Inuit Research Articles

An initial exploration of whether ‘female flight’ is a demographic problem in Eastern Canadian Arctic Inuit communities

ABSTRACTEmigration of indigenous women from small, isolated communities in Alaska and Greenland is seen as a pattern of female flight that results from modernization. As women see more options for a satisfying life, many are leaving remote northern communities. Female flight can result in social, cultural and economic problems for small communities and decrease the sustainability of such locales. We conducted an initial review of census data and found little evidence of female flight across the Canadian Territorial North, in Nunavut specifically, nor in any Nunavut communities. Two study communities in Nunavut, Clyde River and Qikiqtarjuaq were surveyed in an attempt to better understand the factors that affect movement decisions of Canadian Inuit women. Two explanations for the apparent lack of female flight were examined. First, that Nunavut is in an early phase of the demographic transition and thus could expect high migration as it modernizes. The second is that Nunavut communities are modernizing in such a way that young women are choosing to remain at home, and thus the territory is experiencing a unique path to modernity that does not fit the demographic transition model. The evidence more strongly supports the second explanation, although further research is recommended.

Associations between omega-3 fatty acids and 25(OH)D and psychological distress among Inuit in Canada

ABSTRACTBackground: Inuit in Canada have experienced dietary changes over recent generations, but how this relates to psychological distress has not been investigated.Objective: To evaluate how nutritional biomarkers are related to psychological distress.Design: A total of 36 communities in northern Canada participated in the International Polar Year Inuit Health Survey (2007–2008). Of 2796 households, 1901 (68%) participated; 1699 Inuit adults gave blood samples for biomarker analysis and answered the Kessler 6-item psychological distress questionnaire (K6). Biomarkers included n-3 fatty acids and 25-hydroxyvitamin D (25(OH)D). The K6 screens for psychological distress over the last 30 days with six items scored on a 4-point scale. A total score of 13 or more indicates serious psychological distress (SPD). Logistic regression models were used to investigate any associations between SPD and biomarkers while controlling for age, gender, marital status, days spent out on the land, feeling of being alone, income and smoking.Results: The 30-day SPD prevalence was 11.2%, with women below 30 years having the highest and men 50 years and more having the lowest SPD prevalence at 16.1% and 2.6%, respectively. SPD was associated with being female, younger age, not being married or with a common-law partner, spending few days out on the land, feelings of being alone, smoking and low income. Low levels of both 25(OH)D and long-chain n-3 FAs were associated with higher odds for SPD in both unadjusted and adjusted logistic regression models.Conclusion: In this cross-sectional analysis, low levels of 25(OH)D and long-chain n-3 FAs were associated with higher odds ratios for SPD, which highlights the potential impact of traditional foods on mental health and wellbeing. Cultural practices are also important for mental health and it may be that the biomarkers serve as proxies for cultural activities related to food collection, sharing and consumption that increase both biomarker levels and psychological well-being.Abbreviations: n-3 FAs: omega-3 fatty acids; PUFAs: polyunsaturated fatty acids; 25(OH)D: 25-hydroxyvitamin D; IPY: International Polar Year; IHS : Inuit Health Survey; RBC: red blood cell; OR: odds ratio; K6: Kessler 6-item screening scale; SPD: serious psychological distress; EPA: eicosapentaenoic acid (20:5 n-3); DHA: docosahexaenoic acid (22:6 n-3); DPA n-3: docosapentaenoic acid (22:5 n-3); n-3 LC-PUFAs: EPA (20:5 n-3) + DHA (22:6 n-3) + DPA (22:5 n-3); BMI: body mass index (kg m–2)

Adult idiopathic cholestasis: a condition more common in the Canadian Inuit?

