Richmond, Chantelle A.M. (2009). The Social Determinants of Inuit Health: A Focus on Social Support in the Canadian Arctic. International Journal of Circumpolar Health,
Overall, three of the social determinants in this study were significantly associated with health for both younger Inuit and those These were the strength of family ties, educational attainment and obesity. Strong or very strong family ties were associated with higher levels of excellent or very good health, while those with less than a high school education and those who were obese were associated with lower levels of excellent or very good health.
A given social determinant can not only have a direct impact on health, but may also affect conditions influencing other social determinants (Reading and Wien, 2009; Inuit Tapiriit Kanatami, 2014). For instance, poor quality housing has been shown to be associated with both physical and mental health outcomes (Chief Public Health Officer of Canada, 2008). At the same time, disparities in housing have been linked to employment, educational attainment, and food security all of which directly relate to health outcomes From a policy standpoint, it is informative to identify social determinants of health which predict health over and above the effect of all social determinants proposed within the model (2014).
The social, economic and cultural environment differs within and outside Inuit Nunangat, which limits the ability to generalize the relationships between social determinants and perceived health to Inuit residing outside Inuit Nunangat. It may be of interest to examine whether the same influential social determinants of health exist for Inuit residing outside Nunangat. Future research could also examine which social determinants are particularly relevant for each region of Inuit Nunangat. While Wallace (2014) and others have noted the health gap between Inuit and the total population, it remains unknown to what extent the gap can be attributed to the differences in the conditions.
Inuit between who were obese—according to the body mass index and defined by the World Health Organization (World Health Organization, 1995)—were less likely to be in excellent or very good health than those who were underweight, normal weight or overweight. of those who were obese were predicted to be in excellent or very good health compared to (42%) of those in the reference category. It is worth noting that there was no significant difference in the unadjusted probabilities between those who were obese and those who were underweight, normal weight or overweight—the difference was only identifiable when other social determinants were controlled for.
Inuit Tapiriit Kanatami—the national organization of Inuit in Canada—has stated that "this health gap in many respects is a symptom of poor conditions in Inuit communities which are characterized by high poverty rates, low levels of education, limited employment opportunities, and inadequate housing conditions" (Inuit Tapiriit Kanatami, 2014). These factors are known as social determinants of health. The World Health Organization has defined social determinants of health as "the conditions in which people are born, grow, live, work and age, including the health system" (World Health Organization, 2013).
Inuit Tapiriit Kanatami has developed an set of social determinants of Inuit health, through consultation and review of available literature (Inuit Tapiriit Kanatami, 2014). In total, the report identified eleven determinants of health for Inuit in Canada. These were quality of early childhood development, culture and language, livelihoods, income distribution, housing, personal safety and security, education, food security, availability of health services, mental wellness and the environment.
This analysis examines the relationships between social determinants of health and excellent or very good health. The social determinants chosen for analysis were based on the health determinants outlined in Inuit Tapiriit Kanatami's (ITK) 2014 discussion paper Social Determinants of Inuit Health in Canada. Data from the 2012 were used to explore elements of social determinants of health and their relationship to the health of Inuit.
While the literature highlights a number of social determinants that may impact overall health, some did not show an association with health. For instance, while income is considered an important social determinant of health in numerous studies, it was not correlated with health for either age group. It is worth noting that findings are not necessarily definitive—simply because an association between two concepts was not identified does not mean one does not exist. Rather, the lack of significance may be the result of a number of factors, such as sample size or differences between Inuit Tapiriit Kanatami’s conceptual model and the variables available on the 2012 Aboriginal Peoples Survey.