New Publications

Who is environmental health research serving?

About a year ago, and shortly after ITK’s Inuit Research Strategy was released, Jen Jones led the publication of an article that examined environmental health research in the Circumpolar North.

Addressing factors leading to health disparities in the Circumpolar North require approaches that consider and address the social determinants of health including on-going colonization. Today, colonization and related policies and processes, continue to manifest in the marginalization of Indigenous knowledge, particularly its use in research; however, Indigenous populations have moved from being research subjects to leaders and consumers of environmental health research. Given the tensions that exist between how health research is conducted, how the results are mobilized, and who has control and access to the results, we examined how peer-reviewed environment-related Indigenous health research in the Circumpolar North is serving the needs of Indigenous communities, governments, and organizations. Read the full article here.

Citation: Jones, J., Cunsolo, A., & Harper, S. L. (2018). Who is research serving? A systematic realist review of circumpolar environment-related Indigenous health literature. PloS one13(5), e0196090.

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Free open-access article

Jones, Cunsolo, and Harper 2018

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CBC Radio Interview

Jen spoke with CBC host Leonard Linklater about the paper


How can technology support community-led monitoring in a changing climate? Read our new article to find out!

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We are excited to share our recent publication on the need for community-led, integrated and innovative monitoring programmes when responding to the health impacts of climate change in the Circumpolar North.

How does climate change impact health in rural and remote regions in Canada?

It's our pleasure to share our new publication, which provides a synthesis of the forthcoming first order draft of the Canadian Government’s National Assessment on Climate Change ‘Rural and Remote’ chapter, highlighting key health concerns from the literature associated with climate change in rural and remote regions, as well as existing and future adaptation strategies.

New Publication! Using Whiteboard Videos for Health Promotion

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Citation

Saini, M., Roche, S., Papadopoulos, A., Markwick, N., Shiwak, I., Flowers, C., Wood, M., Edge, V., Ford, J., Rigolet Inuit Community Government, Nunatsiavut Government, IHACC Research Team, Wright, C., Harper, S. (2019). Promoting Inuit health through a participatory whiteboard video. Can J Public Health. doi: 10.17269/s41997-019-00189-1

Abstract

Setting: The Inuit community of Rigolet experiences greater rates of self-reported acute gastrointestinal illness (AGI) compared to southern Canada.

Intervention: A whiteboard video tool was collaboratively developed by Rigolet youth, community members, the research team and key regional stakeholders to share public health recommendations for reducing the risk of AGI. The video debuted in Rigolet at a community event in August 2016 and was later provided online for community members and local and regional health departments. Interviews and focus group discussions were used to evaluate the ability of the video to communicate public health information to community members in Rigolet.

Outcomes: Community and government viewers reported that the whiteboard video was novel and engaging. Evaluation participants believed the video was suitable for promoting Inuit health because of the use of locally relevant visuals and narrative, which reflect Inuit art and storytelling traditions. Furthermore, participants indicated that the video co-development process was critical to ensuring community relevance of the video. Short-term outcome results suggest the video can reinforce health knowledge and potentially encourage behavioural change.

Implications: The results suggest this whiteboard video was an effective tool to share information and could increase intention to change behaviours to reduce the risk of AGI in Rigolet. While tools like the whiteboard video are gaining popularity, the participatory approach was used to develop the video, and its use in an Inuit context illustrates its innovation and novelty. This tool may be a useful health promotion tool among Indigenous communities in Canada.

How can integrated health & environmental monitoring support climate change adaptation? Check out our new publication to find out!

Congratulations to Alexandra Sawatzy on her recent publication. Alex reviewed integrated surveillance used for responding to climate and environmental change impacts on human health in the Circumpolar North. The article can be accessed, for free, at: https://www.mdpi.com/1660-4601/15/12/2706

Key Messages:

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Key Message 1:

The wide range and diversity of integrated surveillance systems described in the literature can help guide and target evidence-based public health responses in support of climate change adaptation in the North.

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Key Message 2:

2: Findings offer insight into how these systems can be designed to be more responsive to public health concerns within rapidly shifting Northern environments.

What are key components of integrated surveillance?

