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Vining R, Finn M. Why and how is photovoice used as a decolonising method for health research with Indigenous communities in the United States and Canada? A scoping review. Nurs Inq 2024; 31:e12605. [PMID: 37805822 DOI: 10.1111/nin.12605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 10/09/2023]
Abstract
Globally, including in North America, Indigenous populations have poorer health than non-Indigenous populations. This health disparity results from inequality and marginalisation associated with colonialism. Photovoice is a community-based participatory research method that amplifies the voices of research participants. Why and how photovoice has been used as a decolonising method for addressing Indigenous health inequalities has not been mapped. A scoping review of the literature on photovoice for Indigenous health research in the United States and Canada was carried out. Five electronic databases and the grey literature were searched, with no time limit. A total of 215 titles and abstracts and 97 full texts were screened resulting in 57 included articles. Analysis incorporated Lalita Bharadwaj's Framework For Building Research Partnerships with First Nations Communities. Photovoice was selected to improve knowledge mobilisation and participant empowerment and engagement. Studies incorporated relationship building, meaningful data collection, and public dissemination but had a lesser focus on the inclusion of Indigenous peer researchers or participant involvement in analysis. For photovoice to truly realise its decolonising potential, it must be incorporated into a broader participatory and decolonising research paradigm. In addition, more resources are required to support the involvement of Indigenous people in the research process.
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Affiliation(s)
- Rebecca Vining
- Centre for Global Health, Trinity College Dublin, Dublin, Ireland
- Department of Geography, Maynooth University, Kildare, Ireland
| | - Mairéad Finn
- Centre for Global Health, Trinity College Dublin, Dublin, Ireland
- Graduate School of Healthcare Management, Royal College of Surgeons in Ireland, Dublin, Ireland
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Leeies M, Landry C, Blouw M, Butcher J, Hrymak CS, Vazquez-Grande G, Valiani S, Prakash V, Haddara WMR, Taneja R, Whittemore KG, MacRedmond RE, Paunovic BN, Downar J, Farrell CA, Murthy S, Haroon BA, DosSantos C, Balan M, Rochwerg B, D'Aragon F, Buss M, Burns KEA. Canadian Critical Care Society position statement on reconciliation, decolonization, and Indigenous engagement. Can J Anaesth 2024; 71:311-321. [PMID: 38332414 DOI: 10.1007/s12630-023-02682-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 02/10/2024] Open
Affiliation(s)
- Murdoch Leeies
- Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada.
- Department of Emergency Medicine, University of Manitoba, S203 Medical Services Bldg., 750 Bannatyne Avenue, Winnipeg, MB, R3E 0W2, Canada.
| | - Cameron Landry
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Marcus Blouw
- Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Joshua Butcher
- Department of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada
| | - Carmen S Hrymak
- Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Sabira Valiani
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Varuna Prakash
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Wael M R Haddara
- Division of Critical Care Medicine, Western University, London, ON, Canada
- Critical Care Medicine Program, London Health Sciences Centre, London, ON, Canada
| | - Ravi Taneja
- Division of Critical Care Medicine, Western University, London, ON, Canada
- Department of Anesthesia & Perioperative Medicine, Western University, London, ON, Canada
| | - Kathryn G Whittemore
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Department of Critical Care, Regina General Hospital, Regina, SK, Canada
| | - Ruth E MacRedmond
- Critical Care Medicine, St. Paul's Hospital, Providence Health Care, Vancouver, BC, Canada
- Division of Critical Care Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Bojan N Paunovic
- Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - James Downar
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- Division of Palliative Care, University of Toronto, Toronto, ON, Canada
| | - Catherine A Farrell
- Division of Pediatric Intensive Care, Centre hospitalier universitaire de Sainte-Justine, Montreal, QC, Canada
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
| | - Srinivas Murthy
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Babar A Haroon
- Department of Critical Care, Dalhousie University, Halifax, NS, Canada
| | - Claudia DosSantos
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Marko Balan
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Bram Rochwerg
- Department of Medicine, Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada
| | - Frédérick D'Aragon
- Department of Anesthesiology, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Mandy Buss
- Department of Family Medicine, University of Manitoba, Winnipeg, MB, Canada
- Indigenous Physicians Association of Canada, Vancouver, BC, Canada
| | - Karen E A Burns
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Division of Critical Care, Department of Medicine, Unity Health Toronto - St. Michael's Hospital, Toronto, ON, Canada
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Kassem H, Harris MA, Edwards-Wheesk R, Liberda EN. Traditional activities and general and mental health of adult Indigenous peoples living off-reserve in Canada. Front Public Health 2024; 11:1273955. [PMID: 38328543 PMCID: PMC10847285 DOI: 10.3389/fpubh.2023.1273955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/18/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction We examined associations between traditional Indigenous activities and self-perceived general and mental health in adult Indigenous persons living off-reserve in Canada using the 2012 and 2017 Aboriginal Peoples Surveys (APS), the two most recent datasets. We utilized four traditional Indigenous activities including hunting, making clothes or footwear, making arts or crafts, and gathering wild plants to investigate these self-reported data. Methods Data from 9,430 and 12,598 respondents from the 2012 and 2017 APS, respectively, who responded to 15 questions concerning traditional activities were assessed using multivariable logistic regression to produce odds ratios (OR) and 95% confidence intervals (CI). Covariates included age, sex, education-level, income-level, Indigenous identity, residential school connection, ability to speak an Indigenous language, smoking status, and alcohol consumption frequency. Results Using the 2012 APS, clothes-making was associated with poor self-reported general (OR = 1.50, 95%CI: 1.12-1.99) and mental (OR = 1.59, 95%CI: 1.14-2.21) health. Hunting was associated with good mental health (OR = 0.71 95%CI: 0.56-0.93). Similarly, 2017 analyses found clothes-making associated with poor general health (OR = 1.25, 95%CI: 1.01-1.54), and hunting associated with good general (OR = 0.76, 95%CI: 0.64-0.89) and mental (OR = 0.69, 95%CI: 0.58-0.81) health. Artmaking was associated with poor general (OR = 1.37, 95%CI: 1.17-1.60) and mental (OR = 1.85, 95%CI: 1.58-2.17) health. Conclusion Hunting had protective relationships with mental and general health, which may reflect benefits of participation or engagement of healthier individuals in this activity. Clothes-making and artmaking were associated with poor general and poor mental health, possibly representing reverse causation as these activities are often undertaken therapeutically. These findings have implications for future research, programs and policies concerning Indigenous health.
