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Vigneault LP, Diendere E, Sohier-Poirier C, Abi Hanna M, Poirier A, St-Onge M. Acute health care among Indigenous patients in Canada: a scoping review. Int J Circumpolar Health 2021; 80:1946324. [PMID: 34320910 PMCID: PMC8330756 DOI: 10.1080/22423982.2021.1946324] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/14/2021] [Accepted: 06/17/2021] [Indexed: 11/25/2022] Open
Abstract
A recent report by the Chief Public Health Officer of Canada demonstrates the inferior health status of Indigenous Peoples in Canada when compared to non-Indigenous populations. This scoping review maps out the available literature concerning acute health care for Indigenous Peoples in Canada in order to better understand the health care issues they face. All existing articles concerning health care provided to Indigenous Peoples in Canada in acute settings were included in this review. The targeted studied outcomes were access to care, health care satisfaction, hospital visit rates, mortality, quality of care, length of stay and cost per hospitalisation. 114 articles were identified. The most studied outcomes were hospitalisation rates (58.8%), length of stay (28.0%), mortality (25.4%) and quality of care (24.6%) Frequently studied topics included pulmonary disease, injuries, cardiovascular disease and mental illness. Indigenous Peoples presented lower levels of satisfaction and access to care although they tend to be over-represented in hospitalisation rates for acute care. Greater inclusion of Indigenous Peoples in the health care system and in the training of health care providers is necessary to ensure a better quality of care that is culturally safe for Indigenous Peoples.
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Affiliation(s)
| | - Ella Diendere
- Centre de recherche sur les soins et les services de première ligne de l’Université Laval (CERSSPL-UL), Quebec, Canada
| | | | - Margo Abi Hanna
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Annie Poirier
- Département de médecine familiale et de médecine d'urgence, Université Laval, Quebec, Canada
| | - Maude St-Onge
- Département de médecine familiale et de médecine d'urgence, Université Laval, Quebec, Canada
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Climate Change and Enteric Infections in the Canadian Arctic: Do We Know What’s on the Horizon? GASTROINTESTINAL DISORDERS 2021. [DOI: 10.3390/gidisord3030012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The Canadian Arctic has a long history with diarrheal disease, including outbreaks of campylobacteriosis, giardiasis, and salmonellosis. Due to climate change, the Canadian Arctic is experiencing rapid environmental transformation, which not only threatens the livelihood of local Indigenous Peoples, but also supports the spread, frequency, and intensity of enteric pathogen outbreaks. Advances in diagnostic testing and detection have brought to attention the current burden of disease due to Cryptosporidium, Campylobacter, and Helicobacter pylori. As climate change is known to influence pathogen transmission (e.g., food and water), Arctic communities need support in developing prevention and surveillance strategies that are culturally appropriate. This review aims to provide an overview of how climate change is currently and is expected to impact enteric pathogens in the Canadian Arctic.
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Inuit Country Food and Health during Pregnancy and Early Childhood in the Circumpolar North: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052625. [PMID: 33807905 PMCID: PMC7967653 DOI: 10.3390/ijerph18052625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 02/08/2023]
Abstract
Inuit communities in the Circumpolar North have experienced a nutrition transition characterized by the decreased intake of culturally important, nutrient-rich traditional food (country food), and an increased intake of market food, resulting in concerns over reduced diet quality and emerging chronic diseases. Nutrition in early life is critical for development, may influence health risks in later life, and is an important concern for Inuit community health. The goal of this scoping review was to characterize the nature, extent, and range of the published literature on Inuit country food and health in pregnancy and childhood. A search string was developed and applied to three databases, followed by title and abstract screening and full text review. Articles published between 1995 and 2019 were included, and data were extracted and summarized descriptively. The number of articles generally increased over time, despite the unequal geographic distribution of articles. The majority of the articles focused on environmental contaminants, and one-quarter described nutrient adequacy. Few articles described food security or food safety in pregnancy, and the most utilized quantitative methods. Gaps in understanding of country food use in pregnancy and early childhood highlight areas of future research to support public health policy for this population. Given the critical role of good nutrition in early life and the important contribution country food makes to diet quality for Inuit, further understanding of this interface is warranted.
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Saini M, Roche S, Papadopoulos A, Markwick N, Shiwak I, Flowers C, Wood M, Edge VL, Ford J, Wright C, Harper SL. Promoting Inuit health through a participatory whiteboard video. Canadian Journal of Public Health 2019; 111:50-59. [PMID: 31025298 DOI: 10.17269/s41997-019-00189-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 01/22/2019] [Indexed: 01/17/2023]
Abstract
SETTING The Inuit community of Rigolet experiences greater rates of self-reported acute gastrointestinal illness (AGI) compared to southern Canada. INTERVENTION A whiteboard video tool was collaboratively developed by Rigolet youth, community members, the research team and key regional stakeholders to share public health recommendations for reducing the risk of AGI. The video debuted in Rigolet at a community event in August 2016 and was later provided online for community members and local and regional health departments. Interviews and focus group discussions were used to evaluate the ability of the video to communicate public health information to community members in Rigolet. OUTCOMES Community and government viewers reported that the whiteboard video was novel and engaging. Evaluation participants believed the video was suitable for promoting Inuit health because of the use of locally relevant visuals and narrative, which reflect Inuit art and storytelling traditions. Furthermore, participants indicated that the video co-development process was critical to ensuring community relevance of the video. Short-term outcome results suggest the video can reinforce health knowledge and potentially encourage behavioural change. IMPLICATIONS The results suggest this whiteboard video was an effective tool to share information and could increase intention to change behaviours to reduce the risk of AGI in Rigolet. While tools like the whiteboard video are gaining popularity, the participatory approach was used to develop the video, and its use in an Inuit context illustrates its innovation and novelty. This tool may be a useful health promotion tool among Indigenous communities in Canada.
