Transforming Health Care in Remote Communities: report on an international conference

An international conference titled “Transforming Health Care in Remote Communities” was held at the Chateau Lacombe Hotel in Edmonton, Canada, April 28–30, 2016. The event was organized by the University of Alberta’s School of Public Health, in partnership with the Institute for Circumpolar Health Research in Yellowknife, Northwest Territories, and the Qaujigiartiit Health Research Centre in Iqaluit, Nunavut. There were 150 registrants from 7 countries: Canada (7 provinces and 3 territories), United States, Denmark, Iceland, Norway, Sweden, and Australia. They included representatives of academic institutions, health care agencies, government ministries, community organizations, and private industry. The Conference focused on developing solutions to address health care in remote regions. It enabled new networks to be established and existing ones consolidated

A Call for Urgent Monitoring of Food and Water Security Based on Relevant Indicators for the Arctic

This perspective paper argues for an urgent need to monitor a set of 12 concrete, measurable indicators of food and water security in the Arctic over time. Such a quantitative indicator approach may be viewed as representing a reductionist rather than a holistic perspective, but is nevertheless necessary for actually knowing what reality aspects to monitor in order to accurately understand, quantify, and be able to project critical changes to food and water security of both indigenous and non-indigenous people in the Arctic. More relevant indicators may be developed in the future, taking us further toward reconciliation between reductionist and holistic approaches to change assessment and understanding. However, the potential of such further development to improved holistic change assessment is not an argument not to urgently start to monitor and quantify the changes in food and water security indicators that are immediately available and adequate for the Arctic context

Community food program use in Inuvik, Northwest Territories

Background: Community food programs (CFPs) provide an important safety-net for highly food insecure community members in the larger settlements of the Canadian Arctic. This study identifies who is using CFPs and why, drawing upon a case study from Inuvik, Northwest Territories. This work is compared with a similar study from Iqaluit, Nunavut, allowing the development of an Arctic-wide understanding of CFP use – a neglected topic in the northern food security literature. Methods: Photovoice workshops (n=7), a modified USDA food security survey and open ended interviews with CFP users (n=54) in Inuvik. Results: Users of CFPs in Inuvik are more likely to be housing insecure, female, middle aged (35–64), unemployed, Aboriginal, and lack a high school education. Participants are primarily chronic users, and depend on CFPs for regular food access. Conclusions: This work indicates the presence of chronically food insecure groups who have not benefited from the economic development and job opportunities offered in larger regional centers of the Canadian Arctic, and for whom traditional kinship-based food sharing networks have been unable to fully meet their dietary needs. While CFPs do not address the underlying causes of food insecurity, they provide an important service for communities undergoing rapid change, and need greater focus in food policy herein

Arthrite dans la population autochtone canadienne : différences entre le Nord et le Sud en ce qui a trait à la prévalence et aux corrélats

Contexte Les données sur l’arthrite et les autres troubles musculosquelettiques chez les Autochtones sont rares. Les données d’enquête montrent que l’arthrite et le rhumatisme figurent parmi les troubles chroniques les plus fréquemment signalés et que leur prévalence est plus élevée chez les Autochtones que chez les non-Autochtones. Objectif Décrire le fardeau de l’arthrite au sein de la population autochtone du nord du Canada et démontrer l’impact social et l’importance sur le plan de la santé publique de cette maladie. Méthodologie À partir de données transversales recueillies auprès de plus de 29 000 personnes autochtones âgées de 15 ans et plus et ayant participé à l’Enquête auprès des peuples autochtones de 2006, les différences régionales relatives à la prévalence de l’arthrite ont été évaluées, de même que les liens avec l’utilisation des services de santé et certains facteurs de risque et de comorbidité. Résultats Dans les trois territoires du Nord (le « Nord »), la prévalence de l’arthrite était de 12,7 %, alors qu’elle était de 20,1 % dans les provinces (le « Sud »). Dans le Nord comme dans le Sud, la prévalence était plus élevée chez les femmes que chez les hommes. Elle demeure moins élevée chez les Inuits qu’au sein des autres groupes autochtones. Les personnes atteintes d’arthrite étaient davantage susceptibles de fumer, d’être obèses, de souffrir d’autres maladies chroniques et d’être sans emploi. Les Autochtones atteints d’arthrite ont utilisé le système de santé plus souvent que ceux ne souffrant pas de cette maladie. Conclusion Les conclusions concernant l’arthrite et d’autres maladies chroniques chez les Autochtones ainsi que la reconnaissance des différences entre le Sud et le Nord seront profitables pour la planification de programmes et l’établissement de nouvelles priorités en matière de promotion de la santé. </sec

