The Regional Health Survey (RHS) is a unique national survey of the health and wellness of First Nations people living on-reserve in BC. The RHS is a First Nations-led and -governed survey that combines the understandings of health and wellness among First Nations peoples and the Western health system. The creation of the RHS was mandated by the Assembly of First Nations Chiefs in Assembly in 1994 to fill a gap in knowledge about the health and wellness of First Nations people living on-reserve.i The results of this survey have informed programs and policies that affect the health and wellbeing of individuals, families, and communities. The communities that the FNHA serves have told us that they need good data, collected and shared in a good way, to support strong health governance in their communities.
Three phases of the RHS have been conducted with First Nations in BC; Phase 1 in 2002-2003; Phase 2 in 2008-2010; and Phase 3 in 2015-2017. The FNHA has also committed to Phase 4, with data collection planned for 2020.
For the first time ever, regional-level results and reports will be returned to communities in addition to a provincial-level report. In response to community leadership requests and in order to honour the directives and mandate given to the FNHA by First Nations in BC, the FNHA expanded the sampling strategy for Phase 3 of the RHS. This is exciting because it allowed us to reach more people and more communities than ever before and allowed us to report findings on a regional level. Data collection for Phase 3 of the RHS was carried out from 2015 – 2017. More than 5,700 participants in 122 communities participated. Click here for more information about the national RHS Phase 3.
What makes the RHS unique?
The RHS is the only First Nations-led and -governed national health survey in Canada. It captures a snapshot of the health and wellness of First Nations people living on-reserve and is conducted approximately every five years. The RHS uses three questionnaires to gather information about participants: children (aged 0-11), youth (aged 12-17), and adults (18+). The survey covers a range of topics related to wholistic health and wellness, including mental health and wellness, primary health care, social determinants of health, traditional wellness, health status, and health behaviours. As a survey conducted by First Nations for First Nations, the RHS is a powerful example of First Nations data governance – meaning control and decision-making over how information is collected, used, and shared.
The survey is unique in that RHS staff engage with First Nations community leadership and receive their consent before inviting individual community members to participate. Each participating community completes a Band Council Resolution consenting to participation. Individual participants or their legal guardians complete personal consent forms. Because of this, community privacy has to be protected in the same way as individual privacy.
The RHS is governed nationally by the First Nations Information Governance Centre (FNIGC), which is a First Nations organization that works towards data sovereignty and supports First Nations information and data governance. The First Nations Health Authority (FNHA), in collaboration with First Nations in BC, is responsible for the RHS in BC.
The RHS is guided by the First Nations principles of OCAP® (Ownership, Control, Access, and Possession) and is a leading example of First Nations self-determination in research. The FNIGC established the RHS Code of Ethics, which is based on OCAP®, to outline principles and procedures for carrying out the survey. The FNHA follows the OCAP® principles and the Code of Ethics in coordinating the RHS. This means that we collaborate with regions and communities to ensure all stages of the survey are carried out ethically. Communities and regions played a key role in all aspects of the RHS Phase 3, including selection of indicators and priorities, data collection, and reporting. The FNHA will work closely with communities to ensure that Phase 3 findings are shared ethically in a good way.
Until 1994, First Nations living on-reserve were excluded from all national surveys in Canada. To address this gap, the Assembly of First Nations (AFN) mandated the creation of a National Steering Committee in 1996 to explore the possibility of creating a First Nations-specific population health survey. This committee worked with technical advisors and supporters to develop a pilot survey called the First Nations and Inuit Regional Longitudinal Health Survey (FNIRHS), which was carried out in 1997. This pilot survey evolved into the Regional Health Survey.
Phase 1 of the RHS took place from 2002 to 2003. It was coordinated by the First Nations Chiefs' Health Committee, which no longer exists. The FNHA took over the RHS during Phase 2 in the midst of the transfer of all Health Canada's First Nations Inuit Health Branch services in BC. Phase 2 took place from 2008 to 2010 and Phase 3 occurred from 2015 to 2017.
The First Nations Information Governance Centre (FNIGC) was officially established in 2010 and has since been responsible for the national coordination of the RHS. The FNIGC, and its earlier forms, are data stewards at the national level, and responsible for funding and coordinating the regional partners that steward the data at the regional level.
Data collection for Phase 4 is set to begin in 2020.
