Open Access Research article

Contextual determinants of health behaviours in an aboriginal community in Canada: pilot project

Pamela Joseph14, A Darlene Davis2, Ruby Miller2, Karen Hill2, Honey McCarthy2, Ananya Banerjee1, Clara Chow3, Andrew Mente134 and Sonia S Anand134*

Author Affiliations

1 Department of Medicine and Epidemiology, McMaster University, 1280 Main St, Hamilton, Ontario, L8S 4K1, Canada

2 Six Nations Health Services, 1745 Chiefswood Road, Ohsweken, ON, N0A 1M0, Canada

3 Population Health Research Institute, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada

4 Chanchlani Research Centre, McMaster University, 1280 Main St. W., MDCL Rm. 3204, Hamilton, Ontario, L8S 4K1, Canada

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BMC Public Health 2012, 12:952  doi:10.1186/1471-2458-12-952

Published: 7 November 2012



Rapid change in food intake, physical activity, and tobacco use in recent decades have contributed to the soaring rates of obesity, type 2 diabetes and cardiovascular disease (CVD) in Aboriginal populations living in Canada. The nature and influence of contextual factors on Aboriginal health behaviours are not well characterized.


To describe the contextual determinants of health behaviours associated with cardiovascular risk factors on the Six Nations reserve, including the built environment, access and affordability of healthy foods, and the use of tobacco.

In this cross-sectional study, 63 adults from the Six Nations Reserve completed the modified Neighbourhood Environment Walkability Scale (NEWS), questionnaire assessing food access and availability, tobacco pricing and availability, and the Environmental Profile of Community Health (EPOCH) tool.


The structured environment of Six Nations Reserve scored low for walkability, street connectivity, aesthetics, safety, and access to walking and cycling facilities. All participants purchased groceries off-reserve, although fresh fruits and vegetables were reported to be available and affordable both on and off-reserve. On average $151/week is spent on groceries per family. Ninety percent of individuals report tobacco use is a problem in the community. Tobacco is easily accessible for children and youth, and only three percent of community members would accept increased tobacco taxation as a strategy to reduce tobacco access.


The built environment, access and affordability of healthy food and tobacco on the Six Nations Reserve are not perceived favourably. Modification of these contextual factors described here may reduce adverse health behaviours in the community.

Obesity; Aboriginal health; Health behaviours; Environment design