sherilee harper

EcoHealth Research with Indigenous Communities

GDS Presentation Highlights!

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There were so many great presentations at the conference this year – but I wanted to highlight great presentations by some of my colleagues, collaborators, and students.  I have cut and paste these abstracts from the conference program.

Climate Change and Mental Health in Northern Canada: A Nunatsiavut Regional Perspective 

Ashlee Cunsolo Willox, Cape Breton University; Marilyn Baikie, Memorial University; Juliana Flowers, Cape Breton University; Myrtle Groves, Cape Breton University; Rigolet Inuit Community Government; Greg Jacque, JC Erhardt Memorial; Noah Nochasak, Thompson Rivers University; Inez Shiwak, Rigolet Inuit Community Government; Michele Wood, Nunatsiavut Government

Anthropogenic climate change has been an increasing concern for Inuit across Canada, and the rapid changes to ice thickness and extent, precipitation levels, weather patterns, and wildlife and vegetation dispersion are disrupting livelihoods, lifestyles, and health and well-being for many. Emerging evidence also indicates that climate change and associated environmental degradation may potentially impact mental health and wellness globally. These climate-sensitive mental health impacts are expected to be widespread, cumulative, and unequally distributed around the globe, impacting most severely those living in rural or remote regions and those directly reliant on the natural environment for sustenance and livelihoods, such as Inuit in Canada’s North. Recognizing this, the five Inuit Community Governments of Nunatsiavut, Labrador, Canada conducted a regional study on the impacts of climate change on mental health. This research followed a community-based and community-led participatory framework. Data were gathered through 120 in-depth interviews, 18 digital stories, and 25 video interviews for a documentary film. Participants reported: intense emotional reactions associated with loss of activities, identity, and sense of place (grief, anxiety, stress, distress); real and potential increases in consumption of drugs and alcohol; potential increases in suicide ideation; and potential aggravation of acute anxiety disorders and major depression. Climate change was also reported to act as a magnifier for other forms of stress and distress and to highlight socio-economic inequalities, leading to further negative ramifications for mental health and well-being. These findings contribute to the emerging research on climate change and mental health, and provide a baseline of potential pathways through which climate change may continue to impact on mental health.


Evaluating emerging tools to address uncertainties and complexities of engineering design in northern communities 
Allan Gordon, University of Guelph; Rigolet Inuit Community Government; Victoria Edge, University of Guelph; Khosrow Farahbakhsh, University of Guelph; Nunatsiavut Government, Environment Division; Sherilee Harper, University of Guelph; Rachael Marshall, University of Guelph

Background: It is becoming increasingly evident that water and wastewater infrastructure in many northern communities is not appropriately designed to suit the local climatic, environmental, financial, or cultural context. Conventional engineering methodologies and tools do not to adequately capture the unique local context and complex nature of remote northern communities. Goal: This project explores methodologies and tools for community-based infrastructure planning by better capturing the broader community context. Specifically, these tools were piloted to assess water treatment infrastructure in Rigolet, Nunatsiavut. Methods: The steps included: (1) establishing a system boundary; (2) identifying stocks and flows of material, information, and financial and human resources; and (3) collecting qualitative and quantitative data to characterize flows and stocks by reviewing technical drawings, reports and other literature, and by conducting semi-structured interviews with stakeholders, focus groups with community members, and a community-wide questionnaire. Results: The approach verified the need for inclusion of extended peer communities to enrich the scientific research and incorporate multiple viewpoints and diverse perspectives. The baseline assessment identified the strengths of the current system to be low maintenance requirements and sufficient water supply quantity. System uncertainties identified include uncertain financial capital, impacts of climatic change, trained operator availability, significant dependence on fossil fuels, discharge of untreated sewage, and low public trust in the drinking water infrastructure. Conclusion: This work provides the foundation for identifying potential future states of the drinking water and wastewater system and will assist in the development of appropriate scenarios and narratives to inform future planning processes.


