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By Anne Guèvremont and Dafna Kohen
Data and methodology
Identifying Inuit children
Results
References
Appendix A: Census questions used to determine the Inuit target population for the APS
Appendix B: Communities taking part in the APS
Appendix C: Aboriginal Peoples Survey (APS) and National Longitudinal Survey of Children and Youth (NLSCY) questions used for each table
This report examines the health of Inuit children in the four Inuit Regions in the Arctic: the Inuvialuit Region in the Northwest Territories, the territory of Nunavut, Nunavik in northern Quebec and Nunatsiavut in northern Labrador (see map below). This report is a joint publication between the Social and Aboriginal Statistics Division, the Health Information and Research Division at Statistics Canada, as well as the Inuit Tapiriit Kanatami.
A report published in 2004, "A Portrait of Aboriginal Children Living in Non-reserve Areas: Results from the 2001 Aboriginal Peoples Survey" (Statistics Canada, 2004), examined Aboriginal children's health overall and compared Inuit children to Métis and North American Indian1 (also referred to as First Nations) children. However, the report did not look at regional differences in Inuit children's health. While these regions share a common culture and many traditions, they are at the same time distinct from each other in many ways. The current report provides a more in-depth view of Inuit children's health. This report focuses on six areas of child health: health status, prevalence of chronic conditions, contact with health practitioners, use of and access to dental care, prevalence and duration of breastfeeding and the proportion of young people eating breakfast. These are particularly important as they have implications not only on the physical health of young Inuit children but on healthy development throughout the course of life.
This study uses the Children and Youth Component of the 2001 Aboriginal Peoples Survey (APS). The APS provides data on the social and economic conditions of Aboriginal peoples in Canada. Its specific purpose was to identify the needs of Inuit, First Nations and Métis peoples focusing on issues such as health, schooling and language. The survey was designed and implemented in partnership with National Aboriginal Organizations2 (Statistics Canada, 2006).
The APS is a post-censal survey, meaning that respondents were selected based upon their responses to the 2001 Census. Two questions from the long questionnaire (Forms 2B and 2D) were used to determine the APS Inuit population (see Appendix A).
The interviews for the children's questionnaire were conducted with the "person most knowledgeable" (PMK) about the child. In 82% of cases, the PMK was the birth parent (mother or father). In other instances, the PMK was a grandparent (6%), or an aunt or uncle (3%). In most cases, the interviews were conducted face-to-face using paper and pencil questionnaires.
Differences are reported as significant if they were different at the 5% level. Population weights were applied and results were bootstrapped. Significant differences are noted in the text, while numbers in a table are not necessarily significantly different.
The focus of this report is Inuit children aged 0 to 14. A child was considered Inuk if their parent responded, “Yes, Inuit,” to the APS question, “Is … an Aboriginal person, that is, North American Indian, Métis, or Inuit?” Included here are children with Inuit identity only and those with Inuit identity in combination with Métis and/or First Nations identity.
In 2001, most Inuit children lived in one of four Inuit Regions in the Arctic: the Inuvialuit Region in the Northwest Territories, the territory of Nunavut, Nunavik in northern Quebec and Nunatsiavut in northern Labrador. Data for these four regions are compared in this report. The approximately 3,800 Inuit children interviewed in the 2001 APS represented 18,500 Inuit children in Canada. About 260 children were interviewed in the Inuvialuit Region; 2,000 in Nunavut; 1,050 in Nunavik and 220 in Labrador. Survey information was provided for 230 Inuit children (15% of the total) who lived outside of these four areas. These children are included in the “Total Inuit” category.
For 2001 APS purposes, “Labrador” (as referred to in this report) consisted of a slightly different set of communities than those that comprise the Nunatsiavut region. While Nunatsiavut includes Hopedale and excludes Happy Valley-Goose Bay, the reverse is true for the Labrador region as defined in this report. In this report, the Inuvialuit region includes Inuvialuit and Inuit living in Aklavik, Inuvik, Paulatuk, Sachs Harbour, Tuktoyaktuk and Ulukhaktok.
In a separate set of comparisons, Inuit children were compared with First Nations (on selected reserves and off reserve) and Métis children. To keep the definition for other Aboriginal groups similar to the definition of Inuit children (i.e. a mutually exclusive group), we excluded First Nations and Métis children who identified with more than one Aboriginal group. Included in the sample were about 11,000 First Nations children living on selected reserve (representing 41,500 First Nations children in Canada), 10,000 First Nations Children living off reserve (representing 135,600 children), and 7,500 Métis children (representing 92,500 children). Although the Inuit, First Nations off reserve, and Métis samples in the APS are representative of those groups nationally, the APS sampling strategy focused on the larger reserves in each province. As a result, the information collected for the First Nations on-reserve sample was not designed to be representative of the entire on-reserve population (see Appendix B for a list of all communities included in the survey). This should be taken into consideration when interpreting results for the First Nations on-reserve population.
