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Gallois S, Ambassa A, Ramírez Rozzi F. Indigenous peoples' health: Culturally grounded evidence from the Baka, Southeastern Cameroon. Soc Sci Med 2024; 350:116936. [PMID: 38728976 DOI: 10.1016/j.socscimed.2024.116936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 04/20/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
Abstract
Indigenous Peoples are exposed to the impacts of the climatic, ecological and socioeconomic changes, yet there is a need for a better understanding of their health and higher involvement of Indigenous Peoples in health promotion design and implementation. Our study brings empirical data on the healthcare system of the Baka, forager-horticulturalists from Cameroon. Using a mixed methods approach, we explored the health issues they encounter, the emic determinants of health and healthcare system, and the different threats towards their healthcare system. We conducted focus group discussions, interviews with experts, and self-reported health recalls with 302 individuals living in two settlements from southeastern Cameroon during two fieldwork periods between June and November 2022. Our insights highlight the prevalence of respiratory and children's digestive issues, and the occurrence of illnesses implying a combination of symptoms that would deserve further Western biomedical attention. The Baka's healthcare relies on medicinal plants, knowledge experts, and on the social cohesion of the community, all largely affected by the local social-ecological impacts of global change. Exposure to the market and health facilities does not seem to relate to Baka's health state and practices but might affect their perception of health. Deforestation, poor water quality, and alcohol (ab)use were reported and observed threats to the Baka's health and healthcare system. Our work supplies empirical evidence for a better understanding of Baka's health and healthcare system, helpful in designing health prevention and policies adapted to their reality and culture. Further research and interventions on health should consider the current threats to Baka's local ecosystems and cultural knowledge. These insights contribute to a higher recognition of the Baka's, and most broadly, the Indigenous Peoples' emic perspective on health, and on culturally grounded indicators of the resilience of their healthcare system to current and future challenges.
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Affiliation(s)
- Sandrine Gallois
- Institut de Ciència i Tecnologia Ambientals (ICTA), Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
| | | | - Fernando Ramírez Rozzi
- Eco-anthropologie (EA), Muséum National d'Histoire Naturelle, CNRS, Université de Paris Cité, Musée de l'Homme, Paris, France; UR 2496, Faculté de Chirurgie Dentaire, Université de Paris Cité, Montrouge, France
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2
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Romanello M, Napoli CD, Green C, Kennard H, Lampard P, Scamman D, Walawender M, Ali Z, Ameli N, Ayeb-Karlsson S, Beggs PJ, Belesova K, Berrang Ford L, Bowen K, Cai W, Callaghan M, Campbell-Lendrum D, Chambers J, Cross TJ, van Daalen KR, Dalin C, Dasandi N, Dasgupta S, Davies M, Dominguez-Salas P, Dubrow R, Ebi KL, Eckelman M, Ekins P, Freyberg C, Gasparyan O, Gordon-Strachan G, Graham H, Gunther SH, Hamilton I, Hang Y, Hänninen R, Hartinger S, He K, Heidecke J, Hess JJ, Hsu SC, Jamart L, Jankin S, Jay O, Kelman I, Kiesewetter G, Kinney P, Kniveton D, Kouznetsov R, Larosa F, Lee JKW, Lemke B, Liu Y, Liu Z, Lott M, Lotto Batista M, Lowe R, Odhiambo Sewe M, Martinez-Urtaza J, Maslin M, McAllister L, McMichael C, Mi Z, Milner J, Minor K, Minx JC, Mohajeri N, Momen NC, Moradi-Lakeh M, Morrissey K, Munzert S, Murray KA, Neville T, Nilsson M, Obradovich N, O'Hare MB, Oliveira C, Oreszczyn T, Otto M, Owfi F, Pearman O, Pega F, Pershing A, Rabbaniha M, Rickman J, Robinson EJZ, Rocklöv J, Salas RN, Semenza JC, Sherman JD, Shumake-Guillemot J, Silbert G, Sofiev M, Springmann M, Stowell JD, Tabatabaei M, Taylor J, Thompson R, Tonne C, Treskova M, Trinanes JA, Wagner F, Warnecke L, Whitcombe H, Winning M, Wyns A, Yglesias-González M, Zhang S, Zhang Y, Zhu Q, Gong P, Montgomery H, Costello A. The 2023 report of the Lancet Countdown on health and climate change: the imperative for a health-centred response in a world facing irreversible harms. Lancet 2023; 402:2346-2394. [PMID: 37977174 DOI: 10.1016/s0140-6736(23)01859-7] [Citation(s) in RCA: 67] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/07/2023] [Accepted: 08/31/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Marina Romanello
- Institute for Global Health, University College London, London, UK.
| | - Claudia di Napoli
- School of Agriculture, Policy and Development, University of Reading, Reading, UK
| | - Carole Green
- Department of Global Health, University of Washington, Washington, DC, USA
| | - Harry Kennard
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | - Pete Lampard
- Department of Health Sciences, University of York, York, UK
| | - Daniel Scamman
- Institute for Sustainable Resources, University College London, London, UK
| | - Maria Walawender
- Institute for Global Health, University College London, London, UK
| | - Zakari Ali
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, London, UK
| | - Nadia Ameli
- Institute for Sustainable Resources, University College London, London, UK
| | - Sonja Ayeb-Karlsson
- Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Paul J Beggs
- School of Natural Sciences, Macquarie University, Sydney, NSW, Australia
| | | | | | - Kathryn Bowen
- School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Wenjia Cai
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Max Callaghan
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Diarmid Campbell-Lendrum
- Department of Environment, Climate Change and Health, World Health Organisation, Geneva, Switzerland
| | - Jonathan Chambers
- Institute for Environmental Sciences, University of Geneva, Geneva, Switzerland
| | - Troy J Cross
- Heat and Health Research Incubator, University of Sydney, Sydney, NSW, Australia
| | | | - Carole Dalin
- Institute for Sustainable Resources, University College London, London, UK
| | - Niheer Dasandi
- International Development Department, University of Birmingham, Birmingham, UK
| | - Shouro Dasgupta
- Euro-Mediterranean Center on Climate Change Foundation, Lecce, Italy
| | - Michael Davies
- Institute for Risk and Disaster Reduction, University College London, London, UK
| | | | - Robert Dubrow
- School of Public Health, Yale University, New Haven, CT, USA
| | - Kristie L Ebi
- Department of Global Health, University of Washington, Washington, DC, USA
| | - Matthew Eckelman
- Department of Civil & Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Paul Ekins
- Institute for Sustainable Resources, University College London, London, UK
| | - Chris Freyberg
- Department of Information Systems, Massey University, Palmerston North, New Zealand
| | - Olga Gasparyan
- Department of Political Science, Florida State University, Tallahassee, FL, USA
| | | | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Samuel H Gunther
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Yun Hang
- Gangarosa Department of Environmental Health, Emory University, Atlanta, GA
| | | | - Stella Hartinger
- Carlos Vidal Layseca School of Public Health and Management, Cayetano Heredia Pervuvian University, Lima, Peru
| | - Kehan He
- Bartlett School of Sustainable Construction, University College London, London, UK
| | - Julian Heidecke
- Interdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Jeremy J Hess
- Centre for Health and the Global Environment, University of Washington, Washington, DC, USA
| | - Shih-Che Hsu
- Energy Institute, University College London, London, UK
| | - Louis Jamart
- Institute for Global Health, University College London, London, UK
| | - Slava Jankin
- Centre for AI in Government, University of Birmingham, Birmingham, UK
| | - Ollie Jay
- Heat and Health Research Incubator, University of Sydney, Sydney, NSW, Australia
| | - Ilan Kelman
- Institute for Global Health, University College London, London, UK
| | - Gregor Kiesewetter
- International Institute for Applied Systems Analysis Energy, Climate, and Environment Program, Laxenburg, Austria
| | - Patrick Kinney
- Department of Environmental Health, Boston University, Boston, MA, USA
| | - Dominic Kniveton
- School of Global Studies, University of Sussex, Brighton and Hove, UK
| | | | - Francesca Larosa
- Engineering Mechanics, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Jason K W Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Bruno Lemke
- School of Health, Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Yang Liu
- Gangarosa Department of Environmental Health, Emory University, Atlanta, GA
| | - Zhao Liu
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Melissa Lott
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | | | - Rachel Lowe
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | | | - Jaime Martinez-Urtaza
- Department of Genetics and Microbiology, Autonomous University of Barcelona, Bellaterra, Spain
| | - Mark Maslin
- Department of Geography, University College London, London, UK
| | - Lucy McAllister
- Environmental Studies Program, Denison University, Granville, OH, USA
| | - Celia McMichael
- School of Geography, Earth and Atmospheric Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Zhifu Mi
- Bartlett School of Sustainable Construction, University College London, London, UK
| | - James Milner
- Department of Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Kelton Minor
- Data Science Institute, Columbia University, New York, NY, USA
| | - Jan C Minx
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Nahid Mohajeri
- Bartlett School of Sustainable Construction, University College London, London, UK
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organisation, Geneva, Switzerland
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Karyn Morrissey
- Department of Technology Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | - Kris A Murray
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, London, UK
| | - Tara Neville
- Department of Environment, Climate Change and Health, World Health Organisation, Geneva, Switzerland
| | - Maria Nilsson
- Department for Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | | | - Megan B O'Hare
- Institute for Global Health, University College London, London, UK
| | - Camile Oliveira
- Institute for Global Health, University College London, London, UK
| | | | - Matthias Otto
- School of Health, Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Fereidoon Owfi
- Iranian Fisheries Science Research Institute, Tehran, Iran
| | - Olivia Pearman
- Center for Science and Technology Policy, University of Colorado Boulder, Boulder, CO, USA
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organisation, Geneva, Switzerland
| | | | | | - Jamie Rickman
- Institute for Sustainable Resources, University College London, London, UK
| | - Elizabeth J Z Robinson
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Science, London, UK
| | - Joacim Rocklöv
- Interdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Renee N Salas
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Jan C Semenza
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Jodi D Sherman
- Department of Anesthesiology, Yale University, New Haven, CT, USA
| | | | - Grant Silbert
- Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Marco Springmann
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Meisam Tabatabaei
- Institute of Tropical Aquaculture and Fisheries, Universiti Malaysia Terengganu, Terengganu, Malaysia
| | - Jonathon Taylor
- Department of Civil Engineering, Tampere University, Tampere, Finland
| | | | - Cathryn Tonne
- Barcelona Institute for Global Health, Barcelona, Spain
| | - Marina Treskova
- Interdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Joaquin A Trinanes
- Department of Electronics and Computer Science, University of Santiago de Compostela, Santiago, Spain
| | - Fabian Wagner
- International Institute for Applied Systems Analysis Energy, Climate, and Environment Program, Laxenburg, Austria
| | - Laura Warnecke
- International Institute for Applied Systems Analysis Energy, Climate, and Environment Program, Laxenburg, Austria
| | - Hannah Whitcombe
- Institute for Global Health, University College London, London, UK
| | - Matthew Winning
- Institute for Sustainable Resources, University College London, London, UK
| | - Arthur Wyns
- Melbourne Climate Futures, The University of Melbourne, Melbourne, VIC, Australia
| | - Marisol Yglesias-González
- Centro Latinoamericano de Excelencia en Cambio Climatico y Salud, Cayetano Heredia Pervuvian University, Lima, Peru
| | - Shihui Zhang
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Ying Zhang
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Qiao Zhu
- Gangarosa Department of Environmental Health, Emory University, Atlanta, GA
| | - Peng Gong
- Department of Geography, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Hugh Montgomery
- Department of Experimental and Translational Medicine and Division of Medicine, University College London, London, UK
| | - Anthony Costello
- Institute for Global Health, University College London, London, UK
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3
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Li A, Toll M, Bentley R. Mapping social vulnerability indicators to understand the health impacts of climate change: a scoping review. Lancet Planet Health 2023; 7:e925-e937. [PMID: 37940212 DOI: 10.1016/s2542-5196(23)00216-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 11/10/2023]
Abstract
The need to assess and measure how social vulnerability influences the health impacts of climate change has resulted in a rapidly growing body of research literature. To date, there has been no overarching, systematic examination of where this evidence is concentrated and what inferences can be made. This scoping review provides an overview of studies published between 2012 and 2022 on social vulnerability to the negative health effects of climate change. Of the 2115 studies identified from four bibliographic databases (Scopus, Web of Science, PubMed, and CAB Direct), 230 that considered indicators of social vulnerability to climate change impacts on health outcomes were selected for review. Frequency and thematic analyses were conducted to establish the scope of the social vulnerability indicators, climate change impacts, and health conditions studied, and the substantive themes and findings of this research. 113 indicators of social vulnerability covering 15 themes were identified, with a small set of indicators receiving most of the research attention, including age, sex, ethnicity, education, income, poverty, unemployment, access to green and blue spaces, access to health services, social isolation, and population density. The results reveal an undertheorisation and few indicators that conceptualise and operationalise social vulnerability beyond individual sociodemographic characteristics by identifying structural and institutional dimensions of vulnerability, and a preponderance of social vulnerability research in high-income countries. This Review highlights the need for future research, data infrastructure, and policy attention to address structural, institutional, and sociopolitical conditions, which will better support climate resilience and adaptation planning.