The burden of Acute Gastrointestinal Illness (AGI) for Inuit in Iqaluit, Nunavut, Canada 
Margaret Ellen McDonald, University of Guelph; Victoria Edge, Public Health Agency of Canada; James Ford, McGill University; Sherilee Harper, University of Guelph; Indigenous Health Adaptation to Climate Change Research Team, University of Guelph; Andrew Papadopoulos, University of Guelph; M. Kate Thomas, Public Health Agency of Canada

Background: Acute gastrointestinal illness (AGI) is an important global public health issue. The prevalence and risk factors related to AGI are unknown among Canadian Inuit and it is possible given their unique social, economic, and cultural conditions, these may differ compared with other Canadians. Objectives: This study (1) estimated the prevalence of AGI, and (2) identified risk factors for AGI for Inuit in Iqaluit, Nunavut, Canada. Methods: International burden of illness study methods were modified to reflect the Indigenous culture and Northern context of this study. Specifically, an EcoHealth framework was used to guide the research, which included principles of capacity development, transdisciplinarity, social equity, sustainability, and community participation. Two retrospective, cross-sectional surveys were conducted in Iqaluit in 2012 and 2013. Of the 1,055 individuals that participated in the survey, 694 self-identified as Aboriginal, which formed the basis of analysis. The prevalence of self-reported AGI was estimated using a case definition of diarrhea and/or vomiting in the past 14-days not due to pregnancy, drug or alcohol use, or diagnosed chronic conditions. Multivariable exact logistic regression was used to identify risk factors associated with AGI cases. Results: The 14-day prevalence of AGI for Inuit in Iqaluit was 12.8% in 2012 and 11.6% in 2013. Several, demographic, environmental and socio-economic factors were significantly associated with increased odds of AGI. Conclusions: Estimating the prevalence of AGI and identifying Inuit-specific risk factors for AGI, with continued Northern stakeholders’ collaboration was intended inform and strengthen evidence-based policy to reduce the impact of AGI in Inuit populations. These results will be used to co-develop and co-implement a knowledge translation project with Northern project stakeholders and community members toward enhancing AGI-related public health decision-making processes in Nunavut, Canada.


Health and Vulnerability to Climate Change: A Case Study of the Bakiga of Southwestern Uganda 
Jolène Labbé, University of Guelph, McGill University; Lea Berrang Ford, McGill University; Blanaid Donnelly, McGill University; James Ford, McGill University
Shuaib Lwasa, Makerere University; Scott McEwen, University of Guelph; Didacus Namanya, Ugandan Ministry of Health; IHACC Research Group; Sabastian Twesigomwe, Batwa Development Program

Climate change is one of the most significant threats to human health in many regions of sub-Saharan Africa; the pathways by which health will be affected being varied and complex. Within sub-Saharan Africa, Uganda has been identified as a country of particularly high vulnerability. Populations who practice agriculture and livestock based livelihoods in rural communities are thought to be at increased risk as their capacity to adapt to climate change if often constrained by human and physical capital, poverty, poor infrastructure, low ability to store food, and a dependence on natural resources. There is presently little knowledge about the vulnerability or resilience to the effects of climate change among many of Uganda’s rural populations. This paper addresses this gap by using a vulnerability approach to characterize the health of vulnerability to climate change in two Bakiga communities in rural southwestern Uganda. Field data were gathered from June – August 2013 using a variety of Rapid Rural Appraisal methods and PhotoVoice. The findings were qualitatively analyzed to identify climate-sensitive, community-identified health outcomes, to describe and characterize determinants of sensitivity at individual, community and regional levels, and assess the adaptive capacity of Bakiga health systems. Results will be profiled in conference presentation.


Including the Intangible: Photo-Cards as a Method for Analyzing the Social and Cultural Importance of Food in Rigolet, Nunatsiavut 
Kaitlyn Finner, McGill University; Charlie Flowers, Rigolet Inuit Community Government; James Ford, McGill University; Chris Furgal, Trent University; (RICG) Rigolet Inuit Community Government; Inez Shiwak, Rigolet Inuit Community Government

