Abstract
Objectives
1) To examine the association between place of residence (i.e., on- versus off-communities and between provinces) and daily smoking and heavy drinking among Aboriginal people in Canada; and 2) to identify community- and individual-level factors that may account for these associations.
Methods
Data were from the Aboriginal Peoples Survey (2001). The sample included 52,110 Aboriginal people (≥15 years of age). Community-level variables included: place of residence, community socio-economic status (SES) and perceived community social problems. Individual-level variables included: age, sex, education, income, employment status, marital status, Aboriginal heritage and social support. Multilevel logistic regressions were conducted to analyze the data.
Results
Living in First Nations communities (compared with living off-communities) was associated with daily smoking, and this association was accounted for by perceived community social problems. However, the association between Inuit communities and daily smoking remained after controlling for all covariates (odds ratio (OR) = 1.97, 95% confidence intervals (CI) = 1.44–2.70). Residence in First Nations communities was associated with heavy drinking (OR = 1.54, 95% CI = 1.17–2.04), however this risk became evident only after controlling for community SES, which was also positively associated with heavy drinking (OR = 1.46, 95% CI = 1.26–1.69). Compared with Saskatchewan, Aboriginal people in Atlantic Provinces (OR = 2.80, 95% CI = 2.08–3.78) or Territories (OR = 1.39, 95% CI = 1.01–1.92) were more likely to engage in heavy drinking.
Conclusion
Studies are needed to better understand the increased risk for smoking in Inuit communities and heavy drinking in First Nations communities, Atlantic Provinces and Territories, and to identify possible reasons for the positive association between community SES and heavy drinking among Aboriginal people.
Key Words: Aboriginal people, place of residence, smoking, heavy drinking
Résumé
Objectifs
1) Examiner l’association entre le lieu de résidence (dans les communautés ou à l’extérieur, et entre les provinces) et les excès quotidiens de tabac et d’alcool chez les Autochtones du Canada; et 2) cerner les facteurs communautaires et individuels pouvant expliquer ces associations.
MéThode
Nos données provenaient de l’Enquête auprès des peuples autochtones (2001). L’échantillon incluait 52 110 Autochtones (≥ 15 ans). Les variables communautaires étaient: le lieu de résidence, le statut socioéconomique (SSE) de la communauté et les problèmes sociaux perçus de la communauté. Les variables individuelles étaient: l’âge, le sexe, l’instruction, le revenu, l’emploi, l’état matrimonial, les racines autochtones et le soutien social. Nous avons effectué des analyses de régression multiniveaux pour étudier les données.
Résultats
La vie dans les communautés des Premières nations (par opposition à la vie à l’extérieur de ces communautés) était associée au tabagisme quotidien, et cette association pouvait s’expliquer par les problèmes sociaux perçus de la communauté. Cependant, l’association entre les communautés inuites et le tabagisme quotidien subsistait même après la prise en considération de toutes les covariables (rapport de cotes (RC) = 1,97, intervalle de confiance (IC) de 95 % = 1,44–2,70). Le fait de résider dans une communauté des Premières nations était associé à l’excès d’alcool (RC = 1,54, IC de 95 % = 1,17–2,04), mais ce risque ne devenait manifeste qu’après avoir tenu compte du SSE de la communauté, lequel était aussi lié positivement à l’excès d’alcool (RC = 1,46, IC de 95 % = 1,26–1,69). Comparativement à ceux de la Saskatchewan, les Autochtones des provinces de l’Atlantique (RC = 2,80, IC de 95 % = 2,08–3,78) ou des Territoires (RC = 1,39, IC de 95 % = 1,01–1,92) étaient plus susceptibles de faire des excès d’alcool.
Conclusion
Des études sont nécessaires pour mieux comprendre le risque accru de tabagisme dans les communautés inuites et l’excès d’alcool dans les communautés des Premières nations, les provinces de l’Atlantique et les Territoires, et pour découvrir les raisons possibles de l’association positive entre le SSE communautaire et l’excès d’alcool chez les Autochtones.
Mots Clés: population d’origine amérindienne, lieu de résidence; tabagisme, excès d’alcool
Footnotes
Acknowledgements: This study was approved by the Social Sciences and Humanities Research Council of Canada. Kyu. was supported by a Lawson Postdoctoral Fellowship. Georgiades was supported by a Canadian Institutes of Health Research New Investigator Award and the David R. (Dan) Offord Chair in Child Studies. MacMillan was supported by the Chedoke Health Chair in Child Psychiatry. Boyle was supported by a Canada Research Chair in the Social Determinants of Child Health, which also provided graduate student support to Kyu.
Conflict of Interest: None to declare
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