Inuit Health Survey: Inuit Health in Transition and Resiliency ...

Inuit Health Survey:
Inuit Health in Transition
and Resiliency
Inuvialuit Settlement
Region 2008
Helga Saudny, Crystal Lennie, Kue Young,
Grace Egeland
McGill University / CINE
University of Toronto

Why
Inuit want to have Inuit specific health information
With results informed decisions can be made
Overview of health status and living conditions of
Inuvialuit

Where
Aklavik, Inuvik, Tuktoyaktuk, Sachs Harbour,
Paulatuk and Ulukhaktok
When
August and September 2008

How
Inuvialuit Settlement Region
Steering Committee – Qanuqitpit
BDHSSA: Jane Smith
Aklavik: Glen Gordon
Inuvik: Ethel Gruben, Gayle Gruben
Paulatuk: Fred Bennett
Sachs Harbour: Donna Keogak
Tuktoyaktuk: John Stuart JR.
Ulukhaktok: Joshua Oliktoak
Inuvialuit Regional Corporation: Crystal Lennie
GNWT – Health: Dr. Kami Kondola
ICHR: Susan Chatwood
Advisor to the Committee:
ARI: Alana Mero
Principle Investigator: Dr. Grace Egeland
Co-Principal Investigator: Dr. Kue Young
CINE: Helga Saudny

Participatory Processes:
Memorandum of agreements
Community – University Research Agreement
Research licenses and ethics approval
Development/refinement of questionnaires
Logistical support

Survey content
• Clinical examination
– Body composition (ht,wt,wc)
– Blood pressure and pulse
– Skeletal health for women > 40 years
– Diabetes and cardiovascular risk factors
• Nutrition markers
• Infection
• Contaminants
• Medical chart review

Survey content
• Questionnaires
– Dietary assessments
• 24-hour recall and FFQ for country and market
food
– Dimensions of health
• Self-reported health/Reproductive health
• Medical history
• Mental well-being
• Social support
• Physical activity

Preparations in coastal communities
Ingrid Tensen, Diane McGlade, Joan Fraser, Herb Nakimayak, Nelli Elanik and Joe Kellypalik
•288 Households
• 66% participated
• 34 % unavailable or refused
362 Individuals ≥ 18 years
118 Men
244 Women

Inuit Health Survey Team in Inuvik
L-R: Beverly Lennie, Laura Kaufer , Ingrid Tensen, Amy Harty, Mariah Arey-Storr, Rose Day, Nellie Elanik, Jen Jamieson, Dana
Francey, Mearle, Evelyn Wilson, and Troy Amos

Transportation to the Canadian Coast Guard Ship Amundsen

Clinic visit and interviews onboard the Amundsen

Communication activities
1. Results booklet on board the ship √
2. Results letters to all participants within 5 months √
3. Results to community health centers √
4. Preliminary results workshop for steering committees √
5. Results booklet for communities √
6. IPY – Legacy Photo Project √
7. IHS documentation for Northern Coordination offices √
8. IPY – Yellowknife Circumpolar Science Conference √
9. IPY – Oslo Science Conference √
10. NWT – IPY Results conference √
11. Peer-reviewed articles
12. Contaminants and wellness report

Results for ISR
• Home environment
– Many homes are in need of major repairs (new
roof, plumbing repairs)
– Crowded homes are a problem in ISR, especially in
homes with children
– Crowding = > 1 person/room
– 13% of homes were crowded in ISR versus 3% of
non-Aboriginal lived in crowded homes

Results for ISR
• Smoking
– 82% of homes had smokers (2 per home)
• Smoking was forbidden in 70% of homes
• Individual smoking rates are also high
– 65% of participants were smoking at the time of
the survey
– 22% of other Canadians smoked in 2007

Cost of living in ISR
ISR households
Other Canadian
households
$ spent on
food/month
$ spent on
shelter/month*
$ 1,317.00 $ 609.00
$ 1,471.00 $ 1,137.00
* Includes rent or mortgage, electricity, heating, water, sewage,
garbage

• Food security
Food security in ISR
– Food security exists when “all people, at all times, have access to sufficient, safe and nutritious food
to meet their dietary needs and food preference for an active and healthy life”.
• Food insecurity
– Questions related to food security (food shortage, meal skipping)
• Worried food would run out before you got money to
buy more
• Cut the size of meals, skipped meals, were hungry but
did not eat
• Did not eat for a whole day because there wasn’t
enough money for food
• Could not afford to eat healthy food

Food insecurity in ISR
• Moderate food insecurity
– Quality and/or quantity of food consumed is
affected
• 2 to 5 positive answers
• Severe food insecurity
– Less food eaten and eating patterns are disrupted
• ≥ 6 positive answers

Food insecurity in ISR
Household food insecurity (%)
13 %
Food secure
33 %
54 %
Moderate food
insecurity
Severe food insecurity

Country food in ISR
• Country food
– Inuvialuit prefer to eat country food
• Not having an active hunter
• Not having a boat or skidoo
• Supplies and gas are too expensive
• No time
• ~ one-half worry about contaminants in country food
• Sharing country food is important to Inuvialuit

Most commonly eaten country food in ISR

Most commonly eaten market food in ISR
• Regular soft drinks
– 2 to 4 cans/day
– sugar
– High intakes of sugar = increased risk of obesity,
heart disease and diabetes

• Average Caloric intake is higher among
Inuvialuit compared with other Canadians
• 1/4 to 1/3 of Calories came from food high in
sugar
• Inuvialuit eat enough protein, fat and
carbohydrates
• Younger women need to eat more iron-rich
food
• Majority of Inuvialuit need more vitamin D

Health and clinical data
• Self-reported general health
– 73 % good to excellent
– More men than women said their health was
good or excellent
• At risk waist circumference
– 76% of women
– 56% of men

• Blood lipids
Health and clinical data
– Type and amount risk for heart disease
• Total cholesterol – 59% high levels
• LDL- cholesterol – 76% good levels
• HDL- cholesterol – 68% good levels
• Triglycerides – 72% good levels
• High triglyceride levels and high waist
circumference
– 7.5 times higher risk of diabetes
– Over 1/3 of Inuvialuit have both

Another risk factor for Diabetes
• Blood sugar
• Fasting blood samples were tested for blood
sugar
• Oral glucose tolerance test
• Another blood sample
• 11% of Inuvialuit have blood sugar levels
indicating pre-diabetes or diabetes
• Survey cannot diagnose diabetes or heart
disease

Implications of Research Results
Can lead to policy change*
Can lead to development of new policy*
Can lead to improvement of existing policy*
* Federal, Provincial, Regional levels within Inuit Regions

Thank you
To all Inuvialuit who participated in the survey
community corporations, community health
centers, community research assistants,
nurses and staff
ISR steering committee
Photos by Inuit Health survey staff
Funded and supported by