P2.16-40 Acknowledging Social and Economic Inequities Experienced by Canada’s Inuit: Implications for Diagnosis and Treatment of Lung Cancer

Abstract

The Inuit living in Canada’s north have the highest rates of lung cancer in the world. Barriers to care are numerous and exist at all phases of the lung cancer journey. Beginning with difficulty in accessing the diagnostic phase of care through to treatment at a tertiary cancer centre located over 2000 km away and little to no palliative care available locally, this population experiences obstacles at each step of their lung cancer journey. The Inuit in Canada’s arctic experience dramatically higher rates of social and economic inequity than the rest of Canada with only one hospital serving a land mass similar to the size of Mexico, access to or from many communities is by air only. This means that diagnosis and treatment for lung cancer is provided thousands of kilometres away from family, community and culture, often for months at a time. Along with geographic barriers to care, Inuit peoples also have a historical mistrust of government and mainstream health care services owing to past encounters with colonization and marginalization. A lack of awareness of Inuit specific culture from health care providers (i.e. discrimination) further compounds this lack of trust. These end result of these traumas contribute to the significant health disparities experienced by the Inuit as compared to other Canadians and may in part explain why approximately 30% of Inuit diagnosed with lung cancer between 2000-2010 did not access cancer care. To better meet the needs of this population, TOHCC hired an Indigenous Nurse Navigator in 2016 with a goal to provide culturally safe care for Inuit patients and their families. Collaborative relationships have been built with key stakeholders in Inuit communities through consistent efforts which in turn have garnered awareness of Inuit specific issues within TOHCC and the surrounding city. In depth semi-structured interviews with Inuit patients, caregivers and community leaders. The Indigenous nurse navigator will interview participants either in person or by video during April and May 2019. The results of these interviews will be presented at the 2019 World Lung Cancer Conference in Barcelona. There is still much work to do in breaking down barriers to accessing care at all phases of the lung cancer journey for the Inuit of Canada’s North. This presentation offers the opportunity to hear directly from a marginalized community who potentially have the greatest lung cancer needs of any population in the world.