• 2,300 women
    women were determined to be at high risk for breast cancer by the High Risk Screening Program in Ontario in 2015
  • 86%
    of cancer patients saw a registered dietitian at a regional cancer centre within 14 days of referral in 2016
  • 71%
    of stage III colon cancer patients received chemotherapy within 60 days of after surgery in 2014
  • 86%
    of all cancer surgery patients received their consult within the recommended wait time in 2016, and 87% received their surgery within the recommend wait time
  • Over 43,000
    patients were discussed at comprehensive multidisciplinary cancer conferences (MCCs) in fiscal year 2016/2017
  • About 13%
    of patients who undergo lung, prostate and colorectal surgery have an unplanned hospital visit following surgery
  • 79%
    of breast cancer patients had a guideline-recommended mammogram in the first follow-up year
  • 74%
    of colorectal cancer patients diagnosed in 2013 had a surveillance colonoscopy within 18 months of surgery
  • Over 100
    patient and family advisors, who vary by their type of cancer and experiences, represent diverse regions and work with Cancer Care Ontario to ensure a person-centred cancer system
  • 383,023
    unique patients were screened for symptom severity using Your Symptoms Matter – General Symptoms (YSM-General) in 2016
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Engagement with First Nations, Inuit and Métis Communities: Developing and Sustaining Relationships Within the Cancer System

 
Indicator Desired Direction As of this Report
Number of regions with Regional Aboriginal Cancer Plans developed and finalized  Black Arrow Up  Yellow Arrow Down
Number of regions with Regional Aboriginal Cancer Plans developed but not yet finalized  Black Arrow Up  Yellow Arrow Down
Number of regions where all core First Nation, Inuit and Métis Health Tables are engaged  Black Arrow Up  Yellow Arrow Down
Number of regions with a sustainable structure  Black Arrow Up  Yellow Arrow Down
See Methodology and Approach to find out how the ratings are calculated.

Key findings

The Aboriginal Cancer Control Unit at Cancer Care Ontario has developed Relationship Protocols, a Letter of Relationship, and a Memorandum of Understanding in partnership with First Nations, Inuit and Métis leadership. These documents formalize sustainable relationships with First Nations, Inuit and Métis partners through mutual respect, recognition and understanding. They highlight Cancer Care Ontario’s commitment to establishing a strong foundation necessary to achieve common goals and objectives towards the delivery of cancer services with First Nations, Inuit and Métis peoples across the province.

In this spirit, the Aboriginal Cancer Control Unit has also been working closely with Regional Cancer Programs to build regional capacity supporting engagement with local First Nations, Inuit and Métis communities and organizations. Together, the Aboriginal Cancer Control Unit and the Regional Cancer Programs—in collaboration with local First Nations, Inuit and Métis communities and organizations—are seeking to develop and implement initiatives that will address the unique cancer control issues and needs of First Nations, Inuit and Métis people living within each region. These initiatives are detailed within Regional Aboriginal Cancer Plans, which are currently being developed collaboratively within 12 of the province’s 13* Regional Cancer Programs. These regional partnerships continue to be strengthened as most regions with Regional Aboriginal Cancer Plans with the support of the ACCU have initiated direct engagement with the core First Nations, Inuit and Métis Health Tables in their respective regions to develop and implement this work together.

*Note: Toronto Central North & South are combined.

Who are the First Nations, Inuit and Métis peoples of Ontario?

Three groups are recognized by Canada’s Constitution Act of 1982 as “the Aboriginal peoples of Canada,” who are explicitly defined as “the Indian [now referred to as “First Nations”], Inuit, and Métis peoples.” Together, the First Nations, Inuit and Métis people experience significantly poorer health outcomes than their non-Aboriginal peers, including lower life expectancy1 and a higher burden of chronic conditions2. The lack of First Nations, Inuit and Métis-specific health data continues to hamper our collective ability to accurately determine and effectively address chronic disease prevention priorities in these at-risk populations.

First Nations

Prior to contact with Europeans, First Nations, in what is now defined as Ontario, represented diverse and stable communities whose economy and governance were sound and thriving. The arrival of Europeans and the resulting policies of assimilation—for example, the residential school system—dramatically impacted the First Nations’ way of life and all aspects of their health.

