Our Health Counts: Access to Health Risk Factors and Its Relationship to Diabetes in an Urban First Nations Population

This thesis explores the relationship between health access risk factors and diabetes in an urban First Nations population living in Canada. The proportion of Aboriginal peoples in Canada living in urban areas is increasing. Despite this, health data on urban Aboriginal populations in Canada is sparse and often unreliable. The Our Health Counts (OHC) study collected data from a self-identified urban First Nations population living in Hamilton, ON through respondent driven sampling. As statistical techniques for this data are not yet fully developed, advanced logistic regression modeling strategies were used to assess the relationship between health access risk factors and diabetes. Feeling health services were not culturally appropriate was significantly associated with an increased odds for diabetes (12.07, 95% 2.52, 57.91). A strong potential effect between diabetes was also found for the following barriers: not being able to locate a doctor in the area; feeling health care services accessed were inadequate and if health services were not being offered in the area. Furthermore, this study examined the sensitivity of results for various analysis strategies for data that were obtained using respondent driven sampling (RDS). This study could allow for the implementation of more targeted health interventions and the design of health policies that are more specific to target the urban First Nations population in Canada, as well as provide insight into the use of appropriate statistical methods for data collected through respondent driven sampling.