Victoria L. Edge

Magnitude and distribution of acute, self-reported gastrointestinal illness in a Canadian community

To estimate the magnitude and distribution of self-reported, acute gastrointestinal illness in a Canadian-based population, we conducted a retrospective, cross-sectional telephone survey of approximately 3500 randomly selected residents of the city of Hamilton (Ontario, Canada) from February 2001 to February 2002. The observed monthly prevalence was 10% (95 % CI 9.94-10.14) and the incidence rate was 1.3 (95 % CI 1.1-1.4) episodes per person-year; this is within the range of estimates from other developed countries. The prevalence was higher in females and in those aged < 10 years and 20-24 years. Overall, prevalence peaked in April and October, but a different temporal distribution was observed for those aged < 10 years. Although these data were derived from one community, they demonstrate that the epidemiology of acute gastrointestinal illness in a Canadian-based population is similar to that reported for other developed countries.

“From this place and of this place:” Climate change, sense of place, and health in Nunatsiavut, Canada

As climate change impacts are felt around the globe, people are increasingly exposed to changes in weather patterns, wildlife and vegetation, and water and food quality, access and availability in their local regions. These changes can impact human health and well-being in a variety of ways: increased risk of foodborne and waterborne diseases; increased frequency and distribution of vector-borne disease; increased mortality and injury due to extreme weather events and heat waves; increased respiratory and cardiovascular disease due to changes in air quality and increased allergens in the air; and increased susceptibility to mental and emotional health challenges. While climate change is a global phenomenon, the impacts are experienced most acutely in place; as such, a sense of place, place-attachment, and place-based identities are important indicators for climate-related health and adaptation. Representing one of the first qualitative case studies to examine the connections among climate change, a changing sense of place, and health in an Inuit context, this research draws data from a multi-year community-driven case study situated in the Inuit community of Rigolet, Nunatsiavut, Canada. Data informing this paper were drawn from the narrative analysis of 72 in-depth interviews conducted from November 2009 to October 2010, as well as from the descriptive analysis of 112 questionnaires from a survey in October 2010 (95% response rate). The findings illustrated that climate change is negatively affecting feelings of place attachment by disrupting hunting, fishing, foraging, trapping, and traveling, and changing local landscapes-changes which subsequently impact physical, mental, and emotional health and well-being. These results also highlight the need to develop context-specific climate-health planning and adaptation programs, and call for an understanding of place-attachment as a vital indicator of health and well-being and for climate change to be framed as an important determinant of health.

Population distribution and burden of acute gastrointestinal illness in British Columbia, Canada

BackgroundIn developed countries, gastrointestinal illness (GI) is typically mild and self-limiting, however, it has considerable economic impact due to high morbidity.MethodsThe magnitude and distribution of acute GI in British Columbia (BC), Canada was evaluated via a cross-sectional telephone survey of 4,612 randomly selected residents, conducted from June 2002 to June 2003. Respondents were asked if they had experienced vomiting or diarrhoea in the 28 days prior to the interview.ResultsA response rate of 44.3% was achieved. A monthly prevalence of 9.2% (95%CI 8.4 – 10.0), an incidence rate of 1.3 (95% CI 1.1–1.4) episodes of acute GI per person-year, and an average probability that an individual developed illness in the year of 71.6% (95% CI 68.0–74.8), weighted by population size were observed. The average duration of illness was 3.7 days, translating into 19.2 million days annually of acute GI in BC.ConclusionThe results corroborate those from previous Canadian and international studies, highlighting the substantial burden of acute GI.

Storytelling in a digital age: digital storytelling as an emerging narrative method for preserving and promoting indigenous oral wisdom

This article outlines the methodological process of a transdisciplinary team of indigenous and nonindigenous individuals, who came together in early 2009 to develop a digital narrative method to engage a remote community in northern Labrador in a research project examining the linkages between climate change and physical, mental, emotional, and spiritual health and well-being. Desiring to find a method that was locally appropriate and resonant with the narrative wisdom of the community, yet cognizant of the limitations of interview-based narrative research, our team sought to discover an indigenous method that united the digital media with storytelling. Using a case study that illustrates the usage of digital storytelling within an indigenous community, this article will share how digital storytelling can stand as a community-driven methodological strategy that addresses, and moves beyond, the limitations of narrative research and the issues of colonization of research and the Western analytic project. In so doing, this emerging method can preserve and promote indigenous oral wisdom, while engaging community members, developing capacities, and celebrating myriad stories, lived experiences, and lifeworlds.

