A gender analysis of the stress experience of young Mi'kmaq women

In 1997 the Mi'kmaq Health Research Group, made up of health coordinators of three First Nations organizations and academics from Dalhousie University, conducted the Mi'kmaq Health Survey.1 The single most arresting finding of this study was the stress experience of young females living on reserve. Thirty percent of Mi'kmaq female youth compared to seven percent of Mi'kmaq male youth said they were "quite a bit or extremely stressed." Feeling "sad or depressed for two weeks or more" was selected by 47% of the female youth compared to 21% of male youth. And male Mi'kmaq youth were much more likely to report "I like the way I am" (84%) than were female youth (57%).

The findings of the Health Survey, our first research undertaking, led to our study of adolescent Mi'kmaq women (12 to 18 years old). An Exploration of the Stress Experience of Mi'kmaq On-reserve Female Youth in Nova Scotia (2001) examines physical stressors (e.g., being overweight), mental stressors (e.g., depression, self-esteem, and emotional health) and stressors related to social relationships.

The overall goal of this study was to identify policy and programs that might be effective in reducing the negative stress of young Mi'kmaq women. A second goal was to develop research expertise in First Nations organizations and communities. To capture gender differences and similarities, Mi'kmaq females' stress experiences were compared to those of male youth on reserve. The perspectives of professionals working in youth services were also sought and compared to those of the male and female youth groups. An all-female, on-reserve Youth Advisory Group reviewed the research process, advised us on the content of interviews, and contributed to a description of stressors for their peers.

Literature Review

To facilitate an understanding of the stress experiences of female Mi'kmaq youth, it is useful to begin with the historical background. The Royal Commission on Aboriginal Peoples (1996) stated that "Many Aboriginal people are suffering not only from specific diseases and social conditions but also from a depression of spirit resulting from 200 or more years of damage to their cultures, languages, identities and self-respect."2 Aboriginal peoples suffered from diseases brought by the European population as well as "traumatic social practices"3 that were part of colonization. The aftermath of the residential schools experience and other government policies and practices have resulted in a socio-health trauma that continues to today, with many inequities still evident in Aboriginal people's health status and access to health services. Yet there are some signs of change: secondary and post-secondary school graduation rates are much improved over the pattern of two or three decades ago, although still behind the Canadian average, and First Nations are taking advantage of treaty and Aboriginal rights provisions to obtain renewed access to resources, an expanded landbase, and funds for economic investment. Aboriginal peoples are gradually regaining control over conditions that affect their health and over health policies, and new data on Aboriginal health are becoming available.

The stress experience of Mi'kmaq women is shaped in part by historical, socio-economic and health conditions, but also by gender-based differences and by prospects for their children. A pattern of giving birth at a younger age than the general population, a shift in family structure resulting in more single parent families, higher levels of child mortality, higher levels of poverty than Aboriginal men, and a high level of violence against women are key health indicators. In order to deepen our understanding of what lies behind the stress experience of young Mi'kmaq women today, we applied a gender equity analysis to a review of published literature. In the studies we reviewed about depression, we found that the incidence among Canada's young female population is significantly higher than for young males.4 With respect to racial/ethnic differences, Roberts and colleagues found that while it appears that these differences in depression are present, it is actually the socio-economic status of the group that encourages or discourages the presence of depression.5 Aboriginal youth were found to have one of the highest rates of depression because they live in the lowest socio-economic conditions compared to other groups. Overall, the highest prevalence of depression was found among Aboriginal females due in part to their decrepit living conditions.6

Other literature suggests that learning difficulties are a significant health problem for Aboriginal youth and contribute to Aboriginal children's higher rates of school-leaving.7 A factor that may contribute to poor school performance may stem from teachers' and others' misunderstanding of cultural differences.8

Focus Groups and Interviews

We conducted 21 semi-structured individual interviews and 8 focus group discussions with female Mi'kmaq youth. In order to provide a basis for gender contrast, five individual interviews and two focus groups with male youth living on reserve were conducted. Youth were also asked to suggest policies and programs that might lessen their stress. Upon completion of the study, we returned the findings to the Youth Advisory Group for feedback and discussion.

Interviews were also held with youth-serving counselors and health workers about their perceptions of young Mi'kmaq women's stress experiences, as well as about policies and programs that they felt might assist female youth.

Findings

In the focus groups the young Mi'kmaq women talked about stress primarily as an internal emotional response. For example, being emotionally on-edge was mentioned 13 times (including irritability, frustration, anxiety), feeling down or sad was given 11 mentions, and feeling angry, 9. The women said they found stress relief by communicating their feelings with others. We observed the ease of communication among focus group women, with one group even claiming that the data collection exercise was therapeutic in itself.

In individual interviews, however, young women spoke of stress in externalizing terms, such as expressing anger or frustration (17 and 13 mentions respectively), and acting-out behaviours that included self-harm (12 mentions). Self-harm is usually considered a male phenomenon. This raises the alert that women may be at risk for self-harm.

The young women, in contrast to the young men and the reports of youth-serving professionals, cited a broad array of stressors. The fact that young women on reserve are experiencing multiple stressors must be considered in any overall framework of stress amelioration. One telling comment was that young men did not have "constant stress," implying that the young women did.

