"Connected to the land and to each other": Clam harvesting, Inuit community health, and wellbeing in Nunavut

Public health communication about diet in Inuit communities must balance the benefits and risks associated with both country and store-bought food choices and processes to support Inuit well-being. An understanding of how dietary messages—public health communication addressing the health and safety of country and store-bought food—are developed and disseminated in the Arctic is currently lacking. As part of the Country Foods for Good Health study, this participatory research sought to characterize dietary messaging in the Inuvialuit Settlement Region (ISR), Northwest Territories (NWT), from the perspective of territorial, regional and local dietary message disseminators to further improve message communication in the region. We conducted an in-person interview (n=1) (February 2020), telephone interviews (n=13) (May-June 2020), and follow-up telephone interviews (n=5) (June 2021) with key informants about their involvement in developing and/or disseminating dietary messages about the health benefits and risks of country foods and/or store-bought foods in/for the ISR. Key informants interviewed included health professionals (n=5), government employees (n=6) and community nutrition or food program coordinators (n=3) located in Inuvik, Tuktoyaktuk, Paulatuk and Yellowknife, NWT. We conducted a thematic analysis on the 19 interviews. Our findings indicate that publicly disseminated dietary messages in the ISR are developed at all scales and communicated through a variety of methods. Dietary messages focus predominantly on encouraging healthy store-bought food choices and conveying nutritional advice about store-bought and country foods. As federal and territorial messaging is seldom tailored to the ISR, representation of the Inuvialuit food system and consideration of local food realities is generally lacking. There is a need to evaluate dietary messages and improve collaborations among Inuvialuit country food knowledge holders, researchers, and public health dietary message disseminators at all scales to develop more locally tailored and culturally relevant messaging in the ISR. We recommend utilizing a participatory, collaborative, culture-centered approach to dietary message development and dissemination in northern Indigenous contexts.

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.

An optimal diet for planet and people

Chapter 24 - Climate change, contaminants, and country food: collaborating with communities to promote food security in the Arctic

To environmental toxicologists, the Arctic by the 1990s was becoming known as the final destination for a number of manufactured poisons, including, most notably, dioxins and polyvinyl biphenyls (PCBs), which accumulate in the body fat of large aquatic and land mammals (including human beings), sometimes reaching levels that imperil their survival. Thus the Arctic, which seems so clean on the surface, has become one of the most contaminated places on Earth—a place where Inuit mothers think twice before breast-feeding their babies because high levels of dioxins and other industrial chemicals are being detected in their breast milk and where a traditional diet of "country food" has become dangerous to the Inuit's health. The toxicological due bills for modern industry at the lower latitudes are being left on the Inuit's table in Nunavut. Native people whose diets consist largely of sea animals (whales, polar bears, fish, and seals) have been consuming a concentrated, toxic chemical cocktail. Most of the chemicals that now afflict the Inuit are synthetic compounds of chlorine, and some of them are incredibly toxic. For example, one millionth of a gram of dioxin will kill a guinea pig. 1 To a tourist with no interest in environmental toxicology, the Inuit's Arctic homeland may seem as pristine as ever during its long, snow-swept winters. Many Inuit still guide dogsleds onto the packed ice surrounding their Arctic-island homelands to hunt polar bears and seals. Such a scene may seem pristine, until one realizes that the polar bears' and seals' body fats are laced with dioxins and PCBs. "As we put our babies to our breasts we are feeding them a noxious, toxic cocktail," said Sheila Watt-Cloutier, a grandmother who also serves as president of the Inuit Circumpolar Conference ICC. "When women have to think twice about breast-feeding their babies, surely that must be a wake-up call to the world." 2 Watt-Cloutier was raised in an Inuit community in remote northern Quebec. Unknown to her at the time, toxic chemicals were being absorbed by her body and those of other Inuit in the Arctic. As an adult Watt-Cloutier ranged between her home in Iqaluit (pronounced "Eehalooeet," capital of the new [End Page 479] semisovereign Nunavut Territory) to Montreal, New York City, and other southern points, doing her best to alert the world to toxic poisoning and other perils faced by her people. The ICC represents the interests of roughly 140,000 Inuit living around the North Pole from Nunavut (which means "our home" in the Inuktitut language) to Alaska and Russia. Nunavut itself, a territory four times the size of France, has a population of roughly 25,000, 85 percent of whom are Inuit. Some elders and hunters in Iqaluit have reported physical abnormalities afflicting the seals they catch, including some seals without hair "and seals and walruses with burn-like holes in their skin[s]." 3 Persistent organic pollutants (POPs) have been linked to cancer, birth defects, and other neurological, reproductive, and immune system damage in people and animals. At high levels, these chemicals also damage the central nervous system. Many of them also act as endocrine disrupters, causing deformities in sex organs as well as long-term dysfunction of reproductive systems. POPs also can interfere with the function of the brain and endocrine system by penetrating the placental barrier and scrambling the instructions of naturally produced chemical messengers. The latter tell a fetus how to develop in the womb and postnatally through puberty; should interference occur, immune, nervous, and reproductive systems may not develop as programmed by the genes inherited by the embryo. Pesticide residues in the Arctic today may include some pesticides used decades ago in the southern United States. The Arctic's cold climate slows the natural decomposition of these toxins, so they persist in the Arctic environment longer than at lower latitudes. The...