The majority of Inuit children were rated as being in excellent or very good health (79%) (Table 1). However, the percentage for Inuit children was lower than that for all children in Canada (87%). Among Inuit children, those in Nunavut (52%), the Inuvialuit Region (57%), and Labrador (51%) were as likely as each other to be rated as being in excellent health. This percentage is similar to the percentage of all children nationally rated in excellent health (58%). However, Inuit children from Nunavik were significantly less likely to be rated as being in excellent health (44%) as compared with Inuit children in the other three regions.
Table 1
Health status of Inuit children aged 0 to 14 years, by region and for all children in Canada, 2001
A smaller percentage of First Nations children on selected reserves were rated as being in excellent health compared with Inuit children overall (45% compared with 53%). About the same percentage of First Nations children off reserve (54%) were rated as being in excellent health compared with Inuit children (53%). A slightly higher percentage of Métis children were rated as being in excellent health (56%) as compared with Inuit children. (Table 2)
Results for chronic conditions in each Inuit region are not presented as the sample sizes were too small to produce statistically reliable estimates.
Compared with other Aboriginal children, Inuit children were significantly less likely to report a chronic condition – 33% of Inuit children compared with 35% of First Nations children on selected reserves, 44% of First Nations children off reserve, and 45% of Métis children. However, these results should be interpreted with caution as parents were reporting on “diagnosed” conditions which may be influenced by greater difficulties accessing health professionals in the north, as outlined below. (Table 3)
Table 3
Percentage of 0 to 14 year olds with diagnosed chronic health conditions, by Aboriginal group and for all children in Canada, 2001
Most Inuit children did not have any contact with a general practitioner in the past year (Table 4). In 2001, a significantly smaller percentage of Inuit children (28%) had seen or talked to a family doctor compared to children in Canada (67%). Contact varied across the regions, ranging from 16% in Nunavut to approximately 33% in the Inuvialuit Region and Labrador.
Table 4
Contact of Inuit children aged 0 to 14 with health care professionals, by Inuit region and for all children in Canada, 2001
It should be noted that very few (less than 10 of 53) Inuit communities have a doctor working in the community on a regular basis (Inuit Tapiriit Kanatami, personal correspondence). Medical evacuations to southern hospitals are required for those in need of emergency care and many Inuit are sent to the south for appointments with medical specialists, diagnosis and treatment. The point of first contact with the medical system for most Inuit children (and adults) is with a nurse and each community has a health centre staffed by at least one nurse. Almost half of Inuit children (49%) had seen a nurse in 2001, compared with 20% of children in the Canadian provinces.
Compared with other Aboriginal children, Inuit children were significantly less likely to have seen a doctor in the 12 months prior to the survey (Table 5). Approximately 46% had seen or talked to a physician in the last 12 months, compared with 77% of Métis children, 78% of First Nations children living off reserve and 63% of First Nations children living on selected reserves. In particular, Inuit children were much less likely to have seen or talked to a family doctor or a pediatrician than other Aboriginal children.
Table 5
Contact of Aboriginal children aged 0 to 14 with health care professionals, by Aboriginal group, 2001
Most Inuit communities are not regularly serviced by a resident dentist. In most cases, dentists from southern Canada fly into remote communities at various points during the year. In some communities, there can be many people waiting for treatment and sometimes only the most serious cases can be seen during the dentist’s visit. For emergency dental treatment, Inuit must be evacuated from their community by air for treatment in a southern centre. Trips South are also required for consultations with dental specialists. However, medical evacuations are often given higher priority, resulting in delays for treatment by these dental specialists (Inuit Tapiriit Kanatami, personal correspondence).
Inuit children in Nunavut in 2001 were significantly less likely to have received dental treatment in the last 12 months - 58% compared with 71% in both Nunavik and the Inuvialuit Region, and 72% of children in Labrador (Table 6). A similar percentage of children were in need of dental care in Nunavut (26%), Nunavik (25%), and the Inuvialuit Region (26%), with a significantly higher percentage of children in need of dental care in Labrador (35%). Access was the most frequently cited reason for not having an appointment among Inuit children; this reason was cited by 48% of respondents.
