Is the effect of precipitation on acute gastrointestinal illness in southwestern Uganda different between Indigenous and non-Indigenous communities?

Acute gastrointestinal illness (AGI) is a global public health priority that often disproportionately effects Indigenous populations. While previous research examines the association between meteorological conditions and AGI, little is known about how socio-cultural factors may modify this relationship. This present study seeks to address this research gap by comparing AGI prevalence and determinants between an Indigenous and non-Indigenous population in Uganda. We estimate the 14-day self-reported prevalence of AGI among adults in an Indigenous Batwa population and their non-Indigenous neighbours using cross-sectional panel data collected over four periods spanning typically rainy and dry seasons (January 2013 to April 2014). The independent associations between Indigenous status, precipitation, and AGI are examined with multivariable multi-level logistic regression models, controlling for relative wealth status and clustering at the community level. Estimated prevalence of AGI among the Indigenous Batwa was greater than among the non-Indigenous Bakiga. Our models indicate that both Indigenous identity and decreased levels of precipitation in the weeks preceding the survey period were significantly associated with increased AGI, after adjusting for confounders. Multivariable models stratified by Indigenous identity suggest that Indigenous identity may not modify the association between precipitation and AGI in this context. Our results suggest that short-term changes in precipitation affect both Indigenous and non-Indigenous populations similarly, though from different baseline AGI prevalences, maintaining rather than exacerbating this socially patterned health disparity. In the context of climate change, these results may challenge the assumption that changing weather patterns will necessarily exacerbate existing socially patterned health disparities

Community-based monitoring of Indigenous food security in a changing climate: global trends and future directions

Climate change is expected to exacerbate existing food security challenges, especially in Indigenous communities worldwide. Community-based monitoring (CBM) is considered a promising strategy to improve monitoring of, and local adaptation to climatic and environmental change. Yet, it is unclear how this approach can be applied in food security or Indigenous contexts. The objectives of this paper are to: (1) review and synthesize the published literature on CBM of Indigenous food security; and, (2) identify gaps and trends in these monitoring efforts in the context of climate change. Using a systematic search and screening process, we identified 86 published articles. To be included, articles had to be published in a journal, describe a CBM system, describe any aspect of food security, and explicitly mention an Indigenous community. Relevant articles were thematically analyzed to characterize elements of CBM in the context of climate change. Results show that the number of articles published over time was steady and increased more than two-fold within the last five years. The reviewed articles reported on monitoring mainly in North America (37%) and South America (28%). In general, monitoring was either collaborative (51%) or externally-driven (37%), and focused primarily on tracking wildlife (29%), followed by natural resources (16%), environmental change (15%), fisheries (13%), climate change (9%), or some combination of these topics (18%). This review provides an evidence-base on the uses, characteristics, and opportunities of CBM, to guide future food security monitoring efforts in the context of climate change

Understanding Determinants of Hunting Trip Productivity in an Arctic Community

We examine factors underlying hunting productivity among Inuit in Ulukhaktok, Northwest Territories, Canada. Specifically, we focus on the role of gasoline use as the main variable of interest—commonly cited as a crucial determinant of hunting participation. Over the course of 12 months, 10 hunters recorded their on-the-land activities using a GPS tracking system, participatory mapping sessions, and bi-weekly interviews. A multivariable linear regression model (MvLRM) was applied to assess whether factors such as consumables used (i.e. heating fuel, gasoline, oil, food), distances traveled, or the number of companions on a trip were associated with the mass of edible foods returned to the community. Results indicate that, despite being positively associated with hunting trip productivity when assessed through a univariable linear regression model, gasoline is not a statistically significant determinant of standalone trip yield when adjusting for other variables in a multivariable linear regression. Instead, factors relating to seasonality, number of companions, and days on the land emerged as more significant and substantive drivers of productivity while out on the land. The findings do not suggest that access to, or the availability of, gasoline does not affect whether a hunting trip commences or is planned, nor that an increase in the amount of gasoline available to a hunter might increase the frequency of trips (and therefore annual productivity). Rather, this work demonstrates that the volume of gasoline used by harvesters on standalone hunting trips represent a poor a priori predictor of the edible weight that harvesters are likely to return to the community

Evidence-informed policy for tackling adverse climate change effects on health: Linking regional and global assessments of science to catalyse action.