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Affiliation(s)
- Hallah Kassem
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, ON, Canada
| | - M. Anne Harris
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, ON, Canada
| | - Ruby Edwards-Wheesk
- Department of Chief and Council, Fort Albany First Nation, Fort Albany, ON, Canada
| | - Eric N. Liberda
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, ON, Canada
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Frehlich L, Amson A, Doyle-Baker P, Black T, Boustead D, Cameron E, Crowshoe LL, McBrien K, Ji YJ, McGuire A, Oliver A, Tuttauk L, Zhang J, Checholik C, Wicklum S. Spread of Makoyoh'sokoi (Wolf Trail): a community led, physical activity-based, holistic wellness program for Indigenous women in Canada. J Health Popul Nutr 2023; 42:80. [PMID: 37573348 PMCID: PMC10422705 DOI: 10.1186/s41043-023-00427-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023]
Abstract
Globally, Indigenous populations have been impacted by colonization. Populations who have endured colonization are at higher risk of developing chronic diseases. Canada's Truth and Reconciliation Commission emphasizes reducing barriers to participation in physical activity and recommends the creation of culturally relevant and supportive policies and programing. Physical activity is a cornerstone in health promotion and public health to combat chronic diseases; however, in Canada, Indigenous developed physical activity programing is sparse, and those targeting women are non-existent in some regions. Makoyoh'sokoi (The Wolf Trail Program) is an 18-week long, holistic wellness program that was created by and for Indigenous women. Makoyoh'sokoi was developed by communities following extensive consultation and cultural oversight. Makoyoh'sokoi's core program consists of 12 weeks of weekly physical activity programing and health education, followed by another 6 weeks of weekly health education. Notably, communities have control over the program to modify based on individual needs and challenges. Programs commence and conclude with a ceremony with Elders giving a blessing and opening each other to connection. The goals of Makoyoh'sokoi are to empower women, improve health outcomes, and to implement a sustainable program by training a network of community members in their respective communities to facilitate delivery.
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Affiliation(s)
| | | | | | - Tia Black
- University of Calgary, AB, Calgary, Canada
| | | | - Erin Cameron
- Northern Ontario School of Medicine, Sudbury, ON, Canada
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Hicks LJ, Mushquash CJ, Toombs E. A national-level examination of First Nations peoples’ mental health data: Predicting mental well-being from social determinants of health using the 2017 Aboriginal Peoples Survey. Front Public Health 2023; 11:1073817. [PMID: 37064658 PMCID: PMC10102338 DOI: 10.3389/fpubh.2023.1073817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/07/2023] [Indexed: 04/03/2023] Open
Abstract
IntroductionA history of colonization and assimilation have resulted in social, economic, and political disparities for Indigenous people in Canada. Decades of discriminatory policies (e.g., the Indian Act, the Residential School System) have led to numerous health and mental health inequities, which have been intergenerationally maintained. Four main social determinants of health (i.e., income, education, employment, and housing) disproportionately influence the health of Indigenous peoples. These four social determinants have also been used within the Community Well-Being (CWB) index, which assesses the socio-economic wellbeing of a community. This study sought to extend previous research by assessing how specific indicators of CWB predict self-reported mental wellbeing within First Nations populations across Canada in a national dataset with more recent data.MethodsThis study utilized the 2017 Aboriginal Peoples Survey, which includes data on the social and economic conditions of First Nations people living off reserve aged 15 years and over.ResultsResults from a factorial ANOVA indicated that perceptions of income security, housing satisfaction, higher education, and employment are associated with increased self-reported mental health among First Nations individuals living off-reserve.DiscussionThese results support the idea that individual mental health interventions on their own are not enough; instead, broader social interventions aimed at addressing inequities in various social determinants of health (e.g., housing first initiatives) are needed to better support individual wellbeing.
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Affiliation(s)
- Lydia J. Hicks
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
| | - Christopher J. Mushquash
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
- Dilico Anishinabek Family Care, Thunder Bay, ON, Canada
- Center for Rural and Northern Health Research, Lakehead University, Thunder Bay, ON, Canada
- Thunder Bay Regional Health Sciences Center, Lakehead University, Thunder Bay, ON, Canada
- Thunder Bay Regional Health Research Institute, Lakehead University, Thunder Bay, ON, Canada
| | - Elaine Toombs
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
- Dilico Anishinabek Family Care, Thunder Bay, ON, Canada
- *Correspondence: Elaine Toombs,
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Toombs E, Lund JI, Mushquash AR, Mushquash CJ. Intergenerational residential school attendance and increased substance use among First Nation adults living off-reserve: An analysis of the aboriginal peoples survey 2017. Front Public Health 2023; 10:1029139. [PMID: 36743177 PMCID: PMC9895934 DOI: 10.3389/fpubh.2022.1029139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/21/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction The Truth and Reconciliation Commission of Canada (TRCC) published 94 Calls to Action in 2015 to address long-term, intergenerational effects of the residential school system, highlighting the pervasive impact of colonialism on the wellbeing of Indigenous peoples in Canada. Indeed, research with Indigenous populations in Canada has captured that prior experiences of residential schools contributes to the intergenerational transmission of mental and physical health disparities. Despite these studies, further research is needed that contextualizes the influence of residential schools within broader frameworks that consider Indigenous social determinants of health in Canada. As such, the purpose of the present study was to examine patterns of substance use and mental and physical health among individuals with a history of residential school attendance (RSA) and individuals reporting parent or two-generation (parent and grandparent) RSA. Method Data from the Aboriginal Peoples Survey (2017), involving 10,030 First Nations individuals living off reserve, were analyzed. Results Self-reported mental and physical health scores were significantly lower among those had attended residential schools, whose parents attended residential schools, and whose grandparents attended residential schools, when compared to those who did not. Further, family RSA was associated with increased substance use among participants, though the findings were variable based on sex and specific substance analyzed. Meanwhile, individual and family RSA was not associated with increased likelihood of a mental health diagnosis. Discussion These findings provide additional support for how both parental and two-generation family histories of RSA are associated with individual physical and mental health outcomes. Further, these findings articulate the need for the TRCC's Calls to Action to be actually implemented, including community-based approaches that harness the strength of Indigenous people and communities who aim to close the gap in these health disparities for their children and families.