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Recommendations & Next Steps:

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Article citation:

Sawatzky, A., Cunsolo, A., Jones-Bitton, A., Middleton, J., Harper, S.L. (2018). Responding to Climate and Environmental Change Impacts on Human Health via Integrated Surveillance in the Circumpolar North: A Systematic Realist Review. Int. J. Environ. Res. Public Health.15(12), 2706. Click here to access the article (free open-access)

Abstract:

Environments are shifting rapidly in the Circumpolar Arctic and Subarctic regions as a result of climate change and other external stressors, and this has a substantial impact on the health of northern populations. Thus, there is a need for integrated surveillance systems designed to monitor the impacts of climate change on human health outcomes as part of broader adaptation strategies in these regions. This review aimed to identify, describe, and synthesize literature on integrated surveillance systems in Circumpolar Arctic and Subarctic regions, that are used for research or practice. Following a systematic realist review approach, relevant articles were identified using search strings developed for MEDLINE® and Web of Science™ databases, and screened by two independent reviewers. Articles that met the inclusion criteria were retained for descriptive quantitative analysis, as well as thematic qualitative analysis, using a realist lens. Of the 3431 articles retrieved in the database searches, 85 met the inclusion criteria and were analyzed. Thematic analysis identified components of integrated surveillance systems that were categorized into three main groups: structural, processual, and relational components. These components were linked to surveillance attributes and activities that supported the operations and management of integrated surveillance. This review advances understandings of the distinct contributions of integrated surveillance systems and data to discerning the nature of changes in climate and environmental conditions that affect population health outcomes and determinants in the Circumpolar North. Findings from this review can be used to inform the planning, design, and evaluation of integrated surveillance systems that support evidence-based public health research and practice in the context of increasing climate change and the need for adaptation.

The article can be accessed, for free, at: https://www.mdpi.com/1660-4601/15/12/2706

New Publication: Wastewater treatment and enteric illness in the Arctic

The article is freely available for 50 days: Anyone clicking on this link before February 03, 2019 will be taken directly to the final version of this article: https://authors.elsevier.com/c/1YE0uB8ccghTq

Citation:

Daley, K., Jamieson, R., Rainham, D., Hansen, L. T., Harper, S. L. (2018). Screening-level microbial risk assessment of acute gastrointestinal illness attributable to wastewater treatment systems in Nunavut, Canada. Science of the Total Environment. 657(20): 1253-1264.

Abstract:

Most arctic communities use primary wastewater treatment systems that are capable of only low levels of pathogen removal. Effluent potentially containing fecally derived microorganisms is released into wetlands and marine waters that may simultaneously serve as recreation or food harvesting locations for local populations. The purpose of this study is to provide the first estimates of acute gastrointestinal illness (AGI) attributable to wastewater treatment systems in Arctic Canada. A screening-level, point estimate quantitative microbial risk assessment model was developed to evaluate worst-case scenarios across an array of exposure pathways in five case study locations. A high annual AGI incidence rate of 5.0 cases per person is estimated in Pangnirtung, where a mechanical treatment plant discharges directly to marine waters, with all cases occurring during low tide conditions. The probability of AGI per person per single exposure during this period ranges between 1.0 × 10−1 (shore recreation) and 6.0 × 10−1 (shellfish consumption). A moderate incidence rate of 1.2 episodes of AGI per person is estimated in Naujaat, where a treatment system consisting of a pond and tundra wetland is used, with the majority of cases occurring during spring. The pathway with the highest individual probability of AGI per single exposure event is wetland travel at 6.0 × 10−1. All other risk probabilities per single exposure are <1.0 × 10−1. The AGI incidence rates estimated for the other three case study locations are <0.1. These findings suggest that wastewater treatment sites may be contributing to elevated rates of AGI in some arctic Canadian communities. Absolute risk values, however, should be weighed with caution based on the exploratory nature of this study design. These results can be used to inform future risk assessment and epidemiological research as well as support public health and sanitation decisions in the region.

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How can understanding hospital admission patterns inform climate change adaptation for the healthcare sector in Uganda? Read more to find out!

Kate Bishop-Williams and co-authors recently published an article in the International Journal of Environmental Research and Public Health. The article explored how understanding hospital admission patterns can promote climate change adaptation. Through this article, we illustrate how analyzing hospital data alongside meteorological parameters may inform climate-health planning in low-resource contexts.

How do non-climatic factors reinforce maladaptation trajectories? Check out this new publication to find out.

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Congratulations to Dr. Carol Zaveleta for her recent publication in PLoS One.  Her participatory, community-based study was conducted in collaboration with Shawi communities. Together, they worked to characterize the food system of the Shawi in the Peruvian Amazon, climatic and non-climatic drivers of their food security vulnerability to climate change, and identify potential maladaptation trajectories. They found that transformational food security adaptation should include consideration of Indigenous perceptions and priorities, and should be part of Peruvian food and socioeconomic development policies.  Click here for free article (open access).

Citation:

Zavaleta, C., Berrang-Ford, L., Ford, J., Llanos-Cuentas, A., Carcamo, C., Ross, N., Lancha, G., Sherman, M., Harper, S.L., IHACC Research Team. (2018) Multiple non-climatic drivers of food insecurity reinforce climate change maladaptation trajectories among Peruvian Indigenous Shawi in the Amazon. PLoS ONE 13(10): e0205714. Click here for free article (open access).

