Search Results (13)

Amid the surge in research on mobility and migration in the context of environmental change, little research has focused on the experiences of people for whom travel is cyclical and a part of daily, weekly, or seasonal life. For Inuit in Arctic North America, the land is the heart of cultural and community life. Disruption to time spent on the land is reported to impact the emotional health and well-being of individuals and communities. There is concern that environmental change is creating barriers to safe travel, constituting a creeping disaster. We systematically review and evaluate the literature for discussion of barriers to travel for Inuit in Arctic North America, using an approach from the field of disaster anthropology to identify root causes of constraints to mobility. We identify root causes of risk and barriers to time spent on the land. These emerge from historic and contemporary colonial policy and inequality, as opposed to environmental hazards per se, impacting people’s mobility in profound ways and enacting a form of slow violence. These results suggest a need to understand the underlying processes and institutions that put people at risk. Full article

The history of health research in Inuit communities in Canada recounts unethical and colonizing research practices. Recent decades have witnessed profound changes that have advanced ethical and community-driven research, yet much work remains. Inuit have called for research reform in Inuit Nunangat, most recently creating the National Inuit Strategy on Research (NISR) as a framework to support this work. The present study details the process undertaken to create a research program guided by the NISR to address food security, nutrition, and climate change in Inuit Nunangat. Four main elements were identified as critical to supporting the development of a meaningful and authentic community-led program of research: developing Inuit-identified research questions that are relevant and important to Inuit communities; identifying Inuit expertise to answer these questions; re-envisioning and innovating research methodologies that are meaningful to Inuit and reflect Inuit knowledge and societal values; and identifying approaches to mobilizing knowledge that can be applied to support food security and climate change adaptation. We also identify considerations for funding agencies to support the meaningful development of Inuit-led research proposals, including aligning funding with community priorities, reconsidering who the researchers are, and investing in community infrastructure. Our critical reflection on the research program development process provides insight into community-led research that can support Inuit self-determination in research, enhance local ethical conduct of research, privilege Inuit knowledge systems, and align Inuit-identified research priorities with research funding opportunities in health research. While we focus on Inuit-led research in Nunavut, Canada, these insights may be of interest more broadly to Indigenous health research. Full article

Mining in Inuit Nunangat relies on a southern Canada fly-in/fly-out (FIFO) and local workforce. The FIFO workforce, combined with existing social determinants of health, can create health risks to Inuit Nunangat. These risks were increased with COVID-19. As newspaper reporting can shape public opinion and policy actions regarding these COVID-19 risks, we systematically searched databases to identify newspaper articles during the initial phase of COVID-19 (i.e., articles published from 1 January to 30 June 2020). Descriptive statistics and qualitative thematic analysis were used to analyze the nature, range, and extent of included articles. Most included articles were published by Inuit Nunangat-based newspapers. Half the sources quoted were mining companies and most reported reactions to their initial response were negative. The most frequent topic was concern that an infected FIFO employee could transmit COVID-19 to a worksite and subsequently infect Inuit employees and communities. Inuit Nunangat-based newspapers were crucial in shaping the narrative of the initial response. National newspapers mainly focused on the takeover of TMAC™ during the pandemic, while Inuit Nunangat-based newspapers provided timely and locally-relevant pandemic information. Without Inuit Nunangat-based newspapers, the reporting would be from national and southern newspapers, which was less in-depth, less frequent, and less relevant to Inuit. Full article

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. Full article

Globally, farmers report high levels of occupational stress. The purpose of this study was to identify and explore factors associated with perceived stress among Canadian farmers. A sequential explanatory mixed-methods design was used. An online cross-sectional national survey of Canadian farmers (n = 1132) was conducted in 2015–2016 to collect data on mental health, demographic, lifestyle, and farming characteristics; stress was measured using the Perceived Stress Scale. A multivariable linear regression model was used to investigate the factors associated with perceived stress score. Qualitative interviews (n = 75) were conducted in 2017–2018 with farmers and agricultural sector workers in Ontario, Canada, to explore the lived experience of stress. The qualitative interview data were analyzed via thematic analysis and then used to explain and provide depth to the quantitative results. Financial stress (highest category—a lot: (B = 2.30; CI: 1.59, 3.00)), woman gender (B = 0.55; CI: 0.12, 0.99), pig farming (B = 1.07; CI: 0.45, 1.69), and perceived lack of support from family (B = 1.18; CI: 0.39, 1.98) and industry (B = 1.15; CI: 0.16–2.14) were positively associated with higher perceived stress scores, as were depression and anxiety (as part of an interaction). Resilience had a small negative association with perceived stress (B = −0.04; CI: −0.06, −0.03). Results from the qualitative analysis showed that the uncertainty around financial stress increased perceived stress. Women farmers described the unique demands and challenges they face that contributed to their overall stress. Results from this study can inform the development of mental health resources and research aimed at decreasing stress among Canadian farmers. Full article