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Affiliation(s)
- Manpreet Saini
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.
| | - Steven Roche
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.,ACER Consulting Ltd., 103A-100 Stone Road West, Guelph, ON, N1G 5L3, Canada
| | - Andrew Papadopoulos
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | | | - Inez Shiwak
- Rigolet Inuit Community Government, Rigolet, NL, A0P 1P0, Canada
| | - Charlie Flowers
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.,, Rigolet, NL, Canada
| | - Michele Wood
- Department of Health and Social Development, Nunatsiavut Government, 200 Kelland Drive, Happy Valley-Goose Bay, NL, A0P 1C0, Canada
| | - Victoria L Edge
- Public Health Agency of Canada, 160 Research Lane, Guelph, ON, N1G 5B2, Canada
| | - James Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, LS2 9JT, UK
| | | | | | | | - Carlee Wright
- School of Public Health at the University of Alberta, 11405 87 Ave.. NW, Edmonton, AB, T6G 1C9, Canada
| | - Sherilee L Harper
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.,School of Public Health at the University of Alberta, 11405 87 Ave.. NW, Edmonton, AB, T6G 1C9, Canada
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Kipp A, Cunsolo A, Gillis D, Sawatzky A, Harper SL. The need for community-led, integrated and innovative monitoring programmes when responding to the health impacts of climate change. Int J Circumpolar Health 2019; 78:1517581. [PMID: 31066653 PMCID: PMC6508048 DOI: 10.1080/22423982.2018.1517581] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 08/10/2018] [Accepted: 08/20/2018] [Indexed: 11/07/2022] Open
Abstract
In Northern Canada, climate change has led to many acute and interrelated health and environmental impacts experienced among Inuit populations. Community-based monitoring, in which community members participate in monitoring initiatives using various forms of technology, is a key strategy increasingly used to detect, monitor and respond to climate change impacts. To better understand the landscape of existing environmental and health monitoring programmes mobilising different technologies and operating in the North we conducted a review that used environmental scan methodologies to explore and contextualise these programmes. We consulted with academic researchers with experience in community-led monitoring, conducted systematic searches of grey and peer-reviewed literature, and conducted a secondary search for environment-health mobile-phone applications. Following specific criteria, we identified 18 monitoring programmes using information and communication technologies in the North, and three global monitoring mobile-phone applications, which cumulatively monitored 74 environment and health indicators. Several themes emerged, including the need for: (1) community leadership, (2) indicators of environment and/or human health and (3) innovative technology. This synthesis supports the development of community-led, environment-health monitoring programmes that use innovative technology to monitor and share information related to the health implications of climate change in and around Indigenous communities throughout the Circumpolar North.
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Affiliation(s)
- Amy Kipp
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
| | - Ashlee Cunsolo
- Labrador Institute, Memorial University, Happy Valley-Goose Bay, NL, Canada
| | - Daniel Gillis
- School of Computer Science, University of Guelph, Guelph, ON, Canada
| | - Alexandra Sawatzky
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
| | - Sherilee L. Harper
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Daley K, Truelstrup Hansen L, Jamieson RC, Hayward JL, Piorkowski GS, Krkosek W, Gagnon GA, Castleden H, MacNeil K, Poltarowicz J, Corriveau E, Jackson A, Lywood J, Huang Y. Chemical and microbial characteristics of municipal drinking water supply systems in the Canadian Arctic. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:32926-32937. [PMID: 28612312 DOI: 10.1007/s11356-017-9423-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 05/31/2017] [Indexed: 06/07/2023]
Abstract
Drinking water in the vast Arctic Canadian territory of Nunavut is sourced from surface water lakes or rivers and transferred to man-made or natural reservoirs. The raw water is at a minimum treated by chlorination and distributed to customers either by trucks delivering to a water storage tank inside buildings or through a piped distribution system. The objective of this study was to characterize the chemical and microbial drinking water quality from source to tap in three hamlets (Coral Harbour, Pond Inlet and Pangnirtung-each has a population of <2000) on trucked service, and in Iqaluit (population ~6700), which uses a combination of trucked and piped water conveyance. Generally, the source and drinking water was of satisfactory microbial quality, containing Escherichia coli levels of <1 MPN/100 mL with a few exceptions, and selected pathogenic bacteria and parasites were below detection limits using quantitative polymerase chain reaction (qPCR) methods. Tap water in households receiving trucked water contained less than the recommended 0.2 mg/L of free chlorine, while piped drinking water in Iqaluit complied with Health Canada guidelines for residual chlorine (i.e. >0.2 mg/L free chlorine). Some buildings in the four communities contained manganese (Mn), copper (Cu), iron (Fe) and/or lead (Pb) concentrations above Health Canada guideline values for the aesthetic (Mn, Cu and Fe) and health (Pb) objectives. Corrosion of components of the drinking water distribution system (household storage tanks, premise plumbing) could be contributing to Pb, Cu and Fe levels, as the source water in three of the four communities had low alkalinity. The results point to the need for robust disinfection, which may include secondary disinfection or point-of-use disinfection, to prevent microbial risks in drinking water tanks in buildings and ultimately at the tap.