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Affiliation(s)
- Ang Li
- NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
| | - Mathew Toll
- NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Rebecca Bentley
- NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
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4
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Deivanayagam TA, English S, Hickel J, Bonifacio J, Guinto RR, Hill KX, Huq M, Issa R, Mulindwa H, Nagginda HP, de Morais Sato P, Selvarajah S, Sharma C, Devakumar D. Envisioning environmental equity: climate change, health, and racial justice. Lancet 2023; 402:64-78. [PMID: 37263280 PMCID: PMC10415673 DOI: 10.1016/s0140-6736(23)00919-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 06/03/2023]
Abstract
Climate change has a broad range of health impacts and tackling climate change could be the greatest opportunity for improving global health this century. Yet conversations on climate change and health are often incomplete, giving little attention to structural discrimination and the need for racial justice. Racism kills, and climate change kills. Together, racism and climate change interact and have disproportionate effects on the lives of minoritised people both within countries and between the Global North and the Global South. This paper has three main aims. First, to survey the literature on the unequal health impacts of climate change due to racism, xenophobia, and discrimination through a scoping review. We found that racially minoritised groups, migrants, and Indigenous communities face a disproportionate burden of illness and mortality due to climate change in different contexts. Second, this paper aims to highlight inequalities in responsibility for climate change and the effects thereof. A geographical visualisation of responsibility for climate change and projected mortality and disease risk attributable to climate change per 100 000 people in 2050 was conducted. These maps visualise the disproportionate burden of illness and mortality due to climate change faced by the Global South. Our third aim is to highlight the pathways through which climate change, discrimination, and health interact in most affected areas. Case studies, testimony, and policy analysis drawn from multidisciplinary perspectives are presented throughout the paper to elucidate these pathways. The health community must urgently examine and repair the structural discrimination that drives the unequal impacts of climate change to achieve rapid and equitable action.
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Affiliation(s)
- Thilagawathi Abi Deivanayagam
- Institute for Global Health, University College London, London, UK; Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
| | - Sonora English
- Institute for Global Health, University College London, London, UK
| | - Jason Hickel
- Institute for Environmental Science and Technology, Autonomous University of Barcelona, Barcelona, Spain; International Inequalities Institute, London School of Economics and Political Science, London, UK
| | - Jon Bonifacio
- Youth Advocates for Climate Action Philippines, Quezon City, Philippines
| | - Renzo R Guinto
- Planetary and Global Health Program, St Luke's Medical Center College of Medicine-William H Quasha Memorial, Quezon City, Philippines
| | - Kyle X Hill
- Department of Indigenous Health, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, USA
| | - Mita Huq
- Institute for Global Health, University College London, London, UK
| | - Rita Issa
- Institute for Global Health, University College London, London, UK; School of International Development, University of East Anglia, Norwich, UK
| | | | | | | | | | - Chetna Sharma
- Institute for Global Health, University College London, London, UK
| | - Delan Devakumar
- Institute for Global Health, University College London, London, UK
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5
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Asaaga FA, Purse BV, Rahman M, Srinivas PN, Kalegowda SD, Seshadri T, Young JC, Oommen MA. The role of social vulnerability in improving interventions for neglected zoonotic diseases: The example of Kyasanur Forest Disease in India. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000758. [PMID: 36962744 PMCID: PMC10021172 DOI: 10.1371/journal.pgph.0000758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 01/03/2023] [Indexed: 02/10/2023]
Abstract
Forest-based communities manage many risks to health and socio-economic welfare including the increasing threat of emerging zoonoses that are expected to disproportionately affect poor and marginalised groups, and further impair their precarious livelihoods, particularly in Low-and-Middle Income (LMIC) settings. Yet, there is a relative dearth of empirical research on the vulnerability and adaptation pathways of poor and marginalised groups facing emerging zoonoses. Drawing on a survey of 229 households and a series of key-informant interviews in the Western Ghats, we examine the factors affecting vulnerability of smallholder and tribal households to Kyasanur Forest Disease (KFD), an often-fatal tick-borne viral haemorrhagic fever endemic in south India. Specifically, we investigate how different socio-demographic and institutional factors interact to shape KFD vulnerability and the strategies employed by households to adapt to disease consequences. Although surveyed households generally perceived KFD as an important health issue in the study region, there was variability in concern about contracting the disease. Overall results showed that poor access to land (AOR = 0.373, 95% CI: 0.152-0.916), being at or below the poverty line (AOR = 0.253, 95% CI: 0.094-0.685) and being headed by an older person (AOR = 1.038, 95% CI: 1.006-1.071) were all significant determinants of perceived KFD vulnerability. Furthermore, KFD vulnerability is also modulated by important extra-household factors including proximity to private hospitals (AOR = 3.281, 95% CI: 1.220-8.820), main roads (AOR = 2.144, 95% CI: 1.215-3.783) and study location (AOR = 0.226, 95% CI: 0.690-0.743). Our findings highlight how homogenous characterisation of smallholder and tribal communities and the 'techno-oriented' approach of existing interventions may further marginalise the most vulnerable and exacerbate existing inequalities. These findings are important for designing context-specific and appropriate health interventions (including the prioritisation of awareness raising, knowledge networks, livelihood diversification) that enhances the resilience of at-risk social groups within the KFD context. More broadly, our findings highlight how a focus on social vulnerability can help national and international health planners improve health interventions and prioritise among diseases with respect to neglected endemic zoonoses.
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Affiliation(s)
| | - Bethan V. Purse
- UK Centre for Ecology & Hydrology, Wallingford, United Kingdom
| | - Mujeeb Rahman
- Ashoka Trust for Research in Ecology and the Environment, Bengaluru, Karnataka, India
| | | | - Suresh D. Kalegowda
- National Institute of Veterinary Epidemiology and Disease Informatics, Bengaluru, Karnataka, India
| | - Tanya Seshadri
- Ashoka Trust for Research in Ecology and the Environment, Bengaluru, Karnataka, India
- Agroécologie, INRAE, Institut Agro, Univ. Bourgogne, Univ. Bourgogne Franche-Comté, Dijon, France
| | - Juliette C. Young
- Tribal Health Resource Center, Vivekananda Girijana Kalyana Kendra, BR Hills, Karnataka, India
| | - Meera A. Oommen
- Ashoka Trust for Research in Ecology and the Environment, Bengaluru, Karnataka, India
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6
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Ost K, Berrang-Ford L, Bishop-Williams K, Charette M, Harper SL, Lwasa S, Namanya DB, Huang Y, Katz AB, Ebi K. Do socio-demographic factors modify the effect of weather on malaria in Kanungu District, Uganda? Malar J 2022; 21:98. [PMID: 35317835 PMCID: PMC8939205 DOI: 10.1186/s12936-022-04118-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 03/05/2022] [Indexed: 11/25/2022] Open
Abstract
Background There is concern in the international community regarding the influence of climate change on weather variables and seasonality that, in part, determine the rates of malaria. This study examined the role of sociodemographic variables in modifying the association between temperature and malaria in Kanungu District (Southwest Uganda). Methods Hospital admissions data from Bwindi Community Hospital were combined with meteorological satellite data from 2011 to 2014. Descriptive statistics were used to describe the distribution of malaria admissions by age, sex, and ethnicity (i.e. Bakiga and Indigenous Batwa). To examine how sociodemographic variables modified the association between temperature and malaria admissions, this study used negative binomial regression stratified by age, sex, and ethnicity, and negative binomial regression models that examined interactions between temperature and age, sex, and ethnicity. Results Malaria admission incidence was 1.99 times greater among Batwa than Bakiga in hot temperature quartiles compared to cooler temperature quartiles, and that 6–12 year old children had a higher magnitude of association of malaria admissions with temperature compared to the reference category of 0–5 years old (IRR = 2.07 (1.40, 3.07)). Discussion Results indicate that socio-demographic variables may modify the association between temperature and malaria. In some cases, such as age, the weather-malaria association in sub-populations with the highest incidence of malaria in standard models differed from those most sensitive to temperature as found in these stratified models. Conclusion The effect modification approach used herein can be used to improve understanding of how changes in weather resulting from climate change might shift social gradients in health. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04118-5.
