Social Support and Thriving Health: A New Approach to Understanding the Health of Indigenous Canadians

Abstract

 RESEARCH AND PRACTICE  Objectives. We examined the importance of social support in promoting thriving health among indigenous Canadians, a disadvantaged population.Methods. We categorized the self-reported health status of 31 625 adult indigenous Canadians as thriving (excellent, very good) or nonthriving (good, fair, poor). We measured social support with indices of positive interaction, emotional support, tangible support, and affection and intimacy. We used multivariable logistic regression analyses to estimate odds of reporting thriving health, using social support as the key independent variable, and we controlled for educational attainment and labor force status.Results. Compared with women reporting low levels of social support, those reporting high levels of positive interaction (odds ratio [OR] = 1.4; 95% confidence interval [CI] = 1.2, 1.6), emotional support (OR = 2.1; 95% CI = 1.8, 2.4), and tangible support (OR = 1.4; 95% CI = 1.2, 1.5) were significantly more likely to report thriving health. Among men, only emotional support was significantly related to thriving health (OR = 1.7; 95% CI = 1.5, 1.9). Thriving health status was also significantly mediated by age, aboriginal status (First Nations, Métis, or Inuit), educational attainment, and labor force status.Conclusions. Social support is a strong determinant of thriving health, particularly among women. Research that emphasizes thriving represents a positive and necessary turn in the indigenous health discourse. (Am J Public Health. 2007;97: 182797: -183397: . doi:10.210597: /AJPH.2006 Social Support and Thriving Health: A New Approach to Understanding the Health of Indigenous Canadians | Chantelle A. M. Richmond, PhD, Nancy A. Ross, PhD, and Grace M. Egeland, PhD have so concentrated their efforts on the determinants of disparities that few have sought to model thriving health. In particular, there has been a lack of research into how one's societal resources, such as social support, can shape health status.

Social support, material circumstance and health behaviour: Influences on health in First Nation and Inuit communities of Canada

“…Earlier quantitative findings identified social support as a strong dimension and determinant of Aboriginal health (Richmond, Ross, & Bernier, 2007;Richmond, Ross, & Egeland, 2007). Limitations related to the quantitative stage of this research left important questions unanswered, and we recognized the need to draw from more interpretive approaches for better understanding how one's social embeddedness within their families and communities can impact health.…”

“…Drawing from Canada's 2001 Aboriginal People's Survey, Richmond, Ross and Bernier (2007) found social support to be a consistent dimension of health among Mé tis and Inuit populations of Canada, and in a related analysis, Richmond, Ross, and Egeland (2007) identified social support as a strong determinant of Indigenous health, in particular among women. Cummins, Ireland, Resnick and Blum (1999) identified connection to family as a consistently powerful dimension of physical and emotional health among Native American youth.…”

“…Despite reportedly high levels of social support (Richmond, Ross, & Egeland, 2007), many Aboriginal communities in Canada continue to endure patterns of mortality and morbidity that are influenced strongly by social pathologies, including family violence, sexual abuse, widespread poverty, and suicide (Adelson, 2005). These social problems have manifested into potent predictors of morbidity and mortality among this population, thereby leading us to question the role of social support in these processes.…”

“Now we got lots to eat and they’re telling us not to eat it”: understanding changes to south-east Labrador Inuit relationships to food

“…Ultimately, it is felt that "you are what you eat" (5). Aside from the physical health benefits associated with the activities of procuring traditional foods and eating nutritious foods to ward off deficiencies, Inuit believe that foods reinforce social and cultural connections, which have important implications for social and emotional health and well-being (5,22,24,25). As well, traditional food-sharing activities have been linked with spiritual and mental health benefits, as well as benefits associated with passing cultural knowledge on to future generations (1,2,14,26,27).…”

Community- and individual-level factors associated with smoking and heavy drinking among Aboriginal people in Canada

“…[21][22][23] Lower levels of perceived social support have also been linked to daily smoking and heavy use of alcohol among the non-Aboriginal population. 24,25 Few studies have examined the association between social support and alcohol and tobacco use among Aboriginal people.…”