RHS Phase 2 National Results
RHS Phase 2 (2008/10) NATIONAL RESULTS - RHS QUICK FACTS
Oral Health - BBTD
• 40.4% of 3 to 5 year olds in RHS Phase 1 received dental care in the last 6 months compared to 50.7% in RHS Phase 2.
• Among 6 to 11 year old First Nations children, 83.8% received dental care in the last year. This percentage is lower than the equivalent finding for the general Canadian population (91.3%) and for Aboriginals living off-reserve (92.2%).
• Of the infants surveyed (0–2), 18.7% had their teeth affected by Baby Bottle Tooth Decay (BBTD) compared to 11.9% in RHS Phase 1; 30.9% of the 3 to 5 year old First Nations children had been affected by BBTD and 26.9% of 6 to 11 year olds had a history of BBTD.
• Of the infants with BBTD, 40.6% were treated for the condition, while the majority of preschoolers (77.1%) and school-aged children (90.4%) were also treated for BBTD.
• Furthermore, 36.2% of 3 to 5 year olds and 41.9% of 6 to 11 year olds needed dental fillings in RHS Phase 2 compared to 28.4% and 32.5% in RHS Phase 1, respectively. Finally, 71.1% of 9 to 11 year old First Nations children were in need of a check-up and preventive care and 14.3% required orthodontic care at the time of the survey.
• Less than one in three children were given 100% fruit juice whereas roughly one in five children were given Kool-Aid and 3.8% of children were given soft drinks in their bottles.
Mental Health and Injury
Mental and Social Well-Being
• There was a higher proportion of behavioral and emotional problems for 6 to 11 year olds (14.4%) compared to their younger peers (10%). No significant difference between boys and girls was found in relation to behavioral and emotional problems.
• With respect to having emotional and behavioral problems, the proportion of boys reporting problems significantly decreased overall from 18.4% in RHS Phase 1 to 12.3% in RHS Phase 2.
• Children who do not live with both biological parents were significantly more likely to report having emotional or behavioral problems (15.5%) compared to those who live with both biological parents (9.0%).
• Across all age groups, boys had a higher percentage of injuries and for both genders; older children sustained more of these injuries.
• The most frequently reported injuries were minor cuts/scrapes/bruises (45.1%). The most common causes of injury were falls (52%) followed by accidental contact with a personal/ animal (14.2%) and bicycle related injuries (10.5%).
• 58% of all child injuries were reported to have happened at home. Approximately half of injured children (52.5%) received treatment for their injury in a hospital emergency department.
Health Status and Chronic Conditions
• There was a significant increase in the proportion of caregivers reporting excellent health as their child’s general health status, with the percentage in RHS Phase 2 significantly increasing from 40.7% in RHS Phase 1 to 56.4%.
• Over 85% of caregivers reported their children’s health as excellent (56.4%) or very good (31.1%). Only 2.3% rated the child’s general health as fair/poor.
• 42.4% of caregivers reported that their child had been diagnosed with at least one chronic health condition. Boys experienced a significantly higher percentage of chronic health conditions (45.6%) compared to their female peers (39%).
• The percentage of First Nations children experiencing asthma, chronic ear infections/problems, FASD and chronic bronchitis has significantly decreased between RHS Phase 1 and RHS Phase 2.
• First Nations children with one or more reported chronic health conditions experienced more barriers when accessing health care, as reported by their caregivers. The most frequently reported barrier to healthcare access for both children with or without health conditions was the long waiting list.
Education and Language
• The proportion of First Nations children attending school reached 99.2% for children 6 to 11 years of age in RHS Phase 2, a significant increase compared to 84.5% in RHS Phase 1.
• The percentage of children that repeated a grade among 6 to 11 year olds significantly decreased from 18% in RHS Phase 1 to 13.7% in RHS Phase 2.
• Small communities had a significantly lower proportion of children (6-11) who have repeated a grade (6.3%), compared to their peers living in medium (13.5%) and large communities (14.9%).
• Approximately half of First Nations children could speak or understand a First Nations language at the time of the survey.
