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The existing cancer-related disparities among Inuit are rooted in the structural conditions that create health and health care inequities. No comprehensive review currently exists about structural factors that facilitate or hinder Inuit’s access to and experiences with cancer care services in Canada. The overall aim of this scoping review was to synthesize the available published and grey literature on the structural factors that influence cancer care experienced by Inuit in Canada. Guided by the Joanna Briggs Institute (JBI) scoping review methodology, searches were conducted in a number of electronic databases, grey literature sources, and relevant journals. The extracted data were synthesized using thematic analysis and presented using tables and narrative summaries. Quality assessment was performed for each included study on its relevance to Inuit communities. A total of 30 papers were included in this review. The structural factors were identified and described through five categories related to: colonization, as well as health systems, social, economic, and political structures. Addressing the structural barriers that Inuit face in the cancer care trajectory requires a system-wide approach. Thesis results inform health care delivery and nursing practice with the goal of improving health equity for Inuit in cancer care.

The ongoing Missing and Murdered Indigenous Women (MMIW) crisis has affected thousands of families throughout the United States and Canada, resulting in probable trauma to children in the families and communities for generations. Although awareness of the crisis has been growing in recent years through avenues such as social media (#MMIW, etc.), little action has been taken to stem the crisis and its effects. The effects of the crisis on the children left behind is a compelling question that is not often addressed in the media, however. A systematic review of the scientific literature from the United States and Canada was conducted with the addition of gray literature due to limited results found in the scientific literature. The gray literature examined included relevant websites of relevant organizations and news articles. Results of the study demonstrated a dearth of data related to children and MMIW, with no research studies found. The articles analyzed were primarily focused on recommendations and did not specifically address the effects of MMIW on children. Gray literature findings included mention of some policy actions on state and national levels, including many calls to action that have not yet been addressed or implemented. The lack of data regarding the support needs of children affected by MMIW may be one of the reasons actions have been largely absent. One of the possible courses of action may be to better support Native/Indigenous scholars who have insider status. The MMIW crises is deeply personal and perhaps overwhelming to research, indicating support needs for Native/Indigenous scholars in addition to funding.

One of the most visible impacts of climate change in Arctic environments is declining sea ice. Due to an absence of spatially coarse quantitative data, there is a lack of understanding on declining sea ice on a community scale. This study seeks to document historical trends in air temperature, sea ice thickness (SIT), break-up dates (BUDs) and freeze-up dates (FUDs), correlate sea ice behaviour to air temperatures, and document the socio-economic impacts of sea ice change in Resolute Bay Nunavut, using traditional Inuit knowledge (TIK) and scientific methods. During the scientific portion of this study linear regression, statistical significance, anomaly analysis, and change point detection were used on time series of sea ice concentration (SIC), SIT, and air temperature. Two SIC datasets were accessed to characterize BUDs and FUDs, Canadian Ice Services archived sea ice charts from 1982-2022 and Copernicus Climate Change Services (C3S) gridded satellite derived SIC from 1979-2015. The BUD was defined when SIC fell and stayed below 20%, and the FUD was when SIC returned and stayed above 50%. By applying a statistically significant linear regression to both datasets, the BUD was shown to occur 37.5 days earlier and the FUD occurred 23.4 days later in 2022 than in 1979. This study accessed two SIT datasets, Environment and Climate Change Canada fast ice measurements from 1947-2022 and C3S satellite derived sea ice freeboard measurements from 2002-2020 at four locations in the Barrow Strait. After applying change point detection algorithms, this study found annual maximum fast ice thicknesses increased 32.5 cm from 1948-1981 and decreased 33.2 cm from 1981-2021. Fast ice decreased most substantially in the months of April and May. Sea ice freeboard decreased by 260.8 cm on average from 2002-2020 in the Barrow Strait. Freezing degree days (FDDs) were used to correlate sea ice behaviour to air temperature. As FDDs decrease, sea ice freeboard was the most rapidly changing sea ice parameter and fast ice thickness was most strongly correlated to FDDs. Both these results indicate that air temperature has a greater effect on SIT than the BUD and FUD. During the TIK investigation of this study, seventeen community members from Resolute Bay, Nunavut, ranging from age 19-81 were interviewed about their perception of changes in SIT, BUD, FUD, and seasonal weather patterns. Participants were interviewed about the socio-economic impacts of sea ice change, traditional Inuit methods of determining thickness, and asked to indicate typical areas of thin and thick ice, areas that break-up and freeze-up first, and hunting and travel routes on printed maps. The interviewees described a decline in sea ice thickness, areas of thin ice in the Barrow Strait, north of Cornwallis Island, and between Bathurst and Devon Island, less frequent use of the sea ice, less traditional food available in the community, increased vessel traffic, a decrease in seal population, new species and birds in the area, and detailed traditional methods of determining ice thickness through observation of color and use of the harpoon. Agreement between traditional knowledge and the scientific data was present in typical break-up and freeze-up patterns, and annual maximum thickness decreasing over time. While most respondents indicated FUD was later and BUD earlier, more participants responded there have been changes to the FUD than the BUD, whereas the scientific data showed more severe changes to the BUD than FUD. During interviews, there was consensus that summer temperatures are getting warmer but there was variability in responses when asked about winter temperatures. The scientific results showed less warming in the summer (Jun-Aug) than winter months (Jan-Mar) with the most warming in the fall (Sept-Nov). The lack of agreement between these results could be attributed to local perceived changes to winter weather referring to storminess rather than strictly temperature. TIK provided small scale information about the sea ice that the current state of scientific observation can not. In conclusion, a more holistic understanding of sea ice behaviour can be achieved by including Inuit traditional knowledge in partnership with scientific methods.

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