RHS Phase 1 National Reports
RHS Phase 2 BC Provincial Report
If you have any questions about the RHS and/or data access, please contact the FNHA at RHS@fnha.ca
First Nations Information Governance Centre. (n.d.) About RHS. Retrieved from: http://fnigc.ca/our-work/regional-health-survey/about-rhs.html
The First Nations Health Council, which is now the First Nations Health Authority, took over the responsibility for managing the Regional Health Survey (RHS) during Phase 2 of the survey. 2,476 people in 36 communities participated in data collection for Phase 2, which took place from 2008 to 2010. See the following reports for the provincial findings from RHS Phase 2.
The following map shows the percentage of participants that were from each health region.
Percentage of RHS Phase 2 survey participants from each health region
2008-10 RHS Summary Report PDF (1.74 mb)
2008-10 RHS Report PDF (6.93 mb)
The national reports of the RHS Phase 2 findings can be found at https://fnigc.ca/publications.html
If you have any questions about the RHS, please contact the FNHA Surveys team at RHS@fnha.ca
The Regional Health Survey (RHS ) is a national health survey conducted by and for First Nations. It captures a snapshot of the health and wellness of First Nations peoples living on reserves across Canada. The FNHA, in collaboration with First Nations in BC, is responsible for the RHS in BC and for sharing the knowledge gathered through the survey. Data collection for phase 3 of the RHS was carried out from 2015 – 2017. The FNHA is preparing five regional reports and one provincial report on the RHS Phase 3 findings. The reports are due to be publicly released in the fall of 2019.
In response to community leadership requests and in order to honour the directives and mandate given to the FNHA by First Nations in BC, the FNHA expanded the sampling strategy for Phase 3 of the RHS. This allowed us to reach more people and more communities and, for the first time, allowed us to report findings on a regional level. Regional reporting will provide regional teams and communities with local information to guide decision-making.
In consultation with FNHA regions, every community in the Interior, Fraser Salish and Vancouver Coastal was invited to participate. Vancouver Island and the Northern region chose to invite slightly fewer communities. Leadership in each health region determined their level of involvement through established regional governance processes. 5,739 First Nations people in 122 communities participated. This is approximately double the number of communities and individuals that participated in Phase 2. Their responses reflect the voices and perspectives of First Nations peoples living on-reserve, from birth to old age.
The following map shows the number of participants in each health region.
Number of RHS Phase 3 survey participants in each health region
Communities and community members played a key role in collecting data for the third phase of the RHS. Data collection was carried out between December 2015 and 2017. Field supervisors and support staff were hired from each region to support regional data collection. Community navigators were also hired from within each community whenever possible. Data collectors supported community members to take the survey wherever they felt most comfortable, whether that be band office, health centre, their homes, or another setting. Adults and youth filled out their own surveys and a parent or caregiver was asked to respond on behalf of children (aged 0-11). If individuals needed help filling out the survey, data collectors provided assistance. Their hard work was essential to carrying out this large important survey.
RHS Team Meeting, 2016
The RHS asks many questions and gathers more data than is manageable to be shared in a single report. An indicator selection process was used to determine which questions would be included in the RHS Phase 3 summary reports. Regional and national representatives selected which major sections to include in the reports. They also identified and prioritized questions within each section. The most frequently identified topics and questions were prioritized to be included in the reports.
Areas of interest for the RHS Phase 3 were selected by consulting representatives from all five First Nations Health Authority regions (Fraser Salish, Interior, Norther, Vancouver Coastal and Vancouver Island). These areas of interest were selected by all five regions:
• Traditional wellness, • Mental health and wellness, • Primary health care
• Traditional wellness,
• Mental health and wellness,
• Primary health care
Regional results for all RHS questions will be shared with all communities that participated in Phase 3. It will be accompanied with a clear, simple guide to interpreting the results. Regional results are returned to communities so that First Nations own and control their data, and will allow the data to inform First Nations' decision-making, program planning, and evaluation and community-level health policy.
The national reports of the RHS Phase 3 findings can be found at https://fnigc.ca/publications.html
Provincial and Regional Reports
The provincial and regional reports for RHS Phase 3 will be released in the summer and fall of 2019.
If you have any questions about the RHS, please contact the FNHA Surveys at RHS@fnha.ca