Predictors of obesity among metis children: socio-economic, behavioural and cultural factors.
Cooke, Martin J. ; Wilk, Piotr ; Paul, Kenneth W. 等
Aboriginal children in Canada and the US are at particularly high
risk for overweight and obesity, (1) with a variety of potential health
consequences in childhood and later life. (2) Although as many as 30% of
Aboriginal people in Canada identify as Metis, (3) there have been no
studies of obesity specifically among Metis children. (4)
There is considerable evidence of the effects of socio-economic
risk factors for childhood overweight and obesity, especially parental
income and education, among the general population. (5) The overall
higher risk of obesity experienced by Aboriginal children is likely
related at least in part to social and economic conditions, such as
higher rates of low income, and increased likelihood of living in
underserved communities or neighbourhoods. Average income among Metis
aged 15 years and older was about 80% of that of the Canadian population
in 2005, and the rate of low income among Metis was 21% in that year,
compared with 15% among all Canadians. (6) A higher proportion of Metis
also live in rural areas (6) and there is evidence that Aboriginal
peoples, including Metis, are at high risk for food insecurity, (7)
which may also play a role in the high rates of childhood obesity. (8)
It is generally recognized that the causes of childhood overweight
and obesity are complex and operate on several different levels. (9)
There is also a growing understanding that Aboriginal peoples'
health is affected by unique historical and cultural factors associated
with colonialism, including the loss of access to traditional
environments, (10) and loss of culture and language. (11,12) In the case
of childhood overweight and obesity, Willows and colleagues (9) have
developed a socio-ecological framework that incorporates factors
operating at the levels of the individual, home and community, built
environment and society levels, all within the historical context of
colonization and assimilationist policies that include the Indian Act
and residential schooling. These "Aboriginal determinants of
health" and their effects may be different for First Nations, Metis
and Inuit populations, owing to their unique cultures and geographies
and different histories of colonization and legal recognition. (13)
With this paper we hope to address two gaps in the existing
literature regarding childhood obesity and Indigenous peoples. First,
although there has been some research regarding overweight and obesity
among Aboriginal children in Canada, there has been less work outside of
First Nations communities, and none that focuses on Metis children.
Second, there have been no examinations of the potential effects of
Metis-specific determinants of health, on particular health outcomes. In
this case, we hypothesized that access to culture and traditional
activities and knowledge of Aboriginal languages may be protective
against obesity. (14) Following Willows and colleagues, (9) we
hypothesized that parental residential schooling may have an effect on
risk of obesity that is independent of other risk factors, possibly
through loss of cultural or parenting knowledge.
METHODS AND DATA
Data used for the analyses came from the 2006 Aboriginal Peoples
Survey (APS), * which was administered to a sample of the off-reserve
population who identified as members of an Aboriginal group (First
Nations, Inuit, or Metis) in the 2006 Census. (15) The Children and
Youth Component of the APS contains data on children aged 6 to 14,
provided by the "Person Most Knowledgeable" (PMK) about the
child within the household. Nearly all PMKs (97%) were parents,
including a small number of step- and adoptive parents, and about three
quarters were female, indicating most PMKs were mothers. The analysis
included children identified by the PMK as Metis only.
Variables
Obesity was defined based on the International Obesity Task
Force's (IOTF) sex- and age-specific Body Mass Index cut-offs, (16)
provided on the Statistics Canada datafile, with BMI calculated using
PMK-reported height and weight.
Socio-demographic variables included Census family ([dagger])
status (17) as well as child's age and gender. Aspects of
socio-economic status captured by the APS included the education of the
PMK--a reasonable proxy for parents' education, household income,
and whether the family had experienced food insecurity. Household income
was divided into groups roughly equivalent to quartiles, ([double
dagger]) with the highest as the reference category. Food insecurity was
based on the question, "Has--ever experienced being hungry because
the family has run out of food or money to buy food?" and was coded
dichotomously (Y/N).
