Ministry of Health and Social Services Norway National strategy to reduce social inequalities in health , Minister of Health and Social Services Rio political declaration on social determinants of health PDF document A conceptual framework for action on the social determinants of health PDF document Closing the gap in a generation: Health equity through action on the social determinants of health PDF document A guide to community engagement frameworks for action on the social determinants of health and health equity , National Collaborating Centre for the Determinants of Health and Healthy Public Policy Tools and approaches for assessing and supporting public health action on the social determinants of health and health equity , National Collaborating Centre for the Determinants of Health and Healthy Public Policy Integrating social determinants of health and health equity into Canadian public health practice , National Collaborating Centre for the Determinants of Health Thirteen public interventions in Canada that have contributed to a reduction in health inequalities , National Collaborating Centre for Healthy Public Policy A conceptual model for use in surveillance and public health planning.
Designed as a tool to support those who work to decrease social inequities in health. A framework for educating health professionals to address the social determinants of health , National Academies Press Social determinants of health: The handbook on health inequality monitoring Addressing the social determinants of health: The urban dimension and the role of local government Intersectoral governance for health in all policies: Structures, actions and experiences PDF document Case studies on social determinants of health Alcohol is a socially accepted part of everyday life for most Canadians.
This analysis examines the relationships between social determinants of health and excellent or very social determinants of inuit health in canada a discussion paper good social determinants of inuit health in canada a discussion paper how to write a this is believe essays health. The get toefl twe essay social determinants of health SDH are the conditions in which people are social determinants of inuit health in canada a discussion paper born, grow, work, live, social determinants of inuit health in canada a discussion paper and age, and the wider set of forces and systems shaping the.
In general, primary education consists of six to eight. Prepared by: social determinants of inuit health in canada a discussion paper Nancy Miller Chenier Political essays for soweto and Social Affairs social determinants of inuit health in canada a discussion paper Division Revised 4 social determinants of inuit health in canada a discussion paper December We assumed that only those who reported participation had indeed participated in the Census and multiplied the Census estimate proportionally to correct for Census non-participation.
With respect to the social determinants of health, Stratified analyses found that Inuit who were permanent residents of Ottawa at the time of the study were less likely to report food insecurity compared to Inuit who were temporary residents Other measures of socio-demographics did not vary by residency status or OHIP registration data available upon request.
Medicare and the care of First Nations, Métis and Inuit
These survey measures of socio-economic deprivation were confirmed by ICES linkage results indicating that ICES linkage data additionally suggest that Inuit women in Ottawa were less likely to have had a Pap smear than the general populations of women in Ottawa and Ontario Fig. Rates of emergency room access were elevated for Inuit in Ottawa compared to the general Ottawa and Ontario populations overall and for both acute and non-acute conditions Fig.
Our study documents a striking burden of socio-economic deprivation, chronic disease, and health care access problems for an urban Inuit population in southern Canada. Inuit community members in Ottawa have been well aware of these challenges for decades based on their lived experiences.
Rates of poverty, unemployment, and food insecurity were markedly high as was relative community-level socio-economic deprivation by neighbourhood income quintile. The disproportionate burden of chronic disease included elevated rates of allergies, hypertension, and COPD. Close to half of the Inuit living in Ottawa rated their access to health care as fair or poor, and multiple barriers to health care access were identified. Finally, rates of emergency room access were elevated, and rates of hospitalization were lower for adult Inuit compared to the general Ottawa populations.
Social Determinants of Inuit Health in Canada: A discussion paper
There are two key explanations for this difference. First, we found that the large majority of Inuit in Ottawa had not completed the census. This means the census significantly undercounted the number of resident Inuit in Ottawa. Second, in keeping with the needs assessment framework of our study, we purposely included Inuit who lived within the Ottawa region, but outside of Ottawa city limits who were using health and social services in the City of Ottawa.
Poverty, unemployment, food insecurity, and health care access issues have been well documented for Inuit living in northern communities Tait ; Peters ; Inuit Tapiriit Kanatami Socio-economic deprivation has been linked to the social and economic disruption of colonization Peters ; Inuit Tapiriit Kanatami For urban Inuit, there are additional complexities linked to urban transition. Health care access issues for Inuit are commonly linked to geography Patrick and Tomiak Our study documents substantive barriers in access to culturally relevant health services despite the high density of health providers and services in Ottawa.
