Predictors of household food insecurity and relationship with obesity in First Nations communities in British Columbia, Manitoba, Alberta and Ontario.

OBJECTIVE: To further understandings of household food insecurity in First Nations communities in Canada and its relationship with obesity. DESIGN: Analysis of a cross-sectional dataset from the First Nations Food, Nutrition and Environment Study representative of First Nations communities south of the 60th parallel. Multivariate logistic regression was used to assess associations between food insecurity and sociodemographic factors, as well as the odds of obesity among food-insecure households adjusting for sociodemographic characteristics. SETTING: Western and Central Canada. PARTICIPANTS: First Nations peoples aged ≥19 years. RESULTS: Forty-six percent of First Nations households experienced food insecurity. Food insecurity was highest for respondents who received social assistance; had ≤10 years of education; were female; had children in the household; were 19-30 years old; resided in Alberta; and had no year-round road access into the community. Rates of obesity were highest for respondents residing in marginally food-insecure households (female 56·6 %; male 54·6 %). In gender-specific analyses, the odds of obesity were highest among marginally food-insecure households in comparison with food-secure households, for both female (OR 1·57) and male (OR 1·57) respondents, adjusting for sociodemographic variables. For males only, those in severely food-insecure (compared with food-secure) households had lower odds of obesity after adjusting for confounding (OR 0·56). CONCLUSIONS: The interrelated challenges of food insecurity and obesity in First Nations communities emphasise the need for Indigenous-led, culturally appropriate and food sovereign approaches to food security and nutrition in support of holistic wellness and prevention of chronic disease.

Oil pipelines and food sovereignty: threat to health equity for Indigenous communities.

Energy projects may profoundly impact Indigenous peoples. We consider effects of Canada's proposed Trans Mountain oil pipeline expansion on the health and food sovereignty of the Tsleil-Waututh Nation (TWN) through contamination and impeded access to uncontaminated traditional foods. Federal monitoring and TWN documentation show elevated shellfish biotoxin levels in TWN's traditional territory near the terminus where crude oil is piped. Although TWN restoration work has re-opened some shellfish-harvesting sites, pipeline expansion stands to increase health risk directly through rising bioaccumulating chemical toxins as well as through increased hazardous biotoxins. Climate change from increased fossil fuel use, expected via pipeline expansion, also threatens to increase algae blooms through higher temperature and nutrient loading. As the environmental impact assessment process failed to effectively consider these local health concerns in addition to larger impacts of climate change, new assessment is needed attending to linked issues of equity, sustainability and Indigenous food sovereignty.

Tackling injustices of occupational lung disease acquired in South African mines: recent developments and ongoing challenges.

BACKGROUND: South Africa's mineral resources have produced, and continue to produce, enormous economic wealth; yet decades of colonialism, apartheid, capital flight, and challenges in the neoliberal post-apartheid era have resulted in high rates of occupational lung disease and low rates of compensation for ex-miners and their families. Given growing advocacy and activism of current and former mine workers, initiatives were launched by the South African government in 2012 to begin to address the legacy of injustice. This study aimed to assess developments over the last 5 years in providing compensation, quantify shortfalls and explore underlying challenges. METHODS: Using the database with compensable disease claims from over 200,000 miners, the medical assessment database of 400,000 health records and the employment database with 1.6 million miners, we calculated rates of claims, unpaid claims and shortfall in claim filing for each of the southern African countries with at least 25,000 miners who worked in South African mines, by disease type and gender. We also conducted interviews in Johannesburg, Eastern Cape, Lesotho and a local service unit near a mine site, supplemented by document review and auto-reflection, adopting the lens of a critical rights-based approach. RESULTS: By the end of 2017, 111,166 miners had received compensation (of which 55,864 were for permanent lung impairment, and another 52,473 for tuberculosis), however 107,714 compensable claims remained unpaid. Many (28.4%) compensable claims are from Mozambique, Lesotho, Swaziland, Botswana and elsewhere in southern Africa, a large proportion of which have been longstanding. A myriad of diverse systemic barriers persist, especially for workers and their families outside South Africa. Calculating predicted burden of occupational lung disease compared to compensable claims paid suggests a major shortfall in filing claims in addition to the large burden of still unpaid claims. CONCLUSION: Despite progress made, our analysis reveals ongoing complex barriers and illustrates that the considerable underfunding of the systems required for sustained prevention and social protection (including compensation) needs urgent attention. With class action suits in the process of settlement, the globalized mining sector is now beginning to be held accountable. A critical rights-based approach underlines the importance of ongoing concerted action by all.

Estrategia para desarrollar capacidades en evaluación y manejo de riesgos de salud ambienta / Strategy for development of environmental health risk assessment and management capabilities

Se presentan los resultados de la aplicación de una estrategia para perfeccionar la capacitación en evaluación y manejo de riesgos de salud ambiental en Cuba, con un enfoque holístico, transdisciplinario, enfocado a problemas, basado en la comunidad y con métodos interactivos. Se perfeccionó el programa docente de salud ambiental del Instituto Nacional de Higiene, Epidemiología y Microbiología y se descentralizó esta experiencia a los Institutos Superiores de Ciencias Médicas de Santiago de Cuba y de Villa Clara. Las principales actividades fueron: perfeccionamiento y descentralización de los programas de la Maestría y del Diplomado en Salud Ambiental, desarrollo de cursos y talleres para profesores, elaboración de materiales docentes, diseño de programas docentes para la Licenciatura en Tecnología de la Salud y creación de la Red Nacional de Capacitación en Salud Ambiental. Fueron capacitados 456 profesionales y técnicos cubanos y 73 de países de América Latina(AU)

Estrategia para desarrollar capacidades en evaluación y manejo de riesgos de salud ambienta / Strategy for development of environmental health risk assessment and management capabilities

Se presentan los resultados de la aplicación de una estrategia para perfeccionar la capacitación en evaluación y manejo de riesgos de salud ambiental en Cuba, con un enfoque holístico, transdisciplinario, enfocado a problemas, basado en la comunidad y con métodos interactivos. Se perfeccionó el programa docente de salud ambiental del Instituto Nacional de Higiene, Epidemiología y Microbiología y se descentralizó esta experiencia a los Institutos Superiores de Ciencias Médicas de Santiago de Cuba y de Villa Clara. Las principales actividades fueron: perfeccionamiento y descentralización de los programas de la Maestría y del Diplomado en Salud Ambiental, desarrollo de cursos y talleres para profesores, elaboración de materiales docentes, diseño de programas docentes para la Licenciatura en Tecnología de la Salud y creación de la Red Nacional de Capacitación en Salud Ambiental. Fueron capacitados 456 profesionales y técnicos cubanos y 73 de países de América Latina