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Aging, Health and Health Care: Examining Differences between Aboriginal and non-Aboriginal Seniors in Canada

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Title: Aging, Health and Health Care: Examining Differences between Aboriginal and non-Aboriginal Seniors in Canada Author: Kathi Wilson Last modified by – PowerPoint PPT presentation

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Title: Aging, Health and Health Care: Examining Differences between Aboriginal and non-Aboriginal Seniors in Canada


1
Aging, 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
2
Outline
  • 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

3
Who 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)

4
Aboriginal 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
5
Age Distribution
  • Median age 2006
  • Aboriginal - 27 years
  • Non-Aboriginal - 40 years

6
(No Transcript)
7
Projected 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
8
Research 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)

9
Review 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)

10
Incomplete Picture of Aboriginal Peoples
  • Age focus of health research
  • General population profiles
  • Youth

11
Purpose 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

12
Research Team
  • Investigators
  • Mark Rosenberg Sylvia Abonyi
  • Geography Community Health and Epidemiology
  • Queens University University of Saskatchewan
  • Aboriginal Advisor
  • Bob Lovelace
  • Sir Sanford Fleming College

13
Five-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

14
Phase 2 Data Sources
2001 APS 2000/2001 CCHS
Targeted Population Aboriginal identity Aboriginal ancestry reserve/off-reserve Private dwellings 0-14 years 15 years and older Individuals in private dwellings (not Aboriginal peoples with reserve-residency) 12 years and older
Survey Questions education, income, language, labour activity, income, health, communication, mobility, housing Metis, Children, Arctic physical/mental well-being, lifestyle, use of health care services, access to are common optional content
Respondents 98,649 130,827
Response Rate 84 84.7
15
Common Health and Health Care Variables APS
(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

16
Data 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.

17
Results
  • Exploratory analysis
  • Stage 1
  • Older Aboriginal and non-Aboriginal
  • Stage 2
  • Older Aboriginal peoples (North American Indian,
    Métis, Inuit)

18
Population Reporting Fair/Poor Self-Assessed
Health Status
Chi-Square Significance plt0.001
19
Population Reporting Difficulty with Activities
Chi-Square Significance plt0.001
20
Total Number of Chronic Conditions
Chi-Square Significance plt0.001
21
Visited Physician within Past 12 Months
Chi-Square Significance plt0.001
22
Visited Nurse within Past 12 Months
Chi-Square Significance plt0.001
23
Summary
  • 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

24
Differences 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)

25
Percentage of Aboriginal Population 55 years and
older, 2001
Source Statistics Canada. 2001.
Chi-Square Significance plt0.001
26
Population Reporting Fair/Poor Self-Assessed
Health Status
Source Statistics Canada. 2001.
Chi-Square Significance plt0.001
27
Population Reporting Difficulty with Activities
Source Statistics Canada. 2001.
Chi-Square Significance plt0.001
28
Total Number of Chronic Conditions
Source Statistics Canada. 2001.
Chi-Square Significance plt0.001
29
Visited Physician within Past 12 Months
Source Statistics Canada. 2001.
Chi-Square Significance plt0.001
30
Visited Nurse within Past 12 Months
Source Statistics Canada. 2001.
Chi-Square Significance plt0.001
31
Summary
  • 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

32
Limitations
  • Self-reports
  • Measuring health status - biomedical
  • Health care use - incidence vs. frequency
  • Diversity of the Aboriginal population
  • e.g., on vs. off-reserve

33
Implications
  • 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?

34
Next 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
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