Abstract:

Background: Climate change is affecting food systems globally, with implications for food security, nutrition, and the health of human populations. There are limited data characterizing the current and future consequences of climate change on local food security for populations already experiencing poor nutritional indicators. Indigenous Amazonian populations have a high reported prevalence of nutritional deficiencies. This paper characterizes the food system of the Shawi of the Peruvian Amazon, climatic and non-climatic drivers of their food security vulnerability to climate change, and identifies potential maladaptation trajectories.

Methods and findings: Semi-structured interviews with key informants (n = 24), three photovoice workshops (n = 17 individuals), transect walks (n = 2), a food calendar exercise, and two community dissemination meetings (n = 30 individuals), were conducted within two Shawi communities in Balsapuerto District in the Peruvian Loreto region between June and September of 2014. The Shawi food system was based on three main food sub-systems (forest, farming and externally-sourced). Shawi reported collective, gendered, and emotional notions related to their food system activities. Climatic and non-climatic drivers of food security vulnerability among Shawi participants acted at proximal and distal levels, and mutually reinforced key maladaptation trajectories, including: 1) a growing population and natural resource degradation coupled with limited opportunities to increase incomes, and 2) a desire for education and deforestation reinforced by governmental social and food interventions.

Conclusion: A series of maladaptive trajectories have the potential to increase social and nutritional inequities for the Shawi. Transformational food security adaptation should include consideration of Indigenous perceptions and priorities, and should be part of Peruvian food and socioeconomic development policies.

New Publication Exploring the Hidden Costs of Enteric Illness in the North

Congratulations to Nia King for her recent publication in PloS One.  In the north, per capita healthcare costs are high. However, given Inuit communities’ unique cultural, economic, and geographic contexts, there is a knowledge gap regarding the context-specific indirect healthcare costs borne by Inuit. Therefore, Nia worked with Northern partners to identify the major indirect costs of enteric illness, and explore factors associated with these indirect costs, in Rigolet, Canada.

Citation:

King, N., Vriezen, R., Edge, V.L., Ford, J., Wood, M., IHACC Research Team, Harper, S.L. (2018). The hidden costs: Identification of indirect costs associated with acute gastrointestinal illness in an Inuit community. PloS One, 13(5), e0196990.  Click here for free article (open access).

Abstract:

Background: Acute gastrointestinal illness (AGI) incidence and per-capita healthcare expenditures are higher in some Inuit communities as compared to elsewhere in Canada. Consequently, there is a demand for strategies that will reduce the individual-level costs of AGI; this will require a comprehensive understanding of the economic costs of AGI. However, given Inuit communities’ unique cultural, economic, and geographic contexts, there is a knowledge gap regarding the context-specific indirect costs of AGI borne by Inuit community members. This study aimed to identify the major indirect costs of AGI, and explore factors associated with these indirect costs, in the Inuit community of Rigolet, Canada, in order to develop a case-based context-specific study framework that can be used to evaluate these costs.

Methods: A mixed methods study design and community-based methods were used. Qualitative in-depth, group, and case interviews were analyzed using thematic analysis to identify and describe indirect costs of AGI specific to Rigolet. Data from two quantitative cross-sectional retrospective surveys were analyzed using univariable regression models to examine potential associations between predictor variables and the indirect costs.

Results/Significance: The most notable indirect costs of AGI that should be incorporated into cost-of-illness evaluations were the tangible costs related to missing paid employment and subsistence activities, as well as the intangible costs associated with missing community and cultural events. Seasonal cost variations should also be considered. This study was intended to inform cost-of-illness studies conducted in Rigolet and other similar research settings. These results contribute to a better understanding of the economic impacts of AGI on Rigolet residents, which could be used to help identify priority areas and resource allocation for public health policies and programs.

New Publication! Examining adaptation projects targeting food systems funded by United Nations Framework Convention on Climate Change (UNFCCC)

Congratulations to Aleksandra, member of James Ford's Climate Change Adaptation Research Group, for her new publication in Climate Policy. In her article, Aleksandra documents and examines adaptation projects targeting food systems financed through funding bodies of the United Nations Framework Convention on Climate Change (UNFCCC). Based on her results, Aleksandra recommends that projects should assess the entire food system to ensure future food security.

