Respiratory medicine in Nunavut and Northern Canada

Abstract

Relatively little is known about Inuit health pre-colonization. Health has formed a major part of the history of colonization; both in terms of new exposures to infectious diseases — particularly respiratory pathogens — brought by Europeans, and in terms of Inuit and government perceived needs for health care. Tuberculosis (TB) has been a major cause of mortality for Inuit and northern First Nations (FN) individuals from the 1860s until the 1950s. The establishment of sanatoria distant from people's communities, case finding using patrol boats and forced relocation of infected individuals, and mandatory establishment of permanent communities — at least partly to provide health care — has been an important source of intergenerational trauma for Canadian indigenous peoples. Other important epidemics of respiratory pathogens have included influenza, pertussis, and respiratory syncytial virus. Post-infectious bronchiectasis is particularly common in Inuit youth, and lung cancer is a growing challenge for elders. While access to advanced diagnostic techniques in the North is improving, research needs to focus on optimal use of new diagnostic techniques and intervention studies. Ultimately, reducing respiratory morbidity and mortality will require major improvements in the social determinants of health, including poverty, education, access to clean water, nutrition and housing.