First Nations and Inuit Health Branch

Ottawa, Canada

First Nations and Inuit Health Branch

Ottawa, Canada
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Legrand M.,Environment Canada | Feeley M.,Health Products and Food Branch | Tikhonov C.,First Nations and Inuit Health Branch | Schoen D.,Environment Canada | Li-Muller A.,Environment Canada
Canadian Journal of Public Health | Year: 2010

Exposure to methylmercury (MeHg) from fish and marine mammal consumption continues to present a public health concern. To date, developmental neurotoxicity is the most sensitive health outcome, forming the basis for health-risk assessments and the derivation of biomonitoring guidance values. This article summarizes existing Health Canada MeHg blood guidance values for general population and expands them to include a harmonized provisional interim blood guidance value of 8 μg/L based on the existing provisional Tolerable Daily Intake for children, pregnant women and women of childbearing age. Associated public health actions, according to age, sex, and level of exposure are recommended. © 2010 Canadian Public Health Association.

Li V.,Provincial Laboratory for Public Health | Chui L.,Provincial Laboratory for Public Health | Chui L.,University of Alberta | Simmonds K.,Alberta Ministry of Health | And 6 more authors.
Journal of Clinical Microbiology | Year: 2014

Methicillin-resistant Staphylococcus aureus (MRSA) has become one of the most significant pathogens affecting global public health and health care systems. In Canada and the United States, the spread of MRSA is primarily attributed to a single dominant epidemic clone: CMRSA10/USA300. Despite this, the CMRSA7/USA400 epidemic clone has been reported to be the predominate epidemic clone in several Canadian provinces and some parts of the United States. This study examined the epidemiology of CMRSA7/USA400 MRSA in Alberta, Canada, from June 2005 to December 2012. Molecular characterization of CMRSA7/USA400 isolates was done using spa, SCCmec, PVL, and PFGE typing and identified two predominant spa types in Alberta: t128 and t1787. Although closely related, these spa types have distinct geographic distributions. From 2010 to 2012, the number of t128 infections has remained stable while there has been a nearly 3-fold increase in the number of provincial t1787 infections, accompanied by 10-fold increases in t1787 infection rates in some communities. Most t128 and t1787 patients were First Nations or Inuit people, and isolates were usually from skin and soft tissue infections in outpatients. t128 patients were significantly older than t1787 patients. Antimicrobial susceptibility testing showed higher mupirocin resistance in t1787 than in t128 MRSA. Improved strategies to reduce or stabilize t1787 infections in Alberta are needed. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Tjepkema M.,Statistics Canada | Wilkins R.,Statistics Canada | Wilkins R.,University of Ottawa | Goedhuis N.,First Nations and Inuit Health Branch | Pennock J.,First Nations and Inuit Health Branch
Chronic Diseases and Injuries in Canada | Year: 2012

Objective: To compare cardiovascular disease mortality patterns between First Nations people and non-Aboriginal adults by sex and by income adequacy quintile and level of educational attainment. Methods: A 15% sample of 1991 Canadian census respondents aged 25 years or older was previously linked to 11 years of mortality data. In this study, First Nations people were defined by North American Indian ethnic origin (ancestry), registration under the Indian Act, and/or membership in an Indian band or First Nation. The cohort included 62 400 First Nations people and 2 624 300 non-Aboriginal people. Results: Compared to non-Aboriginal cohort members, the age-standardized cardiovascular disease mortality rate was 30% higher for First Nations men and 76% higher for First Nations women. This represented an excess of 58 deaths and 71 deaths per 100 000 person-years at risk, for First Nations men and women, respectively. Within each income adequacy quintile (adjusted for family size and region of residence) and level of educational attainment, the risk of dying from cardiovascular disease was higher for First Nations people compared to their non-Aboriginal counterparts. Conclusion: First Nations people had higher rates of death from cardiovascular disease than non-Aboriginal Canadians within each income quintile and level of education. Income and education accounted for 67% and 25% of the excess mortality of First Nations men and women respectively.

