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The Missing and Murdered: Statistics and Demographics

There is a lot of disagreement about the number of missing and murdered Indigenous women and girls in Canada. The Royal Canadian Mounted Police (RCMP) acknowledged in a 2014 report that there have been more than 1,200 missing and murdered Indigenous women between 1980 and 2012. Indigenous women's groups, however, document the number of missing and murdered to be over 4,000. The confusion about the numbers has to do with the under-reporting of violence against Indigenous women and girls and the lack of an effective database, as well as the failure to identify such cases by ethnicity ( See Indigenous Women's Issues).

The Native Women's Association of Canada (NWAC) has drawn attention to figures from Statistics Canada documenting high rates of violence against Indigenous women. For example, Indigenous women 15 years and older were 3.5 times more likely to experience violence than non-Indigenous women, according to the 2004 General Social Survey. Violence against Indigenous women and girls is not only more frequent but also more severe. Between 1997 and 2000, the homicide rate for Indigenous women was nearly seven times higher than the rate for non-Indigenous women.

The demographics give a sense of the extent of the violence that Indigenous women and girls face across this country, but they fail to tell the stories of the deep trauma that this violence has on entire communities or the stories of children who have lost their mothers to senseless violence. The statistics cannot reflect the experiences of the families and communities who have lost a loved one. The missing and murdered Indigenous women and girls were mothers, daughters, sisters, aunties, cousins and grandmothers. Many were students completing post-secondary education, such as Loretta Saunders, an Inuk woman murdered at age 26 in 2014, who was completing her honours thesis on this very issue at the time she went missing. Some were only children, such as 14-year-old Azraya Acakabee Kokopenace and 15-year-old Tina Fontaine - who were both in the child welfare system at the time - or 16-year-old Delaine Copenace. This ongoing tragedy affects all Indigenous women and girls from all walks of life and throughout many communities and cities across Canada. Although some perpetrators are known to the victim, many are strangers.

Historical Context: Colonialism, Racism and the Sexualization of Women

Nick Printup, director and producer of the documentary Our Sisters in Spirit (2015), stated in a 2016 interview that "to begin to understand the severity of the tragedy facing Indigenous women today you must first understand the history." The issue of missing and murdered Indigenous women and girls in Canada is as old as the development of Canada itself and must be understood within the historical context of settler colonialism that has led to the ongoing racialization and sexualization of Indigenous women. Historically, Indigenous women were sexualized and held against dangerous cultural attitudes and stereotypes that permeate many facets of Canadian society today.

The late Mohawk poet Tekahionwake ( E. Pauline Johnson) wrote about these stereotypes 125 years ago. In an essay entitled "A Strong Race Opinion: On The Indian Girl in Modern Fiction," which was originally published in the Toronto Sunday Globe on 22 May 1892, Johnson spoke out about the images of the " Indian squaw" that were presented in mainstream literature. Similarly, in her book, Iskwewak - Kah'Ki Yaw Ni Wahkomakanak: Neither Indian Princesses nor Easy Squaws (1995), author Janice Acoose also drew attention to the racialized and sexualized legacy of settler colonialism that has led to an acceptance of violence. As Acoose noted, these colonial attitudes have justified many of the legally sanctioned policies that have targeted Indigenous women and families, such as the and residential schools. Other examples include the pass system (a process by which Indian agents approved passes for First Nations people to leave the reserve for whatever reason) and forced sterilization ( see Eugenics). These policies severely limited Indigenous women's livelihood by severing community ties and preventing Indigenous women's access to community resources and safety networks. Colonial attitudes also justified the mass removal of Indigenous children through policies of state apprehension, such as the Sixties Scoop, and this continues today in what is now referred to as the "Millennium Scoop." Violence against Indigenous women and girls in Canada today cannot be understood without first examining the effects of Canada's deep history of settler colonialism on Indigenous families and communities.

