also provide various programs and services to urban Indigenous peoples.

Indigenous Populations in Canada

In 2016, 1,673,785 people reported an Indigenous identity, making up 4.9 per cent of the Canadian population. Additionally, 977,230 people reported being First Nations (including status and non-status people), 587,545 reported being Métis, and 65,025 reported being Inuit. Since 2006, the Indigenous population has grown by 42.5 per cent. This represents a growth rate four times that of the non-Indigenous population.

The Indigenous population of Canada continues to be predominately urban. According to the 2016 census, 867,415 Indigenous people lived in a city of more than 30,000 people, accounting for over half of the total Indigenous population. During this same period, metropolitan areas with the largest Indigenous populations were Winnipeg (92,810), Edmonton (76,205), Vancouver (61,460) and Toronto (46,315).

Income Levels and Education

Former minister of Aboriginal Relations and Reconciliation Ida Chong with students of LÁU,WELNEW Tribal School in their home-economics classroom (23 November 2012).

In 2019, the rate of employment for Indigenous peoples in Canada (57.5 per cent) was lower than the non-Indigenous population (62.1 per cent). The rate for First Nations people (over 15 years old) was 53.8 per cent, 61.3 per cent for the Métis and 49.0 per cent for the Inuit. ( See also Economic Conditions of Indigenous People).

In comparison to non-Indigenous peoples, Indigenous peoples' income tends to be below the Canadian average. In 2016, the median after-tax income for non-Indigenous people was $31,144. For those who identified as First Nations, it was $21,253, for Métis, $29,068, and Inuit, $23,635.

In 2016, 68.3 per cent of the Indigenous population aged 25 to 64 had a post-secondary certificate, diploma or degree, compared to 70.4 per cent of the non-Indigenous population. Contemporary research has found that educational attainment rates and income are directly related. Indigenous educational programs are crucial to closing the income gap between Indigenous and non-Indigenous wage earners. ( See also Education of Indigenous Peoples in Canada.)

Housing and Living Conditions

Modern cabin and tent (28 April 1997).

In 2016, one in five Indigenous people (19.4 per cent) lived in a dwelling that required major repairs, compared to 6 per cent of the non-Indigenous population. Mould, bug infestations, inadequate heating and contaminated water ( see also Grassy Narrows) are just some of the issues that plague First Nations peoples living on reserves.

Overcrowding is another issue affecting Indigenous living conditions. In 2016, 18.3 per cent of Indigenous people lived in overcrowded housing, compared to 8.5 per cent of the non-Indigenous population. In the same year, 40.6 per cent of Inuit and 8.6 per cent of Métis lived in housing that was crowded. The number of First Nations people living in a crowded dwelling on reserve (36.8 per cent) was higher than First Nations people living elsewhere in Canada (18.5 per cent).

Health of Indigenous Peoples

Indigenous woman [on left is Doris Tait] bandaging the arm of another woman in the Community Health Workers Training Program, Coqualeetza, British Columbia.

© Government of Canada. Reproduced with the permission of Library and Archives Canada (2020). | (courtesy Library and Archives Canada/Department of Health fonds including the former Department of National Health and Welfare fonds/e010969197)

The overall health of Indigenous people has improved in recent years; however, it continues to lag behind the overall population. For example, life expectancy can be 10-15 years shorter for Indigenous peoples and infant mortality rates can be two to four times higher. The tuberculosis rate for Inuit is over 290 times higher than non-Indigenous people.

Suicide rates among First Nations youth are around 5 to 6 times the national average, while Inuit youth rates are approximately 10 times the national average. The causes for high rates of suicide are multiple and may include depression due to social, cultural or generational dislocation; drug and substance abuse; or lack of housing, food and access to opportunity. ( See also Suicide among Indigenous Peoples in Canada).

Increased urbanization of the Indigenous population has resulted in a greater incidence of diseases characteristic of modern society, such as cardiovascular disease, cancers and type-II diabetes. Rates of HIV/ AIDS have increased. In 2016, there were 245 new HIV infections among Indigenous peoples, compared to 217 in 2014.

Proper access to health care is a concern in Indigenous communities. The case of Jordan River Anderson - a five-year-old Cree boy who died in hospital waiting for at-home treatment - demonstrates this point. ( See also Jordan's Principle.)

Food Insecurity

Inuit sharing frozen aged walrus meat (1 April 1999).

Indigenous households are more likely than non-Indigenous households to experience food insecurity. In 2019, 48 per cent of First Nations households did not have enough income to cover their food expenses. In comparison, the food insecurity rate for the country was 8.4 per cent.

People living in remote and northern communities have a more difficult time accessing and affording food. In Nunavut, for example, 46 per cent of households were affected by food insecurity in 2016. Access to certain foods such as fruit, vegetables and milk is more difficult because they must be transported long distances. The resulting high costs, limited availability and lower quality of the food contributes to food insecurity.

In some communities, the harvesting of traditional foods, such as seal, caribou, duck, whale and fish, helps to offset some of the issues accessing food. However, many communities continue to call on governments for increased support. ( See also Country Food (Inuit Food) in Canada.)

Criminal Justice System

Indigenous people are over-represented in the criminal justice system as offenders and inmates, and under-represented as officials, officers, court workers or lawyers. Rates of incarceration among the Indigenous population continue to increase. In 2016-17, Indigenous adults accounted for 27 per cent of admissions to federal correctional services, compared to 23.2 per cent in 2013. Over-represented in federal corrections facilities, Indigenous peoples make up 20 per cent of the total imprisoned population even though they only comprise 4.9 per cent of the Canadian population. Indigenous youth are also overrepresented in the correctional system. They account for 46 per cent of admissions in 2016-17, while representing 8 per cent of the Canadian youth population.

Several social factors have contributed to the over-representation of Indigenous people in the justice system. A history comprised of dislocation from traditional communities, disadvantage, discrimination, forced assimilation including the effects of the residential school system, poverty, issues of substance abuse and victimization, and loss of cultural and spiritual identity are all contributing factors. ( See also PTSD: Intergenerational Transmission of Trauma.)

In a landmark Supreme Court of Canada decision, the Gladue case in 1999 advised that lower courts should consider an Indigenous offender's background and make sentencing decisions accordingly, based on section 718.2 (e) of the Criminal Code. To date, many Indigenous-directed alternatives to incarceration in correctional facilities are being developed, including healing and sentencing circles. However, there are still many questions surrounding the unfair and inhumane treatment of Indigenous peoples in modern jails.

Because existing police forces are not always aware of the cultural differences and needs of Indigenous communities, Indigenous people began to develop their own police forces in the 1970s and 1980s. Indigenous police recruitment programs helped the RCMP and other police forces to add Indigenous constables to their staffs. In 1991, the federal government introduced the First Nations Policing Policy to meet the needs of Indigenous communities. While 62 per cent of officers in First Nations police services identified as Indigenous in 2018, Indigenous officers still only represent 4 per cent of police officers in Canada.

Indigenous Children and Families

In 2016, 60.1 per cent of Indigenous children under the age of four lived in a two-parent household and 34 per cent lived in a one-parent household. Comparatively, 86.2 per cent of non-Indigenous children lived in a two-parent household and 13 per cent lived with one parent.

