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Carnitine palmitoyltransferase 1A (CPT1A) P479L prevalence in live newborns in Yukon, Northwest Territories, and Nunavut.

https://arctichealth.org/en/permalink/ahliterature99279
Source
Mol Genet Metab. 2010 Jul 24;
Publication Type
Article
Date
Jul-24-2010
Author
Sorcha A Collins
Graham Sinclair
Sarah McIntosh
Fiona Bamforth
Robert Thompson
Isaac Sobol
Geraldine Osborne
Andre Corriveau
Maria Santos
Brendan Hanley
Cheryl R Greenberg
Hilary Vallance
Laura Arbour
Author Affiliation
Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.
Source
Mol Genet Metab. 2010 Jul 24;
Date
Jul-24-2010
Language
English
Publication Type
Article
Abstract
Carnitine palmitoyltransferase 1A (CPT1A), encoded by the gene CPT1A, is the hepatic isoform of CPT1 and is a major regulatory point in long-chain fatty acid oxidation. CPT1A deficiency confers risk for hypoketotic hypoglycaemia, hepatic encephalopathy, seizures, and sudden unexpected death in infancy (SUDI). It remains controversial whether the CPT1A gene variant, c.1436C>T (p.P479L), identified in Inuit, First Nations, and Alaska Native infants, causes susceptibility to decompensation, in particular during times of fever and intercurrent illness. Although newborn screening for the P479L variant occurs in some jurisdictions, background knowledge about the presence of the variant in Canadian Aboriginal populations is lacking. In an effort to understand the population implications of the variant in northern Canada, overall frequencies of the variant were assessed. Further studies are underway to determine associated risk. Ethics approval was obtained from university REBs, local research institutes, and with consultation with territorial Aboriginal groups. Newborn screening blood spots from all infants born in 2006 in the three territories were genotyped for the p.P479L variant. p.P479L (c.1436C>T) allele frequencies in the three territories were 0.02, 0.08, and 0.77 in Yukon (n=325), Northwest Territories (n=564), and Nunavut (n=695), respectively. Homozygosity rates were 0%, 3%, and 64%. Aboriginal status was available only in NWT, with allele frequencies of 0.04, 0.44, 0.00, and 0.01 for First Nations, Inuvialuit/Inuit, Métis, and non-Aboriginal populations. Although individual blood spots were not identified for Aboriginal ethnicity in Nunavut infants, ~90% of infants in Nunavut are born to Inuit women. The allele frequency and rate of homozygosity for the CPT1A P479L variant were high in Inuit and Inuvialuit who reside in northern coastal regions. The variant is present at a low frequency in First Nations populations, who reside in areas less coastal than the Inuit or Inuvialuit in the two western territories. The significance of the population and geographic distribution remains unclear, but the high population frequencies of the variant suggest a historically low penetrance for adverse outcomes. Further evidence is needed to determine if there is an increased risk for infant mortality and morbidity and whether newborn screening will be indicated on a population basis.
PubMed ID
20696606 View in PubMed
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Carnitine palmitoyltransferase 1A (CPT1A) P479L prevalence in live newborns in Yukon, Northwest Territories, and Nunavut