Citation: 

Conevska, A., Ford, J., Lesnikowski, A. and Harper, S.L., 2018. Adaptation financing for projects focused on food systems through the UNFCCC. Climate Policyhttps://doi.org/10.1080/14693062.2018.1466682 

Abstract:

Investments in adaptation are required to reduce vulnerability and strengthen the resilience of food systems to the impacts of climate change. For low-income nations, international financing plays a central role in supporting adaptation. In this article, we document and examine adaptation projects targeting food systems financed through funding bodies of the United Nations Framework Convention on Climate Change (UNFCCC). We find that between 2004 and 2015, 3% (n = 96) of adaptation projects supported through the UNFCCC explicitly focused on the production, processing, distribution, preparation and/or consumption of food, with US$546 m mobilized through funding bodies directly and US$1.44bn through co-financing. Agriculture is the most common sector supported, with extreme weather events the primary climate change-related impact motivating nations to apply for adaptation financing. The majority of actions are documented to adapt the food production component of food systems, with limited focus within projects on the full range of food system vulnerability and the implications on food security.

Key policy insights:

  • Enhanced international adaptation financing targeting food systems is needed, and in particular financing to address limited adaptation readiness

  • Supported food system projects should include holistic assessments of the entire food system in order to prioritize sector and food system component issue areas for short- and long-term efficiency

  • To better analyse food system linkages and aid in the prioritization of adaptation activities, adaptation-directed funds should consider placing a higher emphasis on a cross-sectoral approach within projects

  • Linkages between official development assistance and adaptation-directed funds could help optimize financing for food systems and mainstream food system adaptation efforts

https://twitter.com/Climate_Policy/status/996301700569985024

New Publication! Understanding source water protection in Indigenous communities

Congratulations to Rachael Marshall for her new publication in the Journal of Hydrology.  The implementation of source water protection programs is relatively recent in Canada and the United States. Although protecting water at the watershed scale has been a focus of many of these programs, few Indigenous communities located within these watersheds are involved in the process. Therefore, we wanted to examine and map the extent, range, and nature of the published peer-reviewed literature on the adoption, implementation, and outcomes of source water protection programs involving Indigenous populations in Canada and the United States.

Rachael Marshal led the paper; she is a PhD Candidate in Environmental Engineering at the University of Guelph. She has worked in partnership with Indigenous communities in Guatemala, Nunatsiavut, northern and southern Ontario, and Saskatchewan to promote clean drinking water, appropriate water infrastructure, and healthy socio-ecological systems.

Citation:

Marshall, R., Levison, J., McBean, E., Brown, E., Harper, S.L. 2018. Source water protection programs and Indigenous communities in Canada and the United States: a scoping review. Journal of Hydrology. https://doi.org/10.1016/j.jhydrol.2018.04.070

Abstract:

The implementation of source water protection programs is relatively recent in Canada and the United States. Although protecting water at the watershed scale has been a focus of many of these programs, few Indigenous communities located within these watersheds are involved in the process. The purpose of this scoping review was to examine and map the extent, range, and nature of the published peer-reviewed literature on the adoption, implementation, and outcomes of source water protection programs involving Indigenous populations in Canada and the United States. This review followed a systematic process to identify and evaluate the literature. Searches were conducted in three aggregator databases (Web of Science™, ProQuest®, and GreenFILE™). Two independent reviewers conducted a systematic two-stage screening process using inclusion and exclusion criteria in the software DistillerSR©. Articles that met inclusion criteria were analyzed using thematic qualitative and descriptive quantitative methods. The findings indicate that: a) there is a lack of peer-reviewed studies focusing on the ecological outcomes of source water protection programs that are inclusive of Indigenous populations in Canada and the United States; b) the depth to which the literature describes Indigenous involvement in source water protection programs is minimal; and c) Indigenous involvement in source water protection programs is generally not reported as substantial. This review provides several recommendations to improve both the peer-reviewed literature on the topic and source water protection programs. There is a need to improve reporting in the literature on quantitative program results, the nature of Indigenous involvement in source water protection programs, and Indigenous-inclusive inter-jurisdictional success stories. It is also recommended that source water protection programs recognize Indigenous peoples as more than stakeholders groups, and that future studies pull from innovations in other fields to address complex problems and provide new insights to the field of source water protection. The methodology presented in this paper provides a template for researchers in engineering and environmental fields, such as hydrology, to identify and review published literature in a systematic, transparent, and rigorous manner.

Evaluating the strengths, challenges, and opportunities of health-related community-based adaptation research

Article Highlights

  • We examine the application of Community Based Adaptation (CBA) approaches in Indigenous community settings.
  • CBA can co-generate knowledge on climate-health vulnerability and adaptation options, build capacity, and inform decision choices.
  • CBA can also have unintended negative consequences.
  • CBA requires careful consideration of community-researcher relationships and meaningful engagement of knowledge users.
  • CBA holds significant promise but only in the ‘right’ circumstances.