Because of the small sample size in some provinces, geography was
coded into six regions, with Ontario as the reference category. Urban
versus rural residence was defined by Statistics Canada's
classification. (15)
There was only one variable that pertained to physical activity,
derived from the question, "How often does--play sports, including
taking lessons?" Responses were coded as "1-3 times per
week", "4 or more times per week", with "never or
less than once per week" as the reference category. Physical
inactivity was assessed by a question pertaining to three activities,
"On average, about how many hours per day, if any, does--watch TV,
videos or DVDs?", "... spend time on a computer?", or
"... play video games such as Play Stations, Xboxes, Nintendo and
Gameboy, excluding computer games?" TV viewing, time spent playing
video games and time spent on a computer were coded dichotomously as
"two hours or less per day" and "greater than two hours
per day". The APS also asked PMKs whether children had ever been
breastfed.
The APS dataset includes several questions related to
children's cultural activities and knowledge. PMKs were asked,
"Does-- speak an Aboriginal language?" (Y/N). PMKs were also
asked how often children "spend time with Elders" and
"participate in culturally-related activities." Responses were
recoded to three categories, "one to three times per week",
"four or more times per week", with "never or less than
once per week" as the reference category. PMKs were also asked the
question, "Were you ever a student at a federal residential school,
or a federal industrial school?" (Y/N).
Analyses
We used binary logistic regression to model the likelihood of a
child being obese, with bivariate associations assessed using chi-square
tests of independence. Analyses were done using SAS 9.2 for Windows.
Bootstrap weights and the Bootvar procedure for SAS (18) were used to
adjust variance estimates for sampling design effects. 9.8% of the
sample had missing height or weight data and were therefore excluded.
The combined percentage of "Don't know" and refusals was
low for each of the independent variables (0.6% to 2.3%). These were
treated as missing at random and deleted list-wise. The resulting
unweighted sample size was 4,060 Metis children.
RESULTS
Table 1 describes the sample and presents the bivariate
relationships between the independent variables and the dichotomous
obesity variable. Overall, an estimated 16.5% of Metis children aged 6
to 14 were obese. Boys were more likely to be obese than were girls
(18.5% versus 14.4%). Surprisingly, however, Metis children aged 6 to 10
were much more likely to be obese than those aged 11 to 14 (26.9% versus
11.8%). This is considerably different from the results reported for
Canadian children from the 2004 Canadian Community Health Survey, which
found 8.0% of children aged 6 to 11 and 9.4% of those 12 to 17 were
obese, using the same IOTF cut-offs. (19)
Most of the bivariate relationships were in the directions expected
(Table 1). Metis children living in single-parent households and whose
PMKs had less than high school education were at higher risk to obesity
than were those living in other household types or whose parents had
post-secondary education. Those with family incomes in the highest two
categories were less likely to be obese than were those in the lowest
family income categories. The 6.4% of children whose PMKs reported some
experience of hunger due to food insecurity were not more likely to be
obese than were other children.
Relationships between the behavioural variables and obesity were
also generally as predicted. Children reported as having been breastfed
were slightly less likely to be obese than those who were not (15.4%
versus 18.5%). Those who participated in sports four or more times per
week were less likely to be obese than those who participated less
frequently, while those who participated less often in "screen
time" activities, including television, video games or computers,
were less likely to be obese than other children (Table 1).
We had expected that connection to Aboriginal culture and time
spent participating in culture-related activities would be generally
protective against obesity. The bivariate relationships shown in Table 1
indicate that the nearly 6% of Metis children who spoke an Aboriginal
language were more likely to be obese than those who did not (20.8%
versus 16.0%). Likewise, those who spent time with Elders four or more
times per week were more likely to be obese, as were those whose PMKs
reported that they participated in culturally-related activities four or
more times per week. A small proportion of the Metis children in the
sample had PMKs who had themselves attended residential or industrial
school. However, this group was significantly more likely to be obese
than those whose PMKs had not attended residential schools (28.8% versus
16.1%).
