Title: Aging, Health and Health Care: Examining Differences between Aboriginal and nonAboriginal Seniors in
1Aging, Health and Health Care Examining
Differences between Aboriginal and
non-Aboriginal Seniors in Canada
- Kathi Wilson Mark Rosenberg
- Department of Geography Department of Geography
- University of Toronto Mississauga Queens
University - Sylvia Abonyi
- Community Health and Epidemiology
- University of Saskatchewan
SEDAP II - Canada in the 21st Century Moving
Towards an Older Society
2Outline
- Background
- Population and demographic comparisons
- Overview of existing literature
- Objectives and goals of current research
- Data and Methods
- Aboriginal Peoples Survey (APS) 2001
- Canadian Community Health Survey (CCHS) 2000/2001
- Exploratory examination of differences
- Results
- Conclusions/Implications
3Who are Older Aboriginal Peoples?
- Older - demographic concept (65 years and older)
- Elder - cultural concept
- reflects status of honour, wisdom and respect
regardless of age (McLeod-Shabogesic, 1998
Medicine, 1983)
4Aboriginal Peoples in Canada
- Aboriginal identity popn
- 1 million
- represent 3.8 of Canadas total population (2.8
in 1996)
Source Statistics Canada, 2001
http//www12.statcan.ca/english/census01/Products/
Analytic/companion/abor/canada.cfm
5Age Distribution
- Median age 2006
- Aboriginal - 27 years
- Non-Aboriginal - 40 years
6(No Transcript)
7Projected Population Growth
- Aboriginal seniors - 6.5 (2017)
- Non-Aboriginal seniors - 17 (2017)
Source Statistics Canada, Projections of the
Aboriginal Populations, Canada, Provinces and
Territories 2001 to 2017
8Research on Older Aboriginal Peoples
- Growing literature on Aboriginal peoples
- Canadian Journal of Native Studies (1981)
- Native Studies Review (1984)
- Lack of attention toward older Aboriginal
peoples - major reports on older Native people continue to
be based almost entirely on anecdotal evidence
(Buchignani and Armstrong-Esther, 1999, p.7)
9Review of Aboriginal Health Research in the
Social Sciences
- 1995-2005
- 96 articles
- Only 3 focus on older Aboriginal peoples
- Mental health (Cattarinich et al., 2001)
- Inuit - successful aging (Collings, 2001)
- Informal care (Buchignani and Armstrong-Esther,
1999)
10Incomplete Picture of Aboriginal Peoples
- Age focus of health research
- General population profiles
- Youth
11Purpose of Research
- Objectives
- Provide a comparison between Aboriginal and
non-Aboriginal seniors - Provide comprehensive portrait of the health
status of older Aboriginal peoples and their use
of health services - Goals
- Enhance understanding of Aboriginal health status
and use of services in Canada - Knowledge transfer to the Aboriginal and general
policy and planning communities - Provide contextual platform to develop future
qualitative research
12Research Team
- Investigators
- Mark Rosenberg Sylvia Abonyi
- Geography Community Health and Epidemiology
- Queens University University of Saskatchewan
- Aboriginal Advisor
- Bob Lovelace
- Sir Sanford Fleming College
13Five-year Research Plan
- Phase 1- Population Aging Among Aboriginal
Peoples in Canada - 2001 Census of Canada
- Departmental Data, DIAND
- Phase 2 - Health Status of Older Aboriginal
Peoples and their Utilisation of Health Services - 2001 CCHS 2001 APS
- differences between non-Aboriginal and Aboriginal
peoples - differences within Aboriginal population
- Phase 3 - Experiences of Aging among Older
Aboriginal Peoples
14Phase 2 Data Sources
15Common Health and Health Care VariablesAPS
(2001) and CCHS (2001)
- Age cohorts 18-54, 55-64, 65-74, 75
- Health Status
- Self-assessed (excellent/very good/good vs.
fair/poor) - Difficulty with activities Do you have any
difficulty hearing, seeing, communicating,
walking, climbing stairs, bending, learning etc? - 9 Chronic conditions (diagnosed)
- Health Care use in past 12 months
- Physician use
- Nurse
16Data Access
- CCHS and APS microdata file accessed through
Statistics Canadas Regional Data Centre at
McMaster University - The research and analysis are based on data from
Statistics Canada and the opinions expressed do
not represent the views of Statistics Canada.
17Results
- Exploratory analysis
- Stage 1
- Older Aboriginal and non-Aboriginal
- Stage 2
- Older Aboriginal peoples (North American Indian,
Métis, Inuit)
18Population Reporting Fair/Poor Self-Assessed
Health Status
Chi-Square Significance plt0.001
19Population Reporting Difficulty with Activities
Chi-Square Significance plt0.001
20Total Number of Chronic Conditions
Chi-Square Significance plt0.001
21Visited Physician within Past 12 Months
Chi-Square Significance plt0.001
22Visited Nurse within Past 12 Months
Chi-Square Significance plt0.001
23Summary
- Health Status
- In general, Aboriginal population unhealthier
than Aboriginal population - Older cohorts unhealthier than younger cohorts
- Health appears to converge among oldest
Aboriginal and non-Aboriginal seniors - Health Care Use
- Similar access to physicians
- Higher reliance on nurses within Aboriginal
population
24Differences within Aboriginal population
- APS (2001)
- North American Indian
- Métis
- Inuit
- Demographic composition
- Health status (18-44, 45-64, 65)
- Use of health care services (18-44, 45-64, 65)
25Percentage of Aboriginal Population 55 years and
older, 2001
Source Statistics Canada. 2001.
Chi-Square Significance plt0.001
26Population Reporting Fair/Poor Self-Assessed
Health Status
Source Statistics Canada. 2001.
Chi-Square Significance plt0.001
27Population Reporting Difficulty with Activities
Source Statistics Canada. 2001.
Chi-Square Significance plt0.001
28Total Number of Chronic Conditions
Source Statistics Canada. 2001.
Chi-Square Significance plt0.001
29Visited Physician within Past 12 Months
Source Statistics Canada. 2001.
Chi-Square Significance plt0.001
30Visited Nurse within Past 12 Months
Source Statistics Canada. 2001.
Chi-Square Significance plt0.001
31Summary
- Stage 1 Differences between older Aboriginal
non-Aboriginal Canadians - Non-Aboriginal population healthier across age
cohorts - But health status converges among oldest age
cohorts - Older Aboriginal peoples higher reliance on
nurses - Stage 2 Differences within Aboriginal population
- Health status
- Older Inuit appear healthier
- Health care use
- Older Inuit lower levels physician use
- But much higher reliance on nurses
32Limitations
- Self-reports
- Measuring health status - biomedical
- Health care use - incidence vs. frequency
- Diversity of the Aboriginal population
- e.g., on vs. off-reserve
33Implications
- Almost no research on older Aboriginal cohorts
- Represent 5 of Aboriginal population
- Represent 1.5 of older Canadian population
- This research health picture of seniors living
in community - Questions remain
- no knowledge of population living in institutions
- formal/informal caregiving
- Know little about health, services creating
services - Who collects data? What type of data?
34Next Steps
- Phase 2 Determinants of health and health care
use - Traditional healing
- Phase 3 Qualitative research study
- Experiences perceptions of aging
- Broader perspectives on health/health care
- Ontario
- Saskatchewan