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Affiliation(s)
- Elaine Toombs
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada,Dilico Anishinabek Family Care, Fort William First Nation, ON, Canada,*Correspondence: Elaine Toombs ✉
| | - Jessie I. Lund
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
| | - Aislin R. Mushquash
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada,Dilico Anishinabek Family Care, Fort William First Nation, ON, Canada
| | - Christopher J. Mushquash
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada,Dilico Anishinabek Family Care, Fort William First Nation, ON, Canada,Northern Ontario School of Medicine (NOSM) University, Lakehead University, Thunder Bay, ON, Canada,Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada,Thunder Bay Regional Health Research Institute, Thunder Bay, ON, Canada
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Fu X, Du B, Chen Q, Norbäck D, Lindgren T, Janson C, Runeson-Broberg R. Self-rated health (SRH), recovery from work, fatigue, and insomnia among commercial pilots concerning occupational and non-occupational factors. Front Public Health 2023; 10:1050776. [PMID: 36684912 PMCID: PMC9846758 DOI: 10.3389/fpubh.2022.1050776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/17/2022] [Indexed: 01/06/2023] Open
Abstract
Background This study investigated associations of self-rated health (SRH), recovery from work, fatigue, and insomnia with working conditions, the psychosocial work environment, lifestyle, and sense of coherence (SOC) among commercial pilots. Methods A standardized questionnaire was sent to all pilots in an airline company, of whom 354 (61%) responded. Associations were analyzed via ordinal and logistic regression with mutual adjustment. Results Overall, 21.8% of participants reported low SRH, 13.0% reported not recovering from work during their free time, 61.9% experienced fatigue, and 70.6% experienced insomnia symptoms. A high level of demand at work was associated with poor SRH and more fatigue, and low social support at work was associated with insomnia and poorer recovery from work. Habits surrounding exercise and BMI were associated with SRH. Part-time pilots and captains reported experiencing better recovery from work than their counterparts, while female pilots and younger pilots reported less fatigue. Amount of free time after work and the type of airplane operated were associated with experience of insomnia symptoms. Finally, having a strong sense of coherence was protectively associated with all health outcomes. Conclusion The psychosocial environment at work is essential for the health of pilots, and a strong sense of coherence can be protective. Occupational conditions may influence recovery from work, fatigue, and insomnia. Moreover, engaging in exercise, maintaining a healthy weight, working part-time, and having more free time after the working day could improve pilots' health.
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Affiliation(s)
- Xi Fu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou, China
| | - Bingqian Du
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou, China
| | - Qingsong Chen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou, China
| | - Dan Norbäck
- Occupational and Environmental Medicine, Department of Medical Sciences, University Hospital, Uppsala University, Uppsala, Sweden
| | - Torsten Lindgren
- Occupational and Environmental Medicine, Department of Medical Sciences, University Hospital, Uppsala University, Uppsala, Sweden
| | - Christer Janson
- Respiratory, Allergy and Sleep Research, Department of Medical Sciences, University Hospital, Uppsala University, Uppsala, Sweden
| | - Roma Runeson-Broberg
- Occupational and Environmental Medicine, Department of Medical Sciences, University Hospital, Uppsala University, Uppsala, Sweden
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Prędkiewicz P, Bem A, Siedlecki R, Kowalska M, Robakowska M. An impact of economic slowdown on health. New evidence from 21 European countries. BMC Public Health 2022; 22:1405. [PMID: 35870922 PMCID: PMC9308123 DOI: 10.1186/s12889-022-13740-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background The economic slowdown affects the population's health. Based on a social gradient concept, we usually assume that this detrimental impact results from a lower social status, joblessness, or other related factors. Although many researchers dealt with the relationship between economy and health, the findings are still inconsistent, primarily related to unemployment. This study reinvestigates a relationship between the economy's condition and health by decomposing it into macroeconomic indicators. Methods We use data for 21 European countries to estimate the panel models, covering the years 1995–2019. Dependent variables describe population health (objective measures – life expectancy for a newborn and 65 years old, healthy life expectancy, separately for male and female). The explanatory variables primarily represent GDP and other variables describing the public finance and health sectors. Results (1) the level of economic activity affects the population’s health – GDP stimulates the life expectancies positively; this finding is strongly statistically significant; (2) the unemployment rate also positively affects health; hence, increasing the unemployment rate is linked to better health – this effect is relatively short-term. Conclusions Social benefits or budgetary imbalance may play a protective role during an economic downturn. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13740-6.
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Kyoon Achan G, Eni R, Phillips-Beck W, Lavoie JG, Kinew KA, Katz A. Canada First Nations Strengths in Community-Based Primary Healthcare. Int J Environ Res Public Health 2022; 19:13532. [PMID: 36294110 PMCID: PMC9602454 DOI: 10.3390/ijerph192013532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/03/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION First Nation (FN) peoples and communities in Canada are still grappling with the effects of colonization. Health and social inequities result in higher disease burden and significant disparities in healthcare access and responsiveness. For resilience, survival, and self-determination, FN are looking inwards for strengths. This paper reports on the cultural, community, and family strengths that have supported FN communities in developing community-based primary healthcare (CBPHC) strategies to support health and wellbeing. METHODS The study was a partnership between university-based researchers; The First Nations Health and Social Secretariat of Manitoba; and eight First Nation communities in Manitoba. Community-based participatory research methods were used to engage the participating communities. One hundred and eighty-three in-depth, semi-structured key informant interviews were completed between 2014 and 2016 with key members of the First Nation communities, i.e., community-based health providers and users of primary healthcare services, representing all age and genders. Data-collection and analysis were conducted following iterative grounded theory analysis. RESULTS Community-based healthcare models based on local strengths support easier access and shorter wait times for care and compassionate care delivery. Resources such as homecare and medical transportation are helpful. Community cooperation, youth power, responsive leadership, and economic development as well as a strong cultural and spiritual base are key strengths supporting health and social wellbeing. CONCLUSIONS Locally led, self-determined care adds strength in FN communities, and is poised to create long-lasting primary healthcare transformation.