Our modelling strategy was to first construct a full model
including all of the identified covariates and to test for interactions
with the two main non-modifiable risk factors, age group and gender.
That at least one category of all of the independent variables
interacted with one or both of these non-modifiable factors (not shown)
suggested stratification by both age and gender. Four models are
presented here (Tables 2 and 3). Least significant variables were
removed by backward elimination, to produce parsimonious models (not
shown). The elimination of the non-significant variables did not result
in meaningful changes to parameter estimates or standard errors,
suggesting independence from the included variables.
Table 2 presents the full model results for Metis boys and girls
aged 6 to 10. Both boys and girls in lone-parent households were at
higher risk for obesity (OR=1.50 boys, 1.32 girls). Children whose PMK
had less than high school were at higher risk than those whose PMK had
post-secondary education (OR=1.61 boys, 1.92 girls), and girls whose PMK
had high school education were also at higher risk (OR=1.42). Household
income had less clear effects, with important gender differences. Boys
in second-quartile households were at higher risk than those in the
highest (fourth) income quartile (OR=1.19), while girls in
third-quartile and first-quartile households were less likely to be
obese than those in the highest income quartile (ORs=0.71 and 0.96,
respectively). Boys whose PMKs reported the former had experienced
hunger were about half as likely to be obese as others (OR=0.51), but
this was insignificant among girls.
Boys in Atlantic provinces, Quebec, British Columbia and the
Territories were less likely to be obese than boys living in Ontario,
whereas girls in the Atlantic provinces, Prairie regions and the
Territories were at higher risk than those in Ontario. Living in a rural
area was associated with higher risk among boys (OR=1.52), but was
insignificant among girls.
Table 1 showed that children who knew an Aboriginal language were
more likely to be obese, and this effect was positive among boys aged 6
to 10 once the other factors were controlled (OR=1.21). Also
surprisingly, children who spent time with Elders four or more times per
week were more likely than those who did not spent time with Elders to
be obese, and this was true for boys (OR=1.56) and girls (OR=1.70).
Girls whose PMKs reported the former's participating in other
cultural activities four or more times per week were also much more
likely to be obese (OR=3.03); the effect was negative among boys
(OR=0.54). Girls aged 6 to 10 whose PMK had attended a residential or
industrial school were also much more likely to be obese (OR=5.23),
while this effect was insignificant among boys.
As expected, boys aged 6-10 who had been breastfed were less likely
to be obese (OR=0.79), while girls who had been breastfed were at higher
risk (OR=1.11). The effects of participating in sports were generally as
expected among boys and girls, with participating four or more times per
week having protective effects (OR=0.89 boys, 0.45 girls). Similarly,
watching two hours or less of television per day had independent
protective effects among both boys (OR=0.75) and girls (OR=0.65). Boys
who spent two hours or less playing video games were at lower risk
(OR=0.74), as were boys who spent two hours or less on a computer
(OR=0.41). On the other hand, girls with less computer time were more
likely to be obese (OR=1.67).
Table 3 presents similar models for children aged 11-14. As with
the younger children, those living in lone-parent households were also
at higher risk of obesity (OR=1.36 boys, 2.00 girls). The effects of the
other socio-economic variables were not as expected. Among Metis boys in
this age group, those whose PMK had less than high school were more
likely to be obese than those whose PMKs had post-secondary education
(OR=1.47). However, those whose PMKs had high school diplomas were less
likely to be obese than those whose PMKs had post-secondary education
(OR=0.74), and there were no significant effects of PMK education for
girls. Girls in households with income in the second quartile were less
likely to be obese than those with fourth-quartile incomes (OR=0.61),
while boys in second- and third-quartile households had lower risk than
those in the highest income households (ORs=0.76 and 0.42,
respectively). As in the younger age group, the effects of having
experienced hunger were significant only among boys (OR=0.56).
