Our Health Counts: Examining associations between colonialism and ever being incarcerated among First Nations, Inuit, and Métis people in London, Thunder Bay, and Toronto, Canada.

OBJECTIVES: Indigenous peoples have a disproportionately high prevalence of incarceration in the Canadian justice system. However, there is limited Indigenous-driven research examining colonialism and the justice system, specifically associations between racism, externally imposed family disruptions, and history of ever being incarcerated. Therefore, this study examined the association between the proportion of previous incarceration and family disruption, experiences of racism, and victimization for Indigenous adults in London, Thunder Bay, and Toronto, Ontario, Canada. The three communities expressed that they did not want comparison between the communities; rather, they wanted analysis of their community to understand where more supports were needed. METHODS: Indigenous community partners used respondent-driven sampling (RDS) to collect data from First Nations, Inuit, and Métis (FNIM) peoples in London, Thunder Bay, and Toronto. Prevalence estimates, 95% confidence intervals, and relative risk were reported using unweighted Poisson models and RDS-adjusted proportions. RESULTS: Proportions of ever being incarcerated ranged from 43.0% in London to 54.0% in Toronto and 72.0% in Thunder Bay. In all three cities, history of child protection involvement and experiencing racism was associated with an approximate 25.0% increase in risk for previous incarceration. In Toronto and London, victimization was associated with increased risk for incarceration. CONCLUSION: This research highlights disproportionately high prevalence of ever being incarcerated among FNIM living in three Ontario cities. Experiencing racism, family disruption, and victimization are associated with incarceration. Decreasing the rates of family disruption, experiences of racism, and victimization should inform future policy and services to reduce the disproportionately high prevalence of incarceration for FNIM people living in urban settings.

RéSUMé: OBJECTIFS: Les personnes autochtones présentent une prévalence démesurément élevée d'incarcération dans le système judiciaire canadien. Il y a cependant peu d'études dirigées par des Autochtones sur le colonialisme et le système judiciaire, en particulier sur les associations entre le racisme, les perturbations familiales imposées de l'extérieur et les antécédents d'incarcération. C'est pourquoi nous avons fait porter notre étude sur l'association entre la proportion d'incarcérations antérieures et de perturbations familiales, les expériences de racisme et la victimisation chez les adultes autochtones vivant à London, Thunder Bay et Toronto (Ontario), au Canada. Les trois villes ont dit ne pas vouloir que nous fassions de comparaisons entre elles; elles voulaient plutôt des analyses de leur ville pour savoir où des mesures de soutien supplémentaires étaient nécessaires. MéTHODE: Des partenaires associatifs autochtones ont utilisé l'échantillonnage en fonction des répondants (EFR) pour collecter des données auprès des personnes des Premières Nations, des Inuits et des Métis (PNIM) à London, Thunder Bay et Toronto. Les estimations de prévalence, les intervalles de confiance de 95 % et le risque relatif ont été présentés à l'aide de modèles de Poisson non pondérés et de proportions ajustées selon l'EFR. RéSULTATS: La proportion de répondantes et de répondants ayant déjà été incarcérés était de 43 % à London, de 54 % à Toronto et de 72 % à Thunder Bay. Dans les trois villes, la fréquentation des services de protection de l'enfance et l'expérience du racisme étaient associées à une hausse d'environ 25 % du risque d'incarcération antérieure. À Toronto et à London, la victimisation était associée à un risque accru d'incarcération. CONCLUSION: Cette étude souligne la prévalence démesurément élevée de l'incarcération antérieure chez les personnes PNIM vivant dans trois villes de l'Ontario. L'expérience du racisme, les perturbations familiales et la victimisation étaient associées à l'incarcération. La réduction des taux de perturbations familiales, d'expérience du racisme et de victimisation devrait éclairer les politiques et les services futurs afin de réduire la prévalence démesurément élevée de l'incarcération chez les personnes PNIM vivant en milieu urbain.