Amnesty International: A Call to Action

In October 2004, Amnesty International released a report called Stolen Sisters: A Human Rights Response to Discrimination and Violence against Indigenous Women in Canada, in response to the appalling number of Indigenous women who are victims of racialized and sexualized violence. This report was positioned as a call for action. Amnesty highlighted the stories of nine women, including Helen Betty Osborne (a Cree woman abducted and killed at the age of 19 by four white men in The Pas, Manitoba, in 1971) and her 16-year-old cousin Felicia Solomon, whose remains were found in the Red River in 2003. Amnesty shared some stories of the missing and murdered to bring clarity to the severity of the violence faced by Indigenous women. The report also noted a lack of comprehensive reporting and statistical analysis, and called for more police accountability, stating that Indigenous women are both overpoliced and under protected. Amnesty documented the social and economic marginalization of Indigenous women, noting that racism, poverty and marginalization, along with a lack of police protection, heighten Indigenous women's vulnerability to violence.

Tragically, since 2004, the numbers have continued to rise. Five years after the initial report, Amnesty International released No More Stolen Sisters: The Need for a Comprehensive Response to Discrimination and Violence against Indigenous Women in Canada. This report highlighted the following five key issues as reasons for the continued national tragedy of violence against Indigenous women:

The role of racism and misogyny in perpetuating violence against Indigenous women

Sharp disparities in the fulfilment of Indigenous women's economic, social, political and cultural rights

The continued disruption of Indigenous societies caused by the historic and ongoing mass removal of children from Indigenous families and communities

Disproportionately high numbers of Indigenous women in Canadian prisons, many of whom are themselves the victims of violence and abuse

Inadequate police response to violence against Indigenous women as illustrated by the handling of missing persons cases

In 2014, Amnesty presented a report to the Special Parliamentary Committee on Violence Against Indigenous Women entitled Violence against Indigenous Women and Girls in Canada: A Summary of Amnesty International's Concerns and Call to Action. This submission urged the federal government of Canada to take immediate action through a comprehensive approach to addressing violence against Indigenous women and girls in Canada.

Amnesty International has been instrumental in the push to launch a national public inquiry alongside Indigenous communities, women's groups and grassroots movements.

Native Women's Association of Canada: Sisters in Spirit Initiative

The Native Women's Association of Canada (NWAC) secured funds in 2005 from Status of Women Canada to research and provide awareness about violence against Indigenous women. With this funding, the Sisters in Spirit Initiative was launched. NWAC also developed a national database to track cases of violence against Indigenous women. Their work culminated in a final report entitled What Their Stories Tell Us: Research Findings from the Sisters in Spirit Initiative.

The report includes a framework for addressing and preventing violence against Indigenous women along with the stories of missing Indigenous women and recommendations for policy development. NWAC's prevention and safety policy includes tools for educating young Indigenous women and girls on safety issues and looks at risk factors that make Indigenous women vulnerable to violence, including poverty, homelessness and lack of affordable housing ( See also Social Conditions of Indigenous Peoples and Economic Conditions of Indigenous Peoples).

The need for police accountability and transparency, cultural sensitivity training and forming good relationships with Indigenous communities are other key areas highlighted in the report. NWAC also expressed a need for more research and awareness about various forms of violence, particularly violence perpetrated by strangers or acquaintances. The need for improvements in tracking and identifying cases of missing and murdered Indigenous women was another key area identified in the report. NWAC articulated that the violence experienced by Indigenous women is much higher than reported in government statistics and police-collected data. The report noted that about six out of ten incidents of violent crimes against Indigenous people go unreported and that demographic information is not always collected ( See also Demography of Indigenous Peoples).

The Legal Strategy Coalition on Violence Against Indigenous Women

The Legal Strategy Coalition on Violence Against Indigenous Women (LSC) was formed in 2014 following the murder of Inuk student Loretta Saunders. The coalition is a Canada-wide advocacy group that supports a national inquiry and seeks to bring justice to the families of missing and murdered Indigenous women. In February 2015, the LSC released a report in which it argued that over 700 recommendations made in 58 reports on missing and murdered Indigenous women and girls have been largely ignored by police and government.

