BackgroundCommunity food programs (CFPs) provide an important safety-net for highly food insecure community members in the larger settlements of the Canadian Arctic. This study identifies who is using CFPs and why, drawing upon a case study from Inuvik, Northwest Territories. This work is compared with a similar study from Iqaluit, Nunavut, allowing the development of an Arctic-wide understanding of CFP use – a neglected topic in the northern food security literature.MethodsPhotovoice workshops (n=7), a modified USDA food security survey and open ended interviews with CFP users (n=54) in Inuvik.ResultsUsers of CFPs in Inuvik are more likely to be housing insecure, female, middle aged (35–64), unemployed, Aboriginal, and lack a high school education. Participants are primarily chronic users, and depend on CFPs for regular food access.ConclusionsThis work indicates the presence of chronically food insecure groups who have not benefited from the economic development and job opportunities offered in larger regional centers of the Canadian Arctic, and for whom traditional kinship-based food sharing networks have been unable to fully meet their dietary needs. While CFPs do not address the underlying causes of food insecurity, they provide an important service for communities undergoing rapid change, and need greater focus in food policy herein.

Background Among circumpolar populations, recent research has documented a significant increase in risk factors which are commonly associated with chronic disease, notably obesity. Objective The present study undertakes a scoping review of research on obesity in the circumpolar Inuit to determine the extent obesity research has been undertaken, how well all subpopulations and geographic areas are represented, the methodologies used and whether they are sufficient in describing risk factors, and the prevalence and health outcomes associated with obesity. Design Online databases were used to identify papers published 1992–2011, from which we selected 38 publications from Canada, the United States, and Greenland that used obesity as a primary or secondary outcome variable in 30 or more non-pregnant Inuit (“Eskimo”) participants aged 2 years or older. Results The majority of publications (92%) reported cross-sectional studies while 8% examined retrospective cohorts. All but one of the studies collected measured data. Overall 84% of the publications examined obesity in adults. Those examining obesity in children focused on early childhood or adolescence. While most (66%) reported 1 or more anthropometric indices, none incorporated direct measures of adiposity. Evaluated using a customized quality assessment instrument, 26% of studies achieved an “A” quality ranking, while 18 and 39% achieved quality rankings of “B” and “C”, respectively. Conclusions While the quality of studies is generally high, research on obesity among Inuit would benefit from careful selection of methods and reference standards, direct measures of adiposity in adults and children, studies of preadolescent children, and prospective cohort studies linking early childhood exposures with obesity outcomes throughout childhood and adolescence.

BackgroundFalls are overtaking traffic injuries as the leading cause of not only injury hospitalisation, but also death. Stairs are of special interest for prevention by design, being subject to building codes.ObjectivesTo assess importance and determinants of stair as causes of death and hospitalisation in Canada and a major rural-small urban region in the British Columbia interior.MethodsNational and provincial mortality and hospitalisation databases were used to compare determinants and trends of external cause W10 with other falls, grouping nature of injury codes for W10 by head and brain trauma and limb fractures.ResultsIn Canada, stair-related deaths averaged 280/year and 0.9/100 000 person years in 32 000 000 population during 2000–2008, accounting for 63% of inter-level fall deaths, 25% of known and 13% of all fall causes. There were about 10 000 stair-related hospitalisations/year, 36 : 1 hospitalisations:deaths. The British Columbia Interior Health Region had 2586 hospitalisations, 3.5/1000 person years in 750 000 population during 2002–2010; 54% were females, with 46% females and 54% males <65 years-old. Head injuries represented 12% of hospitalisations, extremity fractures most others. Males 5–64-years-old accounted for most severe head injuries, including subdural and epidural haematomas. Stairs were the leading specified cause of head injury, exceeding road crashes.SignificanceStairs are a key built-environment issue, especially for homes. With victims younger than for most falls, disability can be prolonged. Building codes should provide automatic passive protection for all ages by mandating step geometry including deeper treads and short uniform risers, graspable handrails, and high vertical barriers.