title: Individual- and community-level determinants of Inuit youth mental wellness.
abstract: OBJECTIVE
  Following the onset of intensive colonial intervention and rapid social change in the lives of Inuit people, youth in Nunavik have experienced high rates of mental health problems and suicide. Inuit people describe a broad range of contextual influences on mental wellness based on lived experience, but most epidemiological studies have focused on individual risk factors and pathologies. This study aimed to assess the influence of multiple determinants of mental wellness among Inuit youth in Nunavik, including culturally meaningful activities, housing and community social characteristics.
  
  
  METHODS
  Mental wellness was measured in the form of two primary outcomes: self-esteem and suicidal ideation. Using cross-sectional data from the 2004 Nunavik Inuit Health Survey and multilevel regression modelling, we estimated associations between these two outcomes and various independent individual- and community-level explanatory factors among Inuit youth. All variables were selected to reflect Inuit perspectives on determinants of mental wellness. The study design and interpretation of results were validated with Inuit community representatives.
  
  
  RESULTS
  Pride in Inuit identity, traditional activities, community-level social support and community-level socio-economic status were found to be protective. Barriers to participating in traditional activities, household crowding and high community rates of violence were risk factors.
  
  
  CONCLUSIONS
  These findings support Inuit perspectives, expand the scope of epidemiological analysis of Inuit mental wellness and reinforce the need for locally informed, community-wide approaches to mental wellness promotion for Inuit youth.
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC. andrew.p.gray@mail.mcgill.ca.
authors.forename: Andrew Paul
authors.initials: AP
authors.lastname: Gray
authors.forename: Faisca
authors.initials: F
authors.lastname: Richer
authors.forename: Sam
authors.initials: S
authors.lastname: Harper
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007206:Individuality; D004930:Inuit / Q000523:psychology* / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000208:ethnology*; D055361:Multilevel Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D064890:Social Determinants of Health / Q000208:ethnology*; D055815:Young Adult