Indigenous people in Toronto are far more likely than adults in the rest of the province to be homeless, hungry and unemployed, and to get involved with child protection agencies and the justice system, according to a groundbreaking new health report.

Among the report’s staggering findings, based on a survey of Indigenous residents, are that only an estimated 57 per cent have a high school diploma, that 63 per cent are unemployed and that 87 per cent can be categorized as low-income.

The study says such factors are taking a toll on the physical and mental health of the Indigenous population and are part of the legacy of colonization and forced assimilation by successive governments.

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The study was funded by the Canadian Institutes of Health Research and the provincial government. The lead researcher was Dr. Janet Smylie of St. Michael’s Hospital, one of the first Métis physicians in Canada.

“Your family is displaced and it affects how you interact with one another and other people. It puts distance between family,” said Warren Greene, an Ojibwe man who moved to Toronto from a reserve near the Ontario-Manitoba border 20 years ago. His six older siblings were plucked away from the family to attend residential school.

“What happened to us has directly affected our lives. Only now have we started to talk about the bad things that happened then, understand why we are acting this way and recognize how all these experiences are manifested in our lives,” said Greene, who was not part of the study.

Using what’s known as “respondent-driven sampling” to ensure the findings’ scientific validity, researchers surveyed 918 Indigenous adults through a questionnaire with hundreds of questions to build a database of their demographics and experiences ranging from housing to food security, residential schools, the justice system, racism and abuse, as well as their connection with their heritage. The survey results have a 95 per cent confidence interval, meaning there is a 5 per cent chance they are wrong.

“While attempts at assimilation have not been successful, the implementation of these policies has negatively influenced structural determinants of health, such as housing, income, employment and land ties,” said the 70-page study, “Our Health Counts Toronto,” released Wednesday.

“They also undermined language, cultural expression, and family systems. The result is a continued negative impact on the health of Indigenous peoples — including mental and emotional health and well-being.”

Some of the researchers’ findings:

The Indigenous population in Toronto, between 45,000 and 73,000, is estimated at three to four times more than Statistics Canada established.

64 per cent of respondents were single, compared to 28 per cent of all adults in Ontario.

Only 57 per cent have a high school diploma compared to 90 per cent of adults in Ontario.

63 per cent were unemployed compared to the 7 per cent average in Ontario.

87 per cent live below the before-tax low-income cut-off, where a family generally spends 70 per cent or more of its income on food, shelter and clothing.

More than a third were precariously housed or experiencing homelessness at the time of the survey, with more than half having moved at least once in the past year.

One quarter reported they sometimes or often do not have enough to eat.

These socioeconomic challenges have a lot to do with the health of the members of the city’s Indigenous community, said Smylie, the lead researcher.

“We have to get to the causes of the causes of these problems that are linked to our historical and current colonial (government) policies,” said Smylie.

According to the report, rates of chronic health conditions such as asthma, learning disability, diabetes, hepatitis, attention deficit disorder and allergies among urban Indigenous adults are between two and 10 times higher than the general population in Canada.

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Only 31 per cent of the participants in the study reported very good or excellent mental health, compared to 72 per cent among all Canadians. Some 45 per cent of the survey respondents have been told by a health care professional they have a psychological or mental health disorder including anxiety, major depression and post-traumatic stress disorder.

While the report cannot establish a causal relationship between the state of Indigenous health and traumatic experiences in the past, some of the findings suggest a possible link:

Three out of five respondents had at least one family member attend residential school.

22 per cent said they were adopted or had other members of their family adopted between 1951 and 1970, during the infamous “Sixties Scoop,” with another eight per cent being adopted since.

46 per cent of these residential school survivors said their overall health and well-being was negatively impacted by the experience.

Of adults who had a family member attend residential school, 37 per cent have been screened positive for post-traumatic stress disorder.

More than a quarter of the respondents have had a close friend or family member go missing.

One in three have had a close friend or family member die as a result of violence caused by another person.

52 per cent have done some time in jail.

54 per cent said they have experienced racism in the past year.

One in four said they have been treated unfairly by health care professionals because of their Indigenous identity.

Sara Wolfe, a co-founder of the Seventh Generation Midwives Toronto, the custodian of the research data, said the study is the first step to finding solutions to address the community’s health challenges.

“We need ongoing funding to implement programming in the community across jurisdictions. The delivery and the design have to be led by our community,” said Wolfe, an Ojibwe from Brunswick House First Nation.

“The impact of colonialism did not happen overnight, the fix is going to take a long time commitment and we all have a role in helping to make these larger systemic changes.”

The same Indigenous health surveys are being conducted in Hamilton, London, Ottawa, Kenora and Thunder Bay.