• The percentage of children understanding/ speaking one or more First Nations language was higher in RHS Phase 2 for all age groups except 9 to 11 year olds.
• Children who attended an Aboriginal Head Start (AHS) program were more likely to speak or understand a First Nations language.
• 36.3% of children who attended AHS at some point read or are read to daily, compared to 28.7% those who did not attend AHS.
• Family members (parents and grandparents) were the primary sources of cultural understanding for First Nations children. Relatives and school teachers also played a key role in supporting children’s cultural understanding.
Body Mass Index and Nutrition
• The proportion of children with reported weight and height that corresponded to a Body Mass Index (BMI) of normal or underweight has decreased from 41.5% in RHS Phase 1 to 37.7% in RHS Phase 2.
• Subsequently, the number of children categorized as obese and overweight increased from 58.5% to 62.3% in RHS Phase 2.
• The proportion of children considered obese is higher with increasing community size. In small communities, 33% of children are obese compared to 40.8% of children in medium communities and 45.3% in larger communities.
• First Nations children reportedly always or almost always consume a nutritious and balanced diet and a further 36.4% sometimes do. Very few either rarely (3.8%) or never (1.2%) eat a balanced and nutritious diet.
• In RHS Phase 2, a significantly higher percentage of children (44.2%) in small communities (under 300 people) consume at least one traditional protein rich food compared to their peers in medium (28.1%) and large communities (19.8%).
• 30% of First Nations children reportedly had someone often share traditional foods with their household in the 12 months prior to the survey. An additional 55.1% had this happen sometimes and 14.9% never had traditional food shared with their household.
Household Environment – Prenatal Health
• 48.6% of First Nations children lived with both biological parents (not excluding other adults).
• 39.4% of children lived with just their biological mother (with no other adults living in the household) versus 3.1% that lived with just their biological father (with no other adults living in the household).
• Slightly over 5% of the children who were not living with their biological parents lived with their grandparents.
• Approximately 35% of children live in a household with 5-6 people (including the child) and roughly 30% live with 7 or more people.
• As the education level of mothers increased, the percentage of children who had been breastfed also increased. Roughly 50% of mothers with less than a high school education breastfed their children, compared to 71% of mothers with a diploma/certificate and 75.4% of mothers with a university degree. Overall, 57.5% of children were breastfed in RHS Phase 2 to 60.3% in RHS Phase 1.
• The education level of mothers also played a significant role in other prenatal health factors, such as smoking during pregnancy. 53.5% of mothers who smoked during pregnancy had less than a high school education, whereas 42.7% of mothers with a high school diploma smoked during pregnancy. A significant drop in smoking during pregnancy was observed in mothers with a university degree or higher (18%).
Education and Language
• Over 20% of First Nations youth reported using a First Nations language most of the time in their daily lives.
• More than half (56.3%) can understand or speak a First Nations language and 45.8% of youth feel that learning a First Nations language is very important.
• Approximately 88% of First Nations youth were attending school at the time of the survey.
• The large majority of First Nations youth liked school either very much (35.2%) or somewhat (45.2%).
• A high proportion of First Nations youth (39%) reported challenges learning in school, the most frequently cited difficulty was mathematics (52.8%).
• 23.8% of First Nations youth reported aspirations to obtain post-secondary education, with 23.4% wanting to complete a high school degree, 19% wanting to complete a college diploma and 7.1% a trade/vocational certificate/diploma.
• 3.7% of youth have aspirations to complete a Masters degree and 2.3% want a Doctorate degree.
Smoking & Substance Abuse
• 63% of First Nations youth have never used non-prescription cannabis, whereas 9.7% reported using it daily or almost daily. While no significant gender difference was found, cannabis use was more frequently reported among the older youth (15-17).
• About 40% of youth stated that they had consumed an alcoholic beverage in the 12 months prior to the survey.
• Approximately one in five First Nations youth (22.3%) reported never having five or more alcoholic drinks on one occasion, while 4.9% have done so more than once per week.