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. Full article

Across Inuit Nunangat, Inuit rely on wildlife for food security, cultural continuity, intergenerational learning, and livelihoods. Caribou has been an essential species for Inuit for millennia, providing food, clothing, significant cultural practices, and knowledge-sharing. Current declines in many caribou populations—often coupled with hunting moratoriums—have significant impacts on Inuit food, culture, livelihoods, and well-being. Following an Inuit-led approach, this study characterized Inuit-caribou relationships; explored Inuit perspectives on how caribou have been managed; and identified opportunities for sustaining the Mealy Mountain Caribou. Qualitative data were collected in Rigolet, Nunatsiavut, Labrador, Canada through 21 in-depth interviews and two community open houses. Data were analyzed using constant comparative methods and thematic analysis. Rigolet Inuit described: how conservation management decisions had disrupted important connections among caribou and Inuit, particularly related to food, culture, and well-being; the socio-cultural and emotional impacts of the criminalization of an important cultural practice, as well as perceived inequities in wildlife conservation enforcement; and the frustration, anger, and hurt with not being heard or included in caribou management decisions. These results provide insights into experiences of historic and ongoing colonial wildlife management decisions, and highlight future directions for management initiatives for the health and well-being of Inuit and caribou. Full article

This study evaluated the impact of “In the Know” mental health literacy training for Canadian agriculture. We hypothesized that “In the Know” would significantly increase participants’ knowledge around mental health, confidence in recognizing mental health struggles, confidence in speaking about mental health with others, and confidence in helping someone who may be struggling with mental health. “In the Know” was a 4-h, in-person program delivered by a mental health professional who also had experience in agriculture. Six sessions were offered in Ontario, Canada in 2018. Participants were farmers and/or worked primarily with farmers. A pre-training paper questionnaire was administered, followed by a post-training questionnaire at the end of the session and 3 and 6 month post-training questionnaires via email. Wilcoxon signed-rank tests were performed to compare participants’ self-reported knowledge and confidence across four timepoints. “In the Know” significantly improved participants’ self-reported mental health knowledge and confidence in recognizing mental health struggles, speaking to others, and helping others who are struggling immediately following training and often at 3 and 6 months post-training. This is the first study among farming populations to measure program impact with 3- and 6-month follow-ups. Given the reported associations between mental health literacy and increased help-seeking, disseminating “In the Know” more broadly across farming communities may help to increase mental health literacy and thus increase help-seeking among farmers. Full article

Climate change impacts on water systems have consequences for Indigenous communities. We documented climatic changes on water systems observed by Indigenous Shawi and resultant impacts on health and livelihoods, and explored adaptation options and challenges in partnership with two Indigenous Shawi communities in the Peruvian Amazon. Qualitative data were collected via PhotoVoice, interviews, focus group discussions, and transect walks, and analyzed using a constant comparative method and thematic analysis. Quantitative data were collected via a household survey and analyzed descriptively. Households observed seasonal weather changes over time (n = 50; 78%), which had already impacted their family and community (n = 43; 86%), such as more intense rainfall resulting in flooding (n = 29; 58%). Interviewees also described deforestation impacts on the nearby river, which were exacerbated by climate-related changes, including increased water temperatures (warmer weather, exacerbated by fewer trees for shading) and increased erosion and turbidity (increased rainfall, exacerbated by riverbank instability due to deforestation). No households reported community-level response plans for extreme weather events, and most did not expect government assistance when such events occurred. This study documents how Indigenous peoples are experiencing climatic impacts on water systems, and highlights how non-climatic drivers, such as deforestation, exacerbate climate change impacts on water systems and community livelihoods in the Peruvian Amazon. Full article

