ERSTC-INDG 3730 Lecture 8 (23-24).pdf

Indigenous People, Health and the Environment Indigenous people, health and biological and psychosocial relationships the environment Lecture 8 1 1 Environmental Health Hazards/Benefits Model and Approach: Biological Hazards: e.g. bacteria, viruses, parasites and other pathogenic organisms Bene...

Indigenous People, Health and the Environment Indigenous people, health and biological and psychosocial relationships the environment Lecture 8 1 1 Environmental Health Hazards/Benefits Model and Approach: Biological Hazards: e.g. bacteria, viruses, parasites and other pathogenic organisms Benefits: e.g. traditional food species, traditional plants Chemical Hazards: e.g. toxic metals, air pollutants, solvents, pesticides Benefits: e.g. nutrients, anti-oxidants other critical elements of traditional plants, foods and other medicines Physical Hazards: e.g. radiation, temperature, sounds (noise) Benefits: e.g. temperature, sound (music) Mechanical Hazards: e.g. motor vehicle, home, agriculture, workplace injury Benefits: e.g. motor vehicle, traditional form of transportation, home, workplace (traditional and contemporary) benefits Psychosocial Hazards: e.g. stress, lifestyle disruption, effects of social change, marginalization, unemployment Benefits: e.g. stress-relief, balance, identity, cultural connection 2 2 1 Biological Benefits “All forms of life (as well as the non-living products they produce) that can cause positive health effects” • Plants • Insects • Rodents and other animals • Fungi • Bacteria, viruses 3 3 Biological Hazards “All forms of life (as well as the non-living products they produce) that can cause adverse health effects” (Yassi et al., 2001: p55) • Plants • Insects • • • • Rodents and other animals Fungi Bacteria, viruses Toxins and allergens 4 4 2 Common Environmental Hazards and Routes of Exposure Yassi et al., 2001 5 5 Microorganisms Bacteria – E.g. Escherichia coli (E. coli O157:H7) E. coli – Can live outside and organism and multiply in food and water Protozoa – E.g. Giardia Lamblia (‘Beaver fever’) Giardia lamblia – Can live outside and organism and multiply in food and water Viruses – E.g. Influenza – Can survive for a limited period of time but not multiple outside host; not a live organism Influenza A – Spanish flu Ebola virus 6 6 3 Estimated DALYs and Proportion Attributed to Environment of Infectious and Parasitic Disease, 2012 Infectious and Parasitic Diseases DALYs / % attributed to env Diarrhea (including dysentery and cholera) 57 million / 57% Lower respiratory infections (pneumonia, bronchitis) 52 million / 35% Malaria 23 million / 42% Non-Communicable Conditions DALYs / % attributed to env Cardiovascular diseases 119 million / 31% Cancers 49 million / 20% Chronic Obstructive Pulmonary Disease 32 million / 25% Asthma 11 million / 44% Unipolar Depressive Disorder 8 million / 11% 7 http://apps.who.int/iris/bitstream/10665/204585/1/9789241565196_eng.pdf?ua=1 7 Diseases • Infectious (communicable) disease – can be spread from one person to another – Direct – contact between two people (e.g. STIs) – Indirect • Air (e.g. Tb - Mycobacterium tuberculosis) • Infected materials such as food (e.g. Helminths/worms) • Vector borne disease – spread by living organisms (usually insects) that carry the microorganism or parasite between host and a person (e.g. Malaria parasite via mosquitoes); may or may not be harmful to vector / agent of transfer (e.g. West Nile) • Zoonotic diseases – transmitted from animals to humans or vice versa (e.g. Bovine spongiform encephalopathy (BSE) or "Mad cow disease“; Trichinosis) • Foodborne toxins – bacteria and parasites produce disease causing toxins (e.g. Botulism Clostridium botulinum) which cannot be transmitted person to 8 person 8 4 Microorganisms Factors • Crowding • Hygiene • Access to health services: diagnosis and treatment expertise + frequency • Health status • Exclusively Indigenous criteria? – NO ! Leach 1999 9 9 Zoonotic Diseases and Indigenous People Nunavik • 11 outbreaks from 1982 – 1999 affecting 82 people Symptoms: • Initial - nausea, heartburn, diarrhea • Eventual – encysts in body – headache, fever, chills, muscle pain • Can enter central nervous system and cause permanent damage (respiratory paralysis, death) (Proulx et al., 2002)10 10 5 Spread of Biological Hazards (Insect Transmitted Disease) Ixodes scapularis – and human exposure to Lyme disease Figure 1: The numbers and incidence of reported Lyme disease cases (confirmed and probable) by year in Canada, 2009-2015 (https://www.canada.ca/en/publichealth/services/diseases/lyme-disease/surveillance-lymedisease.html) • • • • • Spread