• Significantly more First Nations girls are more likely to binge drink more than once per week (7.0%) than boys (2.5%).
• About one fifth (20.4%) of First Nations youth reported smoking daily, while 67% are non-smokers.
• There is a significantly higher number of daily smokers among the First Nations female youth aged between 15-17 at 33.9% compared to males at 25.4%.
• Roughly 10% of youth 12 to 14 years of age reported being sexually active, in large contrast to almost half (47.2%) of the 15 to 17 year old youth who reported being sexually active. Overall, 27.9% of First Nations youth (12-17) were sexually active at the time of the survey. This figure remains relatively unchanged since RHS Phase 1 (28.4%). Of those that were sexually active (12-17), 92.5% have had sexual intercourse in the last 12 months.
• Of those sexually active, the majority reported having one sexual partner (55.4 %)while roughly one in ten sexually active youth reported having 4 or more partners in the past 12 months.
• Roughly, 80% (79.1%) of sexually active First Nations youth reported using condom as a birth control method, similar to RHS Phase 1 (80.8%). In addition, 22.5 % of youth reported using birth control pills, a slight increase since RHS Phase 1 (19.2%).
• Across all youth respondents, 18.5% cited not having a condom at the time as the main reason for not using a condom. In addition, 16.5% stated that they were under the influence of alcohol or drugs as a reason for not always using condoms.
• Only 6.8% of First Nations youth had been tested for HIV at the time of the survey. Females were more likely than males to receive HIV testing (8.5% vs. 5.1%).
• Approximately 30% of First Nations youth reported having been injured in the 12 months prior to the survey. Of those First Nations youth who reported having been injured, higher proportions were found among the older age groups.
• The three most common types of injury experienced by First Nations youth were major cuts, scrapes or bruises (42.9%), major sprains or strains (34.1%) and broken or fractured bones (30.1%).
• The most commonly cited cause of injury was falling or tripping (44%). Most First Nations youth experienced injuries while playing sports (58.9%) or taking part in a hobby or leisure activity (24.6%).
• Most injuries happened either at home (36.7%) or on the sports field/school facility (32.8%).
Physical Activity and Body Mass Index
• The five most frequently cited physical activities in which First Nations youth participated were walking (86.9%), running or jogging (60.7%), swimming (54.6%), competitive or team sports (53.1%), and bicycling or mountain biking (44.6%).
• In contrast, 38.6% of First Nations youth reported spending more than 1.5 hours on sedentary activities such as watching TV, reading, playing bingo/video games or working at the computer. Boys are significantly more likely (42.9%) than girls (12.7%) to spend more than 1.5 hours playing video games.
• Over half of First Nations youth have a self-reported weight and height that corresponds to the normal or underweight BMI categories (57.3%).
• 29.9% are considered overweight and an additional 12.8% of First Nations youth are considered to be obese. No gender or age differences were found. These rates are similar to those found in RHS Phase 1.
• When asked about degree of satisfaction with weight, the majority of First Nations youth stated they were either very satisfied (37.1%) or somewhat satisfied (14.5%). Boys were more likely to be very satisfied with their weight while girls were more likely to be either somewhat or very dissatisfied with their weight.
• The proportion of First Nations youth having at least one reported chronic health condition is 35.3%. The most commonly reported chronic health condition among First Nations youth was allergies (16.0%), with significantly more girls (18.5%) than boys (13.7%) reporting this condition.
• Of those First Nations youth diagnosed with having allergies in RHS Phase 2, 39.1% reported receiving treatment, representing a significant increase since RHS Phase 1(26.3%).
• Over one in ten First Nations youth (12.7%) were diagnosed with asthma in RHS Phase 2. Of these, 19.8% reported having an asthma attack in the previous year. At the time of the survey, 57.5% of youth diagnosed with asthma were undergoing treatment for their condition.
• First Nations boys were significantly more likely to report having a learning disability (7.4% for boys vs. 4.2% for girls), while First Nations girls were significantly more likely to experience blindness or serious vision problems (4.8% for girls vs. 2.2% for boys).
