Cultural Connection and Physical Health Among Indigenous Peoples in Canada

Background and Purpose: Research linking indigenous culture to indigenous health outcomes has focused almost entirely on improving the cultural competence of the health care systems serving indigenous peoples and communities. Yet, it is unclear how cultural competence and connection influence health outcomes among Aboriginal peoples. To date, only a handful of small scale community level studies have investigated the connection between cultural connectedness and physical health outcomes. This study addresses this gap by providing nationally representative empirical evidence for the role of individual level traditional aboriginal language ability (proxy for cultural connectedness) as a protective/risk factor for several physical health conditions. Given that a limited body of literature has found that high levels of traditional aboriginal language ability at the community level is protective against suicidal ideation and Type II diabetes, we hypothesized that these abilities would also be protective against a myriad of negative physical health conditions. 

Methods: We used the 2012 Aboriginal Peoples Survey (APS), a nationally representative study of First Nations, Metis, and Inuit peoples in Canada. We used a subsample of respondents aged 15 or older that were asked questions about mental health (n= 15,329). Measures of cultural connectivity included: aboriginal language ability (none, understand, understand and speak), exposure (none, outside home only, in home only, both inside and outside home), and importance (low, average, high). We addressed ten health outcomes: asthma, arthritis, high blood pressure, breathing problems, diabetes, heart disease, ulcers, bowel disorders, weight and other long-term conditions. Each outcome was dichotomous (yes/no) and logistic regression was used for all outcomes. Multiple imputation was used to preserve sample size (M= 20). Control variables included: income, education, participation in traditional activities, reservation residence, language importance, Registered Indian status, indigenous identity, respondent’s sex, respondent’s marital status, and household size.

Results: High aboriginal language ability (vs. no ability) significantly reduced risks of: asthma and other breathing problems, bowel disorders, being overweight, and other long-term conditions. High language ability (vs. no ability) was negatively associated with diabetes and heart disease if the individual could only understand, but not speak an aboriginal language. Language exposure exclusively outside the home was negatively associated with asthma, ulcers, bowl disorders, being overweight and other long-term health outcomes. Language importance had no consistent effect on physical health. 

Conclusions and implications: This study supports an important link between literature addressing cultural connectedness, aboriginal language loss, and literature addressing the health disparities among Aboriginal populations. Cultural connectedness, including traditional language capacity, is not only fundamental to the cultural integrity of indigenous peoples, but also may be integral to improving the physical health disparities they experience. However, there were mixed findings from this study—such as high levels of diabetes and heart disease, in spite of some cultural connectivity. Thus, this study also brings to light potential risk factors for the physical health of individuals who have marginal connectivity to their cultures. Policy implications include support for indigenous language preservation efforts including providing opportunities for indigenous language exposure both inside and outside the home environment.