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Garnering Baseline Data, Insight & Attention:
    Exploring Trends at a Health System’s Level

        Emily Lecompte, Health Canada, First Nations Inuit Health Branch (FNIHB)
Bryde Fresque, Human Resources and Skills Development Canada (HRSDC), Horizontal Initiatives
          Presented at the National Aboriginal Health Organization Conference
                               November 24th - 26th, 2009
Presentation Overview
•   Background:
       •       Careers in the health care system
       •       First Nations, Inuit and Métis population: demographics
•   Project Rationale
•   Research Objectives
•   Research Methodology
•   Results: 2001 – 2006 Health Industry Census Statistics
           •      Aboriginal and non-Aboriginal health sector workers
           •      On- and Off-reserve tendencies for FNIM health sector workers
           •      Health industry in the Territories
           •      Health industry in B.C
           •      Health industry in the Prairies
           •      Health industry in Ontario
           •      Health industry in Quebec
           •      Health industry in the Atlantic
•   Limitations
•   Strengths
The Canadian Health Care Industry
 BACKGROUND

• Some issues that have influenced the experience of ill-health
  of First Nations, Inuit and Métis peoples:
          Colonisation
          Discrimination
          Racism
          Poverty
          Displacement
          Area of residence: Isolation
           Housing
          Marginalised status
First Nations, Inuit and Métis in Canada

BACKGROUND
Canadian Aboriginal people now account for 3.8% of the national population
      # of individuals




                                Year of Census

                                                 (Statistics Canada, 2008b; 2005)
The Canadian Health Care Industry


PROJECT RATIONALE:
   Accessing this information will help support the following:

   a) Whether there is a need to allocate more monetary
   resources to provide training to individuals working in the
   health care industry;

   b) Whether the government needs to integrate more
   appropriate programs to address the health sector’s needs
The Canadian Health Care Industry

PROJECT RATIONALE :
 1. To bring in HRSDC as a partner in addressing government-wide
    objectives related to the health care system
 2. To allow AHHRI and HRSDC to verify if larger objectives of
    increasing the number of First Nations, Inuit and Métis people in
    the health sector are being achieved:
       I. One of AHHRI’s objectives calls for system-wide change. Thus, we have
           to bring together F/P/T partners to better address this mandate.
       II. While the Census data on health occupations looks at the supply, mix
           and distribution of health workers, health industry data will look at the
           broader Pan-Canadian HHR Strategy (F/P/T).
The Canadian Health Care Industry
  RESEARCH OBJECTIVES

1. To examine characteristics of workers in the health care labour force in
   order to better illustrate and explain trends in the Canadian health care
   system;

2. To provide the first nation-wide portrait of the Aboriginal and non-
   Aboriginal health workforce using 2001 and 2006 Census data;

3. To highlight nation-wide, provincial and territorial tendencies in the health
   care field to better understand and predict future outcomes in the mix,
   supply and distribution of health care workers;

4. To provide useful baseline information on the health care labour market to
   health workers, community members, First Nations, Inuit and Métis
   organizations, government departments, and academic institutions.
The Canadian Health Care Industry

METHODOLOGY

Data source:
   • Results from the long form questionnaires (20% data sample) of the 2001
      and 2006 national censuses from Statistics Canada were utilized.
   • The long form of the Census questionnaire is given to one in every five
      households (20%) across Canada.
   • Coded by 1997-North American Industry Classification System (NAICS)

Analytical techniques:
   • Use of cross-sectional data
   • Descriptive statistics are used to illustrate trends in the health care
      workforce over two consecutive census periods (2001, and 2006).
The Canadian Health Care Industry

      2001 & 2006 Health Industry Census statistics
Census year   FNIM Health Industry     Non-Aboriginal    Total people in the
                   workers             Health Industry    Canadian health
                                          workers          labour market
   2001       FN: 14 710 (1.25%)
              I: 755 (0.06%)              1 148 840          1 174 810
              M: 9 565 (0.81%)             (97.8%)             (100%)

              Total = 25 970 (2.21%)
   2006       FN: 21 140 (1.46%)
              I: 995 (0.069%)             1 405 495          1 445 055
              M: 16 115 (1.11%)            (97.3%)             (100%)

              Total = 39 560 (2.74%)

                                         Health care and social assistance
                                         (Statistics Canada 2009a; 2009b)
2001 & 2006 CENSUS STATISTICS & Distribution of AHHR
                 Geographic Supply & Distribution of AHHR
                 Geographic Supply
               Distribution of Aboriginal Canadians in the health labour market:

