Our health counts: population-based measures of urban Inuit health determinants, health status, and health care access

Janet Smylie,Michael W Spiller,Michelle Firestone

doi:10.17269/s41997-018-0111-0

Abstract

ObjectiveHealth determinants and outcomes are not well described for the growing population of Inuit living in southern urban areas of Canada despite known and striking health disparities for Inuit living in the north. The objective of this study was to work in partnership with Tungasuvvingat Inuit (TI) to develop population prevalence estimates for key indicators of health, including health determinants, health status outcomes, and health services access for Inuit in Ottawa, Canada.MethodsWe employed community-based respondent driven sampling (RDS) and a comprehensive health assessment survey to collect primary data regarding health determinants, status, and service access. We then linked with datasets held by the Institute for Clinical Evaluative Sciences (ICES), including hospitalization, emergency room, and health screening records. Adjusted population-based prevalence estimates and rates were calculated using custom RDS software.ResultsWe recruited 341 Inuit adults living in Ottawa. The number of Inuit living, working or accessing health and social services in the City of Ottawa was estimated to be 3361 (95% CI 2309–4959). This population experiences high rates of poverty, unemployment, household crowding, and food insecurity. Prevalence of hypertension (25%; 95% CI 18.1–33.9), chronic obstructive pulmonary disease (6.7%; 95% CI 3.1–10.6), cancer (6.8%; 95% CI 2.7–11.9), and rates of emergency room access were elevated for Inuit in Ottawa compared to the general population. Access to health services was rated fair or poor by 43%. Multiple barriers to health care access were identified.ConclusionsUrban Inuit experience a heavy burden of adverse health determinants and poor health status outcomes. According to urban Inuit in Ottawa, health services available to Inuit at the time of the study were inadequate.

Highlights

The striking health inequities experienced by the Inuit living in northern Canada are described in a growing body of literature (Tait 2008; Oliver et al 2012; Wilkins et al 2008; Peters 2012)
Notre étude visait à produire, en partenariat avec l’organisme Tungasuvvingat Inuit (TI), des estimations sur la prévalence d’indicateurs de santé clés dans la population, notamment les déterminants de la santé, les résultats sanitaires et l’accès aux services de santé pour les Inuits vivant à Ottawa, au Canada
In keeping with current ethical and scientific standards in Indigenous health research (Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Social Sciences and Humanities Research Council of Canada 2014; Canadian Institutes of Health Research 2007), the academic research team engaged in a community-based participatory research partnership with the TI to complete this study

Summary

Introduction

The striking health inequities experienced by the Inuit living in northern Canada are described in a growing body of literature (Tait 2008; Oliver et al 2012; Wilkins et al 2008; Peters 2012). Between 33% and 37% of Inuit children and 44% of Inuit adults have one or more chronic health conditions (Tait 2008; Guèvremont and Kohen 2013) This growing burden of disease has been linked to marked disparities in the social determinants of health, including access to medical services (Garner et al 2010; National Collaborating Centre for Aboriginal Health 2009). These disparities in turn have roots in the preceding cultural, socio-economic, and political transitions accompanying European colonization, an experience that is shared by Inuit populations internationally across circumpolar regions (Peters 2012; Inuit Tapiriit Kanatami 2007)

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Discussion

Conclusion