title: Canada's residential school system: measuring the intergenerational impact of familial attendance on health and mental health outcomes.
abstract: We estimate the intergenerational relationship between the residential school (RS) attendance of an older generation family member and the physical and mental health of a younger generation.
  
  
  
  Data from the 2012 Aboriginal Peoples Survey (APS) is used to examine the relationship between previous generational family RS attendance and the current physical and mental health of off-reserve First Nations, Métis and Inuit Canadians. Five outcomes are considered (self-perceived health, mental health, distress, suicidal ideation and suicide attempt). Direct (univariate) and indirect (multivariate) effects of family RS attendance are examined for each dependent variable. We draw from the general and indigenous-specific social determinants of health literature to inform the construction of our models.
  
  
  
  Familial RS attendance is shown to affect directly all five health and mental health outcomes, and is associated with lower self-perceived health and mental health, and a higher risk for distress and suicidal behaviours. Background, mediating and structural-level variables influence the strength of association. Odds of being in lower self-perceived health remain statistically significantly higher with the presence of familial attendance of RS when controlling for all covariates. The odds of having had a suicide attempt within the past 12 months remain twice as high for those with familial attendance of RS.
  
  
  
  Health disparities exist between indigenous and non-indigenous Canadians, an important source of which is a family history of RS attendance. This has implications for clinical practice and Canadian public health, as well as countries with similar historical legacies.
authors.affiliation: Department of Health Policy, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Christina
authors.initials: C
authors.lastname: Hackett
authors.affiliation: Department of Economics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Feeny
authors.affiliation: Department of Economics, McMaster University, Hamilton, Ontario, Canada Institute for Work and Health, Toronto, Ontario, Canada.
authors.forename: Emile
authors.initials: E
authors.lastname: Tompa
mesh_terms: D000328:Adult; D002170:Canada; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007198:Indians, North American; D016901:Intergenerational Relations; D008297:Male; D008603:Mental Health; D012574:Schools / Q000458:organization & administration*; D011795:Surveys and Questionnaires
keywords: Health inequalities; MENTAL HEALTH; PSYCHOSOCIAL FACTORS; SELF-RATED HEALTH; SUICIDE