Canadian Culture Research Articles

Gender-Based Violence and 2SLGBTQI+ Groups

Gender-based violence (GBV) is a pervasive public health issue that affects all Canadians, including Indigenous peoples (First Nations, Inuit, Métis); however, it is well-understood that GBV disproportionately affects certain social groups. An estimated one million Canadians aged 15 and older identify with a sexual orientation other than heterosexual, and approximately 1 in 300 people identify as transgender or non-binary. In Canada, violence rooted in biphobia, homophobia, transphobia, and queerphobia results in disproportionately high levels of GBV experienced by Two-Spirit, lesbian, gay, bisexual, transgender, queer (or questioning), intersex, and other individuals who identify outside of cisgender, heterosexual norms (2SLGBTQI+ people). The health impacts of GBV experienced by people who identify outside of gender and sexuality norms are profound, spanning mental and physical dimensions across the life course. This article employs an anti-oppression queer framework to provide a comprehensive overview of current knowledge and understandings of GBV in Canada concerning 2SLGBTQI+ people, emphasizing (1) the disproportionate risk of GBV faced by 2SLGBTQI+ communities within the context of Canadian social politics; (2) key links between the experiences of GBV among 2SLGBTQI+ people in Canada and associated health disparities; (3) current orientations to GBV policy, practice, and research, with an emphasis on contemporary, inclusive paradigms that shape equity-oriented health and social services; and (4) future directions aimed at eradicating GBV and addressing health inequities among 2SLGBTQI+ people in Canada. While much work remains to be done, the expansion of 2SLGBTQI+ inclusion in GBV prevention within the past five years points to a promising future.

Hepatitis C Diagnosis and Treatment Among Indigenous People in a Canadian Context: Challenges and Community-Led Solutions.

The historical and ongoing impacts of the influence of colonization are experienced by Indigenous people in systemic racism, inequity in healthcare access, and intergenerational trauma; originating in the disruption of a way of life and seen in a grief response, with links to disparate hepatitis C virus (HCV) prevalence. Despite this, the focus often remains on the increased incidence without a strengths-based lens. Although HCV is a global concern that can result in cirrhosis, liver failure, or cancer, diagnosing and linking people to care and treatment early can prevent advanced liver disease. Efforts to engage certain priority populations are occurring; however, historical context and current practices are often forgotten or overlooked. This is especially true with respect to Indigenous people in Canada. This review considers the published literature to elucidate the context of historical and ongoing colonizing impacts seen in the current HCV treatment gaps experienced by Indigenous people in Canada. In addition, we highlight strengths-based and Indigenous-led initiatives and programming that inspire hopefulness and steps toward community-engaged solutions to meet the World Health Organization Goals of eliminating HCV as a public health threat.

Carcerality and the elimination of Indigenous people in Canada

AbstractDrawing from the logic of carcerality, and refined through theories of settler colonialism, I argue in this paper the following. First, carcerality is not just a tactic of settler colonization in Canada for bodily controlling populations, but a key feature of settler colonial claims to land and territory; imposing carceral spaces on Indigenous people is a fundamental necessity for the expectations and ambitions of settler colonization, and as settler colonization in Canada is ongoing, the expansion of these carceral spaces likewise continues. Second, carceral theory can be used to analyze how Indigenous people are made to “disappear” from settler‐dominated spaces, and expose the interlocking roles of state power and social prejudice in these “eliminations.” As all kinds of frontier spaces—urban, rural, and otherwise—are assimilated into the settler colonial assemblage, Indigenous people are forced into mobility that itself is both carceral and eliminatory. Understanding carcerality as something pervasive in settler society, and not just limited to the criminal justice system, changes how we must approach decolonization.