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Affiliation(s)
- Katarina Ost
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | | | - Margot Charette
- Department of Geography, McGill University, Montreal, Canada
| | | | - Shuaib Lwasa
- Department of Geography, Geo-Informatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, College of Agricultural and Environmental Sciences, Makerere University, Kampala, Uganda
| | - Didacus B Namanya
- Indigenous Health Adaptation To Climate Change, Research Team, Edmonton, Canada.,Uganda Martyrs University, Kampala, Uganda.,Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | - Yi Huang
- Department of Atmospheric and Ocean Sciences, McGill University, Montreal, Canada
| | - Aaron B Katz
- Department of Health Services, University of Washington, Seattle, USA
| | | | | | - Kristie Ebi
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,Priestley International Centre for Climate, University of Leeds, Leeds, UK.,School of Interdisciplinary Science, McMaster University, Hamilton, Canada.,Department of Geography, McGill University, Montreal, Canada.,School of Public Health, University of Alberta, Edmonton, Canada.,Department of Geography, Geo-Informatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, College of Agricultural and Environmental Sciences, Makerere University, Kampala, Uganda.,Indigenous Health Adaptation To Climate Change, Research Team, Edmonton, Canada.,Uganda Martyrs University, Kampala, Uganda.,Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda.,Department of Atmospheric and Ocean Sciences, McGill University, Montreal, Canada.,Department of Health Services, University of Washington, Seattle, USA.,Bwindi Community Hospital, Kanungu, Uganda.,Center for Health and the Global Environment, University of Washington, Seattle, USA
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7
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Scarpa G, Berrang-Ford L, Twesigomwe S, Kakwangire P, Galazoula M, Zavaleta-Cortijo C, Patterson K, Namanya DB, Lwasa S, Nowembabazi E, Kesande C, Cade JE. Socio-economic and environmental factors affecting breastfeeding and complementary feeding practices among Batwa and Bakiga communities in south-western Uganda. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000144. [PMID: 36962281 PMCID: PMC10021580 DOI: 10.1371/journal.pgph.0000144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/19/2022] [Indexed: 11/19/2022]
Abstract
Improving breastfeeding and complementary feeding practices is needed to support good health, enhance child growth, and reduce child mortality. Limited evidence is available on child feeding among Indigenous communities and in the context of environmental changes. We investigate past and present breastfeeding and complementary feeding practices within Indigenous Batwa and neighbouring Bakiga populations in south-western Uganda. Specifically, we describe the demographic and socio-economic characteristics of breastfeeding mothers and their children, and individual experiences of breastfeeding and complementary feeding practices. We investigate the factors that have an impact on breastfeeding and complementary feeding at community and societal levels, and we analysed how environments, including weather variability, affect breastfeeding and complementary feeding practices. We applied a mixed-method design to the study, and we used a community-based research approach. We conducted 94 individual interviews (n = 47 Batwa mothers/caregivers & n = 47 Bakiga mothers/caregivers) and 12 focus group discussions (n = 6 among Batwa & n = 6 among Bakiga communities) from July to October 2019. Ninety-nine per cent of mothers reported that their youngest child was currently breastfed. All mothers noted that the child experienced at least one episode of illness that had an impact on breastfeeding. From the focus groups, we identified four key factors affecting breastfeeding and nutrition practices: marginalisation and poverty; environmental change; lack of information; and poor support. Our findings contribute to the field of global public health and nutrition among Indigenous communities, with a focus on women and children. We present recommendations to improve child feeding practices among the Batwa and Bakiga in south-western Uganda. Specifically, we highlight the need to engage with local and national authorities to improve breastfeeding and complementary feeding practices, and work on food security, distribution of lands, and the food environment. Also, we recommend addressing the drivers and consequences of alcoholism, and strengthening family planning programs.
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Affiliation(s)
- Giulia Scarpa
- School of Environment, University of Leeds, Leeds, United Kingdom
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Lea Berrang-Ford
- School of Environment, University of Leeds, Leeds, United Kingdom
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
| | - Sabastian Twesigomwe
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
| | - Paul Kakwangire
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
| | - Maria Galazoula
- Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
| | - Carol Zavaleta-Cortijo
- Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, Canada
| | - Didacus B Namanya
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
- Ministry of Health, Kampala, Uganda
| | - Shuaib Lwasa
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
- Department of Geography, Makerere University, Kampala, Uganda
- The Global Center on Adaptation, Rotterdam, Netherlands
| | - Ester Nowembabazi
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
| | - Charity Kesande
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
| | | | - Janet E Cade
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
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8
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Menzies A, Bowles E, Gallant M, Patterson H, Kozmik C, Chiblow S, McGregor D, Ford A, Popp J. “I see my culture starting to disappear”: Anishinaabe perspectives on the socioecological impacts of climate change and future research needs. Facets (Ott) 2022. [DOI: 10.1139/facets-2021-0066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Climate change disproportionately affects Indigenous Peoples because of strong connections between environmental, cultural, and spiritual well-being. While much of the global discourse surrounding climate change is founded in Western science, the holistic, place-based knowledge of Indigenous Peoples offers a complementary way of understanding and mitigating climate change impacts. The goal of this research was to elevate Anishinaabe concerns, observations, and perspectives about climate change impacts and future research needs. We organized a workshop called “Connecting Guardians in a Changing World” where participants shared concerns about animal and plant life cycles, water cycles and water quality, and impacts to ways of life, including reduced capacity to perform cultural practices and erosion of their knowledge. Participants highlighted the challenge of prioritizing a single impact of climate change, emphasizing that impacts to the environment and ways of life are interconnected. Participants also expressed the need for research and policy that move beyond interdisciplinarity to include intercultural philosophy and research that better reflects Indigenous worldviews and incorporates Indigenous methodologies. Moving forward, meaningful partnerships and opportunities for knowledge sharing should be prioritized in climate change discourse to ensure solutions are generated together, with all of the tools and knowledge available.
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Affiliation(s)
- A.K. Menzies
- School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - E. Bowles
- School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
- Department of Biology, Okanagan Campus, University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - M. Gallant
- Department of Geography and Environment, Mount Allison University, Sackville, NB E4L 1E2, Canada
| | - H. Patterson
- School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - C. Kozmik
- Lands and Resources Department, Magnetawan First Nation, ON P0G 1A0, Canada
| | - S. Chiblow
- Faculty of Environmental and Urban Change, York University, Toronto, ON M3J 1P3, Canada
- Garden River First Nation, ON, Canada
| | - D. McGregor
- Faculty of Environmental and Urban Change, York University, Toronto, ON M3J 1P3, Canada
- Osgoode Hall Law School, York University, Toronto, ON M5G 1Z3, Canada
| | - A. Ford
- Department of Biology, Okanagan Campus, University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - J.N. Popp
- School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
- Department of Geography and Environment, Mount Allison University, Sackville, NB E4L 1E2, Canada
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9
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Muylaert RL, Davidson B, Ngabirano A, Kalema-Zikusoka G, MacGregor H, Lloyd-Smith JO, Fayaz A, Knox MA, Hayman DTS. Community health and human-animal contacts on the edges of Bwindi Impenetrable National Park, Uganda. PLoS One 2021; 16:e0254467. [PMID: 34818325 PMCID: PMC8612581 DOI: 10.1371/journal.pone.0254467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/01/2021] [Indexed: 01/03/2023] Open
Abstract
Cross-species transmission of pathogens is intimately linked to human and environmental health. With limited healthcare and challenging living conditions, people living in poverty may be particularly susceptible to endemic and emerging diseases. Similarly, wildlife is impacted by human influences, including pathogen sharing, especially for species in close contact with people and domesticated animals. Here we investigate human and animal contacts and human health in a community living around the Bwindi Impenetrable National Park (BINP), Uganda. We used contact and health survey data to identify opportunities for cross-species pathogen transmission, focusing mostly on people and the endangered mountain gorilla. We conducted a survey with background questions and self-reported diaries to investigate 100 participants' health, such as symptoms and behaviours, and contact patterns, including direct contacts and sightings over a week. Contacts were revealed through networks, including humans, domestic, peri-domestic, and wild animal groups for 1) contacts seen in the week of background questionnaire completion, and 2) contacts seen during the diary week. Participants frequently felt unwell during the study, reporting from one to 10 disease symptoms at different intensity levels, with severe symptoms comprising 6.4% of the diary records and tiredness and headaches the most common symptoms. After human-human contacts, direct contact with livestock and peri-domestic animals were the most common. The contact networks were moderately connected and revealed a preference in contacts within the same taxon and within their taxa groups. Sightings of wildlife were much more common than touching. However, despite contact with wildlife being the rarest of all contact types, one direct contact with a gorilla with a timeline including concerning participant health symptoms was reported. When considering all interaction types, gorillas mostly exhibited intra-species contact, but were found to interact with five other species, including people and domestic animals. Our findings reveal a local human population with recurrent symptoms of illness in a location with intense exposure to factors that can increase pathogen transmission, such as direct contact with domestic and wild animals and proximity among animal species. Despite significant biases and study limitations, the information generated here can guide future studies, such as models for disease spread and One Health interventions.
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Affiliation(s)
- Renata L. Muylaert
- Molecular Epidemiology and Public Health Laboratory, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
| | - Ben Davidson
- Molecular Epidemiology and Public Health Laboratory, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
| | - Alex Ngabirano
- Conservation Through Public Health, Uring Crescent, Entebbe, Uganda
- Bwindi Development Network, Buhoma, Kanungu, Uganda
| | | | - Hayley MacGregor
- Institute of Development Studies, University of Sussex and STEPS, Brighton, United Kingdom
| | - James O. Lloyd-Smith
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, California, United States of America
| | - Ahmed Fayaz
- Molecular Epidemiology and Public Health Laboratory, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
| | - Matthew A. Knox
- Molecular Epidemiology and Public Health Laboratory, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
| | - David T. S. Hayman
- Molecular Epidemiology and Public Health Laboratory, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
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10
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Scarpa G, Berrang-Ford L, Twesigomwe S, Kakwangire P, Peters R, Zavaleta-Cortijo C, Patterson K, Namanya DB, Lwasa S, Nowembabazi E, Kesande C, Harris-Fry H, Cade JE. A Community-Based Approach to Integrating Socio, Cultural and Environmental Contexts in the Development of a Food Database for Indigenous and Rural Populations: The Case of the Batwa and Bakiga in South-Western Uganda. Nutrients 2021; 13:nu13103503. [PMID: 34684504 PMCID: PMC8537349 DOI: 10.3390/nu13103503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/24/2021] [Accepted: 09/30/2021] [Indexed: 11/16/2022] Open
Abstract
Comprehensive food lists and databases are a critical input for programs aiming to alleviate undernutrition. However, standard methods for developing them may produce databases that are irrelevant for marginalised groups where nutritional needs are highest. Our study provides a method for identifying critical contextual information required to build relevant food lists for Indigenous populations. For our study, we used mixed-methods study design with a community-based approach. Between July and October 2019, we interviewed 74 participants among Batwa and Bakiga communities in south-western Uganda. We conducted focus groups discussions (FGDs), individual dietary surveys and markets and shops assessment. Locally validated information on foods consumed among Indigenous populations can provide results that differ from foods listed in the national food composition tables; in fact, the construction of food lists is influenced by multiple factors such as food culture and meaning of food, environmental changes, dietary transition, and social context. Without using a community-based approach to understanding socio-environmental contexts, we would have missed 33 commonly consumed recipes and foods, and we would not have known the variety of ingredients’ quantity in each recipe, and traditional foraged foods. The food culture, food systems and nutrition of Indigenous and vulnerable communities are unique, and need to be considered when developing food lists.
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Affiliation(s)
- Giulia Scarpa
- School of Environment, University of Leeds, Leeds LS2 9JT, UK;
- School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK;
- Correspondence: ; +44-74-15966075
| | - Lea Berrang-Ford
- School of Environment, University of Leeds, Leeds LS2 9JT, UK;
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
| | - Sabastian Twesigomwe
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
| | - Paul Kakwangire
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
| | - Remco Peters
- School for Policy Studies, University of Bristol, Bristol BS8 1TH, UK;
| | - Carol Zavaleta-Cortijo
- Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, San Martín de Porres 15102, Peru;
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - Didacus B. Namanya
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
- Ministry of Health, Lourdel Road, Nakasero P.O. Box 7272, Uganda
| | - Shuaib Lwasa
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
- Department of Geography, Makerere University, Kampala, Uganda
- The Global Center on Adaptation, 3072 Rotterdam, The Netherlands
| | - Ester Nowembabazi
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
| | - Charity Kesande
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
| | - Helen Harris-Fry
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK;
| | - Janet E. Cade
- School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK;
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11
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Human Responses and Adaptation in a Changing Climate: A Framework Integrating Biological, Psychological, and Behavioural Aspects. Life (Basel) 2021; 11:life11090895. [PMID: 34575043 PMCID: PMC8470032 DOI: 10.3390/life11090895] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 01/14/2023] Open
Abstract
Climate change is one of the biggest challenges of our times. Its impact on human populations is not yet completely understood. Many studies have focused on single aspects with contradictory observations. However, climate change is a complex phenomenon that cannot be adequately addressed from a single discipline’s perspective. Hence, we propose a comprehensive conceptual framework on the relationships between climate change and human responses. This framework includes biological, psychological, and behavioural aspects and provides a multidisciplinary overview and critical information for focused interventions. The role of tipping points and regime shifts is explored, and a historical perspective is presented to describe the relationship between climate evolution and socio-cultural crisis. Vulnerability, resilience, and adaptation are analysed from an individual and a community point of view. Finally, emergent behaviours and mass effect phenomena are examined that account for mental maladjustment and conflicts.