Today there are 133 First Nation communities in Ontario, 126 of which have independently recognized land bases. As of 2014, approximately 202,960 First Nations people reside in Ontario who are registered under the Indian Act, of whom 94,312 live on-reserve or on Crown lands (46%)3. While the greatest proportion of registered First Nations in Ontario live in urban communities (42,007, or 47%), over one quarter of those living on-reserve live in special access communities with no year-round road access (24,993, or 28%)4. Additionally, Ontario is home to an estimated 75,540 First Nations people without registered Indian status5. Among First Nations living off-reserve, a large majority (80%) live in urban areas, which is similar to the percentage of non-Aboriginal Ontarians living in an urban area (86%)6. The First Nations in Ontario are young, with a median age of 26 years, compared to a median age of 41 for non-Aboriginal Ontarians7.

Métis

The genesis of Métis culture and nation dates back to the 1600s, when early European settlers first came into contact with local First Nation communities. Early unions between these predominantly male fur trading European settlers and local First Nations women led to the emergence of a new and highly distinctive Aboriginal people with a unique identity and consciousness. Distinct Métis settlements began to appear throughout what was then called “the Northwest” and subsequently spread throughout what is now defined as Ontario, as Métis settlements sprung up along the rivers and watersheds surrounding the Great Lakes and to the northwest of the province. Historical Métis communities were closely connected through the highly mobile fur-trade network, seasonal rounds, extensive kinship connections, and a collective identity characterized by a common culture, language and unique way of life that was influenced by a complex blend of traditions from both sides of the Atlantic. These strong family connections and the unique Métis way of life that characterized these original Métis settlements form the foundation of the Métis nation we know today and remain strongly evident in contemporary Métis life.

In 2011, 451,795 Canadians self-identified as Métis7. Métis currently comprise almost one-third of the over 1.4 million Aboriginal people in Canada. The Métis population is one of the fastest-growing populations in Canada, having nearly doubled in size between 1996 and 20068. This rapid growth is largely due to changes in peoples’ reporting of identity to Métis between Census years—a phenomenon known as “ethnic mobility”9. The Métis population of Canada is relatively young, with a median age of 31 years compared to 41 years among non-Aboriginal Canadians.7 The majority (85%) of Métis people live in either the Western provinces or in Ontario. Ontario has the second-largest number of Métis, with 86,015 people, or 19% of all Métis living in Canada5. In 2006, about two-thirds (nearly 70%) of the Métis population in Canada lived in urban areas, slightly less than the non-Aboriginal population (81%)1. However, it is important to note, however, that Métis people living in urban areas are twice as likely as their urban non-Aboriginal counterparts to reside in smaller urban centres with populations of fewer than 100,000 residents (41% vs. 20%)10.

Inuit

Inuit in Ontario constitute a small but fast-growing population. In 2011, 3,360 Inuit were living in Ontario5. Compared to the Canadian population, the age structure of the Inuit population also is quite young, with more than half (58%) under 25 years of age. Rapid Inuit population growth and the corresponding young age structure are demographic trends that are expected well into the future. The Inuit population in Ontario continues to grow through high fertility rates and migration away from the Inuit Nunangat (“the place where Inuit live”). Inuit Nunangat is made up of four regions: Inuvialuit Settlement Region (including parts of Northwest Territories and Yukon), Nunavut, Nunavik (Northern Quebec) and Nunatsiavut (Labrador)11. In 2011, about three-quarters (73%) of Inuit in Canada lived in Inuit Nunangat. The remaining 27% lived outside Inuit Nunangat, up from 22% in 2006 and 17% in 19965.

Inuit move to southern cities, such as Ottawa, for many reasons. Some come for work, post-secondary education or housing, and many Inuit are living in Ontario due to long-term medical treatment— treatment that is not available in Inuit Nunangat. Most Inuit communities lack access to specialized medical care11. The 2006 Aboriginal Peoples Survey found that Inuit were significantly less likely to have had contact with a medical doctor during the previous year than non-Aboriginal Canadians10. Inuit living in the Qikiqtaaluk (Baffin) region of Nunavut primarily travel south to Ottawa for medical treatment via Iqaluit (Figure 1), while those living in the Kivalliq Region (Western region of Hudson Bay) are transferred to Winnipeg and those in the Kitikmeot Region go to Edmonton (via Yellowknife). Inuit in need of complex medical care living in Nunavik or Nunatsiavut travel to Montreal or St John’s, respectively. Due to limited options for post-secondary education in Inuit Nunangat, 50% of Inuit with post-secondary credentials (and 85% of those with a university degree) reported having to relocate for their education11.