https://arctichealth.org/en/permalink/ahliterature294610
Source
Molecular Genetics and Metabolism 101 (2010) 200–204
Publication Type
Article
Date
2010
  1 document  
Author
Sorcha A. Collins
Graham Sinclair
Sarah McIntosh
Fiona Bamforth
Robert Thompson
Isaac Sobol
Geraldine Osborne
Andre Corriveau
Maria Santos
Brendan Hanley
Cheryl R. Greenberg
Hilary Vallance
Laura Arbour
Source
Molecular Genetics and Metabolism 101 (2010) 200–204
Date
2010
Language
English
Geographic Location
Canada
Publication Type
Article
File Size
319667
Keywords
Carnitine palmitoyltransferase 1A
Fatty acid oxidation
Newborn screening
Hypoglycemia
Inuit
First Nations
Abstract
Carnitine palmitoyltransferase 1A (CPT1A), encoded by the gene CPT1A, is the hepatic isoform of CPT1 and is a major regulatory point in long-chain fatty acid oxidation. CPT1A deficiency confers risk for hypoketotic hypoglycaemia, hepatic encephalopathy, seizures, and sudden unexpected death in infancy (SUDI). It remains controversial whether the CPT1A gene variant, c.1436CNT (p.P479L), identified in Inuit, First Nations, and Alaska Native infants, causes susceptibility to decompensation, in particular during times of fever and intercurrent illness. Although newborn screening for the P479L variant occurs in some jurisdictions, background knowledge about the presence of the variant in Canadian Aboriginal populations is lacking. In an effort to understand the population implications of the variant in northern Canada, overall frequencies of the variant were assessed. Further studies are underway to determine associated risk. Ethics approval was obtained from university REBs, local research institutes, andwith consultationwith territorial Aboriginal groups.Newborn screening blood spots fromall infants born in 2006 in the three territorieswere genotyped for the p.P479L variant. p.P479L (c.1436CNT) allele frequencies in the three territories were 0.02, 0.08, and 0.77 in Yukon (n=325), Northwest Territories (n=564), and Nunavut (n=695), respectively. Homozygosity rateswere 0%, 3%, and 64%. Aboriginal statuswas available only inNWT,with allele frequencies of 0.04, 0.44, 0.00, and 0.01 for First Nations, Inuvialuit/Inuit,Métis, and non-Aboriginal populations. Although individual blood spots were not identified for Aboriginal ethnicity in Nunavut infants, ~90% of infants in Nunavut are born to Inuit women. The allele frequency and rate of homozygosity for the CPT1A P479L variant were high in Inuit and Inuvialuit who reside in northern coastal regions. The variant is present at a lowfrequency in FirstNations populations,who reside inareas less coastal than the Inuit or Inuvialuit in the two western territories. The significance of the population and geographic distribution remains unclear, but the high population frequencies of the variant suggest a historically low penetrance for adverse outcomes. Further evidence is needed to determine if there is an increased risk for infant mortality and morbidity and whether newborn screening will be indicated on a population basis.
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CPT1A-P479L---Collins-Arbour-etc.pdf

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Causes and risk factors for infant mortality in Nunavut, Canada 1999-2011.

https://arctichealth.org/en/permalink/ahliterature118207
Source
BMC Pediatr. 2012;12:190
Publication Type
Article
Date
2012
Author
Sorcha A Collins
Padma Surmala
Geraldine Osborne
Cheryl Greenberg
Laakkuluk Williamson Bathory
Sharon Edmunds-Potvin
Laura Arbour
Author Affiliation
Department of Medical Genetics, University of British Columbia Island Medical Program, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada.
Source
BMC Pediatr. 2012;12:190
Date
2012
Language
English
Publication Type
Article
Keywords
Carnitine O-Palmitoyltransferase - genetics
Cause of Death
Genetic markers
Humans
Infant
Infant Care - methods
Infant mortality
Infant, Newborn
Infant, Premature
Infection - epidemiology - etiology
Nunavut - epidemiology
Retrospective Studies
Risk factors
Sudden Infant Death - epidemiology - etiology - genetics
Abstract
The northern territory Nunavut has Canada's largest jurisdictional land mass with 33,322 inhabitants, of which 85% self-identify as Inuit. Nunavut has rates of infant mortality, postneonatal mortality and hospitalisation of infants for respiratory infections that greatly exceed those for the rest of Canada. The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. Nunavut has the largest Inuit population in Canada, a population which has been identified as having high rates of Sudden Infant Death Syndrome (SIDS) and infant deaths due to infections.
To determine the causes and potential risk factors of infant mortality in Nunavut, we reviewed all infant deaths (
Notes
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PubMed ID
23231747 View in PubMed
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Collaborating toward improving food security in Nunavut.