ABSTRACTInuit have been the subject of research attention since the earliest encounters with Europeans. Using the Foucauldian concept of biopolitics this article explores the history of researcher–research subject relations produced through health knowledge in the region now known as Nunavik. This history is organized in three time periods: The first is the “Ungava” era and is explored in the observations of members of the Hudson Bay Expedition and subsequent mapping efforts. The second “Nouveau Québec” era begins in 1912 when the current borders of Québec were established and lasts until 1975. After a period of indifference, research interest grows rapidly in the post-war period with a focus of social adaptation and culture change. The third era begins in 1975 with the signing of the James Bay and Northern Quebec Agreement. This marks the beginning of Inuit political development within an Inuit-controlled regional governance structure. The conceptualization of three different health surveys during this period shows an emerging complexity in how Inuit health is imagined. An upcoming fourth survey which marks the first time the study of Inuit physical, social, and community health will be initiated by an Inuit-led health authority.

Social support, material circumstance and health behaviour: Influences on health in First Nation and Inuit communities of Canada

ObjectivesCountry (traditional) foods are integral to Inuit culture, but market food consumption is increasing. The Qanuilirpitaa? 2017 Nunavik Health Survey (Q2017) reported similar country food consumption frequency compared to that in 2004; however, examining food items individually does not account for diet patterns, food accessibility, and correlations between food items. Our objective was to identify underlying dietary profiles and compare them across sex, age, ecological region, and food insecurity markers, given the links among diet, health, and sociocultural determinants.MethodsFood frequency and sociodemographic data were derived from the Q2017 survey (N = 1176). Latent profile analysis identified dietary profiles using variables for the relative frequencies of country and market food consumption first, followed by an analysis with those for country food variables only. Multinomial logistic regression examined the associations among dietary profiles, sociodemographic factors, and food insecurity markers (to disassociate between food preferences and food access).ResultsFour overall dietary profiles and four country food dietary profiles were identified characterized by the relative frequency of country and market food in the diet. The patterns were stable across several sensitivity analyses and in line with our Inuit partners’ local knowledge. For the overall profiles, women and adults aged 30–49 years were more likely to have a market food–dominant profile, whereas men and individuals aged 16–29 and 50+ years more often consumed a country food–dominant profile. In the country food profiles, Inuit aged 16–29 years were more likely to have a moderate country food profile whereas Inuit aged 50+ were more likely to have a high country food–consumption profile. A low country and market food–consumption profile was linked to higher prevalence of food insecurity markers.ConclusionWe were able to identify distinct dietary profiles with strong social patterning. The profiles elucidated in this study are aligned with the impact of colonial influence on diet and subsequent country food promotion programs for Inuit youth. These profiles will be used for further study of nutritional status, contaminant exposure, and health to provide context for future public health programs.