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12
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Brubacher LJ, Berrang-Ford L, Clark S, Patterson K, Lwasa S, Namanya DB, Twesigomwe S, Harper SL. 'We don't use the same ways to treat the illness:' A qualitative study of heterogeneity in health-seeking behaviour for acute gastrointestinal illness among the Ugandan Batwa. Glob Public Health 2021; 17:1757-1772. [PMID: 34097579 DOI: 10.1080/17441692.2021.1937273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The Batwa (Twa), an Indigenous People of southwest Uganda, were evicted from their ancestral forest lands in 1991 due to establishment of the Bwindi Impenetrable Forest. This land dispossession forced Batwa to transition from a semi-nomadic, hunting-gathering livelihood to an agricultural livelihood; eliminated access to Indigenous food, medicines, and shelter; and shifted their healthcare options. Therefore, this exploratory study investigated why Batwa choose Indigenous or biomedical treatment, or no treatment, when experiencing acute gastrointestinal illness. Ten gender-stratified focus groups were conducted in five Batwa settlements in Kanungu District, Uganda (n = 63 participants), alongside eleven semi-structured interviews (2014). Qualitative data were analysed thematically, using a constant comparative method. Batwa emphasised that health-seeking behaviour for acute gastrointestinal illness was diverse: some Batwa used only Indigenous or biomedical healthcare, while others preferred a combination, or no healthcare. Physical and economic access to care, and also perceived efficacy and quality of care, influenced their healthcare decisions. This study provides insight into the Kanungu District Batwa's perceptions of biomedical and Indigenous healthcare, and barriers they experience to accessing either. This study is intended to inform public health interventions to reduce their burden of acute gastrointestinal illness and ensure adequate healthcare, biomedical or Indigenous, for Batwa.
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Affiliation(s)
| | | | - Sierra Clark
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, Canada
| | - Shuaib Lwasa
- Department of Geography, Makerere University, Kampala, Uganda
| | - Didacus B Namanya
- Ugandan Ministry of Health, Kampala, Uganda.,Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
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- School of Public Health, University of Alberta, Edmonton, Canada
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13
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Scarpa G, Berrang-Ford L, Bawajeeh AO, Twesigomwe S, Kakwangire P, Peters R, Beer S, Williams G, Zavaleta-Cortijo C, Namanya DB, Lwasa S, Nowembabazi E, Kesande C, Rippin H, Cade JE. Developing an online food composition database for an Indigenous population in south-western Uganda. Public Health Nutr 2021; 24:2455-2464. [PMID: 33843552 PMCID: PMC8145457 DOI: 10.1017/s1368980021001397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/10/2021] [Accepted: 03/22/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To develop an online food composition database of locally consumed foods among an Indigenous population in south-western Uganda. DESIGN Using a community-based approach and collaboration with local nutritionists, we collected a list of foods for inclusion in the database through focus group discussions, an individual dietary survey and markets and shops assessment. The food database was then created using seven steps: identification of foods for inclusion in the database; initial data cleaning and removal of duplicate items; linkage of foods to existing generic food composition tables; mapping and calculation of the nutrient content of recipes and foods; allocating portion sizes and accompanying foods; quality checks with local and international nutritionists; and translation into relevant local languages. SETTING Kanungu District, south-western Uganda. PARTICIPANTS Seventy-four participants, 36 Indigenous Batwa and 38 Bakiga, were randomly selected and interviewed to inform the development of a food list prior the construction of the food database. RESULTS We developed an online food database for south-western Uganda including 148 commonly consumed foods complete with values for 120 micronutrients and macronutrients. This was for use with the online dietary assessment tool myfood24. Of the locally reported foods included, 56 % (n 82 items) of the items were already available in the myfood24 database, while 25 % (n 37 items) were found in existing Ugandan and Tanzanian food databases, 18 % (n 27 items) came from generated recipes and 1 % (n 2 items) from food packaging labels. CONCLUSION Locally relevant food databases are sparse for African Indigenous communities. Here, we created a tool that can be used for assessing food intake and for tracking undernutrition among the communities living in Kanungu District. This will help to develop locally relevant food and nutrition policies.
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Affiliation(s)
- Giulia Scarpa
- School of Environment, University of Leeds, LS2 9JT, UK
- School of Food Science and Nutrition, University of Leeds, UK
| | - Lea Berrang-Ford
- School of Environment, University of Leeds, LS2 9JT, UK
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
| | - Areej O Bawajeeh
- School of Food Science and Nutrition, University of Leeds, UK
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sabastian Twesigomwe
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
| | - Paul Kakwangire
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
| | - Remco Peters
- Leeds Institute of Health Sciences, University of Leeds, UK
| | | | | | | | - Didacus B Namanya
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
- Ministry of Health, Uganda
| | - Shuaib Lwasa
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
- Department of Geography, Makerere University, Kampala, Uganda
- The Global Center on Adaptation, Rotterdam, Netherlands
| | - Ester Nowembabazi
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
| | - Charity Kesande
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
| | - Holly Rippin
- WHO European Office for Prevention and Control of Non-communicable Diseases (NCD Office), Moscow, Russian Federation
| | - Janet E Cade
- School of Food Science and Nutrition, University of Leeds, UK
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14
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Bryson JM, Patterson K, Berrang-Ford L, Lwasa S, Namanya DB, Twesigomwe S, Kesande C, Ford JD, Harper SL. Seasonality, climate change, and food security during pregnancy among Indigenous and non-Indigenous women in rural Uganda: Implications for maternal-infant health. PLoS One 2021; 16:e0247198. [PMID: 33760848 PMCID: PMC7990176 DOI: 10.1371/journal.pone.0247198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 02/02/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Climate change is expected to decrease food security globally. Many Indigenous communities have heightened sensitivity to climate change and food insecurity for multifactorial reasons including close relationships with the local environment and socioeconomic inequities which increase exposures and challenge adaptation to climate change. Pregnant women have additional sensitivity to food insecurity, as antenatal undernutrition is linked with poor maternal-infant health. This study examined pathways through which climate change influenced food security during pregnancy among Indigenous and non-Indigenous women in rural Uganda. Specific objectives were to characterize: 1) sensitivities to climate-associated declines in food security for pregnant Indigenous women; 2) women's perceptions of climate impacts on food security during pregnancy; and 3) changes in food security and maternal-infant health over time, as observed by women. METHODS Using a community-based research approach, we conducted eight focus group discussions-four in Indigenous Batwa communities and four in non-Indigenous communities-in Kanungu District, Uganda, on the subject of climate and food security during pregnancy. Thirty-six women with ≥1 pregnancy participated. Data were analysed using a constant comparative method and thematic analysis. RESULTS Women indicated that food insecurity was common during pregnancy and had a bidirectional relationship with antenatal health issues. Food security was thought to be decreasing due to weather changes including extended droughts and unpredictable seasons harming agriculture. Women linked food insecurity with declines in maternal-infant health over time, despite improved antenatal healthcare. While all communities described food security struggles, the challenges Indigenous women identified and described were more severe. CONCLUSIONS Programs promoting women's adaptive capacity to climate change are required to improve food security for pregnant women and maternal-infant health. These interventions are particularly needed in Indigenous communities, which often face underlying health inequities. However, resiliency among mothers was strong and, with supports, they can reduce food security challenges in a changing climate.
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Affiliation(s)
- Julia M. Bryson
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Shuaib Lwasa
- Department of Geography, Geo-Informatics and Climatic Sciences, Makerere University, Kampala, Uganda
| | - Didacus B. Namanya
- Department of Community Health, Ugandan Ministry of Health, Kampala, Uganda
| | | | | | - James D. Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | | | - Sherilee L. Harper
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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15
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Asaaga FA, Rahman M, Kalegowda SD, Mathapati J, Savanur I, Srinivas PN, Seshadri T, Narayanswamy D, Kiran SK, Oommen MA, Young JC, Purse BV. 'None of my ancestors ever discussed this disease before!' How disease information shapes adaptive capacity of marginalised rural populations in India. PLoS Negl Trop Dis 2021; 15:e0009265. [PMID: 33705400 PMCID: PMC7987196 DOI: 10.1371/journal.pntd.0009265] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/23/2021] [Accepted: 02/22/2021] [Indexed: 11/25/2022] Open
Abstract
Smallholder farmer and tribal communities are often characterised as marginalised and highly vulnerable to emerging zoonotic diseases due to their relatively poor access to healthcare, worse-off health outcomes, proximity to sources of disease risks, and their social and livelihood organisation. Yet, access to relevant and timely disease information that could strengthen their adaptive capacity remain challenging and poorly characterised in the empirical literature. This paper addresses this gap by exploring the role of disease information in shaping the adaptive capacity of smallholder farmer and tribal groups to Kyasanur Forest Disease (KFD), a tick-borne viral haemorrhagic fever. We carried out household surveys (n = 229) and in-depth interviews (n = 25) in two affected districts-Shimoga and Wayanad-in the Western Ghats region. Our findings suggest that, despite the generally limited awareness about KFD, access to disease information improved households' propensity to implement adaptation strategies relative to households that had no access to it. Of the variety of adaptation strategies implemented, vaccination, avoiding forest visits, wearing of protective clothing and footwear, application of dimethyl phthalate (DMP) oil and income diversification were identified by respondents as important adaptive measures during the outbreak seasons. Even so, we identified significant differences between individuals in exposure to disease information and its contribution to substantive adaptive action. Households reported several barriers to implement adaptation strategies including, lack of disease information, low efficacy of existing vaccine, distrust, religio-cultural sentiments, and livelihood concerns. We also found that informal information sharing presented a promising avenue from a health extension perspective albeit with trade-offs with potential distortion of the messages through misinformation and/or reporting bias. Altogether, our findings stress the importance of contextualising disease information and implementing interventions in a participatory way that sufficiently addresses the social determinants of health in order to bolster households' adaptive capacity to KFD and other neglected endemic zoonoses.
