Community Setting as a Determinant of Health for Indigenous Peoples Living in the Prairie Provinces of Canada: High Rates and Advanced Presentations of Tuberculosis

Mayan, Maria; Gokiert, Rebecca; Robinson, T; Tremblay, Mélissa; Abonyi, Sylvia; Morley, Kirstyn; Long, Richard

doi:10.18584/iipj.2019.10.2.5

Cited by 3 publications

(18 citation statements)

References 38 publications

(43 reference statements)

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“…[19][20][21][22] Three publications reported on the qualitative component of a mixed-methods study [23][24][25] and 2 reported on both quantitative and qualitative components of a mixed method. 26,27 One was a focused ethnography, 28 one a qualitative description study, 29 one used community-based participatory research methods, 30 another relied on citizen panels (deliberative methods), 31 and one was an interpretive phenomenology analysis. 32 Six publications reporting on 5 studies collected data through interviews.…”

Section: Study Design Data Collection and Methods Of Analysismentioning

confidence: 99%

“…32 Six publications reporting on 5 studies collected data through interviews. 21,23,25,[28][29][30] Two publications collected data using interviews and focus groups 19,22 and 1 used interviews with individuals and groups. 24 Two publications collected data using focus groups 20,26 and 1 publication collected data through community panels.…”

Section: Study Design Data Collection and Methods Of Analysismentioning

confidence: 99%

“…Content analysis was used to analyze data in 2 publications. 29,30 One publication each used narrative analysis using social action, 23 1 used a framework approach, 28 and another used the constant comparative method. 22…”

Section: Study Design Data Collection and Methods Of Analysismentioning

confidence: 99%

“…Six publications reporting on 5 studies were conducted in Canada. 19,23,26,29,30,32 Three were in conducted in the UK. 20,21,28 One publication was conducted in each of the following: the Netherlands, 24 New Zealand, 25 the US, 22 and Australia.…”

Section: Location Of Studymentioning

confidence: 99%

“…Of the 3 studies reported in 4 publications that explored the experiences of Indigenous people, 2 included Indigenous people diagnosed with TB and living on-and off-reserve in Alberta, Saskatchewan, or Manitoba. 23,29 One included Indigenous people who either had TB or had a close contact with someone who did and were living in Montreal, Canada, 19 and another included Indigenous residents of a northern First Nations reserve who had experience (direct or through family members) of Canada's TB programs including sanatoria. Two of these studies aimed to explore the experiences of colonialism in TB policy in Canada.…”

Section: Study Participants and Study Objectivesmentioning

confidence: 99%

See 4 more Smart Citations

Tuberculosis Stigma and Racism, Colonialism, and Migration: A Rapid Qualitative Review

Smith¹,

Herington²,

Loshak³

2021

cjht

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Current experiences of tuberculosis policy and care among Indigenous people are interpreted and understood in light of the past colonial violence and cultural genocide. The expressed reluctance to seek health care was often grounded in experiences of colonial violence and racism, pointing toward colonial and racist practice in health care as an important driver of tuberculosis stigma. The ongoing presence of anti-Indigenous racism in Canada’s health care systems underscores the ways that these worries are not confined to historical events but manifest in the interactions across individuals and systems today. For tuberculosis stigma in the context of migration, tuberculosis policies and programs targeting migrant persons or racialized groups were seen as fuelling discriminatory and exclusionary views and practices toward these groups in the wider society and exacerbating tuberculosis stigma. Migrant detention centres were 1 of the sites where tuberculosis stigma was amplified through isolation when diagnosed. Further, the twining of immigration policy with tuberculosis policy led to worries among migrant persons about one’s tuberculosis status and its impact on one’s immigration status, and subsequently a reluctance to access health care. These findings ask us to consider the ways that tuberculosis policy, in concert with immigration policy, can generate tuberculosis stigma. Tuberculosis stigma differs across contexts. It can be both a determinant of, and determined by, other forms of discrimination. Moreover, it requires close attention to the specific setting where tuberculosis stigma is sought to be addressed. The implications of this for tuberculosis policy and care are that a universal, one-size approach to addressing tuberculosis stigma is unlikely to be successful. Rather, program-specific approaches are likely needed that engage with questions as to how different forms of tuberculosis stigma play out in the context of care. Cutting across this review findings were widespread experiences of racism in health care. These findings suggest that, in as much as tuberculosis stigma is a barrier to the uptake of tuberculosis screening and treatment, racism against Indigenous people and racialized migrants remains endemic in Canada’s health care system and may in some cases overshadow the role or experience of tuberculosis stigma. In light of these findings, and again, depending on the particular setting, engaging with anti-racist efforts and challenging white supremacy remain necessary and urgent.

