Inuit-defined determinants of food security in academic research focusing on Inuit Nunangat and Alaska: A scoping review protocol.

BACKGROUND: Academic research on food security in Inuit Nunangat and Alaska frequently adopts the Food and Agriculture Organization of the United Nations' working definition of food security and Western conceptualisations of what it means to be 'food secure'. However, in 2014, the Alaskan branch of the Inuit Circumpolar Council (ICC) stated that academic and intergovernmental definitions and understandings 'are important, but not what we are talking about when we say food security'. The organisation subsequently developed its own conceptualisation and definition: the Alaskan Inuit Food Security Conceptual Framework (AIFSCF), which in 2020 received informal assent by ICC-Canada. AIM: This protocol establishes a review strategy to examine how well academic research reflects Inuit conceptualisations and understandings of food security, as outlined in the AIFSCF. METHODS: Review structure and reporting will be completed according to adapted RepOrting standards for Systematic Evidence Syntheses (ROSES) guidelines. A comprehensive search strategy will be used to locate peer-reviewed research from Medline, Scopus, Web of Science and the Arctic and Antarctic Regions (EBSCO) databases. Dual reviewer screening will take place at the abstract, title, and full-text stages. Different study methodologies (qualitative, quantitative, and mixed methods) will be included for review, on the proviso that articles identify drivers of food security. An a priori coding framework will be applied by a single reviewer to extract data on publication characteristics, methods and article aims. Deductive thematic content analysis will then identify the frequency and precedence afforded within literature to the drivers and dimensions of food security identified by the AIFSCF.

A Systematic Literature Review of Cancer Communication with Indigenous Populations in Canada and the United States.

Cancer is one of the leading causes of death among Indigenous populations. Communication campaigns are an important component of cancer prevention and treatment. However, communication about cancer with Indigenous populations has yet to be fully explored and understood. In this systematic literature review, we examine peer-reviewed research to gain insight into the factors that contribute to effective communication about cancer with Indigenous populations. The review yielded a total of 7313 potential articles and a total of 25 of these manuscripts met the inclusion criteria. Results indicate five primary factors that may increase the effectiveness of communication about cancer with Indigenous populations. Factors include the need to (1) respect traditional knowledge, (2) use appropriate language, (3) involve community members in the communication process, (4) include people from different generations in message design, and (5) engender trust in health communicators. Results also provide insight into communication methods that contribute to effective cancer communication. We identify gaps in the literature and provide recommendations for future cancer communication strategies and research with Indigenous populations.

Identifying key needs for the integration of social-ecological outcomes in arctic wildlife monitoring.

For effective monitoring in social-ecological systems to meet needs for biodiversity, science, and humans, desired outcomes must be clearly defined and routes from direct to derived outcomes understood. The Arctic is undergoing rapid climatic, ecological, social, and economic changes and requires effective wildlife monitoring to meet diverse stakeholder needs. To identify stakeholder priorities concerning desired outcomes of arctic wildlife monitoring, we conducted in-depth interviews with 29 arctic scientists, policy and decision makers, and representatives of indigenous organizations and nongovernmental organizations. Using qualitative content analysis, we identified and defined desired outcomes and documented links between outcomes. Using network analysis, we investigated the structure of perceived links between desired outcomes. We identified 18 desired outcomes from monitoring and classified them as either driven by monitoring information, monitoring process, or a combination of both. Highly cited outcomes were make decisions, conserve, detect change, disseminate, and secure food. These reflect key foci of arctic monitoring. Infrequently cited outcomes (e.g., govern) were emerging themes. Three modules comprised our outcome network. The modularity highlighted the low strength of perceived links between outcomes that were primarily information driven or more derived (e.g., detect change, make decisions, conserve, or secure food) and outcomes that were primarily process driven or more derived (e.g., cooperate, learn, educate). The outcomes expand monitoring community and disseminate created connections between these modules. Key desired outcomes are widely applicable to social-ecological systems within and outside the Arctic, particularly those with wildlife subsistence economies. Attributes and motivations associated with outcomes can guide development of integrated monitoring goals for biodiversity conservation and human needs. Our results demonstrated the disconnect between information- and process-driven goals and how expansion of the monitoring community and improved integration of monitoring stakeholders will help connect information- and process-derived outcomes for effective ecosystem stewardship.

