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PubMed1992

An epidemiological perspective of injuries in the Northwest Territories.

This paper reviews the epidemiology of injuries in the multiethnic population of the Northwest Territories (NWT), Canada, based on mortality, hospital morbidity, and health survey data. Overall, injury mortality in the NWT has remained consistently higher than the Canadian national rate. In the NWT, an increasing trend was observed for motor vehicle accidents and homicide in both sexes, and suicide among males, while other accidents (including fires and drowning) have declined substantially among males. The age group which reported the highest suicide rate was shifted downward between the periods 1961-70 and 1981-86. Of the three major groups in the NWT, the overall injury mortality rate was comparable between Indians and Inuit, and their rates were twice as high as that of non-Natives. The age-standardized hospitalization rate for all injuries for the Keewatin Region was similar to that of Canada as a whole whereas the rate for the entire NWT was about twice as high. In the NWT, age-specific hospitalization rate was highest in both sexes among the elderly (age 65+), followed by those in age group 15-24. A survey of a random sample of Keewatin Region residents indicated a low usage rate for seatbelts and helmets while a significant minority of drivers (18%) admitted to drinking and driving sometimes. Such data contribute to a more comprehensive assessment of the burden of injury mortality and morbidity, an important prerequisite for the investigation of risk factors and design of intervention programs.

Adolescent↗
PubMed1992

Epidemiology of nasopharyngeal and salivary gland carcinoma in Greenland.

From 1950 to 1989 one hundred and forty-four cases of either undifferentiated nasopharyngeal carcinoma (NPC) or salivary gland carcinoma (SGC) were diagnosed in Greenlanders, all born in Greenland. The Greenland SGC is an anaplastic carcinoma with histopathology and electronmicroscopic cytopathological alterations as found in undifferentiated NPC. Both NPC and SGC from Greenland and Alaska are associated with Epstein-Barr virus infection. The incidence rate of NPC based on newly diagnosed cases during the last 15 years is 12.7 for men and 9.2 for women. The same figures for anaplastic SGC are 3.4 and 3.1. These are among the highest incidence rates of Epstein-Barr virus associated carcinomas on record. From 1950 to 1989 there has been an increase in the rate of NPC. From the cumulated rate, it can be predicted that the number of cases will continue to increase during the years to come. During the ten year period 1980 to 1989 patients were questioned about their childhood life style and the family history was taken. The Inuit lifestyle is quite different from that of Europeans and Chinese, but in common with Chinese from Guangzhou (formerly Canton) Greenlanders have a high consumption of fish, fresh as well as dried. Familial clustering has been rarely reported, but in the present investigation 27% of the patients diagnosed between 1980 and 1990 had a positive familial history with one or more confirmed cases among first degree relatives.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2003

Commons committee recommends significant increase in funding for AIDS strategy.

A House of Commons committee says that current funding for the Canadian Strategy on HIV/AIDS should be more than doubled. It calls for designated funding for inmates and First Nations and Inuit peoples, and for HIV vaccine research. Finally, it says that more federal government departments need to become involved in the response to AIDS.

Canada↗
PubMedDate not supplied

A First Nations voice in the present creates healing in the future.

This paper discusses the urgency for change and improvements in health policy determined by the exploding demographics and inequities in the health status of First Nation people. A historical overview of health services for First Nation clients was conducted as set out through government legislation and health and social policies. Until WWII ended, the federal government provided assistance to First Nations through Indian Affairs branches of several departments. This responsibility was gradually transferred to National Health and Welfare. In 1962, the federal government established a Medical Services Branch, later renamed First Nations and Inuit Health Branch, and mandated to provide services to First Nation clients, which fell outside the provincial jurisdiction of health care. Initially centered on public health priorities, services have expanded to include primary health care, dental, mental health, environmental health, home and continuing care, and Non-Insured Health Benefits. The Romanow Report substantiated the urgency for health policy improvements voiced by many First Nations. However, it generalized Aboriginal issues in health care on a national front. Furthermore, its recommendations were specific to health care providers and delivery models and did not address the social and spiritual determinants of health, which are fundamental to a First Nations' holistic approach. Health planners must think holistically, considering traditional and westernized medicine, First Nations' values, priorities and government systems, and present and evolving health systems. Universities, health authorities, provinces and the federal government are continually developing new research and health models, which will also need consideration. Further, the imperative of involving community-level input must be recognized.

Aged↗
PubMedDate not supplied

Determinants of healthy eating in Aboriginal peoples in Canada: the current state of knowledge and research gaps.

