'People need access to healthy meals:' Inequality among Indigenous people may explain psychological distress

Improving the quality and availability of food could help reduce mental health issues among Indigenous populations in Canada, say researchers who analyzed survey responses from 14,000 Indigenous adults.

Suicide is a major cause of death among First Nations, Métis and Inuit people. Collectively, suicide rates among Indigenous people are two to three times higher than among non-Indigenous Canadians, according to previous responses.

Now, researchers have looked at how income-related inequalities relate to psychological distress and suicidal behaviours among Indigenous people living off-reserve in Canada.

The survey responses were originally filed with Statistics Canada in 2012, but the numbers had never been crunched this way until they were analyzed and published in Monday's issue of the Canadian Medical Association Journal.

For the study, researchers looked at which financial factors affect psychological distress, suicidal thoughts and suicide attempts among Indigenous people living off-reserve.

Food insecurity — the uncertainty over having a regular, affordable source of nutritious food — seemed to be a major factor explaining the higher rates of mental health problems among low-income Indigenous people.

It's hoped the finding will help shape government policy, said Mohammad Hajizadeh, one of the authors of the study. He's with the School of Health Administration at Dalhousie University in Halifax.

"Let's say if you hypothetically cannot have a policy that affects income, but at least you have to have a policy that tries to address the food insecurity itself," Hajizadeh said.

The study's authors said a complex combination of biological, social and cultural factors contribute to mental health problems. Of these, food insecurity is considered a major contributor, with 28 per cent of off-reserve Indigenous households reporting some form of it in the 2012 Canadian Community Health Survey.

"Based on our results, addressing food insecurity among low-income Indigenous people living off-reserve may potentially reduce a substantial proportion of the observed income-related inequalities in mental health outcomes," the study's authors wrote.

The idea of food insecurity being linked with psychological distress and mental health conditions makes a lot of sense, said Dr. Lisa Richardson, a strategic advisor in Indigenous health in the Faculty of Medicine at the University of Toronto and an Indigenous physician.

"In this era of reconciliation, what are specific, concrete measures that one can take? This paper has given us an opportunity to do it, because we need to address food security. People need access to healthy meals," Richardson said.

The data could draw more attention to the problem of food insecurity in Indigenous communities, she said. 

"What was really powerful for me was to show that specific, explicit link."

Richardson said in her work, she hears that modern scientific methodology doesn't necessarily capture the resilience and protective buffer from Indigenous culture, language and community connections. But those don't matter if someone is hungry, she added. 

The survey findings represent 600,750 Indigenous adults living off-reserve in Canada, the researchers said.

One of the limitations of the research was the survey doesn't collect information from individuals living in institutions such as prisons and hospitals, shelters and groups, where a disproportionate number of Indigenous people reside, the study's authors acknowledged.