                         On-Reserve                                             Off-Reserve




                                                        # of People
# of People




              NB: Health Canada fully recognizes that the Inuit people do not reside in on-reserve areas
              however, Statistics Canada does not make this distinction and include both Inuit and Métis
              people in on- and off-reserve areas of residence.
                                                                      Health care and social assistance
                                                                      (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry




                 A snapshot of Canada’s
                 Health Labour Market




                    Health care and social assistance
                    (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry

 Aboriginal health sector workers in Nunavut, NWT, & Yukon:




                           # of People




Aboriginal workers in health
  care & social assistance
2001 Census   140
                      +145
2006 Census   285

                                         Health care and social assistance
                                         (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry

                 In the territories, the most popular major field of
                 study for Aboriginal and non-Aboriginal health
                 sector workers is health-related:

                            Census                             Census     Position
   Major field of study                Major field of study
                             2001                               2006       trends
Health professions &                 Health, parks,
related technologies        1500     recreation & fitness       1825       +325
Commerce,                            Business management
management & business        365     & Public                    475       +110
administration                       administration
Social sciences & related            Social Sciences and
fields                       390     behavioural science         370         -20


                                                   Health care and social assistance
                                                   (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry

   Number of Aboriginal health sector in British Columbia:




                            # of People




Aboriginal workers in health
  care & social assistance
2001 Census   725
                        +2 175
2006 Census   2 900

                                          Health care and social assistance
                                          (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry

                       Major field of study of Aboriginal and non-
                       Aboriginal health sector workers in B.C.:
                             Census                               Census     Position
    Major field of study                 Major field of study
                              2001                                 2006       trends
Health professions &                  Health, parks,
                             91 610                               112 285 + 20 675
related technologies                  recreation & fitness
Commerce, management                  Business management
                             18 225                               21 865      + 3 640
& business administration             & Public administration
Social sciences & related             Social Sciences and
                             17 490                               19 480      + 1 990
fields                                behavioural science




                                                  Health care and social assistance
                                                  (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry

   Number of Aboriginal health sector workers in the Prairies:




                           # of People




Aboriginal workers in health
  care & social assistance
2001 Census   1 170
                        +6 255
2006 Census   7 425

                                          Health care and social assistance
                                          (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry


                   Major field of study of Aboriginal and non-
                   Aboriginal health sector workers in the Prairies:
                            Census                                Census     Position
    Major field of study                 Major field of study
                             2001                                  2006       trends
Health professions &                  Health, parks,
                            120 155                               156 810 +36 655
related technologies                  recreation & fitness
Commerce, management                  Business management
                            24 190                                30 635      +6 445
& business administration             & Public administration
Social sciences & related             Social Sciences and
                            22 440                                21 300      - 1 140
fields                                behavioural science



                                                  Health care and social assistance
                                                  (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry

      Number of Aboriginal health sector workers in Ontario:




                           # of People




Aboriginal workers in health
  care & social assistance
2001 Census   740
                        +3 965
2006 Census   4 705

                                            Health care and social assistance
                                            (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry


                   Major field of study of Aboriginal and non-
                   Aboriginal health sector workers in Ontario:
                            Census                                Census     Position
    Major field of study                 Major field of study
                             2001                                  2006       trends
Health professions &                  Health, parks,
                            236 425                               300 225 +63 800
related technologies                  recreation & fitness
Commerce, management                  Business management
                            42 900                                71 035     +28 135
& business administration             & Public administration
Social sciences & related             Social Sciences and
                            55 960                                62 285      +6 325
fields                                behavioural science



                                                  Health care and social assistance
                                                  (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry

      Number of Aboriginal health sector workers in Quebec:




                            # of People




Aboriginal workers in health
  care & social assistance
2001 Census   195
                        +1 410
2006 Census   1 605

                                          Health care and social assistance
                                          (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry


                   Major field of study of Aboriginal and non-
                   Aboriginal health sector workers in Quebec:
                            Census                                Census     Position
    Major field of study                 Major field of study
                             2001                                  2006       trends
Health professions &                  Health, parks,
                            135 450                               179 715 +44 265
related technologies                  recreation & fitness
Commerce, management                  Business management
                            34 475                                58 245     +23 770
& business administration             & Public administration
Social sciences & related             Social Sciences and
                            39 485                                48 400      +8 915
fields                                behavioural science



                                                  Health care and social assistance
                                                  (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry

   Number of Aboriginal health sector workers in the Atlantic:




                            # of People




Aboriginal workers in health
  care & social assistance
2001 Census   190
                        +1 010
2006 Census   1 200

