title: Suicidal ideation: the role of economic and aboriginal cultural status after multivariate adjustment.
abstract: OBJECTIVE
  To determine if Aboriginal (in this paper, First Nations and Métis people) cultural status is independently associated with lifetime suicidal ideation in the Saskatoon Health Region after controlling for other covariates, particularly income status.
  
  
  METHODS
  Data collected by Statistics Canada in all 3 cycles of the Canadian Community Health Survey (CCHS) were merged with identical questions asked in February 2007 by the Saskatoon Health Region. The health outcome was lifetime suicidal ideation. The risk indicators included demographics, socioeconomic status, cultural status, behaviours, life stress, health care use, and other health problems.
  
  
  RESULTS
  Participants (n = 5948) completed the survey with a response rate of 81.1%. The prevalence of lifetime suicidal ideation was 11.9%. After stratification, it was found that high-income Aboriginal people have similar low levels of suicidal ideation, compared with high-income Caucasian people. The risk-hazard model demonstrated a larger independent effect of income status in explaining the association between Aboriginal cultural status and lifetime suicidal ideation, compared with the independent effect of age. After full multivariate adjustment, Aboriginal cultural status had a substantially reduced association with lifetime suicidal ideation. The odds of lifetime suicidal ideation for Aboriginal people reduced from 3.28 to 1.99 after multivariate adjustment for household income alone.
  
  
  CONCLUSIONS
  The results of this study suggest reductions in lifetime suicidal ideation can be observed in Aboriginal people in Canada by adjusting levels of household income.
authors.affiliation: Saskatoon Health Region, Saskatoon, Saskatchewan. marklemstra@shaw.ca
authors.forename: Mark
authors.initials: M
authors.lastname: Lemstra
authors.forename: Cory
authors.initials: C
authors.lastname: Neudorf
authors.forename: Johan
authors.initials: J
authors.lastname: Mackenbach
authors.forename: Tanis
authors.initials: T
authors.lastname: Kershaw
authors.forename: Ushasri
authors.initials: U
authors.lastname: Nannapaneni
authors.forename: Christina
authors.initials: C
authors.lastname: Scott
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007182:Income; D007198:Indians, North American / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012959:Socioeconomic Factors; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology* / Q000706:statistics & numerical data; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data