Swanson and Colman provide a much-needed analysis of associations between exposure to suicide and suicidality outcomes among Canadian youth.1
Youth suicide in Canada cannot be fully understood without consideration of First Nations, Inuit or Métis populations. Some researchers conclude that suicide among Aboriginal people must be considered a different disease from suicide among non-Aboriginal people, with its own antecedent causes.2,3 Suicide rates are 5 to 7 times higher for First Nations youth than for non-Aboriginal youth, and rates among Inuit youth are about 11 times the national average.4,5 Suicide clusters among First Nations youth have been widely reported.4,6
Swanson and Colman are mistaken in their description of their data source as a “population-based nationally representative cohort.” The Canadian National Longitudinal Survey of Children and Youth “excludes children living on Indian reserves or Crown lands … and residents of some remote regions.”7 Such an exclusion should have been identified and addressed among the study’s limitations.
Researchers and editors must attend to health equity dimensions of their work, especially when allegedly representative data prevents us from attending to underserviced groups. Not only are there disparities between the health of Aboriginal and non-Aboriginal Canadians, but an epidemiological gap prevents researchers from understanding and addressing such problems. Some scholars have expressed concern that a lack of data sources including Aboriginal populations may represent a “concerted effort by the government to diminish the collection of data about Aboriginal health conditions.”8
Aboriginal leadership and national agencies have called for research to take place through reciprocal trusting relationships between researchers and Aboriginal people.9 This should never offer a convenient excuse to exclude Aboriginal peoples from national studies when such a relationship has not been established. Scholars exploring subjects with important Aboriginal dimensions should have to defend choices to overlook these populations in purportedly national or representative studies.