Current and potential future trends in the burden of acute gastrointestinal illness (AGI) in Rigolet, Nunatsiavut and Iqaluit, Nunavut, Canada were investigated in the context of climate change. A concurrent mixed methods design was used in which quantitative and qualitative data were concurrently collected and analyzed and then combined to better understand the burden of AGI. In-depth interviews with government stakeholders (n=11), PhotoVoice workshops (n=11), and two community surveys (n=185) were conducted to identify and characterize climate-sensitive health priorities in the Nunatsiavut region. Then, four cross-sectional retrospective surveys in Rigolet (two community censuses, n=462) and Iqaluit (two surveys with randomly selected households, n=1,055), as well as in-depth interviews with cases (n=9) were conducted to examine the incidence, risk factors, and healthcare seeking behavior of AGI. Finally, a scenario planning approach was used to identify and rank trends and conditions driving changes in future waterborne disease in Nunatsiavut. This involved in-depth interviews with national and international experts (n=20) and community focus group discussions (n=29). Climate-sensitive health priorities identified in Nunatsiavut included food security, water security, mental health, new hazards and safety concerns, and health services and delivery. The annual estimated incidence of self-reported AGI ranged from 2.9-3.9 cases/person/year in Rigolet and Iqaluit, which are the highest published estimates globally. Significant risk factors for AGI included food, water, animal exposure, and socio-economic conditions; while community interviewees perceived hygiene, retail food, tap water, boil water advisories, and personal stress to be important risk factors. The proportion of AGI cases seeking medical services ranged from 3-19%, which are among the lowest published rates globally. In the scenario planning process, critical drivers of AGI included ‘extreme weather events’; ‘technology development’; and ‘global interest in Northern resources’. These results provided information about AGI-related exposures and sensitivities to climate change, which can be used to provide information for public health planning, prioritization, and programming in Inuit regions. The improved understanding of AGI in two Canadian Aboriginal communities sheds light on the need to better understand the burden in sub-sets of the population that might be at higher risk, including Aboriginal populations in the context of climate change. / Vanier Canada Graduate Scholarship (CIHR); Public Health Agency of Canada; IRIACC initiative (CIHR, NSERC, SSHRC, IDRC); Nasivvik Centre for Inuit Health and Changing Environments

This thesis is a descriptive study of health care in the Inuit settlement of Gjoa Haven, N.W.T. The purpose of the research was primarily to describe and analyse the interactional networks of health and illness related behaviour that are associated with the Nursing Station. The cultural and organizational background of the administrators and nurses who provide medical services to Inuit are described, as are the attitudes and beliefs held by Inuit about illness and about the health care delivery system.<p>The thesis examines the acculturation of Inuit beliefs and practices related to illness throughout the contact period and focuses particularly on the changing role of the Inuit healer, the anqatquq or shaman. Various influences such as epidemic diseases, missionary activity, and changing economic orientations that have contributed to Inuit dependency patterns and changed beliefs about illness, its causes and cures, are detailed.<p>Theoretically, the thesis is partly a study of the replacement of a traditional medical system by the cosmopolitan medical system and the gradual attenuation of the traditional curer's role. It is also an examination of the manner in which the conflict resulting from differences in attitudes between administrators, nurses and Inuit, affects the delivery and utilization of health services in Gjoa Haven. It demonstrates that where problems occur they are as much a result of conflict between administrators and nurses, as they are due to conflict between nurses and Inuit.<p>The substantive portion of the thesis examines specific domains of interaction such. as health education, agency coordination and native participation and points out areas where failure occurs in each of these arenas. Recommendations are included that suggest strategies for improving the effectiveness of health care delivery and ultimately the health levels of the Inuit population.

