The correlates of current smoking among adult Métis: Evidence from the Aboriginal Peoples Survey and Métis Supplement

Cancer Prevention and Cultural Continuity for Métis Peoples in Canada: A Scoping Review

The purpose of this scoping review was to map the literature on the relationship between cultural continuity and health among Métis people as well as how this knowledge could be translated into cancer prevention initiatives. We included any Métis-specific literature evaluating connections between culture, health, and well-being. We conducted electronic searches of Medline, PubMed, Embase, PsychInfo, I-Portal, and hand-searched journals, and reviewed the grey literature. Based on our inclusion criteria, articles were screened and assessed for eligibility, resulting in a sample of 22 publications. Qualitative, quantitative, and mixed methods designs were considered. The 22 publications included in this review were diverse, ranging from population-based studies to reports and news articles. There were no limitations to publication year, and most of the data presented in this review were published more than five years ago. Nevertheless, the results demonstrate the potential role of Métis cultural continuity in cancer prevention. The scoping review revealed the current lack of Métis-specific data regarding health and its intersectionality with culture. However, the existing literature indicates that cultural continuity for Métis appears to influence health and well-being positively. As such, there may be benefits to incorporating cultural continuity in cancer prevention efforts.

Traditional activities and general and mental health of adult Indigenous peoples living off-reserve in Canada

Introduction

We examined associations between traditional Indigenous activities and self-perceived general and mental health in adult Indigenous persons living off-reserve in Canada using the 2012 and 2017 Aboriginal Peoples Surveys (APS), the two most recent datasets. We utilized four traditional Indigenous activities including hunting, making clothes or footwear, making arts or crafts, and gathering wild plants to investigate these self-reported data.

Methods

Data from 9,430 and 12,598 respondents from the 2012 and 2017 APS, respectively, who responded to 15 questions concerning traditional activities were assessed using multivariable logistic regression to produce odds ratios (OR) and 95% confidence intervals (CI). Covariates included age, sex, education-level, income-level, Indigenous identity, residential school connection, ability to speak an Indigenous language, smoking status, and alcohol consumption frequency.

Results

Using the 2012 APS, clothes-making was associated with poor self-reported general (OR = 1.50, 95%CI: 1.12-1.99) and mental (OR = 1.59, 95%CI: 1.14-2.21) health. Hunting was associated with good mental health (OR = 0.71 95%CI: 0.56-0.93). Similarly, 2017 analyses found clothes-making associated with poor general health (OR = 1.25, 95%CI: 1.01-1.54), and hunting associated with good general (OR = 0.76, 95%CI: 0.64-0.89) and mental (OR = 0.69, 95%CI: 0.58-0.81) health. Artmaking was associated with poor general (OR = 1.37, 95%CI: 1.17-1.60) and mental (OR = 1.85, 95%CI: 1.58-2.17) health.

Conclusion

Hunting had protective relationships with mental and general health, which may reflect benefits of participation or engagement of healthier individuals in this activity. Clothes-making and artmaking were associated with poor general and poor mental health, possibly representing reverse causation as these activities are often undertaken therapeutically. These findings have implications for future research, programs and policies concerning Indigenous health.

Métis health in Canada: a scoping review of Métis-specific health literature

BACKGROUND

Métis are a culturally unique and distinct population, yet little research has evaluated their health separate from the broader Indigenous population. We sought to explore current literature regarding the health of Métis Peoples in Canada and identify potential trends and gaps.

METHODS

Using the Arksey-O'Malley, 5-stage, scoping review method, we searched PubMed, MEDLINE, iPortal Indigenous Articles Portal Research Tool and pertinent reference lists using the terms "Métis," "health" and "Canada." Two reviewers conducted the initial searches independently, including English articles from 2012 to 2022, and focused on only Métis populations' health within Canada. We described characteristics of the articles and themes for discussion.

RESULTS

Of the 572 articles we identified, we included a total of 28 articles in this scoping review, of which 16 were quantitative, 9 were qualitative and 3 used mixed methods. Thirteen articles used consultation with Métis communities as part of their methods, and 8 extracted data from national surveys. One article focused on children, while all other articles focused on adults. Nine articles used data from across Canada, 6 were based in Ontario, 5 in Alberta and 4 each in British Columbia and Manitoba. Themes included health, well-being and spirituality; mental health and substance use; health conditions and risk factors; access to adequate health resources; and experiences in health care.