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Affiliation(s)
- Grace Kyoon Achan
- Education Indigenous Institute of Health and Healing, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
| | - Rachel Eni
- Independent Researcher, Victoria, BC V9C 0M1, Canada
| | - Wanda Phillips-Beck
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, First Nation Health and Social Secretariat Manitoba, University of Manitoba, Winnipeg, MB R3B 2B3, Canada
| | - Josée G. Lavoie
- Department Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P5, Canada
| | - Kathi Avery Kinew
- First Nation Health and Social Secretariat Manitoba, Winnipeg, MB R3B 2B3, Canada
| | - Alan Katz
- Department of Family Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3B 2B3, Canada
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Ahmed F, Liberda EN, Solomon A, Davey R, Sutherland B, Tsuji LJS. Indigenous Land-Based Approaches to Well-Being: The Amisk (Beaver) Harvesting Program in Subarctic Ontario, Canada. Int J Environ Res Public Health 2022; 19:7335. [PMID: 35742603 DOI: 10.3390/ijerph19127335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 11/22/2022]
Abstract
The act of decolonizing knowledge systems involves recovering and renewing traditional, non-commodified cultural patterns, such as the sustenance of intergenerational relationships and traditional practices. A decline in beaver harvesting, which was once an integral part of the Omushkego Cree culture, has resulted in an overabundance of beavers and dams, which has negatively affected communities by increasing the local flooding events and impacting the water quality. The aim of the Amisk (beaver) program was to reconnect the Elders and youth to revitalize traditional on-the-land activities and, in the present case, beaver harvesting and associated activities within the community. The program and evaluation were built using a two-eyed seeing (Etuaptmumk) and community-based participatory research approach. Salivary cortisol, a biomedical measure of stress, was collected before and after participation in the program. Photovoice, along with semi-directed interviews, were employed to identify the key elements of well-being from a First Nations’ perspective. For the beaver harvesting activities, the changes observed in the cortisol concentrations were not statistically significant (p = 0.094). However, the act of beaver dam removal was associated with a statistically significant increase in the post-participation cortisol concentration (p = 0.021). It was noteworthy that increased stress during the removal of the beaver dams–as indicated by the elevated post-activity cortisol levels–were not reflected in a decrease in the qualitative measures (semi-directed interviews and photovoice) of well-being from an Indigenous perspective. In fact, there was a noted increase in the subjective well-being of the participants, which highlights the importance of multiple perspectives when assessing well-being, especially in Indigenous peoples. However, the cortisol findings of the present pilot project need to be interpreted with caution, due to the limited sample sizes.
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Sergeant A, Saha S, Lalwani A, Sergeant A, McNair A, Larrazabal E, Yang K, Bogler O, Dhoot A, Werb D, Maghsoudi N, Richardson L, Hawker G, Siddiqi A, Verma A, Razak F. Diversity among health care leaders in Canada: a cross-sectional study of perceived gender and race. CMAJ 2022; 194:E371-E377. [PMID: 35288408 PMCID: PMC8920524 DOI: 10.1503/cmaj.211340] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Diverse health care leadership teams may improve health care experiences and outcomes for patients. We sought to explore the race and gender of hospital and health ministry executives in Canada and compare their diversity with that of the populations they serve. METHODS This cross-sectional study included leaders of Canada's largest hospitals and all provincial and territorial health ministries. We included individuals listed on institutional websites as part of the leadership team if a name and photo were available. Six reviewers coded and analyzed the perceived race and gender of leaders, in duplicate. We compared the proportion of racialized health care leaders with the race demographics of the general population from the 2016 Canadian Census. RESULTS We included 3056 leaders from 135 institutions, with reviewer concordance on gender for 3022 leaders and on race for 2946 leaders. Reviewers perceived 37 (47.4%) of 78 health ministry leaders as women, and fewer than 5 (< 7%) of 80 as racialized. In Alberta, Saskatchewan, Prince Edward Island and Nova Scotia, provinces with a centralized hospital executive team, reviewers coded 36 (50.0%) of 72 leaders as women and 5 (7.1%) of 70 as racialized. In British Columbia, New Brunswick and Newfoundland and Labrador, provinces with hospital leadership by region, reviewers perceived 120 (56.1%) of 214 leaders as women and 24 (11.5%) of 209 as racialized. In Manitoba, Ontario and Quebec, where leadership teams exist at each hospital, reviewers perceived 1326 (49.9%) of 2658 leaders as women and 243 (9.2%) of 2633 as racialized. We calculated the representation gap between racialized executives and the racialized population as 14.5% for British Columbia, 27.5% for Manitoba, 20.7% for Ontario, 12.4% for Quebec, 7.6% for New Brunswick, 7.3% for Prince Edward Island and 11.6% for Newfoundland and Labrador. INTERPRETATION In a study of more than 3000 health care leaders in Canada, gender parity was present, but racialized executives were substantially under-represented. This work should prompt health care institutions to increase racial diversity in leadership.
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Affiliation(s)
- Anjali Sergeant
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Sudipta Saha
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Anushka Lalwani
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Anand Sergeant
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Avery McNair
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Elias Larrazabal
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Kelsey Yang
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Orly Bogler
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Arti Dhoot
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Dan Werb
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Nazlee Maghsoudi
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Lisa Richardson
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Gillian Hawker
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Arjumand Siddiqi
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Amol Verma
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont
| | - Fahad Razak
- Faculty of Health Sciences (Anjali Sergeant), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Saha, Lalwani, Verma, Razak), St. Michael's Hospital, Toronto, Ont.; Schulich School of Medicine & Dentistry (Anand Sergeant), Western University, London, Ont.; School of Population and Public Health (McNair), University of British Columbia, Vancouver, BC; Arts and Science Program (Larrazabal), McMaster University, Hamilton, Ont.; Temerty Faculty of Medicine (Yang, Bogler, Dhoot, Richardson, Verma, Razak), University of Toronto; Centre on Drug Policy Evaluation (Werb), Unity Health Toronto, Toronto, Ont.; Division of Infectious Diseases and Public Health (Werb), University of San Diego, La Jolla, Calif.; Centre on Drug Policy Evaluation (Maghsoudi), Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Maghsoudi), University of Toronto; Department of Medicine (Richardson, Hawker), University of Toronto; Dalla Lana School of Public Health (Siddiqi), University of Toronto, Toronto, Ont.