Identificación de las Necesidades Clave para la Integración de Resultados Socio-Ecológicos en el Monitoreo de Fauna en el Ártico Resumen Para que el monitoreo efectivo en los sistemas socio-ecológicos cumpla con las necesidades de la biodiversidad, la ciencia, y los humanos, se deben definir claramente los resultados deseados y se deben entender las rutas que se toman de los resultados directos hacia los resultados derivados. El Ártico está sufriendo rápidamente cambios climáticos, ecológicos, y económicos, y requiere de un monitoreo efectivo de fauna para cumplir con las necesidades de diversos accionistas. Realizamos entrevistas a profundidad con 29 científicos del Ártico, responsables de decisiones y políticas, y representativos de organizaciones indígenas y organizaciones no gubernamentales para identificar las prioridades de los accionistas con respecto a los resultados deseados del monitoreo de fauna ártica. Mediante un análisis cualitativo de contenido identificamos y definimos los resultados deseados y documentamos las conexiones entre los resultados. Con un análisis de redes investigamos la estructura de las conexiones percibidas y las clasificamos como causadas por el monitoreo de información, el monitoreo del proceso, o una combinación de ambos. Los resultados con un mayor número de menciones fueron tomar decisiones, conservar, detectar cambios, diseminar, y asegurar alimento. Estos reflejan los enfoques más importantes del monitoreo en el Ártico. Los resultados con poca frecuencia en las menciones (p. ej.: regular) correspondían a temas emergentes. Nuestra red de resultados estuvo compuesta por tres módulos. La modularidad resaltó la poca fuerza de las conexiones percibidas entre los resultados que fueron causados principalmente por la información o que estuvieron más derivados (p. ej.: detectar el cambio, tomar decisiones, conservar o asegurar alimento) y los resultados que fueron causados principalmente por el proceso o que estuvieron más derivados (p. ej.: cooperar, aprender, educar). Los resultados expanden la comunidad monitora y diseminan las conexiones creadas entre estos módulos. Los resultados clave deseados se pueden aplicar extensamente a los sistemas socio-ecológicos dentro y fuera del Ártico, particularmente aquellos con economías de sustento basadas en la fauna. Los atributos y motivaciones asociados con los resultados pueden guiar el desarrollo de los objetivos integrados de monitoreo para la conservación de la biodiversidad y las necesidades humanas. Nuestros resultados demostraron la desconexión entre los objetivos conducidos por la información y aquellos conducidos por el proceso y cómo la expansión de la comunidad monitora y una mejor integración de los accionistas monitores ayudarán a conectar los resultados derivados de la información y derivados del proceso para una administración efectiva del ecosistema.

Communicating Environmental Health Risks with Indigenous Populations: A Systematic Literature Review of Current Research and Recommendations for Future Studies.

Indigenous populations are recognized as a group who are potentially vulnerable to environmental health hazards due to their intimate relationship with and reliance on local environments for aspects of culture, health, and well-being. In many circumstances barriers to effective communication and health risk management are linked to cultural, economic, and geographic factors. A systematic literature review was conducted to consolidate peer-reviewed research on the communication of environmental health risks with Indigenous populations. The comprehensive literature review procedures included searching databases and key journals that represented various fields in communication, environmental health, and Indigenous studies. The review yielded a total of 4,469 potential articles and a total of 13 of these manuscripts met the inclusion criteria. The 13 articles were analyzed to identify lessons learned for effective risk communication. Factors that influence successful risk communication strategies with Indigenous populations on this topic include: (1) developing messages that are congruent with the populations' cultural beliefs and understanding of the environment; (2) including Indigenous populations in message design and delivery; (3) using credible and trustworthy spokespeople in message delivery; (4) identifying and utilizing effective communication materials and channels; and (5) ensuring that messages are understandable to the target audience. Gaps in the literature include the lack of longitudinal studies that empirically measure changes in perception, awareness and behavior, as well as a general lack of theory-based research. Results from this review provide directions for future work to help guide the development of more effective health risk communication research and strategies with Indigenous populations.

Factors influencing H1N1 vaccine behavior among Manitoba Metis in Canada: a qualitative study.