The protective power of dissent? A longitudinal study on cognitive and socio-emotional determinants of COVID-19 vaccine hesitancy among young people in Canada

COVID-19 has elicited polarized reactions to public health measures, fueling anti-vaccination movements worldwide which indicate that vaccine hesitancy represents a common expression of dissent. We investigate changes in cognitive (i.e., trust in government, conspiracy beliefs, vaccine attitudes, and other COVID-19-related factors) and socio-emotional factors (i.e., psychological distress and social support) over time, and examine if these factors are associated with COVID-19 vaccine hesitancy. A sample of Canadian young adults ( N = 2,695; 18 to 40 years old) responded to an online survey in May/June 2021 (after the first vaccination campaign) and then in November 2021 (after vaccine mandates were introduced). Based on survey answers, participants were categorized as “not hesitant”, “hesitant”, and “do not intend to get vaccinated” at each time point. Results from generalized estimating equation models indicate that vaccination hesitancy decreased over time. The importance attributed to specific COVID-19-related factors (e.g., research and science about COVID-19 vaccines, opinions of friends and family) decreased whereas psychological distress increased over time. Cognitive and socio-emotional factors were associated with vaccine hesitancy, with participants who did not intend to get vaccinated reporting the lowest psychological distress scores. We argue that dissent may be an empowering way for young people to restore a sense of personal agency via the opposition to a system perceived as illegitimate and/or unfair. These results raise important questions about potential collateral effects of top-down government and public health interventions in times of crisis.

The antimicrobial potential of traditional remedies of Indigenous peoples from Canada against MRSA planktonic and biofilm bacteria in wound infection mimetic conditions.

Methicillin-resistant Staphylococcus aureus (MRSA) is the leading cause of wound infections, often progressing into serious invasive bloodstream infections. MRSA disproportionately affects Indigenous peoples in Canada with higher rates of skin and wound infections, an example of persistent gaps in health outcomes between Indigenous and non-Indigenous peoples precipitated by the legacy of colonialism. Conversely, Indigenous peoples have long used natural remedies for infections and other diseases; however, their knowledge was rarely considered for modern medicine. The stagnant antibiotic discovery pipeline and alarming rise of resistance to current antibiotics prompted us to turn to Indigenous medicine as an untapped source of antimicrobials. As such, we collected and prepared 85 extracts of medicinal plants of value to Indigenous peoples spanning the Canadian Prairies. We explored the antimicrobial potential of these extracts against MRSA under wound infection-mimetic conditions compared with culture media typically used to study bacterial antibiotic responses and biofilms but not adequately representative of infection sites. We identified extracts with MRSA growth inhibitory [e.g., bergamot, dock, gaillardia, and dandelion extracts] and biofilm prevention and eradication [e.g., gumweed extracts] activities. Extracts, including those of chokecherry, hoary puccoon, and Northern bedstraw, were only active under wound infection-mimetic conditions, highlighting the benefit of antibiotic discovery under host-relevant conditions. Testing growth inhibitory extracts against an S. aureus cross-resistance platform suggested that they act through mechanisms likely distinct from known antibiotic classes. Together, through an interdisciplinary partnership leveraging Western approaches and traditional Indigenous knowledge, we identified plant extracts with promising antimicrobial potential for drug-resistant MRSA wound infections.IMPORTANCEWe explored the antimicrobial potential of traditional Indigenous remedies against MRSA under wound infection-mimetic conditions. We chose to tackle MRSA wound infections because they constitute an Indigenous health priority, ensuring mutual benefits and reciprocity, which are important principles in partnerships between Indigenous and non-Indigenous researchers. Our partnerships strive to serve as steps towards reconciliation with Indigenous peoples in Canada and a roadmap inspiring similar interdisciplinary collaborations to tackle other healthcare priorities. We identified extracts with promising antibacterial growth inhibitory, biofilm prevention, and eradication activities against MRSA. The antimicrobial potential of some extracts was only observed under wound infection-mimetic conditions, a proof-of-concept that screening under infection-mimetic conditions reveals novel activity undetected under standard conditions. The natural product antimicrobial extracts discovered herein warrant further investigation into their mode of action and chemical composition; they may address the dire need for new antimicrobial and anti-biofilm activity to counter the AMR crisis.