Health Status and Mental Health
• The majority of youth self-rated their general health to be excellent (30.1%) or very good (34.7%). About the same proportion reported their mental health as excellent or very good. Roughly half of youth reported that their general health is about the same as it was one year ago.
• The percentage of youth respondents that have thought about suicide or attempted suicide has reduced between RHS Phase 1 and RHS Phase 2. In RHS Phase 2, 16.5% of youth contemplated suicide, a significant reduction since RHS Phase 1(21.1%).
• Another positive finding is the drop in the percentage of youth attempting suicide, which has significantly decreased from 9.6% in RHS Phase 1 to 5.9%.
• Though the overall percentage has decreased, a significantly higher proportion of girls have thought about (22.2%) and attempted suicide (8.3%), compared to their male peers (11.2% and 3.6%, respectively).
Family and Household Structure
• Over one third (36.9%) of youth live in a household with four or less people (including children, youth and adults) and over 10% of youth live in households with nine or more people.
• Just under half (43%) of youth in First Nations communities live in households with six or more people, a decrease from 57.4% in RHS Phase1.
• Under half of youth (46%) reported both parents living together as either married (30.9%) or not married (15.1%).
• Four percent (3.9 %) of parents of youth are reportedly divorced. The majority of First Nations youth (85.1%) live with one or more parents - biological, adoptive and/or step – and of these, 39.5% live with a single parent.
Demographics – Education - Language
• Population data from RHS Phase 2 indicates that the adult First Nations population (aged 18 years and older) is young.
• Approximately 30% of the adult population is less than 30 years of age while 13% are 60 years of age and older.
• First Nations adults with less than a high school education has not changed substantively since RHS Phase 1 (51.5% vs. 52.4%).
• A significantly higher proportion of adult males have less than a high school education compared to females (57.2% vs. 45.7%).
• First Nations females tend to have a higher level of educational attainment across the board – especially at the post-secondary level (27.3% vs. 17.7%).
• First Nations adults attaining graduates degrees has increased from 0.6 in RHS Phase 1 to 1.3% in RHS Phase 2.
• The ability to understand or speak a First Nations language is lowest within the 18 to 29 year age group (59.4%) and highest within the 60 years and older age group (83.8%). This increase mirrors findings from RHS Phase 1.
• First Nations language comprehension tends to be higher in communities that are isolated than in those that are not (79.9% special access vs. 61.2% urban).
• Similar to RHS Phase 1, those who attended residential school were more likely to understand or speak a First Nations language (83.7% vs. 66%).
• Just under half (47.2%) of the adult population reported working for pay at the time of the survey in RHS Phase 2. There has been little change in this dimension since RHS Phase 1 (48.8%).
• The proportion of First Nations adults who were employed at the time of the survey is low for those in the 18 to 29 year age group at 36.3%.
• The percentage of employment rises to 60.8% for those First Nations in the middle age groups (30-59) before declining to just over 20% for those 60 years of age and over.
• In RHS Phase 1 the figures were quite similar –the percentage of employment among those 18 to 29 years was 39.8%, 59.2% in the 30 to 59 year age group, and 22% among those 60 years of age and older.
• The most commonly reported source of income was from paid employment (54.4%), followed by social assistance (39.9%) and child tax benefits (32.6%).
• The RHS data show a slight increase between RHS Phase 1 and RHS Phase 2 in personal income levels among First Nations adults in the ($15,000-$49,999) category.
• Over the same time period there was a significant increase in the percentage of First Nations adults reporting household incomes less than $10,000 from 11.7% in RHS Phase 1 and up to 16.8% in RHS Phase 2.
• There is a significant decrease in the number of adults reporting household income of $30,000-$49,999 going from 25.6% in RHS Phase 1 to 20.9% in RHS Phase 2.
• 43.2% of First Nations adults reported one income source while approximately 18% of the population reported having three or more income sources.
• The percentage of First Nations adults reporting one income source increased from RHS Phase 1 (36%) to RHS Phase 2 (43.2%).