RCMP Reports on Violence against Indigenous Women

In 2013, the commissioner of the Royal Canadian Mounted Police (RCMP) called for a report on missing and murdered Indigenous women to help guide operational planning. In May 2014, the RCMP released Missing and Murdered Aboriginal Women: A National Operational Overview. This report documented a total of 1,181 people - 164 missing Indigenous women and 1,017 Indigenous female homicide victims between 1980 and 2012. An updated report was released in 2015, entitled Missing and Murdered Aboriginal Women: 2015 Update to the National Operational Overview. This update documented an additional 11 Indigenous women identified as missing since the 2014 overview was conducted.

Prior to these reports, the RCMP's investigations of missing and murdered Indigenous women and girls had included a stretch of British Columbia's Highway 16, known as the Highway of Tears. While the RCMP acknowledges 18 murders and disappearances (mostly of Indigenous women and girls) in its list of Highway of Tears cases, dating from 1969 to 2006, Indigenous groups argue that this number is misleading because it reflects only the disappearances and murders that have happened in a specific geographic area, and that the real number in northern British Columbia exceeds 40.

Critique of RCMP Reports

Groups including Amnesty International and the Legal Strategy Coalition on Violence against Indigenous Women (LSC) critiqued the RCMP report for having critical gaps in the data. Amnesty noted that the 2015 update only included cases within the RCMP's own jurisdiction. Over 300 non-RCMP police agencies were included in the original 2014 report, but these were excluded from the update. According to Amnesty International, this means that missing and murdered Indigenous women and girls in Ontario and Québec, for example, were not included in the update. This is concerning given the mistrust and violence that has historically characterized Indigenous-police relationships. In the fall of 2015, eight officers from the Sûreté du Québec were suspended as a result of 14 allegations of abuse of power, sexual assault and other forms of assault against Indigenous women.

The LSC criticized the 2015 report for highlighting intimate partner violence as a risk factor, which places blame on Indigenous men and communities while failing to point out that many of the perpetrators are acquaintances or strangers.

Response from the Federal Government

Despite the ongoing push from Indigenous women and communities and human rights groups such as Amnesty International, the Canadian Feminist Alliance for International Action, Human Rights Watch and the UN Committee on the Elimination of Discrimination against Women, the federal government continued to dismiss the need to launch a national public inquiry. In fact, former prime minister Stephen Harper, speaking at Yukon College in Whitehorse in August 2014, following the death of 15-year-old Tina Fontaine - who was killed after she left her foster home - stated that violence against Indigenous women and girls in Canada should not be viewed as "sociological phenomenon." In other words, the Fontaine case was not part of a larger crisis resulting from a variety of racial, sexual and colonial abuses or socio-economic issues. Several months later, on 17 December 2014, during an interview with CBC chief correspondent Peter Mansbridge, Stephen Harper stated that a national inquiry on missing and murdered Indigenous women wasn't "really high on [the government's] radar."

Following the change in government in 2015, Prime Minister Justin Trudeau and the government of Canada launched a national public inquiry.

National Public Inquiry

Justin Trudeau gives a speech on missing and murdered Indigenous women in front of Parliament in Ottawa (October 2016).