Aboriginal cancer control

The Aboriginal Cancer Control Unit at Cancer Care Ontario works to improve the cancer system and journey for Ontario’s First Nations, Inuit and Métis people. It also strives to ensure that First Nations, Inuit and Métis people in Ontario have access to high-quality cancer prevention, screening and treatment services that are culturally appropriate and that incorporate the Aboriginal holistic approach to health and well-being.

Following a culture-based belief in the interconnection between the physical, mental, emotional and spiritual aspects of life, the Aboriginal Cancer Strategy III (ACS III) promotes a holistic approach to cancer education, prevention, screening and research. The ACS III builds on the success of previous cancer strategies by continuing on the path towards health equity and well-being for First Nations, Inuit and Métis peoples. As we move forward on this path, Cancer Care Ontario remains committed to improving upon the achievements made through the Aboriginal Cancer Strategy II (ACS II) in the past 3 years, including the following:

  • establishing Relationship Protocols with First Nations, Inuit and Métis groups across Ontario;
  • developing Regional Aboriginal Cancer Plans in concert with hiring 5 Aboriginal Project Coordinators and 10 Regional Aboriginal Cancer Leads and 10 Aboriginal Navigators, gaining new knowledge of cancer in First Nations, Inuit and Métis communities; and
  • creating Aboriginal Relationship and Cultural Competency courses to increase understanding of history and knowledge in order to improve health outcomes and person-centred care (see below).

Aboriginal Relationship and Cultural Competency courses

Cancer Care Ontario has launched a series of 9 Aboriginal Relationship and Cultural Competency (ARCC) courses online, to promote greater awareness of First Nations, Inuit and Métis history, culture and the health landscape, to help improve health outcomes and person-centred care.

The courses are geared to healthcare providers, professionals, administrators and others working with First Nations, Inuit and Métis people and communities. Each course takes about 60 minutes to complete and is accredited by the College of Family Physicians of Canada and the Ontario Chapter for up to 9 Mainpro+ credits (1 for each course).

Designed by the Aboriginal Cancer Control Unit, the ARCC courses will help address the great need to understand the underlying history and challenges experienced by First Nation, Inuit and Métis populations. This, in turn, will inform the healthcare system on key issues related to addressing health equity for these populations. As Cancer Care Ontario is committed to developing a cancer system that ensures health equity for all Ontarians, the ARCC courses will also address a key recommendation from the Truth and Reconciliation Commission of Canada report: to provide skills-based training in intercultural competency, conflict resolution, human rights and anti-racism12.

Relationship Protocols

Cancer Care Ontario’s Aboriginal Cancer Control Unit has engaged in the development of Relationship Protocols, which also includes a Memorandum of Understanding and Letter of Relationship with Ontario’s First Nations leadership (Political Territorial Organizations and Independent First Nations), the Métis Nation of Ontario, the Ontario Federation of Indigenous Friendship Centres and Inuit health service providers in Ontario. These Relationship Protocols formalize the working relationships with First Nations, Inuit and Métis, and are relationships based on trust and mutual respect, create accountability for the delivery of the Aboriginal Cancer Strategies, and enable a culturally appropriate approach towards addressing cancer control for First Nations, Inuit and Métis communities in the province. 

The use of a Protocol to formalize relations with First Nation, Inuit and Métis groups was adopted from the Ministry of Aboriginal Affairs, which recognizes protocol agreements as:

  • an agreement that recognizes the unique history and ways of life of Aboriginal communities in Ontario;
  • an agreement that sets a new course for a collaborative relationship between the Ontario government and Aboriginal people;
  • an agreement that is intended to improve the well-being of Aboriginal children, families and communities while protecting and promoting the distinct culture, identity and heritage of Aboriginal peoples; and
  • an agreement that encourages partnership opportunities that recognize and respect Aboriginal traditions.
1. Relationship Protocols signed with First Nations, Inuit and Métis Leadership as of May 17, 2017
Organization/First Nation Date of signing

Grand Council Treaty #3

May 2013

Anishinabek Nation (Union of Ontario Indians)

June 2013

Ontario Federation of Indigenous Friendship Centres

July 2014

Nishnawbe Aski Nation

August 2014

Kitchenuhmaykoosib Inninuwug (Big Trout Lake) First Nation

October 2014

Métis Nation of Ontario (the agreement signed is a known as a Memorandum of Understanding)