Housing and Mold
• Over two-thirds (70.8%) of First Nations adults reported that their household was in need of some type of repair compared to a quarter (25.7%) of the general Canadian population.
• Just over one-third (37.3%) of First Nations adults reported that their household needed major repairs compared to 10.2% of the general Canadian population.
• 50.9% of First Nations adults reported mold and mildew present in their homes, representing a significant increase from RHS Phase 1 (44%).
• The average number of individuals living in each First Nations household is higher than reported in the 2006 Census.
• The household occupancy density (average number of persons per house) was 4.2 compared to 2.5 occupants per house in the general Canadian population.
• Almost half (48.2%) of all First Nations households do not have an internet connection; however, this number has dropped significantly since RHS Phase 1 (70.7%).
• There is a similar pattern for not having a computer in the house, 39.8% in RHS Phase 2 compared to 59.2% in RHS Phase 1.
• The proportion of households that do not have telephone service (17.5%) has not changed significantly since RHS Phase 1 (18.3%).
• One in five (22.6%) First Nations households lack a working smoke detector while over three-quarters (78.1%) lack a carbon monoxide detector.
• In RHS Phase 2, there is 3.4% of First Nations that do not have hot running water in their homes, 2.7% without a flush toilet and 2.1% without cold running water. These numbers are slightly down from RHS Phase 1 (3.7%, 3.5% and 3.5%).
Access to Health Services
• Similar to the trends seen in RHS Phase 1, the proportion of those who perceived their level of health care access to be ‘less’ compared to the general Canadian population tends to increase as self-rated health decreases.
• Of those who rated their health as being very good or excellent, 11.7% estimated their access to health services as being better than the general Canadian population. This estimate has dropped significantly from RHS Phase 1 (24.6% vs. 11.7%).
• Of those living in a special access community, 64.9% perceived themselves as having less access.
• The proportion of those who perceive themselves as having less access decreases as geographic remoteness is minimized (32.7% in urban areas).
• The proportion of First Nations adults indicating better access is highest among those living in an urban community (14.6%) and this proportion decreases as remoteness increases (6.7% in special access areas).
Barriers to Access Health Services
• A higher proportion of First Nations women reported having experienced certain barriers to care than men.
• 17.6% of First Nations adults have experienced barriers to access care due to the inability to arrange transportation. This has increased significantly since RHS Phase 1 (14.5%).
• 37.6% of First Nations adults indicated in RHS Phase 2 that the waiting lists to access care was too long. This has increased from RHS Phase 1 (33.2%).
• 20.6% of First Nations adults said that the access to care was not covered by NIHB and 15.5% indicated that approval for services under NIHB was denied.
• As for barriers related to geography and availability of services, 22.6% of First Nations adults said that a doctor and nurse were not available in their area, 16.1% indicate the service was not available in their area and 11.4% said they did not have a health facility.
• 17.8% of the First Nations adults in the age group of (25-39) reported being hungry but didn’t eat due to lack of money for food (in the past 12 months) and 16.1% of the adults (40-54) reported being hungry as well which may be attributed to the presence of children in the household.
• When examining only those who said yes to skipping or cutting meals due to lack of money. 13.4% of seniors skip/cut meals, almost half of them (46.7%) indicated they do so almost every month.
• Young First Nations adults (18-24) and seniors (55+) reported less difficulty affording to eat balanced meals. This may be attributed to the fact that those between 25 and 54 years of age are more likely to have children to provide for. The same pattern holds for going hungry due to a lack of money.
Challenges & Strengths of Community
Table 1: Issues identified as challenges to the community by order of importance
Type of challenges Proportion (%)
Alcohol and drugs 82.6
Education and training 57.5
Control over decisions 37.9
Gang activities 33.2
Natural environment/resources 32.5
Table 2: Ranking of main community strengths
Family values 61.6
Traditional activities 37.8
Community/health programs 33.4
Community working together 32.6
Use of FN language 31.3
Culture awareness 24.9
Strong leadership 20.4
Natural environment 16.9
Low suicide/crime drug use 13.9
• The RHS Phase 2 data reveal that almost 60% of First Nations adults have lived outside of their First Nations community at some point in their life, however are now living back in the community.