Indigenous children are more likely to live in homes with grandparents. Among the Indigenous population in 2016, 21 per cent of First Nations, 11 per cent of Métis and 23 per cent of Inuit children under the age of four lived with at least one grandparent. Among the non-Indigenous population, 10 per cent of children aged four and under lived with at least one grandparent.

Since the 1960s, a large number of Indigenous children have been placed in care by social agencies. ( See also Sixties Scoop.) In 2016, Indigenous children made up nearly half of all children in foster care in Canada, even though they only made up 7 per cent of children in the country.

Improving Social Conditions

Progress with respect to social conditions is being achieved. However, the gaps that persist between the social and economic conditions of Indigenous people in Canada and those of the general Canadian population continue to pose challenges. Areas of particular social concern include housing, employment, education, health, justice and family and cultural growth. Many communities are implementing community-based strategies stressing the importance of history and culture; governance, culture and spirituality; unique qualities and values; the link between self-government and economic development; and the role and importance of traditional economies.

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Social Conditions of Indigenous Peoples in Canada

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Historically, the federal government has been responsible and provided funding for nearly all the social programs and services provided to Indigenous peoples in Canada. First Nations peoples registered with Indian status receive federal funds for social programs on reserves through the . The funding is directed to First Nations band administrations.

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Introduction

Housing is an issue of particular significance for the Aboriginal population in Canada. Many Aboriginal communities are located in northern and remote communities, where winter conditions are harsher and building supplies are more difficult to access and more expensive. Furthermore, the growth of the Aboriginal population-as highlighted in the infographic The Aboriginal population in Canada-has outpaced the rest of Canada. As a result, the housing conditions of Aboriginal peoples affect an increasingly large share of the population.

This article uses new data from the 2016 Census of Population to analyze the housing conditions of the Aboriginal population in Canada.

One in five Aboriginal people live in a dwelling that is in need of major repairs

Of the 1,673,785 people who reported an Aboriginal identity on the 2016 Census of Population, 324,900 lived in a dwelling that was in need of major repairs.

This group accounted for one‑fifth (19.4%) of the total Aboriginal population in Canada. In comparison, 6.0% of the non‑Aboriginal population reported living in a dwelling in need of major repairs.

One‑quarter (26.2%) of Inuit, 24.2% of First Nations people and 11.3% of Métis lived in a dwelling that was in need of major repairs in 2016. These proportions are down from 2011 by 3.6 percentage points for Inuit, 2.0 percentage points for First Nations people and 1.9 percentage points for Métis. Table 1 shows the percentage of First Nations people with and without registered or treaty Indian status, Métis and Inuit by condition of dwelling in 2016.

Aboriginal identity

Total - Condition of dwelling

Regular maintenance only

Minor repairs needed

Major repairs needed

percent

The proportion of Inuit living in a dwelling that needs major repairs is highest in Nunavut

The majority (72.8%) of the Inuit population lived in Inuit Nunangat in 2016. The proportion who lived in Inuit Nunangat were significantly more likely to live in a dwelling that was in need of major repairs than those who lived outside Inuit Nunangat (31.5% versus 12.2%).

The proportion of Inuit living in Inuit Nunangat who lived in a dwelling that needed major repairs declined by 4.1 percentage points from 2011 to 2016. This decline brought the proportion back to the level it had been in 2006.

Within Inuit Nunangat, the proportion living in a dwelling in need of major repairs was highest in Nunavut (34.3%), followed by Nunatsiavut (32.6%), the Inuvialuit region (31.8%) and Nunavik (23.9%).

The on‑reserve population is more likely to live in a dwelling in need of major repairs

Of the 977,230 First Nations people who lived in Canada in 2016, about one‑quarter (24.2%) lived in a dwelling in need of major repairs.

First Nations people with registered Indian status were more likely to live in a dwelling in need of major repairs than those without registered Indian status (27.4% versus 13.6%).

Among the 744,855 First Nations people with registered or treaty Indian status, 44.2% lived on reserve while 55.8% lived off reserve. There was a pronounced difference in the dwelling conditions of those who lived on reserve and those who did not. The proportion of First Nations people with registered or treaty Indian status who lived in a dwelling that needed major repairs was more than three times higher on reserve (44.2%) than off reserve (14.2%).

While the proportion of First Nations people who lived in a dwelling that needed major repairs was lower in 2016 than in 2011, among those living on reserve the proportion went up. The proportion of First Nations people with registered or treaty Indian status living on reserve who lived in a dwelling that needed major repairs rose by 0.8 percentage points. Five years earlier, in 2006, the proportion was roughly the same as the 2016 level.

Métis living in metropolitan areas are less likely to live in a dwelling in need of major repairs

One‑tenth (11.3%) of the Métis population lived in a dwelling that was in need of major repairs in 2016.

More than six in ten (62.6%) Métis lived in a metropolitan area of at least 30,000 people. Within these areas, the proportion of Métis who lived in a dwelling that needed major repairs was 9.7%. This was lower than the proportion who did not live in a metropolitan area of this size (13.9%).

In the western provinces, where the majority (59.7%) of the Métis population lived, the proportion of Métis living in a dwelling in need of major repairs was 10.8%.

The proportion of Métis who lived in housing in need of major repairs was 11.8% in the Atlantic provinces, Quebec and Ontario.

Métis were most likely to live in housing that was in need of major repairs if they lived in the territories (18.7%).

One in ten Aboriginal people live in housing with a one‑bedroom shortfall

In 2016, close to one‑fifth (18.3%) of the Aboriginal population lived in housing that was considered not suitable for the number of people who lived there, according to the National Occupancy Standard.Note 1 Housing suitability, a measure of crowding, refers to whether the dwelling has enough bedrooms for the size and composition of the household; households that are not in suitable housing are considered to be crowded.

Crowded housing is categorized into dwellings that have a one‑bedroom shortfall, a two‑bedroom shortfall or a shortfall of three or more bedrooms. Therefore a house with a one‑bedroom shortfall would require a single extra bedroom in order to adequately house the number of people who live there.

Just over one in ten (11.5%) Aboriginal people lived in housing with a one‑bedroom shortfall; 4.0% lived in housing with a two‑bedroom shortfall; and 2.8% lived in a dwelling with a shortfall of three or more bedrooms. While a lower proportion of the non‑Aboriginal population lived in housing that was crowded (8.5%), the distribution of the types of shortfalls was similar.

Inuit living in Inuit Nunangat are more likely to live in crowded housing

Two‑fifths (40.6%) of the Inuit population lived in crowded housing in 2016. While more than one‑fifth (22.2%) of Inuit lived in housing with a one‑bedroom shortfall, 11.1% had a shortfall of two bedrooms and 7.4% had a shortfall of three bedrooms or more.

The proportion of Inuit living in crowded housing declined by 2.0 percentage points from 2011 to 2016.

In 2016, Inuit living in Inuit Nunangat were more likely to live in crowded housing than those who lived elsewhere in Canada. Within Inuit Nunangat, half (51.7%) of the Inuit population lived in crowded housing. This was similar to the proportion in 2011 (51.6%). The proportion was 10.9% for Inuit living outside of Inuit Nunangat.

