In Canada, Status First Nations persons—those listed in the country’s Indian Register—are significantly more likely than the average Canadian to meet an untimely death. When it comes to wellness outcomes, disparities along racial and ethnic lines are well documented across many metrics. What is often overlooked, however, is what those data look like at the intersection of race and gender.

In a new paper (PDF) “First People Lost: Determining the State of Status First Nations Mortality in Canada using Administrative Data” with Donna Feir, we combine data from Canada’s Indian Register and the Indigenous and Northern Affairs Canada (INAC) to identify both female and male mortality rates for the First Nations populations relative to the Canadian average. Our findings indicate that girls and women suffer from a disproportionately high rate of mortality as compared to their male and Canadian counterparts.

We show that the mortality rates comparing First Nations peoples to that of the Canadian average are consistently higher in all age groups. Starting in the early teenage years, however, there’s a spike in First Nations female mortality that persists until age 45. The rates approach 400 percent of the average Canadian mortality rate for females and 300 percent for males across these age groups.

It turns out that geography matters as well for mortality rates. In the U.S., much attention is given to zip codes as determinants of wellness outcomes and optimism, though the neighborhood in which someone lives may have more to do with their chances of success than any other factor.

In Canada, the probability of early death is higher for Status First Nations person living on one of Canada’s First Nations Reserves than for those living off reserve. Adding location to the intersection of race and gender, we see staggering numbers that are hidden in data aggregated at larger geographic levels—the mortality rate of on-reserve Status girls between the ages of 15 and 19 is almost five times the national average. These results are often masked in provincial or regional data given that Reserves tend to be very small in terms of their individual populations.

Even more alarming, these differences in mortality across the First Nations female populations and the average Canadian is not new. We document in the paper that these rates have not improved substantially for First Nations girls living on reserves in nearly 30 years.

What are the causes of such high rates of mortality? It could be several things alone or in combination: lack of access to health care, domestic violence and abuse, or poverty. Activists and First Nations communities have been voicing these concerns for some time: the National Women’s Association of Canada’s Missing and Murdered Indigenous Women movement, Amnesty International’s No More Stolen Sisters campaign, and survivors of the Canadian Residential School system (Truth and Reconciliation Commission of Canada (TRC), 2015, p 161) have all focused on the disproportionate abuse and deaths of Indigenous women in Canada.

While we cannot perfectly identify the causes for these high rates of mortality, our research has shown that there is a strong relationship with economic conditions and poverty. Our future work will focus on uncovering the direction of causation to further inform the great work these organizations and others are doing.