The Lifetime Effect of Residential School Attendance on Indigenous Health Status

Objectives. I examined the health impact of lifetime Indian Residential school (IRS) attendance and the mediating influences of socioeconomic status and community adversity on health outcomes in a national sample of Aboriginal peoples in Canada. Methods. In an analysis of data on 13 881 Inuit, Metis, and off-reserve First Nations or North American Indian adults responding to the postcensus 2006 Aboriginal Peoples Survey administered October 2006 to March 2007, I tested the direct effect of IRS attendance on health and indirect effects through socioeconomic and community factors using logistic regression procedures. Results. Negative health status was significantly more likely with IRS attendance than nonattendance. The direct effect of IRS attendance remained significant although it attenuated substantially when adjusting for demographic characteristics, socioeconomic status, and community-level adversities. Community adversity and socioeconomic factors, primarily income, employment status, and educational attainment mediated the effect of IRS on health. Conclusions. Residential school attendance is a significant health determinant in the Indigenous population and is adversely associated with subsequent health status both directly and through the effects of attendance on socioeconomic and community-level risks.