The impact of the COVID-19 pandemic on the labour market outcomes of Indigenous persons living off-reserve in Canada

The recent COVID-19 pandemic had an impact on the labour force activity of many, but the effect of the crisis on the labour market outcomes of Indigenous peoples in Canada is relatively understudied. Using data from the master files of the Canadian Labour Force Survey (LFS), this analysis first considers the relative probability of four mutually exclusive labour force states: employed; unemployed; not in the labour force, but not discouraged; and not in the labour force due to being a discouraged worker. Differences in hours worked as well as earnings comparing Indigenous and non-Indigenous workers are then examined. The findings reveal that, regardless of the COVID-19 pandemic, Indigenous Canadians were relatively more likely to be either unemployed or not in the labour force (including being a discouraged worker) than to be employed as compared to their non-Indigenous counterparts. Indigenous workers earned roughly 3 percent less than their non-Indigenous counterparts. The earnings penalty experienced by Indigenous workers, was slightly smaller at the bottom of the wage distribution at 2 percent, increasing to roughly 3.3 percent at the top 90th percentile of the earnings function. During the COVID-19 period, while the risk of unemployment was lower for Indigenous persons, the risk of being a discouraged worker was even higher for Indigenous Canadians during the pandemic. Using an ad-hoc supplement to the LFS conducted by Statistics Canada in response to the pandemic, this study finds that Indigenous respondents were less likely than non-Indigenous respondents to either work from home or receive any form of Canada relief benefit from April 2020 to October 2021. The implications of these findings suggest a role for policy makers to improve access to funding supports for Indigenous workers and students seeking to pursue higher education to improve labour market outcomes. Additionally, employers play an important role in ensuring that Indigenous workers have fair access to job opportunities.

Co-designing Culturally Safe Indigenous Birth in High-Risk Obstetrics: Implementing Joyce's Principle with Inuit and Cree Families and Their Medical Providers.

Introduction. Maternal evacuation-the transfer of women from remote communities to urban hospitals for childbirth-negatively affects many Indigenous Peoples in Canada. A working group of perinatal service providers in Montreal sought to enhance cultural safety in a high-risk obstetrical unit serving evacuee Indigenous families. This article describes co-design, implementation, and evaluation of short-term cultural safety interventions with Indigenous stakeholders. Methods. Indigenous families and their non-Indigenous service providers displayed their recommendations for culturally safe birth using fuzzy cognitive mapping (FCMs). Joyce's Principle-a framework for securing culturally safe healthcare for Indigenous Peoples-guided their implementation. Results. Four high-priority FCM recommendations included an Indigenous-led cultural safety training for hospital staff. Third party evaluation showed a positive influence on cultural safety knowledge and actions. Discussion. Health services designed with Indigenous stakeholders in accordance with Joyce's Principle have the potential to enhance cultural safety of maternal evacuation.

Leveraging Full Count Census Data through Record Linkage

Academic researchers in the U.S. and Canada have partnered with genealogical organizations and statistical agencies to create massive new scientific data collections from census enumerations. These data are creating new opportunities for research across the social and health sciences. By linking individuals and families across censuses, analysts can create national longitudinal panels that trace the characteristics of individuals over their lives and families over multiple generations. IPUMS disseminates full count census enumerations for ten U.S. census years from 1850 to 1950. These full count data cover almost 800 million individual records and the IPUMS Multigenerational Longitudinal Panel (MLP) project links individuals' records across censuses. IPUMS data can be combined with data from the U.S. Census Bureau’s data linkage infrastructure to link historical records to numerous recent censuses, surveys and administrative data that measure social, economic and health outcomes. The Canadian Peoples (TCP) is a comprehensive public research database of 40 million coded and georeferenced records found in Canadian censuses from the middle of the nineteenth century until after the First World War. The data include personal, family and household characteristics of every individual enumerated in each census from 1852 to 1921. TCP investigators are exploring record linkage technology to solve challenges presented with these historical records. The workshop included one presentation from each organization, with these objectives: introduce the data collections, explain the challenges and opportunities of census linkage, describe the linking strategies, and provide an overview on how to access the data.