Among the older children, there were fewer significant regional
effects. Boys in the Prairie region (OR=1.36) and girls in the Atlantic
region (OR=2.23) and Territories (OR=3.30) were more likely to be obese
than children in Ontario. Both boys and girls who lived in rural
locations were more likely to be obese than those who lived in urban
settings (OR=1.39 boys, 1.55 girls).
Girls aged 11-14 who spoke an Aboriginal language were more likely
to be obese (OR=2.18). As with the younger children, Metis children aged
11 to 14 whose PMKs reported that the former spent time with Elders more
often were more likely to be obese than those who did so less than once
per week. This was true for boys and girls who spent time with Elders
one to three times per week (OR=1.17 boys, 2.32 girls), and for girls
who spent time with Elders four or more times per week (OR=2.36). Those
who participated in other cultural activities four or more times per
week were also more likely to be obese, and this effect was stronger
among girls (OR=2.57) than boys (OR=1.69). Among boys aged 11-14, those
whose PMKs had attended residential school were more than twice as
likely to be obese as others (OR=2.29), while the effect among girls was
in the opposite direction (OR=0.17).
Also like the younger age group, both boys and girls aged 10-14 who
participated in sports more frequently were less likely to be obese,
with both boys and girls who played sports at least four times per week
being about a third as likely to be obese as those who participated less
than once per week (OR=0.33 boys, 0.34 girls). Watching two hours or
less of television per day was also associated with lower likelihood of
being obese among boys (OR=0.80) and girls (OR=0.66). Boys who played
video games two hours or less per day were less likely to be obese
(OR=0.63), but there were not enough 11-14 year-old girls in this
category for a reliable estimate. Girls who used a computer two hours or
less per day were more likely to be obese than those who used computers
more (OR=1.38).
DISCUSSION AND CONCLUSIONS
This study examined the various socio-economic and behavioural
factors that affect the risk of obesity among Metis children. Indeed,
many of these risk factors are similar to those observed in studies of
the general population, including low parental socio-economic status,
(5,20) family structure (5) and living in a rural location (5) as well
as more sedentary behaviours and less physical activity. (5,21) However,
in models stratified by gender and age, some of these relationships
became less clear, with the independent effects of household income and
parental education varying between boys and girls, and by age group.
Differences in the role of socio-economic status variables as predictors
of obesity by gender, age and race/ethnicity group have also been found
in the US. (22,23) Although they require further research to be
explained, these findings emphasize the importance of understanding the
processes that may affect childhood obesity in different populations,
including different Aboriginal groups.
We had expected that language and participation in cultural
activities would be protective against obesity. Although there were
again differences between age and gender groups, the general pattern was
that those participating more often were more likely to be obese. This
is not to suggest that these activities themselves cause obesity.
Rather, these relationships may be due to other factors not captured in
the models, such as family or community characteristics or geography
insufficiently controlled by the region and rural/urban indicators. The
finding that PMK residential school experience has a significant effect,
independent of household income or PMK education, also requires further
investigation to understand, as does the finding that PMK residential
schooling is a positive predictor of obesity among younger boys and
girls, but a negative predictor among older girls.
The APS data used have important limitations. The survey questions
regarding cultural activities did not provide information about what
activities were involved in "participating in cultural
activities" or "spending time with Elders". The physical
activity questions included only sports participation, and the food
insecurity question addressed only the experience of hunger, rather than
more complete conceptualizations of food insecurity (for example, ref.
24). The dependent measures also present limitations. The use of
parental reports of children's height and weight may lead to
underestimates of obesity, (25) and the high degree of nonresponse to
these questions may not be independent of children's actual height
and weight. More recent data are needed, and in the absence of
anthropometric measures, the overall estimates of obesity presented here
should be treated with some caution. Nonetheless, these results provide
evidence that the factors that are related to obesity among Metis
children may include unique cultural and historical factors, and that
the socio-economic and behavioural factors affecting obesity among Metis
children may not be the same across gender and age groups.