February 2015

Association of Iroquois and Allied Indians (agreement signed is known as a Letter of Relationship)

November 2016

Inuit Health Service Providers

May 10, 2017

Regional Aboriginal engagement

Regional Aboriginal Cancer Plans are regional blueprints for the implementation of Cancer Care Ontario’s ACS III. They have been developed through close partnerships with First Nation, Inuit and Métis Core Health Tables and Regional Cancer Program leadership with the goal of ensuring that First Nations, Inuit and Métis people have a voice in the delivery of cancer services. As such, each Plan reflects the unique needs of communities in their respective regions throughout Ontario. Regional Aboriginal Cancer Plans have been developed in 12 of 13 regions in Ontario, and 8 of these have been finalized. The Aboriginal Cancer Control Unit has also started to work closely with the remaining region (Central West/Mississauga Halton) to address cancer control with and for the region’s First Nations, Inuit and Métis population, and will be working in partnership to develop a Regional Aboriginal Cancer Plan.

The Aboriginal Cancer Control Unit has followed a 3-pillar approach towards building regional capacity to address cancer control issues/needs:

    • Meet with Regional Cancer Programs. An initial meeting was held to discuss Aboriginal Cancer Strategy priorities and targets, establish primary contacts and develop a working group within each Regional Cancer Program. The Aboriginal Cancer Control Unit, in close partnership with the Regional Cancer Program working group, developed a draft Regional Aboriginal Cancer Plan to outline steps to make the cancer system more effective and accessible for First Nations, Inuit and Métis people in each region.
    • Work with established Aboriginal Health Tables. The Aboriginal Cancer Control Unit identified core Aboriginal (First Nations, Inuit, Métis, Friendship Centres, Aboriginal Health Access Centres and other Aboriginal groups) Health Tables (boards, committees and advisory groups) to provide guidance and feedback on the Regional Aboriginal Cancer Plans before finalization. This ensures that Aboriginal people in each region have a voice in the delivery of cancer services, and it allows the Regional Cancer Programs to engage directly, respectfully and sustainably with First Nations, Inuit, Métis and other Aboriginal groups.
    • Build Regional Cancer Programs capacity. To address First Nations, Inuit and Métis cancer control issues effectively, dedicated resources were established in the Regional Cancer Programs. Aboriginal Navigators provide support for First Nations, Inuit and Métis people with cancer and their families along every step of the cancer journey. Regional Aboriginal Cancer Leads champion the ACS III strategic vision by engaging and collaborating with healthcare providers across the matrix of primary care. Aboriginal Project Coordinator positions have been created within 5 Regional Cancer Programs to support the work of the Regional Aboriginal Cancer Leads. The Aboriginal Cancer Control Unit also employs 3 Partnership Liaison Officers to support the work of the Regional Cancer Programs and to ensure sustained engagement between Regional Cancer Programs, the Aboriginal Cancer Control Unit and First Nations, Inuit and Métis leadership, Core Health Tables and communities across Ontario.
  • The Aboriginal Cancer Control Unit has established regular reporting procedures to ensure that First Nations, Inuit and Métis leadership, provincial-level Health Tables and local First Nations, Inuit and Métis partners are engaged and informed regarding the Aboriginal Cancer Strategy progress. This also provides an opportunity to ensure that the partners are able to guide and provide feedback on the implementation of deliverables that impact their communities. As such, the Aboriginal Cancer Control Unit meets with Political Territorial Organization leadership (Grand Chiefs and Chiefs), First Nations Tribal Councils, local-level Core Health Tables and communities, the Métis Nation of Ontario Healing and Wellness Branch, Ontario Federation of Indigenous Friendship Centres, Inuit service providers and Aboriginal Health Access Centres.
  • As outlined within the Relationship Protocols signed between Cancer Care Ontario and First Nations, Inuit and Métis leadership, the Aboriginal Cancer Control Unit has committed to providing regular written reports. As such, a written reporting process has been developed to ensure that First Nations, Inuit and Métis political leadership with whom Cancer Care Ontario has a formal relationship receives an annual report detailing work carried out with, and for, the associated communities. These reports were distributed for the 2015/fiscal year, and will likewise be developed based upon activity in the 2016/17 fiscal year. An annual report is being developed for the Ontario Federation of Indigenous Friendship Centres for activities in 2016/17.
  • A key component of developing and implementing Regional Aboriginal Cancer Plans is to ensure that engagement between the Regional Cancer Programs and the core Aboriginal Health Tables is sustained. Structures to sustain the engagement may take the form of developing a regional Aboriginal Cancer advisory committee, meeting with local groups that are already established (such as LHIN Aboriginal Health Circles), or regular touchpoints with individual community health committees. Regular meetings ensure that progress reports on the implementation of each Regional Aboriginal Cancer Plan are provided to First Nations, Inuit, Métis and other Aboriginal partners, and that these partners have the opportunity to provide feedback and guidance on all work undertaken to address cancer control within their communities. Work undertaken in ACS III will involve working closely with Regional Cancer Programs and Core First Nations, Inuit, Métis Health Tables to develop sustainable engagement structures in every region of the province, while continuing to engage closely with those already established.