The Economic Benefits of a Major Canadian Forestry Contribution Program for Indigenous Peoples

This paper evaluates whether the First Nations Forestry Program (FNFP), a contribution program for Indigenous Peoples in Canada, had a statistically measurable effect on the well-being of participating reserves’ inhabitants. Funding data from 1,078 projects was paired with reserve inhabitant profiles from two Statistics Canada censuses. Multiple regression models were then used to test for the statistical significance of project-funding treatments. The results suggest that from 2006 to 2010, the FNFP significantly affected the after-tax incomes of reserve inhabitants who had worked in forestry, as well as a lesser effect on the after-tax incomes of reserve families.

Neurological care and outcomes in a cohort of Canadian pregnant patients with epilepsy

PurposeTo characterize anti-seizure medication (ASM) use over time, therapeutic drug monitoring, ASM dose adjustments and gestational seizure frequency among Canadian people with epilepsy of childbearing potential seen in an urban tertiary care center. MethodsParticipants were retrospectively identified from the medical records of pregnant patients with epilepsy seen at the University Health Network Comprehensive Epilepsy Program between 2014 and 2021. A descriptive analysis of outcomes, a logistic regression analysis of the odds of patients being on three ASMs associated with higher rates of teratogenicity (i.e., valproate, carbamazepine, and topiramate) over time, and a second logistic regression for predictors of seizure freedom during pregnancy were performed. Results195 pregnancies were included: 52 % had a maternal diagnosis of generalized epilepsy and 92 % were prescribed at least one ASM, with 75 % on monotherapy. The majority underwent therapeutic drug monitoring (77 %) with approximately two-thirds requiring dose adjustments (69 %), typically dosage increases (82 %). The proportion of patients on either valproate, topiramate, or carbamazepine decreased over time (OR=0.80; p<0.01). Fifty-seven percent of pregnancies maintained seizure freedom, with seizure-freedom for ≥1 year prior to conception being the strongest predictor of this outcome (OR of gestational seizure recurrence=0.04; p < 0.01). ConclusionThe proportion of patients on three ASMs associated with higher rates of teratogenicity has decreased over the duration of this study. Seizure-freedom prior to conception was associated with a decreased risk of gestational seizure recurrence.

The relationship of childhood maltreatment, adult sexual victimization, depressed mood and symptoms of trauma with fear of childbirth

Background: Fear of childbirth (FoB) is experienced to some degree by most pregnant people and can be intense enough to merit treatment. Despite significant research on the topic of FoB, studies investigating various forms of maltreatment and mental health symptoms in relation to FoB are very limited. In particular, studies including multiple forms of maltreatment along with mental health symptoms as predictors of FoB are extremely limited. We sought to fill this gap and clarify the relative contributions of these variables to the prediction of FoB. Methods: This was a secondary analysis of data from pregnant people in Canada. Participants (N = 881) provided demographic and reproductive history information, completed self-report measures of FoB, childhood maltreatment (multiple forms), adult sexual victimization, depressed mood and symptoms of posttraumatic stress disorder (PTSD). They were also administered a diagnostic interview to assess for specific phobia, FoB. Analyses included descriptive information, Wilcoxon rank sum tests, linear and logistic regression, and path analysis. Results: Most forms of maltreatment showed some association with increased FoB. However, when assessed together, only emotional maltreatment remained a significant predictor of FoB. Both depressed mood and symptoms of PTSD contributed more to FoB than maltreatment, and mediated the relationship of emotional maltreatment with FoB. The only direct effects of childhood emotional maltreatment on FoB were for fears of medical interventions and feelings of embarrassment during labour and delivery. Limitations: Study findings fill significant gaps in our understanding of the relationship between maltreatment, mental health symptoms and FoB. However, the study sample was limited to Canadian participants, most of whom were socio-economically advantaged, cis-gender women of European descent, thus limiting the generalizability of the findings. Further, as childhood maltreatment and sexual assault experiences in adulthood were reported retrospectively, study findings are also vulnerable to recall bias. Conclusions: Findings contribute to our understanding of the relationship between childhood maltreatment, adult sexual victimization, mental health and FoB. These findings can facilitate future research and improved care via a focus on depressed mood, symptoms of PTSD, emotional maltreatment and specific fears of medical interventions and social discomfort as significant contributors to one's experience of FoB.