Abstract

Climate change presents substantial risks to the health of Indigenous peoples. Research is needed to inform health policy and practice for managing risks, with community based adaptation (CBA) emerging as one approach to conducting research to support such efforts. Few, if any, studies however, have critically examined the application of CBA in a health or Indigenous peoples context. We examine the strengths, challenges, and opportunities of health-related CBA research in Indigenous community settings, drawing on the experiences of the multi-nation interdisciplinary Indigenous Health Adaptation to Climate Change (IHACC) project. Data collection was guided by a framework developed to evaluate CBA projects. Semi-structured interviews (n = 114) and focus groups (n = 23, 177 participants) were conducted with faculty-based researchers, institutional partners, community members, students, and trainees involved in the IHACC project in Canada, Uganda, and Peru. Results illustrate the importance of CBA in co-generating knowledge on climate-health vulnerability and adaptation options, capacity building, and informing decision choices. There are also significant challenges of conducting CBA which can have unintended negative consequences, with results emphasizing the importance of managing the tension between health research and tangible and immediate benefits; developing a working architecture for collective impact, including team building, identification of common goals, and meaningful engagement of knowledge users; and the need to continuously monitor and evaluate progress. CBA holds significant promise in a health adaptation context, but only in the ‘right’ circumstances, where considerable time is spent developing the work with partners.

Article Citation

Ford, J.D., Sherman, M., Berrang-Ford, L., Llanos, A., Carcamo, C., Harper, S.L., Lwasa, S., Namanya, D.B., Marcello, T., Maillet, M., Edge, V. 2018. Preparing for the health impacts of climate change in Indigenous communities: The role of community-based adaptation. Global Environmental Change. 49: 129–139.  Click here for open-access article.

 

How are perceptions associated with water consumption in Canadian Inuit? Check Out this New Publication to Find Out!

Congratulations to Carlee Wright for publishing her second article from her MSc thesis!  Click here to read the full article... Citation: Wright, C.J., Sargeant, J.M., Edge, V.L., Ford, J.D., Farahbakhsh, K., Shiwak, I., Flowers, C., Gordon, A.C., RICG, IHACC Research Team (Berrang-Ford, L., Carcamo, C., Llanos, A., Lwasa, S., Namanya, D.B.), and Harper, S.L. (2018). How are perceptions associated with water consumption in Canadian Inuit? A cross-sectional survey in Rigolet, Labrador. Science of The Total Environment, 618(15): 369–378.

 

Abstract

Concerns regarding the safety and aesthetic qualities of one's municipal drinking water supply are important factors influencing drinking water perceptions and consumption patterns (i.e. sources used and daily volume of consumption). In northern Canada, Inuit communities face challenges with drinking water quality, and many Inuit have reported concerns regarding the safety of their drinking water. The objectives of this research were to describe perceptions of municipal tap water, examine use of water sources and changes following the installation of a potable water dispensing unit (PWDU) in 2014, and identify factors associated with water consumption in the Inuit community of Rigolet. This study used data from three cross-sectional census surveys conducted between 2012 and 2014. Principal component analysis (PCA) was used to aggregate data from multiple variables related to perceptions of water, and logistic regressions were used to identify variables associated with water consumption patterns. Three quarters of residents reported using the PWDU after its installation, with concomitant declines reported in consumption of bottled, tap, and brook water. Negative perceptions of tap water were associated with lower odds of consuming tap water (ORPCAcomponent1 = 0.73, 95% CI 0.56–0.94; ORPCAcomponent2 = 0.67, 95% CI 0.49–0.93); women had higher odds of drinking purchased water compared to men (OR = 1.90, 95% CI 1.11–3.26). The median amount of water consumed per day was 1 L. Using brook water (OR = 2.60, 95% CI 1.22–5.56) and living in a household where no one had full-time employment (OR = 2.94, 95% CI 1.35–6.39) were associated with consuming > 2 L of water per day. Results of this study may inform drinking water interventions, risk assessments, and public health messaging in Rigolet and other Indigenous communities.

Participatory Scenario Planning for Climate Change - New Publication!

Congratulations to Melanie Flynn, for her recent publication in Environmental Science & Policy!  Melanie conducted a systematic review of the literature to identify and evaluate how participatory scenario planning has been used in the Arctic.

Citation:

Flynn, M., Ford, J., Pearce, T., and Harper, S.L. (2018). Participatory scenario planning and climate change impacts, adaptation and vulnerability research in the Arctic. Environmental Science & Policy. 79:45–53.