What do the results show?

  • Table 1 provides an overview of Relationship Protocols between Cancer Care Ontario and First Nations, Inuit and Métis leadership. These documents formalize relationships with Aboriginal partners through mutual respect, recognition and understanding, and they highlight Cancer Care Ontario’s accountability and commitment to establishing strong foundational engagement structures necessary to achieve common goals and objectives.
  • The strength of the partnerships developed through the Relationship Protocols has ensured a sustained, ongoing dialogue that has been instrumental to the implementation of Regional Aboriginal Cancer Plans that are resulting in improved access to services and person-centred care. These Protocols set a new course for the way Cancer Care Ontario will engage and collaborate with First Nations, Inuit, Métis and other Aboriginal groups to address increasing cancer incidence and mortality rates among Ontario’s Aboriginal populations.

Regional Aboriginal Cancer Plans have been developed in partnership with First Nations, Inuit and Métis peoples within 12 of the province’s 13* Regional Cancer Programs.

*Note: Toronto Central North and South are combined.

  • Figures 1 and 2 provide an overview of the development of Regional Aboriginal Cancer Plans across Ontario.
  • The Regional Cancer Programs responsible for serving the 10 regions in Ontario with the highest First Nations, Inuit and Métis populations each developed Regional Aboriginal Cancer Plans during the period 2013 to 2015. For the period 2015 to 2019, the Aboriginal Cancer Control Unit is working closely with each of the 13 Regional Cancer Programs in Ontario to develop updated Regional Aboriginal Cancer Plans based on ACS III that reflect provincial and regional First Nations, Inuit and Métis cancer control priorities.
  • Regional Aboriginal Cancer Plans are regional blueprints for making the cancer system work better for First Nations, Inuit, Métis and other Aboriginal groups in each region. Each plan is the result of close partnerships and dialogue among the Aboriginal Cancer Control Unit, Regional Cancer Programs and core First Nations, Inuit and Métis Health Tables. The collaborative and respectful engagement process employed to develop the Regional Aboriginal Cancer Plans ensures that each Plan represents the unique needs of (and belongs to) First Nations, Inuit, Métis and other Aboriginal groups in each region.

Regional partnerships continue to be strengthened as most of the regions with Regional Aboriginal Cancer Plans have engaged with all of the core First Nations, Inuit and Métis Health Tables in their respective regions to develop and implement this work together (Figures 3 and 4).

  • Figures 3 and 4 provide the percentage of core First Nations, Inuit and Métis Health Tables engaged by Regional Cancer Programs since the launch of the Aboriginal Cancer Strategy III in September 2015. This engagement process between the Regional Cancer Programs and core First Nations, Inuit and Métis Health Tables will continue throughout the lifetime of the third Aboriginal Cancer Strategy, and it will be supported by the Aboriginal Cancer Control Unit’s Partnership Liaison Officers.
  • Throughout the lifetime of ACS II (2012 to 2015), the Aboriginal Cancer Control Unit worked closely with the 10 regions in Ontario with highest First Nations, Inuit and Métis populations, as well as the Central region. With expanded capacity as a result of hiring an additional Partnership Liaison Officer (from 2 to 3) in early 2017, the Aboriginal Cancer Control Unit will be working closely with all Regional Cancer Programs to provide direct support for relationship building and enhanced First Nations, Inuit and Métis cancer control in every region in the province. Regional Aboriginal Cancer Plans are being developed with the remaining regions, focusing on the strategic priorities identified within ACS III.
  • A sustainability structure (Figure 5) has been developed when all Core First Nations, Inuit and Métis Health Tables have been engaged in the development of a Regional Aboriginal Cancer Plan, and have agreed to an established process that ensures the opportunity to provide ongoing guidance to the cancer system at the local level. Since the launch of the Aboriginal Cancer Strategy III in September 2015, sustainability structures have been established in 7 regions in Ontario (Northeast, Erie St. Clair, Champlain, North Simcoe Muskoka, Central East, Southwest and Southeast).