In this article, we consider the formation of responsible research relationships with Inuit communities from an “outsider” researcher perspective. Cautious not to prescribe what counts as responsible, we draw on research experiences in several Nunavut communities to introduce and explain “engaged acclimatization.” This neologism refers to embodied and relational methodological processes for fostering responsible research partnerships, and is inspired by the significance of preliminary fieldwork in orienting the lead author's doctoral thesis. As a complement to community‐based participatory methodologies, engaged acclimatization facilitates endogenous research by enacting ethics as a lived experience, initiating and nurturing relationships as a central component of research, and centring methods on circumstances within participating communities. After we locate engaged acclimatization within resonant literature and details of interrelated research projects, our article sketches out four aspects of engaged acclimatization: crafting relations, learning, immersion, and activism. In our discussion of each, we integrate specific insights derived from field notes, observations, photographs, critical reflections, and literature that have brought us to this understanding. The four aspects provide conceptual and methodological tools for readers to apply in the contexts of their own research programs or in guidelines for establishing partnerships with Inuit or Aboriginal communities. The value of this article lies in the extent to which it encourages readers to situate engaged acclimatization in their own research and further develop it as a process.

BackgroundThe incidence of self-reported acute gastrointestinal illness (AGI) in Rigolet, Nunatsiavut, and Iqaluit, Nunavut, is higher than reported elsewhere in Canada; as such, understanding AGI-related healthcare use is important for healthcare provision, public health practice and surveillance of AGI.ObjectivesThis study described symptoms, severity and duration of self-reported AGI in the general population and examined the incidence and factors associated with healthcare utilization for AGI in these 2 Inuit communities.DesignCross-sectional survey data were analysed using multivariable exact logistic regression to examine factors associated with individuals’ self-reported healthcare and over-the-counter (OTC) medication utilization related to AGI symptoms.ResultsIn Rigolet, few AGI cases used healthcare services [4.8% (95% CI=1.5–14.4%)]; in Iqaluit, some cases used healthcare services [16.9% (95% CI=11.2–24.7%)]. Missing traditional activities due to AGI (OR=3.8; 95% CI=1.18–12.4) and taking OTC medication for AGI symptoms (OR=3.8; 95% CI=1.2–15.1) were associated with increased odds of using healthcare services in Iqaluit. In both communities, AGI severity and secondary symptoms (extreme tiredness, headache, muscle pains, chills) were significantly associated with increased odds of taking OTC medication.ConclusionsWhile rates of self-reported AGI were higher in Inuit communities compared to non-Inuit communities in Canada, there were lower rates of AGI-related healthcare use in Inuit communities compared to other regions in Canada. As such, the rates of healthcare use for a given disease can differ between Inuit and non-Inuit communities, and caution should be exercised in making comparisons between Inuit and non-Inuit health outcomes based solely on clinic records and healthcare use.

Purpose Currently, there is a lack of evidence of culturally safe approaches for addressing family violence (FV) experienced by ethnic communities in Aotearoa–New Zealand. This paper aims to report findings that may help develop FV strategies specific to African, Middle Eastern and Latin American victim-survivors. The study is significant in light of the recent proposals that community-led and community-mobilising approaches would be most effective for addressing FV within ethnic communities. Findings from this study indicate that community-led approaches can only be safely used if and when the identified critical issues are addressed. Design/methodology/approach Narrative inquiry methodology guided the original study. This methodology effectively creates spaces where participants can narrate their lived experiences and “stories” from their perspectives. First-hand telling and hearing their stories is empowering, considering the many forms of social exclusion these communities face. Through semi-structured interviews, a space was created for the participants in this study to share their experiences of successfully or unsuccessfully accessing the victims of family violence visa policy. The stories shared included factors that made seeking help inside and outside their communities less or more challenging. Findings Findings from this study indicate that community-led approaches can only be safely used if and when the identified critical issues are addressed. The issues identified include the small and dispersed size of the communities, which impacts support networks and conditions created by immigration visa status, a critical factor linked to reporting, help-seeking and support offered to victim-survivors by the community members. Research limitations/implications The study sample focused on Middle Eastern, Latin American and African communities and only a small sample within these communities. Therefore, it cannot present information explaining all factors that could be considered in developing and implementing FV strategies for ethnic communities. FV is complex and often goes under-reported. The participants in this study were self-referred. The victim-survivors in this study had sought help, engaged with relevant support services, and were willing to share their experiences. These findings cannot be extrapolated to ethnic victim-survivors who have not sought institutional help or have access to advocacy services. Therefore, generalisations should be made with caution. Practical implications The evidence provided in this paper suggests that community-based approaches, including community mobilisation and current approaches using state-based legal tools, will not be effective unless the issues identified are addressed. The article suggests ways of addressing these issues to implement community-based strategies safely. Further research is needed with a large sample of ethnic victim-survivors from specific ethnic communities to gain further insight into the factors impacting these strategies’ effectiveness. Social implications As highlighted in the literature review section, some significant New Zealand Government initiatives increasingly call for community-led and culturally responsive FV strategies. Considering the findings from this study, some critical questions should be asked. The first is whether such strategies would be effective at all. The second is, if such strategies are to be implemented, how can this be done safely so as not to cause further harm to the victim-survivors? The findings also question whether current strategies, mainly those using the legal system as the main protection mechanism for ethnic victim-survivors, are enough. Originality/value Recent New Zealand Government-based studies investigating strategies that could effectively address FV experienced by ethnic communities have highlighted and proposed community-led and community-mobilising approaches for addressing FV with ethnic communities. However, a lack of evidence of culturally safe approaches was identified as a significant gap. This paper reports findings that may help develop FV strategies specific to African, Middle Eastern and Latin American victim-survivors. Findings from this study indicate that community-led approaches can only be safely used if and when the identified critical issues are addressed.