https://arctichealth.org/en/permalink/ahliterature107695
Source
Pages 803-810 in N. Murphy and A. Parkinson, eds. Circumpolar Health 2012: Circumpolar Health Comes Full Circle. Proceedings of the 15th International Congress on Circumpolar Health, Fairbanks, Alaska, USA, August 5-10, 2012. International Journal of Circumpolar Health 2013;72 (Suppl 1):803-810
Publication Type
Article
Date
2013
  1 document  
Author
Jennifer Wakegijig
Geraldine Osborne
Sara Statham
Michelle Doucette Issaluk
Author Affiliation
Government of Nunavut Department of Health, Iqaluit, Nunavut, Canada.
Source
Pages 803-810 in N. Murphy and A. Parkinson, eds. Circumpolar Health 2012: Circumpolar Health Comes Full Circle. Proceedings of the 15th International Congress on Circumpolar Health, Fairbanks, Alaska, USA, August 5-10, 2012. International Journal of Circumpolar Health 2013;72 (Suppl 1):803-810
Date
2013
Language
English
Publication Type
Article
Digital File Format
Text - PDF
Physical Holding
University of Alaska Anchorage
Keywords
Food Supply - methods
Humans
Indians, North American
Nunavut
Poverty - prevention & control
Quality Improvement
Abstract
Community members, Aboriginal organizations, public servants and academics have long been describing a desperate situation of food insecurity in the Eastern Canadian Arctic.
The Nunavut Food Security Coalition, a partnership of Inuit Organizations and the Government of Nunavut, is collaborating to develop a territorial food security strategy to address pervasive food insecurity in the context of poverty reduction.
The Nunavut Food Security Coalition has carried out this work using a community consultation model. The research was collected through community visits, stakeholder consultation and member checking at the Nunavut Food Security Symposium.
In this paper, we describe a continuous course of action, based on community engagement and collective action, that has led to sustained political interest in and public mobilization around the issue of food insecurity in Nunavut.
The process described in this article is a unique collaboration between multiple organizations that has led to the development of a sustainable partnership that will inform policy development while representing the voice of Nunavummiut.
Notes
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PubMed ID
23984307 View in PubMed
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Costs associated with infant bronchiolitis in the Baffin region of Nunavut.

https://arctichealth.org/en/permalink/ahliterature5807
Source
Int J Circumpolar Health. 2005 Feb;64(1):38-45
Publication Type
Article
Date
Feb-2005
Author
David Creery
Priya Lyer
Lindy Samson
Doug Coyle
Geraldine Osborne
Alexander MacDonald
Author Affiliation
Children's Hospital of Eastern Ontario, Canada. dcreery@cheo.on.ca
Source
Int J Circumpolar Health. 2005 Feb;64(1):38-45
Date
Feb-2005
Language
English
Publication Type
Article
Keywords
Bronchiolitis, Viral - diagnosis - economics - ethnology - therapy
Comparative Study
Cost of Illness
Cost-Benefit Analysis
Female
Health Care Costs
Hospital Costs
Hospitalization - economics
Humans
Infant
Inuits
Male
Nunavut - epidemiology
Pilot Projects
Respiratory Syncytial Virus Infections - diagnosis - economics - ethnology - therapy
Retrospective Studies
Rural Health
Abstract
OBJECTIVE. Although infants living in the north of Canada have been reported to have one of the highest rates of hospital admission for bronchiolitis in the world, the economic effects of this condition have not been reported. Passive immunization against the Respiratory Syncytial Virus, the most common causative agent of infant bronchiolitis, is available. METHODS: We tabulated transportation, in-hospital care and family accommodation costs for infants of less than 12 months of age residing in the Baffin Region of Nunavut aged who were admitted to Baffin Regional Hospital in Iqaluit, Nunavut, and the Children's Hospital of Eastern Ontario in Ottawa, Ontario, with a primary diagnosis of bronchiolitis or viral pneumonia, over a 36-month period, between April 1999 and March 2002. RESULTS: One hundred fifty-nine infants were admitted a total of 210 times, with 196 admissions to Baffin Regional Hospital, and 14 to the Children's Hospital of Eastern Ontario, during the study period. The overall, annual, population-based admission rate for the Baffin Region of Nunavut was 197 admissions per thousand infants per year. Total costs were $2,997,373 ($2,357,747 for Baffin Regional Hospital, $639,625 for the Children's Hospital of Eastern Ontario). Overall average costs were $14,273 per admission, $12,029 for infants admitted to Baffin Regional Hospital and $45,688 for infants admitted to the Children's Hospital of Eastern Ontario. CONCLUSIONS: Infant bronchiolitis in the Baffin Region of Nunavut represents a significant burden on the territorial health care system.
PubMed ID
15776991 View in PubMed
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Cultural, socioeconomic, and health indicators among Inuit preschoolers: Nunavut Inuit Child Health Survey, 2007-2008.

