International Journal of Circumpolar Health最新文献

Maternal services and policies are initiated, envisioned and established under a colonial premise. Cheko Gǫįtì (gift of the child) is an effort to analyze and document how maternal care programs and policies affect maternal child services in 4 communities of the Northwest Territories (NT). Two frameworks were adapted, 2-eyed seeing and analyzing public policies. These frameworks guided the research process (community engagement, data collection and analysis and knowledge mobilization). The findings are grouped under the policy dimensions of effectiveness, unintended effects, equity, cost, feasibility and acceptability. What we learned informed our recommendations towards decolonizing the predominant westernized system.

Low temperatures pose a significant yet underrecognized occupational health risk, particularly for outdoor workers with climate-sensitive medical conditions such as diabetes, cardiovascular disease, and respiratory disorders. While cold exposure is often associated with Arctic and high-altitude regions, even temperate and warmer climates experience severe winter temperature drops, placing a broad spectrum of outdoor workers at risk. Despite extensive research highlighting the adverse health effects of cold stress and its contribution to global mortality rates, occupational health and safety (OHS) guidelines remain disproportionately focused on heat-related risks, neglecting the unique vulnerabilities of workers exposed to extreme cold. This paper critically examines the gaps in current OHS policies and regulations regarding cold exposure, emphasizing the urgent need for evidence-based guidelines that specifically address the needs of outdoor workers with preexisting health conditions. By integrating medical, environmental, and occupational safety perspectives, we propose a framework for comprehensive protective measures, including improved risk assessment protocols, workplace adaptations, and regulatory interventions. Addressing this oversight is essential not only for safeguarding workers' health but also for promoting sustainable labor practices and enhancing resilience in industries where cold exposure is a persistent threat. Establishing clear, targeted guidelines will be a crucial step toward mitigating cold-related occupational hazards and fostering a healthier global workforce.

Health organizations support sugar-sweetened beverage (SSB) policies without examination of the purchasing contexts in northern, remote First Nations. Therefore, we sought to explore experiences and practices purchasing SSB in Island Lake Anisininew First Nations. We utilized a community-based participatory design, partnered with Four Arrows Regional Health Authority. We completed semi-structured, qualitative interviews with adult residents from all four communities of Island Lake Anisininew Nations. Thirty-nine interviews were completed, transcribed verbatim, and analyzed thematically. We identified three themes: sensitivity to SSB pricing and strategic shopping, spatial and economic convenience of SSB, and SSB purchasing as a social norm. Many participants identified barriers regarding food and beverage procurement, living in remote communities. Thus, price and convenience were major determinants when purchasing SSB. Participants described various economizing strategies, selecting SSB based on location pricing, type of SSB, and amount purchased. Relatedly, purchasing SSB at community members' homes, "home stores", was described as both the most affordable and convenient option. SSB are perceived as simultaneously expensive and affordable in Island Lake Anisininew First Nations due to high food prices. Community members have sought to overcome challenges of SSB procurement with "home stores", as both an economic opportunity and food security strategy in difficult circumstances.

This paper presents the background, planning, implementation, and outcomes of the inaugural Circumpolar Maternal and Child Health (CMCH) workshop, which aimed to co-develop a values-based and culture-informed research agenda for maternal and child health in the Circumpolar region. Recognizing the historical and ongoing impacts of colonization on Indigenous health systems, the workshop employed community-based participatory research (CBPR) methods to ensure inclusive and equitable engagement of care providers, program designers, Indigenous knowledge holders, and researchers. Through facilitated panels, sharing circles, and breakout sessions, participants explored culturally grounded approaches to maternal health, including the First 1000 Days, trauma-informed care, and birthing practices. Discussions emphasized Indigenous epistemologies, relational approaches, and the need to reframe Western concepts such as risk and trauma through community-defined perspectives. The workshop fostered relationship building and collective reflection, identifying key priorities for future research and collaboration. Reflections underscore the importance of holistic, community-responsive maternal health systems that honour Indigenous values, support local governance, and promote culturally safe, strengths-based care and research.

Working with an Indigenous Advisory Committee, including an Inuit Health Advisor and Researcher, we analyzed the 2017 Aboriginal Peoples Survey to examine prevalence and factors associated with pain-related disabilities (PRDs) among Inuit in Canada. Self-reported data were collected from Inuit ≥15 years. PRDs were defined as 'sometimes', 'often', or 'always' experiencing activity limitations due to pain from a long-term condition lasting ≥ six months. We computed PRD prevalence [95% CI] overall, and by geographic location, age, sex, type and number of co-existing disabilities. Modified Poisson regression with robust variance estimation modelled associations between Inuit social determinants of health and PRDs. Person-level and bootstrap weights were applied for all analyses. Among Inuit, 11.1% [10.0, 12.4] reported PRDs. Females [13.4% (11.8, 15.1)], individuals 55 + [23.7% (21.6, 25.9)], and those who lived outside Inuit Nunangat [17.1% (14.1, 20.5)] experienced higher prevalence of PRDs. Prevalence increased with the number of disabilities-highest among those with co-existing physical disabilities. Additionally, higher education, residential school attendance, and those who experienced difficulties related to food, housing, employment, and health were more likely to report PRDs. Characteristics which may increase the risk of PRDs need to be shared with Inuit stakeholders to guide next steps for awareness, advocacy, services and interventions.

