Abstract

First Nations experience disproportionate rates of suicide when compared to the general population. Various risk factors are identified to increase understanding of the prevalence of suicide among First Nations, but environmental dimensions of suicide are understudied. This study asks whether water insecurity, as reflected by long-term drinking water advisories (LT-DWA), has any bearing on the distribution of suicide in First Nations across Canada, and specifically in Ontario. To assess this, we established the proportion of First Nations with LT-DWAs in Canada and in Ontario that have had suicides occur between 2011 and 2016 through a review of media archives. This proportion was compared to census data on the proportion of First Nations with suicides in Canada and in Ontario between 2011 and 2016, and statistical significance of difference was determined through chi-square goodness of fit test. Overall, the findings were mixed. Nationally, there was no significantly difference of proportion of First Nations with LT-DWAs with combined (confirmed and probable) reported suicides occurring when compared to census proportions; however, at the provincial level, findings had significant differences. The authors conclude that water insecurity in First Nations, as indicated by the presence of a LT-DWA in First Nations across may be an important environmental dimension of suicide, contributing to enhanced risk for suicide in First Nations.

Ansloos, J., & Cooper, A. (2023). Is suicide a water justice issue? Investigating long-term drinking water advisories and suicide in First Nations in Canada. International Journal of Environmental Research and Public Health, 20(5), 4045.

1. Introduction

Suicide is one of the most urgent issues facing First Nations in Canada, with suicide rates approximately three times higher compared with the general population [1]. Global incident rates across a 60-year period suggest an upward trend of suicide among Indigenous peoples [2]. For First Nations in Canada, suicide is often cited as a leading cause of death for youth [3], and the leading cause of death for adults under the age of 44 [4]. Many risk factors are identified to increase understanding of the disproportionate prevalence of suicide among First Nations, but there is an urgent need to understand environmental dimensions. This exploratory study investigates one potential environmental dimension of suicide among First Nations: water insecurity.

1.1. Suicide among First Nations in Canada

As early as 1995, the Royal Commission on Aboriginal Peoples categorized suicide risk factors for First Nations, including biopsychological factors (e.g., depression, substance use disorders), situational factors (e.g., disruptions to family life due to child welfare policies, off-reserve hospitalizations), socioeconomic factors (e.g., income levels, education levels), and cultural stressors (e.g., suppression of belief systems and spirituality, racial discrimination) [5]. Since then, a range of other demographic factors, including gender, age, and geographic location, have been found to have a significant bearing on rates of suicide among First Nations. Youth aged 15 to 24, men, and those living on reserve, are at higher risk for suicide [1]. Socioeconomic factors have also been consistently associated with high rates of suicide in First Nations [6,7,8]. Recently, household income, labour force status, education, and marital status accounted for 66% of suicide risk after adjusting for risk associated with age and sex among First Nations adults [1], demonstrating that socioeconomic factors have heavy bearing on suicide rates. However, to date, environmental dimensions of suicide among First Nations have received little research.

Qualitative studies have suggested that First Nations affected by a lack of access to safe drinking water are likely to have disproportionately high suicide rates [28] and that water insecurity may be associated with mental health issues in First Nations [36], which by extension might intersect with suicide risk. Among Indigenous peoples in Canada, more broadly, it has been found that mental health outcomes associated with suicide may be affected by climate change, and in particular changes to land, ice, snow, weather, and sense of place [37,38,39]. Related to this, research has shown that environmental changes and related damages to environmental infrastructure accompanying climate change are linked to enhanced psychosocial distress, which in turn might affect suicidality [37]. In a recent study among Inuit in Nunatsiavut, climate change enhanced the likelihood of suicidal ideation [40,41].

https://www.mdpi.com/1660-4601/20/5/4045#Findings

https://archive.org/details/ansloos-water-insecurity-suicide-May-2023