Arthritis in the Canadian Aboriginal population: north-south differences in prevalence and correlates

Background Information on arthritis and other musculoskeletal disorders among Aboriginal people is sparse. Survey data show that arthritis and rheumatism are among the most commonly reported chronic conditions and their prevalence is higher than among non-Aboriginal people. Objective To describe the burden of arthritis among Aboriginal people in northern Canada and demonstrate the public health significance and social impact of the disease. Methods Using cross-sectional data from more than 29 000 Aboriginal people aged 15 years and over who participated in the Aboriginal Peoples Survey 2006, we assessed regional differences in the prevalence of arthritis and its association with other risk factors, co-morbidity and health care use. Results The prevalence of arthritis in the three northern territories ("North") is 12.7% compared to 20.1% in the provinces ("South") and is higher among females than males in both the North and South. The prevalence among Inuit is lower than among other Aboriginal groups. Individuals with arthritis are more likely to smoke, be obese, have concurrent chronic diseases, and are less likely to be employed. Aboriginal people with arthritis utilized the health care system more often than those without the disease. Conclusion Aboriginal-specific findings on arthritis and other chronic diseases as well as recognition of regional differences between North and South will enhance program planning and help identify new priorities in health promotion. </sec

Arthritis in the Canadian Aboriginal Population: North-South Differences in Prevalence and Correlates

BackgroundInformation on arthritis and other musculoskeletal disorders among Aboriginal people is sparse. Survey data show that arthritis and rheumatism are among the most commonly reported chronic conditions and their prevalence is higher than among non-Aboriginal people.ObjectiveTo describe the burden of arthritis among Aboriginal people in northern Canada and demonstrate the public health significance and social impact of the disease.MethodsUsing cross-sectional data from more than 29 000 Aboriginal people aged 15 years and over who participated in the Aboriginal Peoples Survey 2006, we assessed regional differences in the prevalence of arthritis and its association with other risk factors, co-morbidity and health care use.ResultsThe prevalence of arthritis in the three northern territories (“North”) is 12.7% compared to 20.1% in the provinces (“South”) and is higher among females than males in both the North and South. The prevalence among Inuit is lower than among other Aboriginal groups. Individuals with arthritis are more likely to smoke, be obese, have concurrent chronic diseases, and are less likely to be employed. Aboriginal people with arthritis utilized the health care system more often than those without the disease.Conclusion: Aboriginal-specific findings on arthritis and other chronic diseases as well as recognition of regional differences between North and South will enhance program planning and help identify new priorities in health promotion

Type-specific prevalence of Human Papillomavirus infection among women in the Northwest Territories, Canada

SummaryBackgroundCertain types of Human Papillomavirus (HPV) are highly associated with cervical cancer and precursor lesions (dysplasia), but the distribution of HPVs in Northern Canada is largely unknown. This study determined the prevalences of HPV infection due to different virus types and the association of different virus types with cervical dysplasia in the Northwest Territories (NWT).MethodsBetween April 2008 and March 2009, women who underwent routine Pap testing in the NWT were included in the study. An in-house Luminex assay detected type-specific HPV infections. The HPV prevalence rates and population attributable risk fractions were calculated.ResultsIn 5725 bio-samples, the overall HPV prevalence was 24.2%, and of the HPV-positive samples, 76.6% harbored high-risk types, 35.2% harbored multi-type infections, and 21.6% harbored HPV16 or 18 infections. The HPV prevalence was approximately 50% higher among Aboriginal than non-Aboriginal women. The age-specific HPV prevalence exhibited a U-shape distribution in the Aboriginal group. The prevalence of HPV16 or 18 infections found in high-grade lesions was 34.1%. Among this study population, 89.5% of the cases with cervical dysplasia were attributable to HPV infection, with 27.1% attributable to HPV16/18.ConclusionThe high prevalence of high-risk HPV in this population, particularly in the Aboriginal group, will require further studies to identify specific predictors of infection