“Years ago”: reconciliation and First Nations narratives of tuberculosis in the Canadian Prairie Provinces

Komarnisky, Sara V.; Hackett, P. A.; Abonyi, Sylvia; Heffernan, Courtney; Long, Richard

doi:10.1080/09581596.2015.1067672

Cited by 12 publications

(18 citation statements)

References 21 publications

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“…Four publications did not report the study design used. [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.…”

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%

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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%

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

Smith¹,

Herington²,

Loshak³

2021

cjht

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“…As we have elaborated elsewhere for participants in this study (Komarnisky et al, 2016), and as Møller (2005Møller ( , 2010 has described for the Inuit, related studies among contemporary Alberta TB patients also point to the legacy of the TB sanatorium era as contributing to delays in seeking diagnosis and treatment, and a general apprehension about healthcare (Gibson, Cave, Doering, Ortiz, & Harms, 2005;Moffatt et al, 2013). Research in urban Montreal reported similar findings on the impact of negative memories and experiences rooted in colonial treatment strategies as being significant for the mistrust Indigenous participants expressed towards the contemporary healthcare system (Brassard, Anderson, Menzies, Schwartzman, & Macdonald, 2008;Macdonald, Rigillo, & Brassard, 2010).…”

Section: Tb Symptoms Experienced In Contextmentioning

confidence: 99%

“Finally when I started falling down”: Indigenous tuberculosis patient experiences of health and illness on the Canadian prairies

Abonyi¹,

Mayan²,

Boffa³

et al. 2017

IJIH

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This paper adds evidence to a growing body of literature seeking to understand the disproportionate occurrence of tuberculosis (TB) in Indigenous populations of Canada and reveals insights that may inform effective interventions. As a disease, TB is recognized as a disorder of the body, for which there are successful treatments. Its persistence in some populations, however, requires an understanding of TB as an illness, whereby disease is shaped into behaviours and experiences. Fifty-five self-identified Indigenous participants with infectious pulmonary TB completed a questionnaire and an interview as part of the Determinants of Tuberculosis Transmission (DTT) project. Questionnaire data report on sociodemographic information and exposure to TB risk factors, while interview data describe participants' experiences of TB within the context of their personal histories and everyday lives. Analysis showed that TB symptoms did not stand out as unusual in the everyday life and health experiences of participants. State of health and decisions about accessing healthcare were associated with socioeconomic deprivation, as well as negative experiences connected with historical and contemporary impacts of colonization. The "tipping point" concept effectively captures the shift in health that pushes participants to seek healthcare. Family, friends, and other caregivers are important influences and need to be part of the effort to avoid advanced TB illness and stop the cycle of transmission. More significantly, there is a need to address the structures and systems that produce and perpetuate life conditions that result in a usual state of compromised health. KeywordsTuberculosis, Indigenous, Canada, social determinants of health, illness experience, tipping point Note on TerminologyWe use the term Indigenous throughout this paper to refer to the first inhabitants of what is now called Canada. In a global context, this term links peoples in similar circumstances of colonization. Where it appears in the text, the term Aboriginal refers to a formal recognition of Indigenous people in Canada in the Constitution Act of 1982, as members of three groups: First Nations ("Indians"), Métis, and Inuit. Terms used throughout this paper reflect those used in source material. Where we report epidemiological information from our research, we use terms consistent with federal government reporting standards for comparability. AcknowledgementsThank you to the 55 people who shared their stories with the project team with the hope that their experiences will change for the better the programs, policies, and services that aim to eliminate TB from Indigenous people and communities.

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“…13 Although eventually every individual with suspicion of TB was required to be treated in a sanatorium, the implications for Indigenous peoples, who often only spoke their first language and were far removed from their communities, have been particularly significant (i.e., lost family members, cultural disconnect). 14 Today, sanatoria no longer exist, and policies on how to treat TB have changed, yet in the management of infectious TB, isolation, whether at home or in hospital, is still recommended. Typically, individuals with infectious TB are isolated at the outset of treatment, as per management policies that differ across the Prairie provinces of Canada.…”

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confidence: 99%

Respiratory isolation for tuberculosis: the experience of Indigenous peoples on the Canadian prairies

Mayan

Robinson

Gokiert

et al. 2017

public health action

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The Prairie provinces of Canada. To understand how Indigenous peoples with infectious pulmonary tuberculosis living in different community settings in the Prairie provinces of Canada experience respiratory isolation. Using an exploratory qualitative approach, we interviewed participants living in urban centres, non-remote reserve settings and remote and isolated reserve settings. Through qualitative content analysis of 48 interviews, we determined that participants experienced feelings of confinement regardless of the community setting in which they lived. Participants also experienced family and social disconnect, but the experience was more potent for the remote and isolated reserve participants, who were required to be flown out of their home communities to receive treatment, and for those urban centre and non-remote reserve participants who lacked social connections. The roles of past experiences with sanitoria and of family in providing social support are discussed. The conclusions of this study focus on examining isolation policies and improving the hospital isolation experience.

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“Years ago”: reconciliation and First Nations narratives of tuberculosis in the Canadian Prairie Provinces

Cited by 12 publications

References 21 publications

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

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

“Finally when I started falling down”: Indigenous tuberculosis patient experiences of health and illness on the Canadian prairies

Respiratory isolation for tuberculosis: the experience of Indigenous peoples on the Canadian prairies

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