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Affiliation(s)
| | - Mujeeb Rahman
- Ashoka Trust for Research in Ecology and the Environment, Bengaluru, India
| | - Suresh D. Kalegowda
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics, Bengaluru, India
| | | | | | | | - Tanya Seshadri
- Ashoka Trust for Research in Ecology and the Environment, Bengaluru, India
| | - Darshan Narayanswamy
- Department of Health and Family Welfare Services, Government of Karnataka, Shivamogga, India
- ICMR-National Institute for Traditional Medicine, Belgavi, India
| | - Shivani K. Kiran
- Department of Health and Family Welfare Services, Government of Karnataka, Shivamogga, India
| | - Meera A. Oommen
- Ashoka Trust for Research in Ecology and the Environment, Bengaluru, India
| | - Juliette C. Young
- UK Centre for Ecology & Hydrology, Edinburgh, United Kingdom
- Agroécologie, AgroSup Dijon, INRAE, Univ. Bourgogne, Univ. Bourgogne Franche-Comté, Dijon, France
| | - Bethan V. Purse
- UK Centre for Ecology & Hydrology, Wallingford, United Kingdom
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Patterson K, Berrang-Ford L, Lwasa S, Namanya DB, Ford J, Research Team IHACC, Harper SL. Food security variation among Indigenous communities in South-western Uganda. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021. [DOI: 10.1080/19320248.2020.1852146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Kaitlin Patterson
- Dept. Of Population Medicine, University of Guelph, Guelph, Ontario, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
- Indigenous Health Adaptation to Climate Change Research Group, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Shuaib Lwasa
- Indigenous Health Adaptation to Climate Change Research Group, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Dept. Of Geography Geoinformatics and Climatic Sciences, Makerere University, Kampala, Uganda
| | - Didacus B. Namanya
- Indigenous Health Adaptation to Climate Change Research Group, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Ugandan Ministry of Health, Kampala, Uganda
| | - James Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
- Indigenous Health Adaptation to Climate Change Research Group, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - IHACC Research Team
- Indigenous Health Adaptation to Climate Change Research Group, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Sherilee L. Harper
- Indigenous Health Adaptation to Climate Change Research Group, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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17
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Adams EA, Nyantakyi-Frimpong H. Stressed, anxious, and sick from the floods: A photovoice study of climate extremes, differentiated vulnerabilities, and health in Old Fadama, Accra, Ghana. Health Place 2020; 67:102500. [PMID: 33373811 DOI: 10.1016/j.healthplace.2020.102500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/06/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Although there is a large and growing literature on anticipated climate change impacts on health, we know very little about the linkages between differentiated vulnerabilities to climate extremes and adverse physical and mental health outcomes. In this paper, we examine how recurrent flooding interacts with gendered vulnerability, social differentiation, and place-related historical and structural processes to produce unequal physical and mental health outcomes. We situated the study in Old Fadama, Ghana, using a Photovoice approach (n = 20) and theoretical concepts from political ecologies of health and feminist political ecology. Overall, the study revealed several adverse physical and mental health impacts of flooding, with vulnerability differentiated based particularly on gender and age, but also housing, class, and income. Our findings suggest the need for greater attentiveness to social differentiation in scholarship involving political ecologies of health. The paper builds on the health and place literature by linking the social and contextual to the medical.
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Affiliation(s)
- Ellis Adjei Adams
- Keough School of Global Affairs, Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
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18
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Howland O. Fakes and chemicals: indigenous medicine in contemporary Kenya and implications for health equity. Int J Equity Health 2020; 19:199. [PMID: 33160378 PMCID: PMC7648973 DOI: 10.1186/s12939-020-01313-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 10/27/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Access to effective biomedical treatments for humans and livestock in Kenya is far from universal. Indigenous healing has a significant role to play in contemporary society in Kenya, yet access is not the only reason for this. Beliefs surrounding the composition of biomedicines, people's experiences of biomedical care, and issues of counterfeit biomedicines sold over the counter have led to patients seeking care outside of biomedical institutions. METHODS This study explores local realities of treatment seeking in one rural and one urban study site, for both humans and their livestock, including when, where and how people access certain types of medicines. Using an ethnographic approach to interviews, focus groups and observations, I explore the role that indigenous healing, both herbal and occasionally spiritual, plays within this context with healers and community members. RESULTS Indigenous healing remains important for many people due to their mistrust and suspicion of biomedicine and big pharma. Their interactions with the healer or doctor, and the equity of these interactions, influence their decisions whether to access herbal or biomedical care, or a combination of the two. Indigenous healing bridges the gap many people experience when they are unable to access biomedical treatments and effectively creates a broader, more equitable coverage for healthcare. The plurality of reasons surrounding decision making is complex, but it is clear that many people often use indigenous healing, improvements in the regulation of both formulas and practice would assist people to access more effective treatment. CONCLUSIONS Indigenous healing is an important way in which Kenyans in rural and urban areas access healthcare for themselves and their animals. Issues of counterfeit biomedicines have led to broad mistrust and people favour indigenous healing, depending on the illness or severity of symptoms. Indigenous healing is a vital way in which people in underserved rural and urban populations access care. Herbal medicines and indigenous healing are trusted due to the greater transparency in their creation, and the more equitable relationship between indigenous doctor and patient. The study demonstrates that a pluralistic system is appropriate to increasing equity in access to healthcare in both urban and rural settings, as well as the importance of biomedical care providers respecting indigenous healing and viewing it with legitimacy. By taking a One Health perspective to understand the intersection of humans, livestock and the environment, we can better understand critical aspects affecting decision making for treatment and implications for healthcare equity in a rapidly changing world.
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Affiliation(s)
- Olivia Howland
- PDRA, University of Liverpool, Liverpool, UK.
- Visiting Scientist, ILRI, Nairobi, Kenya.
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19
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Bryson JM, Bishop-Williams KE, Berrang-Ford L, Nunez EC, Lwasa S, Namanya DB, Indigenous Health Adaptation To Climate Change Research Team, Harper SL. Neglected Tropical Diseases in the Context of Climate Change in East Africa: A Systematic Scoping Review. Am J Trop Med Hyg 2020; 102:1443-1454. [PMID: 32228798 DOI: 10.4269/ajtmh.19-0380] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
East Africa is highly affected by neglected tropical diseases (NTDs), which are projected to be exacerbated by climate change. Consequently, understanding what research has been conducted and what knowledge gaps remain regarding NTDs and climate change is crucial to informing public health interventions and climate change adaptation. We conducted a systematic scoping review to describe the extent, range, and nature of publications examining relationships between NTDs and climatic factors in East Africa. We collated all relevant English and French publications indexed in PubMed®, Web of Science™ Core Collection, and CAB Direct© databases published prior to 2019. Ninety-six publications were included for review. Kenya, Tanzania, and Ethiopia had high rates of publication, whereas countries in the Western Indian Ocean region were underrepresented. Most publications focused on schistosomiasis (n = 28, 29.2%), soil-transmitted helminthiases (n = 16, 16.7%), or human African trypanosomiasis (n = 14, 14.6%). Precipitation (n = 91, 94.8%) and temperature (n = 54, 56.3%) were frequently investigated climatic factors, whereas consideration of droughts (n = 10, 10.4%) and floods (n = 4, 4.2%) was not prominent. Publications reporting on associations between NTDs and changing climate were increasing over time. There was a decrease in the reporting of Indigenous identity and age factors over time. Overall, there were substantial knowledge gaps for several countries and for many NTDs. To better understand NTDs in the context of a changing climate, it would be helpful to increase research on underrepresented diseases and regions, consider demographic and social factors in research, and characterize how these factors modify the effects of climatic variables on NTDs in East Africa.
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Affiliation(s)
- Julia M Bryson
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada.,Department of Population Medicine, University of Guelph, Guelph, Canada
| | | | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Emily C Nunez
- Department of Epidemiology and Biostatistics, Western University, London, Canada.,Department of Population Medicine, University of Guelph, Guelph, Canada
| | - Shuaib Lwasa
- Department of Geography, Geo-Informatics and Climatic Sciences, Makerere University, Kampala, Uganda
| | - Didacus B Namanya
- Department of Community Health, Ugandan Ministry of Health, Kampala, Uganda
| | | | - Sherilee L Harper
- Department of Population Medicine, University of Guelph, Guelph, Canada.,School of Public Health, University of Alberta, Edmonton, Canada
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20
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Ford JD, King N, Galappaththi EK, Pearce T, McDowell G, Harper SL. The Resilience of Indigenous Peoples to Environmental Change. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.oneear.2020.05.014] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Tallman PS, Valdés-Velásquez A, Salmón-Mulanovich G, Lee GO, Riley-Powell AR, Blanco-Villafuerte L, Hartinger SM, Paz-Soldán VA. A "Cookbook" for Vulnerability Research. Front Public Health 2019; 7:352. [PMID: 31824913 PMCID: PMC6881268 DOI: 10.3389/fpubh.2019.00352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/06/2019] [Indexed: 11/13/2022] Open
Abstract
There is a growing need to facilitate the interdisciplinary study of the relationship between the environment and human health and well-being. It is increasingly recognized that vulnerability is a key construct allowing discipline-specific research questions on these topics to be meaningfully contextualized. However, there is little consensus regarding the meaning of the concept of vulnerability or how it can best be utilized in research studies. In this perspective article, we use the metaphor of a “cookbook” to review promising trends in vulnerability research and to make this body of research accessible to a multi-disciplinary audience. Specifically, we discuss a selection of “recipes” (theoretical frameworks), “ingredients” (vulnerability domains), “cooking tools” (qualitative and quantitative methods), and approaches to “meal presentation” (communication of results) drawn from vulnerability studies published in the past 15 years. Our aim is for this short “cookbook” to serve as a jumping-off point for scholars unfamiliar with the vulnerability literature and an inspiration for scholars more familiar with this topic to develop new ways to navigate the tension between locally-specific assessments of vulnerability and attempts at standardization. Our ultimate take-home message is that the specifics theories and methods used in vulnerability research are less important than attention to what we see as the 3 ‘T’s of transparency, triangulation, and transferability, and to efforts to make vulnerability research both “place-based” and comparable.
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Affiliation(s)
- Paula S Tallman
- Keller Science Action Department, The Field Museum of Natural History, Chicago, IL, United States
| | | | - Gabriela Salmón-Mulanovich
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of Biomedical Engineering PUCP-UPCH, Pontificia Universidad Católica del Perú, Lima, Peru
| | - Gwenyth O Lee
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States.,School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Amy R Riley-Powell
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States.,Institute of Development Studies, University of Sussex, Sussex, United Kingdom
| | - Luciana Blanco-Villafuerte
- School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Stella M Hartinger
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.,The Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Valerie A Paz-Soldán
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
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22
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Billiot S, Beltrán R, Brown D, Mitchell FM, Fernandez A. Indigenous Perspectives for Strengthening Social Responses to Global Environmental Changes: A Response to the Social Work Grand Challenge on Environmental Change. JOURNAL OF COMMUNITY PRACTICE 2019; 27:296-316. [PMID: 33013154 PMCID: PMC7531751 DOI: 10.1080/10705422.2019.1658677] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The "Grand Challenges for Social Work," is a call to action for innovative responses to society's most pressing social problems. In this article, we respond to the "Grand Challenge" of Creating Social Responses to a Changing Environment from our perspective as Indigenous scholars. Over the last several decades, diminishing natural resources, pollution, over-consumption, and the exploitation of the natural environment have led to climate change events that disproportionately affect Indigenous peoples. We present how environmental changes impact Indigenous peoples and suggest culturally relevant responses for working with Indigenous communities. We propose a decolonizing cyclical, iterative process grounded in Indigenous Ways of Knowing.