Carriere G.M.,Statistics Canada | Tjepkema M.,Statistics Canada | Pennock J.,First Nations and Inuit Health Branch | Goedhuis N.,First Nations and Inuit Health Branch
International Journal of Circumpolar Health | Year: 2012

Objectives. To compare cancer incidence patterns between residents of Inuit Nunangat and the rest of Canada. Study design. Cancer cases were geographically linked to either Inuit Nunangat or the rest of Canada using postal codes or other geographic information. Population estimates were derived from the 2001 and 2006 censuses. Methods. Cancer cases were combined from 1998 to 2007 for Inuit Nunangat and the rest of Canada. Agestandardised incidence rates were calculated for all site cancers and sub-sites by sex. Standardised rate ratios between these 2 areas were calculated for all site cancers and sub-sites. Results. The age-standardised incidence rate for all cancer sites (1998-2007) was 14% lower for the Inuit Nunangat male population and 29% higher for the female population by comparison to the rest of Canada. Cancers of the nasopharynx, lung and bronchus, colorectal, stomach (males), and kidney and renal pelvis (females), were elevated in the Inuit Nunangat population compared to the rest of Canada, whereas prostate and female breast cancers were lower in the Inuit Nunangat population. Conclusions. Cancers with potentially modifiable risk factors, such as buccal cavity and pharynx, nasopharynx, lung and bronchus, and colorectal cancer were elevated in the Inuit Nunangat population compared to the rest of Canada. Besides greater smoking prevalence within Inuit Nunangat by comparison to the rest of Canada, distinct socioeconomic characteristics between respective area populations including housing, and income may have contributed to incidence differentials. This study demonstrated that a geographic approach can be used in cancer surveillance when populations of interest are spatially distinguishable, and reside across distinct jurisdictions whose combined cancer registries will not completely provide information to identify the population of interest. © 2012 Gisèle M. Carrière et al.

Pollock S.L.,Public Health Agency of Canada | Sagan M.,First Nations and Inuit Health Manitoba Region | Oakley L.,First Nations and Inuit Health Manitoba Region | Fontaine J.,First Nations and Inuit Health Branch | Poffenroth L.,First Nations and Inuit Health Manitoba Region
Canadian Journal of Public Health | Year: 2012

Objectives: First Nations communities in Manitoba were significantly affected by the pandemic H1N1 influenza virus (pH1N1) in 2009. Our objective was to conduct an epidemiologic investigation of a pH1N1 outbreak in one remote First Nations community (population 3,300) in northern Manitoba to inform a timely public health response and provide recommendations for preventing future outbreaks. Methods: Chart reviews were conducted at the nursing station for patients meeting the influenza-like illness (ILI) case definition during the study period (April 20 to June 11, 2009). Descriptive analyses examined age, gender, clinical presentation, management, outcomes and risk factors. Comparisons were made for hospitalized versus non-hospitalized cases and laboratory-confirmed versus possible cases using Pearson's chi-square test for gender and symptoms and using a t-test for age. Results: There were 180 ILI cases, including 23 laboratory-confirmed cases of pH1N1. Forty percent of children <1 year old in the community and 9.4% of pregnant women presented to the nursing station with ILI. Most ILI cases were managed through the community nursing station, although 18.3% of cases (n=33) were medically evacuated and 16.1% (n=29) were hospitalized. There were no differences between hospitalized versus non-hospitalized or laboratory-confirmed versus possible cases. Risk factors identified in a subset of cases included exposure to an individual with ILI prior to illness onset, overcrowding and inadequate access to household water. Conclusions: Early arrival and rapid transmission of pH1N1 rendered usual non-pharmacological control measures largely ineffective. Recommendations for prevention of future outbreaks include an effective communications strategy and daily surveillance for disease detection and monitoring. Key determinants of health should be addressed in remote First Nations communities to prevent disease and protect the health of these populations. © Canadian Public Health Association, 2012.