Table 6
Dental care of Inuit children aged 2 to 14, by Inuit region and for all children in Canada, 2001
Compared with other Aboriginal children, Inuit children in 2001 were less likely to have received dental treatment in the last 12 months – 67% of Inuit children compared with 70% of First Nations children on selected reserves, 77% of First Nations Children off reserve and 75% of Métis children (Table 7). Inuit children were similarly likely to need dental treatment, but less likely to have an appointment than other Aboriginal children. For Inuit children, access was the biggest reason for not having a dental appointment. In comparison, for Métis and First Nations children living off reserve, cost was most likely to be selected as the reason for no appointment. This difference may in part be due to Non-Insured Health Benefits (NIHB) available to both Inuit and those registered under the Indian Act. The cost of many dental services like check-ups, cleanings and fillings are usually covered through NIHB (Inuit Tapiriit Kanatami, 2006)
The Public Health Agency of Canada states that, “Exclusive breastfeeding is recommended for the first six months of life, as it provides all the nutrients, growth factors and immunological components a healthy term infant needs.” (Health Canada, Expert Advisory Panel on Exclusive Breastfeeding 2004). The percentage of 0 to 3 year old Inuit children who had been or were currently being breastfed (66%) was lower than the national average (80%), but Inuit children were more likely than Canadian children outside of the territories to have been breastfed for more than six months. Inuit children aged 0 to 3 living in Labrador were more likely than those in Nunavut to be breastfed (78% compared with 61%). Inuit children in Nunavut were significantly more likely than those in Nunavik and the Inuvialuit region to have been breastfed for more than six months. The percentage of children breastfed for more than 6 months was higher than the national average in three of the four Inuit regions (Nunavut, Nunavik, and Labrador). The difference between the percentage for children in the Inuvialuit region and that for all children in Canada was not significant (Table 8).
Table 8
Percentage of Inuit children aged 0 to 3 years breastfed, by Inuit region and for all children in Canada, 2001
Compared to other Aboriginal groups, Inuit children aged 0 to 3 years were more likely to have been breastfed than First Nations children living on selected reserves (66% versus 62%), and less likely to have been breastfed than First Nations children off reserve (66% versus 72%). Inuit children were as likely to have been breastfed as Métis children (66% versus 70%). Of breastfed children, Inuit children were significantly more likely to have been breastfed for more than 6 months (59%) as compared to Métis children (39%) and First Nations children both on selected reserves (42%) and off reserve (43%). (Table 9)
The Dieticians of Canada (2004) recommend that all children start their day with a good breakfast. Children who eat breakfast perform better at school, have healthier weights, and eat more essential nutrients. Most Inuit children 6 to 14 years old reported eating breakfast 5 to 7 days per week (82%). Inuit children in Nunavik and the Inuvialuit region were more likely to report eating breakfast 5 to 7 days a week (86% of children in each region) than were children in Labrador and Nunavut (79% in each region). (Table 10)
Table 10
Percentage of Inuit children aged 6 to 14 eating breakfast 5 to 7 days a week, by Inuit region, 2001
To compare these rates to the rate of eating breakfast for Canadian children (excluding children outside of the territories), we used data from the National Longitudinal Survey of Children and Youth (NLSCY, Cycle 4, 2000/01). In the NLSCY, 12 to 15 year olds were asked: During a school week (Monday to Friday), how many days do you normally eat breakfast? About 57% of 12 to 14 year olds reported eating breakfast every school day; 75% reported eating breakfast 3 or more school days per week. These numbers were then compared with the rates of Inuit children of a similar age group. The percentage of 12 to 14 year old Canadian children who reported eating breakfast 3 or more school days per week is similar to the percentage of Inuit children aged 12 to 14 years who reported eating breakfast 5 to 7 times a week (75% of Inuit children - 74% in Nunavut, 81% in Nunavik, 70% in the Inuvialuit region, and 64% in Labrador).
The percentage of Inuit children eating breakfast 5 to 7 days per week was similar to the percentage of other Aboriginal children eating breakfast – 84% of First Nations children on selected reserves, 90% of First Nations children off reserve, and 87% of Métis children. (Table 11)
Table 11
Percentage of Aboriginal children aged 6 to 14 eating breakfast 5 to 7 days a week, by Aboriginal group, 2001
Canadian Dental Association (2005). CDA Position on First Visit to the Dentist. Ottawa, ON: Author.
