The Indigenous population in Canada totals approximately 1.6 million individuals, representing about 5% of the total population. The off‐reserve Indigenous population represents the fastest growing segment of the Indigenous population, with over 50% living in urban settings. Despite the size of the off‐reserve population, research on the health of Indigenous peoples tends to remain focused on reserve‐based populations. The purpose of this paper is to contribute to a better understanding of health and social determinants of health among off‐reserve Indigenous peoples in Canada. Using data from the 1991 and 2012 Aboriginal Peoples Surveys this paper examines changes in health status and the social determinants of health over a 20‐year time span. Results show a decline in health care use and self‐reported health status in the period between 1991 and 2012. The results may be related to urbanization, aging, and increased prevalence of some chronic conditions. The findings may also be tied to barriers to achieving adequate off‐reserve health care—jurisdictional disputes, disjointed program coverage, systemic racism, and a lack of equity‐oriented health services. There remains a pressing need for Indigenous and non‐Indigenous governments, researchers, and policymakers to build new relationships that bridge these gaps in health and access to timely care.

中文翻译：

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1991–2012年，加拿大储备不足的土著居民的健康状况和健康决定因素的长期趋势

加拿大的原住民总数约为160万，占总人口的5％。保留区外的土著人口是土著人口增长最快的部分，超过50％的人口居住在城市环境中。尽管保护区外的人口众多，但有关土著人民健康的研究往往仍侧重于基于保护区的人口。本文的目的是帮助加拿大储备不足的原住民更好地了解健康和健康的社会决定因素。本文使用1991年和2012年的原住民调查数据，研究了20年间健康状况的变化以及健康的社会决定因素。结果显示，在1991年至2012年期间，医疗保健使用和自我报告的健康状况有所下降。结果可能与城市化，老龄化和某些慢性病的患病率增加有关。研究结果还可能与实现适当的储备金之外的医疗保健的障碍有关—司法管辖权纠纷，计划覆盖范围分散，系统种族主义和缺乏公平的医疗服务。土著和非土著政府，研究人员和决策者仍然迫切需要建立新的关系，以弥合健康和及时获得医疗服务方面的差距 方案覆盖面不连贯，系统种族主义和缺乏公平的卫生服务。土著和非土著政府，研究人员和决策者仍然迫切需要建立新的关系，以弥合健康和及时获得医疗服务方面的差距 方案覆盖面不连贯，系统种族主义和缺乏公平的卫生服务。土著和非土著政府，研究人员和决策者仍然迫切需要建立新的关系，以弥合健康和及时获得医疗服务方面的差距。