Abstract

Background

The objective of this study was to describe sex-specific hospitalization rates among Indigenous people in Canada (excluding Quebec), separately for First Nations people living on and off reserve, Inuit living in Inuit Nunangat (excluding Nunavik), Métis, and the non-Indigenous population.

Data and methods

The 2006 and 2011 Canadian Census Health and Environment Cohorts (CanCHECs) were used, allowing hospital records to be examined by Indigenous identity as reported on the census. Five years of hospitalization data were used for each CanCHEC. Causes of hospitalization were based on the most responsible diagnosis and coded at the chapter level according to the International Classification of Diseases (ICD-10-CA). Age-standardized hospitalization rates (ASHRs) were calculated per 100,000 population, and rate ratios (RRs) were calculated for each Indigenous group relative to non-Indigenous people.

Results

ASHRs were higher among Indigenous people than among non-Indigenous people; this was true for females and males from both the 2006 and the 2011 cohorts. Hospitalization patterns varied by sex and Indigenous group. The greatest disparities with the non-Indigenous population were observed among on-reserve First Nations females and males from both cohorts. Elevated RRs were observed for diseases of the endocrine, nutritional and metabolic system among First Nations females and males living on reserve; hospitalizations for mental health among First Nations females and males living off reserve and Inuit males; and diseases of the respiratory system among Inuit females. For Métis females and males, equally elevated RRs were observed for diseases of the endocrine system and mental health. ASHRs for most causes decreased between the 2006 and 2011 cohorts, with the exception of ASHRs for mental health among First Nations females and males living on reserve, which increased.

Interpretation

Findings are consistent with recognized health disparities between Indigenous and non-Indigenous people. Further research is warranted to understand reported differences in hospitalization patterns.

Keywords

Administrative data, CanCHEC, census, data linkage, First Nations, health care, hospital records, Inuit, Inuit Nunangat, Métis, on-reserve

DOI: https://www.doi.org/10.25318/82-003-x202100700002-eng

Findings

In Canada, there are continuing disparities in health outcomes between the Indigenous and non-Indigenous populations. The reasons behind these disparities are complex. It is recognized that the ongoing effects of colonization, racism and intergenerational trauma on Indigenous people, as well as their greater disadvantage in many of the social determinants of health relative to the non-Indigenous population, have contributed to their poorer health outcomes. [Full article]

Author

Evelyne Bougie (Evelyne.Bougie@canada.ca) is with the Health Analysis Division, Analytical Studies Branch, at Statistics Canada.

Acknowledgements

The author is grateful for the feedback received from Jeremiah Hwee, Dafna Kohen, Veeran-Anne Singh, Mike Tjepkema, Rochelle Garner and Gisèle Carrière on earlier drafts of this manuscript. The author is also grateful for the feedback provided by the anonymous peer reviewers, as well as the feedback received from analysts at the Public Health Agency of Canada, the Centre for Indigenous Statistics and Partnerships, the Congress of Aboriginal Peoples, Inuit Tapiriit Kanatami, and the Native Women’s Association of Canada.

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