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Affiliation(s)
- Shanondora Billiot
- School of Social Work, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Ramona Beltrán
- Social Work, University of Denver, Denver, Colorado, USA
| | - Danica Brown
- School of Social Work, Portland State University, Portland, Oregon, USA
| | | | - Angela Fernandez
- School of Social Work, University of Washington, Seattle, Washington, USA
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23
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Wilson M, Patterson K, Nkalubo J, Lwasa S, Namanya D, Twesigomwe S, Anyango J. Assessing the determinants of antenatal care adherence for Indigenous and non-Indigenous women in southwestern Uganda. Midwifery 2019; 78:16-24. [PMID: 31336220 DOI: 10.1016/j.midw.2019.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/28/2019] [Accepted: 07/08/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND With an increasing number of women attending antenatal care for the recommended number of contacts, focus now must be placed on the quality and utility of care; without understanding adherence, the true contribution of antenatal care to improved maternal health outcomes is difficult to determine. OBJECTIVE This research explored the practicality of antenatal care recommendations for women and the factors which facilitate or hinder adherence and shape the overall utility of care. DESIGN Qualitative data were collected using a community-centred approach by means of focus group discussions with women and key informant interviews with healthcare providers throughout May and June of 2017. Data were analysed via thematic analysis guided by an essentialist/realist paradigm. SETTING Kanungu District, Uganda; a district in southwestern Uganda. PARTICIPANTS A convenience sample of 38 Indigenous Batwa and non-Indigenous Bakiga women from four matched communities and three healthcare providers. FINDINGS A number of barriers to antenatal care adherence were identified which included a lack of monetary and material resources, a lack of a shared understanding and perceived value of care, and gender and position-based power dynamics, all of which were compounded by previous experiences with antenatal care. The factors identified which influenced adherence were highly complex and non-linear, affected by individual, community, health centre, and health system-level factors. Promotion of spousal involvement in antenatal care had different effects based on pre-existing individual levels of spousal support, either improving or hindering adherence. A lack of resources created a double burden for women through which maternal health was jeopardized by the inability to adhere to antenatal care recommendations and the poor quality patient-provider relationships which resulted and deterred future antenatal care attendance. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The capacity to avail oneself of antenatal care varied significantly for women based on their socio-economic status, levels of autonomy, and spousal support. Strategies to improve antenatal care need to focus on health equity to ensure care has a high degree of utility for all women. The interconnectedness of care and those who deliver care necessitates healthcare providers to develop strong patient-provider relationships through their attitudes, behaviours, and the delivery of equitable care. In light of a historical emphasis on attendance, this research highlights the significance of improving the quality and utility of antenatal care, inclusive of Indigenous perspectives, to deliver high-value care.
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Affiliation(s)
- Mackenzie Wilson
- University of Guelph, Department of Population Medicine, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada.
| | - Kaitlin Patterson
- University of Guelph, Department of Population Medicine, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada.
| | | | - Shuaib Lwasa
- Makerere University, Department of Geography, Geo Informatics and Climatic Sciences, P.O Box 7062, Kampala, Uganda
| | - Didacus Namanya
- Ministry of Health, Department of Community Health, Plot 6, Lourdel Rd, P.O Box 7272, Kampala, Uganda
| | | | - Jane Anyango
- Uganda Nursing School Bwindi - UCU affiliate, P.O. Box 52, Kanungu, Uganda
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24
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Busch J, Berrang-Ford L, Clark S, Patterson K, Windfeld E, Donnelly B, Lwasa S, Namanya D, Harper SL. Is the effect of precipitation on acute gastrointestinal illness in southwestern Uganda different between Indigenous and non-Indigenous communities? PLoS One 2019; 14:e0214116. [PMID: 31048893 PMCID: PMC6497252 DOI: 10.1371/journal.pone.0214116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 03/07/2019] [Indexed: 11/25/2022] Open
Abstract
Acute gastrointestinal illness (AGI) is a global public health priority that often disproportionately effects Indigenous populations. While previous research examines the association between meteorological conditions and AGI, little is known about how socio-cultural factors may modify this relationship. This present study seeks to address this research gap by comparing AGI prevalence and determinants between an Indigenous and non-Indigenous population in Uganda. We estimate the 14-day self-reported prevalence of AGI among adults in an Indigenous Batwa population and their non-Indigenous neighbours using cross-sectional panel data collected over four periods spanning typically rainy and dry seasons (January 2013 to April 2014). The independent associations between Indigenous status, precipitation, and AGI are examined with multivariable multi-level logistic regression models, controlling for relative wealth status and clustering at the community level. Estimated prevalence of AGI among the Indigenous Batwa was greater than among the non-Indigenous Bakiga. Our models indicate that both Indigenous identity and decreased levels of precipitation in the weeks preceding the survey period were significantly associated with increased AGI, after adjusting for confounders. Multivariable models stratified by Indigenous identity suggest that Indigenous identity may not modify the association between precipitation and AGI in this context. Our results suggest that short-term changes in precipitation affect both Indigenous and non-Indigenous populations similarly, though from different baseline AGI prevalences, maintaining rather than exacerbating this socially patterned health disparity. In the context of climate change, these results may challenge the assumption that changing weather patterns will necessarily exacerbate existing socially patterned health disparities.
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Affiliation(s)
- Johanna Busch
- Department of Geography, McGill University, Montreal, Canada
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Montreal, Canada
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
- * E-mail:
| | - Sierra Clark
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, Canada
| | - Emma Windfeld
- Department of Geography, McGill University, Montreal, Canada
| | - Blanaid Donnelly
- Department of Geography, McGill University, Montreal, Canada
- Community Veterinary Outreach, Ottawa, Canada
| | - Shuaib Lwasa
- Department of Geography, Makerere University, Kampala, Uganda
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25
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Billiot S, Mitchell FM. Conceptual interdisciplinary model of exposure to environmental changes to address indigenous health and well-being. Public Health 2018; 176:142-148. [PMID: 30583872 DOI: 10.1016/j.puhe.2018.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 04/25/2018] [Accepted: 08/30/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Global environmental changes not only impact the physical environment but the health and well-being of people on earth. Emerging research demonstrates how indigenous peoples' physical and behavioural health is disproportionately affected by changes to their ecosystems in combination with pre-existing social and economic inequities. This article introduces a conceptual model to enhance our understanding of environmental change and its impact on indigenous behavioural health and well-being. STUDY DESIGN Using an indigenous theoretical lens, this article presents a review of existing theoretical frameworks applied to environmental changes and empirical studies with indigenous populations. METHODS The conceptual model joins elements from the indigenist stress-coping model from the field of social work with the exposure pathway model from the field of public health. RESULTS The interdisciplinary model joins elements from the indigenist stress-coping model with the exposure pathway model to highlight indigenous-specific sensitivities and cultural buffers that are particular to the impacts of environmental change among indigenous peoples. CONCLUSIONS Implications for public health and social work policy, practice and research with indigenous communities are discussed.
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Affiliation(s)
- S Billiot
- School of Social Work, University of Illinois Urbana-Champaign, 1010 West Nevada Street, Urbana, IL 61801, USA.
| | - F M Mitchell
- School of Social Work, Arizona State University, 411 N. Central Avenue, Suite 800, Phoenix, AZ 85004-0689, USA.
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26
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Transition Management for Improving the Sustainability of WASH Services in Informal Settlements in Sub-Saharan Africa—An Exploration. SUSTAINABILITY 2018. [DOI: 10.3390/su10114052] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This paper explores how transition management processes can be designed to address the unsustainability of water, sanitation, and hygiene (WASH) services in informal settlements in cities in Sub-Saharan Africa. The unsustainability of services related to WASH in informal settlements in Sub-Saharan Africa is deeply embedded in current societal and governance structures, cultures, and practices; it is context-dependent and involves numerous actors with different interests. Based on a literature review and empirical work in Arusha (Tanzania), Dodowa (Ghana), and Kampala (Uganda), we identify five context dimensions that account for the unsustainability of WASH services: (a) multiplicity of WASH practices, structures, and arrangements; (b) governance capacities for WASH services and maintenance; (c) landownership for sustainable access to WASH; (d) public participation in decision-making related to WASH; and (e) socio-economic inequalities governing access to WASH. These dimensions pose numerous conceptual and application challenges for transition management. Based on these challenges, recommendations are formulated for the design of a contextualized, participatory transition management process that is not only functional, but also emancipatory.
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27
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An analysis of the nutrition status of neighboring Indigenous and non-Indigenous populations in Kanungu District, southwestern Uganda: Close proximity, distant health realities. Soc Sci Med 2018; 217:55-64. [DOI: 10.1016/j.socscimed.2018.09.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 08/30/2018] [Accepted: 09/14/2018] [Indexed: 01/20/2023]
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Understanding Weather and Hospital Admissions Patterns to Inform Climate Change Adaptation Strategies in the Healthcare Sector in Uganda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112402. [PMID: 30380686 PMCID: PMC6265697 DOI: 10.3390/ijerph15112402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 10/21/2018] [Accepted: 10/25/2018] [Indexed: 12/20/2022]
Abstract
Background: Season and weather are associated with many health outcomes, which can influence hospital admission rates. We examined associations between hospital admissions (all diagnoses) and local meteorological parameters in Southwestern Uganda, with the aim of supporting hospital planning and preparedness in the context of climate change. Methods: Hospital admissions data and meteorological data were collected from Bwindi Community Hospital and a satellite database of weather conditions, respectively (2011 to 2014). Descriptive statistics were used to describe admission patterns. A mixed-effects Poisson regression model was fitted to investigate associations between hospital admissions and season, precipitation, and temperature. Results: Admission counts were highest for acute respiratory infections, malaria, and acute gastrointestinal illness, which are climate-sensitive diseases. Hospital admissions were 1.16 (95% CI: 1.04, 1.31; p = 0.008) times higher during extreme high temperatures (i.e., >95th percentile) on the day of admission. Hospital admissions association with season depended on year; admissions were higher in the dry season than the rainy season every year, except for 2014. Discussion: Effective adaptation strategy characteristics include being low-cost and quick and practical to implement at local scales. Herein, we illustrate how analyzing hospital data alongside meteorological parameters may inform climate-health planning in low-resource contexts.
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Assessment of individual and household malaria risk factors among women in a South African village. Acta Trop 2017; 175:71-77. [PMID: 27965145 DOI: 10.1016/j.actatropica.2016.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/02/2016] [Accepted: 12/09/2016] [Indexed: 11/23/2022]
Abstract
There is need to understand how various malaria risk factors interact at the individual, household and community levels, as well as wider contexts, in order to guide the design and implementation of effective and more comprehensive control strategies. Using a cross-sectional approach, this study investigated various malaria risk factors among residents of Mgedula Village, a malaria-endemic community located in Jozini Local Municipality, UMkhanyakude District, South Africa from May to August 2014. Data from 121 randomly sampled women were collected using close-ended questionnaires. The women were aged between 18 and 40 years; and had been residents in the study area for five years or more. A multivariable logistic regression model was used to measure the association between a history of malaria infection in the previous 12 months and various potential risk factors. The results showed that practicing animal husbandry (OR 20), residing in household structures that had not been sprayed (OR 16.7) and cross-border movement (OR 14.3) were greatly associated with malaria infection. Other factors that were significantly associated with this infection included illiteracy (OR 9.1), having a largely populated household (OR 6.1) and low income (OR 1.65). Individuals with a history of malaria infection were less likely to lack basic malaria-related knowledge (OR 0.58), to have negative attitude towards malaria (OR 0.29) and also to have poor malaria practices (OR 0.3). There was no association between a malaria episode and residing at a long distance from the health facility. Indoor residual spraying indicated a notable reduction of malaria risk at the community level. However, other socio-economic, geographical and socio-demographic factors interacted at different levels to increase this risk among different individuals and households. To achieve malaria elimination by the year 2018, these aspects should be considered when developing and implementing elimination strategies at the individual, household and community levels, among high-risk populations.
