Report: Determinants of Mental Health Among Indigenous Canadians

This report investigates the determinants of mental health within Canadian Indigenous populations, highlighting the impact of historical traumas like residential schooling, cultural suppression, and historical oppression. It explores the significant disparities in mental health outcomes between Indigenous and non-Indigenous peoples, focusing on factors such as residential schooling, cultural continuity, substance abuse, and food insecurity. The study utilizes secondary data from Health Canada to analyze the relationship between household food insecurity and various mental health consequences, including depressive episodes, anxiety disorders, and self-elimination thoughts. The analysis reveals a positive correlation between food insecurity and adverse mental health outcomes, emphasizing the need for interventions to reduce household food insecurity and improve mental well-being within these communities. The report also acknowledges limitations such as the use of self-reported data and the need for longitudinal studies, while concluding with recommendations for supporting mental health services, empowering Indigenous communities, and training mental wellness workers. This report is a valuable resource for understanding the complex interplay of factors affecting the mental health of Indigenous Canadians and the potential for positive change.

Running head: DETERMINANTS OF MENTAL HEALTH
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Determinants of Mental Health
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Institution

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Determinants of Mental Health
The indigenous populations in Canada have faced numerous mental challenges given that
they have been subjected to a number of historical traumas. Colonization, cultural suppression,
and historical oppression are to blame for their mental woes. Research has also shown that
Aboriginals in Canada have a significant disparity in terms of their mental health compared to
non-indigenous people. Indigenous people suffer from poorer mental health and high suicidal
rate compared the non- indigenous people. There are many determinants of mental health among
the aboriginals.
Residential schooling happens to be one of the determinants of mental health among the
Aboriginals in Canada. It is responsible for the severe multi-generational effects on families as
well as communities. Not only had the attendees suffered from the trauma of residential
schooling but also the generations which followed as well. As results of the trauma parents went
through from residential schooling, it was difficult for them to form healthy emotional bonds
with their children given that they were separated from their own families at a young age. They
were also denied the sense of community which is normally characterized by indigenous people
as one of their traditions. Subsequent research showed that residential schools attendees were
likely to have developed mental related issues (Gundersen & Ziliak, 2015). Some of these issues
include post-traumatic stress disorder, substance abuse disorder, and depression.
Cultural continuity is another determinant of mental health among the Aboriginals. The
suicidal rate was found to be high among the youths who had undergone a profound cultural
change. Another study has shown that there is a decreased suicidal rate in a society where there
is a strong sense of community control. There are several characteristics associated with cultural
continuity: control of police and fire services, education matters, and health issues, local facilities

DETERMINANTS OF MENTAL HEALTH 3
for cultural activities, self-government, and involvement in land claims. Communities that
maintained serious community practices had lower suicidal rates among the youth. Cultural
discontinuity is associated with identity and autonomy which with time bring about mental
distress.
Substance abuse is also to blame for poor mental health among the Aboriginals. Alcohol
is the most abused substance and is a growing problem within the community. In fact, it is
believed to be one of the leading causes of death for Aboriginals. Aboriginal men have a
tendency of avoiding medical services as a way of helping them cope with depressive symptoms;
instead, they use unhealthy strategies which have numerous health effects. Excessive drinking is
one of the strategies they use to cope with stress and other depressive symptoms. Therefore
substance abuse plays a role in the mental health of Aboriginals mostly men.
Food insecurity is another determinant of mental health among the Aboriginals.
Aboriginal people are vulnerable to food insecurity compared to the non-indigenous population
in Canada. Household food insecurity is associated with mental health. Food insecurity is
associated with the low-income group in the sense that they can’t afford to provide to adequately
to their families. A research study has shown, individuals in the low-income group are three to
four times likely to report cases of mental distress as compared to high-income groups. This
paper intends to examine whether the level of household food insecurity is associated with six
adverse mental health consequences. The mental health outcomes include; depressive episodes in
the last one year, depressive thoughts in the last one month, anxiety disorders, mood disorders,
self-reported mental health status, and self-elimination thoughts.
The study used secondary data obtained from Health Canada’s office of nutrition policy
and nutrition given that it was not possible because it was hard to collect primary data. The

DETERMINANTS OF MENTAL HEALTH 4
recent four survey cycles were used given that they contained information on many health issues
ranging from health status, health care utilization, and health care determinants (Statistics
Canada, 2016). Sample sizes, as well as another aspect of conducting surveys, were reached at
by the Canada statistics office given that it is part of their mandate. Questionnaires administered
during this study comprised of questions seeking to address the contribution of food insecurity to
the increased cases of mental health among the aboriginal population in Canada.
Various social demographic variables were also used in the study as part of the analysis.
Notably, these include; age, gender, household education, marital status, and availability of
household income. Household education was designed to measure the overall knowledge
concerning each household member. The same criterion was employed while considering the
availability of house income as well as the total contribution in the 12 months before the
interview. The relationship between these factors and the adverse mental health outcomes was
also established. Notably, this was important to establish the role these factors played as far as
the mental health of the aboriginal population of Canada is concerned.
Several health questions were also used as a way of assessing the population mental
health and the well-being of the population. The survey narrowed down to a number of mental
health consequences (Moffat, Mohammed, & Newbold, 2017). The identified consequences were
analyzed to assess what could have brought such outcomes and therefore deal with the root cause
to avert such result in the future (Davison, Marshall-Fabien, & Tecson, 2015). Respondents
were advised to respond to the outcomes which they were certain or diagnosed of by a physician
to ensure the study was quite authentic.
Data obtained from the Canadian statistical office was analyzed using statistical software
given that it was not practical to do the study otherwise due to the complexity of the data.