While the impacts of information and communication technologies (ICTs) on society have been extensively studied, the most nuanced research approaches continue to focus on urban geographies in the Global North. There remains a paucity of critical work that focuses on ICT use in Indigenous, rural, and Global South communities. This paper responds to that gap by critically examining how the introduction of ICTs within Indigenous communities can exert epistemic violence against local knowledge systems. It does so through a case study of ICT usage within an Inuit community in the Canadian Arctic. I use a combination of participant observation, archival research, and semi-structured interviews to ask how the introduction of ICTs is transforming knowledge politics that impact Inuit Qaujimaningit (IQ; Inuit knowledge). I find that digital engagement erodes key components of the IQ system, including social practices within Inuit communities, travel outside of the community, and experiential learning while outside of the community. These findings have implications for the study of global digital geographies, applied research within the area of ICT for development, and Indigenous engagements with emerging technologies.

Food sovereignty among Inuit in Nunavut, Canada has long meant year-round harvest of country (hunted, fished, or gathered) food. In recent decades, climatic and non-climatic challenges have complicated these subsistence activities, threatening food security. We examine the meaning of country food, identify determinants of low-yield periods of country food harvest and their effects on community health, and summarize coping strategies and ideas for sustaining food security during these “leaner” periods. Thirty semi-structured interviews were conducted in July and August of 2018 with elders and/or hunters and trappers in Cambridge Bay and Pond Inlet. We found country food holds diverse meanings in the lives of our participants, including for their diet and nutrition, health, Inuit identity and traditions, practice of harvest and subsistence, and spirituality. Participants reported reduced wildlife populations, environmental or weather issues, changing wildlife migration patterns, and financial or equipment-related constraints as determinants of low-yield periods of harvest. Community health is impacted during lean periods across four interrelated dimensions: “craving” of country food, physical health, mental health, and nutrition. Due to their lifelong reliance on country food, elders were described as being particularly vulnerable and are prioritized within the traditional food sharing system. The most commonly cited coping strategies were turning to intra- or inter-community food sharing networks for country food and purchasing groceries. To support communities during low-yield periods of harvest, participants suggested increased support for Hunters and Trappers Organizations to acquire country food for community distribution, as well as greater financial and equipment support for harvesters.

Climate change influences on environment as a determinant of Indigenous health: Relationships to place, sea ice, and health in an Inuit community

Indigenous knowledge is central to understanding environment and health sciences in the Arctic, yet limited research in these fields has explored the human–animal–environment interface from the unique perspectives of Inuit women. Using a community-led, Inuit-centred research approach, we characterized the use and meaning of country food in the context of community well-being for Inuit women in Nunavut, Canada. In-depth conversational interviews and focus groups ( n = 16) were held with Inuit women ( n = 10) who are knowledge holders in the Qikiqtani region that hold decades of country food knowledge. Data were analyzed using thematic analysis and constant comparative methods. Inuit women described country food in the context of (1) well-being, connection, and identity, (2) hunger, craving, and healing, (3) food security and nourishment, and (4) change and adaptation. Inuit women described a wide range of country food as central to physical and mental health, food security, identity, culture, healing and medicine. Adaptive strategies were discussed, such as eating more fish when caribou were scarce. This research highlights the critical role of country food for health and well-being for Inuit women and shares knowledge and perspective that is relevant to wildlife and environment researchers, public health practitioners, policy makers, and others interested in advancing health, well-being, and food sovereignty in Inuit communities.