One‑fifth (20.6%) of Inuit living in Nunatsiavut and 28.6% of those living in the Inuvialuit region lived in crowded housing in 2016, while the highest levels of Inuit living in crowded housing were in Nunavik (52.0%) and Nunavut (56.4%).

Data table for Chart 1

Aboriginal identity

First Nations

Métis

Inuit

percent

One‑bedroom shortfall

13.9

6.8

22.2

Two‑bedroom shortfall

5.2

1.4

11.1

Three‑or‑more‑bedroom shortfall

4.0

0.4

7.4

One‑quarter of First Nations people live in crowded housing

One‑quarter (23.1%) of First Nations people lived in crowded housing in 2016. This figure was 2.5 percentage points lower than in 2011.

A higher proportion of First Nations people with registered Indian status than First Nations people without registered Indian status lived in crowded housing (26.6% versus 11.9%).

The proportion of First Nations people with registered or treaty Indian status living in a crowded dwelling was higher on reserve (36.8%) than off reserve (18.5%). On reserve, the proportion living in crowded housing was virtually unchanged from 2011 to 2016. Off reserve, the proportion went down by 3.5 percentage points from 2011 to 2016.

Métis in metropolitan areas are more likely to live in crowded housing

About one in ten (8.6%) Métis lived in housing that was crowded.

While Métis living in a rural area were the most likely to live in a dwelling that was in need of major repairs, those who lived in metropolitan areas of 30,000 or more people were most likely to be in housing that was crowded. In these metropolitan areas, 8.7% of Métis lived in crowded housing compared with 8.3% of those who did not live in such areas.

The lowest proportion of Métis living in crowded housing was in Quebec (4.8%). In the Atlantic provinces, 6.2% lived in crowded housing; while, in Ontario, this figure was 7.4%. In the western provinces, 9.9% of the Métis population lived in crowded housing, as did 11.4% of Métis in the territories.

Data sources
Methods
Definitions

Additional information

Additional analysis on Aboriginal peoples can be found in The Daily of October 25, 2017, and in the Census in Brief articles entitled Diverse family characteristics of Aboriginal children aged 0 to 4, catalogue no. 98‑200‑X2016020 and The Aboriginal languages of First Nations people, Métis and Inuit, catalogue no. 98‑200‑X2016022.

Additional information on the Aboriginal population can be found in the Highlight tables, Catalogue no. 98‑402‑X2016009; the Data tables, Catalogue nos. 98‑400‑X2016154 to 98‑400‑X2016180; the Census Profile, Catalogue no. 98‑316‑X2016001; and the Focus on Geography Series, Catalogue no. 98‑404‑X2016001.

An infographic entitled The Aboriginal population in Canada illustrates the demographic growth of the First Nations, Métis and Inuit populations, and touches on Aboriginal languages in Canada.

For details on the concepts, definitions and variables used in the 2016 Census of Population, please consult the Dictionary, Census of Population, 2016, Catalogue no. 98‑301‑X.

In addition to response rates and other data‑quality information, the Guide to the Census of Population, 2016, Catalogue no. 98‑304‑X, provides an overview of the various phases of the census, including content determination, sampling design, collection, data processing, data quality assessment, confidentiality guidelines and dissemination.

Acknowledgments

This report was prepared by Thomas Anderson of Statistics Canada's Social and Aboriginal Statistics Division, with the assistance of other staff members in that division, and the collaboration of staff members of the Census Subject Matter Secretariat, Census Operations Division, and Communications and Dissemination Branch.

Notes

Footnote 1.

The National Occupancy Standard (NOS) was developed by Canada Mortgage and Housing Corporation (CMHC) through consultations with provincial housing agencies.
Return to note 1 referrer

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Census in Brief: The housing conditions of Aboriginal people in Canada

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Housing is an issue of particular significance for the Aboriginal population in Canada. Many Aboriginal communities are located in northern and remote communities, where winter conditions are harsher and building supplies are more difficult to access and more expensive. Furthermore, the growth of the Aboriginal population-as highlighted in the infographic The Aboriginal population in Canada -has outpaced the rest of Canada.

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CBC News · Posted: Feb 06, 2007 12:19 PM ET | Last Updated: February 6, 2007

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Living conditions for First Nations ‘unacceptable’: Fontaine | CBC News

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First Nations people in Canada live in Third World conditions, with a lack of access to clean water and decent housing, the national chief of the Assembly of First Nations said Tuesday.

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Mental wellness resources and crisis help for First Nations people, Métis and Inuit
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Acknowledgments

We would like to acknowledge the review of preliminary findings and/or draft versions of the report by Indigenous organizations, including Inuit Tapiriit Kanatami, the Métis National Council, and the National Association of Friendship Centres, and federal departments including Indigenous Services Canada and Crown Indigenous Relations and Northern Affairs Canada. The analysis and the report were greatly strengthened by the suggestions and recommendations provided in the process. We also thank Jodie Golden, Public Health Agency of Canada ( PHAC) for reviewing the draft report for safe messaging.

Abstract

Suicide rates have consistently been shown to be higher among First Nations people, Métis and Inuit in Canada than the rate among non-Indigenous people; however, suicide rates vary by community, Indigenous group, age group and sex. The historical and ongoing impacts of colonization, forced placement of Indigenous children in residential schools in the 19th and 20th centuries, removal of Indigenous children from their families and communities during the "Sixties scoop" and the forced relocation of communities has been well documented. These resulted in the breakdown of families, communities, political and economic structures; loss of language, culture and traditions; exposure to abuse; intergenerational transmission of trauma; and marginalization, which are suggested to be associated with the high rates of suicide. While suicide among Indigenous people has been examined previously, studies were based on a decades-old cohort or used an area-based geozones approach. Past studies also examined suicides among only one or two Indigenous groups using the same methodology. Finally, they did not examine suicide among Indigenous people for some geographies such as on and off reserve, rural areas and small, medium and large population centres.

This article attempts to fill some of these knowledge gaps using the 2011 Canadian Census Health and Environment Cohort (CanCHEC), resulting from a record integration between the 2011 National Household Survey (NHS) and the Canadian Vital Statistics Database (CVSD). It presents suicide rates for the 2011 to 2016 time period among self-identifying First Nations, Métis, Inuit, and non-Indigenous people in private dwellings in Canada. It also explores the influence of socioeconomic factors in the disparity in risk of suicide between First Nations people, Métis, Inuit and non-Indigenous people in Canada.

Suicide rates among First Nations people, Métis and Inuit were significantly higher than the rate among non-Indigenous people. The rate among First Nations people (24.3 deaths per 100,000 person-years at risk) was three times higher than the rate among non-Indigenous people (8.0 deaths per 100,000 person-years at risk). Among First Nations people living on reserve, the rate was about twice as high as that among those living off reserve. However, suicide rates varied by First Nations band, with just over 60% of bands having a zero suicide rate. The rate among Métis (14.7 Note E: Use with caution deaths per 100,000 person-years at risk) was approximately twice as high as the rate among non-Indigenous people. Among Inuit, the rate was approximately nine times higher than the non-Indigenous rate (72.3 versus 8.0 deaths per 100,000 person-years at risk). Suicide rates and disparities were highest in youth and young adults (15 to 24 years) among First Nations males and Inuit male and females.

