Running effects colonization, providing health and wellness and

Running Head: Social Determinants and Suicide Risk
Social Determinants and Suicide Risk among Indigenous (Inuit) People of Northern Canada
Sociology 206
Veronique Gauthier
December 2016
Sociology 206
Colleen Smith
Social Determinants and Suicide Risk among Indigenous (Inuit) People of Northern Canada
Indigenous people have long been marginalized in Canada. Assimilation tactics of the
Europeans during the colonization of Canada has resulted in enormous social and cultural
turmoil. Indigenous people have experienced countless difficulties and numerous health
disparities exist as a consequence. Particularly, the Inuit people, situated primarily in Northern
Canada, have the highest rates of suicide in the world (Health Canada, 2006); however, precolonially
the Inuit suicide rates were almost non-existent (Morris & Crooks, 2015). Although
suicide has previously been viewed with an individual lens, research suggests that various social,
economic, and physical environments operating at different stages of life determine an
individual’s overall mental health. Given that proper mental health is integral to human health
and well being, the experiences of Indigenous people, along with resulting social determinants of
health, have negatively influenced health outcomes for Indigenous populations around the globe.
The risk factors for suicide are heavily associated with social inequalities, whereby the greater
the inequality, the higher the inequality in risk of suicide. In this paper particular attention is
afforded to the social, historical, physical, and mental health stressors that contribute to high
suicide rates. Lastly, this paper outlines implementations that may help to overcome the effects
colonization, providing health and wellness and thus lowering suicidal risk among Inuit people.
Suicidal behavior includes thinking about, planning, obtaining means to, attempting,
and/or carrying out the act of killing one’s self (World Health Organization (WHO), 2002).
Among Inuit populations in Northern Canada, the rates of suicide are between 59.5 and 74.3 per
100,000 compared to the Canadian population’s rates of 15.0 per 100,000 (WHO, 2002); Among
Inuit men however, aged 15-24 years, the group highest at risk for suicide, the rates are as high
as 295 per 100,000 (Leenaars, A, 2006).
Historical Trauma
A theoretical model by sociologist Emile Durkheim (1897) provides an outlook on the
social causes of Indigenous suicide and illuminates the intergenerational impacts of colonization
on Indigenous peoples. Durkheim describes one dimension of suicide as being caused by
anomie: “a state in which old values have lost meaning and new values have not been accepted
to take their place” (cited in Edwards, 1996, pp. 110). According to the theory, “people in this
state appear to lack a sense of purpose and meaning to life” (cited in Edwards, 1996, pp. 110).
Using the theoretical idea of anomie (Durkheim, 1897), Indigenous culture, including traditions,
connection with land, and kinship, which comprise the basis of Indigenous life (Edwards, 2004,
pp. 16-33), could arguably be said to “have lost their meaning”. Additionally “new values”,
particularly those forced by European colonizers, “have not been accepted to take their place”.
One of the major inhibitors of social, physical, and mental wellness for Indigenous
populations is the extensive discrimination that has been experienced by Indigenous people
(Guittar, 2012). In 2008, Stephen Harper, Prime Minister of Canada, acknowledged the historical
colonization of Indigenous peoples saying assimilation methods, namely Residential Schools,
deliberately tried to “kill the Indian in the child” (Harper, 2008) and break the bonds of family,
community, and culture. Those forced to attend residential school experienced sexual abuse,
physical abuse, and uncontrollable loss of culture, tradition, and family. When they emerged to
reintegrate into society, “they did not have skills, knowledge, or motivation to live a traditional
life, never developed parenting skills, nor did they have sufficient skills or were accepted enough
by non-Indigenous” (Morris & Crooks, 2015, pp. 322) people to effectively amalgamate. The
unresolved nature of the trauma experienced by Indigenous people throughout time has become
intergenerational (Elias, Mignone, Hall, Hong, Hart & Sareen, 2012). Under such conditions,
Durkheim suggests there is an ongoing increased risk for suicide.