Abstract:

Participatory scenario planning (PSP) approaches are increasingly being used in research on climate change impacts, adaptation, and vulnerability (IAV). We identify and evaluate how PSP has been used in IAV studies in the Arctic, reviewing work published in the peer-reviewed and grey literature (n = 43). Studies utilizing PSP commonly follow the stages recognized as ‘best practice’ in the general literature in scenario planning, engaging with multiple ways of knowing including western science and traditional knowledge, and are employed in a diversity of sectors. Community participation, however, varies between studies, and climate projections are only utilized in just over half of the studies reviewed, raising concern that important future drivers of change are not fully captured. The time required to conduct PSP, involving extensive community engagement, was consistently reported as a challenge, and for application in Indigenous communities requires careful consideration of local culture, values, and belief systems on what it means to prepare for future climate impacts.

Canadian and Australian perspectives on promising practices for integrative Indigenous and Western knowledge systems

Congratulations to first-author Rob Stefanelli, from Heather Castleden's HEC Lab, on his publication that examines Canadian and Australian researchers' perspectives on promising practices for implementing indigenous and Western knowledge systems in water research and management. 

Citation:

Stefanelli, R., Castleden, H., Cunsolo, A., Martin, D., Harper, S.L. and Hart, C., 2017. Canadian and Australian researchers' perspectives on promising practices for implementing indigenous and Western knowledge systems in water research and management. Water Policy, DOI: 10.2166/wp.2017.181. Click here to access the article.

Abstract:

National and international policies have called for the inclusion of Indigenous peoples and the uptake of Indigenous knowledge alongside Western knowledge in natural resource management. Such policy decisions have led to a recent proliferation of research projects seeking to apply both Indigenous and Western knowledge in water research and management. While these policies require people with knowledge from both Western and Indigenous perspectives to collaborate and share knowledge, how best to create and foster these partnerships is less understood. To elicit this understanding, 17 semi-structured interviews were completed with academic researchers from Canada and Australia who conduct integrative water research. Participants, most of whom were non-Indigenous, were asked to expand on their experiences in conducting integrative water research projects, and findings were thematically analyzed. Our findings suggest that Indigenous and Western knowledge systems influence how one relates to water, and that partnerships require a recognition and acceptance of these differences. We learned that community-based participatory research approaches, and the associated tenets of fostering mutual trust and community ownership for such an approach, are integral to the meaningful engagement that is essential for developing collaborative partnerships to implement both Indigenous and Western knowledge systems and better care for water.

New Publication! Water quality and health in northern Canada

Congratulations to Carlee Wright on her first first-author publication!  Carlee worked with the Rigolet Inuit Community Government to examine potential associations between stored drinking water and acute gastrointestinal illness in Labrador Inuit. Citation: Wright, C.J., Sargeant, J.M., Edge, V.L., Ford, J.D., Farahbakhsh, K., Shiwak, I., Flowers, C., IHACC Research Team, and Harper, S.L.  (2017). Water quality and health in northern Canada: stored drinking water and acute gastrointestinal illness in Labrador Inuit. Environmental Science and Pollution Research, DOI: 10.1007/s11356-017-9695-9.  Click here to access the article.

Abstract: One of the highest self-reported incidence rates of acute gastrointestinal illness (AGI) in the global peer-reviewed literature occurs in Inuit communities in the Canadian Arctic. This high incidence of illness could be due, in part, to the consumption of contaminated water, as many northern communities face challenges related to the quality of municipal drinking water. Furthermore, many Inuit store drinking water in containers in the home, which could increase the risk of contamination between source and point-of-use (i.e., water recontamination during storage). To examine this risk, this research characterized drinking water collection and storage practices, identified potential risk factors for water contamination between source and point-of-use, and examined possible associations between drinking water contamination and self-reported AGI in the Inuit community of Rigolet, Canada. The study included a cross-sectional census survey that captured data on types of drinking water used, household practices related to drinking water (e.g., how it was collected and stored), physical characteristics of water storage containers, and self-reported AGI. Additionally, water samples were collected from all identified drinking water containers in homes and analyzed for presence of Escherichia coli and total coliforms. Despite municipally treated tap water being available in all homes, 77.6% of households had alternative sources of drinking water stored in containers, and of these containers, 25.2% tested positive for total coliforms. The use of transfer devices and water dippers (i.e., smaller bowls or measuring cups) for the collection and retrieval of water from containers were both significantly associated with increased odds of total coliform presence in stored water (ORtransfer device = 3.4, 95% CI 1.2–11.7; ORdipper = 13.4, 95% CI 3.8–47.1). Twenty-eight-day period prevalence of self-reported AGI during the month before the survey was 17.2% (95% CI 13.0–22.5), which yielded an annual incidence rate of 2.4 cases per person per year (95% CI 1.8–3.1); no water-related risk factors were significantly associated with AGI. Considering the high prevalence of, and risk factors associated with, indicator bacteria in drinking water stored in containers, potential exposure to waterborne pathogens may be minimized through interventions at the household level.