PubMed | Health Analysis Division and First Nations and Inuit Health Branch
Type: Journal Article | Journal: Health reports | Year: 2015

Avoidable mortality is a measure of deaths that potentially could have been averted through effective prevention practices, public health policies, and/or provision of timely and adequate health care. This longitudinal analysis compares avoidable mortality among First Nations and non-Aboriginal adults.Data are from the 1991-to-2006 Canadian Census Mortality and Cancer Follow-up Study. A 15% sample of 1991 Census respondents aged 25 or older was linked to 16 years of mortality data. This study examines avoidable mortality among 61,220 First Nations and 2,510,285 non-Aboriginal people aged 25 to 74.During the 1991-to-2006 period, First Nations adults had more than twice the risk of dying from avoidable causes compared with non-Aboriginal adults. The age-standardized avoidable mortality rate (ASMR) per 100,000 person-years at risk for First Nations men was 679.2 versus 337.6 for non-Aboriginal men (rate ratio = 2.01). For women, ASMRs were lower, but the gap was wider. The ASMR for First Nations women was 453.2, compared with 183.5 for non-Aboriginal women (rate ratio = 2.47). Disparities were greater at younger ages. Diabetes, alcohol and drug use disorders, and unintentional injuries were the main contributors to excess avoidable deaths among First Nations adults. Education and income accounted for a substantial share of the disparities.The results highlight the gap in avoidable mortality between First Nations and non-Aboriginal adults due to specific causes of death and the association with socioeconomic factors.

Wang J.W.,McGill University | Mark S.,First Nations and Inuit Health Branch | Henderson M.,McGill University | O'Loughlin J.,University of Montréal | And 4 more authors.
Pediatric Obesity | Year: 2013

Background: Sugar-sweetened beverage (SSB) consumption is linked to weight gain and metabolic syndrome (MetS) components in children, but whether these associations are modified by excess weight and glucose tolerance status in children is not known. Objective: The objective of this study was to examine the cross-sectional associations between SSB intake and MetS components among children above and below the 85th body mass index (BMI) percentile and those with and without impaired glucose tolerance (IGT). Methods: Data were from the QUébec Adiposity and Lifestyle InvesTigation in Youth study (2005-2008). Caucasian children aged 8-10 years (n = 632) were recruited from 1040 primary schools in Québec, Canada. SSB consumption was assessed by three 24-h dietary recalls, body fat mass by dual-energy absorptiometry, physical activity by 7-d accelerometer. Multivariate linear regressions were used, with age, sex, fat mass index and physical activity as covariates, including waist circumference (WC), systolic blood pressure (SBP), concentrations of triglyceride and high-density lipoprotein cholesterol and homeostasis model assessment of insulin resistance (HOMA-IR) as outcome variables. Results: Among overweight children, a 100-mL higher SSB consumption was associated with a 0.1-unit higher HOMA-IR (P = 0.009) and a 1.1-mm Hg higher SBP (P = 0.001). In children with IGT, a 100-mL higher SSB consumption was associated with a 1.4-mm Hg higher SBP and a 4.0-cm higher WC (P

PubMed | Alberta First Nations Information and Governance Center, University of Calgary, First Nations and Inuit Health Branch and Alberta First Nations Leadership Table
Type: Journal Article | Journal: BMC health services research | Year: 2016