On 8 December 2015, the Government of Canada announced plans for the launch of an independent national inquiry into missing and murdered Indigenous women and girls. The government pledged $53.86 million over the course of two years for the inquiry, and held a "pre-inquiry" to seek input from stakeholders across Canada. The inquiry was officially launched in September 2016. From the outset, the commission of inquiry was scheduled to provide a final report by 1 November 2018, outlining its findings and recommendations for steps forward.
Pre-Inquiry Findings
The first step of the investigation was a pre-inquiry process, which took place between December 2015 and February 2016. The goal was to receive input from groups including family members, Indigenous communities and front-line workers about the scope and structure of the inquiry. This process aligns with the inquiry's commitment to focus on the well-being of Indigenous families and to ensure the process is culturally appropriate. A summary of the feedback from the pre-inquiry process was published in May 2016. It included four recommendations:

The inquiry's leadership must be transparent, independent and representative of the Indigenous population. It was also recommended that Indigenous women should lead the inquiry. The investigation itself must be "sensitive to the needs of survivors, families and loved ones. Efforts must be made to avoid a long, drawn-out and legal process"

The inquiry must address various points of view and must hear from as many people and organizations as possible

A "broad approach to [the inquiry's] analysis of the issues" is important. The inquiry must take into consideration - and recommend solutions to - all of the socio-economic, cultural and political causes of violence against Indigenous women, girls, trans and two-spirited people. (See also Lesbian, Gay, Bisexual and Transgender Rights in Canada)

The inquiry must provide various forms of support to families and their allies. This includes ceremonies, spiritual support, mental health counselling and community support

Based on these findings, the government appointed five commissioners to lead the inquiry: Marion Buller (chief commissioner, member of the Mistawasis First Nation and first Indigenous woman appointed to British Columbia's provincial court bench); Michèle Audette (former president of the Native Women's Association of Canada); Brian Eyolfson (human rights lawyer); Marilyn Poitras (constitutional law expert); and Qajaq Robinson (lawyer raised in Nunavut). The inquiry also includes other staff and will likely not hear formal testimony from the families until spring 2017. Marilyn Poitras resigned as a commissioner in July 2017, stating that she is "unable to perform [her] duties as a commissioner with the process designed in its current structure."
National Inquiry Findings
The National Inquiry officially began on 1 September 2016. It was expected to release an interim report by 1 November 2017 and a final report by 1 November 2018.
Criticisms of the Inquiry
There have been some critiques of the commission from various Indigenous groups, who say it lacks transparency, communication and inclusivity. In December 2016, the Native Women's Association of Canada stated that the commission failed to keep families informed of its progress. In February 2017, the inquiry fired its communications director, Michael Hutchinson (of the Aboriginal Peoples Television Network), causing concern that the hearing of testimony might be further delayed. While Hutchinson's interim replacement, Sue Montgomery (of theMontreal Gazette) has said that this would not delay the inquiry, the families of the missing and murdered continued to press the commissioners for more clarity and better communication.

Some activists have also criticized the commission for failing to include missing and murdered Indigenous men, boys, trans and two-spirited people in the inquiry. In February 2017, Susan Vella, the commission's lead counsel, said that while the inquiry is open to hearing testimony from Indigenous men and boys, its focus will remain on Indigenous women and girls. The commission also indicated that its inquiry will include groups such as two-spirited and trans people.

Prevailing Attitudes toward Indigenous Women

During an opening address at an international conference on MMIWG, writer Maria Campbell stated that "patriarchy and misogyny are so ingrained in our society that they are normal, and our silence makes them normal." Other Indigenous women activists have referred to the lack of awareness about missing and murdered Indigenous women as a "deafening silence." The following examples demonstrate the ways stereotypes that may lead to violence against Indigenous women and girls are perpetuated and accepted within different venues throughout society. In the two cases below, Indigenous women spoke out to raise awareness about such violence.

In 2012, Mi'kmaq lawyer, activist and professor Pamela Palmater spoke out against offensive names of menu items at the Holy Chuck Restaurant. The "Half-Breed" and "Dirty Drunken Half-Breed" were the names of two hamburgers on the menu. These terms are racial slurs that have been used to perpetuate violence against Indigenous peoples.