This thesis is a descriptive study of health care in the Inuit settlement of Gjoa Haven, N.W.T. The purpose of the research was primarily to describe and analyse the interactional networks of health and illness related behaviour that are associated with the Nursing Station. The cultural and organizational background of the administrators and nurses who provide medical services to Inuit are described, as are the attitudes and beliefs held by Inuit about illness and about the health care delivery system.<p>The thesis examines the acculturation of Inuit beliefs and practices related to illness throughout the contact period and focuses particularly on the changing role of the Inuit healer, the anqatquq or shaman. Various influences such as epidemic diseases, missionary activity, and changing economic orientations that have contributed to Inuit dependency patterns and changed beliefs about illness, its causes and cures, are detailed.<p>Theoretically, the thesis is partly a study of the replacement of a traditional medical system by the cosmopolitan medical system and the gradual attenuation of the traditional curer's role. It is also an examination of the manner in which the conflict resulting from differences in attitudes between administrators, nurses and Inuit, affects the delivery and utilization of health services in Gjoa Haven. It demonstrates that where problems occur they are as much a result of conflict between administrators and nurses, as they are due to conflict between nurses and Inuit.<p>The substantive portion of the thesis examines specific domains of interaction such. as health education, agency coordination and native participation and points out areas where failure occurs in each of these arenas. Recommendations are included that suggest strategies for improving the effectiveness of health care delivery and ultimately the health levels of the Inuit population.

This study sought to characterize the risk to human health from dietary mercury (Hg) exposure in two Inuit communities, Repulse Bay and lgloolik. Hg exposure was estimated using food frequency questionnaires. Body burden was determined by measuring Hg in hair samples. Estimated average daily Hg exposures for women of child-bearing age were 21.3 mug in Repulse Bay, and 6.0 mug in lgloolik; the general population exposures were 43.1 mug in Repulse Bay and 23.2 mug in lgloolik. Average hair concentrations were 2.1 mg/kg and 2.8 mg/kg in Repulse Bay, 2.1 mg/kg and 6.2 mg/kg in lgloolik for women of child-bearing age and the general population respectively. No participants had concentrations above the "at risk" concentration of 30 mg/kg. Significant correlations were observed between hair Hg concentration and traditional food intake. These results do not necessitate direct intervention, but validate continued monitoring of Hg exposure in Nunavut.

No description available.

Societies that foster high quality social environments and integration produce healthier populations. The mechanisms underlying the protective effect of social integration appear to be through various forms of social support. In the Canadian Aboriginal context, few authors have explored the relationship between health and social support. This gap in understanding is significant because Aboriginal frameworks of health point to the salience of larger social structures (i.e., family), yet patterns of population health point to distinctly social causes of morbidity and mortality (e.g., violence, alcoholism). An interesting paradox emerges: patterns of Aboriginal health suggest that social support is not working to promote health. This dissertation explores this paradox through a mixed-methods approach to describe the value of social support for Aboriginal health, and to critically examine the social-structural processes and mechanisms through which social support influences Aboriginal health at the community level. / Principal components analyses of the 2001 Aboriginal Peoples Survey (APS) identified social support as a consistent dimension of Metis and Inuit health, and multivariable logistic regression modelling of the 2001 APS identified social support to be a significant determinant of thriving health among Indigenous men and women (e.g., those reporting their health as excellent/very good versus good/fair/poor). The results also indicate a distinct social gradient in thriving health status and social support among Aboriginal Canadians. / Narrative analyses of 26 interviews with Aboriginal Community Health Representatives point to two key explanations for the health-support paradox: (i) social support is not a widely accessible resource; and (ii) the negative health effects of social support can outweigh the positive ones. The formation of health behaviours and cultural norms - which underpin social supports - are inextricably tied to the poor material circumstances that characterize Canada's Aboriginal communities. The thesis concludes with a critical examination of the processes through which environmental dispossession has influenced the determinants of Aboriginal health, broadly speaking. Effects are most acute within the material and social environments of Aboriginal communities. More research attention should focus on identifying the pathways through which the physical, material and social environments interact to influence the health of Aboriginal Canadians.

No description available.