ABSTRACTDespite extensive investigations, some patients have no identifiable cause for their cholestatic liver enzyme abnormalities. The aim of this study was to document the clinical, laboratory, radiologic and histologic features of adult patients with idiopathic cholestasis (AIC). A computerised database of referred patients to a tertiary care hospital outpatient department for assessment of hepatobiliary disorders between 2005 and 2015 was employed to identify and describe features associated with AIC. Of 6,560 patient referrals, sufficient documentation to warrant a diagnosis of AIC was present in 17 (0.26%) cases. Of the 17, a disproportionate number were Canadian Inuit (7/60, 12% Inuit referrals vs. 10/6,500, 0.16% non-Inuit referrals, p<0.0001). The median age of the 17 subjects was 57 years and nine (53%) were female. Clinical and/or laboratory evidence of autoimmune disorders was present in six (35%) cases. Clinical features of hepatic decompensation, radiologic findings in keeping with cirrhosis and histologic confirmation of cirrhosis were present in 47%, 31% and 42% of individuals, respectively. There were no significant improvements in cholestatic liver enzymes and function tests in those treated with ursodiol and/or immunomodulants (n=7) compared to those left untreated (n=10). In conclusion, AIC is a rare condition diagnosed by exclusion. It appears to be more common in the Canadian Inuit population and those with autoimmune disorders. Advanced liver disease is a frequent finding at presentation. Intervention with ursodiol and/or immunomodulants does not appear to be of therapeutic value.

Partity „Koori” i „Inuit” Krzysztofa Knittla – intermedialny „pejzaż dźwiękowy”

Partity „Koori” i „Inuit” Krzysztofa Knittla – intermedialny „pejzaż dźwiękowy”

NU01.05 Indigenous Population with Lung Cancer

NU01.05 Indigenous Population with Lung Cancer

The EPA guidance on suicide treatment and prevention needs to be adjusted to fight the epidemics of suicide at the North Pole area and other autochthonous communities

More and more, youth suicide in the Inuit community is gaining importance, with a frequency in Greenland rising from 14.4 (1960–64) to 110.4 per 100,000 person-years (2010–11). The huge cultural/educational changes during the last 20 years and the role of globalization, especially of the occidental influence on this community may be at the origin of such an “epidemics” of suicide in this cultural region. Recently, a political organization representing the Inuit community in Canada (ITK for Inuit Tapiriit Kanatami) launched a National Inuit Suicide Prevention Strategy (NISP) based on the specificities of this community in comparison to the occidental civilization. In fact, not only the Canadian Inuit community is concerned by this epidemics of suicide, but also many other autochthonous groups. In this context, the European Psychiatric Association (EPA) guidance on suicide treatment and prevention needs to be adjusted to autochthonous individuals’ needs.

Overview of Benefits of First Nations Language Immersion

In the wake of the Truth and Reconciliation Commission of Canada report into the ‘cultural genocide’ perpetrated by the State of Canada against First Nations, Métis and Inuit peoples, through the widespread use of Residential Schools, the federal government offered an apology and an apparent opportunity for reconciliation[i]. Part of this programme was new legislation that would govern the relationship between First Nations and the federal government over First Nations education. Entitled the First Nations Control of First Nations’ Education (FNCFNE), the proposed bill promised a new deal and an apparent chance to renew a tarnished relationship. Yet in spite of its name, the bill offered very little in terms of progress. Indeed if it had been implemented, in many cases, the bill would have done little to increase First Nations’ control over the education of First Nations’ children and likely would have made effective language education extremely difficult. Indeed, this article’s analysis of the bill shows that, at its core, the law represents little more than the reinforcing of existing settler-colonial power dynamics. In particular, while it would have shifted virtually the totality of administrative responsibility for on-reserve education to First Nations it would have reserved ultimate power – manifest through control over funding – to Ottawa. As a result the FNCFNE would have represented a profound step in undermining First Nations language rights and language education in Canada. [i] “Prime Minister Stephen Harper's statement of apology”, CBC News, 11 June 2008

Inuit Early Child Care Centres

The wisdom of the Inuit people (IQ) is a great resource to draw on for designing early childhood centres for all Indigenous children as well as for others in our increasingly diverse society. Respecting their rights, as the two settings described in this article do, can lighten the burden of trauma carried by so many children and, by building trust , release their humanity to the benefit of us all.