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12
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Boksa P, Hutt-MacLeod D, Clair L, Brass G, Bighead S, MacKinnon A, Etter M, Gould H, Sock E, Matoush J, Rabbitskin N, Ballantyne C, Goose A, Rudderham H, Plourde V, Gordon M, Gilbert L, Ramsden VR, Noel V, Malla A, Iyer SN. Demographic and Clinical Presentations of Youth using Enhanced Mental Health Services in Six Indigenous Communities from the ACCESS Open Minds Network. Can J Psychiatry 2022; 67:179-191. [PMID: 34796730 PMCID: PMC8935596 DOI: 10.1177/07067437211055416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE In many Indigenous communities, youth mental health services are inadequate. Six Indigenous communities participating in the ACCESS Open Minds (AOM) network implemented strategies to transform their youth mental health services. This report documents the demographic and clinical presentations of youth accessing AOM services at these Indigenous sites. METHODS Four First Nations and two Inuit communities contributed to this study. Youth presenting for mental health services responded to a customized sociodemographic questionnaire and presenting concerns checklist, and scales assessing distress, self-rated health and mental health, and suicidal thoughts and behaviors. RESULTS Combined data from the First Nations sites indicated that youth across the range of 11-29 years accessed services. More girls/women than boys/men accessed services; 17% identified as LBGTQ+. Most (83%) youth indicated having access to at least one reliable adult and getting along well with the people living with them. Twenty-five percent of youth reported difficulty meeting basic expenses. Kessler (K10) distress scores indicated that half likely had a moderate mental health problem and a fourth had severe problems. Fifty-five percent of youth rated their mental health as fair or poor, while 50% reported suicidal thoughts in the last month. Anxiety, stress, depression and sleep issues were the most common presenting problems. Fifty-one percent of youth either accessed services themselves or were referred by family members. AOM was the first mental health service accessed that year for 68% of youth. CONCLUSIONS This report is the first to present a demographic and clinical portrait of youth presenting at mental health services in multiple Indigenous settings in Canada. It illustrates the acceptability and feasibility of transforming youth mental health services using core principles tailored to meet communities' unique needs, resources, and cultures, and evaluating these using a common protocol. Data obtained can be valuable in evaluating services and guiding future service design. Trial registration name and number at Clinicaltrials.gov: ACCESS Open Minds/ACCESS Esprits ouverts, ISRCTN23349893.
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Affiliation(s)
- Patricia Boksa
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Daphne Hutt-MacLeod
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Eskasoni Mental Health Services and ACCESS Open Minds Eskasoni, Eskasoni First Nation, Nova Scotia, Canada
| | - Lacey Clair
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Elsipogtog Health and Wellness Centre and ACCESS Open Minds New Brunswick, Elsipogtog First Nation, New Brunswick, Canada
| | - Gregory Brass
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Aaschihkuwaataauch (ACCESS Open Minds Cree Nation of Mistissini) and Mental Health Maanuuhiikuu, Pimuhteheu (Public Health Department), Cree Board of Health and Social Services of James Bay, Cree Nation of Mistissini, Quebec, Canada
| | - Shirley Bighead
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Sturgeon Lake Health Centre, Sturgeon Lake First Nation, Saskatchewan, Canada
| | - Aileen MacKinnon
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Saqijuq-ACCESS OM-Puvirnituq, Puvirnituq, Quebec, Canada and Saqijuaq (Puvirnituq, Kangirsuk, Akulivik)
| | - Meghan Etter
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,ACCESS Open Minds Ulukhaktok, Ulukhaktok, Northwest Territories and Inuvialuit Regional Corporation, Inuvik, Northwest Territories, Canada
| | - Hayley Gould
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Eskasoni Mental Health Services and ACCESS Open Minds Eskasoni, Eskasoni First Nation, Nova Scotia, Canada
| | - Eva Sock
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Elsipogtog Health and Wellness Centre and ACCESS Open Minds New Brunswick, Elsipogtog First Nation, New Brunswick, Canada
| | - Julie Matoush
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Aaschihkuwaataauch (ACCESS Open Minds Cree Nation of Mistissini) and Mental Health Maanuuhiikuu, Pimuhteheu (Public Health Department), Cree Board of Health and Social Services of James Bay, Cree Nation of Mistissini, Quebec, Canada
| | - Norma Rabbitskin
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Sturgeon Lake Health Centre, Sturgeon Lake First Nation, Saskatchewan, Canada
| | - Clifford Ballantyne
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Sturgeon Lake Health Centre, Sturgeon Lake First Nation, Saskatchewan, Canada
| | - Annie Goose
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,ACCESS Open Minds Ulukhaktok, Ulukhaktok, Northwest Territories and Inuvialuit Regional Corporation, Inuvik, Northwest Territories, Canada
| | - Heather Rudderham
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Eskasoni Mental Health Services and ACCESS Open Minds Eskasoni, Eskasoni First Nation, Nova Scotia, Canada
| | - Vickie Plourde
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,School of Psychology, 5568University of Moncton, Moncton, New Brunswick, Canada
| | - Maria Gordon
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Aaschihkuwaataauch (ACCESS Open Minds Cree Nation of Mistissini) and Mental Health Maanuuhiikuu, Pimuhteheu (Public Health Department), Cree Board of Health and Social Services of James Bay, Cree Nation of Mistissini, Quebec, Canada
| | - Lorna Gilbert
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Sturgeon Lake Health Centre, Sturgeon Lake First Nation, Saskatchewan, Canada
| | - Vivian R Ramsden
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Academic Family Medicine, 7235University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Valerie Noel
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Ashok Malla
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Srividya N Iyer
- ACCESS Open Minds Youth Mental Health Services Research Network, 26632Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Ahmed F, Zuk AM, Tsuji LJS. The Impact of Land-Based Physical Activity Interventions on Self-Reported Health and Well-Being of Indigenous Adults: A Systematic Review. Int J Environ Res Public Health 2021; 18:7099. [PMID: 34281031 DOI: 10.3390/ijerph18137099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/26/2021] [Accepted: 06/30/2021] [Indexed: 01/03/2023]
Abstract
For many Indigenous communities, decreased participation in traditional land-based activities has led to higher rates of chronic disease and a decrease in well-being. This systematic review explores how traditional land-based activities impact self-reported health and well-being of Indigenous adults, using Indigenous and Western perspectives. A search of three electronic databases (PubMed, Scopus, and Web of Science) identified nine studies which explored the experiences and perspectives of Indigenous adults taking part in land-based subsistence and ceremonial activities. A thematic analysis of these studies identified many interconnected physical, spiritual, mental, emotional, and community benefits. Community engagement throughout all stages of the interventions was an important factor in effectively addressing challenges and barriers stemming from colonization, decreased knowledge transfer, and increased use of technology. Participants reported developing more effective stress management techniques, a greater awareness of modifiable risk factors along with increased engagement with Elders. Ultimately, land-based subsistence and ceremonial activities were identified as playing an influential role in the lives of Indigenous adults. The involvement of community members allowed for the development of more culturally relevant interventions. Future community-specific research is needed to increase engagement in traditional physical-activities, improve well-being and overall reduce the risk of chronic disease.