Public Deliberation for Ethically Complex Policies: The Case of Medical Assistance in Dying in Canada.

Almost 50,000 people in Canada have had a medically assisted death since federal legislation was passed in 2016. Still, the debate about the permissibility of medical assistance in dying (MAiD) continues to rage. The central role of shared values and ethics in public policy making emphasizes the importance of engaging the public, particularly around heavily value-laden issues such as MAiD. Public deliberation, a mode of engagement that fosters sustained and reasoned discussion between participants, is well-suited to addressing such ethically contentious policy issues. In this paper, we review recent efforts to engage the public on assisted dying within and outside Canada and explain how public deliberation could contribute substantively to MAiD policy making.

Exploring vaccine hesitancy among citizens of the Métis Nation of Ontario: a population-based data linkage study

Objective and ApproachUnderstanding vaccine hesitancy among distinct communities is crucial to ensuring equitable uptake of vaccination. The objective was to examine the influence of psychological antecedents of vaccine uptake, known as the “5Cs”, on COVID-19 vaccination among Métis Nation of Ontario (MNO) citizens. The Métis people are one of three Indigenous peoples in Canada. A population-based online survey was implemented by the MNO, including the short version of the “5C” (confidence, complacency, constraint, calculation, collective responsibility) psychological antecedents of vaccination scale. Census sampling achieved a 39% response rate and respondents were linked to the COVID-19 vaccine database (COVAX) in Ontario (n=4,012). Analyses included logistic regression models (adjusted for sociodemographics) and exploratory latent class analyses. ResultsIn logistic regression models, MNO citizens who were less confident that COVID-19 vaccines were safe (OR=0.04; 95% CI=0.03-0.06) and did not agree vaccination was a collective action to prevent the spread of disease (OR=0.11, 95% CI: 0.07-0.17) had lower odds of being vaccinated. MNO citizens who disagreed the risk of COVID-19 was small (OR=14.87, 95% CI: 9.99-22.13) had a higher odds of being vaccinated. Vaccine hesitancy profiles with (i) lower confidence in availability/safety of COVID-19 vaccines, (ii) lower perceptions about severity of COVID-19 and (iii) higher everyday life constraints/stressors were associated with lower vaccination rates (males, OR: 4.69; CI: 3.18–6.92; females, OR: 4.77, CI: 3.03–7.51) in latent class analyses. Conclusions and ImplicationsMétis-specific analyses enabled a community-driven response, resulting in low vaccine hesitancy and high uptake.

‘Standing with Each Other’: Indigenous-Muslim Relation-Making on Turtle Island

Within the context of the northern part of Turtle Island, the space of relationships between Indigenous and Muslim communities is one intertwined within the history and geopolitical realities of settler-colonialism and immigration. This paper is an exploration of the theme of space, and relationship formation from the perspective of Muslim and Indigenous peoples in Canada who have engaged in building relations over the past two decades. This article is based on a wider qualitative semi-structured interview-based research project, supported by content analyses of existing literature and online resources produced by relevant organizations and initiatives. The research analysis has led me to thematically organize these spaces into four general types of spaces: 1) organization-led spaces of relationship building; 2) spaces of conviviality as pathways to relationship building; 3) relational spaces defined through acts of documentation; and 4) spiritually and emotionally bonded spaces that transcend a secular framework. This analysis led to identifying practices of relational meaning-making that form a preliminary understanding of what characterizes Indigenous-Muslim relations on Turtle Island.

Prevalence and correlates of oral antibiotic use in Canada.