First Nations, Métis and Inuit presence in the Newfoundland and Labrador curriculum

This article responds to the Truth and Reconciliation Commission Canada’s 2015 call for the education of Canadians about ‘residential schools, treaties, and Aboriginal peoples’ historical and contemporary contributions to Canada.’ It is an analysis of the Canadian and world studies curricula and texts in Newfoundland and Labrador, 1 of the 13 provinces and territories of Canada. The analysis is based on academic research and consultations with First Nations, Métis and Inuit peoples (FNMI) educators, educational administrators and knowledge holders. Although there is evidence of reform, as a whole the curriculum suffers from silences and lack of context, problematic placement and associations, the intrusion of settler perspectives, contradiction over judgement about issues related to FNMI peoples and inconsistency that undermine efforts at reform. This article provides guidance to curriculum designers, textbook writers, teachers and administrators participating in the decolonization of education in Canada.

HIV/AIDS Risk and Prevention Issues Among Inuit Living in Nunavut Territory of Canada.

HIV infections occur across the Arctic but their incidence among aboriginal populations varies vastly. At the time this research was initiated there were no data on their occurrence, risk of HIV/AIDS or preventive strategies among Inuit living in the Nunavut territory of Canada. This review is the first to assess the risk of HIV infection among Inuit and evaluate current prevention strategies among Canadian-Inuit populations. The contents of this article are based on the author's own research, undertaken during 3 visits to the Canadian Arctic and the published literature. Disproportionately high rates of Chlamydia and Gonorrhoea within Inuit communities confirm the potential threat of silent HIV transmission. Inuit awareness of HIV/AIDS issues remains inadequate. It is easy to blame distorted perceptions fuelled by the media, religious influence and socio-cultural factors. Aboriginal and Inuit groups, including youth, women and injection drug abusers are at increased risk of infection. The adaptability of proven prevention methods including condom use and male circumcision are discussed. Access to treatment, adherence and resistance issues in the North Canada, require attention. HIV/AIDS poses a considerable threat to Canadian Inuit public health. The most important problem to be addressed is Inuit lack of awareness and understanding of HIV. Education is the single most effective means of prevention. Inuit-specific and culture-sensitive interventions are recommended. Further research opportunities exist to investigate Inuit understanding over HIV/AIDS issues and to assess local prevention efforts.

Suicide and Suicide Prevention among Inuit in Canada.

Inuit in Canada have among the highest suicide rates in the world, and it is primarily among their youth. Risk factors include known ones such as depression, substance use, a history of abuse, and knowing others who have made attempts or have killed themselves, however of importance are the negative effects of colonialism. This took place for Inuit primarily during the government era starting in the 1950s, when Inuit were moved from their family-based land camps to crowded settlements run by white men, and children were removed from their parents and placed into residential or day schools. This caused more disorganization than reorganization. The most negative effect of this colonialism/imperialism for Inuit has been on their family and sexual relationships. Many Inuit youth feel alone and rejected. Suicide prevention has been taking place, the most successful being community-driven programs developed and run by Inuit. Mental health factors for Indigenous peoples are often cultural. It is recommended that practitioners work with the community and with Inuit organizations. Empowered communities can be healing.

Arctic (in)security and Indigenous peoples: Comparing Inuit in Canada and Sámi in Norway

