Indigenous Health Disparities and Suicide in Canadian Urban Communities

Introduction to Aboriginal Populations in Canada

The Inuit, Metis, and First Nations are three distinct groups constitutionally recognized as comprising the Aboriginal population of Canada. Each has distinct needs and characteristics. For instance, the First Nations include over 50 individual groupings, the Inuit speak a variety of different dialects, and while the Metis speak several languages, they maintain their specific language, Michif. Rather than viewing these groups through a Pan-Aboriginal perspective that emphasizes shared present health needs and historical differences, the Aborigines of Canada expect their linguistic and cultural diversity to be affirmed and recognized. The term "Aborigines" carries derogatory connotations from the colonial legacy and is therefore generally frowned upon. Indigenous peoples prefer the terms Inuit and Metis, First Nations, or Indigenous to refer to each of the distinctive groups. In this report, these terms are used interchangeably.

Aboriginal Populations in Urban Centers

A significant portion of Indigenous populations now resides in urban centers across Canada. Statistical data from Canada indicates that the percentage of Indigenous populations dwelling in urban areas grew from 47% in 1996 to 49% in 2001, and by 2006 had reached 54%. Research on the urban life of Indigenous peoples in Canada shows that First Nations and Metis populations without recognized status are the most urbanized, accounting for 74% and 66% of those living in urban areas, respectively. Among First Nations with recognized status—that is, those registered—approximately 38% are urban dwellers, while fewer than 30% of the Inuit live in cities. An independent source reports that nearly 11,000 Inuit live outside Nunangat, the traditional territory primarily located in the Arctic, with concentrations in Edmonton, Yellowknife, Montreal, and Ottawa-Gatineau. In Toronto alone, Inuit comprise only 1.4% of the total Indigenous population (First Nation Inuit and Metis Report, 2012).

A 2006 survey by EKOS revealed that nearly 42% of Indigenous people living outside reserves had experienced racial discrimination, with schools accounting for 28% of these incidents. Additional research on urban Indigenous populations confirmed that many experience racism in various forms (Environics, 2010).

Racial Discrimination and Service Access

Among those reporting racial discrimination or poor treatment, 48% of Inuit and 50% of First Nations people are more likely to report negative treatment in service provision compared to non-Indigenous people, while the Metis report a mistreatment rate of 36%. In Toronto, discrimination accounts for approximately 59% of reported incidents. These findings have significant consequences for Indigenous peoples' willingness to access services.

In 2011, the lack of running and portable water prompted a First Nation to declare a state of emergency on April 15th. This crisis required a dedicated and integrated approach, as it posed serious health risks and strained the community's financial resources. The community's access to electricity is limited to generators, which are unreliable because residents are not connected to the main power grid. Efforts to connect the community to the grid are underway. Notably, out of 170 job opportunities available in 2008, approximately 50 positions for teachers and nurses were held by people from outside the community (First Nation Inuit and Metis Report, 2012).

Poverty and Social Impoverishment in Pikangikum

Pikangikum First Nation is one of the most isolated and impoverished Indigenous communities. Most residents lack plumbing or running water and live in substandard, overcrowded housing. Poverty is widespread; residents face water and food insecurity and lack gainful employment. Poor education by provincial standards and severe infrastructure deficits compound the challenges of social exclusion, racial discrimination, and the historical injustices of colonialism. The absence of residential educational institutions further limits opportunities. These conditions create a disoriented youth generation caught between cultural and social disconnection and traditional First Nations origins, ill-equipped to navigate contemporary societal norms and demands.

A report from the North/South Partnership for Children identified significant environmental challenges facing Pikangikum residents, documenting major economic, infrastructural, health, social, governance, and community capacity deficits. These deficiencies are interconnected and not susceptible to quick-fix solutions (Death Review of the Youth Suicides at the Pikangikum First Nation, 2006–2008, n.d.).

Youth Identity Crisis and Suicide

Although youth view police officers as role models, and despite officers' awareness of the challenges facing Indigenous youth, little concrete action has been taken to help. The Metropolitan Toronto Police was the first urban police service in Canada to establish a dedicated unit addressing the specific needs of Aboriginal youth. However, cultural and historical factors continue to prevent Indigenous peoples from fully utilizing available police services.

Many young people in the NishnawbeAski community face a profound identity crisis. They do not feel they belong anywhere and lack a sense of connection. The media exposes them to lavish, trendy lifestyles through school and temporary visits to urban centers, yet when they confront the extreme poverty and neglect in which their families live, they are torn between two worlds. Although labeled as Indians, they know this identity does not fit them; though the land and its resources should sustain them, neither media nor mainstream education helps them make this essential connection. Daily, they grapple with existential questions about why they exist and who they truly are.

When intergenerational emotional, physical, and sexual abuse—consequences of identity loss and residential school trauma—are added to this crisis, suicide becomes an understandable, if tragic, response. For some young Indigenous people, suicide emerges as a perceived escape from the vicious cycle of abuse, racial and social discrimination, and unrelenting poverty (Death Review of the Youth Suicides at the Pikangikum First Nation, 2006–2008, n.d.).

Education as a Critical Health Factor

Basic infrastructure improvements—connection to safe sewerage systems, provision of safe drinking water in every home, and access to a dependable power grid—would address immediate needs such as the use of pit latrines and unreliable diesel generators. However, education stands as the most critical social determinant of health. No greater barrier exists to social wellbeing, general health, mental health, and suicide prevention in Pikangikum than its inadequate education system. Many children do not attend school or sniff solvents; those who do attend receive insufficient preparation for the challenges they will face outside their community. Nearly all fail to gain admission to post-secondary institutions (Death Review of the Youth Suicides at the Pikangikum First Nation, 2006–2008, n.d.).