Definitions of food security increasingly emphasize the social and cultural importance of food. As a result there has been a shift in food security research to go beyond measuring and documenting the quantities and types of foods that are available and consumed to also include questions concerning how appropriate the available and consumed foods are based on the preferences and culture of the individuals, groups and communities. This expanded understanding of food security is especially relevant within the context of Northern Canada as food has historically been and continues to be an integral part of Inuit identity and culture. Many Inuit communities are experiencing increasing challenges to accessing their traditional foods from the land due to climate change as well as complex social and economic changes that culminate in food insecurity. In order to address these complex changes and to ensure food secure communities, interventions and policies must take into account the social and cultural importance of food. Focusing on a community based participatory research project with the community of Rigolet, Nunatsiavut, Labrador, this presentation will discuss the value of photo-cards as a tool and method for food security research. Drawing from and adapting data collection methods such as card sorts and conversational interviews, photo-cards have been used in Rigolet’s food security research as a means of eliciting community members’ preferences and cultural experiences with the foods that have been historically, and are currently, available within the community. The presentation demonstrates how photo-cards allowed participants to express their emotions, preferences and cultural experiences and affinity to certain foods in a way that was not available with the research methods traditionally used in food security research.


Using heat stress mapping to predict emergency room visits in rural Southern Ontario (2010-2012) 
Kate Bishop-Williams, University of Guelph; Olaf Berke, University of Guelph; David Kelton, University of Guelph; David Pearl, University of Guelph

In Southern Ontario, climate change gave rise to an increasing occurrence of heat waves, causing heat stress to the general public, with potentially fatal consequences. Heat waves are defined as three consecutive days with temperatures of 32°C and above. Heat stress is the level of discomfort. Heat stress indices measure heat stress, e.g. the heat stress index (HSI) is based on temperature and humidity, indicating serious health impacts above a level of 70 units. Maps visualizing the distribution of heat stress can provide information about related health risks and insight for control strategies. Information to inform heat wave preparedness models in Ontario was previously only available for major metropolitan areas. Hospitals in communities of fewer than 100,000 individuals were recruited for a pilot study by telephone. The number of people visiting the emergency room or 24-hour urgent care service was collected for 27 days, including three heat waves and six 3 day control periods from 2010-2012. The heat stress index was estimated using data from 37 weather stations, and subsequently interpolated across Southern Ontario by geostatistical kriging. Ordinary logistic regression modeling was applied to determine the odds of increased emergency room visits in a rural hospital with respect to the HSI. When the HSI exceeded a threshold value of 70 units, the odds of emergency room visits doubled (OR = 2.08, CI95%= (1.03-4.20), p = 0.04). This finding will aid hospitals and rural local public health units in preparing for emergencies during heat waves. Future research is needed to assess the relation between heat stress and individual characteristics and demographics of rural communities in Ontario.

Zooprophylaxis: a realist review 
Blanaid Donnelly, McGill University; Lea Berrang Ford, McGill University; Pascal Michel, Public Health Agency of Canada; Nancy Ross, McGill University

Malaria is a preventable, treatable disease that it is responsible for 500 million clinical cases resulting in 800,000 mortalities per year, 90% of which occur in Sub-Saharan Africa. The World Health Organization recommended zooprophylaxis, or the use of animals to divert mosquitoes from humans to reduce malaria risk, as a component of malaria control programs in 1982. However the evidence to support this strategy is conflicting. Some research shows that the presence of livestock and other animals may attract mosquitoes into close proximity with humans, thereby increasing human malaria risk. A realist review of the English language, peer-reviewed literature on zooprophylaxis was conducted to understand why this lack of consensus exists within the literature and under what circumstances animals increase or decrease human risk of malaria. Three electronic databases were searched, and forward and backward citation tracking used to identify articles relating to zooprophylaxis. Sixty-nine documents were identified based on a keyword search. Seventeen empirical studies were included and analyzed. The weight of evidence suggests that zooprophylaxis could be an effective strategy to reduce malaria transmission in specific contexts. First, zooprophylaxis is only effective when the mosquito species present do not have a strong preference for humans. Second, in order to take advantage of mosquito preference for animals, animals must be kept out of human sleeping quarters at night. Third, where bed nets are used, mosquitoes are more likely to feed on animal hosts as alternative. Further study is needed to understand the role of socioeconomic status as well as that of distance between animals and human sleeping quarters on zooprophylactic success and how these factors vary by region, animal species and number.