Uncontrolled disease activity in inflammatory diseases of the joints, skin and bowel leads to morbidity and disability. Disease-modifying therapies are widely used to suppress this disease activity, but cost-coverage is variable. For Treaty First Nations and Inuit people in Canada without alternative private or public health insurance, cost-coverage for disease-modifying therapy is provided through Non-Insured Health Benefits (NIHB). Our objective was to describe the prevalence and patterns of treatment with disease-modifying therapy for the NIHB claimant population, and also examine adjuvant therapy (analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids) use.Cases (n=2512) were defined by 1 claim for a disease-modifying anti-rheumatic drug (DMARD) or biologic between 1999 and 2012 in the NIHB pharmacy claim database. The proportion of the population with claims for individual agents and drug classes annually was calculated to estimate annual incidence and prevalence rates for use of disease-modifying therapy, and the prevalence of use of individual DMARDs, biologics and adjuvants. Differences in the proportion accessing adjuvant therapies and median doses in the 6months following initiation of disease-modifying therapies was estimated.The incidence rate of treatment was calculated at an average of 127.5 cases per 100,000 population between 2001 and 2012, and the cumulative prevalence, accounting for patients lost to the database, increased and then stabilized at 1.3% in the last three years of the study. Annual dispensation of methotrexate, combination DMARD therapy and biologic therapy approached 35%, 19%, and 10% of the cohort respectively. A declining prevalence of claims for acetaminophen (28% to 15%) and anti-inflammatories (73% to 63%) occurred from 2000 to 2012, however corticosteroid (32%) and opioid (65%) dispensation remained stable. The proportion of patients with claims for NSAIDs (69.9% to 61.1%, p=0.002), oral corticosteroids (45.4% to 33.6%, p<0.001) and parenteral corticosteroids (16.2% to 8.3%, p=0.002) decreased in the 6months following biologic initiation.The proportion of NIHB clients with active claims for disease-modifying therapy is lower than expected based on existing epidemiologic knowledge of the prevalence of inflammatory conditions in the First Nations and Inuit populations. These findings should be further explored in order to optimize treatment outcomes for NIHB claimants with inflammatory disease.

Hossack F.,First Nations and Inuit Health Branch | An H.,University of Alberta
Environment and Development Economics | Year: 2014

Cash is often used in economic experiments as an incentive to encourage realistic decision making or to compensate participants for their time. However, in many less developed countries, remunerating participants with cash can upset existing relationships with local institutions. In cases where the use of cash is not feasible, an alternative type of payment is required. Using a framed field experiment in Odisha, India (formerly Orissa), we explore an alternative payment method, in-kind, where typical household items are used in place of cash. We compare the differences in the valuation of yield stabilizing seed traits between in-kind and cash. Our results suggest that farmers are willing to pay less for seeds when they are paid cash than when they are paid in-kind. Bids are higher by 1.18 Indian Rupees when farmers are paid in-kind, corresponding to about a 7 per cent higher valuation. Copyright © Cambridge University Press 2014.

Konrad S.,University of Saskatchewan | Skinner S.,University of Saskatchewan | Kazadi G.B.,First Nations and Inuit Health Branch | Gartner K.,University of Saskatchewan | Lim H.J.,University of Saskatchewan
Canadian Journal of Infectious Diseases and Medical Microbiology | Year: 2013

Objective: To characterize and identify determinants of HIV disease progression among a predominantly injection drug use (IDU) HIV population in the highly active antiretroviral therapy era. Methods: The present retrospective study was based on 343 HIV patients diagnosed from 2005 to 2010 from two clinics in Saskatoon, Saskatchewan. Disease progression was defined as the time from diagnosis to immunological AIDS (CD4 count <200 cells/μL) and death. Uni- and multivariable Cox proportional hazards models were used. Results: Of the 343 patients, 79% had a history of IDU, 77% were hepatitis C virus (HCV) coinfected and 67% were of Aboriginal descent. The one-year and three-year immunological AIDS-free probabilities were 78% and 53%, respectively. The one-year and three-year survival probabilities were 97% and 88%, respectively. Multicollinearity among IDU, HCV and ethnicity was observed and, thus, separate models were built. HCV coinfection (HR 2.9 [95% CI 1.2 to 6.9]) was a significant predictor of progression to immunological AIDS when controlling for baseline CD4 counts, treatment, age at diagnosis and year of diagnosis. For survival, only treatment use was a significant predictor (HR 0.34 [95% CI 0.1 to 0.8]). HCV coinfection was marginally significant (P=0.067). Conclusion: Baseline CD4 count, HCV coinfection, year of diagnosis and treatment use were significant predictors of disease progression. This highlights the importance of early treatment and the need for targeted interventions for these particularly vulnerable populations to slow disease progression.

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