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Section: Study Design Data Collection and Methods Of Analysismentioning

confidence: 99%

Section: Study Design Data Collection and Methods Of Analysismentioning

confidence: 99%

Section: Study Design Data Collection and Methods Of Analysismentioning

confidence: 99%

Section: Location Of Studymentioning

confidence: 99%

Section: Study Participants and Study Objectivesmentioning

confidence: 99%

See 3 more Smart Citations

Tuberculosis Stigma and Racism, Colonialism, and Migration: A Rapid Qualitative Review

Smith¹,

Herington²,

Loshak³

2021

cjht

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Exploration of inter-jurisdictional TB programming and mobility in a Canadian First Nation community

et al. 2022

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Background Colonially imposed jurisdictional boundaries that have little meaning to Indigenous peoples in Canada may confound tuberculosis (TB) prevention and care activities. This study explores how inter-jurisdictional mobility and the current accommodation of mobility through policies and programming sustain a regional TB epidemic in northwestern Saskatchewan, and northeastern Alberta. Methods A qualitative instrumental case study was performed using a community based participatory approach. Semi-structured interviews were conducted with First Nations peoples from a high-incidence community in Canada including community-based healthcare workers. These interview data are presented in the context of a multi-level document analysis of TB program guidelines. Results The location of the community, and related lack of access to employment, services and care, necessitates mobility across jurisdictional boundaries. There are currently no formal federal or provincial guidelines in place to accommodate highly mobile patients and clients within and across provincial TB prevention and care programs. As a result, locally developed community-based protocols, and related ad-hoc strategies ensure continuity of care. Conclusion Indigenous peoples living in remote communities face unique push/pull factors that motivate mobility. When these motivations exist in communities with increased risk of contagion by communicable infectious diseases such as TB, public health risks extend into increasingly large areas with competing jurisdictional authority. Such mobility poses several threats to TB elimination. We have identified a gap in TB services to systematically accommodate mobility, with specific implications for Indigenous peoples and reconciliation. We recommend clearly defined communication paths and inter-jurisdictional coordination to ensure maintenance of care for mobile populations.

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La gestión territorial y los determinantes sociales para el control de la tuberculosis en un distrito de Lima

Herrera¹,

Pinto²,

Causo³

2022

Alpha Centauri

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El estudio determinó la incidencia de la gestión territorial y los determinantes sociales en el control de la tuberculosis en el distrito de El Agustino. El estudio se realizó mediante el enfoque cuantitativo no experimental de diseño descriptivo correlacional, de corte transversal, con una muestra de 90 participantes. Se utilizó la técnica del muestreo no probabilístico donde se aplicaron tres cuestionarios. Se observó que la variable Gestión territorial presento mayor frecuencia la categoría Ineficiente (52.2%), seguida de la categoría Medianamente eficiente (28.9%), y para la categoría Eficiente (18.9%). Para la variable, determinantes sociales, obtuvo mayor frecuencia la categoría Eficiente (61.1%), seguida de la categoría Medianamente eficiente (20.0%) y para la categoría Ineficiente (18.9%). En relación a la Tuberculosis pulmonar, la mayor frecuencia fue en la categoría satisfactorio (48.9%), seguida de la categoría insatisfactorio (33.3%), y para la categoría Medianamente satisfactorio (17.8%). Se encontró significancia estadística en la variable tuberculosis, (p=0.005), destacando la opción de tuberculosis 1: Insatisfecho al tratamiento, lo que sugiere sinergia combinada de la gestión territorial y los determinantes sociales, si influyen (p= 0.008), pero de manera combinada, aunque a nivel independiente. Se encontró que los niveles de la gestión territorial y los de la variable determinantes sociales fueron significativos (p=0.021). Conclusión: Se determinó que la sinergia combinada de ambas Gestión territorial y Determinantes sociales de la salud es la que produjo la significancia en la variable dependiente Tuberculosis (p=0.005<0.05).

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Community Setting as a Determinant of Health for Indigenous Peoples Living in the Prairie Provinces of Canada: High Rates and Advanced Presentations of Tuberculosis

Cited by 3 publications

References 38 publications

Tuberculosis Stigma and Racism, Colonialism, and Migration: A Rapid Qualitative Review

Tuberculosis Stigma and Racism, Colonialism, and Migration: A Rapid Qualitative Review

Exploration of inter-jurisdictional TB programming and mobility in a Canadian First Nation community

La gestión territorial y los determinantes sociales para el control de la tuberculosis en un distrito de Lima

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