Socioeconomic factors, including household income, labour force status, level of education, marital status and geographic factors such as living on or off reserve (First Nations people) and community size (Inuit) accounted for a notable proportion of the disparity in risk of death by suicide among First Nations people (78%), Métis (37%) and Inuit (40%) adults, 25 years or older. However, due to limitations of the data, the role of other previously-identified factors such as historical and intergenerational trauma, community distress, cultural continuity, family strength and mental wellness were not explored here.

The findings from this study could contribute further to the understanding of suicide among First Nations people, Métis and Inuit in Canada, particularly with respect to the variability in suicide rates and socioeconomic factors associated with the disparity in suicide risk.

Introduction

First Nations people living on and off reserve, Métis and Inuit, die by suicide at a higher rate than non-Indigenous people. These suicides not only result in loss to family, friends and peers leading to immense grief and bereavement, but also to the community and society at large, in particular when the deceased is a young person. The impact of suicide is more widespread and severe in small Indigenous communities where many people are related and many experience similar personal and collective adversity.

The suicide rate for children and youth was previously reported to be 10 times higher among males and 22 times higher among females between 2005 and 2007 in areas with a high percentage of First Nations people compared with low-percentage areas. In Inuit Nunangat, the Inuit homeland made up of the Inuvialuit Region (northwest part of Northwest Territories), Nunavut, Nunavik (Northern Québec), and Nunatsiavut (Northern Labrador), the suicide rate among children and youth was 33 times higher than for the rest of Canada between 2004 and 2008. In fact, suicide is one of the leading causes of death among children and youth in areas with a high proportion of First Nations people and in Inuit Nunangat.

In adults, the suicide rates (1991 to 2006) among First Nations people and Métis have been reported to be twice as high as that among non-Indigenous adults. The suicide rate among adults in Inuit Nunangat (1999 to 2003) was four times higher than the rate among all adults in Canada; the disparity was greater among men than women.

It is important to note, however, that national level suicide rates may underestimate regional or community level differences. For example, previous reports have shown that suicide rates among First Nations youth in British Columbia range from 0 to 633 deaths per 100,000 people by tribal council. In fact, the majority of these tribal councils had a zero or very low suicide rate. A similar regional variance has been seen among Inuit communities in Nunavut. The suicide rate varied from under 50 deaths per 100,000 in Whale Cove to just over 250 deaths per 100,000 people in Qikiqtarjuaq.

Several representatives of Indigenous peoples and governments, communities and government agencies have developed programs, policies or strategies to address the high suicide rate among First Nations people, Inuit and Métis. Development and evaluation of these require timely data on suicide rates. Many existing estimates of suicide rates are based on an older cohort (1991 Census cohort), which excluded non-tax filers and those under 25, or are from studies that used an area-based geozones approach. The latter classified areas with higher proportions of First Nations residents as First Nations "identity areas" or examined mortality rate in Inuit Nunangat as a proxy for the rate among Inuit. These approaches may have led to under or over estimation of suicide rates. In addition, past reports have only estimated suicide rates among one or two Indigenous groups using the same methodology. Finally, there are gaps in knowledge of suicide rates among Indigenous people for certain geographical areas, including urban areas and on or off reserve.

This article presents suicide rates among self-identifying First Nations, Métis, Inuit and non-Indigenous peoples, who lived in private dwellings (i.e., excluding those who were in collective dwellings and institutions), for the 2011 to 2016 time period. These findings are based on the 2011 Canadian Census Health and Environment Cohort (CanCHEC), which was developed by integrating records in the the 2011 National Household Survey (NHS) and the Canadian Vital Statistics - Deaths Database (CSVD from 2011 to 2016). Suicides that occurred over the follow up period of 5.63 years (from Census day on May 10, 2011 to end of follow-up on December 31, 2016) were used to generate age-standardized and age-specific mortality rates. These are presented as estimated number of deaths by suicide per 100,000 person-years at risk. The person-year concept is often used in cohort studies and represents unit of time when individuals are at risk of dying, and can be roughly understood as persons per year. Specifically, the article (1) presents suicide rates among First Nations people, Métis and Inuit alongside comparisons with the suicide rates of non-Indigenous people to explore disparities, a better understading of which could inform prevention strategies, (2) presents the estimated proportion of First Nations bands that experienced no suicides as an estimate of the variability in suicide rates, and (3) explores the role of socioeconomic and geographic factors in explaining the excess mortality from suicide among the three groups.

Results

Suicide among First Nations people in Canada

In the current analyses, among the 851,280 First Nations people (based on population estimates using the 2011 CanCHEC and its weights), including status and non-status individuals, living on and off reserve and in private dwellings in 2011, an estimated 1,180 people died by suicide between 2011 and 2016. This resulted in an age-standardized suicide rate of 24.3 deaths per 100,000 person-years at risk (Table 1), which was three times higher than the suicide rate among non-Indigenous people (8.0). The suicide rate was higher among males than females (29.6 versus 19.5, respectively). This pattern is similar to that seen among non-Indigenous people among whom males (12.3) also had a higher suicide rate than females (3.9). However, these numbers indicate that the disparity in suicide rates - measured by dividing the suicide rate among First Nations people by that among non-Indigenous people (or rate ratios [ RR]) - between First Nations and non-Indigenous peoples is higher among females than males (RR = 5.0 among First Nations females and RR = 2.4 among First Nations males; Table 1).

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Suicide rates were highest among youth aged 15 to 24 (48.7; non age-standardized) (data not shown) when compared with other age groups. Suicide rates were lower among the older age groups. They were significantly higher among First Nations people than non-Indigenous people in most age groups under 45 years of age, but the disparities were widest among those under 15 years ( RR = 8.9) and 15 to 24 years ( RR = 6.3) (data not shown). This was particularly apparent among females between 15 and 24 years of age ( RR = 12.0; Table A.1 in appendix).

The suicide rate was nearly twice as high among First Nations people living on reserve than among First Nations people living off reserve (non age-standardized rate of 34.1 versus 19.5, respectively). Among on-reserve First Nations people, suicide rates were highest for males aged 15 to 24 years (78.8) (Chart 1). Rates were lower in the older age groups among both males and females on reserve (Table A.2 in appendix). Disparities were particularly elevated among 15 to 24-year-old First Nations females living on reserve ( RR = 15.8) in comparison to non-Indigenous females across Canada. Disparities were smaller in the older age groups, but continued to be seen until age 55 for females and age 45 for males. For those aged 55 and older, suicide rates were not statistically different between on-reserve First Nations and non-Indigenous people. A similar comparison to rates among First Nations people living off reserve was not done since most age-specific estimates were not published due to low cell counts or precision (table A.2 in appendix).

