For decades, Indigenous communities have said their numbers are far higher than reported by government agencies.

Not so, according to officialdom.

“Always our studies in the past have been critiqued or undermined as not having a scientifically sound approach,” says Sara Wolfe, founding partner of Seventh Generation Midwives Toronto, which caters to Indigenous mothers and babies.

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“Or there’s been concerns about bias or questioning of the relevance… of the study that’s been done.”

The tables were turned recently.

The census released in October pegged Toronto’s Indigenous population at 23,065, up from the 19,270 census estimate in 2011.

Not so, says a new study that confirms what Indigenous people have been saying all along.

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The study by researchers from York University and St. Michael’s Hospital, in collaboration with Indigenous agencies, was published in the British Medical Journal Open.

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It says the census — that gold standard in population counting — vastly underestimated the Indigenous population in Toronto. The study’s most conservative assumption places it between 45,000 and 73,000 people, or two to four times the 2011 census estimate.

This finding has major implications, particularly in funding for health care and community services.

Statistics Canada is receptive to the study. The agency’s chief priority is accuracy and precision, said Marc Hamel, director-general of the census program.

When there are reports of discrepancies, “we review all the processes we have internally. We also try to work with these groups to better understand the way the study was conducted,” he said. “We always have to be careful when we compare results from different studies because different methodologies are being used, different concepts.”

Lead scientist Janet Smylie, from St. Michael’s Hospital, and lead author of the study Michael Rotondi, a York University professor, employed a statistical method called respondent-driven sampling, which leveraged the inherently strong social networking of Indigenous populations.

Michael Rotondi, a professor at York University, is lead author of a study that found the census underestimated the number of Indigenous people in Toronto.

Specifically, 20 people called “seeds” completed the survey and were given five uniquely coded coupons. They gave these to other Aboriginal people who then filled the survey, and those people gave out coupons to others in their social networks, and so on.

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It allowed Indigenous community members to recruit each other for the study which then reached a large sample of more than 900 adults.

“This helps better track Indigenous community members who might be homeless and otherwise unstably housed,” says Rotondi.

They partnered with Wolfe’s midwifery clinic, which led a multi-agency collaboration to plan the questions, recruit trained Indigenous interviewers and disseminate the survey that took more than an hour to complete.

The census, on the other hand, uses the concept of usual residence and is based on private dwellings.

“It doesn’t measure, for example, where people would be temporarily residing for whatever purpose, whether it be work, school or receive certain types of services,” says Hamel.

“The census is never perfect, like any study. We know we have unaccounted populations. We have measures to identify and account and to make adjustments to the population estimation programs that are used by the government to make decisions.”

The survey included a question of whether or not the respondents had completed the 2011 census.

“Even under a conservative model we were able to say only about 19 per cent (of individuals) had even completed the census,” Rotondi says.

“One of the big reasons is people don’t trust governments, long forms and mandatory surveys,” says Wolfe, who is Ojibwe from Brunswick House First Nation and was the community lead for the study.

“We might be afraid to tell someone on the phone that says they’re from the government that we’re Indigenous,” says Smylie, who is Métis. “We might purposely not want to participate. We might be opting out because we feel socially excluded or frustrated with the government. Or, it’s not on our priority list ’cause we’re too busy trying to get enough groceries on our shelf and we’re running around and didn’t even know the census was happening. Or (we’re) renting a room somewhere or couch surfing.”

These were some of the barriers the respondent-driven sampling broke down.

The impact of this study will be tremendous and long-term, the researchers say.

“It doesn’t mean that just because there are more Indigenous people everyone’s going to have to pay more taxes. It could mean if we’re counting properly (and allocating correctly) we’re paying less taxes,” said Smylie.

“This is irrefutable evidence,” said Wolfe. “There’s no way you can say the population is not this big any more.”

This is relevant because, “Indigenous people are not getting asked for input and consulted on the decisions being made… because there’s a presumption that we are not a significant or substantial portion of the population,” says Wolfe.

Why does it matter if the people accessing care are Indigenous as long as they have access to it? Two reasons: to counter ongoing racism and to redress intergenerational trauma produced by historic wrongs.

In a report titled First Peoples, Second Class Treatment, Smylie says she wrote that if you’re a First Nation person living in the province of Alberta having a heart attack, “you’re less likely to get a picture of your heart, called a coronary angiogram, and more likely to die just because you’re First Nation. It doesn’t matter if you live in the city or a rural area or if you’re rich or poor.”

Residential schools, the last of which closed 20 years ago, left Indigenous people with a painful legacy. Abuses that are only just being seriously documented have left a community history of complex trauma.

“That might be something you’d need specialized services and responses,” said Smylie. “We also know that some Indigenous people benefit greatly from access to traditional healing and traditional counseling and a revitalization of Indigenous culture.”

Says Wolfe: “Everyone needs to make a concerted effort to work together to close these (health) gaps so we can have as good a chance as everyone else in society to reach our full potential.”

Shree Paradkar writes about discrimination and identity. You can follow her @shreeparadkar