In July 2015, two paintings appeared on a storefront window - including one depicting bound and gagged Indigenous women - during the Hospitality Days cultural festival in Bathurst, New Brunswick. Patty Musgrave, Aboriginal advisor for New Brunswick Community College, wrote to city council, expressing her outrage at the painting, which trivialized, and perhaps even glorified, violence against Indigenous women and the history of colonialism. Musgrave stated that "the building that housed these art pieces was a building in which two human beings were murdered. One a woman. These murders were never solved and ... it is quite offensive that you would allow paintings to be hung in the windows of this building while still-grieving families must see this as part of your 'Hospitality Days.'"

Activists and the families of missing and murdered Indigenous women continue to persevere against these prevailing attitudes, seeking justice, accountability, reconciliation and better public education ( See also Indigenous Peoples: Political Organization and Activism).

Support and Awareness

In recent years, with the launch of the national public inquiry and more awareness about MMIWG, there has been a tremendous amount of support for Indigenous families and communities. Indigenous associations have provided political, emotional and legal support and have also been instrumental in pushing for an inquiry. Annual marches, vigils, the making of documentaries, and other awareness campaigns have brought people together with a common goal of seeking justice. The annual Women's Memorial March, also called Their Spirits Live Within Us, has taken place every 14 February since the early 1990s. The first one was held in Vancouver's Downtown Eastside, in unceded Coast Salish territories ( see Indigenous Territory). The Memorial March now takes place in cities across Canada to raise awareness, promote empathy and compassion, and bring healing to families that have lost a loved one.

In 2017, the Government of Manitoba officially recognized 4 October as a day to honour MMIWG. The fourth of October is also marked by Sisters in Spirit vigils that bring awareness and honour the families of missing and murdered Indigenous women and girls. Events that take place on this day are supported through the Native Women's Association of Canada (NWAC) and take place in cities across Canada. Other grassroots initiatives to raise awareness include the Walking with Our Sisters Campaign and the REDress Campaign (two separate art installation projects) and the Faceless Dolls Project (an initiative of the NWAC).

Support has also come from non-Indigenous allies who have participated in vigils and awareness campaigns, as well as mainstream media, which has begun documenting and providing public education about violence against Indigenous women and girls, such as the CBC. In June 2016, it was announced that actress Zoe Saldana ( Avatar, Guardians of the Galaxy) was working on a documentary called "Gone Missing" to help raise awareness about MMIWG.

The National Inquiry's Final Report

On 3 June 2019, the National Inquiry into Missing and Murdered Indigenous Women and Girls released its Final Report titled Reclaiming Power and Place. After more than two years of testimony from Indigenous Knowledge Keepers, experts, and 1,484 survivors and family members of the missing and murdered, in addition to cross-Canada public hearings and evidence-gathering from many Indigenous and non-Indigenous groups and individuals, the Final Report was unveiled at the Canadian Museum of History in Gatineau, Quebec. Chief Commissioner Marion Buller, Commissioners Michèle Audette, Qajaq Robinson, and Brian Eyolfson, Prime Minister Justin Trudeau, family and friends of the missing and murdered, as well as national and provincial Indigenous leaders gathered to release the findings of the National Inquiry to the public.

The two-volume report spanned more than 1,000 pages and contained 231 individual "Calls for Justice." These were "legal imperatives," not merely "recommendations," to immediate action on behalf of Indigenous and non-Indigenous governments, institutions, social service providers, industries, and individual Canadians of all walks of life. Chief Commissioner Marion Buller declared that "Despite their different circumstances and backgrounds, all of the missing and murdered are connected by economic, social and political marginalization, racism, and misogyny woven into the fabric of Canadian society."

In unequivocal terms, Buller condemned Canadian society for its indifference and inaction in the face of the tragedy confronting Indigenous women and girls for the past several decades: "The hard truth is that we live in a country whose laws and institutions perpetuate violations of fundamental rights, amounting to a genocide against Indigenous women, girls and 2SLGBTQQIA [two-spirit, lesbian, gay, bisexual, transgender, queer, questioning, intersex and asexual] people."

