The International Polar Year Inuit Health Survey, Qanuqitpit?, Qanuippitali?, Kanuivit? (“what about us, how are we?”)
The International Polar Year (IPY) Inuit Health Survey, “what about us, how are we?”, was initiated to obtain an overview of the health status and living conditions of Inuit adults residing in 36 remote Arctic communities in Canada. Results are emerging and provide a glimpse into the current situation of Canada’s most northern inhabitants.
The survey was developed using a participatory process with steering committees representing three regions: Nunavut, Nunatsiavut in Northern Labrador, and Inuvialuit Settlement Region in the Western Arctic (see map). The work of these steering committees was further coordinated with the IPY Inuit Health Survey National Results Committee.
The adult survey occurred in 2007 and 2008, with assistance from the Canadian Coast Guard Ship Amundsen which was equipped with research and laboratory facilities. A total of 2,595 adults took part in the survey, representing 1,901 randomly selected households and a household participation rate of 68%.
Major challenges to public health are a high prevalence of household crowding (1 in 4 homes are crowded), hidden homelessness (1 in 5 homes provide shelter to homeless visitors), and substandard housing (2 in 5 homes need major repairs) (1).
The adult survey found that Inuit are no longer protected from the cardiometabolic consequences of overweight and obesity as previously believed. The prevalence of diabetes is now similar to the rate in the general Canadian population, and the hypertriglyceridemic-waist phenotype, a surrogate marker of visceral fat (fat around the organs), was strongly associated with glycemia and type 2 diabetes among Inuit (2).
Inuit still have a lower rate of diabetes than found in First Nations populations. The prevalence of overweight and obesity among Inuit, while high at 64%, is comparable to the general Canadian population (3). A lower prevalence of overweight and obesity was associated with speaking an Inuit language in the home and regular walking, while a higher prevalence was related to frequent consumption of sugar-sweetened beverages (3-4). One possible interpretation of the finding that speaking an Inuit language was associated with a lower prevalence of overweight and obesity is that speaking an Inuit language may be an indicator of adherence to Inuit ways which may protect against emergence of obesity, such as physical activity associated with being out on the land and a lower intake of energy-dense market foods.
Food insecurity, which involves a spectrum of disrupted eating from reduced consumption of quality foods, eating less, skipping meals and going hungry, was highly prevalent at 62.6% and contributed to a poor diet among adults (5). The long-term consequences of poor diet quality would be a greater burden of diet-related chronic diseases in the Arctic. Having an active hunter in the home contributed to food security, and adults who did not consume traditional food had lower intake of many nutrients (6). As well, the survey indicated that older Inuit adults who consumed traditional food had a higher vitamin D status (as assessed by serum 25 hydroxyvitamin D) than younger adults, thereby raising concerns regarding the risk of future osteoporosis among young Inuit women lacking an optimal level of vitamin D (7).
These findings are just a sample of insights of Inuit health status emerging from the survey. The results suggest that public health attention should be directed to the dual burden of food insecurity and dietary transition, accompanied by other fundamental challenges to community health including substandard and crowded housing. It is not too late to avert an epidemiologic disaster of a greater burden of chronic disease in the Inuit population. The IPY Inuit Health Survey results are being used to inform policy and programming both regionally and nationally. Results from the survey helped inform components of Nunavut’s Poverty Reduction Strategy.
The National Results Steering Committee continues to work with investigators to disseminate results and plan next steps with the ultimate goal of reducing health disparities in Inuit Nunangat (the homeland).
|Authors :||Contribution by the
National Results Steering Committee
Grace M. Egeland, Ph.D.
Helga Saudny, M.Sc.
Minich K, Saudny H, Lennie C, Wood M, Williamson Bathory L, Cao Z, Egeland GM. (2011) Inuit housing and homelessness: results from the International Polar Year Inuit Health Survey 2007-2008. Int J Circumpolar Health, 70: 5.
Egeland GM, Zhou C, Young TK. (2011). Hypertriglyceridemic-waist phenotype and glucose intolerance among Canadian Inuit. CMAJ, 183: E553-E558.
Zienczuk N, Young TK, Cao ZR, Egeland GM. (2012). Dietary correlates of an at-risk BMI among Inuit adults in the Canadian high arctic: cross-sectional international polar year Inuit Health Survey 2007-2008. Nutr J, 11:73 [Epub ahead of print].
Zienczuk N, Egeland GM. (2012). Association between socioeconomic status and overweight and obesity among Inuit adults: International Polar Year Inuit Health Survey, 2007-2008. Int J Circumpolar Health, 71: 1-7.
Huet C*, Rosol R, Egeland GM. (2012). The prevalence of food insecurity is high and the diet quality poor in Inuit communities. J Nutr, 142 (3): 541-7.
Egeland GM, Johnson-Down L, Cao ZR, Sheikh N, Weiler H. (2011). Food insecurity and nutrition transition combine to affect nutrient intakes in Canadian Arctic communities. J Nutr, 141 (9): 1746-53.
El Hayek J, Egeland G, Weiler H. (2011). Older age and lower adiposity predict better 25-hydroxy vitamin D concentration in Inuit adults: International Polar Year Inuit Health Survey, 2007-2008. Arch Osteoporos , 6: 167-77.