Acknowledgements: Funding was provided by an operating grant from
the Canadian Institutes of Health Research, Institute for Aboriginal
Peoples' Health.
Conflict of Interest: None to declare.
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Received: November 20, 2012
Accepted: May 26, 2013
Martin J. Cooke, PhD, [1,2] Piotr Wilk, PhD, [3] Kenneth W. Paul,
MSc, [1] Shelley L.H. Gonneville [4]
Author Affiliations
[1.] School of Public Health and Health Systems, University of
Waterloo, Waterloo, ON
[2.] Department of Sociology & Legal Studies, University of
Waterloo, Waterloo, ON
[3.] Department of Paediatrics and Department of Epidemiology &
Biostatistics, Schulich School of Medicine and Dentistry, Western
University, London, ON
[4.] Healing and Wellness Branch, Metis Nation of Ontario, Ottawa,
ON
Correspondence: Martin Cooke, School of Public Health and Health
Systems, University of Waterloo, 200 University Dr. W., Waterloo, ON N2L
3G1, E-mail: cooke@uwaterloo.ca
* This analysis used data provided by Statistics Canada through the
Research Data Centres programme. The analysis and conclusions do not
represent the views of Statistics Canada.
([dagger]) A Census family refers to a married or common-law couple
or lone parent and any children who are living in the same dwelling.17
Census family status captures the structure of relationships among
family members in the household, including whether members are married,
parents or children.
([double dagger])) Because of Statistics Canada's disclosure
rules, these cut- offs are rounded and are not exactly equivalent to
quartiles.
Table 1. Characteristics of Sample of Metis Children
Aged 6 to 14 Years, and Percent Obese (N=4060)
Variable Value Percent
of
Sample
Sex Male 50.5
Female 49.5
Age (years) 6-10 29.2
11-14 70.8
Single-parent No 69.6
household Yes 30.4
PMK education Some post-secondary 58.3
HS diploma 24.2
Less than HS diploma 17.5
Household income <$39,000 23.7
$39,001-$63,000 24.9
$63,001-$94,000 24.9
>$94,000 26.6
Experience hunger Never 93.6
Ever 6.4
Region Quebec 6.4
Atlantic region 4.7
Ontario 19.3
Prairie region 51.9
British Columbia 16.8
Territories 1.0
Urban/Rural Urban 69.1
Rural 30.8
Aboriginal language No 94.1
Yes 5.9
Time with Elders <1 62.0
(times/week) 1-3 25.9
[greater than or equal to] 4 12.1
Culturally-related <1 86.2
activities 1-3 12.1
(times/week) >4 1.7
PMK attended No 98.3
residential school Yes 1.7
Breastfed No 29.4
Yes 70.6
Sports participation <1 27.9
(times/week) 1-3 49.4
[greater than or equal to] 4 22.7
Watches television [greater than or equal to] 2 26.7
(hours/day) [greater than or equal to] 2 73.3
Plays video games [greater than or equal to] 2 4.0
(hours/day) <2 96.1
Computer time [greater than or equal to] 2 6.9
(hours/day) [greater than or equal to] 2 93.1
Variable Percent P-value
Obese
Sex 18.5 0.0005
14.4
Age (years) 26.9 <0.0001
11.8
Single-parent 14.5 <0.0001
household 20.3
PMK education 14.4 <0.0001
16.3
22.5
Household income 20.4 <0.0001
18.8
12.9
13.5
Experience hunger 16.4 0.7967
15.4
Region 11.5 0.0160
21.2
14.1
18.1
13.2
25.0
Urban/Rural 15.4 0.0179
18.4
Aboriginal language 16.0 0.0442
20.8
Time with Elders 15.1 0.0005
(times/week) 16.2
22.5
Culturally-related 16.1 0.0708
activities 16.3
(times/week) 28.6
PMK attended 16.1 0.0186
residential school 28.6
Breastfed 18.5 0.0204
15.4
Sports participation 18.6 <0.0001
(times/week) 17.5
11.0
Watches television 19.4 0.0021
(hours/day) 15.2
Plays video games 25.0 0.0008
(hours/day) 15.9
Computer time 10.7 0.0149
(hours/day) 16.6
Data: 2006 Aboriginal Peoples Survey, Children and Youth master file.