                                            Health care and social assistance
                                            (Statistics Canada 2009a; 2009b)
The Canadian Health Care Industry



          Major field of study of Aboriginal and non-Aboriginal
          health sector workers in the Atlantic provinces:
                            Census                               Census     Position
    Major field of study                Major field of study
                             2001                                 2006       trends
Health professions &                 Health, parks,
                            52 865                               64 785     +11 920
related technologies                 recreation & fitness
Commerce, management                 Business management
                            13 905                               17 700      +3 795
& business administration            & Public administration
Social sciences & related            Social Sciences and
                             9 285                                9 605       +320
fields                               behavioural science



                                                 Health care and social assistance
                                                 (Statistics Canada 2009a; 2009b)
Age distribution of health industry workers AHHR
            Geographic Supply & Distribution of
        Census                                                 Aboriginal

  Age
                     2001               2006                   Non-
                                                               Aboriginal

                  72 230 (6.3%)      90 710 (6.45%)
  15 – 24 yrs.
                   1 710 (6.6%)       2 650 (6.7%)
                  631 250 (55%)     699 360 (49.75%)
  25 – 44 yrs.
                  16 360 (63%)       22 115 (55.9%)
                 426 775 (37.15%)   585 455 (41.65%)
  45 – 64 yrs.
                  7 715 (29.7%)      14 400 (36.4%)
                  18 585 (1.6%)      32 970 (2.3%)
   65 yrs +
                    180 (0.7%)         395 (1%)
                   x / 1 148 840      x / 1 405 495
  Total people
                     x / 25 970         x / 39 560

                                     Health care and social assistance
                                     (Statistics Canada 2009a; 2009b)
Geographic Supply & Distribution of AHHR
 LIMITATIONS

• Cross-sectional data provides an idea of health labour market
  workers at one point in time and does not provide monthly or
  annual trends;
• Generalization of data: limited to Federal/Provincial/
  Territorial levels due to concerns of confidentiality and
  undercount of some Aboriginal communities and reserves;
• Difficult to draw conclusions about recruitment and retentions
  of health sector workers over a 5 year span;
• Cannot know the from which institutional level health sector
  workers were trained or educated (e.g. university or college)
STRENGTHS Geographic Supply & Distribution of AHHR

• This report provides a 1st snapshot of Canada’s health labour
  market including its provinces and territories;
• This report provides baseline data that demonstrates emerging
  trends in major fields of education which in turn affects the
  health care system, its employees and those who access health
  services
• Data is valuable to inform the planning, implementation and
  evaluation of education and training programs and resources
  that encourage First Nations, Inuit and Métis peoples to choose
  health career paths.
• Baseline data can direct priorities in the planning of programs
  and policy design that focus on careers and training in health
  sciences and business administration.
Aboriginal Health Human Resource Initiative

          Contact information
                   Emily Lecompte
 Aboriginal Health Human Resource Initiative (AHHRI)
First Nations Inuit Health Branch (FNIHB), Health Canada
            Emily_Lecompte@hc-sc.gc.ca

                    Bryde Fresque
                Horizontal Initiatives
        Aboriginal Affaires Directorate, HRSDC
         Bryde.Fresque@hrsdc-rhdscc.gc.ca

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Garnering Baseline Data, Insight & Attention: Exploring Trends at a Health System’s Level