Sustainable Development Goal 6 (SDG-6) addresses poor water quality, inadequate sanitation, and improper hygiene, all of which negatively impact health and disproportionately impact Indigenous Peoples’ health. Understanding and responding to local contexts is critical to effectively improve water, sanitation, and hygiene (WASH); however, in-depth understanding of local knowledge, practices, and perceptions are often overlooked. As such, this study described the knowledge, practices, and perceptions of WASH held by residents of two Indigenous Shawi communities in the Peruvian Amazon. Quantitative data were collected via a cross-sectional survey and analyzed using descriptive statistics. Qualitative data were collected via interviews, PhotoVoice, focus group discussions, and participatory transect walks, and analyzed using a constant comparative approach to thematic analysis. Emergent themes included characterizing water sources, collection methods, and consumption patterns; knowledge, perceptions, and practices related to WASH; and knowledge and perceptions of health issues related to WASH. This study provides insight into the ongoing challenges related to WASH in Indigenous communities in the Peruvian Amazon and highlights the need to prioritize interventions that will advance WASH-related SDGs. Full article

Environments are shifting rapidly in the Circumpolar Arctic and Subarctic regions as a result of climate change and other external stressors, and this has a substantial impact on the health of northern populations. Thus, there is a need for integrated surveillance systems designed to monitor the impacts of climate change on human health outcomes as part of broader adaptation strategies in these regions. This review aimed to identify, describe, and synthesize literature on integrated surveillance systems in Circumpolar Arctic and Subarctic regions, that are used for research or practice. Following a systematic realist review approach, relevant articles were identified using search strings developed for MEDLINE^® and Web of Science™ databases, and screened by two independent reviewers. Articles that met the inclusion criteria were retained for descriptive quantitative analysis, as well as thematic qualitative analysis, using a realist lens. Of the 3431 articles retrieved in the database searches, 85 met the inclusion criteria and were analyzed. Thematic analysis identified components of integrated surveillance systems that were categorized into three main groups: structural, processual, and relational components. These components were linked to surveillance attributes and activities that supported the operations and management of integrated surveillance. This review advances understandings of the distinct contributions of integrated surveillance systems and data to discerning the nature of changes in climate and environmental conditions that affect population health outcomes and determinants in the Circumpolar North. Findings from this review can be used to inform the planning, design, and evaluation of integrated surveillance systems that support evidence-based public health research and practice in the context of increasing climate change and the need for adaptation. Full article

This article characterizes the health risk perceptions toward excreta and wastewater management practices among waste management stakeholders in Vietnam and explores the implications of such perceptions on hygiene behaviors and preventative actions. Key informant interviews (n = 19; 12 women and 7 men) were conducted with farmers, community leaders, researchers, and government representatives in Hanoi and Ha Nam Province. Interviews were audio-recorded with permission, transcribed, and analyzed using a constant comparative method and qualitative thematic analysis. Researchers and government representatives perceived that the lack of knowledge of safe waste management practices among farmers was responsible for the use of “outdated” and often “unsafe” waste management practices. However, many farmers were aware of the health risks and safe hygienic practices but felt that safety measures were impractical and viewed susceptibility to diseases as low risk. Farmers also identified unfavorable climate and working conditions, limited financial capacity, and limited farm space as barriers to adopting safe management practices. At the broader level, inadequate communication between ministries often led to the creation of inconsistent waste management regulations. These barriers create constraints on efforts to improve sustainable waste management practices. Promoting collaboration between sectors, encouraging farmer-to-farmer knowledge sharing, and designing and implementing risk communication strategies that account for risk perceptions of stakeholders are recommended. Full article

Background: Season and weather are associated with many health outcomes, which can influence hospital admission rates. We examined associations between hospital admissions (all diagnoses) and local meteorological parameters in Southwestern Uganda, with the aim of supporting hospital planning and preparedness in the context of climate change. Methods: Hospital admissions data and meteorological data were collected from Bwindi Community Hospital and a satellite database of weather conditions, respectively (2011 to 2014). Descriptive statistics were used to describe admission patterns. A mixed-effects Poisson regression model was fitted to investigate associations between hospital admissions and season, precipitation, and temperature. Results: Admission counts were highest for acute respiratory infections, malaria, and acute gastrointestinal illness, which are climate-sensitive diseases. Hospital admissions were 1.16 (95% CI: 1.04, 1.31; p = 0.008) times higher during extreme high temperatures (i.e., >95th percentile) on the day of admission. Hospital admissions association with season depended on year; admissions were higher in the dry season than the rainy season every year, except for 2014. Discussion: Effective adaptation strategy characteristics include being low-cost and quick and practical to implement at local scales. Herein, we illustrate how analyzing hospital data alongside meteorological parameters may inform climate-health planning in low-resource contexts. Full article