BACKGROUND: During the first wave of the H1N1 influenza pandemic in 2009, Aboriginal populations in Canada experienced disproportionate rates of infection, particularly in the province of Manitoba. To protect those thought to be most at-risk, health authorities in Manitoba listed all Aboriginal people, including Metis, among those able to receive priority access to the novel vaccine when it first became available. Currently, no studies exist that have investigated the attitudes, influences, and vaccine behaviors among Aboriginal communities in Canada. This paper is the first to systematically connect vaccine behavior with the attitudes and beliefs that influenced Metis study participants' H1N1 vaccine decision-making. METHODS: Researchers held focus groups (n = 17) with Metis participants in urban, rural, and remote locations of Manitoba following the conclusion of the H1N1 pandemic. Participants were asked about their vaccination decisions and about the factors that influenced their decisions. Following data collection, responses were coded into the broad categories of a social-ecological model, nuanced by categories stemming from earlier research. Responses were then quantified to show the most influential factors in positively or negatively affecting the vaccine decision. RESULTS: Media reporting, the influence of peer groups, and prioritization all had positive and negative influential effects on decision making. Whether vaccinated or not, the most negatively influential factors cited by participants were a lack of knowledge about the vaccine and the pandemic as well as concerns about vaccine safety. Risk of contracting H1N1 influenza was the biggest factor in positively influencing a vaccine decision, which in many cases trumped any co-existing negative influencers. CONCLUSIONS: Metis experiences of colonialism in Canada deeply affected their perceptions of the vaccine and pandemic, a context that health systems need to take into account when planning response activities in the future. Participants felt under-informed about most aspects of the vaccine and the pandemic, and many vaccine related misconceptions and fears existed. Recommendations include leveraging doctor-patient interactions as a site for sharing vaccine-related knowledge, as well as targeted, culturally-appropriate, and empowering public information strategies to supply reliable vaccine and pandemic information to potentially at-risk Aboriginal populations.

Updated review on contaminant communication experiences in the circumpolar Arctic.

Arctic populations are amongst the highest exposed populations to long-range transported contaminants globally, with the main exposure pathway being through the diet. Dietary advice is an important immediate means to address potential exposure and help minimize adverse health effects. The objective of this work is to enable easier access to dietary advice and communication guidance on contaminants with a focus on the Arctic. This manuscript is part of a special issue summarizing the Arctic Monitoring and Assessment Programme's Assessment 2021: Human Health in the Arctic. The information was derived with internet searches, and by contacting relevant experts directly. Results include risk communication efforts in European Arctic countries, effectiveness evaluation studies for several Arctic countries, experience of social media use, and the advantages and challenges of using social media in risk communication. We found that current risk communication activities in most Arctic countries emphasize the importance of a nutritious diet. Contaminant-related restrictions are mostly based on mercury; a limited amount of dietary advice is based on other contaminants. While more information on effectiveness evaluation was available, specific information, particularly from Arctic countries other than Canada, is still very limited.

Community-level risk factors for notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008.

BACKGROUND: Enteric pathogens are an important cause of illness, however, little is known about their community-level risk factors (e.g., socioeconomic, cultural and physical environmental conditions) in the Northwest Territories (NWT) of Canada. The objective of this study was to undertake ecological (group-level) analyses by combining two existing data sources to examine potential community-level risk factors for campylobacteriosis, giardiasis and salmonellosis, which are three notifiable (mandatory reporting to public health authorities at the time of diagnosis) enteric infections. METHODS: The rate of campylobacteriosis was modeled using a Poisson distribution while rates of giardiasis and salmonellosis were modeled using a Negative Binomial distribution. Rate ratios (the ratio of the incidence of disease in the exposed group to the incidence of disease in the non-exposed group) were estimated for infections by the three major pathogens with potential community-level risk factors. RESULTS: Significant (p≤0.05) associations varied by etiology. There was increased risk of infection with Salmonella for communities with higher proportions of 'households in core need' (unsuitable, inadequate, and/or unaffordable housing) up to 42% after which the rate started to decrease with increasing core need. The risk of giardiasis was significantly higher both with increased 'internal mobility' (population moving between communities), and also where the community's primary health facility was a health center rather than a full-service hospital. Communities with higher health expenditures had a significantly decreased risk of giardiasis. Results of modeling that focused on each of Giardia and Salmonella infections separately supported and expanded upon previous research outcomes that suggested health disparities are often associated with socioeconomic status, geographical and social mobility, as well as access to health care (e.g. facilities, services and professionals). In the campylobacteriosis model, a negative association was found between food prices in communities and risk of infection. There was also a significant interaction between trapping and consumption of traditional foods in communities. Higher rates of community participation in both activities appeared to have a protective effect against campylobacteriosis. CONCLUSIONS: These results raise very interesting questions about the role that traditional activities might play in infectious enteric disease incidence in the NWT, but should be interpreted with caution, recognizing database limitations in collection of case data and risk factor information (e.g. missing data). Given the cultural, socioeconomic, and nutritional benefits associated with traditional food practices, targeted community-based collaborative research is necessary to more fully investigate the statistical correlations identified in this exploratory research. This study demonstrates the value of examining the role of social determinants in the transmission and risk of infectious diseases.

