Moving beyond the historical quagmire of measuring infant mortality for the First Nations population in Canada

Infant mortality is a metric influenced by societal, political and medical advances. The way vital events are collected and reported are not always uniform. A lack of uniformity has disadvantaged some groups in society. In Canada, a multi-jurisdictional vital statistics system has truncated our ability to produce infant mortality rates for the Indigenous population. To understand how this evolved, this paper outlines the history of infant mortality, generally and internationally, and then documents the efforts to harmonize the collection and reporting of vital statistics (births and deaths) in Canada. Following this analysis is a historical review of vital event reporting for Canada's Indigenous population. A major finding of this paper is that racism, reframing, and jurisdictional posturing has limited our ability to accurately estimate live births and infant deaths for the Indigenous population. To improve Indigenous infant mortality estimation, Canada's governments need to transcend multijurisdictional challenges and fulfill international reporting obligations to Indigenous communities.