Conceptualisation and Operationalisation of a Holistic Indicator of Health for Older Inuit: Results of a Sequential Mixed-Methods Project

Elder Inuit define health as holistic and multifaceted, which contrasts with health-related research where single factor indicators are usually used to measure health in an Inuit context. As the number of Inuit elders is growing, indicators derived from an Inuit definition of health are important if health systems are to be inclusive of the realities of Indigenous Peoples and culture. This study explored and operationalised a model of Inuit health in aging that draws from physical, emotional, spiritual, and interpersonal components identified as salient by participants in this research. Qualitative data gathered through two workshops with 21 participants were analysed to identify key dimensions of health from an Inuit perspective. Quantitative data were retrieved from Statistics Canada Aboriginal Peoples Survey (APS; 2006) with a weighted sample of 4450 Inuit aged ≥ 50 years residing across Inuit Nunangat. Using measures corresponding to the dimensions identified previously, Latent Class Analyses were applied to group survey participants into health profiles to create a holistic indicator of health. Multinomial regressions were conducted with related health and social measures to assess the concurrent validity of the indicator. Health was conceptualised along eight themes: general health balance, mental health, spirituality, not experiencing many activity limitations, being loved and having positive relationships, speaking Inuktitut, and being free of addiction. The holistic indicator grouped participants into three health profiles: (1) good health for most variables; (2) very good perceived and physical health, but poor mental health; and (3) poor health for most variables. Using mixed methods to bridge the concept of health defined in qualitative workshops with quantitative health indicators can contribute to the definition and description of a culturally relevant and sociologically complex understanding of healthy aging in an Inuit context.