Photos of Carlee's Research

How does seasonality and weather affect perinatal health?

Congratulations to Sarah MacVicar on her recent publication that examines how seasonality and weather affect perinatal Indigenous health in southwestern Uganda! Click here to access the abstract. 

Citation: MacVicar, S., Berrang-Ford, L., Harper, S.L., Steele, V., Lwasa, S., Bambaiha, D.N., Twesigomwe, S., Asaasira, G., Ross, N. and IHACC Research Team, 2017. How seasonality and weather affect perinatal health: Comparing the experiences of Indigenous and non-Indigenous mothers in Kanungu District, Uganda. Social Science & Medicine. 187: 39–48.

Abstract:  Maternal and newborn health disparities and the health impacts of climate change present grand challenges for global health equity, and there remain knowledge gaps in our understanding of how these challenges intersect. This study examines the pathways through which mothers are affected by seasonal and meteorological factors in sub-Saharan Africa in general, and Kanungu District (Uganda), in particular. We conducted a community-based study consisting of focus group discussions with mothers and interviews with health care workers in Kanungu District. Using a priori and a posterioricoding, we found a diversity of perspectives on the impacts of seasonal and weather exposures, with reporting of more food available in the rainy season. The rainy season was also identified as the period in which women performed physical labour for longer time periods, while work conditions in the dry season were reported to be more difficult due to heat. The causal pathways through which weather and seasonality may be affecting size at birth as reported by Kanungu mothers were consistent with those most frequently reported in the literature elsewhere, including maternal energy balance (nutritional intake and physical exertion output) and seasonal illness. While both Indigenous and non-Indigenous mothers described similar pathways, however, the severity of these experiences differed. Non-Indigenous mothers frequently relied on livestock assets or opportunities for less taxing physical work than Indigenous women, who had fewer options when facing food shortages or transport costs. Findings point to specific entry points for intervention including increased nutritional support in dry season periods of food scarcity, increased diversification of wage labour opportunities, and increased access to contraception. Interventions should be particularly targeted towards Indigenous mothers as they face greater food insecurity, may have fewer sources of income, and face greater overall deprivation than non-Indigenous mothers.

Food insecurity by season in households with children in Iqaluit

Congratulations to Catherine Huet for her new publication in BMC Public Health!  Her article examines food security in household with children in Iqaluit.  Click here for free access to the open-access article!  

Citation:

Huet, C., Ford, J., Berrang-Ford, L., Edge, V.L., Shirley, J., IHACC Research Team, King, N., Harper, S.L. (2017). Food insecurity and food consumption by season in households with children in an Arctic city: a cross-sectional study. BMC Public Health. 17:578

Abstract:

Background: High rates of food insecurity are documented among Inuit households in Canada; however, data on food insecurity prevalence and seasonality for Inuit households with children are lacking, especially in city centres. This project: (1) compared food consumption patterns for households with and without children, (2) compared the prevalence of food insecurity for households with and without children, (3) compared food consumption patterns and food insecurity prevalence between seasons, and (4) identified factors associated with food insecurity in households with children in Iqaluit, Nunavut, Canada.

Methods: Randomly selected households were surveyed in Iqaluit in September 2012 and May 2013. Household food security status was determined using an adapted United States Department of Agriculture Household Food Security Survey Module. Univariable logistic regressions were used to examine unconditional associations between food security status and demographics, socioeconomics, frequency of food consumption, and method of food preparation in households with children by season.

Results: Households with children (n = 431) and without children (n = 468) participated in the survey. Food insecurity was identified in 32.9% (95% CI: 28.5–37.4%) of households with children; this was significantly higher than in households without children (23.2%, 95% CI: 19.4–27.1%). The prevalence of household food insecurity did not significantly differ by season. Demographic and socioeconomic characteristics of the person responsible for food preparation, including low formal education attainment (ORSept = 4.3, 95% CI: 2.3–8.0; ORMay = 3.2, 95% CI: 1.8–5.8), unemployment (ORSept = 1.1, 95% CI: 1.1–1.3; ORMay = 1.3, 95% CI: 1.1–1.5), and Inuit identity (ORSept = 8.9, 95% CI: 3.4–23.5; ORMay = 21.8, 95% CI: 6.6–72.4), were associated with increased odds of food insecurity in households with children. Fruit and vegetable consumption (ORSept = 0.4, 95% CI: 0.2–0.8; ORMay = 0.5, 95% CI: 0.2–0.9), as well as eating cooked (ORSept = 0.5, 95% CI: 0.3–1.0; ORMay = 0.5, 95% CI: 0.3–0.9) and raw (ORSept = 1.7, 95% CI: 0.9–3.0; ORMay = 1.8, 95% CI: 1.0–3.1) fish were associated with decreased odds of food insecurity among households with children, while eating frozen meat and/or fish (ORSept = 2.6, 95% CI: 1.4–5.0; ORMay = 2.0, 95% CI: 1.1–3.7) was associated with increased odds of food insecurity.