Climate change and mental health: an exploratory case study from Rigolet, Nunatsiavut, Canada

As the impacts from anthropogenic climate change are increasing globally, people are experiencing dramatic shifts in weather, temperature, wildlife and vegetation patterns, and water and food quality and availability. These changes impact human health and well-being, and resultantly, climate change has been identified as the biggest global health threat of the 21st Century. Recently, research is beginning to indicate that changes in climate, and the subsequent disruption to the social, economic, and environmental determinants of health, may cause increased incidences and prevalence of mental health issues, emotional responses, and large-scale sociopsychological changes. Through a multi-year, community-led, exploratory case study conducted in Rigolet, Nunatsiavut, Labrador, Canada, this research qualitatively explores the impacts of climate change on mental health and well-being in an Inuit context. Drawing from 67 in-depth interviews conducted between January 2010 and October 2010 with community members and local and regional health professionals, participants reported that changes in weather, snow and ice stability and extent, and wildlife and vegetation patterns attributed to climate change were negatively impacting mental health and well-being due to disruptions in land-based activities and a loss of place-based solace and cultural identity. Participants reported that changes in climate and environment increased family stress, enhanced the possibility of increased drug and alcohol usage, amplified previous traumas and mental health stressors, and were implicated in increased potential for suicide ideation. While a preliminary case study, these exploratory findings indicate that climate change is becoming an additional mental health stressor for resource-dependent communities and provide a baseline for further research.

Vulnerability of indigenous health to climate change: a case study of Uganda's Batwa Pygmies.

The potential impacts of climate change on human health in sub-Saharan Africa are wide-ranging, complex, and largely adverse. The regions Indigenous peoples are considered to be at heightened risk given their relatively poor health outcomes, marginal social status, and resource-based livelihoods; however, little attention has been given to these most vulnerable of the vulnerable. This paper contributes to addressing this gap by taking a bottom-up approach to assessing health vulnerabilities to climate change in two Batwa Pygmy communities in rural Uganda. Rapid Rural Appraisal and PhotoVoice field methods complemented by qualitative data analysis were used to identify key climate-sensitive, community-identified health outcomes, describe determinants of sensitivity at multiple scales, and characterize adaptive capacity of Batwa health systems. The findings stress the importance of human drivers of vulnerability and adaptive capacity and the need to address social determinants of health in order to reduce the potential disease burden of climate change.

Community vulnerability to the health effects of climate change among indigenous populations in the Peruvian Amazon: a case study from Panaillo and Nuevo Progreso

This paper presents the results of an exploratory study working with two Amazonian communities in Peru to identify key climate-related health risks from the perspective of local residents, and characterize how these risks are experienced and managed. The work adopts a vulnerability-based approach and utilizes participatory methodologies to document and examine local perspectives on vulnerability and adaptive capacity. Thirty nine community members were engaged in participatory photography (photovoice), and rapid rural appraisal workshops were conducted with a total 40 participants. Contextual information was obtained from 34 semi-structured interviews with key informants and participant observation during fieldwork. Three climate-related health risks were identified by the communities as pressing issues (food insecurity, water insecurity, and vector-borne disease), all of which are climate-dependent and reported to be being affected by observed changes in climatic conditions. Sensitivity to these risks is high due to social and economic disadvantages which force people to live in suboptimal conditions, partake in dangerous activities, and engage in unhealthy behaviors. Traditional approaches to health and strong social networks are important in moderating health risks, but are placed under increasing stress in the context of local social and economic changes due to larger scale influences, including resource development, deforestation, and changing social relations.

‘Changing Climate, Changing Health, Changing Stories’ Profile: Using an EcoHealth Approach to Explore Impacts of Climate Change on Inuit Health

Global climate change and its impact on public health exemplify the challenge of managing complexity and uncertainty in health research. The Canadian North is currently experiencing dramatic shifts in climate, resulting in environmental changes which impact Inuit livelihoods, cultural practices, and health. For researchers investigating potential climate change impacts on Inuit health, it has become clear that comprehensive and meaningful research outcomes depend on taking a systemic and transdisciplinary approach that engages local citizens in project design, data collection, and analysis. While it is increasingly recognised that using approaches that embrace complexity is a necessity in public health, mobilizing such approaches from theory into practice can be challenging. In 2009, the Rigolet Inuit Community Government in Rigolet, Nunatsiavut, Canada partnered with a transdisciplinary team of researchers, health practitioners, and community storytelling facilitators to create the Changing Climate, Changing Health, Changing Stories project, aimed at developing a multi-media participatory, community-run methodological strategy to gather locally appropriate and meaningful data to explore climate–health relationships. The goal of this profile paper is to describe how an EcoHealth approach guided by principles of transdisciplinarity, community participation, and social equity was used to plan and implement this climate–health research project. An overview of the project, including project development, research methods, project outcomes to date, and challenges encountered, is presented. Though introduced in this one case study, the processes, methods, and lessons learned are broadly applicable to researchers and communities interested in implementing EcoHealth approaches in community-based research.

Estimation of the costs of acute gastrointestinal illness in British Columbia, Canada

The costs associated with gastrointestinal infection (GI) in the province of British Columbia, Canada, were estimated using data from a population-based survey in three health service delivery areas, namely Vancouver, East Kootenay and Northern Interior. The number of cases of disease, consequent expenditure of resources and associated economic costs were modeled as probability distributions in a stochastic model. Using 2004 prices, the estimated mean annual cost per capita of gastrointestinal infection was CAN

Acute gastrointestinal illness in two Inuit communities: burden of illness in Rigolet and Iqaluit, Canada.

128.61 (207.96 euros), with a mean annual cost per case of CAN