Introduction
Canada’s youngest territory is one of the least developed geographical areas with respect to infrastructure and resources available to the population. Nunavut is home to a large number of Indigenous people who identify as Inuit; nearly the entire population identifies as such. Unfortunately, much of the population of Nunavut continue to live in conditions of poverty. Although the territory is nearly twenty years old, it seems as though the government forgets that Nunavut exists when they announce funding for other Indigenous communities. The northern part of Canada is often overlooked, which means health problems among Inuit people will continue to be unresolved.
Up until recent years, there was a lack of research done in the northern areas of Canada to assess the health of the Inuit population. Now the research that has been conducted has provided insight into the severity of the health and living conditions that Inuit people are faced with on a daily basis. The Inuit population is known to have one of the lowest life expectancy rates in the country, which is due to a number of health-related factors that must be examined closely. How do environmental, nutritional and social aspects affect the health and well-being of Nunavut’s Inuit population? This question is one that must be answered in order to begin to fully understand why the health status of Inuit people is much lower than the Canadian population. Not only should these factors be examined individually, it is also important to examine how these three factors work together to lower the health status of Inuit individuals residing in northern Canada.
Environment
Every year winter seems to become a little colder and summer becomes just a little bit warmer. Precipitation patterns are changing across seasons, the weather becomes more unpredictable and the average global temperature continues to slowly rise. All of these issues are related to climate change, which has been a hot topic in recent years. Even though some politicians continue to believe that climate change is a hoax, the effects it has on humanity are visible and should be taken seriously. Northern regions of the world have been experiencing some of the worst effects of climate change. Many individuals are able to recognize the changes to the land, but often forget that the health and well being of humanity is also impacted. Individuals residing in Nunavut are at higher risk of experiencing physical and mental health related problems due to climate change when compared to other geographical areas of the country. The northern Inuit population are susceptible to the harsh effects of climate change because they rely on environmental resources every day as part of their traditional knowledge and culture (Ford et al., 2012: 292).
Land
Natural and human-made water sources in Nunavut are highly susceptible to the changes in weather patterns. Much of the infrastructure that has been built was made to withstand very cold temperatures and are not made for temperatures that keep shifting. Dramatic changes in temperature causes the ground to move, which eventually causes damage to water supplies. Higher precipitation and increased ice thawing is also damaging water supplies, which ultimately is infecting the drinking water with harmful bacteria (Ford et al. 2014: 11). Since Northern communities are generally underdeveloped, their water infrastructure is not able to adapt with the rapid changes in weather, therefore putting Inuit people at a higher risk of waterborne diseases and illnesses (Ford et al. 2014: 12).
As mentioned, climate change is affecting the arctic ice patterns in the winter. Inuit people use the ice to travel to destinations that are inaccessible by vehicle during the warmer months of the year. They also rely on the ice to go fishing and even to hunt. These ways of life are important for Inuit culture as it is part of their traditional knowledge that has been passed down by generations. These changes in ice patterns pose a safety hazard and increase the risk of injury for Inuit people who rely on the ice for travel and food sources (Ford et al. 2014: 9). As the ice becomes less trustworthy, Inuit people are also at risk of losing their traditional ways of life because it is harder to pass down their knowledge to their children. Keeping the various Indigenous cultures alive is very important for Indigenous people because cultural assimilation by Euro-Canadians has already threatened to eliminate Indigenous knowledge and culture. These past (and current) events have taken a toll on not only the physical health, but also mental well being of Indigenous people.
Mental health
Since climate change is increasing the risk of losing traditional hunting and fishing, Inuit people are experiencing a loss of cultural identity. A loss of cultural identity can have a detrimental effect on the mental health of Inuit people. Unfortunately, many Inuit communities do not have access to mental health resources and many individuals end up taking their life. Suicide rates in Nunavut are among the highest in the world. The suicide rate recorded in Nunavut in 2012 was seventy-six out of one hundred thousand people (Willox et al. 2015: 173). Mental health problems have been prevalent for years due to cultural assimilation and daily life difficulties that Indigenous people face. On top of dealing with daily hardships, many individuals are also left to deal with the after-affects of the death of a loved one due to suicide.
As mentioned, the effects of climate change is a factor in determining why the health status of Inuit people is lower than the general Canadian population. Nutritional factors such as hunger and food instability are also negatively affecting the health of Inuit people in Nunavut.
