Cancer-related health behaviours and health service use among Inuit and other residents of Canada's north

This article identifies the extent to which demographic, socio-economic and geographic factors account for differences between Inuit and other Northern Canadian residents in health-related behaviours and health service use related to cancer incidence and diagnosis. The study population includes Inuit, Métis, First Nation and non-Aboriginal residents aged 21-65 who live in Nunavut, Northwest Territories, Labrador, Nunavik and Jamésie in northern Quebec, and the northern regions of Saskatchewan and Manitoba. Data are drawn from confidential versions of the 2000-2001 and 2004-2005 Canadian Community Health Surveys and the 2001 Aboriginal People's Survey produced by Statistics Canada. Multivariate Logistic regression analysis is applied to a set of health-related behaviours including cigarette smoking, binge drinking and obesity, and a set of basic health service use measures including consultation with a physician, consultation with a nurse, Pap smear testing and mammography. We found that significantly higher smoking and binge drinking rates and lower rates of female cancer screening among Inuit are found not to be accounted for by differences in observable demographic and socio-economic characteristics, location of residence or distance from a hospital. As such we conclude that health-related behaviours leading to increased cancer risk and to a lower utilization of diagnostic cancer screening appear to be due to unobserved factors specific to Inuit and their unique social-cultural context. Policy interventions to address these problems may need to be targeted specifically to Inuit Canadians and should not be considered in isolation of their broader health, economic and social environment.