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Affiliation(s)
- Kiley Daley
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Lisbeth Truelstrup Hansen
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark.
| | - Rob C Jamieson
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Jenny L Hayward
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Greg S Piorkowski
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- Alberta Agriculture and Forestry, Edmonton, AB, Canada
| | - Wendy Krkosek
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Graham A Gagnon
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Heather Castleden
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- Queen's University, Kingston, ON, Canada
| | - Kristen MacNeil
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Joanna Poltarowicz
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Emmalina Corriveau
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Amy Jackson
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Justine Lywood
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Yannan Huang
- Centre for Water Resources Studies, Dalhousie University, Halifax, NS, B3H 4R2, Canada
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King N, Vriezen R, Edge VL, Ford J, Wood M, Harper S. The hidden costs: Identification of indirect costs associated with acute gastrointestinal illness in an Inuit community. PLoS One 2018; 13:e0196990. [PMID: 29768456 PMCID: PMC5955559 DOI: 10.1371/journal.pone.0196990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/24/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Acute gastrointestinal illness (AGI) incidence and per-capita healthcare expenditures are higher in some Inuit communities as compared to elsewhere in Canada. Consequently, there is a demand for strategies that will reduce the individual-level costs of AGI; this will require a comprehensive understanding of the economic costs of AGI. However, given Inuit communities' unique cultural, economic, and geographic contexts, there is a knowledge gap regarding the context-specific indirect costs of AGI borne by Inuit community members. This study aimed to identify the major indirect costs of AGI, and explore factors associated with these indirect costs, in the Inuit community of Rigolet, Canada, in order to develop a case-based context-specific study framework that can be used to evaluate these costs. METHODS A mixed methods study design and community-based methods were used. Qualitative in-depth, group, and case interviews were analyzed using thematic analysis to identify and describe indirect costs of AGI specific to Rigolet. Data from two quantitative cross-sectional retrospective surveys were analyzed using univariable regression models to examine potential associations between predictor variables and the indirect costs. RESULTS/SIGNIFICANCE The most notable indirect costs of AGI that should be incorporated into cost-of-illness evaluations were the tangible costs related to missing paid employment and subsistence activities, as well as the intangible costs associated with missing community and cultural events. Seasonal cost variations should also be considered. This study was intended to inform cost-of-illness studies conducted in Rigolet and other similar research settings. These results contribute to a better understanding of the economic impacts of AGI on Rigolet residents, which could be used to help identify priority areas and resource allocation for public health policies and programs.
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Affiliation(s)
- Nia King
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Rachael Vriezen
- Department of Food, Agriculture, and Resource Economics, University of Guelph, Ontario, Canada
| | - Victoria L. Edge
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
- Indigenous Health Adaptation to Climate Change Research Team, Guelph, Ontario, Canada
| | - James Ford
- Indigenous Health Adaptation to Climate Change Research Team, Guelph, Ontario, Canada
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Michele Wood
- Department of Health and Social Development, Nunatsiavut Government, Goose Bay, Labrador, Canada
| | - IHACC Research Team
- Indigenous Health Adaptation to Climate Change Research Team, Guelph, Ontario, Canada
| | | | - Sherilee Harper
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
- Indigenous Health Adaptation to Climate Change Research Team, Guelph, Ontario, Canada
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Yansouni CP, Pernica JM, Goldfarb D. Enteric Parasites in Arctic Communities: Tip of the Iceberg? Trends Parasitol 2016; 32:834-838. [PMID: 27593337 DOI: 10.1016/j.pt.2016.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 08/04/2016] [Indexed: 01/18/2023]
Abstract
Human enteric parasitoses, particularly from Cryptosporidium, were recently recognized as being highly prevalent in parts of the Arctic. This is important because cryptosporidiosis has been repeatedly associated with impaired growth and development and may synergize with other challenges faced by children in remote Arctic communities, such as overcrowding and food insecurity.
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Affiliation(s)
- Cedric P Yansouni
- J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Canada.
| | - Jeffrey M Pernica
- Division of Infectious Disease, Department of Pediatrics, McMaster University, Hamilton, Canada
| | - David Goldfarb
- Department of Pathology and Laboratory Medicine, BC Children's and Women's Hospital, Vancouver, Canada
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