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30
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MacVicar S, Berrang-Ford L, Harper S, Steele V, Lwasa S, Bambaiha DN, Twesigomwe S, Asaasira G, Ross N. How seasonality and weather affect perinatal health: Comparing the experiences of indigenous and non-indigenous mothers in Kanungu District, Uganda. Soc Sci Med 2017. [DOI: 10.1016/j.socscimed.2017.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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31
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MacVicar S, Berrang-Ford L, Harper S, Huang Y, Namanya Bambaiha D, Yang S. 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 2017; 12:e0179010. [PMID: 28591162 PMCID: PMC5462429 DOI: 10.1371/journal.pone.0179010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 05/23/2017] [Indexed: 11/28/2022] Open
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.
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Affiliation(s)
- Sarah MacVicar
- Department of Geography, McGill University, Montréal, Quebec, Canada
- * E-mail:
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Montréal, Quebec, Canada
| | - Sherilee Harper
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Yi Huang
- Department of Atmospheric & Oceanic Sciences, McGill University, Montréal, Quebec, Canada
| | | | - Seungmi Yang
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Quebec, Canada
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Bishop-Williams KE, Sargeant JM, Berrang-Ford L, Edge VL, Cunsolo A, Harper SL. A protocol for a systematic literature review: comparing the impact of seasonal and meteorological parameters on acute respiratory infections in Indigenous and non-Indigenous peoples. Syst Rev 2017; 6:19. [PMID: 28122603 PMCID: PMC5267362 DOI: 10.1186/s13643-016-0399-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/19/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acute respiratory infections (ARI) are a leading cause of morbidity and mortality globally, and are often linked to seasonal and/or meteorological conditions. Globally, Indigenous peoples may experience a different burden of ARI compared to non-Indigenous peoples. This protocol outlines our process for conducting a systematic review to investigate whether associations between ARI and seasonal or meteorological parameters differ between Indigenous and non-Indigenous groups residing in the same geographical region. METHODOLOGY A search string will be used to search PubMed®, CAB Abstracts/CAB Direct©, and Science Citation Index® aggregator databases. Articles will be screened using inclusion/exclusion criteria applied first at the title and abstract level, and then at the full article level by two independent reviewers. Articles maintained after full article screening will undergo risk of bias assessment and data will be extracted. Heterogeneity tests, meta-analysis, and forest and funnel plots will be used to synthesize the results of eligible studies. DISCUSSION AND REGISTRATION This protocol paper describes our systematic review methods to identify and analyze relevant ARI, season, and meteorological literature with robust reporting. The results are intended to improve our understanding of potential associations between seasonal and meteorological parameters and ARI and, if identified, whether this association varies by place, population, or other characteristics. The protocol is registered in the PROSPERO database (#38051).
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Affiliation(s)
| | - Jan M Sargeant
- Department of Population Medicine, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada.,Centre for Public Health and Zoonoses, University of Guelph, Guelph, ON, Canada
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Montreal, QC, Canada
| | - Victoria L Edge
- Department of Population Medicine, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada
| | - Ashlee Cunsolo
- Labrador Institute, Memorial University, Happy Valley-Goose Bay, NL, Canada
| | - Sherilee L Harper
- Department of Population Medicine, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada
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Abstract
Objective Climate change is projected to increase the burden of food insecurity (FI) globally,
particularly among populations that depend on subsistence agriculture. The impacts of
climate change will have disproportionate effects on populations with higher existing
vulnerability. Indigenous people consistently experience higher levels of FI than their
non-Indigenous counterparts and are more likely to be dependent upon land-based
resources. The present study aimed to understand the sensitivity of the food system of
an Indigenous African population, the Batwa of Kanungu District, Uganda, to seasonal
variation. Design A concurrent, mixed methods (quantitative and qualitative) design was used. Six
cross-sectional retrospective surveys, conducted between January 2013 and April 2014,
provided quantitative data to examine the seasonal variation of self-reported household
FI. This was complemented by qualitative data from focus group discussions and
semi-structured interviews collected between June and August 2014. Setting Ten rural Indigenous communities in Kanungu District, Uganda. Subjects FI data were collected from 130 Indigenous Batwa Pygmy households. Qualitative methods
involved Batwa community members, local key informants, health workers and governmental
representatives. Results The dry season was associated with increased FI among the Batwa in the quantitative
surveys and in the qualitative interviews. During the dry season, the majority of Batwa
households reported greater difficulty in acquiring sufficient quantities and quality of
food. However, the qualitative data indicated that the effect of seasonal variation on
FI was modified by employment, wealth and community location. Conclusions These findings highlight the role social factors play in mediating seasonal impacts on
FI and support calls to treat climate associations with health outcomes as
non-stationary and mediated by social sensitivity.
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Donnelly B, Berrang-Ford L, Labbé J, Twesigomwe S, Lwasa S, Namanya DB, Harper SL, Kulkarni M, Ross NA, Michel P. Plasmodium falciparum malaria parasitaemia among indigenous Batwa and non-indigenous communities of Kanungu district, Uganda. Malar J 2016; 15:254. [PMID: 27146298 PMCID: PMC4855715 DOI: 10.1186/s12936-016-1299-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 04/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The indigenous Batwa of southwestern Uganda are among the most highly impoverished populations in Uganda, yet there is negligible research on the prevalence of malaria in this population. Plasmodium falciparum malaria parasitaemia prevalence was estimated in an indigenous Batwa and a non-indigenous neighbouring population, and an exploration of modifiable risk factors was carried out to identify potential entry points for intervention. Additionally, evidence of zooprophylaxis was assessed, hypothesizing that livestock ownership may play a role in malaria risk. METHODS Two cross-sectional surveys of Batwa and non-Batwa communities were carried out in Kanungu District, Uganda in July 2013 and April 2014 based on a census of adult Batwa and a two-stage systematic random sample of adult non-Batwa in ten Local Councils where Batwa settlements are located. A community-based questionnaire and antigen rapid diagnostic test for P. falciparum were carried out in the cross-sectional health surveys. A multivariable logistic regression model was built to identify risk factors associated with positive malaria diagnostic test. A subset analysis of livestock owners tested for zooprophylaxis. RESULTS Batwa experienced higher prevalence of malaria parasitaemia than non-Batwa (9.35 versus 4.45 %, respectively) with over twice the odds of infection (OR 2.21, 95 % CI 1.23-3.98). Extreme poverty (OR 1.96, 95 % CI 0.98-3.94) and having an iron sheet roof (OR 2.54, 95 % CI 0.96-6.72) increased the odds of infection in both Batwa and non-Batwa. Controlling for ethnicity, wealth, and bed net ownership, keeping animals inside the home at night decreased the odds of parasitaemia among livestock owners (OR 0.29, 95 % CI 0.09-0.94). CONCLUSION A health disparity exists between indigenous Batwa and non-indigenous community members with Batwa having higher prevalence of malaria relative to non-Batwa. Poverty was associated with increased odds of malaria infection for both groups. Findings suggest that open eaves and gaps in housing materials associated with iron sheet roofing represent a modifiable risk factor for malaria, and may facilitate mosquito house entry; larger sample sizes will be required to confirm this finding. Evidence for possible zooprophylaxis was observed among livestock owners in this population for those who sheltered animals inside the home at night.
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Affiliation(s)
- Blánaid Donnelly
- />Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC H3A 0B9 Canada
| | - Lea Berrang-Ford
- />Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC H3A 0B9 Canada
| | - Jolène Labbé
- />Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC H3A 0B9 Canada
| | | | - Shuaib Lwasa
- />Department of Geography, Geoinformatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, CAES, Makerere University, P.O Box 7062, Kampala, Uganda
| | | | - Sherilee L. Harper
- />Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1 Canada
| | - Manisha Kulkarni
- />School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, 600 Peter Morand Cres., 301E, Ottawa, ON K1H 8M5 Canada
| | - Nancy A. Ross
- />Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC H3A 0B9 Canada
| | - IHACC Research Team
- />Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC H3A 0B9 Canada
- />Batwa Development Program, Buhoma, Kanungu District, Uganda
- />Department of Geography, Geoinformatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, CAES, Makerere University, P.O Box 7062, Kampala, Uganda
- />Ministry of Health, Plot 6 Lourdel Rd, P.O Box 7272, Kampala, Uganda
- />Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1 Canada
- />School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, 600 Peter Morand Cres., 301E, Ottawa, ON K1H 8M5 Canada
- />Office of the Chief Science Officer, Public Health Agency of Canada, 130 Colonnade Road, Ottawa, ON K1A 0K9 Canada
| | - Pascal Michel
- />Office of the Chief Science Officer, Public Health Agency of Canada, 130 Colonnade Road, Ottawa, ON K1A 0K9 Canada
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Harper SL, Edge VL, Ford J, Willox AC, Wood M, McEwen SA. Climate-sensitive health priorities in Nunatsiavut, Canada. BMC Public Health 2015; 15:605. [PMID: 26135309 PMCID: PMC4489362 DOI: 10.1186/s12889-015-1874-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 05/26/2015] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND This exploratory study used participatory methods to identify, characterize, and rank climate-sensitive health priorities in Nunatsiavut, Labrador, Canada. METHODS A mixed method study design was used and involved collecting both qualitative and quantitative data at regional, community, and individual levels. In-depth interviews with regional health representatives were conducted throughout Nunatsiavut (n = 11). In addition, three PhotoVoice workshops were held with Rigolet community members (n = 11), where participants took photos of areas, items, or concepts that expressed how climate change is impacting their health. The workshop groups shared their photographs, discussed the stories and messages behind them, and then grouped photos into re-occurring themes. Two community surveys were administered in Rigolet to capture data on observed climatic and environmental changes in the area, and perceived impacts on health, wellbeing, and lifestyles (n = 187). RESULTS Climate-sensitive health pathways were described in terms of inter-relationships between environmental and social determinants of Inuit health. The climate-sensitive health priorities for the region included food security, water security, mental health and wellbeing, new hazards and safety concerns, and health services and delivery. CONCLUSIONS The results highlight several climate-sensitive health priorities that are specific to the Nunatsiavut region, and suggest approaching health research and adaptation planning from an EcoHealth perspective.
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Affiliation(s)
- Sherilee L Harper
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada.
- Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford, Cesar Carcamo, Alejandro Llanos, Shuaib Lwasa, Didacus Bambaiha Namanya, Montreal, Canada.
| | - Victoria L Edge
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada.
- Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford, Cesar Carcamo, Alejandro Llanos, Shuaib Lwasa, Didacus Bambaiha Namanya, Montreal, Canada.
| | - James Ford
- Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford, Cesar Carcamo, Alejandro Llanos, Shuaib Lwasa, Didacus Bambaiha Namanya, Montreal, Canada.
- Department of Geography, McGill University, Montreal, QC, Canada.
| | - Ashlee Cunsolo Willox
- Department of Nursing, Cross-Appointed with Indigenous Studies, Cape Breton University, Sydney, NS, Canada.
| | - Michele Wood
- Department of Health and Social Development, Nunatsiavut Government, Goose Bay, Labrador, Canada.
| | - Scott A McEwen
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada.