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Kyoon-Achan G, Schroth RJ, DeMaré D, Sturym M, Edwards JM, Sanguins J, Campbell R, Chartrand F, Bertone M, Moffatt MEK. First Nations and Metis peoples' access and equity challenges with early childhood oral health: a qualitative study. Int J Equity Health 2021; 20:134. [PMID: 34098968 PMCID: PMC8183050 DOI: 10.1186/s12939-021-01476-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/12/2021] [Indexed: 12/28/2022] Open
Abstract
Background Inequities in early childhood oral health are evident amongst Indigenous peoples and communities in Manitoba, Canada. Early childhood caries (ECC) is decay in primary dentition in children under 6 years of age. A severe form of the disease occurs at a higher rate in Indigenous populations compared to the general population. ECC has been strongly associated with social determinants of health. Methods Focus groups and sharing circles were conducted with four First Nations and Metis communities in urban and rural communities in Manitoba. There were eight groups in total of purposively sampled participants (n = 59). A grounded theory approach guided thematic analysis of audio recorded and transcribed data. Results Indigenous participants experienced challenges similar to those found in the general population, such as encouraging and motivating parents and caregivers to establish regular oral hygiene routines for their children. However other challenges reported, disproportionately affect Indigenous communities. These include poor access to dental care, specifically no dental offices within 1 h driving radius and not having transportation to get there. Not having evidence-based oral health information to support good oral hygiene practices, preventing parents from making the best choices of oral hygiene products and oral health behaviours for their children. Poverty and food insecurity resulting in poor nutritional choices and leading to ECC. For example, feeding children sugary foods and beverages because those are more readily avialble than healthy options. Confusing or difficult encounters with dental professionals, highlighted as a factor that can erode trust, reduce compliance and impact continued attendance at dental offices. Conclusion Closing existing early childhood oral health gaps for First Nations and Metis peoples and communities requires equity-oriented healthcare approaches to address specific problems and challenges faced by these populations. Family, community and systemic level interventions that directly implement community recommendations are needed.
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Affiliation(s)
- Grace Kyoon-Achan
- Department of Preventive Dental Science, Dr. Gerald Niznick College Of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 3P4, Canada. .,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada. .,Ongomiizwin Research - Indigenous Institute of Health and Healing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 3P4, Canada. .,Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Robert J Schroth
- Department of Preventive Dental Science, Dr. Gerald Niznick College Of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 3P4, Canada. .,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada. .,Ongomiizwin Research - Indigenous Institute of Health and Healing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 3P4, Canada. .,Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. .,Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Daniella DeMaré
- Department of Preventive Dental Science, Dr. Gerald Niznick College Of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 3P4, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Melina Sturym
- Department of Preventive Dental Science, Dr. Gerald Niznick College Of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 3P4, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| | | | - Julianne Sanguins
- Health & Wellness Department, Manitoba Metis Federation, 150 Henry Avenue, Winnipeg, MB, R3B 0J7, Canada
| | - Rhonda Campbell
- First Nations Health and Social Secretariat of Manitoba, 600-275 Portage Ave, Winnipeg, MB, R3B 2B3, Canada
| | - Frances Chartrand
- Health & Wellness Department, Manitoba Metis Federation, 150 Henry Avenue, Winnipeg, MB, R3B 0J7, Canada
| | - Mary Bertone
- Department of Preventive Dental Science, Dr. Gerald Niznick College Of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 3P4, Canada
| | - Michael E K Moffatt
- Department of Preventive Dental Science, Dr. Gerald Niznick College Of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 3P4, Canada.,Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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15
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Abstract
This work is a cross-sectional comparative study conducted on 528 residents in the slum and non-slum areas of Pokhara, Nepal. Of the total number of respondents, 90.2% in the slums and 63.3% in the non-slums indicated the existence of a main source of noise, and 80.7% in the slums and 66.0% in the non-slums replied that they had been highly annoyed by noise. The indoor noise levels measured for 24 h were higher in slums than in non-slums, ranging from 59 to 78 dBA and from 51 to 69 dBA, respectively. The Mann-Whitney U test showed a significantly poorer status of slum dwellers in four health domains. Logistic regression analysis identified that living in a slum was a significant predictor (OR, 2.35; 95% CI, 1.35-4.09) of a low level of health. Meanwhile, a high level of noise annoyance was a good determinant (OR, 6.71; 95% CI, 3.13-14.36) of low quality of life among slum dwellers revealing a distinguishing negative effect of the high level of noise annoyance in the slum areas.