Conclusions:  Food insecurity is high among households with children in Iqaluit. Despite the partial subsistence livelihoods of many Inuit in the city, we found no seasonal differences in food security and food consumption for households with children. Interventions aiming to decrease food insecurity in these households should consider food consumption habits, and the reported demographic and socioeconomic determinants of food insecurity.

Does Weather Matter for Foetal Growth in Uganda?

Congratulations to Sarah MacVicar for her new publication!  Sarah's paper examines associations between in utero meteorological exposures and foetal growth among Indigenous and non-Indigenous mothers in rural Uganda. If you ever wondered how weather conditions impact foetal growth, check out this paper!  Click here to view the open-access paper. 

Paper citation:

MacVicar, S., Berrang-Ford, L., Harper, S.L., Huang, Y., Namanya, B.D. and Yang, S., 2017. Whether weather matters: Evidence of association between in utero meteorological exposures and foetal growth among Indigenous and non-Indigenous mothers in rural Uganda. PloS one, 12(6), p.e0179010.

Abstract:

Pregnancy and birth outcomes have been found to be sensitive to meteorological variation, yet few studies explore this relationship in sub-Saharan Africa where infant mortality rates are the highest in the world. We address this research gap by examining the association between meteorological factors and birth weight in a rural population in southwestern Uganda. Our study included hospital birth records (n = 3197) from 2012 to 2015, for which we extracted meteorological exposure data for the three trimesters preceding each birth. We used linear regression, controlling for key covariates, to estimate the timing, strength, and direction of meteorological effects on birth weight. Our results indicated that precipitation during the third trimester had a positive association with birth weight, with more frequent days of precipitation associated with higher birth weight: we observed a 3.1g (95% CI: 1.0–5.3g) increase in birth weight per additional day of exposure to rainfall over 5mm. Increases in average daily temperature during the third trimester were also associated with birth weight, with an increase of 41.8g (95% CI: 0.6–82.9g) per additional degree Celsius. When the sample was stratified by season of birth, only infants born between June and November experienced a significant associated between meteorological exposures and birth weight. The association of meteorological variation with foetal growth seemed to differ by ethnicity; effect sizes of meteorological were greater among an Indigenous subset of the population, in particular for variation in temperature. Effects in all populations in this study are higher than estimates of the African continental average, highlighting the heterogeneity in the vulnerability of infant health to meteorological variation in different contexts. Our results indicate that while there is an association between meteorological variation and birth weight, the magnitude of these associations may vary across ethnic groups with differential socioeconomic resources, with implications for interventions to reduce these gradients and offset the health impacts predicted under climate change.

Photos of Sarah's Research:

 

New Book Chapter about Reconciliation and Water Research

Citation:

Castleden, H., Hart, C., Cunsolo, A., Harper, S.L. and Martin, D. (2017). Reconciliation and relationality in water research and management in Canada: Implementing Indigenous ontologies, epistemologies, and methodologies. In Water Policy and Governance in Canada (pp. 69-95). Springer International Publishing. Click here for access.

Abstract

Water-related issues disproportionately affect Indigenous communities in Canada. Despite millions in investment, Western-trained scientists, engineers, and other researchers as well as the government agencies that have constitutionally-mandated fiduciary responsibilities to address such issues have been rather unsuccessful in solving them. This has been due, in large part, to an overreliance on methods of Western science and management, ignoring the vast place-based wisdom of Indigenous knowledge systems and relational practices regarding water found across the country. The underlying reasons for this partiality are not innocuous; entrenched colonial and racist policies, programs, and practices have persisted across time and space. In recent years, there is increasing recognition of the importance of applying Indigenous approaches to water challenges in Canada. But strategies for successful implementation are only beginning to emerge. In an attempt to respond to this knowledge gap, our research has sought to systematically identify and assess how both Indigenous and Western ontologies, epistemologies, and methodologies have been implemented in water research and management. In doing so, this chapter identifies some of the most promising practices in Canada. We share these with the goal of contributing to processes of reconciliation and responsibility towards each other as well as our roles as water stewards across the country.