• The proportion of men and women who have lived outside of their community is roughly the same (59.4% male vs. 59.0% female).
• First Nations adults who lived outside of their community for extended periods of time, over 70% reported being away from their community for one or more years (approximately 38% reporting more than 5 years) but returned back to the community.
• Of those that moved away from their community (59.2%), over half moved away for reasons of employment or education.
• First Nations males were significantly more likely to move away for employment (36.3% vs. 15.4%), while females were more likely to move away for reasons of education (31.2% vs.25%).
• Almost twice as many First Nations women (11.9%) as men (6.6%) reported moving for housing-related reasons.
• Reasons for returning to First Nations communities are quite different from the factors underlying movement away from communities. The majority of First Nations adults return home for family related reasons (60%).
• 31% return home because of a strong connection to their community/home while 9% return home because the culture is familiar and to expose their children to First Nations culture (7.5%).
• Slightly higher percentages of women report family, housing, familiar culture and exposure of children to culture as reasons for returning home.
• Younger First Nations adults (18-34) have moved away more frequently than older First Nations adults. Over 20% of First Nations adults, aged 18 to 34 years, have moved two or more times as compared to 8% of 35 to 54 year olds and less than 6% of First Nations adults 55 years of age and over.
• Even though First Nations adults have moved away from their community at some point in time in their lives, RHS 2008/10 data suggest that respondents still retain strong ties to their communities.
• While living outside of their First Nations community at some point in time in the past 12 months, most First Nations adults reported (54.%) that they still wanted to receive services such as health and education from their community.
• 40% of those who indicated they moved away from their community at some point in time reported that they voted in First Nations elections.
Substance Use and Abuse – Gambling
Substance Use and Abuse
• 43% of First Nations adults are daily smokers with an additional 13.7% self-identifying as occasional smokers. In comparison, 17.1% of the general Canadian population are daily smokers.
• Younger First Nations adults, aged 18 to 29 years, have the highest proportion of daily smokers (51.5%). This decreased slightly since RHS Phase 1 (53.9%).
• There is a noticeable significant decrease in the proportion of daily smokers when comparing respondents with less than high school education (47.8%) to those with graduate studies (30.9%).
• The highest proportion of alcohol consumption was reported in the 18 to 29 year old age group, with 81.4% drinking in the past year. There is a significant decrease in the consumption of alcohol with increasing age.
• 71% of First Nations adults have gambled at some point in their lives. This includes betting or spending money on bingo, card games, lottery tickets, VLT machines, casinos or sports games.
• The number of adult females who have gambled is significantly higher than that of males (53% vs. 47%).
• First Nations adult women are more likely than men to borrow money for gambling (28.3% vs. 26.5%).
• First Nations men are more likely to bet more money than they can afford and their gambling is also more likely to have caused financial problems.
• The proportion of self-reported diabetes in the First Nations adult population was 20.7% at the time of the survey, which represents a 0.9% increase from RHS Phase 1 (19.8%).
• Type 2 diabetes accounts for the majority of reported diabetes in the First Nations adult population (80.8%).
• Diabetes increases with age and First Nations women have a greater frequency of diabetes than men across all age categories, contrary to the pattern observed in the general Canadian population where diabetes is more common among men.
• Among First Nations with Type 2 diabetes 55 years of age and older, a number of conditions such as glaucoma (7.9% vs. 4.1%), liver disease excluding hepatitis (4.6% vs. 2%), stroke (10.5% vs. 4.9%) and heart disease (29.1% vs. 15.2%) occur at double the proportion observed in the remaining RHS population.
• Hypertension, an important risk factor for cardiovascular disease, was reported more frequently among Type 2 diabetics (66.1% vs. 40.7%).
• 49.3% of First Nations with diabetes have a BMI corresponding to the obese category (30-39.9), while 11.3 % are considered morbidly obese (40 and over).
© The First Nations Information Governance Centre, ISBN 978-0-9879882-0-1, Published 2011 and Revised 2012