What is EcoHealth? 
EcoHealth Club, EcoHealth Club at Univeristy of Guelph; Katherine Bishop-Williams, EcoHealth Club at Univeristy of Guelph; Alexandra Swirski, EcoHealth Club at Univeristy of Guelph

EcoHealth is an inter- and transdisciplinary field that seeks to understand the relationships between human, animal, and environmental health and the interactions between them. It focuses on breaking down sectoral and disciplinary barriers to communicate about these important issues in order to enhance research and policy. The EcoHealth Club at the University of Guelph is made up of students and faculty interested in sharing their ideas, learning about and promoting EcoHealth concepts and ideas on campus and in the wider community. Current members include students from many different departments, including Population Medicine and Geography.We believe that humans, animal and environmental health will all benefit from increased interest and engagement.

Perceptions of Learning Success among younger generation Inuit in Ulukhaktok, NWT, Canada 
Genevieve Lalonde, University of Guelph; Tristan Pearce, University of the Sunshine Coast/ University of Guelph

This poster describes research that will examine perceptions of learning success among younger generation Inuit in a case study of Ulukhaktok, Northwest Territories, Canada. The research responds to a knowledge gap on the relevance and effectiveness of a western-based education system in the Arctic. Many agree that the formalization of education has displaced Inuit cultural identity and has contributed to the breakdown of traditional modes of learning, observation and apprenticeship. Meanwhile subsistence hunting and fishing remain a valued part of Inuit culture, but there is concern that some younger generation Inuit may not be as well equipped to participate in subsistence, particularly under changing conditions with negative implications for food security, health and well-being, and economy. If education in the Arctic is to serve the interests of students and contribute to the development of healthy communities it must embody Inuit perceptions of learning success and values.

Vulnerability of an Inuit Food System to Climate and Socio-Economic Changes
Colleen Parker, University of Guelph; Tristan Pearce, University of Guelph

The aim of this research is to determine the role food sharing plays in food security in an Inuit community. The objectives of this research are: 1) document and describe the dimensions of food security in an Inuit community; 2) identify and describe food sharing networks in an Inuit community; and 3) identify factors which aid or constrain food sharing. Data will be collected using ethnographic research techniques including, free-listing, semi-structured and structured interviews, and participant observation. The research will be undertaken in collaboration with community partners and follow established protocols and guidelines for research in the community and region. Similar studies are being conducted or have been completed across the Arctic and this research will contribute to the growing body of knowledge examining food sharing and food securing in light of climate change.

Inuit Traditional Knowledge and Adaptation to the Health Effects of Climate Change
Linnaea Jasiuk, University of Guelph; Tristan Pearce, University of Guelph

Climate change is occurring and the effects are impacting human health directly and indirectly. Inuit communities are experiencing dramatic impacts of climate change resulting in the emergence or exacerbation of health concerns (Ford 2012; Furgal and Seguin 2006). There is an expressed urgency for efforts to identify specific vulnerabilities and adaptive capacities to develop effective health interventions (Ford 2012; Lesnikowski et al. 2011). The vulnerability approach is considered effective for evaluating community specific economic, political, social, technological and cultural factors influencing their exposure, sensitivity and adaptive capacity (Ford and Smit 2004; Pearce et al. 2010). Given the plethora of socio-economic and cultural factors influencing how climate change impacts Inuit health, the vulnerability approach is ideal for research on the vulnerability and adaptive capacity of Inuit. Traditional knowledge is a key determinant of a community’s adaptive capacity (Pearce et al. 2010). Incorporation of Inuit traditional knowledge in vulnerability assessments is promoted to help capture intricate, culturally specific interactions between social, biophysical and biomedical vulnerability determinants; in particular Inuit conceptualizations on and approaches to, health are important to articulate, for identification of relevant health risks, prioritization of adaptations and design of effective, culturally responsive interventions (Ford 2012; Furgal and Seguin 2006). In this regard there is a scarcity of knowledge and opportunity for research. This work examines Inuit conceptualizations of and approaches to health and the development of culturally responsive and effective adaptation strategies for climate related health-stresses, in a case study of Ulukhaktok, NT.

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