6. HEALTH ISSUES

6.1 HEALTH STATUS

First Nations people were asked to provide a rating of their current state of health. Just over four in ten (43 per cent) rated their health to be excellent and half provided a rating of fair. A small minority - eight per cent - indicated their health to be poor.

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• Men and those with higher levels of income and education (as well as Internet access) are more apt to characterize their health as excellent. Residents of Quebec also provided more positive ratings of their health. Older individuals (and consequently those more likely to be out of the labour force) and those with lower-rated literacy skills provided poorer ratings of their health.

The rating provided by First Nations people on-reserve in terms of personal health is somewhat poorer than that provided by Canadians overall. The general public are more likely, for example, to provide a self-rating of their health that is excellent, compared with the rating provided by First Nations people (a difference of 14 percentage points).

6.2 EATING HABITS

Most individuals describe their eating habits as healthy (27 per cent) or mainly healthy (35 per cent). One-third of First Nations people say their diet needs improvement and a minority (five per cent) say their eating habits are not usually very healthy.

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• Those more apt to describe their eating habits as well-balanced and healthy are older (55 years and over), not in the labour force, and living in higher socio-economic communities. Individuals without children and those without Internet access also rated their eating habits more positively.
  
• Individuals between 25 and 34 years of age, with Internet access and with a college-level education more often describe their eating habits as mainly healthy. This is less likely to be true for those with lower levels of education.
  
• Those who say their eating habits need improvement have income levels in the upper middle range ($30,000 to $49,000).
  
• Ratings of eating habits correspond with self-rated health: those who describe their eating habits as healthy are also more likely to rate their own health as excellent. They are also more likely to rate their literacy as above average, suggesting a generally positive view of themselves.

About half of First Nations individuals say their current eating habits are similar to two to three years ago and 37 per cent say their eating habits are healthier than they were then. Relatively few (one in ten) have seen their eating habits decline over the last two to three years.

• Likelihood of indicating an improvement in eating habits increases with income and education levels. Similarly, residents with access to the Internet, higher-rated literacy skills and living in average or above-average socio-economic status communities are more apt to say they eat healthier now compared to two or three years ago. Improvement in eating habits is also related to excellent (self-rated) health.

According to respondents, the most important reason for healthy eating is because it is better for one's overall health (74 per cent). This is followed by reasons such as: to feel better (17 per cent); have more energy (15 per cent); live longer (seven per cent); and to keep fit and in shape (three per cent).

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• A well-balanced diet to improve one's overall health is more persuasive for older individuals compared to youth. Residents with lower levels of income and with an Aboriginal mother tongue are more likely than others to have provided a "don't know" response to this item.

6.3 EXERCISE

Over three-quarters of First Nations people on-reserve characterize themselves as physically active (28 per cent very active and 49 per cent somewhat active). One in five (18 per cent) say they are somewhat inactive and a minority (five per cent) say they are very inactive.

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• More active individuals are residents who are employed, have higher levels of income and rated their literacy skills as above average. Men and those who characterize their health as excellent are also more apt to be active. Individuals who are physically inactive are more likely to be Francophone and to have earnings in the middle range (between $20,000 and $29,000).

The majority of individuals feel that they should be more physically active - 35 per cent say they should be doing a lot more and another 43 per cent say they should be doing a bit more. Those who are currently physically active are more likely than those who are inactive to have indicated that they are content with their current level of activity (28 per cent versus five per cent). Conversely, those who are inactive more often indicated that they should be doing a lot more (62 per cent, compared to 25 per cent of those who are active).

• As with eating habits, those who are more likely to be content with their current level of physical activity are employed and have excellent levels of health (self-rated).

Lack of time is the predominant barrier to more physical activity (cited by 44 per cent). Another 12 per cent indicated that they "don't get around to it". For others, a physical condition prevents them from engaging in more physical activity (17 per cent). Eight per cent mentioned lack of facilities as a barrier to physical activity and seven per cent said they were not interested in more physical activity. Other reasons were mentioned by five per cent of individuals or fewer.