Uncovering SARS-COV-2 vaccine uptake and COVID-19 impacts among First Nations, Inuit and Métis Peoples living in Toronto and London, Ontario.

BACKGROUND: First Nations, Inuit and Métis Peoples across geographies are at higher risk of SARS-CoV-2 infection and COVID-19 because of high rates of chronic disease, inadequate housing and barriers to accessing health services. Most Indigenous Peoples in Canada live in cities, where SARS-CoV-2 infection is concentrated. To address gaps in SARS-CoV-2 information for these urban populations, we partnered with Indigenous agencies and sought to generate rates of SARS-CoV-2 testing and vaccination, and incidence of infection for First Nations, Inuit and Métis living in 2 Ontario cities. METHODS: We drew on existing cohorts of First Nations, Inuit and Métis adults in Toronto (n = 723) and London (n = 364), Ontario, who were recruited using respondent-driven sampling. We linked to ICES SARS-CoV-2 databases and prospectively monitored rates of SARS-CoV-2 testing, diagnosis and vaccination for First Nations, Inuit and Métis, and comparator city and Ontario populations. RESULTS: We found that SARS-CoV-2 testing rates among First Nations, Inuit and Métis were higher in Toronto (54.7%, 95% confidence interval [CI] 48.1% to 61.3%) and similar in London (44.5%, 95% CI 36.0% to 53.1%) compared with local and provincial rates. We determined that cumulative incidence of SARS-CoV-2 infection was not significantly different among First Nations, Inuit and Métis in Toronto (7364/100 000, 95% CI 2882 to 11 847) or London (7707/100 000, 95% CI 2215 to 13 200) compared with city rates. We found that rates of vaccination among First Nations, Inuit and Métis in Toronto (58.2%, 95% CI 51.4% to 64.9%) and London (61.5%, 95% CI 52.9% to 70.0%) were lower than the rates for the 2 cities and Ontario. INTERPRETATION: Although Ontario government policies prioritized Indigenous populations for SARS-CoV-2 vaccination, vaccine uptake was lower than in the general population for First Nations, Inuit and Métis Peoples in Toronto and London. Ongoing access to culturally safe testing and vaccinations is urgently required to avoid disproportionate hospital admisson and mortality related to COVID-19 in these communities.

Interventions for the prevention and management of occupational stress injury in first responders: a rapid overview of reviews.

BACKGROUND: First responders are a high-risk population for occupational stress injuries as they often encounter prolonged stress within their line of work. The aim of this rapid overview of reviews is to summarize existing evidence on interventions for the prevention and management of occupational stress injury (OSI) in first responders. METHODS: MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science, and Cochrane Library were searched for systematic reviews examining the impact of prevention, rehabilitation, and resilience-building strategies targeting frontline community safety personnel in February 2019. Pairs of reviewers screened titles and abstracts followed by full-text articles and conducted data abstraction and quality appraisal using the AMSTAR II tool. To ensure a rapid overview process, the search strategy was limited to the last 10 years, quality appraisal of reviews and abstraction of study-level data was completed by one person and verified by another, and the quality of the individual primary studies was not appraised. The findings were summarized descriptively. RESULTS: A total of 14 reviews with 47 unique primary studies were found after screening 1393 records. A majority of studies targeted OSI in police officers (78.7%), followed by firefighters (17%) and correctional officers (4.3%). Of the 47 included primary studies, 24 targeted prevention of OSI (i.e., resilience training, stress management, suicide prevention, and other health promotions) and 23 targeted rehabilitation (i.e., drug therapy, psychotherapy, and other therapies). Prevention strategies including resilience training programs had positive outcomes, while suicide prevention and psychotherapy interventions reported mixed results. CONCLUSIONS: Some promising interventions targeting the prevention and rehabilitation of OSI among police officers, firefighters, and correctional officers were identified in the included studies, and these results will serve as a basis for the development of evidence-based strategies to mitigate future risks in this population. However, several gaps were also identified in this area that will require further investigation prior to widespread implementation of effective interventions. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019125945.