Urbanization among Indigenous peoples is growing globally. This has implications for the assertion of Indigenous rights in urban areas, as rights are largely tied to land bases that generally lie outside of urban areas. Through their impacts on the broader social determinants of health, the links between Indigenous rights and urbanization may be related to health. Focusing on a Canadian example, this study explores relationships between Indigenous rights and urbanization, and the ways in which they are implicated in the health of urban Indigenous peoples living in Toronto, Canada. In-depth interviews focused on conceptions of and access to Aboriginal rights in the city, and perceived links with health, were conduced with 36 Aboriginal people who had moved to Toronto from a rural/reserve area. Participants conceived of Aboriginal rights largely as the rights to specific services/benefits and to respect for Aboriginal cultures/identities. There was a widespread perception among participants that these rights are not respected in Canada, and that this is heightened when living in an urban area. Disrespect for Aboriginal rights was perceived to negatively impact health by way of social determinants of health (e.g., psychosocial health impacts of discrimination experienced in Toronto). The paper discusses the results in the context of policy implications and future areas of research.
Many consider smoking to be a personal choice for which individuals should be held accountable. We assessed whether there is any evidence of bias against smokers in cardiac care decision-making by determining whether smokers were as likely as non-smokers to undergo revascularization procedures after cardiac catheterization.
Prospective cohort study. Subjects and setting. All patients undergoing cardiac catheterization in Alberta, Canada.
Patients were categorized as current smokers, former smokers, or never smokers, and then compared for their risk-adjusted likelihood of undergoing revascularization procedures (percutaneous coronary intervention or coronary artery bypass grafting) after cardiac catheterization.
Among 20406 patients undergoing catheterization, 25.4% were current smokers at the time of catheterization, 36.6% were former smokers, and 38.0% had never smoked. When compared with never smokers (reference group), the hazard ratio for undergoing any revascularization procedure after catheterization was 0.98 (95% CI 0.93-1.03) for current smokers and 0.98 (0.94-1.03) for former smokers. The hazard ratio for undergoing coronary artery bypass grafting was 1.09 (1.00-1.19) for current smokers and 1.00 (0.93-1.08) for former smokers. For percutaneous coronary intervention, the hazard ratios were 0.93 (0.87-0.99) for current smokers and 1.00 (0.94-1.06) for former smokers.
Despite potential for discrimination on the basis of smoking status, current and former smokers undergoing cardiac catheterization in Alberta, Canada were as likely to undergo revascularization procedures as catheterization patients who had never smoked.
The scientific study of the sexual dynamics that come into play during residency training seems to both fascinate and repel trainees and their supervisors. One of the more provocative and shameful dimensions of this area of inquiry, the abuse of residents, causes a good deal of distress. How do we respond to findings of significant psychological abuse, discrimination on the basis of sex or sexual orientation and sexual harassment in medical settings? How can we ignore over a decade of research? How can we not heed the experience of so many young physicians? Given the uncertain times in Canadian medicine and the insecurity in our professional and personal lives, we must work together to improve the culture of our teaching institutions and implement measures nationally and locally to close this dark chapter.
Effects of the "homosexual" label in obtaining community accommodation were examined, in a sample of 180 individuals advertising rooms or flats for rent in two Canadian cities, Windsor and London, Ontario, and in Detroit, Michigan. Telephone calls, for half the sample, made simple enquiries as to availability; for the other half, similar enquiries were made by an individual who was ostensibly homosexual. In the latter condition, rooms were significantly more likely to be described as unavailable. Comparisons are made to similar, previous research, and to current perspectives about community reactions to stigmatizing conditions.
This paper considers the ways in which accounts from Glasgow Catholics diverge from those of Protestants and explores the reasons why people leave jobs, including health grounds. Accounts reveal experiences distinctive to Catholics, of health-threatening stress, obstacles to career progression within (mainly) private-sector organisations, and interactional difficulties which create particular problems for (mainly) middle class men. This narrows the employment options for upwardly mobile Catholics, who may then resort to self-employment or other similarly stressful options. The paper considers whether the competence of Catholics or Catholic cultural factors are implicated in thwarting social mobility among Catholics or, alternatively, whether institutional sectarianism is involved. We conclude that, of these options, theories of institutional sectarianism provide the hypothesis which currently best fits these data. In Glasgow, people of indigenous Irish descent are recognisable from their names and Catholic background and are identified as Catholic by others. Overt historical exclusion of Catholics from middle class employment options now seems to take unrecognised forms in routine assumptions and practices which restrict Catholic employment opportunities. It is argued that younger Catholics use education to overcome the obstacles to mobility faced by older people and circumvent exclusions by recourse to middle class public-sector employment. This paper aims to link historical, structural and sectarian patterns of employment experience to accounts of health and work, and in so doing to contribute to an explanation for the relatively poor health of Catholic Glaswegians with Irish roots.