The Final Report declared that the violence against Indigenous women, girls, and 2SLGBTQQIA people is "a national tragedy of epic proportion." The commissioners called for a new era in relations between Indigenous women, girls, 2SLGBTQQIA, and the Canadian people, a relationship centred on the empowerment of Indigenous women and girls: "To put an end to this tragedy, the rightful power and place of women, girls and 2SLGBTQQIA people must be reinstated, which requires dismantling the structures of colonialism within Canadian society."

Despite hundreds of pages of heartbreaking testimonials and studies revealing thousands of lives lost and families destroyed, Commissioner Qajaq Robinson wrote in a spirit of hopefulness that "Ending this genocide and rebuilding Canada into a decolonized nation requires a new relationship and an equal partnership between all Canadians and Indigenous Peoples. I hope that the Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls can be a tool to do just that." This spirit of hopefulness was echoed by Jeremiah Bosse, widower of Daleen Bosse, a woman from Onion Lake Cree Nation murdered in May 2004: "Today I feel hopeful for the first time that as victims of violence our words will be heard. The words of our lost ones are spoken! We will be there to represent them; they may be lost, but they are not forgotten!"
National Inquiry Facts
2,386-Total number of participants in the Truth Gathering Process:

1,484 family members and survivors provided testimony

819 individuals shared through artistic expressions

83 experts, Knowledge Keepers and officials provided testimony

15 community hearings were held across Canada

9 Knowledge Keeper, expert and institutional hearings were held across Canada

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Missing and Murdered Indigenous Women and Girls in Canada

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Missing and murdered Indigenous women and girls in Canada (MMIWG) refers to a human rights crisis that has only recently become a topic of discussion within nat...

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https://www.nytimes.com/2019/05/30/world/canada/canada-indigenous-violence.html

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A mural in Winnipeg honoring missing and murdered Indigenous women. Credit... Aaron Vincent Elkaim for The New York Times

As violence against Indigenous women and girls grows, a national inquiry into the causes is drawing to a close, with a report expected on June 3.

A mural in Winnipeg honoring missing and murdered Indigenous women. Credit... Aaron Vincent Elkaim for The New York Times

WINNIPEG - In the 24 hours before the disappearance of Tina Fontaine, a 15-year-old from the Sagkeeng First Nation in Canada, she was seen by provincial child welfare workers, police officers and health care professionals.

Then she was found dead, dumped in Manitoba's Red River, and wrapped in a plastic bag and duvet weighed down with 25 pounds of rocks.

"Canada and the system failed Tina at every step," Thelma Favel, the great-aunt who raised her, said on a recent day from her small home in Powerview, a sleepy town on Lake Winnipeg near the reserve of the Sagkeeng First Nation. "Why are so many of our girls dying?"

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Tina Fontaine's great-aunt, Thelma Favel, who cared for her as a foster parent in Powerview, Manitoba, showing a photo of the girl. Credit... Aaron Vincent Elkaim for The New York Times

Many in Canada have been asking that question.

Tina's death in 2014 - and the acquittal of a white man in her killing - was one of an increasing number of deaths and disappearances of Indigenous women and girls that has shocked Canadians in recent years. The violence galvanized the government of Prime Minister Justin Trudeau to open a $54 million national inquiry three years ago that promised to get at the root causes of the violence.

Part of Mr. Trudeau's pledge to overcome decades of "humiliation, neglect and abuse" of Indigenous populations, and to reconcile with them, the inquiry heard testimony from nearly 1,500 families of victims and survivors in often emotional hearings across the country.

Its findings are to be made public on June 3, and its chief commissioner Marion Buller, a prominent Indigenous judge, recently hinted that it could include, among other things, recommendations that homicides of Indigenous women automatically be treated as first-degree murder. Law enforcement is also expected to be called to account.
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But some Indigenous advocates have said that, however good its intentions, the inquiry has been marred by a lack of transparency and poor communication with families of victims.