No significant differences were seen in the suicide rates among First Nations people (on and off reserve combined) by province and territory. However, in every province, the suicide rate among First Nations people was higher than the non-Indigenous rate (Atlantic provinces were grouped together to increase sample size; suicide rates were not reportable for the non-Indigenous population in Yukon, Northwest Territories and Nunavut). And, the rate ratios were notably higher in the Prairie provinces. It was 4.6, 4.5 and 3.5 in Manitoba, Saskatchewan and Alberta, respectively. In other provinces, it ranged from 1.9 to 2.6. Suicide rates did not differ significantly by type of population centre. It was 28.8 among First Nations people in rural areas, 22.9 Note E: Use with caution among those in small population centres and 18.8 Note E: Use with caution among those in large population centres. The suicide rate among First Nations people in each of these areas was significantly higher compared with non-Indigenous rates (9.3 for rural areas, 9.0 for small population centres and 7.2 for large population centres).

These national and provincial level estimates, while useful, underestimate the variability in the suicide rates among individual First Nations communities. Suicide rates were estimated at the band level using a geographic approach (for more details, please refer to the methods section). Of the just over 600 First Nations bands in Canada, 555 were associated with reserves that were enumerated in the 2011 NHS and with individuals in the CanCHEC cohort. Just over 60% of First Nations bands had experienced no suicides between 2011 and 2016. The proportion of bands without suicides, when examined in the context of the overall on-reserve suicide rate among First Nations people (34.1) highlights the obscuring of variability in the national level estimate. This proportion of bands with zero suicide rate varied by province and territory. A larger proportion of bands in the Atlantic provinces (55%), Ontario (71%), Saskatchewan (53%), British Columbia (78%), Yukon (80%) and Northwest Territories (74%) had zero suicide rates. In the other provinces, the proportion ranged from 39% to 44%. It should be noted that 31 reserves were incompletely enumerated in the 2011 Census many of which were in Ontario and Québec (a brief description of these reserves can be found in the methods section), and were not included in this analysis. Also, band members who did not live on their band's reserve at the time of the Census were not included in the analysis.

Socioeconomic factors have previously been shown to be associated with suicide among Indigenous people in North America. To examine if similar patterns were evident in the 2011 CanCHEC cohort, the role of individual socioeconomic factors such as household income, labour force status, level of education, marital status and geographic factors such as living on or off reserve on risk of death by suicide were examined for First Nations people aged 25 years or older. After adjusting for age and sex, the risk of suicide among First Nations adults was twice as high as that among non-Indigenous adults (hazard ratio [HR] = 2.0; Table A.4 in appendix). Adjusting for household income resulted in a decrease in risk by 35%. After further adjusting for labour force status, level of education and marital status, First Nations adults were still at a higher risk of suicide than non-Indigenous adults ( HR = 1.4). Together, these factors accounted for 66% of the excess suicide risk. Further adjusting for living on and off reserve resulted in a HR of 1.2, which was not significantly different from 1.0. Together, all these factors accounted for 78% of the excess suicide risk among First Nations adults.

Suicide among Métis in Canada

Based on the current analysis, of the 452,985 self-identifying Métis (based on population estimates using the 2011 CanCHEC and its weights) who lived in private households in 2011, approximately 415 individuals died by suicide in the 2011 to 2016 period. As a result, the suicide rate was 14.7 Note E: Use with caution deaths per 100,000 person-years at risk (Table 2), which was nearly twice as high as the rate among non-Indigenous people (8.0). The rate among Métis males (22.6 Note E: Use with caution ) was more than three times higher than the rate among Métis females (7.2 Note E: Use with caution ). The suicide rate was nearly twice as high among Métis (22.6 Note E: Use with caution ) as non-Indigenous males (12.3). However, the suicide rates for Métis (7.2 Note E: Use with caution ) and non-Indigenous females (3.9) were not significantly different from each other.

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Among the provinces and territories, because of low counts when broken down, suicide rates for Métis could only be generated for Ontario, Manitoba, Saskatchewan, Alberta and British Columbia combined (Ontario and west). In these provinces, the rate among Métis (13.4 Note E: Use with caution ) were higher than that among non-Indigenous people (7.6). Suicide rates among Métis in rural (16.5 Note E: Use with caution ), small (12.8 Note E: Use with caution ) and large population centres (15.5 Note E: Use with caution ) were not significantly different. The rate among Métis in large population centres was higher than the rate among non-Indigenous people (7.2; marginally significant). Suicide rates could not be published for medium population centres due to low cell counts.

Among Métis adults over 25, after adjusting for age and sex, the risk of suicide was twice as high as that among non-Indigenous adults (hazard ratio = 1.9; Table A.4 in appendix). Adjusting for household income, labour force status, population centre type of place of residence, level of education and marital status accounted for 37% of excess suicide risk. The risk of suicide was 1.6 times higher among Métis than non-Indigenous people after adjusting for these factors.

Suicide among Inuit in Canada

There were approximately 59,220 Inuit in Canada in 2011 who lived in private households (based on population estimates using the 2011 CanCHEC and its weights). Among them, there were an estimated 250 deaths by suicide between 2011 and 2016. This lead to a suicide rate of 72.3 deaths per 100,000 person-years at risk (Table 3). This was nine times higher ( RR = 9.0) than the suicide rate among non-Indigenous people (8.0). The suicide rate was three times higher among Inuit males than Inuit females (109.3 versus 35.4 Note E: Use with caution , respectively).

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Suicide rates among Inuit were highest in youth; the highest suicide rate was seen among Inuit males between 15 and 24 years of age (363.2; non age-standardized) living in Inuit Nunangat (Chart 2). Publishable estimates could only be produced for Inuit females between the ages of 15 and 24 and 25 to 34. Suicide rate among females 15 to 24 years of age was 108.9 Note E: Use with caution , which was 33 times higher than non-Indigenous females of that age (Table A.3 in appendix).

Rates among Inuit were also compared by Inuit Nunangat region. Rates were significantly higher among Inuit in Nunatsiavut (188.2 Note E: Use with caution ; non age-standardized) than those in Nunavik (98.1) and Nunavut (94.0). Rates among Inuit in Inuvialuit region could not be published due to low reliability of estimates.

The national, Inuit Nunangat and Inuit regional level estimates underestimate the variation in rates among individual Inuit communities. Among the 50 Inuit communities, 11 communities had a suicide rate of zero. However, for most communities (66%), estimates were too unreliable to be published. It should be noted that some deaths may not have linked to the NHS and others may not have been in Vital Statistics at the time of data integration. The latter shortcoming has previously been reported by Jack Hicks. These exclusions may have biased the estimate of number of communities without suicides.

In multivariate analyses, among Inuit adults 25 years and older, the risk of death by suicide was 4.8 times higher than the risk among non-Indigenous adults, after accounting for age and sex (Table A.4 in appendix). After further adjusting for household income, labour force status, level of education and marital status, the hazard ratio decreased to 3.4 suggesting that these factors accounted for 37% of the excess risk of death by suicide among Inuit. After adjusting for size of community (population centre type), Inuit adults were still at 3.3 times higher risk of suicide than non-Indigenous adults ( HR = 3.3). All combined, these factors accounted for 40% of the excess risk of suicide among Inuit adults.