Determinants of Health and Suicide Risk
The sociology of health and illness, or the sociology of health and wellness, examines the
interaction between society and health. According to World Health Organization (2013), “the
conditions in which people are born, grow, live, work and age, including the health system” are
known as social determinants of health. “These circumstances are shaped by the distribution of
money, power and resources at global, national and local levels, which are themselves influenced
by policy choices” (WHO, 2013). European ideology currently determines these conditions and
circumstances for most Indigenous peoples, although, Durkheim (1897) indicates that social
determinants such as the level of social integration (the degree to which the people are bound
together in social networks) and the level of social regulation (the degree to which people’s
desires and emotions are regulated by societal norms and customs) directly impact suicidal
tendency. The quality of the social determinants of health that is experienced by Indigenous
people helps explain the ongoing health inequalities, such as suicide. For example, Indigenous
people have poorer health, income and social status, nutritional status, physical environments,
education, employment opportunities, and as mentioned experience loss of culture and social
exclusion (Mitrou, F, Cooke, M, Lawrence, D, Povah, D, Mobilia, E, Guimond, E, & Zubrick,
2014) when compared to non-Indigenous people. For the purposes of this paper culture and
social exclusion will be addressed as examples of determinants of health and increased suicide
Culture as a Social Determinant of Health
According to the Royal Commission on Aboriginal Peoples (1995):
Culture is the whole complex of relationships, knowledge, languages, beliefs,
values and ethical rules that bind a people together and give a collective and its
individual members a sense of who they are and where they belong (pp. 25).
As Harper (2008) acknowledged, the trauma that Indigenous people experienced through
colonization and assimilation sought to destroy the culture of the people. Given culture is the
basis of Indigenous life; the destruction of such has vastly affected the “mind and spirit of the
people” (Leenaars, A, 2006). Corresponding with Durkheim’s theory (1897), when a major
social change takes place, especially those changes that are traumatic in nature such as abrupt
eradication of culture, people may feel a sense of anomie. Studies find that cultural genocide, or
acculturation, is implicit in Indigenous communities having the highest rates of suicide; whereas,
communities that recognize traditional culture and epistemology have the lowest, and transitional
communities have intermediate rates (Johnson, T. & Tomren, H., 1999).
Social Exclusion as a Determinant of Health
Social inclusion (or as Durkheim (1897) theorized, social integration and social
regulation) is a broad social determinant of health that intersects with several other social
determinants of health. It refers to the degree to which people are provided the opportunity to
participate in Canadian society. Indigenous people have limited access to social, cultural and
economic resources. Socially excluded individuals are more likely to be unemployed, earn lower
wages and have limited access to affordable housing. They have less access to health and social
services, and means of furthering their education. Furthermore, Indigenous people continue to
have little influence on decisions made by governments and other institutions (Galabuzi, G. E.,
2009). Social exclusion creates a sense of anomie and depression that further diminishes the
possibility of inclusion in society, which according to Durkheim will facilitate suicidal tendency.
Conclusion: Cultural Continuity as a Determinant of Health and Healing
Over the last century large inequities have developed in virtually every measure of health
and wellness among Indigenous people. Dispossession of rights, culture and epistemology by
way of colonization and assimilation continues to take its toll. Although efforts to improve
Indigenous health have begun, global, national and local barriers continue to create ineffectual
policy and practice that promotes high suicide rates among Indigenous populations. Lower rates
of suicide have been found in Indigenous communities that foster traditional native culture
(Chandler & Lalonde, 1998). Yoder, Whitbeck, Hoyt, and LaFromboise (2006) determined that
enculturation, a higher identification with the traditional culture, was protective against suicidal
ideation. Thus, a successful health strategy would need to encompass widespread community
redevelopment and be built on the principles of self-governance and self-determination.
Although cultural continuity and self-determination are not typically considered as critical health
determinants, research shows that they promote resiliency and protect against suicide among
Indigenous people (Chandler, Lalonde & Hallett, 2007) providing back to them their rights and
culture. Furthermore, while developing healing strategies, consideration should be given to the
complex and intersecting nature of the social determinants of health and how they all contribute
to the overall health and wellness of the people. Therefore, Canadian policy makers must
develop cultural respectful strategies that go beyond the biomedical realms and remove any
barriers that Indigenous people face in comparison to non-Indigenous counterparts.
Presently, in spite of continuing difficulty, Inuit have developed a considerable political
voice and organizational capacity, progressing toward self-determination through the signing of
Land Claim Agreements, a Partnership Accord, and the election of Inuit governments (National
Collaborating Centre for Aboriginal Health, 2012). By increasing levels of self-determination in
the Inuit communities, Inuit people are able to restructure allowing for reintegration of Inuit
culture, language, and epistemology in a way that is conducive to their overall health and
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