"Justin Trudeau is trying to put rose-colored glasses on a very dark chapter of Canadian history," said Kim O'Bomsawin, an Indigenous filmmaker whose documentary " Quiet Killing " examines violence against Indigenous women. "This is just more words."

Yet even before its release, the inquiry has been forcing a national reckoning.

Among the cases attracting renewed scrutiny is that of Cindy Gladue, a 36-year-old Indigenous sex trade worker and mother of three who bled to death in a bathtub in an Edmonton motel room in June 2011; the man accused of her killing, Bradley Barton, an Ontario truck driver, was acquitted by an all-white jury.

Human rights advocates say Ms. Gladue was dehumanized during Mr. Barton's trial, including having her preserved pelvis introduced as evidence.

After the Alberta Court of Appeal ordered a retrial in 2017, Mr. Barton appealed the decision to Canada's Supreme Court, which ruled on Friday that he should be retried for manslaughter. Justice Michael Moldaver wrote that the criminal justice system has let Ms. Gladue down.

The violence against Indigenous girls and women, experts say, is deeply rooted in Canada's history.

From the 1870s until 1996, Canada forced thousands of Indigenous children to go to residential schools in an effort to suppress their language and culture. Many faced physical, sexual and mental abuse.

The trauma from this history has contributed, experts say, to persistently high rates of poverty, drug abuse, alcoholism, domestic violence and suicide.

Cindy Blackstock, a professor of social work at McGill University, who is director of the First Nations Child and Family Caring Society of Canada, said other problems were chronically underfunded social services for vulnerable girls and women and a lack of educational opportunities.

The violence has been unrelenting.

Indigenous women and girls make up about 4 percent of the total female population of Canada but 16 percent of all female homicides, according to government statistics.

Some 1,181 Indigenous women were killed or went missing across the country between 1980 and 2012, according to a 2014 report by the Royal Canadian Mounted Police.

That number has since risen and Patricia Hajdu, who served as minister for the status of women, has estimated that it may be as high as 4,000 since many of the cases go unreported. The police have estimated that 10 percent of missing women in the country are Indigenous.

Winnipeg, whose name is derived from the Cree words for "murky water," has the largest Indigenous population in Canada.

That is where Tina Fontaine's life came to an end.

Her history in many ways reflects the cycle of violence affecting Indigenous communities. Her paternal grandfather was sent to a residential school, and became an alcoholic. Her mother, who became a ward of the state as a child, eventually joined the sex trade.

Ms. Favel said the child was "doomed before she was born." Her mother was 12 when she began dating her father, who was then 23. After their chaotic relationship fell apart and Tina's father was afflicted with cancer, Tina and her sister Sarah went to live with her.

Ms. Favel said Tina was a happy girl who showed promise. She liked math and dancing, and television crime shows. She aspired to be a social worker.

But at 12, the girl's father, who only had four months to live, was beaten to death in an argument with two men over $60.

Despairing, she began to skip school, smoke pot and cut herself. She got a tattoo with two angel wings and her father's name on her back. When asked to write a victim's impact statement during the trial of her father's killers, she fell apart.

"She kept crumpling the paper and said she couldn't do it," recalled Ms. Favel, on whose living room wall hangs a painting of Tina, waifish with big brown eyes.

In June 2014, Tina left Ms. Favel's home and went to Winnipeg, about 75 miles away, to visit her mother. Ms. Favel gave her $50 and a prepaid phone card, telling her to call if she wanted to come home. The call never came.

Instead, she said, the girl texted photographs of herself with a black eye to her sister, saying that their mother, who was working in the sex trade, had beaten her. Alarmed, Ms. Favel said she reached out to three Manitoba family services agencies, which bickered over who was responsible.

Eventually, Tina was placed by child and family services in a series of local motels, from which she ran away. She began living on the streets in Winnipeg's impoverished north end.