https://arctichealth.org/en/permalink/ahliterature96608
Source
Rural Remote Health. 2010 Apr-Jun;10(2):1365
Publication Type
Article
Author
Grace M Egeland
Nancy Faraj
Geraldine Osborne
Author Affiliation
CINE, Macdonald Campus, McGill University, Montreal, Quebec, Canada. grace.egeland@mcgill.ca
Source
Rural Remote Health. 2010 Apr-Jun;10(2):1365
Language
English
Publication Type
Article
Abstract
INTRODUCTION: Indicators of socioeconomic status, health behaviours and health histories are important for evaluating population health and indicators associated with 'indigeneity' features, prominently as determinants of health for Indigenous peoples. Health surveillance of young children, who represent society's most vulnerable, can provide meaningful data regarding achieving an optimal healthy start in life. METHODS: A cross-sectional health survey of Inuit children, aged 3-5 years, was conducted between 2007 and 2008. The latitude of the communities ranged from 56 degrees 32'N to 72 degrees 40'N. A bilingual research team conducted face-to-face interviews which included the use of questionnaires covering factors associated with indigeneity, the physical and socio-economic environment, health behaviours and health histories. Weighted prevalence estimates were calculated. RESULTS: The participation rate was 72.3%; 388 randomly selected children participated. Indicators of traditional food utilization and sharing were highly prevalent and Inuktitut was spoken by 65.2% of preschoolers in the Inuktitut speaking regions. A large percent of the preschoolers lived in a crowded dwelling (53.9%) and in public housing (69.7%), and in a home in need of major repairs (37%). There was an average of 2 smokers per household but the majority of homes restricted smoking to outside the home (83.1%). The majority of mothers smoked during pregnancy (82.5%). For children who were not adopted, there was a high prevalence of breastfeeding initiation (80.6%). A high prevalence of children were ever hospitalized, excluding deliveries (41.6%), and within the past year 40.7% of the children had to be taken to the health centre or hospital for a respiratory problem. CONCLUSION: Indicators of indigeneity suggest the Inuktitut language is thriving and that children are learning Inuit ways through extended family contact and country food utilization and sharing. The high prevalence of smoking restrictions in the home is evidence of the success of public health messaging but further work is needed to improve health behaviours. The high prevalence of household crowding, homes in need of major repairs, public housing and income support all indicate chronic economic and social disadvantages that have negative implications for children's health. Interventions are needed to improve housing and reduce poverty for families with young children.
PubMed ID
20568906 View in PubMed
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The current state of birth outcome and birth defect surveillance in northern regions of the world.

https://arctichealth.org/en/permalink/ahliterature98473
Source
Int J Circumpolar Health. 2009 Dec;68(5):443-58
Publication Type
Article
Date
Dec-2009
Author
Laura Arbour
Vladimir Melnikov
Sarah McIntosh
Britta Olsen
Geraldine Osborne
Arild Vaktskjold
Author Affiliation
University of British Columbia, Department of Medical Genetics, Island Medical Program, Victoria, BC V8P 5C2, CANADA. larbour@uvic.ca
Source
Int J Circumpolar Health. 2009 Dec;68(5):443-58
Date
Dec-2009
Language
English
Publication Type
Article
Keywords
Arctic Regions - epidemiology
Congenital Abnormalities - epidemiology
Female
Humans
Population Surveillance - methods
Pregnancy
Pregnancy outcome
Registries
World Health
Abstract
OBJECTIVES: Little is known about the rates of congenital anomalies in the northernmost regions of the world. As in other parts of the world, it is crucial to assess the relative rates and trends of adverse birth outcomes and birth defects, as indicators of population health and to develop public health strategies for prevention. The aim of this review is to catalogue existing and developing birth outcome and birth defect surveillance within and around the geographic jurisdiction of the International Union of Circumpolar Health (IUCH). STUDY DESIGN: Descriptive study. METHODS: The representatives of the IUCH Birth Defects Working Group catalogued existing and developing birth and birth defect surveillance systems and the extent of information they contain to determine inter-regional comparability. RESULTS: Systematic population-based registration of birth outcomes including birth defects occurs to some degree in all circumpolar countries, but the quality of collection and the coverage in northernmost regions vary. There are limited circumpolar jurisdictions with surveillance systems collecting birth defect information beyond the perinatal period. Efforts are underway in Canada and Russia to improve the quality and comprehensiveness of the information collected in the northern regions. CONCLUSIONS: Although there is variability in the comprehensiveness of information collected in northern jurisdictions limiting sophisticated comparative analyses between regions, there is untapped potential for baseline analyses of specific risks and outcomes that could provide insight into geographic differences and gaps in surveillance that could be improved.
PubMed ID
20044963 View in PubMed
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The development of a comprehensive maternal-child health information system for Nunavut-Nutaqqavut (Our Children).

