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Under international law, birth registration is considered a human right because it determines access to important legal protections as well as essential services and social supports across the lifespan. Difficulties related to birth registration and the acquisition of personal identification (PID) are largely regarded as problems specific to low-income countries. For Indigenous people in northern and rural Canada, however, lack of PID, like birth certificates, is a common problem that is rooted in the geography of the region as well as historical and contemporary settler colonial policies. This communication elucidates the complicated terrain of unregistered births for those people living in northern Ontario in order to generate discussion about how the social determinants of health for Indigenous people in Canada are affected by PID. Drawing on intake surveys, qualitative interviews and participant observation field notes, we use the case study of "Susan" as an entry point to share insights into the "intergenerational problem" of unregistered births in the region. Susan's case speaks to how unregistered births and lack of PID disproportionately impacts the health and well-being of Indigenous people and communities in northern Ontario. The implications and the need for further research on this problem in Canada are discussed.

A Case Study in Personal Identification and Social Determinants of Health: Unregistered Births among Indigenous People in Northern Ontario