Peter M. Foggin

Geographical and socio-ecological variations of traffic accidents among children

This paper deals with geographical and socio-ecological variations of pedestrian and cyclist accidents (n = 1233) among children (less than 15 years) on the Island of Montreal. The model includes variables on each child and his behavior when the accident happened and other temporal and spatial characteristics; environmental and socio-ecological data on the areas in which accidents occurred were also recorded. Descriptive, spatial and comparative analyses show specific patterns of location and occurrence of accidents. Factor analysis identifies the structure of characteristics linked to high accident areas for childrens traffic accidents. A strong similarity between zone characteristics emerged from the factor analysis for both types of accident. Only a few census tracts (between 9% to 13%) are high accident areas, but they are very concentrated spatially, and for some of them (2% for pedestrians and 4% for cyclists) the rate is five to eight times higher than for the rest of the urban area. Population structure and density factors contribute 40% of the variation in accident rates. In terms of numbers, fewer children were injured as cyclists than as pedestrians, and more boys than girls are involved in these accidents. Accidents occur under good conditions of visibility and on straight streets. Parked cars in school areas are also a sign of danger. Difficulties in interpreting information on directions and speed of moving vehicles are associated with high accident frequencies, particularly for young pedestrians (6-7 years).

The other face of development: Native population, health status and indicators of malnutrition—The case of the Cree and Inuit of Northern Quebec

The cultural setting of the isolated Cree Indian and Inuit communities is described and measures of their health examined. Questionnaires were employed to consider both epidemiological and socio-cultural facets and physical examination evaluated serological indicators of nutritional status. Changes of lifestyle toward store purchased food and a lessened reliance on hunting and fishing along with the non-native nature of the health services available seem to be leading to heart conditions, hypertension and diabetes all of which give cause for concern.

Health status and risk factors of seminomadic pastoralists in Mongolia: A geographical approach

The particular lifestyle of nomadic or seminomadic people has much to do with their health status. This discussion of the conceptual basis and some preliminary results of the 1992-94 health status and risk factor survey in Mongolia serves to highlight some of the relationships existing between the general health status and potential risk factors observed among pastoral nomads. In addition to graphic description of the data, a statistical analysis suggests significant associations between certain health status indicators and gender, location, lifestyle factors (e.g. smoking) socio-economic status, preventive health care and the physical environment. With regard to locational factors, there are strong regional differences in a wide-ranging number of health status indicators. The results of this study, obtained as they were at the threshold of Mongolias economic and political transformation, will serve as a baseline against which to evaluate future changes in the health of Mongolians.

Risk factors and child mortality among the Miao in Yunnan southwest China.

Environmental factors and the lifestyle of communities in developing countries as in the industrialized world have a great deal to do with their health status. This study carried out among the Miao people of southeastern Yunnan province in Southwest China has demonstrated important links between child mortality (one indicator of health status) and specific risk factors. These include lifestyle variables such as geographic mobility, the age of weaning and religious belief. In addition, the use of available health care facilities was another explanatory variable. Perhaps surprisingly, a history of tuberculosis seemed also to be empirically related to the presence or absence of child mortality. Although it was impossible to show a significant statistical relationship between traditional practices and child mortality from the studys database, the authors have observed qualitatively that birthing customs play an important role in explaining the perinatal component of child mortality. These various relationships shed some light on potential areas for intervention with a view to reducing the levels of child mortality among minority peoples in China and elsewhere.

Correlates of health-care use: Inuit and cree of Northern Quebec

This case study of the use of health-care services in northern Quebec is the first of a series of reports dealing with the health status, risk factors and access to care of the two major aboriginal populations in this region, the Cree and the Inuit. The focus of the broader study is on the health status and risk factors in these native populations. This research, based on a survey conducted in 1983-84, describes the present health status and health-care system of the Cree and Inuit, then presents a path analysis model of their use of health services. The purpose of this approach is to provide health planners and care providers with useful information and to encourage the development of well-organized and reasonable health-care service delivery to these populations.

Epidemiology of obesity in relationship to some chronic medical conditions among Inuit and Cree Indian populations in New Quebec, Canada

The tremendous sociocultural, economic and environmental changes in North American native populations over the last 50 years have been accompanied by the appearance of new public health problems. The prevalence of ‘lifestyle’ diseases, obesity, hypertension and non-insulin dependent diabetes is increasing [1,2]. Disease patterns among Arctic populations are also changing following the introduction of Western culture and technology. Epidemiologic monitoring of specific health problems, for instance chronic diseases such as obesity, diabetes and hypertension is important if we are to understand this continuing process of acculturation. To our knowledge, ours was the first population-based screening for these chronic conditions among native populations of New Quebec. Our survey, which examined obesity, blood glucose levels, cholesterol and blood pressure in the native populations in New Quebec, is part of a continuous epidemiologic monitoring of the health status of the Cree and Inuit Indians in this peripolar region.

Respiratory health indicators and acculturation among the Inuit and Cree of Northern Quebec: A regional approach using geographic seriation analysis

The goal of the research reported on is the analysis of the geo-statistical relationships observed between three indicators of respiratory health (acute and chronic bronchitis; pulmonary function) and an index of acculturation. Data used in this work were obtained by means of a field survey that was conducted in the north of Quebec over a 24-month period (1982-1984). With regard to acculturation, a very elusive concept, a Bertin-type geographic seriation technique is used to characterize the levels of modernity of each of the 21 villages involved in this study. Notwithstanding difficulties of measurement, it can be concluded from this analysis that better levels of respiratory health are positively associated, to a degree, with acculturation. This is a very significant result in that it would demonstrate the opposite of what has been tentatively noted in some other studies of the health status of Aboriginal populations.

Cardiovascular mortality as it relates to the geographic distribution of employment in non-metropolitan Quebec

This exploratory analysis examines relationships between employment-specific cardiovascular mortality and certain spatially-based potential risk factors. Standard mortality ratios (SMRs) are mapped on the basis of non-metropolitan primary and secondary employment basins of Quebec. In order to control for geographical anomalies, the data are broken down into three spatial grids: employment basins with the employment poles, employment basins without the employment poles and the employment poles (municipalities) taken alone. This cartography suggests a certain number of cardiovascular disease-prone employment areas in Quebec. Linkage analysis and principal components analysis are used to simplify and clarify the complex relationships that exist among selected independent variables (potential risk factors) and multiple regression analysis is used to identify the functional relationships between these employment, geographic and demographic variables and the studys dependent variable (ischaemic heart disease and cerebrovascular mortality) in the form of standard mortality ratios (SMRs). Cardiovascular mortality (SMRs) are found to be related negatively to an employment age-factor and, in the case of women, negatively to agricultural employment, marginally and positively to pulp and paper employment. It would appear that outside the very large cities in areas of primary and industrial employment, men are at greater risk of cardiovascular mortality during their working lives than those who are over the age of 65. Although it was not possible to establish strong positive links between most employment sectors and cardiovascular mortality, it is possible to conclude that there is a negative association for men between textile employment and cerebrovascular mortality; that in the case of women, those who work in agriculture are less at risk than women who are working in industrial employment. There is also some statistical evidence that there is an association between women in the pulp and paper industry and cardiovascular risk levels. This research provides some clues as to the need to investigate certain areas of employment that may be creating unnecessary risks to health, especially in the case of female workers.