Risk communication and perceptions about lead ammunition and Inuit health in Nunavik, Canada.

Lead ammunition is commonly used to hunt waterfowl and other wildlife in the Arctic. Hunting with lead is problematic because the toxicant can be transferred to the consumer. Therefore, it is critical to evaluate perceptions and awareness of the risks associated with using lead ammunition among Arctic populations. Results of the Nunavik Child Development Study (a longitudinal health study gathering information on health and well-being among Inuit in Nunavik, Canada) included advice to eliminate the use of lead ammunition in hunting practices. We surveyed 112 Nunavik residents (93 women; 18 men) about their awareness of lead related messages, use of lead ammunition and risk perceptions about contaminants. Sixty-seven participants (59.8%) reported there was an active hunter in their household. We found that only 27% of participants had heard or seen the messages about reducing lead ammunition. After participants viewed the Nunavik Child Development Study messages about lead, 44% stated they would stop using lead ammunition. However, 28% indicated that they would continue using lead ammunition. We conclude that, while messages had an overall positive effect, further study is required to understand why people continue to use lead ammunition.

A spatial and temporal analysis of notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008.

BACKGROUND: This is the first study to describe the geographical and temporal distribution of notifiable gastrointestinal illness (NGI) in the Northwest Territories (NWT), Canada. Understanding the distribution of NGI in space and time is important for identifying communities at high risk. Using data derived from the Northwest Territories Communicable Disease Registry (NWT CDR), a number of spatial and temporal techniques were used to explore and analyze NGI incidence from the years 1991 to 2008. Relative risk mapping was used to investigate the variation of disease risk. Scan test statistics were applied to conduct cluster identification in space, time and space-time. Seasonal decomposition of the time series was used to assess seasonal variation and trends in the data. RESULTS: There was geographic variability in the rates of NGI with higher notifications in the south compared to the north. Incidence of NGI exhibited seasonality with peaks in the fall months for most years. Two possible outbreaks were detected in the fall of 1995 and 2001, of which one coincided with a previously recognized outbreak. Overall, incidence of NGI fluctuated from 1991 to 2001 followed by a tendency for rates to decrease from 2002 to 2008. CONCLUSIONS: The distribution of NGI notifications varied widely according to geographic region, season and year. While the analyses highlighted a possible bias in the surveillance data, this information is beneficial for generating hypotheses about risk factors for infection.

Sociodemographic patterning of dietary profiles among Inuit youth and adults in Nunavik, Canada: a cross-sectional study.