Notes: HS (high school); PMK (person most knowledgeable). Significance
assessed using chi-square test of independence of independent
variable and obesity status. Percentages calculated using
sample weights. Totals may not sum to 100% due to rounding.
Table 2. Logistic Regression Models Predicting Obesity
Among Metis Boys and Girls Aged 6-10 Years
Variable Boys (N=1030) Girls (N=1005)
OR (95% CI) OR (95% CI)
Socio-economic Characteristics
Single-parent household 1.50 (1.35-1.67) 1.32 (1.18-1.48)
Other household type 1.00 1.00
PMK education
Post-secondary 1.00 1.00
HS diploma 0.98 (0.89-1.06) 1.42 (1.27-1.59)
Less than HS diploma 1.61 (1.42-1.81) 1.92 (1.71-2.15)
Household income
4th quartile 1.00 1.00
3rd quartile 1.09 (0.95-1.24) 0.71 (0.62-0.81)
2nd quartile 1.19 (1.04-1.36) 1.33 (1.18-1.52)
1st quartile 0.95 (0.83-1.01) 0.96 (0.82-1.12)
Experience hunger
Never 1.00 1.00
Ever 0.51 (0.41-0.63) 1.23 (0.99-1.53)
Geographic Characteristics
Atlantic region 0.68 (0.55-0.83) 2.29 (1.91-2.76)
Quebec 0.48 (0.39-0.59) 0.97 (0.79-1.2)
Ontario 1.00 1.00
Prairie region 0.91 (0.80-1.04) 1.25 (1.08-1.44)
British Columbia 0.73 (0.62-0.87) 1.15 (0.97-1.36)
Territories 0.61 (0.48-0.78) 1.42 (1.05-1.92)
Urban location 1.00 1.00
Rural location 1.52 (1.39-1.66) 0.94 (0.86-1.03)
Culture-related Characteristics
Aboriginal language
No 1.00 1.00
Yes 1.21 (1.03-1.42) 0.89 (0.75-1.05)
Time with Elders
Never or less than once/week 1.00 1.00
1-3 times/week 1.07 (0.97-1.17) 0.99 (0.89-1.10)
4 or more times/week 1.56 (1.35-1.81) 1.70 (1.50-1.94)
Other cultural activities
Never or less than once/week 1.00 1.00
1-3 times/week 1.02 (0.89-1.16) 1.04 (0.93-1.17)
4 or more times/week 0.54 (0.41-0.71) 3.03 (2.16-4.25)
PMK residential school
Yes 0.70 (0.47-1.02) 5.23 (3.59-7.60)
No 1.00 1.00
Early Life Experience
Breastfed 0.79 (0.72-0.87) 1.11 (1.01-1.22)
Not breastfed 1.00 1.00
Physical Activity/Inactivity
Sports participation
Never or less than once/week 1.00 1.00
1-3 times/week 1.08 (0.97-1.19) 0.98 (0.89-1.07)
4 or more times/week 0.89 (0.79-0.99) 0.45 (0.38-0.52)
Television
More than 2h/day 1.00 1.00
2h or less/day 0.75 (0.68-0.82) 0.65 (0.58-0.71)
Video games
More than 2h/day 1.00 1.00
2h or less/day 0.74 (0.68-0.81) 0.81 (0.57-1.13)
Computer time
More than 2h/day 1.00 1.00
2h or less/day 0.41 (0.30-0.55) 1.67 (1.32-2.11)
Data: 2006 Aboriginal Peoples Survey, Children and Youth master file.
