Healthcare use for acute gastrointestinal illness in two Inuit communities: Rigolet and Iqaluit, Canada

Responsible Editor: Anders Koch, Statens Serum Institut Denmark.

Abstract

Background

The incidence of self-reported acute gastrointestinal illness (AGI) in Rigolet, Nunatsiavut, and Iqaluit, Nunavut, is higher than reported elsewhere in Canada; as such, understanding AGI-related healthcare use is important for healthcare provision, public health practice and surveillance of AGI.

Objectives

This study described symptoms, severity and duration of self-reported AGI in the general population and examined the incidence and factors associated with healthcare utilization for AGI in these 2 Inuit communities.

Design

Cross-sectional survey data were analysed using multivariable exact logistic regression to examine factors associated with individuals’ self-reported healthcare and over-the-counter (OTC) medication utilization related to AGI symptoms.

Results

In Rigolet, few AGI cases used healthcare services [4.8% (95% CI=1.5–14.4%)]; in Iqaluit, some cases used healthcare services [16.9% (95% CI=11.2–24.7%)]. Missing traditional activities due to AGI (OR=3.8; 95% CI=1.18–12.4) and taking OTC medication for AGI symptoms (OR=3.8; 95% CI=1.2–15.1) were associated with increased odds of using healthcare services in Iqaluit. In both communities, AGI severity and secondary symptoms (extreme tiredness, headache, muscle pains, chills) were significantly associated with increased odds of taking OTC medication.

Conclusions

While rates of self-reported AGI were higher in Inuit communities compared to non-Inuit communities in Canada, there were lower rates of AGI-related healthcare use in Inuit communities compared to other regions in Canada. As such, the rates of healthcare use for a given disease can differ between Inuit and non-Inuit communities, and caution should be exercised in making comparisons between Inuit and non-Inuit health outcomes based solely on clinic records and healthcare use.

• Aboriginal health
• Indigenous health
• Inuit health
• gastrointestinal illness
• healthcare utilization
• Nunatsiavut
• Nunavut

Acknowledgements

First and foremost, we thank the residents in Iqaluit and Rigolet for welcoming us into their community, engaging with us throughout the project, and contributing to the larger IHACC research project. We are thankful to all the surveyors in Rigolet (M. Baikie, I. Shiwak, and D.Wolfrey) and Iqaluit (M. Naglingniq, S. Kownirk, G. Akpik, M. Atagoyuk, N. Atagoyuk, T. Atagoyuk, J. Campbell, N. Campbell, P. Davidee, A. Kilabuk-Degrasse, N. Lewis, S. Lewis, L. Mark, D. McGlade, E. Nevin, O. Nowdlak, I. Oopakak, M. Petooloosie, M. Pillaktuaq, M. Unahah). This survey would not have been possible without their diligent work and expertise. We would like to thank M. Baikie, P. Workman, K. Hutchinson, W. Joy, and many others in the Department of Health and Social Services, Government of Nunavut; M.E. Thomas and others at the Nunavut Research Institute; M. Wood, G. Turner, M. Kinney, T. Buckle, and others at the Department of Health and Social Development, Government of Nunatsiavut; M. LeBlanc-Havard, C. Brice-Bennett, G. Elliott, and others at the Labrador Grenfell Health Authority; C. Wolfrey, S. Blake, S. Wolfrey, and M. Williams at the Rigolet Inuit Community Government; and S. Maclachlan, N. Markwick, C. Huet, J. Ostapchuk, M.E. MacDonald, Y. Guo, and J. Fraser at the University of Guelph. Thanks to S. Majowicz for her assistance and burden of AGI expertise. Particular thanks to A. Bunce and P. Arpin for their dedication throughout the project. These people played instrumental roles in contributing to the study design, data collection, data interpretation, and ultimately the success of this project. Thanks also to A. Bonnycastle for creating the map.

Conflict of interest and funding

The study design and conduct were independent of the funding source. This work was supported by the Public Health Agency of Canada; the Nasivvik Centre for Inuit Health and Changing Environments; the International Research Initiative on Adaptation to Climate Change (IRIACC) funded by the International Development Research Centre (IDRC), Canadian Institutes for Health Research (CIHR), Social Sciences and Humanities Research Council (SSHRC), and National Science and Engineering Research Council (NSERC); and a Vanier Canada Graduate Scholarship to S. Harper (CIHR).