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• Lack of time is most likely to be a barrier to more physical activity for those with higher levels of income, education and literacy, people with Internet access, individuals in the younger/middle age categories (25 to 44 years), employed individuals, and parents with children. Those who are already physically active are more likely to cite lack of time as a constraint to more physical activity.
  
• Lack of exercise due to a physical condition was cited more often by older residents (55 years and older), those not in the labour force, residents with lower levels of education, income and literacy, Francophones and those who rated themselves to be in poor health.
  

6.4 HEALTHY PREGNANCY

According to First Nations residents under 40 years of age,3 the most important things pregnant women can do to increase their chances of having a healthy baby are: have a healthy diet (65 per cent); cut down or abstain from alcohol (53 per cent); cut down or abstain from smoking (48 per cent); and exercise (40 per cent). The remaining responses were mentioned by 14 per cent of respondents or fewer.

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• There were few significant differences in responses across sub-groups. In general, women and parents tended to be more knowledgeable about this issue (i.e., named more things pregnant women should do). Men, however, were more likely than women to note that pregnant women should cut down or abstain from smoking. Youth (16 to 24 years) were less able to provide a response to the question than their older counterparts.

The vast majority of First Nations individuals indicated that they would seek information about having a healthy pregnancy from their community health nurse (78 per cent). Another one in five (22 per cent) would seek information from their family doctor. Informal sources of information such as friends, family or community leaders were cited infrequently.

• Again, there are few notable sub-group differences. The exception is that residents of Quebec are more likely to seek information from their local hospital and less from a community health nurse. Residents in larger communities (3,001 or more population) and in more affluent communities more often indicated their family doctor as a source of information.

About two-thirds of residents indicated that consuming alcohol during pregnancy is likely to harm the unborn baby. There was little difference in responses based on whether the question indicated the level of alcohol consumption as being one alcoholic drink per week or three alcoholic drinks per week. Between eight and ten per cent of individuals believe that these levels of alcohol consumption are not likely to have an impact on the fetus.

• While the number of cases available for analysis of this variable is too small to thoroughly test sub-group differences,4 those with an Aboriginal mother tongue are less sensitive to this issue than Anglophones.

6.5 FETAL ALCOHOL SYNDROME

Virtually all First Nations people living on-reserve (96 per cent) have heard of Fetal Alcohol Syndrome (FAS) (somewhat lower in Quebec at 86 per cent). Moreover, most residents rightly indicated that FAS causes harmful effects to the unborn fetus (59 per cent) or to the child (36 per cent). Four per cent indicated FAS had harmful effects on the adult. Fifteen per cent responded "don't know" when asked about the effects of FAS.

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• Those who are less likely to have knowledge of the effects of FAS (i.e., provided a "don't know" response) are unemployed/not in the labour force, between 16 and 24 years of age, and have lower levels of education and literacy. Those living in smaller and lower socio-economic communities, and residents of Saskatchewan are also more likely to have indicated a "don't know" response.

When asked to name some of the specific effects of FAS, individuals provided a broad list of potential physical, mental and behavioural impacts. The most frequently mentioned impact was learning disabilities (43 per cent). Other impacts that came to mind were physical disorders (32 per cent) and mental disorders (26 per cent). About one in five residents of First Nations talked about birth defects, behavioural problems, delayed development and brain damage. Attention deficit disorder and cranial deformities were each mentioned by 16 per cent. The remaining responses were noted by 13 per cent or fewer. Only thirteen per cent could not name any specific examples of effects of FAS.

• People with higher levels of income ($50,000 or more), a post-secondary education and higher-rated levels of literacy provided a broader list of impacts of FAS. Residents of Ontario were more likely to name many different effects. Youth (16 to 24 years) could name fewer specific effects of FAS. Individuals with a lower level of education and residents of Saskatchewan are more likely to have provided a "don't know" response to the item compared to others.

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