Nutrition
Hunger
Nutritional resources obtained from the land are a large part of the diet of Inuit people. As previously mentioned, climate change affects the way Inuit people are able to hunt and fish to obtain subsistence. Obtaining food sources has become much more dangerous, therefore other ways to obtain food, such as in grocery stores, must be used in conjunction with traditional hunting and fishing. However, this is also not an easy fix. Fresh produce and meat from grocery stores in Nunavut is very expensive and is not the best quality due to the travel time and the extra transportation costs. Many Inuit people are left to buy cheaper options when visiting grocery stores. The products they end up having the funds to buy may have little nutritional value and may only last a family a few days, which contributes to families suffering from hunger.
Hunger is an ongoing issue in the northern regions of Canada. When discussing hunger, it is referring to inadequate nutritional requirements from the food being consumed which can lead to chronic health problems and a poor health status (Findlay, Langlois & Kohen, 2013). Due to such high costs of food at grocery stores, many children (and adults) rated themselves as being hungry on most days (Findlay, Langlois & Kohen, 2013). Nearly twenty-five percent of children examined in a study were experiencing hunger whereas only three percent of the total Canadian population of children experienced hunger in the same year (Findlay, Langlois & Kohen, 2013).
Significantly more Inuit children are hungry when compared to the Canadian population. Hunger is also related to the availability of food in grocery stores, and access to the grocery stores themselves. This issue which is being addressed is referred to as food insecurity.
Food insecurity
There are three components that are involved in food insecurity. These components are: access to food in grocery stores and on the land (distance from these stores is something to be considered), availability of fresh food in stores that are transported from other areas, and quality of food provided in grocery stores and the land (Ford et al. 2012: 294). Food insecurity is an important issue in the northern part of the country that does not seem to be addressed by the government. Nunavut was found to have some of the highest rates of food insecurity in the country. (Rosol et al. 2011: 492). While conducting research in three northern areas in Canada, Rosol et al. found that in 2007-2008, Nunavut had the highest rates of food insecurity among adults, children and overall households. Nearly seventy percent of households, sixty-eight percent of adults and fifty-seven percent of children were all rated as food insecure (Rosol et al. 2011: 492). Another study was able to find similar results as Rosol et al. Egeland, Pacey, Cao and Sobol found that nearly seventy percent of young children in their sample were living in food-insecure households (2010: 245). Food insecurity is an issue that must be addressed by the government sooner rather than later because research has found a link between food insecurity and higher rates of obesity in Inuit children (Egeland et al. 2010: 245).
Over sixty percent of Inuit pre-school aged children in Nunavut were rated as obese or morbidly obese (based on their age, height and weight). These children were also living in food insecure households (Egeland et al., 2010: 245). Children are the future of the Inuit culture in Nunavut. If they are unhealthy during their young years of life, they are at risk of dying young, which continues the low life expectancy rate for the Inuit population. These children must be healthy and live in healthy environments in order to live long, successful lives and allow the Inuit culture and their traditions to be passed on to future generations.
Social
Much of the Canadian population takes their warm houses and easy access to health care for granted. Not every Canadian is fortunate enough to live their daily lives without worrying about having adequate housing and being close to a hospital. The health of Inuit people residing in Nunavut is also affected by these social factors.
Housing
Housing structures in Nunavut are known to be in some of the worst conditions in the country. Many houses are not built to withstand the rapidly changing weather conditions, they are too small to house large families, and many of them are in need of major repairs. In many instances, Inuit people do not have enough money to do the major repairs that their houses need. Inadequate housing is also linked to poor child health. Inuit children spend a lot of time indoors due to the extremely cold temperatures during the majority of the year (Kohen, Bougie & Guevremont, 2015: 21). A recent study provided evidence indicating that many Inuit children are living in houses that are not up to adequate Canadian health and safety standards. Thirty-six percent of children live in households that are overcrowded and thirty percent of children live in households that needed major repairs (Kohen et al. 2015: 23).
Overcrowding in households is a major cause for concern, especially for young children. A house is considered to be overcrowded when there are more people residing in a lodgement than there is room for. Overcrowding is a violation against fire and health safety because the air quality in the home is below what is considered appropriate. If houses contain too many people per square foot, the risk of contracting a respiratory tract infection is greatly increased among all residents of the house, especially in children (Kovesi et al. 2007). Low air quality puts young children at risk to contracting illnesses and diseases as their immune systems are not fully developed. Northern Canada is not warm enough to leave windows and doors open to air out a house, therefore having adequate air quality in homes is crucial in this area of the country.
