| dc.description.abstract | The health disparities experienced by Aboriginal populations in Canada have been an
important topic for provincial and national health care. In general, the health status and
resource utilization of Aboriginal groups have been lower than that of the Canadian
population. Recently, an assessment tool called the Resident Assessment Instrument
(RAI) was mandated for use in home care settings. This dissertation examined the
health status (as measured by the RAI) of Aboriginal and non-Aboriginal clients
assessed for home care in Ontario by analyzing client demographics, health status
indicators, and summary scale scores. Sequential multilevel linear modeling analyzed
the summary scale scores with respect to ancestry, sex, age, and socio-economic
status; regional differences in outcome scores were observed. Aboriginal ancestry had
a significant effect on depression, cognitive status, and activities of daily living scores
when control variables were not considered. Once age, sex, and socio-economic status
were accounted for, Aboriginal ancestry did not have an effect on these outcome
measures. Aboriginal ancestry did have a significant effect on pain scores. Qualitative
data obtained through key informant interviews identified several challenges to providing
home care to Aboriginal peoples, including language, infrequent access to services in
rural areas, and client transience. These findings support the recognition of individual
demographic as well as regional factors as contributors to disease prevalence within the
home care population. Further validation of the RAI-HC and development of an
Aboriginal RAI tool would increase the utility of the RAI with Aboriginal clients and
provide a higher quality of data with which to direct policy and funding. | |
