Misi Yehewin (big breath): a cross-sectional survey series of Métis health and wellbeing during the early COVID-19 pandemic in Alberta, Canada

Introduction: The COVID-19 pandemic disproportionately affected Indigenous populations, yet Métis-specific data remain limited. We described COVID-19-related experiences, physical and mental health, health behaviours, and socio-economic wellbeing among Métis people in Alberta (Canada) during the early pandemic. Methods: was a cross-sectional survey series conducted with the Otipemisiwak Métis Government of the Métis Nation within Alberta. Self-identified Métis aged ≥16 years completed surveys in three phases: December 2020-January 2021 (Wave 1), March-April 2021 (Wave 2), and November-December 2021 (Wave 3). Each wave included an independent sample of participants. We calculated weighted proportions for 28 key items and compared estimates across waves. Results: Overall, 2,439 participants completed the surveys. Confirmed COVID-19 cases were reported by 5% of participants in Wave 1 and 15% in Wave 3. Reports of worsening physical and mental health were less frequent in later phases; yet, across waves, 41% screened positive for depressive symptoms, 47% for anxiety, and 68% for high perceived stress. Food insecurity was reported by 39.4% of participants in Wave 1 and 52.9% in Wave 3. Reduced family time and cultural activities were common, particularly in earlier waves. Reports of financial strain (~56%), racism (~25%), and strong Métis identity (~89%) was similar across waves. Conclusion: Findings highlight ongoing structural inequities influencing Métis health during COVID-19. Despite fewer reports of worsening overall health in later phases, symptom-based measures showed persistently high perceived stress and widespread food insecurity. Métis-led, culturally grounded strategies are needed to address both immediate and long-term determinants of health.