While international relations has increasingly begun to recognize the political salience of Indigenous peoples, the related field of security studies has not significantly incorporated Indigenous peoples either theoretically or empirically. This article helps to address this gap by comparing two Arctic Indigenous peoples – Inuit in Canada and Sámi in Norway – as ‘securitizing actors’ within their respective states. It examines how organizations representing Inuit and Sámi each articulate the meaning of security in the circumpolar Arctic region. It finds that Inuit representatives have framed environmental and social challenges as security issues, identifying a conception of Arctic security that emphasizes environmental protection, preservation of cultural identity, and maintenance of Indigenous political autonomy. While there are some similarities between the two, Sámi generally do not employ securitizing language to discuss environmental and social issues, rarely characterizing them as existential issues threatening their survival or wellbeing.Drawing on securitization theory, this article proposes three factors to explain why Inuit have sought to construct serious challenges in the Arctic as security issues while Sámi have not: ecological differences between the Canadian and Norwegian Arctic regions, and resulting differences in experience of environmental change; the relative degree of social inclusion of Inuit and Sámi within their non-Indigenous majority societies; and geography, particularly the proximity of Norway to Russia, which results in a more robust conception of national security that restricts space for alternative, non-state security discourses. This article thus links recent developments in security studies and international relations with key trends in Indigenous politics, environmental change, and the geopolitics of the Arctic region.

Challenges in the Assessment of Inuit Food Security

In the past few years, food security survey modules have been widely used to assess Inuit food access. However, these modules were not originally designed for use in mixed economies where both purchased and country (hunted, fished, and gathered) foods contribute to peoples’ diets. These methods have been extensively tested and modified for use in Alaska, but research conducted in the Canadian Arctic has not been rigorously evaluated. This paper examines the validity of a modified version of the commonly used USDA Household Food Security Survey Module for assessing the food security of Inuit households in Kangiqsujuaq, Nunavik. The data come from 110 household surveys that were collected as part of an extended ethnographic project in the community. Rasch modeling of the food security module results indicates that, even with modifications that make reference to country food, the module assesses only the dimension of food security related to material wealth. Household income is a contributing factor for country food access, because it is important for access to harvesting equipment; however, other factors related to country food harvesting may affect the reliability of some food security module questions. Consequently, studies that assess Inuit food access using only standard survey modules may misrepresent how Inuit experience food insecurity, which is a serious concern given the current food crisis among Inuit in Canada. Assessment tools that provide reliable and valid assessments of country food access, specifically including traditional knowledge and social support networks, need to be developed.

Inuit take action towards suicide prevention

Sept 10, 2016, is World Suicide Prevention Day (WSPD), an opportunity to reflect on suicide in a global context, and also on what regions can learn from each other. The unique challenges of addressing suicide within Indigenous communities calls us to learn from efforts by and with Indigenous peoples, which may have global relevance. Inuit Tapiriit Kanatami (ITK), a political organisation representing Inuit in Canada, launched its National Inuit Suicide Prevention Strategy (NISPS) on July 27, 2016,1 in Kuujjuaq, Nunavik... Language: en

Toward Precision Medicine: TBC1D4 Disruption Is Common Among the Inuit and Leads to Underdiagnosis of Type 2 Diabetes.

A common nonsense mutation in TBC1D4 was recently found to substantially increase the odds of type 2 diabetes in Greenlandic Inuit, leading to exclusively increased postprandial glucose. We investigated the frequency and effect of the TBC1D4 mutation on glucose metabolism and type 2 diabetes diagnosis among Canadian and Alaskan Inuit. Exome sequencing of the TBC1D4 variant was performed in 114 Inuit from Nunavik, Canada, and Sanger sequencing was undertaken in 1,027 Alaskan Inuit from the Genetics of Coronary Artery Disease in Alaskan Natives (GOCADAN) Study. Association testing evaluated the effect of the TBC1D4 variant on diabetes-related metabolic traits and diagnosis. The TBC1D4 mutation was present in 27% of Canadian and Alaskan Inuit. It was strongly associated with higher glucose (effect size +3.3 mmol/L; P = 2.5 x 10-6) and insulin (effect size +175 pmol/L; P = 0.04) 2 h after an oral glucose load in homozygote carriers. TBC1D4 carriers with prediabetes and type 2 diabetes had an increased risk of remaining undiagnosed unless postprandial glucose values were tested (odds ratio 5.4 [95% CI 2.5-12]) compared with noncarriers. Of carriers with prediabetes or type 2 diabetes, 32% would remain undiagnosed without an oral glucose tolerance test (OGTT). Disruption of TBC1D4 is common among North American Inuit, resulting in exclusively elevated postprandial glucose. This leads to underdiagnosis of type 2 diabetes, unless an OGTT is performed. Accounting for genetic factors in the care of Inuit with diabetes provides an opportunity to implement precision medicine in this population.