To address this health inequity, TI has asked policy makers to work across jurisdictions to ensure that preventive, primary care, specialist, emergency room, and hospital services are accessible, culturally safe, and better matched to community needs.
Assessing the social determinants of self-reported Inuit health in
TI is also recommending Inuit-specific cultural safety training programs for health and social service providers working with Inuit and access for all Inuit to trained Inuit cultural interpreters Smylie et al. According to the Canadian Community Health Survey, the prevalence of hypertension among adults in Ottawa was The cancer prevalence rate in Canada in was 2. In response to these findings, TI is recommending further study to better understand and enhance the health service use pathways of Inuit accessing emergency departments in Ottawa Smylie et al.
There were a few limitations of the study.
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First, RDS cannot guarantee a random sample of network members Heckathorn et al. Assumptions regarding recruiter-recruit relationships, minimum recruitment chain length, sampling with replacement, and network segregation were met in our study Smylie et al. Additionally, RDS is a relatively new sampling method, and there is an active literature on estimation using RDS data Heckathorn et al. There is also debate in the literature regarding the actual design effects in RDS surveys Wejnert et al. Existing multivariable regression analyses using RDS samples have not appropriately addressed the correlation between observations and the unequal sampling probabilities inherent in RDS; therefore, we have focused on reporting prevalence estimates for which methods are better established.
The majority of our results are based on self-report from a survey conducted over a 5-month period in The findings are therefore subject to self-reporting bias and temporal variation. For example, our RDS versus sample percent estimates of permanent versus transient residency for Inuit in Ottawa may have been impacted by an increase in the number of transient residents arriving in Ottawa at the end of the survey period which occurred in the fall season.
Finally, we note there is a range of uncertainty in our estimates, with some CIs indicating less than optimal precision. Both the variance in CI width and suboptimal precision of some estimates reflect RDS methods in which weights are different for each variable, and for a given sample size, there is more variance than there would be for a random sample.
This study also has multiple strengths, including the comprehensive and ongoing partnership with TI throughout the study design, implementation, and dissemination, which optimized community participation and uptake of study results. The study results address important and persistent gaps in urban Inuit health information and clearly demonstrate that there is a larger population requiring services than indicated by census counts.
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Inuit adults living in Ottawa are experiencing striking socio-economic adversity and a significant burden of chronic disease. Health services at the time of the study were poorly matched to needs, as indicated by multiple barriers in access to health care and elevated rates of emergency room use. It includes the communities located in the four Inuit regions: Nunatsiavut Northern coastal Labrador , Nunavik Northern Quebec , the territory of Nunavut and the Inuvialuit region of the Northwest Territories. These regions collectively encompass the area traditionally occupied by Inuit in Canada.
National Center for Biotechnology Information , U. Canadian Journal of Public Health. Can J Public Health. Published online Oct 9. Spiller , 4 and Tungasuvvingat Inuit 5. Michael W. Author information Article notes Copyright and License information Disclaimer. Janet Smylie, Phone: , Email: ac.
Corresponding author. Received Jan 22; Accepted Jul 3. Abstract Objective Health determinants and outcomes are not well described for the growing population of Inuit living in southern urban areas of Canada despite known and striking health disparities for Inuit living in the north. Methods We employed community-based respondent driven sampling RDS and a comprehensive health assessment survey to collect primary data regarding health determinants, status, and service access.
Adapting to the Effects of Climate Change on Inuit Health | AJPH | Vol. Issue S3
Results We recruited Inuit adults living in Ottawa. Conclusions Urban Inuit experience a heavy burden of adverse health determinants and poor health status outcomes. Keywords: Urban Inuit, Respondent-driven sampling, Indigenous health, Population health assessment, Community-partnered research, Data linkage. Introduction The striking health inequities experienced by the Inuit living in northern Canada are described in a growing body of literature Tait ; Oliver et al.
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