OBJECTIVES: Country (traditional) foods are integral to Inuit culture, but market food consumption is increasing. The Qanuilirpitaa? 2017 Nunavik Health Survey (Q2017) reported similar country food consumption frequency compared to that in 2004; however, examining food items individually does not account for diet patterns, food accessibility, and correlations between food items. Our objective was to identify underlying dietary profiles and compare them across sex, age, ecological region, and food insecurity markers, given the links among diet, health, and sociocultural determinants. METHODS: Food frequency and sociodemographic data were derived from the Q2017 survey (N = 1176). Latent profile analysis identified dietary profiles using variables for the relative frequencies of country and market food consumption first, followed by an analysis with those for country food variables only. Multinomial logistic regression examined the associations among dietary profiles, sociodemographic factors, and food insecurity markers (to disassociate between food preferences and food access). RESULTS: Four overall dietary profiles and four country food dietary profiles were identified characterized by the relative frequency of country and market food in the diet. The patterns were stable across several sensitivity analyses and in line with our Inuit partners' local knowledge. For the overall profiles, women and adults aged 30-49 years were more likely to have a market food-dominant profile, whereas men and individuals aged 16-29 and 50+ years more often consumed a country food-dominant profile. In the country food profiles, Inuit aged 16-29 years were more likely to have a moderate country food profile whereas Inuit aged 50+ were more likely to have a high country food-consumption profile. A low country and market food-consumption profile was linked to higher prevalence of food insecurity markers. CONCLUSION: We were able to identify distinct dietary profiles with strong social patterning. The profiles elucidated in this study are aligned with the impact of colonial influence on diet and subsequent country food promotion programs for Inuit youth. These profiles will be used for further study of nutritional status, contaminant exposure, and health to provide context for future public health programs.

RéSUMé: OBJECTIFS: Les aliments traditionnels font partie intégrante de la culture inuite, mais la consommation d'aliments du marché est en augmentation. L'enquête de santé des Inuit Qanuilirpitaa? réalisée en 2017 (Q2017) a mis en évidence que la fréquence de consommation d'aliments traditionnels était similaire à celle rapportée en 2004. Or, les fréquences de consommation des aliments pris individuellement ne tiennent pas compte des habitudes alimentaires, de l'accessibilité des aliments et des corrélations entre les aliments consommés. Notre objectif était d'identifier les profils alimentaires sous-jacents et de les comparer selon le sexe, l'âge, la région écologique et les marqueurs d'insécurité alimentaire, étant donné le lien entre l'alimentation, la santé et les déterminants socioculturels. MéTHODES: Les données sur les fréquences alimentaires et sociodémographiques sont issues de l'enquête Q2017 (N=1176). L'analyse des profils latents a permis d'identifier des profils alimentaires en utilisant les variables pour les fréquences relatives de la consommation d'aliments traditionnels et du marché et uniquement celles pour les aliments traditionnels. Des régressions logistiques multinomiales ont été utilisées pour examiner les associations entre les profils alimentaires, les facteurs sociodémographiques et les marqueurs d'insécurité alimentaire (pour dissocier les préférences alimentaires de l'accès aux aliments). RéSULTATS: Quatre profils alimentaires globaux et quatre profils alimentaires spécifiques à la consommation d'aliments traditionnels ont été identifiés en fonction de la fréquence relative des aliments traditionnels et des aliments du marché dans l'alimentation. Les profils étaient en accord avec les connaissances locales de nos partenaires Inuit. Pour les profils alimentaires globaux, les femmes et les adultes âgés de 30 à 49 ans étaient plus susceptibles d'avoir un profil dominé par les aliments du marché, tandis que les hommes et les personnes âgées de 16 à 29 ans et celles de 50 ans et plus avaient plus fréquemment un profil dominé par les aliments traditionnels. En ce qui concerne les profils de consommation d'aliments traditionnels, les Inuit âgés de 16 à 29 ans étaient plus susceptibles d'avoir un profil modéré de consommation d'aliments traditionnels, tandis que les Inuit âgés de 50 ans et plus étaient plus susceptibles d'avoir un profil élevé de consommation d'aliments traditionnels. Un profil bas de consommation d'aliments traditionnels et de marché était associé à une prévalence plus élevée de marqueurs d'insécurité alimentaire. CONCLUSION: Nous avons identifié différents profils alimentaires et ces derniers étaient associés à des caractéristiques socio-démographiques distinctes. Les profils alimentaires mis en lumière dans cette étude concordent avec l'impact du colonialisme sur l'alimentation au Nunavik et aux programmes subséquents de promotion des aliments traditionnels auprès des jeunes Inuit. Ces profils seront utilisés pour une étude plus approfondie du statut nutritionnel, de l'exposition aux contaminants et des issues de santé afin d'identifier des pistes de solutions pour les futurs programmes de santé publique.

New migration and distribution patterns of Atlantic walruses (Odobenus rosmarus rosmarus) around Nunavik (Québec, Canada) identified using Inuit Knowledge.

