Gender and place influences on health risk perspectives in northern Canadian Aboriginal communities

Developing a better understanding of the factors underlying health and environmental risk perspectives has been the focus of significant research in recent years. Although many previous studies have shown that perspectives of risk are often associated with gender, sociocultural variables and place, our understanding of the relationship between these factors and risk remains equivocal. A research study was undertaken to develop better insights into the understanding and perspectives of various types of health risks in two sets of northern Canadian Aboriginal communities – the Yellowknives Dene First Nation communities of N’Dilo and Dettah in the Northwest Territories and the Inuit communities of Nain and Hopedale in Nunatsiavut. Gender was found to have a limited overall effect on risk perspectives, consistent with other studies that found no gender differences in communities stressed by multiple and concurrent risks. Nonetheless, subtle gender differences were seen in the qualitative responses, with women focusing more on community impacts and mitigating actions. Threats to ‘place-identity’ associated with changes in traditional lifestyle and connection to the land were strongly associated with risk perspectives. These results reinforce the need to be cautious in making assumptions about the complex effects of community and personal attributes, such as gender and gender relations, in assessing the factors underlying risk views and concerns. They also suggest the importance of gathering multiple types of data (both quantitative and qualitative) in order to fully assess the effects of both gender and place. Ultimately, understanding risk in a northern context requires recognizing the unique circumstances and identities of northern Aboriginal peoples

15. L’évaluation de la fidélité d’implantation

En 2011, la Régie régionale de la santé et des services sociaux du Nunavik a commencé à appuyer financièrement le Projet de Distribution d’Omble chevalier (Arctic Char Distribution Project ou AC/DP dans son acronyme en anglais) pour les femmes enceintes. Cette initiative favorisait la consommation d’une nourriture traditionnelle invite – le poisson « Omble chevalier » – pour les femmes enceintes vivant dans les villages du Nunavik, une région du nord du Québec peuplée majoritairement de personnes d’origine inuite. Cette intervention visait à réduire l’exposition aux contaminants environnementaux et à améliorer l’état nutritionnel et la sécurité alimentaire. La mise en œuvre du projet a été évaluée sur la base des données collectées à partir de documents du projet, de notes de terrain et d’entretiens qualitatifs avec les bénéficiaires et les exécutants du projet. Les thèmes émergeant des données ont été discutés à la lumière du cadre de fidélité à la mise en œuvre développé par Carroll et coll. (2007). Les femmes enceintes ont pleinement adopté l’initiative pour sa pertinence culturelle. Toutefois, la mise en œuvre du projet était incomplète : elle ne couvrait pas toutes les zones géographiques prévues, et il y avait une incohérence récurrente dans l’approvisionnement et la distribution du poisson. En outre, l’initiative n’était pas financée de façon stable. Ce travail montre que la complexité du projet est susceptible d’entraver la réussite de la mise en œuvre, en particulier en termes de communication et de coordination.In 2011, the Nunavik Regional Board of Health and Social Services began supporting the Arctic Char Distribution Project (AC/DP) for pregnant women. This initiative promoted consumption of a traditional Inuit food – the fish Arctic char – for pregnant women living in villages of Nunavik, an area in northern Quebec (Canada) inhabited predominantly by people of Inuit ethnicity. This intervention was intended to reduce exposure to environmental contaminants and improve nutriritional status and food security. The project’s implementation was assessed based on data collected from background documentation, field notes and qualitative interviews with project recipients and implementers. Themes emerging from the data were discussed in the light of the framework for implementation fidelity developed by Carroll et al in 2007. Pregnant women fully embraced the initiative for its cultural appropriateness. However, project implementation was incomplete because it did not cover all intended geographic areas, and there was a recurring inconsistency in the supply and distribution of the fish. In addition, the initiative has been inconsistently funded. This work highlights the extent to which project complexity can impede successful implementation, particularly in terms of communication and coordination.En 2011, la Junta Regional de Salud y Servicios Sociales de Nunavik comenzó a proporcionar apoyo financiero al Arctic Char Distribution Project (AC/DP) para mujeres embarazadas. Esta iniciativa promovió el consumo de alimentes tradicionales de los inuit, el salmôn del ârtico, para las mujeres embarazadas que viven en las aldeas de Nunavik, una régión del norte de Quebec poblada principalmente por personas de origen inuit. Esta intervención tenía por objeto reducir la exposición a los contaminantes ambientales y mejorar el estado nutricional y la seguridad alimentaria. La ejecución del proyecto se evaluó sobre la base de los datos recogidos de los documentas del proyecto, las notas sobre el terreno y las entrevistas cualitativas con los beneficiarios y ejecutores del proyecto. Los temas que surgieron de los datos fueron discutidos a la luz del marco de fidelidad de implementación desarrollado por Carroll et al. (2007). Las mujeres embarazadas han adoptado plenamente la iniciativa por su relevancia cultural. Sin embargo, la ejecución del proyecto fue incompleta: no abarcó todas las zonas geográficas previstas y había una incoherencia récurrente en el suministro y la distribución de pescado. Además, la iniciativa no se financió sobre una base estable. Este trabajo muestra que la complejidad del proyecto puede dificultar una ejecución exitosa, especialmente en términos de comunicación y coordinación

