摘要：Objectives. We examined the importance of social support in promoting thriving health among indigenous Canadians, a disadvantaged population. Methods. We categorized the self-reported health status of 31625 adult indigenous Canadians as thriving (excellent, very good) or nonthriving (good, fair, poor). We measured social support with indices of positive interaction, emotional support, tangible support, and affection and intimacy. We used multivariable logistic regression analyses to estimate odds of reporting thriving health, using social support as the key independent variable, and we controlled for educational attainment and labor force status. Results. Compared with women reporting low levels of social support, those reporting high levels of positive interaction (odds ratio [OR]=1.4; 95% confidence interval [CI]=1.2, 1.6), emotional support (OR=2.1; 95% CI=1.8, 2.4), and tangible support (OR = 1.4; 95% CI = 1.2, 1.5) were significantly more likely to report thriving health. Among men, only emotional support was significantly related to thriving health (OR=1.7; 95% CI=1.5, 1.9). Thriving health status was also significantly mediated by age, aboriginal status (First Nations, Métis, or Inuit), educational attainment, and labor force status. Conclusions. Social support is a strong determinant of thriving health, particularly among women. Research that emphasizes thriving represents a positive and necessary turn in the indigenous health discourse. The early 1990s were a politically turbulent time for Canada’s indigenous peoples. What began as one community’s struggle over land rights quickly escalated into nationwide frustration over Canada’s colonial legacy and the environmental, economic, and social marginalization that has transformed the health status of First Nations, Métis, and Inuit peoples, the 3 groups that constitute Canada’s indigenous population. First Nations form the largest of the 3 groups (numbering approximately 600000) and are geographically dispersed on reservations and in rural and urban communities below Canada’s Arctic (the 60th parallel). Métis, the second most populous group (numbering approximately 300000), generally live in the contiguous provinces west of and including Ontario. Historically, Métis were the descendents of French and English fur traders who took Indian wives. The Inuit are Canada’s northernmost peoples; they number approximately 45000 and live in a number of communities across Canada’s Arctic (i.e., above the 60th parallel). Combined, Canada’s indigenous peoples constitute 3.4% of the nation’s population, and they cope with a standard of living far below that of the nonindigenous population. 1 , 2 The social suffering of Canada’s indigenous population is indicated by staggering rates of suicide among youths, family violence, and other self-destructive and violent behaviors. 3 , 4 Researchers have taken a keen interest in the determinants of indigenous health, 5 including poverty, 6 – 10 violence, 11 and access to health care. 12 , 13 Given the health-related and social adversities faced by indigenous Canadians, identification of the health outcomes associated with these adversities has been useful in policy development (e.g., in the establishment of Aboriginal Head Start, an early childhood development program). Particularly useful is the recognition that indigenous concepts of health are shaped by larger social dynamics, including family, community, nature, and Creator. 14 , 15 Researchers, however, have so concentrated their efforts on the determinants of disparities that few have sought to model thriving health. In particular, there has been a lack of research into how one’s societal resources, such as social support, can shape health status.