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Affiliation(s)
- Eunhwa Choi
- Faculty of Health Sciences, Pokhara University, Lekhnath, Nepal
- Institute of Construction and Environmental Engineering, Seoul National University, Seoul, Republic of Korea
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16
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Paranjpe MD, Chin AC, Paranjpe I, Reid NJ, Duy PQ, Wang JK, O'Hagan R, Arzani A, Haghdel A, Lim CC, Orhurhu V, Urits I, Ngo AL, Glicksberg BS, Hall KT, Mehta D, Cooper RS, Nadkarni GN. Self-reported health without clinically measurable benefits among adult users of multivitamin and multimineral supplements: a cross-sectional study. BMJ Open 2020; 10:e039119. [PMID: 33148746 PMCID: PMC7643504 DOI: 10.1136/bmjopen-2020-039119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Multiple clinical trials fail to identify clinically measurable health benefits of daily multivitamin and multimineral (MVM) consumption in the general adult population. Understanding the determinants of widespread use of MVMs may guide efforts to better educate the public about effective nutritional practices. The objective of this study was to compare self-reported and clinically measurable health outcomes among MVM users and non-users in a large, nationally representative adult civilian non-institutionalised population in the USA surveyed on the use of complementary health practices. DESIGN Cross-sectional analysis of the effect of MVM consumption on self-reported overall health and clinically measurable health outcomes. PARTICIPANTS Adult MVM users and non-users from the 2012 National Health Interview Survey (n=21 603). PRIMARY AND SECONDARY OUTCOME MEASURES Five psychological, physical, and functional health outcomes: (1) self-rated health status, (2) needing help with routine needs, (3) history of 10 chronic diseases, (4) presence of 19 health conditions in the past 12 months, and (5) Kessler 6-Item (K6) Psychological Distress Scale to measure non-specific psychological distress in the past month. RESULTS Among 4933 adult MVM users and 16 670 adult non-users, MVM users self-reported 30% better overall health than non-users (adjusted OR 1.31; 95% CI 1.17 to 1.46; false discovery rate adjusted p<0.001). There were no differences between MVM users and non-users in history of 10 chronic diseases, number of present health conditions, severity of current psychological distress on the K6 Scale and rates of needing help with daily activities. No effect modification was observed after stratification by sex, education, and race. CONCLUSIONS MVM users self-reported better overall health despite no apparent differences in clinically measurable health outcomes. These results suggest that widespread use of multivitamins in adults may be a result of individuals' positive expectation that multivitamin use leads to better health outcomes or a self-selection bias in which MVM users intrinsically harbour more positive views regarding their health.
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Affiliation(s)
- Manish D Paranjpe
- Health Sciences and Technology, Harvard Medical School, Boston, Massachusetts, USA
| | - Alfred C Chin
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
| | - Ishan Paranjpe
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Phan Q Duy
- Medical Scientist Training Program, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jason K Wang
- Health Sciences and Technology, Harvard Medical School, Boston, Massachusetts, USA
| | - Ross O'Hagan
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Artine Arzani
- Weill Cornell Medical College, New York City, New York, USA
| | | | - Clarence C Lim
- Texas A&M University System Health Science Center College of Medicine, Bryan, Texas, USA
| | - Vwaire Orhurhu
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Pain Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ivan Urits
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Pain Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Anh L Ngo
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Benjamin S Glicksberg
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kathryn T Hall
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Darshan Mehta
- Harvard Medical School, Boston, Massachusetts, USA
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States
| | | | - Girish N Nadkarni
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Icahn School of Medicine at Mount Sinai, New York City, New York, USA
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17
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Lavalley J, Kastor S, Tourangeau M, Goodman A, Kerr T. You just have to have other models, our DNA is different: the experiences of indigenous people who use illicit drugs and/or alcohol accessing substance use treatment. Harm Reduct J 2020; 17:19. [PMID: 32209101 PMCID: PMC7092530 DOI: 10.1186/s12954-020-00366-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 03/13/2020] [Indexed: 11/10/2022] Open
Abstract
Objectives In Canada, and elsewhere, indigenous peoples who use illicit drugs and/or alcohol (IPWUID/A) commonly experience vulnerability and a disproportionate burden of harm related to substance use. In Vancouver, Canada, there are concerns that inequitable access, retention, and post treatment care within substance use treatment programs may exacerbate these harms. This study sought to understand the policies and practices with the potential to produce inequities and vulnerabilities for IPWUID/A in substance use treatment, situate the vulnerabilities of IPWUID/A in substance use treatment within the context of wider structural vulnerability of IPWUID/A, and generate recommendations for culturally safe treatment options. Methods This research employed a qualitative indigenous-led community-based approach using the indigenous methodology of talking circles to explore experiences with substance use treatment. Under the participatory research framework, community researchers led the study design, data collection, and analysis. Talking circles elicited peers’ experiences of substance use treatment and were audio-recorded and transcribed. Results The talking circles identified three key themes that illustrated the experiences of IPWUID/A when accessing substance use treatment: (a) barriers to accessing detox and substance use treatment; (b) incompatible and culturally inappropriate structure, policies, and procedures within treatment programs, such as forced Christianity within treatment settings; and (c) the importance of culturally relevant, peer-led substance use treatment programming. Discussion Our work demonstrates that some IPWUID/A have limited access to or retention in mainstream treatment due to excessive waiting times, strict rules, and lack of cultural appropriate care while in treatment. However, IPWUID/A narratives revealed strategies that can improve IPWUID/A access and experiences, including those informed by the diverse perspectives of IPWUID/A and those that include trauma-informed and culturally safe practices.
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Affiliation(s)
- Jennifer Lavalley
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, British Columbia, V6Z 2A9, Canada
| | - Shelda Kastor
- Western Aboriginal Harm Reduction Society, Vancouver, British Columbia, Canada
| | - Malcolm Tourangeau
- Western Aboriginal Harm Reduction Society, Vancouver, British Columbia, Canada
| | | | - Ashley Goodman
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, British Columbia, V6Z 2A9, Canada
| | - Thomas Kerr
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, British Columbia, V6Z 2A9, Canada. .,Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada.