Why is this important to Ontarians?

A foundation of trust and mutual respect between Cancer Care Ontario and Ontario’s First Nations, Inuit and Métis leadership, Health Tables and communities is essential if we are to work together to improve cancer control for Aboriginal peoples in the province. For this reason, “Building Productive Relationships” is the First Strategic Priority of both ACS II and ACS III, and it is the foundational component of all work undertaken. In order to build, develop and maintain relationships with its First Nations, Inuit and Métis partners, Cancer Care Ontario recognizes First Nations, Inuit and Métis traditions and practices, and it honours the unique histories, cultures and diversity of Aboriginal peoples in Ontario.

The mechanisms put in place by Cancer Care Ontario and the Regional Cancer Programs that have been outlined above set a course for a new relationship with First Nations, Inuit and Métis peoples, and they emphasize Cancer Care Ontario’s ongoing commitment to working appropriately, effectively and sustainably with First Nations, Inuit and Métis in Ontario. This approach is vital to ensuring that Ontario’s cancer system recognizes the first peoples of this country, understands their unique needs and works together in true partnership to address cancer control.

Find out more

View Notes

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  2. Gionet L, Roshanafshar S. Study: select health indicators of First Nations people living off-reserve, Métis and Inuit 2007 to 2010. Ottawa: Stats Can; 2013.
  3. Indigenous and Northern Affairs Canada [Internet]. Ottawa: Government of Canada. Registered Indian population by sex and residence 2014—Statistics and Measurement Directorate; 2015 May 21 [cited 2015 Sep 4]. Available from: http://www.aadnc-aandc.gc.ca/eng/1429798605785/1429798785836#tbc1303.
  4. Chiefs of Ontario and Cancer Care Ontario. Cancer in First Nations in Ontario: risk factors and screening. Toronto: 2015.
  5. Statistics Canada. Aboriginal Peoples in Canada: First Nations people, Métis and Inuit: National Household Survey, 2011. Ottawa: Statistics Canada; 2013. Available from: http://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-011-x/99-011-x2011001-eng.cfm.
  6. Statistics Canada. Aboriginal Identity (8), Area of Residence (6), Age Groups (12) and Sex (3) for the Population of Canada, Provinces and Territories, 2006 Census - 20% Sample Data. Catalogue no. 97-558-XCB2006006 [Internet]. Ottawa: Statistics Canada; [cited 2015 Sep 4]. Available from: http://www12.statcan.gc.ca/census-recensement/2006/dp-pd/tbt/Rp-eng.cfm?LANG=E&APATH=3
    &DETAIL=1&DIM=0&FL=A&FREE=0&GC=0&GID
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  8. Gionet L. Métis in Canada: Selected Findings of the 2006 Census [Internet]. Ottawa: Statistics Canada; 2014 [cited 2015 Mar 9]. Available from: http://www.statcan.gc.ca/pub/11-008-x/2009001/article/10769-eng.htm
  9. Statistics Canada. Population Projections by Aboriginal Identity in Canada, 2006 to 2031 [Internet]. Ottawa: Statistics Canada; 2015 [cited 2017 Feb 10]. Available from: http://www.statcan.gc.ca/pub/91-552-x/91-552-x2011001-eng.htm
  10. Statistics Canada. Aboriginal Peoples in Canada in 2006. Inuit, Métis and First Nations, 2006 Census: Métis. Ottawa: Statistics Canada; 2008.
  11. Indigenous and Northern Affairs Canada. Aboriginal Peoples Survey 2012: Gender Differences in Inuit Education and Employment [Internet]. Ottawa: Government of Canada; 2015 [cited 2016 Nov 4]. Available from: https://www.aadnc-aandc.gc.ca/eng/1422283951935/1422284231303.
  12. Truth and Reconciliation Commission of Canada. Honouring the truth, reconciling for the future: summary of the final report of the Truth and Reconciliation Commission of Canada [Internet]. 2015. Available from: http://www.myrobust.com/websites/trcinstitution/File/Reports
    /Executive_Summary_English_Web.pdf
    .