Healthcare use for acute gastrointestinal illness in two Inuit communities: Rigolet and Iqaluit, Canada
Sherilee L. Harper1*, Victoria L. Edge1,2, James Ford3, M. Kate Thomas1,4, David Pearl1, Jamal Shirley5, IHACC6, RICG7 and Scott A. McEwen1
1Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada; 2Office of Public Health Practice, Public Health Agency of Canada, Guelph, Ontario, Canada; 3Department of Geography, McGill University, Montreal, Quebec, Canada; 4Centre for Food-borne, Environmental & Zoonotic Infectious Diseases, Public Health Agency of Canada, Guelph, Ontario, Canada; 5Nunavut Research Institute, Iqaluit, Nunavut, Canada; 6Indigenous Health Adaptation to Climate Change Research Group: Lea Berrang-Ford, Cesar Carcamo, Alejandro Llanos, Shuaib Lwasa, Didacus Bambaiha Namanya; 7Rigolet Inuit Community Government, Rigolet, Nunatsiavut, Labrador, Canada
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.
Keywords: Aboriginal health; Indigenous health; Inuit health; gastrointestinal illness; healthcare utilization; Nunatsiavut; Nunavut
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