Dieticians of Canada (2004). Eat Well, Play Well: At Home! Retrieved June 19, 2007 from: http://www.dietitians.ca/public/content/eat_well_live_well/english/faqs_tips_facts/dc_tips/index.asp
Health Canada, Expert Advisory Panel on Exclusive Breastfeeding (2004). Exclusive Breastfeeding Duration: 2004 Health Canada Recommendation. Ottawa : Minister of Public Works and Government Services.
Human Resources and Development Canada, Health Canada (2002). The Well-Being of Canada's Young Children. Ottawa, ON : Government of Canada.
Inuit Tapiriit Kanatami (2006). Your Health Benefits: An Inuit Guide to Accessing Non-Insured Health Benefits. Ottawa , ON : ITK
Statistics Canada (2003). Aboriginal Peoples Survey 2001: Concepts and methods guide. Ottawa : Minister of Public Works and Government Services. (Catalogue number 89-591-XIE)
Statistics Canada (2004). A Portrait of Aboriginal Children Living in Non-reserve Areas: Results from the 2001 Aboriginal Peoples Survey. Ottawa : Minister of Public Works and Government Services. (Catalogue number 89-597-XWE)
Question 17: What were the ethnic or cultural origins of this person's ancestors? (Persons who indicated Aboriginal ancestry were included in Inuit target population)
Question 18: Is this person an Aboriginal person, that is, North American Indian, Métis or Inuit (Eskimo)? (Persons who gave a positive response were included in the Inuit target population)
The following is a list of communities selected for the 2001 Aboriginal Peoples Survey (APS):
Newfoundland and Labrador
Samiajij Miawpukek
Prince Edward Island
Lennox Island 1
Nova Scotia
Eskasoni 3
Indian Brook 14
Millbrook 27
New Brunswick
Burnt Church 14
Devon 30
Quebec
Eastmain
Mistissini
Nemiscau
Oujé-Bougoumou
Waskaganish
Waswanipi
Wemindji
Whapmagoostui
Ontario
Christian Island 30 and 30A
Couchiching 16A
Curve Lake First Nation 35
Deer Lake
English River 21
Fort Hope 64
Fort William 52
Garden River 14
Kettle Point 44
Lac Seul 28
Mississagi River 8
Mnjikaning First Nation 32 (Rama First Nation 32)
Pikwakanagan (Golden Lake 39)
Sagamok
Sandy Lake 88
Wikwemikong Unceded 26
Manitoba
Chemawawin 2
Cross Lake 19, 19A and 19E
Ebb and Flow 52
Fairford 50
Fisher River 44 and 44A
Nelson House 170
Norway House 17
Opaskwayak Cree Nation 21A, 21B, 21E, 21I
Oxford House 24
Peguis 1B
Sandy Bay 5
Sioux Valley 58
Split Lake 171
St. Theresa Point
Waywayseecappo First Nation
Saskatchewan
Ahtahkakoop 104
Assiniboine 76
Big River 118
Buffalo River Dene Nation 193 (Peter Pond Lake 193)
Canoe Lake 165
Chicken 224 and 225
Clearwater River
Cote 64
Cowessess 73
Flying Dust First Nation 105 (Meadow Lake 105)
Gordon 86
James Smith 100
Kitsakie 156B
Lac La Ronge 156
Little Pine 116
Makaoo (Part) 120
Makwa Lake 129B and 129C
Ministikwan 161 and 161A
Montreal Lake 106 and 106B
Moosomin 112B
Mosquito 109
Peepeekisis 81
Piapot 75
Poundmaker 114
Seekaskootch 119
Standing Buffalo 78
Sturgeon Lake 101
Wapachewunak 192D
Waterhen 130
White Bear 70
Alberta
Alexis 133
Blood 148
John d'Or Prairie 215
Louis Bull 138B
Montana 139
Peigan 147
Samson 137
Siksika 146
Stoney 142, 143, 144
Stony Plain 135
Tsuu T'ina Nation 145 (Sarcee 145)
Utikoomak Lake 155 and 155A
Wabamun 133A
Wabasca 166, 166A, 166B, 166C, 166D)
White Fish Lake 128
British Columbia
Alert Bay 1 and 1A
Alkali Lake 1
Campbell River 11
Capilano 5
Chehalis 5
Chemainus 13
Cole Bay 3
Cowichan 1
East Moberly Lake 169
Fort Nelson 2
Gitanmaax 1
Gitsegukla 1
Gitwangak 1
Hagwilget 1
Kamloops 1
Kitamaat 2
Mission 1
Musqueam 2
Nanaimo Town 1
Nishga Nation (New Aiyansh, Laxgalts'ap, Gitwinksihlkw, Gingolx)
Okanagan (Part) 1 CSD - 801, (Part) 1 CSD - 804
Seabird Island
Sechelt (Part) CSD - 803
South Saanich 1
Stony Creek 1
Tache 1
Tsahaheh 1
Tsinstikeptum 9
Tsulquate 4
Williams Lake 1
Woyenne 27
Northwest Territories
Hay River Dene 1
Newfoundland and Labrador
Happy Valley-Goose Bay
Makkovik
Nain
Postville
Rigolet
Nunavik (northern Quebec)
Akulivik
Aupaluk
