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Back to the basics: Identifying and addressing underlying challenges in achieving high quality and relevant health statistics for Indigenous populations in Canada
Open accessAbstract
Canada is known internationally for excellence in both the quality and public policy relevance of its health and social statistics. There is a double standard however with respect to the relevance and quality of statistics for Indigenous populations in Canada. Indigenous specific health and social statistics gathering is informed by unique ethical, rights-based, policy and practice imperatives regarding the need for Indigenous participation and leadership in Indigenous data processes throughout the spectrum of indicator development, data collection, management, analysis and use. We demonstrate how current Indigenous data quality challenges including misclassification errors and non-response bias systematically contribute to a significant underestimate of inequities in health determinants, health status, and health care access between Indigenous and non-Indigenous people in Canada. The major quality challenge underlying these errors and biases is the lack of Indigenous specific identifiers that are consistent and relevant in major health and social data sources. The recent removal of an Indigenous identity question from the Canadian census has resulted in further deterioration of an already suboptimal system. A revision of core health data sources to include relevant, consistent, and inclusive Indigenous self-identification is urgently required. These changes need to be carried out in partnership with Indigenous peoples and their representative and governing organizations.
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“An additional significant example of Canadian Indigenous community-based epidemiology research is Our Health Counts, a research initiative created by First Nations, Inuit, and Métis researchers and health service providers living in urban and related homelands, which meets community standards with the intention of addressing the near absence of population-based health assessment information for”
From Addressing the need for indigenous and decolonized quantitative research methods in Canada (2021) · cites this paper as Smylie & Firestone, 2015
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Gray, M., Williams, K., Oster, R. T., Bruno, G., Cooper, A., Healy, C., Rich, R. L., Claringbold, S. S., Teare, G. F., Wessel, S., et al. (2023) · Journal of Health Services Research & Policy · doi:10.1177/13558196231219955 · Cited by 7
Keenan, N. F., Aitchison, S. G., Jetté, N., Parko, K., Roach, P., Santos, A. D., Archer, J. S., Andersen, E., Stairmand, J., Stanley, J., et al. (2025) · The Lancet Global Health · doi:10.1016/s2214-109x(24)00507-2 · Cited by 6
Hicks, L. J., Mushquash, C. J., & Toombs, E. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1073817 · Cited by 7
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Clark, W., Lavoie, J. G., Nickel, N. C., & Dutton, R. (2020) · American Indian Culture and Research Journal · doi:10.17953/aicrj.44.3.clark_etal · Cited by 6
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Self-citationPlaces of death and places of care for Indigenous Peoples in Ontario: a retrospective cohort study
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Metadata
- Authors
- Smylie, J., & Firestone, M.
- Affiliations
- St. Michael's Hospital (CA)
- Corresponding author
- Smylie, Janet
- Venue
- Statistical Journal of the IAOS
- Publisher
- SAGE Publications
- Published
- 2015
- Volume
- 31
- Issue
- 1
- Pages
- 67-87
- ISSN
- 1874-7655 (ISSN-L)
- PMC
- PMC4716822
- OpenAlex
- W1446504491
- Cited by
- 155
- References
- 47
- Citations by year
- 2026: 14 · 2025: 12 · 2024: 14 · 2023: 15 · 2022: 21 · 2021: 20 · 2020: 19 · 2019: 17 · 2018: 15 · 2017: 2 · 2016: 5 · 2015: 1
- FWCI
- 9.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Statistical Journal of the IAOS (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Public Health Agency of Canada
- Public Health Agency
- U.S. Public Health Service (137902-1)
- Canadian Institutes of Health Research (137902_1)
- Topics
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Social Sciences › Anthropology › Indigenous Cultures and History
- Keywords
- Indigenous data sovereignty, indigenous self-identification, misclassification, nonresponse bias, health disparities, census, health data quality, health data sources, Canada
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