Time filter

Source Type

Chatwood S.,University of Toronto | Chatwood S.,Institute for Circumpolar Health Research | Bjerregaard P.,University of Southern Denmark | Kue Young T.,University of Toronto
American Journal of Public Health | Year: 2012

Global health should encompass circumpolar health if it is to transcend the traditional approach of the "rich North" assisting the "poor South." Although the eight Arctic states are among the world's most highly developed countries, considerable health disparities exist among regions across the Arctic, as well as between northern and southern regions and between indigenous and nonindigenous populations within some of these states. While sharing commonalities such as a sparse population, geographical remoteness, harsh physical environment, and underdeveloped human resources, circumpolar regions in the northern hemisphere have developed different health systems, strategies, and practices, some of which are relevant to middle and lower income countries. As the Arctic gains prominence as a sentinel of global issues such as climate change, the health of circumpolar populations should be part of the global health discourse and policy development. (Am J Public Health.


PubMed | Memorial University of Newfoundland, University of Alberta, Institute for Circumpolar Health Research and Qaujigiartiit Health Research Center
Type: Journal Article | Journal: International journal of environmental research and public health | Year: 2016

Residents in the Canadian Arctic regularly travel in remote, backcountry areas. This can pose risks for injuries and death, and create challenges for emergency responders and health systems. We aimed to describe the extent and characteristics of media-reported backcountry travel emergencies in two Northern Canadian territories (Nunavut and Northwest Territories). A case-series of all known incidents between 2004 and 2013 was established by identifying events in an online search of two media outlets, Nunatsiaq News and Northern News Services. We identified 121 incidents; these most commonly involved young men, and death occurred in just over 25% of cases. The territories differed in the seasonal patterns. News media provides a partial source of data to estimate the extent and characteristics of backcountry emergencies. This information is needed to improve emergency preparedness and health system responsiveness in the Arctic.


Young T.K.,University of Alberta | Ng C.,University of Toronto | Chatwood S.,Institute for Circumpolar Health Research | Chatwood S.,University of Toronto
International Journal of Circumpolar Health | Year: 2015

Background. Health surveys are a rich source of information on a variety of health issues, including health care. Objectives. This article compares various national and regional surveys in terms of their geographical coverage with respect to the Canadian North, especially their Aboriginal population, and the comparability of the survey contents relating to health care. Methods. Three surveys were selected as providing some information on health care, with separate estimates for the North and its Aboriginal populations. They are the Canadian Community Health Survey (CCHS), Aboriginal Peoples Survey (APS) and the First Nations Regional Health Survey (RHS). Results. Different surveys focus on different categories of Aboriginal people, and no single survey has covered all categories of Aboriginal people in the North consistently. RHS is targeted at the on-reserve First Nations population only. APS and CCHS sample the off-reserve First Nations population as well as Métis and Inuit. To achieve adequate sample size for North–South comparisons and comparisons among Aboriginal groups within the North, several cycles of the biennial/annual CCHS can be merged, producing a large data set with consistent coverage of topics using comparable questions. The content areas of the 3 surveys can be broadly categorized as health status, health determinants and health care. Substantial variation exists across surveys in the domains covered. There are also changes over time in terms of definitions, questions and even basic concepts. The available health care content of the 3 surveys focus on access to different types of health services, contact with different categories of health professionals, unmet health needs and the use of preventive services. Many important dimensions of health care are not covered. Not all these basic indicators are available for the North or its Aboriginal populations. Conclusions. A comprehensive survey of health care in the North with sufficient sample size to provide reliable estimates for its subpopulations – urban and remote, Aboriginal and non-Aboriginal, and First Nations, Inuit and Métis – would provide useful information to decision-makers and service providers. Analytical studies can also be conducted to investigate the correlations and interactions among health status, health determinants and health care and assess whether such relationships differ among the different population groups. © 2015 T. Kue Young et al.


Ford J.D.,McGill University | Lardeau M.-P.,McGill University | Blackett H.,Institute for Circumpolar Health Research | Chatwood S.,Institute for Circumpolar Health Research | Kurszewski D.,Institute for Circumpolar Health Research
BMC Public Health | Year: 2013

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. © 2013 Ford et al.; licensee BioMed Central Ltd.


Ford J.D.,McGill University | Willox A.C.,Cape Breton University | Chatwood S.,Institute for Circumpolar Health Research | Furgal C.,Trent University | And 3 more authors.
American Journal of Public Health | Year: 2014

Climate change will have far-reaching implications for Inuit health. Focusing on adaptation offers a proactive approach for managing climate-related health risks-one that views Inuit populationsasactiveagents in planning and responding at household, community, and regional levels. Adaptation can direct attention to the root causes of climate vulnerability and emphasize the importance of traditional knowledge regarding environmental change and adaptive strategies. An evidence base on adaptation options and processes for Inuit regions is currently lacking, however,thusconstrainingclimate policy development. In this article, we tackled this deficit, drawing upon our understanding of the determinants of health vulnerability to climate change in Canada to propose key considerations for adaptation decision-making in an Inuit context.