Antimicrobial use (AMU) is a known driver of antimicrobial resistance. Insight into prevalence and correlates of AMU can help identify health inequities and areas for targeted action. To better understand sociodemographic and medical dimensions of AMU in Canada, the Public Health Agency of Canada, in partnership with Statistics Canada, developed a Rapid Response Module questionnaire on self-reported oral antibiotic use, to be administered as part of the 2018 Canadian Community Health Survey (CCHS). To provide data on the proportion of people in Canada that self-report the use of antibiotics and sociodemographic and health factors associated with use. This cross-sectional study used data from the CCHS, a national survey of 24,176 people with a clustered multi-stage stratified random sampling design. In 2018, an antibiotic use module was administered to CCHS participants. Among respondents 18 years and older, 26% reported receipt of at least one oral antibiotic over the past year. Several sociodemographic and health factors had higher adjusted odds of receiving an antibiotic prescription, including those aged 18 years compared to aged 48 years (mean), women compared to men, immigrants compared to non-immigrants (excluding Indigenous), current and former smokers compared to those who have never smoked, and those with comorbidities (asthma, chronic obstructive pulmonary disease, arthritis, heart disease, cancer, bowel disorder and urinary incontinence). Variations in AMU across different key populations and sociodemographic groups highlight the need to improve our understanding of different drivers of AMU and for tailored interventions to reduce inequitable risks of antimicrobial resistance.

Sacred Sharing Circles: Urban Indigenous Experience with Bariatric Surgery in Manitoba.

Obesity and type 2 diabetes (T2DM) are growing global health concerns. A disproportionate number of Indigenous Peoples live with obesity and its complications. Bariatric surgery offers superior weight loss and comorbidity resolution when compared to medical management. There is a paucity of literature regarding the experiences of Indigenous Peoples undergoing bariatric surgery. The aim of this study was to employ two-eyed seeing and a decolonizing approach to explore the experiences of urban Indigenous bariatric surgery patients. An Indigenous Advisory Committee guided the conception and design of the study. Four urban Indigenous bariatric surgery patients with T2DM participated in two sequential sharing circles and individual interviews facilitated by an Elder. Audio transcripts were analyzed for emerging themes using inductive thematic analysis. Themes generated from shared participant experiences and knowledge included the following: (1) Experiencing hardship or challenges; (2) Reflecting on the importance of supports; (3) Understanding relationships with food; and (4) Healing and recovery. Overall, the participants described a generally positive experience with the bariatric pathway. Participants also described varied connectedness to their Indigenous identity but uniformly expressed interest in more culturally diverse supports such as sharing circles, access to an elder, and Indigenous peer mentorship. Indigenous Peoples have strong motivators for pursuing bariatric surgery and desire access to culturally relevant supports. Suggestions for program improvement included offering sharing circles, providing access to an elder, and Indigenous peer mentorship. This study is the first to qualitatively explore the bariatric surgery experiences of Indigenous Peoples in Canada.

Housing and respiratory health among Indigenous peoples in Canada

Indigenous (First Nations, Metis and Inuit) peoples bear a disproportionate burden of infectious and noninfectious respiratory disease in rural and urban communities in Canada. Biologic and behavioral determinants exist and have relevance, but the primary determinants are socioeconomic, environmental and political. Although Canada has recently declared a national housing crisis, crowded and poor-quality housing, or no housing at all, has been experienced by generations of Indigenous peoples. Crowding in homes or shelters increases risk of exposure and dose to infectious agents. Indoor air pollutants are due to housing defects, sources of heat and smoke, and include mold, endotoxin, mite allergens, gases and particulate matter, which in turn are associated with respiratory irritation and disease. Environmental radon is a noted risk factor for lung cancer in communities located in high risk regions. Studies have demonstrated that interventions in Indigenous communities on both the social and biomedical fronts, to improve housing and health care, result in improved well-being, of which respiratory health is only one component.

Cancer Prevention and Cultural Continuity for Métis Peoples in Canada: A Scoping Review.