Discussion

The report is the first to examine suicide rates among all three Indigenous peoples, including First Nations people, Métis and Inuit, of different age groups and living in different geographies using one methodology. However, gaps in knowledge remain. Further research is needed to assess long-term trends and estimate the role of other risk and protective factors of suicide among Indigenous peoples, which should be done in consultation with First Nations people, Métis and Inuit, as recommended by the Truth and Reconciliation Commission of Canada.

In the current analysis, the suicide rates among First Nations people, Métis and Inuit were many times higher than the non-Indigenous rate during the 2011 to 2016 time period. The rates were highest among Inuit and, specifically, adolescents and young adults. The suicide rate among First Nations people living on reserve was higher than that among those living off reserve, and among males than females. The higher suicide rate among males has been attributed to their tendency to use more lethal methods and to the differential effect of specific stressors in the two sexes. However, greater disparities were observed among First Nations females, where higher suicide rates were seen when compared with non-Indigenous females. These patterns are similar to what has been previously reported.

Of particular concern is the high rate of suicide among Indigenous children under 15. The suicide rate among First Nations boys, nationally, was four times higher than among non-Indigenous boys. It was ten times higher among First Nations boys living on reserve. As with other national trends, this rate may obscure regional differences. Previously reports have suggested that in some remote First Nations communities in Ontario, under-15 suicide rates were nearly 50 times higher than non-Indigenous rates. And, among Inuit communities of Nunatsiavut, the age-specific disparity was largest among 10 to 19-year-olds relative to their non-Indigenous counterparts outside Inuit Nunangat ( RR = 15.8). Also, rate of death by suicide among Inuit children 10 to 14 years of age appears to be increasing since 1989 although significant fluctuations are seen across time. In line with these rates among children, suicidal ideation among grade 5 to 8 school children in Saskatoon was nearly twice as high among Indigenous children as non-Indigenous children after accounting for mental health, cognitive abilities and bullying experiences. While risk factors for suicide among children are numerous and complex, a recent report suggests that Inuit children and youth in Nunavut experience a lack of mental health services that are specific to them, culturally relevant and of adequate quality.

And, while time trends were not examined here, suicide attempts among First Nations people in British Columbia have been reported elsewhere to be declining. Risk of self-inflicted injury hospitalization among Registered Indians, and disparity between them and their non-Indigenous counterparts decreased between 1991 to 2010. However, this is in contrast to trends in remote First Nations communities in Ontario. There, Indigenous youth suicide was previously reported to be on the rise because of the emergence of suicide among communities that previously did not experience it, exposure to suicide or suicide attempts among family members and peers, and increase in clusters of suicides.

Methods

Data

The 2011 Canadian Census Health and Environment Cohort (CanCHEC) used here is a population-based integrated dataset that follows the non-institutional (household) population enumerated in the 2011 National Household Survey (NHS) for different health outcomes such as mortality, cancer, and hospitalizations. Briefly, record integration for the 2011 CanCHEC was carried out using Statistics Canada's Social Data Linkage Environment (SDLE). The SDLE helps create linked population data files for social analysis through integration to the Derived Record Depository (DRD), a dynamic relational database containing only basic personal identifiers. Survey and administrative data are linked to the DRD using a generalized record integration software that supports deterministic and probabilistic integration.

The NHS is a voluntary survey, conducted in May 2011, of approximately 4.5 million (30%) private dwellings randomly selected from the 2011 Census of Population. The NHS covers all persons who usually live in Canada, including permanent and non-permanent residents, and individuals living on First Nations reserves, Métis settlements or Inuit communities. There were 36 incompletely enumerated First Nations reserves in the 2011 NHS. In 13 of these communities, enumeration was delayed because of forest fires in Northern Ontario and occurred at a later date. The NHS excludes residents of institutions (for example, hospitals, nursing homes, penitentiaries) and collective dwellings (for example, work camps, hotels, shelters).

Records for approximately 6.7 million NHS respondents were eligible for integration; 97% linked to the DRD using a probabilistic approach based on telephone number, surnames, given names, birthdate, and place of residence. No differences in integration rates were found by collection mode, province, sex, or birth decade. To ensure representativeness of the linked cohort, weights were calculated to adjust for non-integration.

To protect the confidentiality of Census respondents, data made available for analysis did not contain personal identifiers such as name, and address. In addition, estimates based on small cell counts (fewer than five deaths or fewer than 10 total individuals) were suppressed.

Variables

Self-reported Indigenous identity, age, sex, household income, labour force status, highest level of education, marital status and province of residence variables were available in the 2011 NHS dissemination dataset. Variables for the Inuit Nunangat regions were generated using Standard Geographical Classification (SGC) codes. Similarly, a variable for on and off-reserve areas of residence was generated using SGC. A binary suicide variable was created using ICD-10 codes in the "Underlying cause of death" variable in the CVSD. Generation of suicide and person-years at risk variables are described in the following section.

Estimation of weighted suicide rates

For suicide rate estimates, each person's time at risk of death by suicide was split into single years of follow-up, and within each year of follow-up, into durations before and after birth date. In the process, each person was aged on his or her birthday. This allows for the appropriate categorization into age groups for computing suicide rates. Weighted age-standardized suicide rates (ASMRs) (see figure 1 for a brief description of this measure) and their 95% confidence intervals were estimated. Those under the age of one were excluded from the analysis due to under-representation of this group in the integrated dataset. Briefly, ASMRs were computed by dividing the count of cohort members who died by suicide in the follow-up period by the total person-years at risk. Age standardization was done with age-specific mortality rates in 5-year age groups using the 2011 total Indigenous population as the reference population. Weighted age-specific suicide rates generated without age standardization were used for comparisons between age groups within an Indigenous group or between an Indigenous group and the non-Indigenous population. These rates were also used to compare suicide rates in the on and off-reserve First Nations populations since their age structures were somewhat similar in 2011 (median age: 23.9 and 27.1 years, respectively). Suicides were identified using the following International Statistical Classification of Diseases and Related Health Problems 10th Revisions ( ICD-10) codes: X60-X84, Y87.0. For each member of the cohort, person-years of follow-up were calculated as the number of days from the beginning of the study period to the date of death or end of study divided by 365.25. Variance was calculated using 500 bootstrap weights.

Description for Figure 1
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Figure 1 is a schematic showing the method used to estimate the suicide rate using number of deaths as the numerator and person-years as the denominator. The schematic illustrates a hypothetical example with seven individuals who were "followed" from May 10, 2011 (Census day) to December 31, 2016 (end of follow-up period) to see if they had died. In this example, three of the seven individuals died during follow-up. Person 1, 4 and 7, who died during the follow-up period, each contributed 3.0, 1.5 and 4.2 person-years at risk, respectively, to the denominator. The others, who were alive as of December 31, 2016, each contributed 5.6 person-years to the denominator. In all, the seven individuals contributed 31.1 person-years to the denominator. The crude mortality rate is calculated by dividing the number of deaths by the total person-years contributed by the seven individuals, and multiplied by 100,000. In this hypothetical example, the crude suicide-related mortality rate is 9,646.3 deaths per 100,000 person-years of follow-up.