Inuit Knowledge of Beluga Whale (Delphinapterus leucas) Foraging Ecology in Nunavik (Arctic Quebec), Canada

The beluga whale (Delphinapterus leucas (Pallas, 1776)) is expected to be influenced by changes in the environment. In Nunavik, the Arctic region of Quebec, Nunavimmiut (Inuit of Nunavik) have depended on beluga for centuries developing an extensive understanding of the species and its ecology. Forty semi-directive interviews were conducted with Inuit hunters and Elders from four Nunavik communities, who had a range of 28 to 47 years of beluga hunting experience. Interviews followed an ethnocartographic format and were analyzed using a mixed methods approach. Hunters most commonly reported prey species from the sculpin, cod, salmon, and crustacean families; regional variations in prey as well as foraging habitat were found. Hunters identified significant changes in body condition (i.e. blubber thickness), which were associated with observations about the seasonality of feeding. The timing of fat accumulation in the late fall and winter coupled with the understanding that Hudson Bay is not known as a productive area suggest alternate hypotheses to feeding for the seasonal movements exhibited by these whales. Inuit Knowledge of beluga foraging ecology presented here provides information on diet composition and seasonality of energy intake of the beluga and can be an important component of monitoring diet composition for this species into the future.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Public health in the Canadian Arctic: Contributions from International Polar Year research

The contributions of several IPY health projects are highlighted in the context of population health indicators for Inuit Nunangat. Food and housing are two critical social determinants of health contributing to health issues on many levels. The nutritional deficit associated with food insecurity and the transition away from traditional and towards market foods represents a dual risk with profound consequences. Knowledge of the physiological benefits associated with traditional food consumption is increasing, including for mental health and chronic disease. Ensuring the safety of traditional foods in terms of zoonotic diseases is thus highly valuable and efforts to institute adequate monitoring and address knowledge gaps are underway. Acute respiratory disease among the young remains a significant public health issue with potential long term effects. The human papilloma virus is manifesting itself among women across northern Canada with high risk types that are more similar to profiles observed in Europe than in North America with possible implications for immunization programs. Despite a high prevalence of Hepatitis B virus infections among residents of Inuit Nunangat, the outcomes appear to be relatively beni

Évaluation des interventions de santé mondiale

Une couverture universelle des soins de santé en 2030 pour tous les êtres humains, du Nord au Sud ? Réaliser cet objectif de développement durable aussi ambitieux que nécessaire exigera une exceptionnelle volonté politique, mais aussi de solides données probantes sur les moyens d’y arriver, notamment sur les interventions de santé mondiale les plus efficaces. Savoir les évaluer est donc un enjeu majeur. On ne peut plus se contenter de mesurer leur efficacité : il nous faut comprendre pourquoi elles l’ont été (ou pas), comment et dans quelles conditions. Cet ouvrage collectif réunissant 27 auteurs et 12 autrices de différents pays et de disciplines variées a pour but de présenter de manière claire et accessible, en français, un florilège d’approches et de méthodes avancées en évaluation d’interventions : quantitatives, qualitatives, mixtes, permettant d’étudier l’évaluabilité, la pérennité, les processus, la fidélité, l’efficience, l’équité et l’efficacité d’interventions complexes. Chaque méthode est présentée dans un chapitre à travers un cas réel pour faciliter la transmission de ces savoirs précieux