Summary: | Housing is a social determinant of health and specific equity concern for First Nations Peoples living on-reserve in Canada. Lasting results of discriminatory colonial structures and federal government control on-reserve include challenges with housing quality and quantity. Some First Nations face distressing levels of housing shortages and household crowding. This study was a multimethod secondary analysis of data collected in two community-based research studies with First Nations in Saskatchewan. The main research question was “What relationships exist between federal housing programs, household crowding, and health among First Nations Peoples living on-reserve in Saskatchewan?” Specific sub-questions were “How do First Nations Peoples in two communities in Saskatchewan describe challenges and solutions related to household crowding on-reserve?” and “What is the relationship between household crowding and (a) overall physical health, (b) overall mental health, and (c) chronic and infectious respiratory diseases among First Nations Peoples living on-reserve in two communities in Saskatchewan?” I undertook a qualitative secondary analysis of 34 interviews with First Nations adults living on-reserve to answer the first sub-question, where I identified four themes: (1) designing for kinship, (2) relieving system pressure, (3) planning instead of reacting, and (4) renovating alongside building. I completed a quantitative secondary analysis of interviewer-administered surveys from 831 First Nations adults living on-reserve to answer the second sub-question, where I identified the household crowding measure was significantly associated with chronic bronchitis diagnosis. Integration of findings to answer the overarching research question emphasized that federal housing systems need to change to improve housing status and related health outcomes on-reserve. Suggested federal-level changes include the provision of sufficient and sustained funding and support of First Nations’ control.
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