Problems in search of solutions: health and Canadian aboriginals.

The purpose of this paper is to explore the health status of Canadian Aboriginals, along with their perceived community health problems and proposed solutions to these issues. Data are drawn from the 1991 Aboriginal Peoples Survey (APS), which is a weighted random sample of the Aboriginal population. Comparisons were made with respect to group identity (North American Indian, Métis and Inuit) and geographic location (reserve, urban, rural and North) and across a series of health status and health care use indicators. Analysis reveals that geographic location, as compared with Aboriginal identity, appears to have a large impact with respect to health status and use of physician services. On-reserve Aboriginals, for example, reported a lower likelihood of having seen a physician and were more likely to rank their health as fair or poor. Location also influenced perceived community health problems and solutions. Self-identified problems included drugs, cancer and arthritis, while corresponding solutions included education, counseling and service access. Although the problems and solutions were relatively consistent across space, they too varied in their importance. In general, the results tend to reinforce the determinants of health framework, suggesting that the provision of health services is insufficient to remove health disparities on its own. Instead, broader social-welfare provisions must be considered.