Aboriginal peoples are the original inhabitants of Canada. These many diverse peoples have distinct languages, cultures, religious beliefs and political systems. The current dietary practices of Aboriginal peoples pose significant health risks. Interventions to improve the nutritional status of Aboriginal peoples must reflect the realities of how people make food choices and therefore should be informed by an understanding of contemporary patterns of food procurement, preparation and distribution. Most of the literature documenting the health of Aboriginal peoples is primarily epidemiologic, and there is limited discussion of the determinants that contribute to health status. The majority of studies examining dietary intake in Aboriginal communities do not aim to study the determinants of food intake per se even though many describe differences in food intake across sex, age groups, seasons and sometimes communities, and may describe factors that could have an effect on food consumption (e.g., employment status, level of education, household size, presence of a hunter/trapper/fisher, occupation, main source of income). For these reasons, there are many gaps in knowledge pertaining to the determinants of healthy eating in Aboriginal peoples that must be filled. Given the diversity of Aboriginal peoples, research to address the gaps should take place at both the national level and at a more local level. Research would be important for each of Inuit, Métis and First Nations.

Adult↗
PubMed2006

Waste disposal in first-nations communities: the issues and steps toward the future.

The interests of First Nations communities in Canada have traditionally had little voice at the various points of authority that maintain the equilibrium or balance necessary to get environmental protection laws ratified, regulations distributed, and enforcement actions initiated on First Nations lands. (First Nations is the term commonly used in Canada to describe the various societies of indigenous peoples who are accorded status as "Indians" by the Indian Act of 1985 and who are not of Inuit or Métis descent.) Along with a lack of adequate funding to address human and environmental issues-as well as past industrial exploitation of First Nations lands-the safety and acceptability of many solid waste management practices in Canadian First Nations communities have become a serious concern for many members from both human and environmental health perspectives. A history of poor management, monitoring, and remediation of solid waste facilities across Canada's First Nations Communities and the lack of current resolve over this issue has left First Nations people feeling the consequences of pollution to their environment: rivers, land, and air. First Nations people are traditionally connected to the land, and consequently the degradation of the environment also leads to a decline in a way of life for the people and thus a decline in the cultural health of communities. This article examines the issues surrounding waste management on First Nations communities, looks at how First Nations are trying to handle their solid waste, and considers the larger issues of environmental degradation that First Nations communities face throughout Canada.

Canada↗
PubMed1991

Disease pattern in Greenland: studies on morbidity in Upernavik 1979-1980 and mortality in Greenland 1968-1985.

The disease pattern is described for the population of Upernavik, which is the administrative centre of a very large, sparsely populated municipality in North Western Greenland. The number of medical contacts per person was by and large similar in Upernavik and Denmark despite different health care systems, but the distribution of diagnoses was different. Persons with poor socioeconomic status (housing conditions and social group) were admitted to hospital more often than those with high status. Mortality in Greenland was studied using a computerized register of causes of death covering all deaths in residents of Greenland during 1968-1985. Age standardized mortality rate was twice as high in Inuit of Greenland as in the population of Denmark but five times higher in children. Mortality due to infectious diseases, ischaemic heart disease and certain accidents decreased during the period studied while mortality due to lung cancer, suicide and homicide increased. Regional differences in mortality were pronounced with high infant mortality and high mortality from acute infections and accidents in the socioeconomically poor settlements and remote districts. The suicide and homicide rates were highest in the capital and in the remote East Greenland. Compared with Denmark, mortality rates were higher in Greenland from most causes with ischaemic heart disease as an exception, being significantly less common in Greenland in both males and females. A comprehensive literature review describes the disease pattern in Greenland with special emphasis on the period after 1970. It is concluded that epidemiology can contribute to future health planning in Greenland and that research and development must be given high priority. Some major health problems facing the Greenlandic community are the high mortality from suicides and homicides, the prevalence of violence often triggered by alcohol, the many accidents, the high infant and child mortality and the high mortality from preventable cancers (lung and cervix).

Cause of Death↗
PubMed1991

Canadian Cancer Statistics 1991.

During 1991, an estimated 109,000 new cases of cancer will be diagnosed in Canada (excluding non-melanoma skin cancer). Estimated cancer deaths in 1991 will total 56,700. Excluding non- melanoma skin cancer, over one in three Canadians will develop some form of cancer during their lifetime, while one in four men and one in five women will die from this disease. These statistics are discussed, as well as cancer risk factors, cancer in children, age and sex distribution of cancer, cancer survival rates, trends in cancer incidence and mortality since 1970, smoking and lung cancer, and cancer among the Inuit and Indians.

