title: The influence of community well-being on mortality among Registered First Nations people.
abstract: BACKGROUND
  Living in a community with lower socioeconomic status is associated with higher mortality. However, few studies have examined associations between community socioeconomic characteristics and mortality among the First Nations population.
  
  
  METHODS
  The 1991-to-2006 Census Mortality and Cancer Cohort follow-up, which tracked a 15% sample of Canadians aged 25 or older, included 57,300 respondents who self-identified as Registered First Nations people or Indian band members. The Community Well-Being Index (CWB), a measure of the social and economic well-being of communities, consists of income, education, labour force participation, and housing components. A dichotomous variable was used to indicate residence in a community with a CWB score above or below the average for First Nations communities. Age-standardized mortality rates (ASMRs) were calculated for First Nations cohort members in communities with CWB scores above and below the First Nations average. Cox proportional hazards models examined the impact of CWB when controlling for individual characteristics.
  
  
  RESULTS
  The ASMR for First Nations cohort members in communities with a below-average CWB was 1,057 per 100,000 person-years at risk, compared with 912 for those in communities with an above-average CWB score. For men, living in a community with below-average income and labour force participation CWB scores was associated with an increased hazard of death, even when individual socioeconomic characteristics were taken into account. Women in communities with below-average income scores had an increased hazard of death.
  
  
  CONCLUSIONS
  First Nations people in communities with below-average CWB scores tended to have higher mortality rates. For some components of the CWB, effects remained even when individual socioeconomic characteristics were taken into account.
authors.affiliation: Statistics Canada Regional Office, Vancouver, British Columbia.
authors.forename: Lisa N
authors.initials: LN
authors.lastname: Oliver
authors.affiliation: Indigenous and Northern Affairs Canada.
authors.forename: Chris
authors.initials: C
authors.lastname: Penney
authors.affiliation: Departments of Sociology and Economics, University of New Brunswick.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Peters
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D019352:Censuses; D005260:Female; D006801:Humans; D007198:Indians, North American; D004930:Inuit; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D012307:Risk Factors; D012959:Socioeconomic Factors
keywords: Aboriginal health; age-standardized mortality rates; cohort studies; community; data linkage; indigenous; longitudinal studies; rate ratios; socioeconomic