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STATA (Version 14) was the leading software employed in the analysis given that it is able to
handle such complex and huge data (Adams et al., 2017). SPSS and R software were used to do
some simple descriptive analyses which did not require complex analysis.
Bivariate analysis was employed to establish the proportion by a level of the household
food insecurity of the aboriginal population in Canada concerning each of the mental health
outcomes highlighted earlier. The use of crude also determined odds of reporting mental health
outcomes and adjusted binary logistic analysis (Garthwaite, Collins, & Bambra, 2015).
Covariates were also included in multivariate models by doing an analysis of their relationships
with their respective mental health outcomes.
Reducing the general marginal effect was conducted to quantify mental health outcome
reduction by eliminating severe household food insecurity of the aboriginal population of Canada
compared to the other community which is considered as food secure. The probability of
reporting each of the mental outcomes was also assessed by a generation of probit models.
To account for the clustering caused by the survey designs which are, analyses were
conducted on the sample weighted data obtained from the Canada statistics office. Estimates
were also generated using the 500 bootstrap replicates. To test the level of significance, an alpha
level of p < 0.05 was used. Statistics Canada vetting procedure was involved in approving the
small size sample estimates to ensure that they met the minimum conditions set by the
institution.
From the analysis conducted, the aboriginal Canadian population within the age of
between 18-64 experiencing household food insecurity is 27.1 percent [95% CI: 24.9-29.3],
while severe cases of some households experiencing an extreme level of households food

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insecurity was established to be at 5.4 percent [95% CI: 9=3.7-7.5] (Tarasuk, 2017). There were
different proportions of respondents reporting any of the six mental outcomes.
Weighted and bootstrapped percent of aboriginal Canadian population who had reported
the various mental health consequences the level of food insecurity was also conducted.
Correlation between the household food insecurity and the rate of reporting of the six adverse a
mental consequence was established to be positive (Boksa, Joober, & Kirmayer, 2015). The
analysis also established that the existence of a two-fold difference as far as the burden of mental
outcomes between food insecure and marginally food insecure households is concerned. One of
the issues of great concern according to the study was the high level of mental health
consequences among the food insecure households. The analyses established a range from
35.5percent [95% CI: 29.5-38.6 disorders associated with anxiety] to 53.6 percent [95% CI:
47.9-58.2, elimination of self-life].
Results from reducing the effect marginally were also determined. Notably, these results
can help in identifying the percent point reduction concerning the six mental health
consequences in a scenario where respondents were in a food secure society (Sriram & Tarasuk,
2016). The marginal effects explain how various measures which could employ can minimize
and gradually reduce household food insecurity in the aboriginal population of Canada (Tarasuk
et al., 2015). Given that the extreme cases of food insecurity in this particular group of people
were to be drastically improved it, therefore, means that there would be a point reduction in the
rate of recorded cases of depressive thoughts among these households (Maynard et al., 2018).
Other factors notwithstanding, Household food insecurity contribute magnificently in the number
of matters relating to mental health consequences (O'Donnell, Wendt, & National Association of

DETERMINANTS OF MENTAL HEALTH 7
Friendship Centres., 2017). Besides, the analysis established reduced health psychological
consequences concerning all levels of household food insecurity.
The analysis has established a directly proportional relationship between household food
insecurity and the various mental health consequences (Yang, 2015). Notably, this implies that a
possible intervention to reduce household food insecurity would mean a reduction in the number
of mental health consequences cases (Compton & Shim, 2015). It also established that
respondent reporting severe household food insecurity had the highest risk. Marginal household
food insecurity group also recorded an increased risk of reporting mental health consequences.
Through marginal effect reduction, the study estimated the impact of food insecurity. The
extreme food insecure population would experience an improvement of a significant percentage
as far as cases of mental health consequences are concerned (White, Imperiale, & Perera, 2016).
A decisive intervention in the health of the aboriginal population would shift the risk
curve and therefore reduce the gradient concerning all risks involved. There is some intervention
which could be employed ranging from financial support, income volatility protections income
transfers and better access to higher education among the people at risk (Sriram & Trace, 2015).
Use of large sample frequently puts the study at risk of type error one as it is the case in
this study given that it has employed a large sample size. Notably, this implies rejecting the null
hypothesis when it is; in fact, true (Oleckno, 2008).
By the use of self-reported mental outcomes, it means that there is a considerable room
for error. This could be attributed to a low response rate of particular consequences of mental
health
Time constraint was also a limitation given that there was no adequate time to carry out
more analysis and come up with more concrete findings (Andermann, 2016). Resources were

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also not sufficient as anyone would wish to do a significant research study on a matter of mental
health magnitude.
A longitudinal study would have been ideal for this kind of education given that
observation over a considerable period to offer good recommendations on how to deal with
household food insecurity.
In conclusion, there are a number of measure which can be put in pace to address the
mental illness menace among the Aboriginals: Supporting and lobbying for cooperation among
government entities to provide sustainable, dedicated funding for provision of mental health
services, training of young Aboriginal professionals, empowering the Aboriginals economically,
as well as supporting their mental wellness workers. Those are some of the steps which help
fight mental illness decisively.

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