Greenland has a high prevalence of chronic suppurative otitis media (CSOM), causing hearing loss (HL) in children. Understanding regional differences in prevalence is essential for public health service provision. This school-based cross-sectional study is the first to examine the prevalence of HL among children attending the only school in Tasiilaq, East Greenland. Video-otoscopy, tympanometry and pure-tone air and bone conduction audiometry were performed. In total 92 of 114 children aged 5-11 were included. 51 children (55%) had HL defined as pure-tone-average (PTA) >15 dB in the worst hearing ear according to the American-Speech-Language-Hearing-Association-criteria. Whereas 21 children (23%) had HL with PTA >20 in worst hearing ear according to the WHO-criteria. None of the children had previously been diagnosed. Among the 184 otoscopies, 45 were normal (24%), 43 showed wax-block (23%), 10 showed tympanic membrane perforation (5%) and 86 had other otitis media-related sequelae (47%). A high prevalence of HL and CSOM were found among children in East Greenland. 25% of the children should be assessed for hearing rehabilitation, indicating that HL on the east coast remains undiagnosed and untreated. The results highlight regional variation in CSOM and HL and support the need for regional data and new initiatives to prevent HL across Greenland.

Alberta Health Services enacted the Patient Access to Spiritual Ceremony policy on National Indigenous Peoples' Day in 2023. The policy aims to directly support Indigenous patients to practice their traditional ceremonies on healthcare premises. This paper details the process of developing and implementing the policy, explores the challenges, and underscores the broader implications for healthcare institutions seeking to integrate cultural practices. Relational conversations and storytelling with key players in the development of the policy were carried out, explored alongside review of the literature and analysis of ethical considerations. Policy development involved consultations with Indigenous communities, Elders, and healthcare professionals to ensure cultural authenticity and safety of the policy implemented across various healthcare levels. The development process encountered several challenges that required careful navigation, including managing open flames within medical facilities, addressing concerns around ceremonial smoke, and the effort to institutionalize such a policy highlighted underlying issues of racial bias that needed to be addressed proactively. The policy exemplifies a commitment to respecting spiritual practices while maintaining a safe and inclusive environment for patients and represents a significant stride towards addressing historical injustices and promoting cultural inclusivity in healthcare.

Indigenous older adults across the globe face higher rates of chronic illness and lower life expectancy than non-Indigenous populations, yet little research has examined how physical literacy might support their health and well-being. Traditionally applied to children and youth, physical literacy-understood as one's relationship with movement and physical activity across the life course-shares with Indigenous worldviews an emphasis on holistic well-being rooted in culture, community, and the environment. This exploratory review examines global literature to identify how physical literacy concepts-such as motivation, confidence, physical competence, and knowledge-connect with ways of knowing, being, and doing among Indigenous older adults, as well as in physical activity programs for this population. Findings reveal strong connections between physical literacy and culturally grounded forms of movement, with successful programs often integrating physical activity with cultural practices such as sharing circles. These initiatives reflect holistic views of health and highlight opportunities for culturally rooted approaches to physical literacy. The findings suggest that meaningful engagement with Indigenous older adults calls for physical literacy frameworks co-developed through community partnerships that honor Indigenous ways of knowing, being, and doing. Implications for policy and practice include the need for participatory program design that prioritizes social connection, intergenerational learning, spiritual health, and community well-being.

Northern regions of Canada have the highest reported incidence of childhood rickets in the country, yet this public health problem remains poorly described. The goal of this research was to explore the food and vitamin D supplementation experiences in pregnancy and infancy and examine associations with rickets diagnosis. Data were collected systematically through a retrospective chart review of Inuit children from 18 communities in Nunavut born from 2010-2013. Although most pregnant people reported consuming country food daily or weekly, one in three pregnant people reported being food insecure. Fewer than half of infants were reported to have received daily vitamin D supplement at two months of age, and frequency of supplement use declined with age. Rickets diagnosis was present in 1.63% of children (95% CI = 1.20%-2.20%). The odds of rickets diagnosis were higher for children whose mothers experienced food insecurity during pregnancy than for those whose mothers had never experienced food insecurity (OR = 5.279; 95% CI = 1.248-16.191). Enhanced support for food security, breastfeeding and vitamin D supplementation in early life is needed. In the context of social determinants of health, this study highlights the far-reaching and negative impacts of food insecurity on the health of Inuit children in Nunavut.