Environmental changes are affecting the Arctic at an unprecedented rate, but limited scientific knowledge exists on their impacts on species such as walruses (Odobenus rosmarus). Inuit Traditional and Local Ecological Knowledge (Inuit TEK/LEK) held by Inuit walrus harvesters could shed light on walrus ecology and related environmental changes. Our main objective was to study spatial and temporal changes in Atlantic walrus (Odobenus rosmarus rosmarus) distribution in Nunavik (northern Québec, Canada) using Inuit TEK/LEK. To do so, we documented the knowledge and observations of 33 local hunters and Elders as part of a larger project on Atlantic walruses in Nunavik. We first gathered information on changes in Inuit land use patterns and harvesting practices through time and space, which was a crucial step to avoid potential biases in interpreting local observations on walrus distribution. We found that walrus hunters are now covering smaller hunting areas over shorter time periods, reducing in space and time their observations of Atlantic walruses around Nunavik. While clearly taking these limitations into account, we learned from interviews that some areas abandoned by Atlantic walruses in the past were now being re-occupied. Importantly, Atlantic walruses, which migrate following the melting ice, are now traveling along the eastern coast of Nunavik one month earlier, suggesting that Atlantic walrus migration has changed due to variations in sea-ice coverage around Nunavik. Our study not only highlighted important changes in Atlantic walrus distribution and migration in Nunavik, but also sheds light on the importance of documenting temporal and spatial changes in Inuit land use patterns and harvesting practices to understand the ecology of Arctic species using Inuit Knowledge. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00300-021-02920-6.

Seasonal variations in exposure to methylmercury and its dietary sources among pregnant Inuit women in Nunavik, Canada.

Among populations living in close connection with the sea, rivers and lakes for subsistence, diet varies according to local monthly wildlife species availability and food preferences. This may lead to variations in methylmercury (MeHg) exposure over a year, although no biomonitoring studies have documented this issue in Circumpolar populations, the most exposed to international Hg emissions. Our aim was to characterize seasonal variations in MeHg exposure among pregnant Inuit women from Nunavik and to identify country foods responsible for these variations. Between October 2016 and March 2017, 97 participants were recruited. Blood mercury (Hg) was tested and hair Hg was measured by centimeter as a surrogate for monthly MeHg exposure over the past year. Latent class growth analysis was conducted to identify groups of pregnant women with similar hair Hg monthly trajectories. Country foods consumption was documented by season. Seasonal daily intakes of MeHg were estimated based on concentrations in country foods. Retrospective monthly hair Hg analyses revealed that MeHg exposure was lowest in winter, and highest in summer and early fall months. Three latent classes (groups) of pregnant women with similar trajectories of monthly hair Hg variations were identified: high (n = 20, 21%), moderate (n = 38, 41%) and low variation (n = 35, 38%). Beluga meat was the country food contributing to most of daily MeHg intake, primarily during summer and fall, and was the only one associated with the odds of being classified into moderate and high variation groups (OR 95% CI: 1.19 [1.01-1.39] and 1.25 [1.04-1.50]). These findings underscore the importance of monthly variations in exposure to MeHg due to the seasonality of local foods consumed and responsible for elevated MeHg exposure. Further studies critically need to understand local diet fluctuations over a year to adequately assess MeHg exposure, adopt timely preventive interventions and evaluate the effectiveness of the Minamata Convention.

Vulnerability of Aboriginal health systems in Canada to climate change.

Climate change has been identified as potentially the biggest health threat of the 21st century. Canada in general has a well developed public health system and low burden of health which will moderate vulnerability. However, there is significant heterogeneity in health outcomes, and health inequality is particularly pronounced among Aboriginal Canadians. Intervention is needed to prevent, prepare for, and manage climate change effects on Aboriginal health but is constrained by a limited understanding of vulnerability and its determinants. Despite limited research on climate change and Aboriginal health, however, there is a well established literature on Aboriginal health outcomes, determinants, and trends in Canada; characteristics that will determine vulnerability to climate change. In this paper we systematically review this literature, using a vulnerability framework to identify the broad level factors constraining adaptive capacity and increasing sensitivity to climate change. Determinants identified include: poverty, technological capacity constraints, socio-political values and inequality, institutional capacity challenges, and information deficit. The magnitude and nature of these determinants will be distributed unevenly within and between Aboriginal populations necessitating place-based and regional level studies to examine how these broad factors will affect vulnerability at lower levels. The study also supports the need for collaboration across all sectors and levels of government, open and meaningful dialogue between policy makers, scientists, health professionals, and Aboriginal communities, and capacity building at a local level, to plan for climate change. Ultimately, however, efforts to reduce the vulnerability of Aboriginal Canadians to climate change and intervene to prevent, reduce, and manage climate-sensitive health outcomes, will fail unless the broader determinants of socio-economic and health inequality are addressed.

