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The Cedar Project: Using indigenous-specific determinants of health to predict substance use among young pregnant-involved indigenous women in Canada

Shahram, Sana Z.
Bottorff, Joan L.
Oelke, Nelly D.
Dahlgren, Leanne
Thomas, Victoria
Spittal, Patricia M.
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Abstract
Background: Indigenous women in Canada have been hyper-visible in research, policy and intervention related to substance use during pregnancy; however, little is known about how the social determinants of health and substance use prior to, during, and after pregnancy intersect. The objectives of this study were to describe the social contexts of pregnant-involved young Indigenous women who use substances and to explore if an Indigenous-Specific Determinants of Health Model can predict substance use among this population. Methods: Using descriptive statistics and hierarchical logistic regression guided by mediation analysis, the social contexts of pregnant-involved young Indigenous women who use illicit drugs’ lives were explored and the Integrated Life Course and Social Determinants Model of Aboriginal Health’s ability to predict heavy versus light substance use in this group was tested (N = 291). Results: Important distal determinants of substance use were identified including residential school histories, as well as protective factors, such as sex abuse reporting and empirical evidence for including Indigenous-specific determinants of health as important considerations in understanding young Indigenous women’s experiences with pregnancy and substance use was provided. Conclusions: This analysis provided important insight into the social contexts of women who have experiences with pregnancy as well as drug and/or alcohol use and highlighted the need to include Indigenous-specific determinants of health when examining young Indigenous women’s social, political and historical contexts in relation to their experiences with pregnancy and substance use.
Keywords
Canada, Aboriginal health, women’s health, substance use, addictions, pregnancy, maternal health, social determinants of health
Date
2017
Type
Journal article
Journal
BMC Women's Health
Book
Volume
17
Issue
1
Page Range
1-13
Article Number
ACU Department
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Source URL
Event URL
Open Access Status
Open access
License
CC BY 4.0
File Access
Open
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