A study of the peopling of Greenland using next generation sequencing of complete mitochondrial genomes.

The Greenlandic population history is characterized by a number of migrations of people of various ethnicities. In this work, the analysis of the complete mtDNA genome aimed to contribute to the ongoing debate on the origin of current Greenlanders and, at the same time, to address the migration patterns in the Greenlandic population from a female inheritance demographic perspective. We investigated the maternal genetic variation in the Greenlandic population by sequencing the whole mtDNA genome in 127 Greenlandic individuals using the Illumina MiSeq® platform. All Greenlandic individuals belonged to the Inuit mtDNA lineages A2a, A2b1, and D4b1a2a1. No European haplogroup was found. The mtDNA lineages seem to support the hypothesis that the Inuit in Greenland are descendants from the Thule migration. The results also reinforce the importance of isolation and genetic drift in shaping the genetic diversity in Greenlanders. Based on the mtDNA sequences, the Greenlandic Inuit are phylogenetically close to Siberian groups and Canadian Inuit.

Claims for disease-modifying therapy by Alberta non-insured health benefits clients.

BackgroundUncontrolled disease activity in inflammatory diseases of the joints, skin and bowel leads to morbidity and disability. Disease-modifying therapies are widely used to suppress this disease activity, but cost-coverage is variable. For Treaty First Nations and Inuit people in Canada without alternative private or public health insurance, cost-coverage for disease-modifying therapy is provided through Non-Insured Health Benefits (NIHB). Our objective was to describe the prevalence and patterns of treatment with disease-modifying therapy for the NIHB claimant population, and also examine adjuvant therapy (analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids) use.MethodsCases (n = 2512) were defined by ≥1 claim for a disease-modifying anti-rheumatic drug (DMARD) or biologic between 1999 and 2012 in the NIHB pharmacy claim database. The proportion of the population with claims for individual agents and drug classes annually was calculated to estimate annual incidence and prevalence rates for use of disease-modifying therapy, and the prevalence of use of individual DMARDs, biologics and adjuvants. Differences in the proportion accessing adjuvant therapies and median doses in the 6 months following initiation of disease-modifying therapies was estimated.ResultsThe incidence rate of treatment was calculated at an average of 127.5 cases per 100,000 population between 2001 and 2012, and the cumulative prevalence, accounting for patients lost to the database, increased and then stabilized at 1.3 % in the last three years of the study. Annual dispensation of methotrexate, combination DMARD therapy and biologic therapy approached 35 %, 19 %, and 10 % of the cohort respectively. A declining prevalence of claims for acetaminophen (28 % to 15 %) and anti-inflammatories (73 % to 63 %) occurred from 2000 to 2012, however corticosteroid (32 %) and opioid (65 %) dispensation remained stable. The proportion of patients with claims for NSAIDs (69.9 % to 61.1 %, p = 0.002), oral corticosteroids (45.4 % to 33.6 %, p < 0.001) and parenteral corticosteroids (16.2 % to 8.3 %, p = 0.002) decreased in the 6 months following biologic initiation.ConclusionsThe proportion of NIHB clients with active claims for disease-modifying therapy is lower than expected based on existing epidemiologic knowledge of the prevalence of inflammatory conditions in the First Nations and Inuit populations. These findings should be further explored in order to optimize treatment outcomes for NIHB claimants with inflammatory disease.