Notes: HS (high school); PMK (person most knowledgeable). Confidence
intervals produced using bootstrap estimates of variance. Effects in
bold indicate (p [less than or equal to] 0.05).
Table 3. Logistic Regression Models Predicting Obesity
Among Metis Boys and Girls Aged 11-14 Years
Variable Boys (N=1030) Girls (N=1005)
OR (95% CI) OR (95% CI)
Socio-economic Characteristics
Single-parent household 1.36 (1.18-1.58) 2.00 (1.59-2.52)
Other household type 1.00 1.00
PMK education
Post-secondary 1.00 1.00
HS diploma 0.74 (0.65-0.85) 0.98 (0.77-1.23)
Less than HS diploma 1.47 (1.23-1.74) 1.21 (0.99-1.48)
Household income
4th quartile 1.00 1.00
3rd quartile 0.42 (0.35-0.51) 0.98 (0.75-1.25)
2nd quartile 0.76 (0.64-0.91) 0.61 (0.46-0.80)
1st quartile 0.99 (0.82-1.18) 1.09 (0.81-1.47)
Experience hunger
Never 1.00 1.00
Ever 0.56 (0.45-0.69) 1.16 (0.87-1.54)
Geographic Characteristics
Atlantic region 1.06 (0.80-1.39) 2.23 (1.58-3.13)
Quebec 0.79 (0.58-1.07) 1.32 (0.93-1.88)
Ontario 1.00 1.00
Prairie region 1.36 (1.16-1.56) 1.28 (1.00-1.64)
British Columbia 0.85 (0.67-1.02) 0.88 (0.64-1.21)
Territories 0.92 (0.63-1.35) 3.30 (2.22-4.89)
Urban location 1.00 1.00
Rural location 1.39 (1.24-1.57) 1.55 (1.29-1.84)
Culture-related Characteristics
Aboriginal language
No 1.00 1.00
Yes 0.82 (0.66-1.03) 2.18 (1.66-2.84)
Time with Elders
Never or less than once/week 1.00 1.00
1-3 times/week 1.17 (1.03-1.34) 2.32 (1.92-2.79)
4 or more times/week 1.16 (0.99-1.36) 2.36 (1.91-2.92)
Other cultural activities
Never or less than once/week 1.00 1.00
1-3 times/week 1.14 (0.96-1.35) 1.04 (0.82-1.31)
4 or more times/week 1.69 (1.16-2.44) 2.57 (1.66-3.98)
PMK residential school
Yes 2.29 (1.48-3.53) 0.17 (0.11-.26)
No 1.00 1.00
Early Life Experience
Breastfed 0.98 (0.86-1.11) 0.75 (.063-.090)
Not breastfed 1.00 1.00
Physical Activity/Inactivity
Sports participation
Never or less than once/week 1.00 1.00
1-3 times/week 0.79 (0.70-0.90) 0.48 (0.40-0.57)
4 or more times/week 0.33 (0.28-0.38) 0.34 (0.25-0.47)
Television
More than 2h/day 1.00 1.00
2h or less/day 0.80 (0.72-0.90) 0.66 (0.57-0.78)
Video games
More than 2h/day 1.00 -- *
2h or less/day 0.63 (0.54-0.74) -- *
Computer time
More than 2h/day 1.00 1.00
2h or less/day 1.08 (0.92-1.27) 1.38 (1.08-1.75)
Data: 2006 Aboriginal Peoples Survey, Children and Youth master file.
Notes: HS (high school); PMK (person most knowledgeable). Confidence
intervals produced using bootstrap estimates of variance. Effects in
bold indicate (p [less than or equal to] 0.05).
* Not estimable because of small counts.