There was considerable overlap in key stressors named by respondents across the three groups; the Youth Advisory Group also concurred with this list. All three groups recognized family problems (e.g., an absent parent, drugs or alcohol) as an important source of stress. Young women rated school stress higher than did young men. Both groups of young people named relationship issues with their friends, including boyfriends/girlfriends, as a considerable source of stress. Violence and abuse were mentioned only by young women, and drug and alcohol use only by young men.

One of the unexpected positive results of this study is that both male and female youth described their identity as Mi'kmaq and spoke of their background with considerable pride. This positive identity is a remarkable and precious advantage for this group of on-reserve youth and should be preserved and capitalized upon for building successful life pathways as they move towards adulthood. In contrast, several youth-serving professionals cited lack of identity as an intra-personal stress.

Impressions of reserve life by gender revealed quite rigid role definitions for men and women. Young men also gave the impression that they were less likely to be forgiven for their mistakes (rowdy behaviour, for example) than were young women, for whom pregnancy (often regarded as a mistake by youth and adults) was commonplace. Both groups agreed that economic factors, such as women as the main breadwinner, could overrule male gender dominance. Both groups also recognized that women were considered responsible for the family. Some youth-serving professionals said that girls talked about the pressure to take care of other children in the family.

School is a major Stressor of young people and there was consistency among the respondent groups about the reasons for a young person leaving school. For young men, it was often because of difficulty doing schoolwork, for which they blamed themselves, and for young women, it was often pregnancy. Most focus group females qualified this response by adding that the young mothers had no child care, which made leaving school the only option. Pregnancy was unquestioned as an interrupter for female Mi'kmaq students. Youth-serving professionals thought pregnancy among teen women was inevitable and did not distinguish between planned, unplanned, wanted, and unwanted pregnancies.

Policy and Program Interventions

All groups we met with called for more culturally-relevant education to help Mi'kmaq female youth reduce stress, recover from stressful experiences, and generally improve their lives. An improved school environment-described as one with less racism, less bullying, and more sensitive teachers-might also be achieved through on-reserve schools. Counseling and learning supports were also deemed necessary. Only the young women mentioned the need for young mothers to have access to babysitting in order to remain in school. Starting school at 10 a.m. might be considered as a strategy for school retention given the late night lifestyle of youth, and the universal sleep disturbances of youth.9 The Youth Advisory Group concurred with a late starting time for school, and stated that Mi'kmaq, not French, should be the second language taught in school.

Most proposals were gender-neutral and very few young people commented upon jobs or educational supports. While few long-term socio-economic strategies were suggested, or strategies that addressed the broad determinants of health, the research team also recommends these approaches.

NOTES

1. Mi'kmaq Health Research Group (Etter L, Moore C, McIntyre L, Rudderham S, Wien F). The Health of the Nova Scotia Mi'kmaq Population. Sydney: Union of Nova Scotia Indians, 1999.

2. Royal Commission on Aboriginal Peoples. Report on the Royal Commission on Aboriginal Peoples, Volume 3, Gathering Strength. Ottawa: Canadian Communication Group, 1996, 109.

3. Levitt C, Doyle-MacIsaac M, Grava-Gubins I, Ramsay G, Rosser W. Our Strength for Tomorrow: Valuing our Children. Part 7: Aboriginal Children. Canadian Family Physician 1998;44:358-362.

4. Canadian Council on Social Development. The Progress of Canada's Children, 1998. Focus on Youth. Ottawa: 1998.

5. Roberts RE, Roberts CR, Chen RY. Ethnocultural differences in the prevalence of adolescent depression. American Journal of Community Psychology 1997;25(1):95-110.

6. Isabel den Heyer and Fred Wien with the assistance of Jean Knockwood and Virick Francis. Mi'kmaq Students with Special Education Needs in Nova Scotia. Sydney: Mi'kmaq Kina'matnewey, 2001; First Nations Education Council. Special Education Report, First Nation Education Council. Quebec, 1992; First Nations Education Steering Committee/First Nations Schools Association. None Left Behind - Addressing Special Needs Education in First Nation Schools: A Proposal for Action. North Vancouver: First Nations Education Steering Committee, 1997.

7. Beiser M, Sack W, Manson SM, Redshirt R, Dion R. Mental health and academic performance of First Nations and majority-culture children. American Journal of Orthopsychiatry 1998;68(3):455-467.

8. Minde R, Minde K. Socio-cultural determinants of psychiatric symptomology in James Bay Cree. Canadian Journal of Psychiatry 1995;40(6):304-312.

9. Laberge L, Petit D, Simard C, Vitaro F, Tremblay RE, Montplaisir J. Development of sleep patterns in early adolescence. Journal of Sleep Research 2001;10(1):59-67.

Lynn McIntyre, Professor, Faculty of Health Professions, Dalhousie University, Frederic Wien, Professor, Maritime School of Social Work, Dalhousie University, Sharon Rudderham, Former Health Director, Union of Nova Scotia Indians, Loraine Etter, Health Director, Confederacy of Mainland Mi'kmaq, Carla Moore, Health Policy Analyst, Atlantic Policy Congress of First Nation Chiefs, Nancy MacDonald, Assistant Professor, Maritime School of Social Work, Dalhousie University, Sally Johnson, Acting Health Director, Union of Nova Scotia Indians, Ann Gottschall, Study Coordinator. This study was funded by the Atlantic Centre of Excellence for Women's Health.

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