Age-standardized and age-specific suicide rates, expressed as the number of deaths by suicide per 100,000 person-years at risk, were generated by sex, Indigenous identity and select geographic areas. Indigenous identity, as self-reported in the 2011 NHS Survey, included: First Nations, Métis, Inuit, Multiple Indigenous identity, Indigenous identity responses not indicated elsewhere and non-Indigenous. However, in this paper, only estimates for single identity groups are presented. Geographic areas studied include: province/territory; on or off-reserve; rural areas or small, medium and large population centres, and for Inuit, inside/outside Inuit Nunangat and by the four regions of Inuit Nunangat (Nunatsiavut, Nunavik, Nunavut, and the Inuvialuit region), as well as outside Inuit Nunangat. Rate ratios, or the ratio of suicide rate among First Nations people, Métis or Inuit over suicide rate among non-Indigenous people were computed to examine the magnitude of disparity in the Indigenous group compared to the non-Indigenous population. To estimate variance of the rate ratios, variance and covariance of the mortality rates in the Indigenous group of interest and non-Indigenous population were estimated using PROC RATIO in SAS-callable SUDAAN. Variance of the rate ratios was then computed using Taylor linearization and the variance and covariance estimates from PROC RATIO, and used in generating 95% confidence intervals.

Hypothesis testing was done to identify suicide rates that were significantly different from one another using p<0.05. The weighted number of suicides and suicide rates were not published if (1) the unweighted number of suicides in a cell was less than five, (2) the weighted population count in the cell were less than 10, or (3) coefficient of variance (CV) was greater than 33.3% (40% for those under 15 years). Weighted numbers of suicides were also randomly rounded to base five. ASMRs with CV greater than 16.6% and less than or equal to 33.3% are presented with an "E" to indicate that these should be used with caution.

Estimation of suicide rate by First Nations band

For estimating suicide rates by First Nations band, reserve CSDs associated with each band were grouped. Reserves that were shared by multiple bands were grouped separately. This was done for seven reserves. Three of these had a population of 10 or less. And, one was incompletely enumerated in the 2011 NHS. This grouping resulted in about 600 First Nations bands. Of these, 561 included individuals that were in the 2011 CanCHEC. Others were associated with reserves that were incompletely enumerated in the 2011 NHS or had participated in the 2011 Census and not the NHS. In the end, 555 bands were included in the analysis. Suicide rates were computed by First Nations band, from which the number and percentage of bands with a reportable zero suicide rate were identified. The percentage of bands with a zero suicide rate were calculated with and without the reserves that were associated with multiple bands and were found to be similar.

Multivariate analysis

To examine the role of socioeconomic and geographic factors in the excess risk of suicide among Indigenous people relative to non-Indigenous people, Cox proportional hazards modelling was performed. Analyses were restricted to those 25 years and older to allow for the use of labour force status, level of education and marital status as covariates. For this analysis, age at baseline on Census day, was used since other covariates also had the same reference period. Hazard ratios for suicide were estimated among First Nations people, Métis and Inuit (with non-Indigenous people as the reference group). Covariates were entered sequentially into the model in this order: age group together with sex, household income quintile (based on after-tax income adjusted for economic family size), labour force status (employed, unemployed and not in the labour force), highest level of education (less than high school, high school, post-secondary education below Bachelor's level and university degree), marital status (never legally married or single, legally married and not separated, separated but still legally married, divorced or widowed) and living on or off reserve (for First Nations people) or in population centres or rural areas (for Métis and Inuit). Household income quintiles were generated for each province and territory separately to account for regional differences. In secondary analysis, household income was used as a continuous variable or household income quintiles were generated at the national level and used in place of the original income quintile variable to examine the robustness of the influence of this predictor on the relative risk of death by suicide among First Nations people, Métis and Inuit. Covariates were chosen based on previous literature on the relationship between socioeconomic factors and suicide. and the availability of related variables in the 2011 NHS data.

From the hazard ratios (age and sex-adjusted and additionally adjusted for socioeconomic factors), the percent of excess risk of suicide among First Nations, Métis and Inuit people accounted for by household income, labour force status, highest level of education, marital status and geography was computed. The proportion of excess mortality explained was calculated as the difference between the age and sex-adjusted and the final hazard ratios, divided by the former minus 1. Analyses were not carried out separately by sex due to sample size limitations.

Assessing validity of suicide rates

Suicide rates based on the linked 2011 CanCHEC cohort were compared with previously generated estimates using different methodologies to assess validity.

The non age-standardized suicide rate for the total population of Canada between 2009 and 2013 was previously estimated to be 11.4 deaths per 100,000 people; in comparison, in the CanCHEC cohort, the overall suicide rate was 10.5 deaths per 100,000 person years between 2011 and 2016. While there are no published rates of suicide for First Nations people, Métis and Inuit for the 2011 to 2016 period, suicide rates for all individuals in Inuit Nunangat, which is home to 73% of Inuit in Canada, was previously estimated to be 83.5 deaths per 100,000 people. In the 2011 CanCHEC cohort, the rate was 83.5 deaths per 100,000 person years at risk. However, the estimates by Inuit Nunangat region between 2011 and 2016 (167.3 Note E: Use with caution in Nunatsiavut, 87.5 in Nunavik and 83.1 in Nunavut) were somewhat different in comparison to previous estimates from the 2009 to 2013 period (185.4, 98.3, 79.0, respectively). While, the estimates are similar, there are several potential reasons for this discrepancy between the two sets of estimates. While there is some overlap in time periods for the two estimates (2009 to 2013 for previous estimates and 2011 to 2016 for the estimates in this report), they are not identical. There is some year-to-year fluctuation in suicides rates. For example, in Nunavut, previous estimates suggest that the rate ranged from 58.2 to 108.5 deaths per 100,000 people. Some deaths that occurred between 2011 and 2016 were not linked to the 2011 NHS. Also, the CanCHEC cohort excludes institutional population (e.g., nursing homes, jails), and those living in collective dwellings (e.g., motels, hotels, rooming houses) at the time of census collection and those that were not enumerated by the 2011 NHS. The denominators used in the two studies are also different; in the previously published tables, the suicide rates are per 100,000 people; in the current study, the rates are per 100,000 person years.

Limitations

Several limitations of the analysis should be noted. Suicide rates presented in this article may underestimate the true rates because of (1) exclusion of the institutional population and population living in collective dwelling, (2) exclusion of persons not enumerated by the 2011 NHS including the homeless among whom Indigenous people are overrepresented, (3) non-integration of some deaths between 2011 and 2016 to the 2011 NHS, (4) potential integration error, (5) potential misclassification of suicides in the CVSD to avoid stigmatization or as a result of misclassification as an accident, or inability in ascribing a cause, etc., and (6) potentially missing deaths, due to processing delays, in Vital Statistics at the time of data integration. Furthermore, Indigenous identity in the Census is self-reported, which may have led to underestimation or overestimation of suicide rates in some Indigenous groups. Also, 36 Indian reserves and Indian settlements were incompletely enumerated in the 2011 NHS, which could have resulted in under or over-estimation of suicide rates. Most (29) of these reserves were in Québec and Ontario, with the rest in Saskatchewan, Alberta and British Columbia. Among the ones in Québec and Ontario, some are proximal to Census Metropolitan Areas (CMA) while others were rural or remote. The former includes Kahnawake, Kanesatake and Wendake. Mortality rates for small areas and small subgroups of the population may experience substantial year-to-year random fluctuations since death is a relatively rare event, particularly death by suicide. Finally, baseline socioeconomic and demographic factors used in the multivariate analysis may not reflect conditions at the time of death. This may have led to some biases in the findings.