INTERPRETATION

Métis-specific health research is lacking in Canada, with a gap in volume, subject matter and diversity in the demographics studied. This review illustrates the need for more research with strong community engagement to further explore Métis health and health service needs.

Evaluation of the relationship between values and psychological resilience of individuals diagnosed with substance use disorder: A cross-sectional study

The purpose of this study was to determine the relationship between values and psychological resilience in individuals with substance use disorder. This descriptive and correlational study was conducted with 70 individuals diagnosed with substance use disorder who had applied to the Alcohol and Drug Addiction Treatment and Research Center between February and April 2022 and volunteered to participate in the study. The data were collected using the Personal Information Form, Values Scale, and Brief Resilience Scale (BRS). All participants were male, the average age of substance use onset was 17.67 ± 5.95 years, and they had been receiving addiction treatment for 1.97 ± 2.30 years on average. The average total score of the individuals on the BRS scale was 17.18 ± 1.45. A significant positive correlation was found between the social values, intellectual values, spiritual values, materialistic values, human dignity, and freedom sub-dimensions of the Values Scale and psychological resilience (p < .001). Additionally, spiritual values were found to have the highest positive effect on the psychological resilience levels of individuals (B = 0.185; p < .05). Individuals with higher levels of social values, intellectual values, spiritual values, materialistic values, human dignity, and freedom were found to have higher psychological resilience. Nursing care provided by taking into account the values of the individual and strengthening their values may contribute to the psychological resilience of the patient.

Health effects of Indigenous language use and revitalization: a realist review

Background

Indigenous populations across the world are more likely to suffer from poor health outcomes when compared to other racial and ethnic groups. Although these disparities have many sources, one protective factor that has become increasingly apparent is the continued use and/or revitalization of traditional Indigenous lifeways: Indigenous language in particular. This realist review is aimed at bringing together the literature that addresses effects of language use and revitalization on mental and physical health.

Methods

Purposive bibliographic searches on Scopus were conducted to identify relevant publications, further augmented by forward citation chaining. Included publications (qualitative and quantitative) described health outcomes for groups of Indigenous people who either did or did not learn and/or use their ancestral language. The geographical area studied was restricted to the Americas, Australia or New Zealand. Publications that were not written in English, Spanish, French, Portuguese or German were excluded. A realist approach was followed to identify positive, neutral or negative effects of language use and/or acquisition on health, with both qualitative and quantitative measures considered.

Results

The bibliographic search yielded a total of 3508 possible publications of which 130 publications were included in the realist analysis. The largest proportion of the outcomes addressed in the studies (62.1%) reported positive effects. Neutral outcomes accounted for 16.6% of the reported effects. Negative effects (21.4%) were often qualified by such issues as possible cultural use of tobacco, testing educational outcomes in a student’s second language, and correlation with socioeconomic status (SES), health access, or social determinants of health; it is of note that the positive correlations with language use just as frequently occurred with these issues as the negative correlations did.

Conclusions

Language use and revitalization emerge as protective factors in the health of Indigenous populations. Benefits of language programs in tribal and other settings should be considered a cost-effective way of improving outcomes in multiple domains.

Spirituality, Ethnic Identity, and Substance Use among American Indian/Alaska Native Adolescents in California

Background. American Indian/Alaska Native (AIAN) adolescents have a higher prevalence of commercial tobacco, alcohol, and marijuana use than other racial/ethnic groups in the United States. It is unclear whether cultural factors such as ethnic identity, spirituality, and ceremonial use of traditional tobacco are associated with substance use, especially use of emerging tobacco products such as electronic cigarettes, among AIAN adolescents. Methods. This study investigated the association between hypothesized cultural protective factors (ethnic identity, spirituality, and ceremonial use of traditional tobacco) and past-month use of commercial cigarettes, e-cigarettes, marijuana, blunts, and alcohol among 156 AIAN adolescents in California (mean age = 15.3 years, 55% female). Adolescents from six AIAN schools and afterschool programs completed paper-and-pencil surveys. We used Logistic regression analyses to identify the significant cultural correlates of past-month substance use, controlling for demographic covariates. Results. As hypothesized, strong ethnic identity was protective against cigarette, marijuana, and alcohol use. However, it was not protective against e-cigarette or blunt use. Spirituality was associated with an increased risk of cigarette and marijuana use. Previous ceremonial use of traditional tobacco was not associated with past-month recreational substance use. Conclusions. Results indicate that the associations between cultural factors and substance use vary across substances. Future research should identify cultural factors that protect AIAN adolescents against use of newer products such as e-cigarettes and blunts.