Piecing together the Labrador Inuit food security policy puzzle in Nunatsiavut, Labrador (Canada): a scoping review.

Inuit in Canada experience greater social and economic inequities than the general Canadian population. Food security exemplifies this inequity and is a distinct determinant of Inuit health. This scoping review focuses on food security-related policies implemented in Nunatsiavut, located in Northern Labrador. The primary objective was to identify the range of existing policies that pertain to food security in Nunatsiavut. The secondary objective was to complete a directed content analysis to map each policy against the applicable dimension of food security. This scoping review followed the Johanna Briggs methodology. The search strategy included the databases: Medline (via Ovid), EMBASE (via Ovid), CINAHL, and Scopus, and a hand search of the relevant journals, conference abstracts and grey literature. This search was undertaken from April 2019 - October 2019. A content analysis mapped each policy against the applicable dimension of food security. Results: The results showed that twenty five policies were identified, spanning three levels of government, that explicitly or implicitly addressed at least one dimension of food security. Accessibility was the most frequent food security dimension identified. The Government of Canada developed 60% of policies and the Nunatsiavut Government implemented 48% of policies. Most policies focused on proximal factors for food security. Identifying distal policies for food security and understanding the impact of existing policies in Nunatsiavut remain as areas of further investigation. Ethics and Dissemination:This project was reviewed by the Nunatsiavut Government Research Advisory Committee.

Climate impacts on northern Canada: introduction.

There is significant evidence that northern Canada's climate has already undergone substantial change. These changes have meant significant impacts for physical, natural and human systems in Canada's North. Climate models suggest that such trends will continue into the future, and therefore shifts in Arctic systems are expected for some time to come. This introductory paper is the first in a series published in two issues of Ambio presenting work conducted for northern chapters of two recent Canadian national climate science assessment initiatives, From Impacts to Adaptation: Canada in a Changing Climate 2007 and Human Health in a Changing Climate: A Canadian Assessment of Vulnerabilities and Adaptive Capacity. Collectively, these assessments involved the work of 24 scientists with expertise in a variety of disciplines and regions in the Canadian North. These assessment processes adopted aspects of a vulnerability approach to climate assessment, primarily through a review of existing and projected exposures and elements of adaptive capacity based on existing literature. In so doing, they have contributed towards a more comprehensive understanding of climate impacts and adaptations across the northern regions of the country. This paper provides an overview and introduction to the series of papers contained in the two issues of Ambio.

Implications of climate change for northern Canada: the physical environment.

The physical environment of the Canadian North is particularly sensitive to changes in climate because of a large concentration of cryospheric elements including both seasonal and multiyear forms of freshwater and sea ice, permafrost, snow, glaciers, and small ice caps. Because the cryosphere responds directly to changes in air temperature and precipitation, it is a primary indicator of the effects of climate variability and change. This article reviews the major changes that have occurred in the recent historical record of these cryospheric components at high latitudes in Canada. Some changes have been less pronounced in the Canadian North than elsewhere, such as changes in sea-ice coverage, whereas others have been potentially more significant, such as ablation of the extensive alpine and high-Arctic small glaciers and ice caps. Projections of future changes are also reviewed for each cryospheric component. Discussion about two other physical components of the North intrinsically linked to the cryosphere is also included, specifically: i) freshwater discharge to the Arctic Ocean via major river networks that are fed primarily by various forms of snow and ice, and ii) the related rise in sea level, which is strongly influenced by ablation of the cryosphere, and coastal stability, which also depends on the thermal integrity of coastal permafrost.

Climate impacts on northern Canada: regional background.

