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1 Housing As a Determinant of Health in the Sayisi Dene First Nation

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1 Housing As a Determinant of Health in the Sayisi Dene First Nation Housing as a determinant of health in The Sayisi Dene First Nation, Tadoule Lake, Manitoba by David Boutilier A thesis submitted to the Faculty of Graduate Studies of The University of Manitoba in partial fulfilment of the requirements of the degree of MASTER OF ARTS Department of Anthropology University of Manitoba Winnipeg Copyright © 2013 by David Boutilier 1 Abstract This thesis is an exploration of housing as a social and environmental determinant of health and draws example from one Manitoban First Nation community. Aboriginal people across Canada suffer a disproportionate burden of morbidity and mortality relative to the rest of the country. Literature on the social determinants of health is reviewed with emphasis on the role of housing conditions in achieving and maintaining good health, followed by the historical context for Canadian Aboriginal settlement patterns and the current housing crisis. Local history and the results from a 2010 housing survey of the Sayisi Dene First Nation are described. Crowding, in-home water availability, housing design, and building materials are identified as risk factors for health problems, whereas occupant behavior appears to have little effect on conditions. Recent popular challenge to the longstanding and ongoing effects of colonialism sheds light on the degree to which all Canadians accept these pervasive circumstances. i Acknowledgements Saying thank you in a way that genuinely reflects the extent of my gratitude isn't easy. I owe a great debt to the Sayisi Dene for their hospitality and benevolent reception to this project and to myself. For stories shared, cups of coffee, caribou, smokes, for all the doors opened —if we could all treat strangers so kindly the world would be a very comfortable place. In particular Danny Bighead's courteous and thoughtful company left an indelible impression on my own character. A superb committee is responsible for the following content. My supervisor, Dr. Linda Larcombe, whose unconditional patience and good nature demonstrated to me the limits of dedication, stimulated the development of my ideas but also kept them in check. Dr. Rob Hoppa's effortless intelligence, availability, and blue email text saw me through all stages of this degree, and I’d have neither started nor finished without this investment. Dr. Jeffrey Masuda's invaluable observations provided a depth of insight I would not have otherwise attained. Without the time and energy commitments of these individuals I would’ve given up and left long ago and I thank them for that. Many important family members and friends also contributed to this work, including Laura, who pushed me through its final stages. To all others I have yet to thank directly: I will. Finally, I would like to thank the following individuals and agencies for funding: Dr. C. Thomas Shay; Dr. Jill Oakes and Dr. Rick Riewe; The University of Manitoba Department of Anthropology, Faculty of Arts, and Faculty of Graduate Studies; The National Sanitarium Association; Canadian Institutes of Health Research. ii Dedication In memory of Yeleba iii Table of contents Abstract..................................................................................................................................................i Acknowledgements ............................................................................................................................. ii Dedication........................................................................................................................................... iii Table of contents.................................................................................................................................iv List of figures..................................................................................................................................... vii List of tables ...................................................................................................................................... vii Chapter 1: Introduction ......................................................................................................................1 Introduction.......................................................................................................................................1 Overview of thesis ............................................................................................................................2 Overview of current health disparities among Aboriginal Canadians ..............................................5 Overview of housing conditions in First Nations Communities in Canada today............................8 Housing conditions on Reserves in Manitoba...................................................................................9 Chpater 2: The Social Determinants of Health...............................................................................12 Background to SDH ........................................................................................................................12 Definition and development of SDH ..............................................................................................14 Examples of SDH............................................................................................................................19 Stress ..........................................................................................................................................22 Social exclusion..........................................................................................................................23 Employment, unemployment, and working conditions..............................................................23 Early life.....................................................................................................................................24 Education....................................................................................................................................25 Access to services.......................................................................................................................25 Aboriginal Status........................................................................................................................26 Housing ......................................................................................................................................28 Discussion and chapter conclusions................................................................................................34 Chapter 3: Towards understanding housing as an Aboriginal determinant of health ...............36 Introduction.....................................................................................................................................36 Housing and settlement patterns through history............................................................................36 Treaties and the Indian Act .............................................................................................................41 Treaty right to health and housing ..................................................................................................44 Rights, responsibilities, action ........................................................................................................49 Chapter 4: Tadoule Lake community background and housing and health survey overview...51 Community geography and demographic background ...................................................................51 “The people of the eastern sun” ......................................................................................................51 Relocation and return .................................................................................................................54 iv Chapter 5: Tadoule Lake Housing and Health Survey, Methods and Results ............................62 Survey Methods ..............................................................................................................................62 Community-based research in action..............................................................................................62 Survey overview .............................................................................................................................63 Data collection, statistical, and other study limitations ..................................................................65 Sampling strategy:......................................................................................................................65 Sample size per variable:............................................................................................................66 Nature of data:............................................................................................................................66 Statistical limitations:.................................................................................................................66 Survey observations ........................................................................................................................67 Crowding....................................................................................................................................68 Exterior structural conditions .....................................................................................................71 Windows and doors................................................................................................................73
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