The mental health of Indigenous peoples in Canada: A critical review of research

Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness. Research indicates that colonialism and its associated processes are important determinants of Indigenous peoples' health internationally. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health. This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada. We searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006-2016. Over two hundred papers are included in the review and coded according to research theme, population group, and geography. Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps. Mental health research related to Indigenous peoples in Canada overemphasizes suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples. The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world.

Factors Associated With Current Smoking Among Off-Reserve First Nations and Métis Youth: Results From the 2012 Aboriginal Peoples Survey

First Nations and Métis, two of Canada's constitutionally recognized Indigenous groups, suffer from poorer overall health than non-Indigenous Canadians. Current smoking, a known predictor of chronic health conditions, is close to twice as prevalent among Indigenous youth as it is among non-Indigenous Canadian youth. However, little population-level research has examined the correlates of current smoking among this population. Guided by a health framework centered on Indigenous-specific determinants, we used data from the 2012 Aboriginal Peoples Survey to examine the correlates of current smoking among First Nations and Métis youth aged 15-17 years living outside of First Nations reserves. Using binary logistic regression, we investigated how culturally specific factors, namely knowledge of an Indigenous language, participation in traditional activities, and family members' attendance at residential schools, were correlated with current smoking. We also considered demographic, geographic, socioeconomic and health-related correlates. Overall, an estimated 20.6% of First Nations and Métis youth reported current smoking. We found no significant associations between culturally specific activities and current smoking in the multivariate analyses, although those who spoke an Indigenous language were more likely to smoke. Those who participated in sports more often were less likely to smoke, and respondents who reported heavy drinking and who were from families with lower income were more likely to smoke. Gender, body mass index, urban/rural geography and regional geography, and mother's highest level of education were not significantly correlated with smoking. The results of our study support prior research that has found a disturbingly high prevalence of current smoking among Indigenous youth, compared to their non-Indigenous counterparts. Our results highlight the importance of considering sports participation, co-occurring health-risk behaviours and socioeconomic factors when developing interventions aimed at reducing the prevalence of smoking among First Nations and Métis youth.

A cross-sectional examination of the correlates of current smoking among off-reserve First Nations and Métis adults: Evidence from the 2012 Aboriginal Peoples Survey

INTRODUCTION

The purpose of this study was to examine the correlates of current smoking among off-reserve First Nations and Métis adults, two Aboriginal Canadian groups that are at higher risk to smoke and more likely to suffer from chronic health conditions relative to their non-Aboriginal counterparts. A particular focus was on culturally specific factors and their associations with current smoking.

METHODS

We used data from Statistics Canada's, 2012 Aboriginal Peoples Survey to investigate the correlates of smoking among 12,720 First Nations and Métis adults. Sequential binary logistic regression models were estimated to examine associations between smoking and culturally specific, demographic, geographic, socioeconomic and health-related variables.

RESULTS

Overall, 39.4% were current smokers. Multivariate results found that those who had hunted, fished or trapped within the last year were more likely to be smokers. In addition, respondents who were exposed to an Aboriginal language at home or outside the home were more likely to be smokers. Current smoking was significantly associated with being aged 35 to 49 years, living in a small population center, low income, low education, unemployment, being unmarried, low ratings of self-perceived health, heavy drinking and low body mass index. Respondents aged 65 years and older and those living in British Columbia were less likely to smoke.

DISCUSSION

The results of this study suggest that it may be useful to consider cultural characteristics, particularly language in efforts to reduce the prevalence of manufactured tobacco use among First Nations and Métis adults. Interventions should also consider demographic, geographic and socioeconomic variables, in addition to co-occurring health-risk behaviors.