Understanding the implications of climate change on northern Canada requires a background about the size and diversity of its human and biogeophysical systems. Occupying an area of almost 40% of Canada, with one-third of this contained in Arctic islands, Canada's northern territories consist of a diversity of physical environments unrivaled around the circumpolar north. Major ecozones composed of a range of landforms, climate, vegetation, and wildlife include: Arctic, boreal and taiga cordillera; boreal and taiga plains; taiga shield; and northern and southern Arctic. Although generally characterized by a cold climate, there is an enormous range in air temperature with mean annual values being as high as -5 degrees C in the south to as low as -20 degrees C in the high Arctic islands. A similar contrast characterizes precipitation, which can be > 700 mm y(-1) in some southern alpine regions to as low as 50 mm y(-1) over islands of the high Arctic. Major freshwater resources are found within most northern ecozones, varying from large glaciers or ice caps and lakes to extensive wetlands and peat lands. Most of the North's renewable water, however, is found within its major river networks and originates in more southerly headwaters. Ice covers characterize the freshwater systems for multiple months of the year while permafrost prevails in various forms, dominating the terrestrial landscape. The marine environment, which envelops the Canadian Arctic Archipelago, is dominated by seasonal to multiyear sea ice often several meters thick that plays a key role in the regional climate. Almost two-thirds of northern Canadian communities are located along coastlines with the entire population being just over 100 000. Most recent population growth has been dominated by an expansion of nonaboriginals, primarily the result of resource development and the growth of public administration. The economies of northern communities, however, remain quite mixed with traditional land-based renewable resource-subsistence activities still being a major part of many local economies.

Climatic conditions in northern Canada: past and future.

This article reviews the historical, instrumental, and future changes in climate for the northern latitudes of Canada. Discussion of historical climate over the last 10 000 years focuses on major climatic shifts including the Medieval Warm Period and the Little Ice Age, and how these changes compare with those most recently experienced during the period of instrumental records. In reference to the latter, details are noted about observed trends in temperature and precipitation that have been recorded over the last half century, which exhibit strong west to east and north to south spatial contrasts. A comprehensive review of future changes is also provided based on outputs from seven atmosphere-ocean global climate models and six emission scenarios. Discussion focuses on annual, seasonal, and related spatial changes for three 30-year periods centered on the 2020s, 2050s, and 2080s. In summary, substantial changes to temperature and precipitation are projected for the Canadian North during the twenty-first century. Although there is considerable variability within the various projections, all scenarios show higher temperature and, for the most part, increasing precipitation over the entire region.

Implications of climate change for economic development in northern Canada: energy, resource, and transportation sectors.

Northern Canada is projected to experience major changes to its climate, which will have major implications for northern economic development. Some of these, such as mining and oil and gas development, have experienced rapid expansion in recent years and are likely to expand further, partly as the result of indirect effects of changing climate. This article reviews how a changing climate will affect several economic sectors including the hydroelectric, oil and gas, and mining industries as well as infrastructure and transportation, both marine and freshwater. Of particular importance to all sectors are projected changes in the cryosphere, which will create both problems and opportunities. Potential adaptation strategies that could be used to minimize the negative impacts created by a climate change are also reviewed.

Implications of climate change for northern Canada: freshwater, marine, and terrestrial ecosystems.

Climate variability and change is projected to have significant effects on the physical, chemical, and biological components of northern Canadian marine, terrestrial, and freshwater systems. As the climate continues to change, there will be consequences for biodiversity shifts and for the ranges and distribution of many species with resulting effects on availability, accessibility, and quality of resources upon which human populations rely. This will have implications for the protection and management of wildlife, fish, and fisheries resources; protected areas; and forests. The northward migration of species and the disruption and competition from invading species are already occurring and will continue to affect marine, terrestrial, and freshwater communities. Shifting environmental conditions will likely introduce new animal-transmitted diseases and redistribute some existing diseases, affecting key economic resources and some human populations. Stress on populations of iconic wildlife species, such as the polar bear, ringed seals, and whales, will continue as a result of changes in critical sea-ice habitat interactions. Where these stresses affect economically and culturally important species, they will have significant effects on people and regional economies. Further integrated, field-based monitoring and research programs, and the development of predictive models are required to allow for more detailed and comprehensive projections of change to be made, and to inform the development and implementation of appropriate adaptation, wildlife, and habitat conservation and protection strategies.