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New report finds 'critical and alarming gap' in high quality, comprehensive and inclusive data for urban Indigenous populations in Canada

Toronto, February 28, 2018

By Leslie Shepherd

Dr. Janet Smylie
Dr. Janet Smylie

More than one-quarter of Indigenous adults living in Toronto have had a close friend or relative disappear or go missing, according to a comprehensive new report on the health and health-care needs of Indigenous people in Canada’s largest city.

Yet 18 per cent of those missing people were never reported to police, according to the report, Our Health Counts Toronto, released today.

The report also found that one in 10 Indigenous adults in Toronto have had to file a missing person’s report with police for a child or relative and one in three have had a close friend or relative die as a result of violence caused by another person.

Our Health Counts Toronto is the largest urban Indigenous population health study in Canada. The research was conducted by Indigenous people for Indigenous people, said project lead Dr. Janet Smylie, a researcher at St. Michael`s Hospital and one of the first Métis physicians in Canada.

The study found that 11 per cent of Indigenous adults living in Toronto had been students at a federal residential or industrial school and 59 per cent said they had at least one relative who had attended such schools. Almost half of those who were students themselves (46 per cent) said their health and well-being were still negatively impacted by the experience. Of those who had a relative attend a residential school, 37 per screened positive for post-traumatic stress disorder.

“These findings are aligned with the recommendations made by the Truth and Reconciliation Commission to recognize and address the roots of Indigenous health inequities in Canada – historic and ongoing colonial processes such as residential schools and racism in our policing and legal systems,” said Dr. Smylie, a scientist with St. Michael’s Centre for Urban Health Solutions.

“When we factor in the recent acquittals of two white men in the Colten Boushie and Tina LaFontaine murder trials it becomes painfully obvious that there are major system issues. Authentic truth and reconciliation is going to require non-Indigenous peoples to engage in some difficult conversations and self-reflections.”

The study also found signs of resilience and hope.

“The release of this report is very timely,” said Sara Wolfe, a founding partner from Seventh Generation Midwives Toronto and the lead community partner for the Our Health Counts Toronto study.

“There is a national awakening as to the layers of system failures affecting Indigenous peoples in Canada, and the unacceptable gaps in areas including health, education, employment, violence and criminal justice. But if we build off of our many strengths and resiliencies, we will start to find hope for good health and equality.”

Most Indigenous adults surveyed said their physical, mental, emotional and spiritual aspects were in balance some, most or all of the time and more than three-quarters said they felt a strong connection to the land/Mother Earth.

The survey found a strong desire for traditional ceremonies, medicines and food.

Two-thirds of Indigenous adults in Toronto have participated in traditional ceremonies, such as smudging, sweat lodges, healing or Qulliq or Kudlik lamp lighting ceremonies. However, one-third said they experienced challenges in accessing traditional ceremonies, such as being unsure where to find them, not knowing enough about them, and distance to travel.

Almost half (49 per cent) of Indigenous adults used traditional medicines to maintain health and well-being.

“Solutions to the gaps in health outcomes are already held within the community itself, but unless programs and services are Indigenous-led, use holistic and culturally relevant approaches, and have sustainable funding, using appropriate funding formulas that address the actual population size and disparities, these gaps will continue to cost everyone,” Wolfe said.

Dr. Smylie said access to and consumption of traditional foods are important methods for alleviating food insecurity and improving health among Indigenous peoples.

Half of indigenous people in Toronto said they had eaten traditionally hunted/gathered/grown foods such as game meat, wild rice and berries in the past 12 months and 74 per cent of adults said they would prefer eating more.

Those findings are significant given that one in four of the people surveyed indicated they and others in their household sometimes or often did not have enough to eat in the last year.

An earlier finding of the study was that the Indigenous population in Toronto is two to four times larger than reported by the last national Census – 34,000 to 69,000 vs. 19,500 reported by Statistics Canada.

Only 14 per cent of Indigenous adults in Toronto completed the 2011 Census; to obtain a representative sample, 53 per cent should have filled it out.

Dr. Smylie said the discrepancy could be explained by people moving or being homeless, being distrustful of government surveys or, in the case of many young people in all parts of Canadian society, disengaged from such formal government processes.

This study was conducted using respondent driven sampling, an internationally recognized method for gathering reliable information from hard-to-reach populations. Twenty people called “seeds” completed the survey and were then given five uniquely coded coupons to give to other Indigenous people in their social network. Those people then completed the survey and gave out coupons to others in their social network.

This study was funded by the Canadian Institutes of Health Research.


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St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.