Members of First Nations communities are more than twice as likely to face an early and avoidable death than other Canadians, with the greatest risk faced by native women and young adults, according to a new benchmark study by Statistics Canada.
The sweeping study, using data from the 1991 long-form census, tracks mortality rates of 61,220 native adults and 2.5-million non-aboriginal Canadians over a 15-year period.
The results show a trend that widened over the course of the study, with the First Nations group significantly more likely to die before they reached their 75th birthday and from preventable conditions. Diabetes, disorders linked to alcohol and drug use, and injuries were the leading causes.
"Closing the gap in the quality of life between First Nations and Canada has to be our national priority," Assembly of First Nations National Chief Perry Bellegarde said in a statement to The Globe and Mail. "This report provides further evidence of what we know: The gap has not changed over time and it is killing our people."
Native men were twice as likely to die prematurely from avoidable causes and native women were 2-1/2 times as likely, the study found. The highest risk was found among First Nations members between 25 and 34 years of age. The risks for both men and women fell substantially when education and income were taken into account, suggesting, the researchers conclude, that socioeconomic factors "explain a substantial share" of the disparity.
The new numbers follow the report from the Truth and Reconciliation Commission earlier this year, which identified lingering health effects as a legacy of residential schools, and called on the federal government to take action to close the health gap and to provide sustainable funding for aboriginal healing centres and the integration of indigenous medicine in health care.
For Josée Lavoie, the director of the Manitoba First Nations Centre for Aboriginal Health Research at the University of Manitoba, the results are sadly familiar.
They are a reflection, she said, of the often "dismal access" for native populations to medical and mental-health services, as well as housing and education.
"It just gets worse," she said. "I see little action to improve it."
Health Canada responded to the findings by outlining its $2.6-billion annual investment in three broad areas: primary health care, which includes health promotion and disease prevention; supplementary health benefits; and health infrastructure support.
"Health Canada's objectives in relation to First Nations health are to improve health outcomes, ensure availability of, and access to, quality health services and support greater control of the health system by First Nations," it said in an e-mail statement.
Toronto physician and researcher Janet Smylie said the new numbers fill a gap in existing research created by the fact that Canada does not track ethnicity on death certificates.
She called the numbers "shocking," but suspects they actually underreport the disparity because the census undercounts aboriginal people, who represent a disproportionate percentage of the country's homeless population and those that are "highly mobile."
"To me, this is compelling evidence that we need to take serious the recommendations of the [Truth and Reconciliation Commission]," said Dr. Smylie, director of Well Living House, an indigenous action research centre at Toronto's St. Michael's Hospital.
It is also important, Dr. Smylie said, to remember the link between alcohol and drug use and unresolved complex trauma when looking at the causes of death.
The Statistics Canada study covers the period between June, 1991, and the end of 2006, and includes individuals 25 and older. It divides "avoidable mortality" into two groups: preventable deaths caused by factors such as injuries; and treatable mortality, which is a death that potentially could have been averted by screening, early detection and successful treatment, such as tuberculosis and female breast cancer.