Justice on Turtle Island: Continuing the evolution of policing with First Nations, Métis and Inuit Peoples in Canada

The relationship between policing and Canada’s First Nations and Métis peoples has historically been strained, and these tensions continue trans-generationally. This social innovation paper explores the possibility of integrating two effective paradigms that might positively enhance the relationship between policing and First Nations, Métis and Inuit peoples of Canada. The first is increased multi-sectoral collaboration around social issues, based on proven models such as Prince Albert Saskatchewan’s community mobilization initiative. The second is finding culturally sensitive alternatives to criminal courts by diverting cases into restorative justice processes that resonate more closely with Indigenous beliefs. These approaches would focus more on restoring community balance than pitting adversaries against one another in the mainstream criminal courts. Proposed for consideration is widening the restorative justice circle to include multi-sectoral resources to reduce the chances of re-offending and enhance conflict intervention and resolution.

Household food security and breast-feeding duration among Canadian Inuit.

There have been few studies investigating the association between food security and breast-feeding duration and none have been conducted among Canadian Inuit, a population disproportionately burdened with food insecurity. We evaluated the association between household food security and breast-feeding duration in Canadian Inuit children. Data were obtained from the Nunavut Inuit Child Health Survey, a population-based cross-sectional survey. The Canadian Territory of Nunavut in 2007 and 2008. Caregivers of Inuit children aged 3-5 years. Participating children were randomly sampled from community medical centre lists. Out of 215 children, 147 lived in food-insecure households (68·4 %). Using restricted mean survival time models, we estimated that children in food-secure households were breast-fed for 16·8 (95 % CI 12·5, 21·2) months and children in food-insecure households were breast-fed for 21·4 (95 % CI 17·9, 24·8) months. In models adjusting for social class, traditional knowledge and child health, household food security was not associated with breast-feeding duration (hazard ratio=0·82, 95 % CI 0·58, 1·14). Our research does not support the hypothesis that children living in food-insecure households were breast-fed for a longer duration than children living in food-secure households. However, we found that more than 50 % of mothers in food-insecure households continued breast-feeding well beyond 1 year. Many mothers in food-secure households also continued to breast-feed beyond 1 year. Given the high prevalence of food insecurity in Inuit communities, we need to ensure infants and their caregivers are being adequately nourished to support growth and breast-feeding, respectively.

Developing and Field Testing a Community Based Youth Initiative to Increase Tuberculosis Awareness in Remote Arctic Inuit Communities.

BackgroundInuit in Canada have the highest reported tuberculosis (TB) incidence rate in Canada, even higher than other Canadian Indigenous groups. The aim of this study was to increase TB awareness among Inuit youth and their communities by equipping those who can best reach this population with a community based, youth focused, education initiative built on interventions adapted from a previous TB awareness study.MethodsThe Taima TB Youth Education Initiative was a field test case study of a knowledge translation (KT) strategy aimed at community members who provide health education in these communities. In the first stage of this study, interventions from a larger TB awareness campaign were adapted to focus on youth living in remote Inuit communities. During the second stage of the study, investigators field tested the initiative in two isolated Inuit communities. It was then applied by local implementation teams in two other communities. Evaluation criteria included feasibility, acceptability, knowledge uptake and health behavior change.ResultsImplementation of the adapted KT interventions resulted in participation of a total of 41 youth (19 females, 22 males) with an average age of 16 years (range 12–21 years) in four different communities in Nunavut. Community celebration events were attended by 271 community members where TB messaging were presented and discussed. All of the health care workers and community members surveyed reported that the adapted interventions were acceptable and a useful way of learning to some extent. Knowledge uptake measures indicated an average TB knowledge score of 64 out of 100. Local partners in all four communities indicated that they would use the Taima TB Youth Education Initiative again to raise awareness about TB among youth in their communities.ConclusionsThe TB awareness interventions adapted for the Taima TB Youth Education Initiative were acceptable to the Inuit communities involved in the study. They resulted in uptake of knowledge among participants. Implementation by local implementation teams was feasible as evidenced by the participation and attendance of youth and community members in all communities. The ability to implement the interventions by local implementation teams indicates there is potential to scale up in other remote communities in the arctic setting.