Urban Aboriginal mobility in Canada: Examining the association with health care utilization

Abstract

In recent decades, Indigenous peoples across the globe have become increasingly urbanized. Growing urbanization has been associated with high rates of geographic mobility between rural areas and cities, as well as within cities. In Canada, over 54 percent of Aboriginal peoples are urban and change their place of residence at a higher rate than the non-Aboriginal population. High rates of mobility may affect the delivery and use of health services. The purpose of this paper is to examine the association between urban Aboriginal peoples' mobility and conventional (physician/nurse) as well as traditional (traditional healer) health service use in two distinct Canadian cities: Toronto and Winnipeg. Using data from Statistics Canada's 2006 Aboriginal Peoples Survey, this analysis demonstrates that mobility is a significant predisposing correlate of health service use and that the impact of mobility on health care use varies by urban setting. In Toronto, urban newcomers were more likely to use a physician or nurse compared to long-term residents. This was in direct contrast to the effect of residency on physician and nurse use in Winnipeg. In Toronto, urban newcomers were less likely to use a traditional healer than long-term residents, indicating that traditional healing may represent an unmet health care need. The results demonstrate that distinct urban settings differentially influence patterns of health service utilization for mobile Aboriginal peoples. This has important implications for how health services are planned and delivered to urban Aboriginal movers on a local, and potentially global, scale.

Planning and Delivery of Health Services - An Article Review on Urban Aboriginal Mobility in Canada: Examining the Association With Healthcare Utilization

“…Research by Wilson, Rosenberg, and Abonyi (2011) explains that the older Aboriginal population is predominantly affected, as they experience geographic isolation and loss of traditional approaches to healing due to their colonial past. This strengthens the article's findings by indicating that "traditional healing represents an unmet healthcare need" for the Aboriginal population in Toronto and may require a person to travel outside the city in search of traditional healthcare services (Snyder & Wilson, 2012). For further support, the results illustrate that only a small fraction of newcomers have access to traditional healer use in Toronto when compared to Winnipeg.…”

“…Snyder and Wilson open the article by briefing the readers on the history of Indigenous population of Canada, referred to as Aboriginals. They suggest various "push and pull factors" including socioeconomic status (SES), education, and unmet healthcare needs that influence the Aboriginal population to migrate to urban environments (Snyder & Wilson, 2012). These factors of migration strongly align with Evelyn Peters' research (2005) on urban Aboriginal communities in Canada, and set a foundation upon which the authors attempt to explain the utilization of health services amongst the Aboriginal population.…”

“…Using the data from Statistics Canada's 2006 APS, Snyder and Wilson have astutely applied this model, using binary logistic regression analysis, to correlate the three factors to physician, nurse, and traditional healer use. In their research, Winnipeg and Toronto are the two Canadian Census Metropolitan Areas (CMAs) that were compared due to the contrasting differences in their Aboriginal population size, geographical location, and Aboriginal-led services offered (Snyder & Wilson, 2012). By using a similar approach, research conducted by Peters (2006) and Snyder and Wilson (2015) both provide support for this viewpoint.…”

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An article from Social Science and Medicine, written by Snyder and Wilson (2012), examined the use of healthcare services by urban Aboriginal populations in Canada. Using the Behavioural Model of Health Services Use (BMHSU), predisposing, enabling, and need factors were organized and used for data analysis.

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Diabetes prevalence, incidence and mortality in First Nations and other people in Ontario, 1995–2014: a population-based study using linked administrative data

“…This information may be outdated, given the high mobility of First Nations people. 34,35 In addition, the Registered Persons Database contains information for a small number of individuals who are deceased or no longer living in Ontario; as such, this database likely underestimates mortality.…”