Chatwood S.,Institute for Circumpolar Health Research | Chatwood S.,University of Toronto | Young K.,University of Toronto | Young K.,Institute for Circumpolar Health Research
Canadian Journal of Public Health | Year: 2010

Over the past four years, despite low resource allocations to the North, northern residents and community organizations have taken significant initiatives towards the development of health research. In this commentary, we present a model for the development of northern health research based on our experiences in establishing the Institute for Circumpolar Health Research (ICHR) in the Northwest Territories. It is hoped that the lessons we have learned will inform decision-makers and encourage them to make strategic investments to support further health research capacity and institutional development within the North. Factors that have enabled the development of a health research institute in the North include leadership, a vision for health research, and the engagement of key partners and stakeholders. Challenges arise in the development of appropriate governance and policy for health research. There is an urgency to target resources to support the development of policies and governance for health research in northern jurisdictions. Both academic and community-based research need to be strengthened. © 2010 Canadian Public Health Association.


Young S.K.,Institute for Circumpolar Health Research | Young T.K.,University of Alberta
International Journal of Circumpolar Health | Year: 2016

Background. Primary care in remote communities in northern Canada is delivered primarily by nurses who receive clinical support from physicians in regional centres and the patient transportation system. To improve continuity, quality and access to care in remote northern communities, it is important to understand the perspectives of front-line providers and the complex challenges they face. Objective. To design and implement a survey of primary care providers to identify issues relating to inter-professional communication, clinical support and patient evacuation. Methods. In collaboration with the territorial government and regional health authority partners, we developed a 21-item self-administered questionnaire survey, which could be completed online. The survey was sent to 218 physicians and nurses who were employed in the Northwest Territories (NWT) at the time of the survey and were involved in sending patients out of the community and/or receiving patients. The survey also contained an open-ended question at the end seeking comments regarding primary health care. Results. The overall low response rate of 39% among nurses and 19% among physicians threatens the validity of the quantitative results. The majority of providers were satisfied with their ability to communicate with other providers in a timely manner, their freedom to make clinical decisions and their overall experience practicing in the NWT. The patient transfer system appears to work from both the sender and receiver perspectives. However, a common theme reported by nurses was that physicians providing clinical advice, especially short-term locums, were not familiar with the local situation, whilst physicians at the receiving end remarked that the clinical information provided to them often lacked clarity. Conclusions. Important lessons were learnt from the pilot study, especially in better engagement of providers in planning and dissemination. The questionnaire design and the online method of delivery were acceptable. Although important issues were identified, a larger definitive survey is needed to investigate them in the future. © 2016 Stephanie K. Young and T. Kue Young.


Ng C.,University of Toronto | Chatwood S.,Institute for Circumpolar Health Research | Chatwood S.,University of Toronto | Young T.K.,University of Toronto
Chronic Diseases in Canada | Year: 2010

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.


PubMed | University of Toronto, University of Manitoba and Institute for Circumpolar Health Research
Type: | Journal: International journal of circumpolar health | Year: 2016

In circumpolar regions, harsh climates and scattered populations have prompted the centralization of care and reduction of local maternity services. The resulting practice of routine evacuation for birth from smaller towns to larger urban centres points to a potential conflict between the necessity to ensure patient safety and the importance of delivering services that are responsive to the health needs and values of populations served.To identify recommended performance/quality indicators for use in circumpolar maternity care systems.We searched Scopus, Ebscohost databases (including Academic Search Complete and CINAHL), the Global Health Database, High North Research Documents, and online grey literature. Articles were included if they focused on maternal health indicators in the population of interest (Indigenous women, women receiving care in circumpolar or remote regions). Articles were excluded if they were not related to pregnancy, birth or the immediate post-partum or neonatal periods. Two reviewers independently reviewed articles for inclusion and extracted relevant data.Twenty-six documents were included. Twelve were government documents, seven were review articles or indicator compilations, four were indicator sets recommended by academics or non-governmental organizations and three were research papers. We extracted and categorized 81 unique health indicators. The majority of indicators reflected health systems processes and outcomes during the antenatal and intra-partum periods. Only two governmental indicator sets explicitly considered the needs of Indigenous peoples.This review demonstrates that, although most circumpolar health systems engage in performance reporting for maternity care, efforts to capture local priorities and values are limited in most regions. Future work in this area should involve northern stakeholders in the process of indicator selection and development.


PubMed | University of Alberta and Institute for Circumpolar Health Research
Type: | Journal: International journal of circumpolar health | Year: 2016

Primary care in remote communities in northern Canada is delivered primarily by nurses who receive clinical support from physicians in regional centres and the patient transportation system. To improve continuity, quality and access to care in remote northern communities, it is important to understand the perspectives of front-line providers and the complex challenges they face.To design and implement a survey of primary care providers to identify issues relating to inter-professional communication, clinical support and patient evacuation.In collaboration with the territorial government and regional health authority partners, we developed a 21-item self-administered questionnaire survey, which could be completed online. The survey was sent to 218 physicians and nurses who were employed in the Northwest Territories (NWT) at the time of the survey and were involved in sending patients out of the community and/or receiving patients. The survey also contained an open-ended question at the end seeking comments regarding primary health care.The overall low response rate of 39% among nurses and 19% among physicians threatens the validity of the quantitative results. The majority of providers were satisfied with their ability to communicate with other providers in a timely manner, their freedom to make clinical decisions and their overall experience practicing in the NWT. The patient transfer system appears to work from both the sender and receiver perspectives. However, a common theme reported by nurses was that physicians providing clinical advice, especially short-term locums, were not familiar with the local situation, whilst physicians at the receiving end remarked that the clinical information provided to them often lacked clarity.Important lessons were learnt from the pilot study, especially in better engagement of providers in planning and dissemination. The questionnaire design and the online method of delivery were acceptable. Although important issues were identified, a larger definitive survey is needed to investigate them in the future.

Loading Institute for Circumpolar Health Research collaborators
Loading Institute for Circumpolar Health Research collaborators