  • 1. Garnering Baseline Data, Insight & Attention: Exploring Trends at a Health System’s Level Emily Lecompte, Health Canada, First Nations Inuit Health Branch (FNIHB) Bryde Fresque, Human Resources and Skills Development Canada (HRSDC), Horizontal Initiatives Presented at the National Aboriginal Health Organization Conference November 24th - 26th, 2009
  • 2. Presentation Overview • Background: • Careers in the health care system • First Nations, Inuit and Métis population: demographics • Project Rationale • Research Objectives • Research Methodology • Results: 2001 – 2006 Health Industry Census Statistics • Aboriginal and non-Aboriginal health sector workers • On- and Off-reserve tendencies for FNIM health sector workers • Health industry in the Territories • Health industry in B.C • Health industry in the Prairies • Health industry in Ontario • Health industry in Quebec • Health industry in the Atlantic • Limitations • Strengths
  • 3. The Canadian Health Care Industry BACKGROUND • Some issues that have influenced the experience of ill-health of First Nations, Inuit and Métis peoples: Colonisation Discrimination Racism Poverty Displacement Area of residence: Isolation  Housing Marginalised status
  • 4. First Nations, Inuit and Métis in Canada BACKGROUND Canadian Aboriginal people now account for 3.8% of the national population # of individuals Year of Census (Statistics Canada, 2008b; 2005)
  • 5. The Canadian Health Care Industry PROJECT RATIONALE: Accessing this information will help support the following: a) Whether there is a need to allocate more monetary resources to provide training to individuals working in the health care industry; b) Whether the government needs to integrate more appropriate programs to address the health sector’s needs
  • 6. The Canadian Health Care Industry PROJECT RATIONALE : 1. To bring in HRSDC as a partner in addressing government-wide objectives related to the health care system 2. To allow AHHRI and HRSDC to verify if larger objectives of increasing the number of First Nations, Inuit and Métis people in the health sector are being achieved: I. One of AHHRI’s objectives calls for system-wide change. Thus, we have to bring together F/P/T partners to better address this mandate. II. While the Census data on health occupations looks at the supply, mix and distribution of health workers, health industry data will look at the broader Pan-Canadian HHR Strategy (F/P/T).
  • 7. The Canadian Health Care Industry RESEARCH OBJECTIVES 1. To examine characteristics of workers in the health care labour force in order to better illustrate and explain trends in the Canadian health care system; 2. To provide the first nation-wide portrait of the Aboriginal and non- Aboriginal health workforce using 2001 and 2006 Census data; 3. To highlight nation-wide, provincial and territorial tendencies in the health care field to better understand and predict future outcomes in the mix, supply and distribution of health care workers; 4. To provide useful baseline information on the health care labour market to health workers, community members, First Nations, Inuit and Métis organizations, government departments, and academic institutions.
  • 8. The Canadian Health Care Industry METHODOLOGY Data source: • Results from the long form questionnaires (20% data sample) of the 2001 and 2006 national censuses from Statistics Canada were utilized. • The long form of the Census questionnaire is given to one in every five households (20%) across Canada. • Coded by 1997-North American Industry Classification System (NAICS) Analytical techniques: • Use of cross-sectional data • Descriptive statistics are used to illustrate trends in the health care workforce over two consecutive census periods (2001, and 2006).
  • 9. The Canadian Health Care Industry 2001 & 2006 Health Industry Census statistics Census year FNIM Health Industry Non-Aboriginal Total people in the workers Health Industry Canadian health workers labour market 2001 FN: 14 710 (1.25%) I: 755 (0.06%) 1 148 840 1 174 810 M: 9 565 (0.81%) (97.8%) (100%) Total = 25 970 (2.21%) 2006 FN: 21 140 (1.46%) I: 995 (0.069%) 1 405 495 1 445 055 M: 16 115 (1.11%) (97.3%) (100%) Total = 39 560 (2.74%) Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 10. 2001 & 2006 CENSUS STATISTICS & Distribution of AHHR Geographic Supply & Distribution of AHHR Geographic Supply Distribution of Aboriginal Canadians in the health labour market: On-Reserve Off-Reserve # of People # of People NB: Health Canada fully recognizes that the Inuit people do not reside in on-reserve areas however, Statistics Canada does not make this distinction and include both Inuit and Métis people in on- and off-reserve areas of residence. Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 11. The Canadian Health Care Industry A snapshot of Canada’s Health Labour Market Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 12. The Canadian Health Care Industry Aboriginal health sector workers in Nunavut, NWT, & Yukon: # of People Aboriginal workers in health care & social assistance 2001 Census 140 +145 2006 Census 285 Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 13. The Canadian Health Care Industry In the territories, the most popular major field of study for Aboriginal and non-Aboriginal health sector workers is health-related: Census Census Position Major field of study Major field of study 2001 2006 trends Health professions & Health, parks, related technologies 1500 recreation & fitness 1825 +325 Commerce, Business management management & business 365 & Public 475 +110 administration administration Social sciences & related Social Sciences and fields 390 behavioural science 370 -20 Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 14. The Canadian Health Care Industry Number of Aboriginal health sector in British Columbia: # of People Aboriginal workers in health care & social assistance 2001 Census 725 +2 175 2006 Census 2 900 Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 15. The Canadian Health Care Industry