Adolescent↗
PubMed1990

Fatal accidents in Greenland.

The occurrence of fatal accidents in Greenland was studied for 1968-1985 with emphasis on the native Inuit population. 1004 deaths were recorded, 43% of which were drowning and boat accidents. The mortality rates from all fatal accidents together were 202 and 72 per 100,000 person-years in males and females, respectively, and fatal accidents made up 16% of all deaths. 23% of the accidents were alcohol related, considerably more in certain age groups and in females. Most accident types, including alcohol related accidents, showed a decreasing mortality trend during the period of study but boat accidents not related to alcohol increased significantly. The mortality rates were higher in East Greenland than in West Greenland for most accident types and, in West Greenland, the mortality rates from drowning, boat accidents, fire and accidental shots increased with remoteness from the capital. Many accidents can be prevented but certain accidents are natural consequences of traditional activities which hold compensating benefits.

Accidents↗
PubMed1990

Hydatid cyst presenting as a breast lump.

Cystic hydatid disease is caused by the parasite Echinococcus granulosus. Indigenous infections are seen among the Indians and Inuit. Man is an occasional intermediate host in whom the disease is manifested by the presence of one or more hydatid cysts, usually located in the liver or lung and rarely at other sites such as the breast, as in this case report. The cyst is usually asymptomatic; in this it case was discovered on routine mammography. On aspiration biopsy, 1 ml of clear fluid was removed, but there was a residual lump which was successfully excised.

Adult↗
PubMed1990

Geographic variation of mortality in Greenland. Economic and demographic correlations.

Geographic variation of mortality in the native (Inuit) Greenlandic population was studied and compared at community level with income, population change and community size. Six well defined geographic regions were identified. Mortality rates from infectious diseases and accidents were lowest in West Greenlandic towns and highest in settlements and in East Greenland; they showed a significant negative correlation with income. Mortality rate from ischaemic heart disease was highest in West Greenlandic towns excluding the capital (Nuuk) while no clear geographic pattern was observed for cerebrovascular disease. The suicide rate was very high in the capital and in East Greenland while it was low, at the Danish level, in West Greenlandic settlements. The study has demonstrated an internal variation in the Greenlandic mortality pattern which must be taken into account in the planning of both scientific studies and practical health interventions.

Cause of Death↗
PubMed1989

Tuberculosis in Canada 1987.

In 1987, 1,957 new or reactivated cases of tuberculosis were reported in Canada, an 8.8% drop from 1986. This corresponds to an overall decline of almost 50% in Canada's tuberculosis rates over the past decade. This article examines tuberculosis rates by sex, age and province, and identifies four high risk groups. The first group, comprising North American Indians and Inuit, has a rate five to ten times higher than the Canadian population. Poor inner city residents have rates up to four times higher, and foreign-born Canadians up to three times higher. For all Canadians, risk increases with age, and thus the elderly comprise the fourth risk group. A fifth group, males aged 25 to 44 infected with Human Immunodeficiency Virus (HIV) and who later develop Acquired Immune Deficiency Syndrome (AIDS), has emerged in the United States although no increased risk is at yet seen in Canada.

Adolescent↗
PubMed1989

Genetic studies of low-abundance human plasma proteins. XIII. Population genetics of C1R complement subcomponent and description of new variants.

Isoelectric focusing and immunoblotting reveals considerable biochemical and genetic variation in the C1R subcomponent of the first complement component. The nature of the intraindividual biochemical variation can be explained by differences in sialic acid content because after digestion with neuraminidase the terminal sialic acids are removed to yield a single major band corresponding to the C1R polypeptide. Plasma samples from a large number of different ethnic groups, consisting of U.S. whites, U.S. blacks, Nigerian blacks, and Inuit, Aleut, and Amerindian populations from the Western Hemisphere have revealed genetically determined charge variation with heterozygous phenotypes consisting of two major asialo bands, indicating that the underlying variation is not due to variation in sialic acid content. Two previously reported common alleles, C1R*1 and CIR*2, have been observed in all studied populations, the notable exception being the Dogrib Indian population, which is devoid of the C1R*2 allele. Several new alleles--designated C1R*3, C1R*4, C1R*5, C1R*6, and C1R*7-have been observed, with variable frequencies ranging from the occurrence in a single individual and related family members to the polymorphic occurrence of certain alleles in several populations. Of these new alleles, the C1R*5 is of considerable interest in population and anthropological genetics studies. The C1R*5 allele is widely distributed, at a frequency of .03 to .17, in all of the North American aboriginal populations screened. This allele is not present in U.S. whites but is present at a polymorphic frequency in U.S. and Nigerian blacks.(ABSTRACT TRUNCATED AT 250 WORDS)

Alleles↗
PubMedDate not supplied

The use of chewing tobacco and snuff in Canada, 1986.

