Risk Factors for Obesity Among of f-Reserve Aboriginal Children in Canada

Abstract

Background: Rising rates of obesity and overweight among Canadian children have attracted research attention. First Nations, Inuit, and Metis children have even higher rates of these conditions, yet there has been little investigation of the risk factors for obesity and overweight in these populations. Aboriginal children may be more likely to have behavioural, economic and social characteristics, such as low family income, that also increase risk of overweight and obesity in the general population. However, there may also be risk factors are specific to Aboriginal populations, as recent research on social determinants of Aboriginal health suggests. Moreover, research on most aspects of Aboriginal health has focused on First Nations and Inuit communities, although roughly half of Aboriginal children live in urban areas. Methods: We examine determinants of obesity among off-reserve Aboriginal children and ask how demographic and family characteristics, behaviour and activity patterns, and geography predict BMI and obesity among children 6 to 14. We use 2006 Aboriginal Children's Survey data (ACS), binary logistic regression and generalized additive models to investigate the effects of covariates on the BMI scores of Aboriginal children aged 6 to 14. Additive models are appropriate given the distributional properties of BMI and the suggestion that the CDC child obesity definitions might not be completely appropriate for Aboriginal children. We use CDC child obesity definitions and logistic regression models to confirm results. Results: Estimated obesity and overweight rates are considerably higher than those published for Canadian children. Aboriginal boys are at particular risk. We find different regional patterns in the Aboriginal population than have been found in the general population, with rates highest in the Prairies. Among Aboriginal groups, Registered Indian children had higher BMI scores than non-status First Nations, Metis, or Inuit children. Family characteristics, including lone parent and low-income status, had strong independent effects. Behaviours such as sports participation and TV viewing had effects similar in direction to those in the general population, but were less important than family income and region. Traditional activities and spending time with Elders also led to lower BMI. Conclusions: Child overweight and obesity are particularly important given the young age of Aboriginal populations and the life-long effects of these childhood conditions. We find that overweight and obesity among off-reserve Aboriginal children are predicted by many of the same factors that are important in the general population, but that there may be other factors that are also important for Aboriginal children.