Robin Fears and co-authors discuss evidence-informed regional and global policy responses to health impacts of climate change

Contributions of scale: What we stand to gain from Indigenous and local inclusion in climate-health monitoring and surveillance systems

Understanding how climate change will affect global health is a defining challenge this century. This is predicated, however, on our ability to combine climate and health data to investigate the ways in which variations in climate, weather, and health outcomes interact. There is growing evidence to support the value of place- and community-based monitoring and surveillance efforts, which can contribute to improving both the quality and equity of data collection needed to investigate and understand the impacts of climate change on health. The inclusion of multiple and diverse knowledge systems in climate-health surveillance presents many benefits, as well as challenges. We conducted a systematic review, synthesis, and confidence assessment of the published literature on integrated monitoring and surveillance systems for climate change and public health. We examined the inclusion of diverse knowledge systems in climate-health literature, focusing on: 1) analytical framing of integrated monitoring and surveillance system processes 2) key contributions of Indigenous knowledge and local knowledge systems to integrated monitoring and surveillance systems processes; and 3) patterns of inclusion within these processes. In total, 24 studies met the inclusion criteria and were included for data extraction, appraisal, and analysis. Our findings indicate that the inclusion of diverse knowledge systems contributes to integrated climate-health monitoring and surveillance systems across multiple processes of detection, attribution, and action. These contributions include: the definition of meaningful problems; the collection of more responsive data; the reduction of selection and source biases; the processing and interpretation of more comprehensive datasets; the reduction of scale dependent biases; the development of multi-scale policy; long-term future planning; immediate decision making and prioritization of key issues; as well as creating effective knowledge-information-action pathways. The value of our findings and this review is to demonstrate how neither scientific, Indigenous, nor local knowledge systems alone will be able to contribute the breadth and depth of information necessary to detect, attribute, and inform action along these pathways of climate-health impact. Rather, it is the divergence or discordance between the methodologies and evidences of different knowledge systems that can contribute uniquely to this understanding. We critically discuss the possibility of what we, mainly local communities and experts, stand to lose if these processes of inclusion are not equitable. We explore how to shift the existing patterns of inclusion into balance by ensuring the equity of contributions and justice of inclusion in these integrated monitoring and surveillance system processes

Climate-sensitive health priorities in Nunatsiavut, Canada

Background: This exploratory study used participatory methods to identify, characterize, and rank climate-sensitive health priorities in Nunatsiavut, Labrador, Canada. Methods: A mixed method study design was used and involved collecting both qualitative and quantitative data at regional, community, and individual levels. In-depth interviews with regional health representatives were conducted throughout Nunatsiavut (n = 11). In addition, three PhotoVoice workshops were held with Rigolet community members (n = 11), where participants took photos of areas, items, or concepts that expressed how climate change is impacting their health. The workshop groups shared their photographs, discussed the stories and messages behind them, and then grouped photos into re-occurring themes. Two community surveys were administered in Rigolet to capture data on observed climatic and environmental changes in the area, and perceived impacts on health, wellbeing, and lifestyles (n = 187). Results: Climate-sensitive health pathways were described in terms of inter-relationships between environmental and social determinants of Inuit health. The climate-sensitive health priorities for the region included food security, water security, mental health and wellbeing, new hazards and safety concerns, and health services and delivery. Conclusions: The results highlight several climate-sensitive health priorities that are specific to the Nunatsiavut region, and suggest approaching health research and adaptation planning from an EcoHealth perspective

Relative Undernourishment and Food Insecurity Associations with Plasmodium falciparum Among Batwa Pygmies in Uganda: Evidence from a Cross-Sectional Survey

Although malnutrition and malaria co-occur among individuals and populations globally, effects of nutritional status on risk for parasitemia and clinical illness remain poorly understood. We investigated associations between Plasmodium falciparum infection, nutrition, and food security in a cross-sectional survey of 365 Batwa pygmies in Kanungu District, Uganda in January of 2013. We identified 4.1% parasite prevalence among individuals over 5 years old. Severe food insecurity was associated with increased risk for positive rapid immunochromatographic test outcome (adjusted relative risk [ARR] = 13.09; 95% confidence interval [95% CI] = 2.23–76.79). High age/sex-adjusted mid-upper arm circumference was associated with decreased risk for positive test among individuals who were not severely food-insecure (ARR = 0.37; 95% CI = 0.19–0.69). Within Batwa pygmy communities, where malnutrition and food insecurity are common, individuals who are particularly undernourished or severely food-insecure may have elevated risk for P. falciparum parasitemia. This finding may motivate integrated control of malaria and malnutrition in low-transmission settings