https://arctichealth.org/en/permalink/ahliterature131396
Source
Int J Circumpolar Health. 2011 Sep;70(4):363-72
Publication Type
Article
Date
Sep-2011
Author
Samantha Lauson
Sarah McIntosh
Natan Obed
Gwen Healey
Sirisha Asuri
Geraldine Osborne
Laura Arbour
Author Affiliation
UBC Department of Medical Genetics, Victoria, Canada.
Source
Int J Circumpolar Health. 2011 Sep;70(4):363-72
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Child
Child Welfare
Consumer Health Information - methods
Female
Humans
Information Services - organization & administration
Maternal Welfare
Nunavut
Population Surveillance
Pregnancy
Pregnancy Complications - prevention & control
Preventive Health Services - organization & administration
Abstract
Nunavut is the most northerly jurisdiction in Canada of which 85% of inhabitants are Inuit. Although most infants are born healthy, Nunavut leads the country for adverse early child health outcomes such as infant mortality, rates of birth defects, prematurity and low birth weight. Public health and community efforts are needed to understand and improve outcomes.
To inform these issues, a combined University of British Columbia/Nunavut Public Health Strategy effort has initiated a comprehensive maternal-child health surveillance system (from 16 weeks gestation to age 5). A diverse group of professional and lay stakeholders were brought together initially to determine local interest. Following this, a series of small working groups were held to decide on potential prenatal, perinatal and early child health variables, to be documented.
Over 100 Nunavut participants have now had some role in the development of the system which has been initiated. Pre-existing standard prenatal forms and well-child assessment forms have been modified to include "Nunavut specific" variables of nutrition, food and domestic security, exposures in pregnancy, birth defects, development, chronic diseases of childhood and paternal information.
This comprehensive maternal-child health information system has been developed with the extensive input of health care providers and stakeholders, utilizing community and public health systems already in place. Careful assessment of local needs has contributed to database development, privacy protection, potential data utilization for health promotion and plans for dissemination of findings. It is hoped that this will be a user-friendly surveillance system, adaptable to other community and public health systems that will improve the understanding of Aboriginal maternal-child health determinants.
PubMed ID
21910957 View in PubMed
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Identification of environmental sources of lead exposure in Nunavut (Canada) using stable isotope analyses.