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18
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Neufeld HT, Richmond C. Exploring First Nation Elder Women's Relationships with Food from Social, Ecological, and Historical Perspectives. Curr Dev Nutr 2020; 4:nzaa011. [PMID: 32110768 PMCID: PMC7039853 DOI: 10.1093/cdn/nzaa011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/09/2019] [Accepted: 01/29/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The ongoing negative health effects of colonization have disproportionately affected Indigenous women, who are disproportionately affected by diabetes, food insecurity, and undernutrition. Indigenous women also perceive their health less positively than men do. This article draws theoretically from the socio-ecological model to explore health inequalities experienced by Indigenous women associated with the intergenerational effects of the residential school legacy, specifically related to food practices. OBJECTIVES Study objectives were to describe and compare the historical context of present-day urban and rural food environments, and explore the hypothesis that food insecurity may be associated with cultural loss resulting from the intergenerational trauma of residential schools in this region of southwestern Ontario, Canada. METHODS Framed by a larger community-based participatory study, life history interviews took place with 18 Elder women living on- and off-reserve in southwestern Ontario, Canada. RESULTS Women discussed painful circumstances of displacement from the land and social disconnection from families and communities. The 10 participants who were residential school survivors conveyed the intergenerational effects of loss, responsibility, lack of support, and an altered sense of identity as narratives of survival. Six women had moved away from their home communities, which created challenges to fully engage in local food procurement and sharing practices. These altered geographies present practical limitations, along with apparent mechanisms of social and cultural exclusion. CONCLUSIONS Research on Indigenous Peoples' food systems requires further analysis of the root causes of disparities in the context of societal and gender relations. Food sovereignty has been the domain of women, who have led movements aimed at both social and environmental justice. Unraveling the historical, social, and environmental determinants of Indigenous food knowledge will support and guide community and policy recommendations, highlighting the ongoing effects of residential schooling and other indirect examples of environmental dispossession that have disproportionately affected Indigenous women.
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Affiliation(s)
- Hannah Tait Neufeld
- School of Public Health and Health Systems, The University of Waterloo, Waterloo, Ontario, Canada
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19
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Ucieklak-Jeż P, Bem A. Does "Rural" Always Mean the Same? Macrosocial Determinants of Rural Populations' Health in Poland. Int J Environ Res Public Health 2020; 17:E397. [PMID: 31936149 DOI: 10.3390/ijerph17020397] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/18/2019] [Accepted: 01/03/2020] [Indexed: 12/27/2022]
Abstract
Rural areas, as well as urban ones, are not homogeneous in terms of social and economic conditions. Those surrounding large urban centers (suburban rural areas) act different roles than those located in remote areas. This study aims to measure the level of inequalities in social determinants of health (SDH) between two categories of rural areas. We pose the following research hypotheses: (hypothesis H1) rural areas in Poland are relatively homogenous in the context of SDH and (hypothesis H2) SDH affects life expectancies of rural residents. Based on data covering all rural territories, we found that rural areas in Poland are homogenous in SDH. We also find important determinants of health rooted in a demographic structure—the feminization index and a ratio of the working-age population. On the other hand, we cannot confirm the influence of commonly used SDH-GDP and unemployment rate.
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20
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Wang Y, Li W, Xiong J, Li Y, Wu H. Effect of Land Expropriation on Land-Lost Farmers' Health: Empirical Evidence from Rural China. Int J Environ Res Public Health 2019; 16:E2934. [PMID: 31443280 DOI: 10.3390/ijerph16162934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 11/17/2022]
Abstract
With rapid urbanization and industry development, China has witnessed substantial land acquisition. Using the rural household survey data, this paper examines the impact of land expropriation on land-lost farmers’ self-reported health with the ordered probit model and investigates the possible mechanisms. The results show that the land expropriation puts higher health risks over those land-lost farmers and the health status of land-lost farmers is significantly worse than that of those with land. Land expropriation has a negative impact on the land-lost farmer’s health through income effects and psychological effects. The health status of land-lost farmers can be enhanced through amending current land requisition policies, increasing the amount of compensation, improving the earning capacity of land-lost farmers and strengthening mental health education.
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21
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Kelly BD, Sorin GM, Barry JM, Whiston L, Donnelly-Swift E, Darker C. Community-based, cross-sectional study of self-reported health in post-recession Ireland: what has changed? QJM 2018; 111:555-559. [PMID: 29860494 DOI: 10.1093/qjmed/hcy113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Health has a complex relationship with economic conditions. Ireland's economic recession (2008-13) and sharp recovery (from 2014 onwards) offer a valuable opportunity to study self-reported health and its correlates in the context of rapid economic change. AIM To assess the correlates of self-reported health in Dublin, Ireland after the economic recession of 2008-13. DESIGN Cross-sectional, face-to-face household survey using random cluster sampling. METHODS Self-reported health and its correlates were assessed in randomly selected households in Tallaght (a suburb of Dublin) and results were compared with a similar survey in 2014. RESULTS Five hundred and eighty-three eligible households were invited to participate and interviews were completed in 351 (response rate: 60.2%). The proportion of respondents rating their health as 'very good' or 'good' was 71.8%, essentially unchanged from four years earlier (70.8%). In 2018, better self-reported health was associated with less stress, holding private health insurance, not living with a person with a disability or chronic illness, and greater education; taken together, these factors explained 39.4% of variation in self-reported health. Unlike 2014, self-reported health in 2018 was no longer directly associated with employment status. CONCLUSIONS Self-reported health has stabilized in Ireland since the end of the economic recession, but its correlates have shifted. Stress and carer burden are now among the strongest correlates of poor self-reported health in Ireland.
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Affiliation(s)
- B D Kelly
- Department of Psychiatry, Trinity College Dublin, Trinity Centre for Health Sciences, Tallaght University Hospital, Dublin, Ireland
| | - G M Sorin
- Department of Psychiatry, Trinity College Dublin, Trinity Centre for Health Sciences, Tallaght University Hospital, Dublin, Ireland
| | - J M Barry
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Tallaght Cross, Dublin, Ireland
| | - L Whiston
- School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin, Ireland
| | - E Donnelly-Swift
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Tallaght Cross, Dublin, Ireland
| | - C Darker
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Tallaght Cross, Dublin, Ireland
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