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MacFarlane EK, Shakya R, Berry HL, Kohrt BA. Implications of participatory methods to address mental health needs associated with climate change: 'photovoice' in Nepal. BJPsych Int 2015; 12:33-35. [PMID: 29093845 PMCID: PMC5618911 DOI: 10.1192/s2056474000000246] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
'Photovoice', a community-based participatory research methodology, uses images as a tool to deconstruct problems by posing meaningful questions in a community to find actionable solutions. This community-enhancing technique was used to elicit experiences of climate change among women in rural Nepal. The current analysis employs mixed methods to explore the subjective mental health experience of participating in a 4- to 5-day photovoice process focused on climate change. A secondary objective of this work was to explore whether or not photovoice training, as a one-time 4- to 5-day intensive intervention, can mobilise people to be more aware of environmental changes related to climate change and to be more resilient to these changes, while providing positive mental health outcomes.
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Affiliation(s)
- Elizabeth K MacFarlane
- Graduate Student, Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Graduate Student, Fuqua School of Business, Duke University, Durham, North Carolina, USA, email
| | - Renu Shakya
- Clinical Psychology Graduate Program, Tribhuvan University, Kathmandu, Nepal; TIRI Fellow, Colorado State University Livestock Climate Change Collaborative Research Support Program, Kathmandu, Nepal
| | - Helen L Berry
- Adjunct Professor, ANU Climate Change Institute, The Australian National University; and Professor, Faculty of Health, University of Canberra, Australia
| | - Brandon A Kohrt
- Assistant Professor, Duke Global Health Institute, Duke University, Durham, North Carolina, USA; Technical Advisor, Transcultural Psychosocial Organization (TPO), Nepal, Kathmandu, Nepal; Assistant Professor, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
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The burden and determinants of self-reported acute gastrointestinal illness in an Indigenous Batwa Pygmy population in southwestern Uganda. Epidemiol Infect 2014; 143:2287-98. [PMID: 25500189 DOI: 10.1017/s0950268814003124] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Acute gastrointestinal illness (AGI) is an important public health priority worldwide. Few studies have captured the burden of AGI in developing countries, and even fewer have focused on Indigenous populations. This study aimed to estimate the incidence and determinants of AGI within a Batwa Pygmy Indigenous population in southwestern Uganda. A retrospective cross-sectional survey was conducted in January 2013 via a census of 10 Batwa communities (n = 583 participants). The AGI case definition included any self-reported symptoms of diarrhoea or vomiting in the past 2 weeks. The 14-day prevalence of AGI was 6·17% [95% confidence interval (CI) 4·2-8·1], corresponding to an annual incidence rate of 1·66 (95% CI 1·1-2·2) episodes of AGI per person-year. AGI prevalence was greatest in children aged <3 years (11·3%). A multivariable mixed-effects logistic regression model controlling for clustering at the community level indicated that exposure to goats [odds ratio (OR) 2·6, 95% CI 1·0-6·8], being a child aged <3 years (OR 4·8, 95% CI 1·2-18·9), and being a child, adolescent or senior Batwa in the higher median of wealth (OR 7·0, 95% CI 3·9-9·2) were significantly associated with having AGI. This research represents the first Indigenous community-census level study of AGI in Uganda, and highlights the substantial burden of AGI within this population.
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Lewnard JA, Berrang-Ford L, Lwasa S, Namanya DB, Patterson KA, Donnelly B, Kulkarni MA, Harper SL, Ogden NH, Carcamo CP. Relative undernourishment and food insecurity associations with Plasmodium falciparum among Batwa pygmies in Uganda: evidence from a cross-sectional survey. Am J Trop Med Hyg 2014; 91:39-49. [PMID: 24821844 PMCID: PMC4080566 DOI: 10.4269/ajtmh.13-0422] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Although malnutrition and malaria co-occur among individuals and populations globally, effects of nutritional status on risk for parasitemia and clinical illness remain poorly understood. We investigated associations between Plasmodium falciparum infection, nutrition, and food security in a cross-sectional survey of 365 Batwa pygmies in Kanungu District, Uganda in January of 2013. We identified 4.1% parasite prevalence among individuals over 5 years old. Severe food insecurity was associated with increased risk for positive rapid immunochromatographic test outcome (adjusted relative risk [ARR] = 13.09; 95% confidence interval [95% CI] = 2.23–76.79). High age/sex-adjusted mid-upper arm circumference was associated with decreased risk for positive test among individuals who were not severely food-insecure (ARR = 0.37; 95% CI = 0.19–0.69). Within Batwa pygmy communities, where malnutrition and food insecurity are common, individuals who are particularly undernourished or severely food-insecure may have elevated risk for P. falciparum parasitemia. This finding may motivate integrated control of malaria and malnutrition in low-transmission settings.
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Affiliation(s)
- Joseph A. Lewnard
- *Address correspondence to Joseph A. Lewnard, Department of Geography, McGill University, 805 Sherbrooke W, Burnside 705, Montreal, Quebec, Canada H3A 0B9. E-mail:
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Ford JD, Lardeau MP, Blackett H, Chatwood S, Kurszewski D. Community food program use in Inuvik, Northwest Territories. BMC Public Health 2013; 13:970. [PMID: 24139485 PMCID: PMC4015817 DOI: 10.1186/1471-2458-13-970] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 10/07/2013] [Indexed: 11/13/2022] Open
Abstract
Background Community food programs (CFPs) provide an important safety-net for highly food insecure community members in the larger settlements of the Canadian Arctic. This study identifies who is using CFPs and why, drawing upon a case study from Inuvik, Northwest Territories. This work is compared with a similar study from Iqaluit, Nunavut, allowing the development of an Arctic-wide understanding of CFP use – a neglected topic in the northern food security literature. Methods Photovoice workshops (n=7), a modified USDA food security survey and open ended interviews with CFP users (n=54) in Inuvik. Results Users of CFPs in Inuvik are more likely to be housing insecure, female, middle aged (35–64), unemployed, Aboriginal, and lack a high school education. Participants are primarily chronic users, and depend on CFPs for regular food access. Conclusions This work indicates the presence of chronically food insecure groups who have not benefited from the economic development and job opportunities offered in larger regional centers of the Canadian Arctic, and for whom traditional kinship-based food sharing networks have been unable to fully meet their dietary needs. While CFPs do not address the underlying causes of food insecurity, they provide an important service for communities undergoing rapid change, and need greater focus in food policy herein.
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Affiliation(s)
- James D Ford
- Department of Geography, McGill University, Montreal, Canada.
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Ford JD, McDowell G, Shirley J, Pitre M, Siewierski R, Gough W, Duerden F, Pearce T, Adams P, Statham S. The Dynamic Multiscale Nature of Climate Change Vulnerability: An Inuit Harvesting Example. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/00045608.2013.776880] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gadamus L. Linkages between human health and ocean health: a participatory climate change vulnerability assessment for marine mammal harvesters. Int J Circumpolar Health 2013; 72:20715. [PMID: 23984268 PMCID: PMC3752289 DOI: 10.3402/ijch.v72i0.20715] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Indigenous residents of Alaska's Bering Strait Region depend, both culturally and nutritionally, on ice seal and walrus harvests. Currently, climate change and resultant increases in marine industrial development threaten these species and the cultures that depend on them. OBJECTIVE To document: (a) local descriptions of the importance of marine mammal hunting; (b) traditional methods for determining if harvested marine mammals are safe to consume; and (c) marine mammal outcomes that would have adverse effects on community health, the perceived causes of these outcomes, strategies for preventing these outcomes and community adaptations to outcomes that cannot be mitigated. DESIGN Semi-structured interviews and focus groups were conducted with 82 indigenous hunters and elders from the Bering Strait region. Standard qualitative analysis was conducted on interview transcripts, which were coded for both inductive and deductive codes. Responses describing marine mammal food safety and importance are presented using inductively generated categories. Responses describing negative marine mammal outcomes are presented in a vulnerability framework, which links human health outcomes to marine conditions. RESULTS Project participants perceived that shipping noise and pollution, as well as marine mammal food source depletion by industrial fishing, posed the greatest threats to marine mammal hunting traditions. Proposed adaptations primarily fell into 2 categories: (a) greater tribal influence over marine policy; and (b) documentation of traditional knowledge for local use. This paper presents 1 example of documenting traditional knowledge as an adaptation strategy: traditional methods for determining if marine mammal food is safe to eat. CONCLUSIONS Participant recommendations indicate that 1 strategy to promote rural Alaskan adaptation to climate change is to better incorporate local knowledge and values into decision-making processes. Participant interest in documenting traditional knowledge for local use also indicates that funding agencies could support climate change adaptation by awarding more grants for tribal research that advances local, rather than academic, use of traditional knowledge.
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Affiliation(s)
- Lily Gadamus
- Natural Resources Division, Kawerak, Inc., Nome, Alaska AK-99762, USA.
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Ford JD. Ford responds. Am J Public Health 2013; 103:e6-7. [PMID: 23153162 PMCID: PMC3518363 DOI: 10.2105/ajph.2012.301100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2012] [Indexed: 03/18/2024]
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Ford JD, Bolton K, Shirley J, Pearce T, Tremblay M, Westlake M. Mapping human dimensions of climate change research in the Canadian Arctic. AMBIO 2012; 41:808-22. [PMID: 22829324 PMCID: PMC3492565 DOI: 10.1007/s13280-012-0336-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 05/08/2012] [Accepted: 06/20/2012] [Indexed: 05/31/2023]
Abstract
This study maps current understanding and research trends on the human dimensions of climate change (HDCC) in the eastern and central Canadian Arctic. Developing a systematic literature review methodology, 117 peer reviewed articles are identified and examined using quantitative and qualitative methods. The research highlights the rapid expansion of HDCC studies over the last decade. Early scholarship was dominated by work documenting Inuit observations of climate change, with research employing vulnerability concepts and terminology now common. Adaptation studies which seek to identify and evaluate opportunities to reduce vulnerability to climate change and take advantage of new opportunities remain in their infancy. Over the last 5 years there has been an increase social science-led research, with many studies employing key principles of community-based research. We currently have baseline understanding of climate change impacts, adaptation, and vulnerability in the region, but key gaps are evident. Future research needs to target significant geographic disparities in understanding, consider risks and opportunities posed by climate change outside of the subsistence hunting sector, complement case study research with regional analyses, and focus on identifying and characterizing sustainable and feasible adaptation interventions.
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Affiliation(s)
- James D. Ford
- Department of Geography, McGill University, Montreal, QC Canada
| | - Kenyon Bolton
- Department of Geography, McGill University, Montreal, QC Canada
| | | | - Tristan Pearce
- Department of Geography, University of Guelph, Guelph, ON Canada
| | - Martin Tremblay
- Aboriginal Affairs and Northern Development Canada, Gatineau, QC Canada
| | - Michael Westlake
- Aboriginal Affairs and Northern Development Canada, Gatineau, QC Canada
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Sherman M, Berrang-Ford L, Ford J, Lardeau MP, Hofmeijer I, Cortijo CZ. Balancing Indigenous Principles and Institutional Research Guidelines for Informed Consent: A Case Study from the Peruvian Amazon. ACTA ACUST UNITED AC 2012. [DOI: 10.1080/21507716.2012.714838] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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