https://arctichealth.org/en/permalink/ahliterature257354
Source
Environ Int. 2014 Oct;71:63-73
Publication Type
Article
Date
Oct-2014
Author
Myriam Fillion
Jules M Blais
Emmanuel Yumvihoze
Maya Nakajima
Peter Workman
Geraldine Osborne
Hing Man Chan
Author Affiliation
Centre for Advanced Research in Environmental Genomics, University of Ottawa, 30 Marie Curie, Gendron 160, Ottawa, Ontario K1N 6N5, Canada.
Source
Environ Int. 2014 Oct;71:63-73
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Child
Child, Preschool
Drinking Water - chemistry
Dust - analysis
Environmental Exposure - analysis - prevention & control
Environmental Monitoring - statistics & numerical data
Environmental Pollutants - analysis - blood - toxicity
Female
Follow-Up Studies
Housing
Humans
Inuits
Isotopes - analysis
Lead - analysis - blood - toxicity
Male
Mass Spectrometry
Nunavut
Paint - analysis
Pregnancy
Soil - chemistry
Abstract
Blood lead levels (BLLs) were measured in the adult Inuit population of Nunavut, Northern Canada, during the Inuit Health Survey (IHS) in 2007-2008. Approximately 10% of the adult participants had BLL over the Health Canada's guidance of 100µg/L.
1) To repeat the measurement of BLL among the IHS participants with high BLL and household members including pregnant women and children under 10years of age; 2) to measure lead (Pb) concentrations in environmental samples to identify potential sources and 3) to explore how Pb from environmental samples contributes to BLL using Pb stable isotopic analyses.
Blood samples were collected from 100 adults and 56 children in 2012. A total of 169 environmental samples (tap water, house dust, paint, country food, soil, and ammunition) were collected from 14 houses from three communities where the IHS participants had the highest BLL. Total Pb concentrations and Pb isotope mass balance were determined by inductively coupled plasma-mass spectrometry (ICP-MS).
The geometric mean of BLL was 43.1µg/L; BLL increased with age and was higher in adults than children (71.1 vs. 17.5µg/L). Median Pb concentrations in water (1.9µg/L) and dust (27.1µg/m(2) for wiped dust, 32.6mg/kg for vacuum dust coarse fraction, and 141.9mg/kg for vacuum dust fine fraction) were generally higher than in other parts of Canada. Median Pb concentrations of food and soil coarse and fine fractions were low (36.6µg/kg, 5.4mg/kg and 11.8mg/kg respectively); paint chips exceeded the Canadian guidelines in two houses (median: 3.8mg/kg). Discriminant analyses and isotope ratio analyses showed that ammunition and house dust are major sources of Pb in this study population.
Analyses of Pb stable isotopes are useful to identify the routes of exposure to Pb. This approach can contribute to develop targeted public health programmes to prevent Pb exposure.
PubMed ID
24973640 View in PubMed
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Prevalence of affirmative responses to questions of food insecurity: International Polar Year Inuit Health Survey, 2007-2008.

https://arctichealth.org/en/permalink/ahliterature130409
Source
Int J Circumpolar Health. 2011;70(5):488-97
Publication Type
Article
Date
2011
Author
Renata Rosol
Catherine Huet
Michele Wood
Crystal Lennie
Geraldine Osborne
Grace M Egeland
Author Affiliation
Centre for Indigenous Peoples' Nutrition and Environment (CINE), School of Dietetics and Human Nutrition, Macdonald Campus, McGill University, Ste-Anne-de-Bellevue, Quebec, H9X 3V9, Canada.
Source
Int J Circumpolar Health. 2011;70(5):488-97
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Arctic Regions - epidemiology
Canada - epidemiology
Cross-Sectional Studies
Female
Food Deprivation
Food Habits - ethnology
Food Supply - statistics & numerical data
Humans
Inuits - psychology - statistics & numerical data
Male
Malnutrition - ethnology - prevention & control
Middle Aged
Nutritional Status
Population Surveillance
Poverty - ethnology
Prevalence
Socioeconomic Factors
Starvation - ethnology - prevention & control
Abstract
Assess the prevalence of food insecurity by region among Inuit households in the Canadian Arctic.
A community-participatory, cross-sectional Inuit health survey conducted through face-to-face interviews.
A quantitative household food security questionnaire was conducted with a random sample of 2,595 self-identified Inuit adults aged 18 years and older, from 36 communities located in 3 jurisdictions (Inuvialuit Settlement Region; Nunavut; Nunatsiavut Region) during the period from 2007 to 2008. Weighted prevalence of levels of adult and household food insecurity was calculated.
Differences in the prevalence of household food insecurity were noted by region, with Nunavut having the highest prevalence of food insecurity (68.8%), significantly higher than that observed in Inuvialuit Settlement Region (43.3%) and Nunatsiavut Region (45.7%) (p=0.01). Adults living in households rated as severely food insecure reported times in the past year when they or other adults in the household had skipped meals (88.6%), gone hungry (76.9%) or not eaten for a whole day (58.2%). Adults living in households rated as moderately food insecure reported times in the past year when they worried that food would run out (86.5%) and when the food did not last and there was no money to buy more (87.8%).
A high level of food insecurity was reported among Inuit adults residing in the Canadian Arctic, particularly for Nunavut. Immediate action and meaningful interventions are needed to mitigate the negative health impacts of food insecurity and ensure a healthy Inuit population.
Notes
Comment In: Int J Circumpolar Health. 2011;70(5):447-922208994
Comment In: Int J Circumpolar Health. 2011;70(5):444-622208993
PubMed ID
22005728 View in PubMed
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14 records – page 1 of 2.