A missing person's report was filed with Winnipeg police. On two occasions on Aug. 1, 2014, she was turned away from city shelters, according to a March report by the Manitoba Advocate for Children and Youth, which noted she was vulnerable to sexual exploitation.

On Aug. 8, Winnipeg police pulled over a truck in which Ms. Fontaine was riding with an intoxicated man. The girl was allowed to go despite being the subject of a missing person's report.

Later that day, she was found unconscious in a back alley. After being hospitalized, testing positive for drugs and telling a case worker she was spending time with a much older drug user called Sebastian, she was discharged and placed at a Best Western Hotel in Winnipeg's gritty downtown.

The advocate's report noted that the child abuse unit of the Winnipeg Police should have intervened. Instead, Ms. Fontaine left the hotel on her own.

After Ms. Fontaine was found dead in the Red River, the police arrested Sebastian, whose real name is Raymond Cormier. The New Brunswick native had 92 previous convictions, including assault with a weapon and drug possession.

During an elaborate sting operation, the police bugged his apartment and recorded him. Prosecutors said the recordings showed he had wanted to have sex with Ms. Fontaine and had been enraged after finding she was 15 years old.

"I drew the line and that's why she got killed," he was overheard saying.

The court also heard that Mr. Cormier had owned the same type of duvet that was wrapped around Tina's body.

But the autopsy failed to determine cause of death and there was no evidence of sexual assault and no forensic evidence linking Mr. Cormier to the crime. In February 2018, Mr. Cormier was acquitted of second-degree murder, spawning outrage and protests across the country.

Visitors regularly pay tribute to Tina at a makeshift memorial of pink roses and photographs near the dock where her body was found. On a recent day, a card said: "sleeping beauty."

Ms. Fontaine's legacy is also felt in other ways.

After her death, volunteers routinely dredge the Red River looking for the bodies of missing and murdered Indigenous women and girls.

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'Why Are So Many of Our Girls Dying?' Canada Grapples With Violence Against Indigenous Women (Published 2019)

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As violence against Indigenous women and girls grows, a national inquiry into the causes is drawing to a close, with a report expected on June 3. A mural in Winnipeg honoring missing and murdered Indigenous women. Credit...

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https://www.nationalobserver.com/2019/09/10/analysis/canadas-indigenous-suicide-crisis-worse-we-thought

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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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https://www150.statcan.gc.ca/n1/pub/99-011-x/99-011-x2019001-eng.htm

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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.

﻿

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).

﻿

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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# data[].attributes.attachment_link.title
Suicide among First Nations people, Métis and Inuit (2011-2016): Findings from the 2011 Canadian Census Health and Environment Cohort (CanCHEC)

# data[].attributes.attachment_link.description
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.

# data[].attributes.body
https://www.cbc.ca/news/politics/auditor-general-reports-2021-1.5927572

# data[].attributes.body
https://www.vice.com/en/article/mbd4v4/first-nations-in-canada-still-face-chronic-issues-in-getting-safe-drinking-water

# data[].attributes.body
https://www.vice.com/en/article/8xwvx3/the-indigenous-teen-who-confronted-trudeau-about-unsafe-water-took-on-the-un

# data[].attributes.body
https://www.justice.gc.ca/eng/rp-pr/jr/jf-pf/2017/july04.html

https://www.nwac.ca/wp-content/uploads/2015/05/Fact_Sheet_Missing_and_Murdered_Aboriginal_Women_and_Girls.pdf

# data[].attributes.body
http://www.femicideincanada.ca/about/history/indigenous

# data[].attributes.body
https://www.nytimes.com/2019/05/30/world/canada/canada-indigenous-violence.html

# data[].attributes.body
https://www.theguardian.com/commentisfree/2020/sep/07/canada-indigenous-women-and-girls-missing

# data[].attributes.body
https://www.thecanadianencyclopedia.ca/en/article/missing-and-murdered-indigenous-women-and-girls-in-canada