Chisasibi
Inukjuak
Ivujivik
Kangiqsualujjuaq
Kangiqsujuaq
Kangirsuk
Kuujjuaq
Kuujjuarapik
Puvirnituq
Quaqtaq
Salluit
Tasiujaq
Umiujaq
Inuvialuit region (Northwest Territories)
Aklavik
Holman
Inuvik
Paulatuk
Sachs Harbour
Tuktoyaktuk
Nunavut
Arctic Bay
Arviat
Baker Lake
Bathurst Inlet
Cambridge Bay
Cape Dorset
Chesterfield Inlet
Clyde River
Coral Harbour
Gjoa Haven
Grise Fiord
Hall Beach
Igloolik
Iqaluit
Kimmirut
Kugaaruk
Kugluktuk
Pangnirtung
Pond Inlet
Qikiqtarjuaq
Rankin Inlet
Repulse Bay
Resolute
Sanikiluaq
Taloyoak
Umingmaktok
Whale Cove
Newfoundland and Labrador
Port Hope Simpson
Manitoba
Alonsa
Camperville
Cormorant
Duck Bay
Moose Lake
Mountain (North)
Norway House
St. Laurent
Wabowden
Saskatchewan
Beauval
Buffalo Narrows
Green Lake
La Loche
Pinehouse
Prince Albert
Île-à-la-Crosse
North Battleford
Alberta
Buffalo Lake
East Prairie
Elizabeth
Fishing Lake
Fort Vermilion
Gift Lake
Grouard Mission
Kikino
Paddle Prairie
Peavine
Wabasca
Wood Buffalo
Yukon
Whitehorse
Northwest Territories
Déline
Fort Good Hope
Fort Liard
Fort McPherson
Fort Providence
Fort Resolution
Fort Simpson
Fort Smith
Rae-Edzo
Tulita
Wha Ti
Yellowknife
APS | NLSCY |
In general, would you say …’s health is…
|
In general, would you say …’s health is…
|
APS | NLSCY |
Which, if any, of the following long-term conditions of health problems does … have that have been diagnosed by a doctor, nurse or health professional?
(Child considered having any chronic condition if he or she had any of the above.) Does a physical condition or mental condition reduce the amount or the kind of activity….can do:
|
In the following questions long-term conditions refer to conditions that have lasted or are expected to last 6 months or more and have been diagnosed by a health professional. Does child have any of the following long-term conditions:
(Other conditions listed but only these two were used in this document.) Does child have any long term conditions or health problems which prevent or limit his/her participation in school, at play, or in any other activity for a child of his/her age? |
APS | NLSCY |
In the past 12 months, have you seen or talked on the phone with a pediatrician about …’s physical, emotional or mental health? In the past 12 months, have you seen or talked on the phone with a general practitioner or family physician about …’s physical, emotional or mental health? In the past 12 months, have you seen or talked on the phone with another medical specialist about …’s physical, emotional or mental health? In the past 12 months, have you seen or talked on the phone with a public health nurse or nurse practitioner about …’s physical, emotional or mental health?
|
In the past year, how many times have you seen or talked on the telephone with any of the following about child-s physical, emotional or mental health with:
|
APS | NLSCY |
When was the last time…had any dental care?
Does…need dental treatment at this time? Have arrangements been made for … to receive the needed treatment? Why have arrangements not been made?
|
In the past year, how many times have you seen or talked on the telephone with any of the following about child’s physical, emotional or mental health with: A dentist or orthodontist? No comparable national data for other questions. |
APS | NLSCY |
For children born on or after May 16, 1997: Is …currently being breast-fed? For how many months has he/she been breast-fed? For children born before May 16, 1997, or children not currently being breast-fed: Was…ever breast-fed? For how many months was…breast-fed? |
Are/Is you/her/his mother currently breast-feeding <child name>? Did you/her/his mother breast-feed him/her even if only for a short time? For how long? |
APS | NLSCY |
Last week, how often did … eat breakfast?
|
12-15 year olds were asked: During a school week (Monday to Friday), how many days do you normally eat breakfast? |
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