The purpose of this scoping review was to map the literature on the relationship between cultural continuity and health among Métis people as well as how this knowledge could be translated into cancer prevention initiatives. We included any Métis-specific literature evaluating connections between culture, health, and well-being. We conducted electronic searches of Medline, PubMed, Embase, PsychInfo, I-Portal, and hand-searched journals, and reviewed the grey literature. Based on our inclusion criteria, articles were screened and assessed for eligibility, resulting in a sample of 22 publications. Qualitative, quantitative, and mixed methods designs were considered. The 22 publications included in this review were diverse, ranging from population-based studies to reports and news articles. There were no limitations to publication year, and most of the data presented in this review were published more than five years ago. Nevertheless, the results demonstrate the potential role of Métis cultural continuity in cancer prevention. The scoping review revealed the current lack of Métis-specific data regarding health and its intersectionality with culture. However, the existing literature indicates that cultural continuity for Métis appears to influence health and well-being positively. As such, there may be benefits to incorporating cultural continuity in cancer prevention efforts.

Trends in mental health and smoking disparities between sexual minority and heterosexual adults in Canada, 2003–2020

Sexual minority populations experience a higher burden of mental health and substance use/misuse conditions than heterosexual comparators—a health inequality that has predominantly been attributed to forms of minority stress experienced by the former group. Sexual minority-affirming legislative and policy advances, as well as improvements in social attitudes toward sexual minorities in recent decades, should presumably reduce experiences of minority stress, thereby attenuating these disparities. We conducted temporal trend analyses of annual prevalence of anxiety, depression, poor self-rated mental health, and cigarette smoking, stratified by sexual orientation and gender/sex subgroups using the Canadian Community Health Survey, 2003–2020. Descriptive analyses were used to display temporal trends; joinpoint regression was used to identify significant changes in prevalence data during 2003–2020; and prevalence ratios were estimated by year to detect any reduction in disparities. The prevalence of self-rated mental health and mood and anxiety disorders increased, whereas the prevalence of smoking decreased, between 2003 and 2020, among both sexual minority and heterosexual people in Canada. We observed a significant inflection point in 2009 in the self-rated mental health trend among bisexual women, where rates of poor mental health initially decreased from 2003 but then increased drastically from 2009 to 2020. Significant inflection points in current smoking trends were observed in 2012 among bisexual and heterosexual women and in 2013 among heterosexual men; in all three groups, both segments demonstrated decreasing trends, however, the slope of the trend became more pronounced in the latter period. Consistent with other North American studies, we found that relative differences between sexual minority and heterosexual groups for all four outcomes remained the same or increased during this 18-year period. Findings highlight the need to better understand mechanisms bolstering sexual orientation health disparities.

Cultural Exclusion and the Transformation of the Cultural Landscape: The Origins of Anti-Chinese Racism in Canada

Anti-Chinese racism in Canada is a social structure of racialized exclusion that over time came to be built into the settler colonialism that continues to shape the country. Colonizers of European, and especially of British and French origins, have consequently created the cultural landscapes that constitute the country (i.e., its material constructions and dominant cultural overlays). When read against these landscapes, people of Chinese origins and members of other racialized groups continue to be positioned as aliens who do not belong in the country in way in which people racialized as white are not. Focusing on British Columbia (BC), Canada’s westernmost province, and the historical activity of people of Chinese origins, this paper traces the history of anti-Chinese racism and its links to Anglo-Canadian settler colonialism. Canada has long been linked to China, and the Chinese entered BC at the same time as Europeans before the country existed. Despite this, Chinese people have repeatedly been positioned as threats to Anglo-Canadian dominance, and especially to control over the land and its resources. Chinese Canadian resistance to racist exclusions, along with that of other groups, has led to the elimination of legislated exclusions. However, historic exclusions continue to shape cultural landscapes and popular understandings of who belongs and who does not. Remaking these landscapes requires an antiracist project of pursuing common projects that cross over racialized differences to remake the territory in ways that affirm the presence of all the peoples of Canada.