Unfortunately overcrowded housing and low air quality are very common in Nunavut. When a house is overcrowded, indoor CO2 levels rise which decreases the quality of the air (Kovesi et al. 2007). Many people living close together provides a perfect environment for illnesses to spread between occupants (Kovesi et al. 2007). Statistics Canada’s 2006 census revealed that thirty percent of Inuit households were housing five or more people whereas only nine percent of the total Canadian population was housing five or more people per lodgement (Statistics Canada, 2010). Other studies that have been conducted since the release of this census also provide similar data. One study done by Kovesi et el. found that most houses in Nunavut had less than three bedrooms, but were housing more than six people per house. These particular houses had CO2 levels that were higher than the recommended limit. Along with higher CO2 levels, these houses also had higher rates of respiratory tract infections in children (Kovesi et al. 2007). Kovesi et al. found a correlation between high CO2 levels and respiratory tract infections (2007). Although one does not necessarily cause the other, the other factors involved in overcrowded houses such as low air quality and unacceptable air circulation aid in the development and spreading of respiratory tract infections.
When respiratory tract infections occur, children need to see a doctor in order to diagnose them and provide them with proper treatment if necessary. Unfortunately, this can be quite difficult to do in the remote regions of Nunavut. The lack of health services available in Nunavut aids in maintaining the poor health of Inuit people.
Health services
The lack of government funding has left Nunavut and other northern regions of Canada without appropriate health services available. Many Inuit people live in rural areas that are very far from large cities, making travel for adequate health care very difficult. Nunavut currently only has one general hospital for the entire territory (Government of Nunavut). There are also twenty-two health centres scattered across the territory, however, most of these health centres are not open every day of the week as they only employ one nurse per centre (Government of Nunavut). Inuit people do not have proper access to doctors and physicians which is something that should be easily available to all Canadians. The lack of appropriate health centres available to Inuit people has a negative effect on their physical health and mental well-being.
As mentioned, mental health is an ongoing concern for northern communities in Canada. With the lack of health services available, Inuit people do not have access to mental health services and resources. Nunavut has the highest rate of suicide in the country and the territory also has higher rates of mental illnesses such as depression and bipolar disorder (Weber, 2017). In many cases, these mental illnesses need treatment by healthcare professionals and clinical psychologists. It is hard enough to obtain mental health help in developed areas of Canada, but in Nunavut it is nearly impossible. This is due to the lack of government funding in the northern regions, especially in the health sector.
Improving Inuit Health
Changes need to be made by the government to improve the health and life expectancy of Inuit people in Nunavut. Climate change is becoming a greater concern for northern communities in Canada. Since it is going to be very hard to reduce the average global temperature, places like Nunavut must improve their infrastructures so they are able to adapt to the changing weather conditions (Ford et al. 2014: 10). Policies must be put in place by the government and they must be willing to provide funds towards improving the infrastructures in Nunavut. Without making these changes, climate change will continue to negatively affect the lives and the health of Inuit people. Other forms of adaptation that need to be addressed are assessing the causes of vulnerability and strengthening socio-economic areas of Nunavut’s Inuit people (Ford et al. 2014: 13). Before the health of northern regions can begin to get better, the government must be able to determine the causes of poor health and improve the education of Inuit children and adults.
Fortunately, the government has begun some initiatives to help improve the lives of Inuit people. One initiative that the Government of Canada began through the Inuit-to-Crown partnership is working towards eliminating tuberculosis in northern communities in Inuit Nunangat (Murray, 2017). In 2015, the tuberculosis rate among Inuit individuals was two hundred and seventy times higher than the overall Canadian population (Government of Canada, 2017). When regions of Inuit Nunangat were being assessed, Nunavut was found to have the highest active rates of tuberculosis (Government of Canada, 2017). Thirteen million dollars was announced to be used for the prevention and education of tuberculosis in northern regions of Canada. The program will educate, test and provide easier access to medications to cure tuberculosis (Government of Canada, 2017). Although this initiative sounds great, there are still problems that arise. People must be able to get themselves to the hospital in Iqaluit or to regional health centers in order to be assessed and treated for tuberculosis. In order for this to truly function to its full potential, the government must also begin to think of ways to provide better health care services to all residents of Nunavut.
Conclusion
The quality of Inuit health is determined based on a number of factors. As discussed, climate change, nutritional and social factors all help in determining the quality of life of Inuit people. None of these factors work alone as they cannot be independent from one another. Climate change affects housing and other forms of infrastructure, which in turn, affects health. Climate change also affects the access and availability of natural food sources for Inuit people who live off the land. Housing and nutrition also work together in determining the quality of health of Nunavut’s Inuit population. In many cases, inadequate housing is linked to poverty, therefore if a family does not make a lot of money, they will not be able to afford fresh produce and meat products at the local grocery store. When discussing determinants of health, every factor works with one another to either help increase, or in this case decrease the health status of a group of people.
As mentioned, the Government of Canada has a lot of work to do to improve the living conditions, access to health care and food availability in Nunavut. Steps need to be taken sooner rather than later to improve the life expectancy and keep the Inuit people and their culture alive for many years to come.