Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
Psychology and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
BMC Psychol. 2019 Aug 28;7(1):57. doi: 10.1186/s40359-019-0331-y.
Indigenous people are over represented among homeless populations worldwide and the prevalence of Indigenous homelessness appears to be increasing in Canadian cities. Violence against Indigenous women in Canada has been widely publicized but has not informed the planning of housing interventions. Despite historical policies leading to disenfranchisement of Indigenous rights in gender-specific ways, little is known about contemporary differences in need between homeless Indigenous men and women. This study investigated mental health, substance use and service use among Indigenous people who met criteria for homelessness and mental illness, and hypothesized that, compared to men, women would have significantly higher rates of trauma, suicidality, substance dependence, and experiences of violence.
This study was conducted using baseline (pre-randomization) data from a multi-site trial. Inclusion in the current analyses was restricted to participants who self-reported Indigenous ethnicity, and combined eligible participants from Vancouver, BC and Winnipeg, MB. Logistic regression analyses were used to model the independent associations between gender and outcome variables.
In multivariable regression models among Indigenous participants (n = 439), female gender was predictive of meeting criteria for PTSD, multiple mental disorders, current high suicidality and current substance dependence. Female gender was also significantly associated with reported physical (AOR: 1.52, 95% CI = 1.10-2.23) and sexual (AOR: 6.31, 95% CI = 2.78-14.31) violence.
Our analyses of Indigenous men and women who are homeless illustrate the distinct legacy of colonization on the experiences of Indigenous women. Our findings are consistent with the widely documented violence against Indigenous women in Canada. Housing policies and services are urgently needed that take Indigenous historical contexts, trauma and gender into account.
This trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374 ; ISRCTN57595077 ; ISRCTN66721740 .
在全球范围内，无家可归者中土著居民的比例过高，加拿大城市中土著无家可归者的比例似乎在增加。加拿大针对土著妇女的暴力行为已被广泛报道，但并未为住房干预措施的规划提供信息。尽管历史政策以特定于性别的方式剥夺了土著人民的权利，但对于无家可归的土著男女之间当代需求的差异却知之甚少。本研究调查了符合无家可归和精神疾病标准的土著人民的心理健康、药物使用和服务使用情况，并假设与男性相比，女性的创伤、自杀意念、药物依赖和暴力经历的比率会高得多。
本研究使用多地点试验的基线（随机分组前）数据进行。目前的分析仅限于自我报告为土著族裔的参与者，将来自温哥华和温尼伯的合格参与者合并。逻辑回归分析用于对性别与结果变量之间的独立关联进行建模。
在纳入的 439 名土著参与者的多变量回归模型中，女性性别与符合创伤后应激障碍、多种精神障碍、当前高自杀意念和当前药物依赖的标准相关。女性性别还与报告的身体暴力（AOR：1.52，95%CI=1.10-2.23）和性暴力（AOR：6.31，95%CI=2.78-14.31）显著相关。
我们对无家可归的土著男女的分析说明了殖民化对土著妇女经历的独特影响。我们的研究结果与加拿大针对土著妇女的广泛报道的暴力行为一致。迫切需要制定住房政策和服务，将土著的历史背景、创伤和性别考虑在内。
这项试验已经在国际标准随机对照试验编号注册中心进行了注册，并分配了 ISRCTN42520374；ISRCTN57595077；ISRCTN66721740。