Major field of study of Aboriginal and non- Aboriginal health sector workers in B.C.: Census Census Position Major field of study Major field of study 2001 2006 trends Health professions & Health, parks, 91 610 112 285 + 20 675 related technologies recreation & fitness Commerce, management Business management 18 225 21 865 + 3 640 & business administration & Public administration Social sciences & related Social Sciences and 17 490 19 480 + 1 990 fields behavioural science Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 16. The Canadian Health Care Industry Number of Aboriginal health sector workers in the Prairies: # of People Aboriginal workers in health care & social assistance 2001 Census 1 170 +6 255 2006 Census 7 425 Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 17. The Canadian Health Care Industry Major field of study of Aboriginal and non- Aboriginal health sector workers in the Prairies: Census Census Position Major field of study Major field of study 2001 2006 trends Health professions & Health, parks, 120 155 156 810 +36 655 related technologies recreation & fitness Commerce, management Business management 24 190 30 635 +6 445 & business administration & Public administration Social sciences & related Social Sciences and 22 440 21 300 - 1 140 fields behavioural science Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 18. The Canadian Health Care Industry Number of Aboriginal health sector workers in Ontario: # of People Aboriginal workers in health care & social assistance 2001 Census 740 +3 965 2006 Census 4 705 Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 19. The Canadian Health Care Industry Major field of study of Aboriginal and non- Aboriginal health sector workers in Ontario: Census Census Position Major field of study Major field of study 2001 2006 trends Health professions & Health, parks, 236 425 300 225 +63 800 related technologies recreation & fitness Commerce, management Business management 42 900 71 035 +28 135 & business administration & Public administration Social sciences & related Social Sciences and 55 960 62 285 +6 325 fields behavioural science Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 20. The Canadian Health Care Industry Number of Aboriginal health sector workers in Quebec: # of People Aboriginal workers in health care & social assistance 2001 Census 195 +1 410 2006 Census 1 605 Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 21. The Canadian Health Care Industry Major field of study of Aboriginal and non- Aboriginal health sector workers in Quebec: Census Census Position Major field of study Major field of study 2001 2006 trends Health professions & Health, parks, 135 450 179 715 +44 265 related technologies recreation & fitness Commerce, management Business management 34 475 58 245 +23 770 & business administration & Public administration Social sciences & related Social Sciences and 39 485 48 400 +8 915 fields behavioural science Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 22. The Canadian Health Care Industry Number of Aboriginal health sector workers in the Atlantic: # of People Aboriginal workers in health care & social assistance 2001 Census 190 +1 010 2006 Census 1 200 Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 23. The Canadian Health Care Industry Major field of study of Aboriginal and non-Aboriginal health sector workers in the Atlantic provinces: Census Census Position Major field of study Major field of study 2001 2006 trends Health professions & Health, parks, 52 865 64 785 +11 920 related technologies recreation & fitness Commerce, management Business management 13 905 17 700 +3 795 & business administration & Public administration Social sciences & related Social Sciences and 9 285 9 605 +320 fields behavioural science Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 24. Age distribution of health industry workers AHHR Geographic Supply & Distribution of Census Aboriginal Age 2001 2006 Non- Aboriginal 72 230 (6.3%) 90 710 (6.45%) 15 – 24 yrs. 1 710 (6.6%) 2 650 (6.7%) 631 250 (55%) 699 360 (49.75%) 25 – 44 yrs. 16 360 (63%) 22 115 (55.9%) 426 775 (37.15%) 585 455 (41.65%) 45 – 64 yrs. 7 715 (29.7%) 14 400 (36.4%) 18 585 (1.6%) 32 970 (2.3%) 65 yrs + 180 (0.7%) 395 (1%) x / 1 148 840 x / 1 405 495 Total people x / 25 970 x / 39 560 Health care and social assistance (Statistics Canada 2009a; 2009b)
  • 25. Geographic Supply & Distribution of AHHR LIMITATIONS • Cross-sectional data provides an idea of health labour market workers at one point in time and does not provide monthly or annual trends; • Generalization of data: limited to Federal/Provincial/ Territorial levels due to concerns of confidentiality and undercount of some Aboriginal communities and reserves; • Difficult to draw conclusions about recruitment and retentions of health sector workers over a 5 year span; • Cannot know the from which institutional level health sector workers were trained or educated (e.g. university or college)
  • 26. STRENGTHS Geographic Supply & Distribution of AHHR • This report provides a 1st snapshot of Canada’s health labour market including its provinces and territories; • This report provides baseline data that demonstrates emerging trends in major fields of education which in turn affects the health care system, its employees and those who access health services • Data is valuable to inform the planning, implementation and evaluation of education and training programs and resources that encourage First Nations, Inuit and Métis peoples to choose health career paths. • Baseline data can direct priorities in the planning of programs and policy design that focus on careers and training in health sciences and business administration.
  • 27. Aboriginal Health Human Resource Initiative Contact information Emily Lecompte Aboriginal Health Human Resource Initiative (AHHRI) First Nations Inuit Health Branch (FNIHB), Health Canada Emily_Lecompte@hc-sc.gc.ca Bryde Fresque Horizontal Initiatives Aboriginal Affaires Directorate, HRSDC Bryde.Fresque@hrsdc-rhdscc.gc.ca