Appendix

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Suicide among First Nations people, Métis and Inuit (2011-2016): Findings from the 2011 Canadian Census Health and Environment Cohort (CanCHEC)

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The article presents suicide rates for the 2011-2016 time period among self-identifying First Nations, Métis, Inuit, and non-Indigenous people in private dwellings in Canada. It also explores the influence of socioeconomic factors in the disparity in risk of suicide between First Nations people, Métis, Inuit and non-Indigenous people in Canada.

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Create a new document and edit with others at the same time -- from your computer, phone or tablet. Get stuff done with or without an internet connection. Use Docs to edit Word files. Free from Google.

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For decades, the suicide rates among First Nations, Inuit and Métis people in Canada have been many times higher than for the non-Indigenous population.

Recent estimates suggest that suicide rates among Indigenous peoples in Canada are at least three times higher than non-Indigenous peoples. For Inuit people specifically, the rate is 9 times higher.

Many Indigenous communities have declared states of emergency over the suicide crisis. In 2016, the First Nation of Attawapiskat received international media attention after it declared a state of emergency following nearly a dozen suicide attempts in one night, including one by an 11-year-old. In the months before that, there were 100 other suicide attempts.

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This August, God's Lake First Nation declared a state of emergency after four young people died by suicide. There had been dozens of suicide attempts all summer in the northern Manitoba community of around 1,500 people.

"We must develop a comprehensive plan in partnership with the federal government, otherwise the crisis will continue, and we will continue to experience tragedy and trauma," said God's Lake Chief Gilbert Andrews at the time.

Ahead of the federal election, First Nations leaders and health advocates are urging parties to prioritize this issue and are reflecting on the ways it was addressed over the last four years by the previous Liberal government.

"There is no silver bullet for suicide prevention," said Carol Hopkins, executive director of the Thunderbird Partnership, which specializes in addictions and mental health advocacy for Indigenous Peoples.

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She said that a number of mental health and suicide prevention initiatives have been pursued under the Liberal government but that gaps in funding and oversight remain a significant barrier to making lasting progress.

READ MORE: Andrew Scheer rejects use of 'genocide' in reference to Indigenous women, girls

It also pledges to implement the NDP motion previously passed by the House of Commons on suicide prevention.

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It also says the party would "take action to implement" the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) by the end of 2020.

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Scheer also told reporters in September that he will support a national suicide crisis strategy.

Hopkins said there are many pilot projects and research efforts on the suicide crisis funded by levels of government, but many are short term. This poses a problem.

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"We have tons of evidence about what works," she said. "But we don't have sustainable funding and flexible funding to put those things into place."

There needs to be a change in philosophy by the government to recognize that Indigenous Peoples "are not optional" and that "our needs are not optional," Hopkins said.

Because the suicide crisis is directly linked to the violent history of colonization and ongoing policies stemming from it, Hopkins said it's important to situate the high suicide rates - and solutions - in that broader context.

"We have to shift our focus and understand that we have to invest in the environment as well as we are investing in the problems of the people," Hopkins said. "It's also understanding the problems that they have with the environment around them that sustains the depression, the anxiety and the decision that leads to suicide."

"If we invest in interventions that are focused solely on the individual, then we're not going to make any difference at all," she said.

She said initiatives such as the campaign, modelled after It Gets Better, is a good example of positive work being done. We Matter is a website created in 2016 by and for Indigenous youth, where people can share stories of hardship and also support. We Matter also has toolkits for Indigenous youth, teachers and other support workers to address mental health challenges.

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READ MORE: Liberals benefited from record Indigenous voter turnout in 2015. Can they again?

Hopkins also pointed to a lack of good data on the issue of Indigenous suicides. There's a lack of co-ordination and consistency of data collection on this issue, and Canada doesn't break suicide numbers down by Indigenous identity.

"We see these crises pop up every now and again because Indigenous leadership and government have tried to follow the path to explore partnerships for funding, and following that path has not yielded enough results to get a significant impact. And so they're constantly treading water to try and save their future there," Hopkins said.

Hopkins added she would also like to see governments support Indigenous people with their own data collection.

"We don't even know the whole true picture because of the lack of data," Hopkins said. "My question is what's high enough? What's the number? When does that number and that data trigger change?"

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The report situates the crisis within the "historical and ongoing impacts of colonization, forced placement of Indigenous children in residential schools ... removal of Indigenous children from their families ... and the forced relocation of communities."

It also highlights some positive trends discovered within the data, including the fact that more than 60 per cent of First Nations bands had a zero suicide rate. Further, several "resiliency factors" are linked to lower suicide rates within Indigenous communities, specifically "cultural continuity."

This can happen when a high proportion of the community has knowledge of an Indigenous language or when communities "gain control over educational, health care, police and fire services" and establish cultural facilities.

READ MORE: Indigenous communities and water crises - is a real solution in the works?

Alvin Fiddler is the grand chief of Nishnawbe Aski Nation (NAN), which represents 49 First Nations communities in northern Ontario spanning roughly two-thirds of the province - a population of about 45,000 people.

NAN began tracking suicides in its communities when the deaths began to rise in the mid-1980s - t he total since then has reached more than 500. Fiddler told Global News that NAN loses about 18 youth and adults per year to suicide. In 2017, that number jumped to around 38.

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He said there are a number of suicide prevention initiatives taking place that seem to be bringing about positive changes. But he said they need more permanent solutions and sustainable funding.

"It cannot just be one year or two years," Fiddler said.
READ MORE: God's Lake First Nation declares state of emergency after string of suicides
He also pointed out that a significant factor in discussing solutions to the suicide crisis is the conditions in the communities.

"There's a lot of challenges around infrastructure," he said.

"We're looking at the parties that are running in this election, what sort of platform, or what are they saying about infrastructure on reserve? Are they committed to improving quality of life, making investments on housing and water, on infrastructure and broadband?" he said.

Fiddler referenced the UNDRIP and said implementing that declaration as legislation would be a good place to start on the journey of reconciliation.

"We haven't even, in my view, begun to really make or take any significant steps towards that. That would have been a really good signal, especially the children and youth, that the government is serious about addressing these issues."
If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help. Youth in crisis can contact Kids Help Phone at 1-800-668-6868 or the First Nations and Inuit Hope for Wellness Help Line at 1-855-242-3310.
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'Our needs are not optional': How federal leaders plan to address the Indigenous suicide crisis

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For decades, the suicide rates among First Nations, Inuit and Métis people in Canada have been many times higher than for the non-Indigenous population. Recent estimates suggest that suicide rates among Indigenous peoples in Canada are at least three times higher than non-Indigenous peoples. For Inuit people specifically, the rate is 9 times higher.