This paper reviews current data relating to the use of smokeless tobacco products in Canada. Sources of data include production, disposition, and sales statistics; special population surveys, and estimates obtained from the 1986 Labour Force Survey smoking supplement. In Canada, the use of smokeless tobacco products is confined to the male population. About 0.7% of males over age 15 use chewing tobacco and 0.4% use snuff. The pattern of use is similar to that of the United States in the early 70s. Prevalence rates for both substances tend to be higher in older age groups. Men employed in outdoor occupations are more likely to use chewing tobacco or snuff. Chewing tobacco use tends to be more prevalent in eastern Canada and snuff use in western Canada. The low national prevalence estimates conceal the relatively high usage rates among sub-populations. Among Inuit youth in the Northwest Territories in 1982, 25% of the 10-14 age group used smokeless tobacco.

Adolescent↗
PubMed1989

On suicide statistics.

The classical methodological problem of suicidology is reliability of official statistics. In this article, some recent contributions to the debate, particularly concerning the increased problem of suicide among Inuit, are reviewed. Secondly the suicide statistics of Greenland are analyzed, with the conclusion that the official statistics, as published by the Danish Board of Health, are generally reliable concerning Greenland.

Death Certificates↗
PubMed1989

Will the increased military low-level flying activity in Labrador be detrimental to the hearing of humans in the region?

The Government of Canada has directed the Department of National Defence to encourage our NATO allies to increase use of their facilities at Goose Bay, Labrador. This has already resulted in a substantial increase in the amount of military flying in the area, and more is projected. Much of the flying is done at very low altitude. The aboriginal people in the region (the Innu and, to a lesser extent, the Inuit) are demanding a halt to low-level military flying, and their representatives claim that the noise from the low-flying jet aircraft can cause hearing loss and ear disease. A survey on the ground in the area measured noise levels up to 127.7 dBA with very brief exposure levels. A task force commission to look at the problem concluded that occasionally low-level subsonic overflights might produce noise levels that were potentially damaging to hearing, but that the probability of this happening is at present very low because of the low frequency of flights. This might change if the frequency of flights increases.

Aircraft↗
PubMed1986

Vitamin-D-deficient rickets in Manitoba, 1972-84.

Vitamin-D-deficient rickets still exists in children in Manitoba and adjacent areas. Between 1972 and 1984, 48 cases were documented at Winnipeg Children's Hospital. The patients ranged in age from 1 to 49 months; 40 were Canadian natives (38 Indians and 2 Inuit), most of whom lived in the Island Lake area of northern Manitoba. Of the 48, 16 had clinical signs of rickets, 12 had tetany due to hypocalcemia and 38 had radiologic evidence of rickets. Hypocalcemia was found in 27, and hypophosphatemia in 19; hyperaminoaciduria was found in 7 of 20. All 48 had elevated serum alkaline phosphatase levels. In addition to rickets, 16 patients aged 12 months or more had evidence of malnutrition. Climate and lifestyle in northern areas of the Canadian midwest result in little or no biosynthesis of vitamin D by solar radiation; therefore, adequate dietary vitamin D intake is essential to prevent deficiency. The diets of pregnant women and infants in these areas are deficient in vitamin D. The authors recommend vitamin D supplements for all pregnant women and infants in areas of risk to eradicate this preventable disease.

Amino Acids↗
PubMed1986

Lack of evidence of hepatitis D (delta) infection in Newfoundland and Labrador.

Epidemiologic knowledge of hepatitis D virus (HDV) infection is limited. A seroepidemiologic study was undertaken to determine the prevalence of the infection in Newfoundland and Labrador. Between October 1983 and October 1985 over 200 people were recognized through routine serodiagnosis and screening as having hepatitis B seromarkers. A total of 223 serum samples from 186 of these people were tested for anti-HDV. The subjects were mainly asymptomatic carriers of hepatitis B surface antigen or patients with acute or chronic hepatitis B from the native Indian and Inuit and the non-native populations. None of the serum samples were positive for anti-HDV. The absence of anti-HDV in a substantial number of people in the province who are infected with hepatitis B virus is strong evidence that HDV infection is not prevalent in the local population, including native people.

Acute Disease↗