by bite of tick ( I. scapularis) Caused by bacterium Borrelia burgdorferi Most common vector borne disease in temperate zone Nausea, fever, muscle pain, nervous system disorders Growth of tick population positively influenced by temperature, precipitation 11 Leighton et al., 2012 11 Environmental Change and Spread of Biological Hazards Vector (tick)-borne Diseases Bouchard et al. 2019 • Temperature • Precipitation • Seasonal weather 12 12 6 Defense Mechanisms • Immune System • Antibiotics • Antivirals / vaccinations Health Effects Infection – when a biological organism establishes itself in the body of a host Resulting in morbidity and/or mortality 13 13 Factors Influencing the Spread of Biological Hazards • Water (drinking, hygiene) quality and access • Sanitation - dumping of untreated sewage into surface water • Housing - overcrowding and poor ventilation (airborne transmission of Tb, measles, influenza, pneumonia etc) • Environmental changes taking place and influence on movement of insect vectors with environmental change • Relationship with other living beings in the environment - close connection with animal as potential vectors for zoonoses Vulnerability to biological hazards => V=f(E,A) • Exposure influenced by: lifestyle, livelihoods, access to information (monitoring etc) • Adaptive capacity influenced by: housing, sanitation infrastructure, water treatment and access, pre-existing health status, access to adequate health services for diagnoses, treatment and prevention etc. (see Smith et al 2006 for example) 14 14 7 Biological Agents and their Benefits (Chemical and other) Traditional Foods • Lipids – fish and m. mammal tissues high in EPA and DHA omega-3 fatty acids – linked to low rates of ischemic heart disease, inflamatory disease (Dyerberg etal., 1975; Yamori et al., 1995) – protection against high blood pressure, diabetes, and certain cancers (breast, colon, prostate) – brain development on fetus, birth wt, all aided by omega-3 fatty acids • Minerals – majority of essential minerals for all groups comes from country foods – nutrient density (nutrient per caloric intake) greater for Arctic men and women in country foods portion of diet (Kuhnlein, 1995; Kuhnlein et al., 1995,1996) – high selenium concentrations in marine species - anticarcinogen, antagonistic effect on MeHg toxicity (experimentally) – Zn, Fe, Ca, Se, Co, Mn, B6, ascorbic acid and protein interact with Cd – Zn, Fe, Ca, Se, Co, Cr, interact with toxicity of lead 15 15 Biological Agents and their Benefits (Chemical and other) Traditional Foods • Vitamins and Protein – low Vit A and Ca intakes, B12 and pantothenic acid, niacin, riboflavin, thiamin intakes good – clinical evidence of deficiencies not seen in Arctic populations – country foods provide enough protein to reach RNI, over 80% of protein requirements came from country foods in Sanikiluaq (Wein, 1995) • Social and Cultural Benefits – not to be underestimated as country food is central to social health of many individuals and communities and dietary shifts have been associated with social, mental and physical pathologies elsewhere – country foods reported to embody, define, maintain and continue culture, tradition and identity of Aboriginal peoples – provide basis for active traditional lifestyle (less sedentary) • Economic Benefits – estimated value of country foods of $10,000 per household in NWT (replacement costs by equal weight in market meats) (Usher and Wenzel, 1989) 16 16 8 Biological Agents and their Benefits (Chemical and other) Traditional Plants and Medicines • Elder Bertha Skye – Birch Trees as Medicine https://www.youtube.com/watch?v=I1xhxSD7i_g • (*watch in class*) Native Veterans, PTSD and Native American Medicine https://www.youtube.com/watch?v=scAgN__svvY (*watch on your own*) 17 17 Benefits of Relationship with Biological Components of Land Healthy Country = Healthy People Participation in Indigenous Cultural and Natural Resource Management = Physical health and well-being • More frequent exercise • Lower obesity, diabetes, renal disease, CVD, psychological stress • Better nutritional status (e.g. omega-3 fatty acids; iron) Improved socio-economic well-being • Food sources and other valued resources • Decreased health costs • “Sustainable livelihoods” Burgess et al., 2009 Weir et al., 2011 18 18 9 Healthy Country / Environment = Healthy People Physical health benefits Physical health and well-being More bush meat consumption More bush fruit and vegetable consumption Lower obesity Lower type II diabetes Lower blood pressure Lower risk for heart disease Burgess et al., 2009 Yugul Mangi Women Rangers: https://www.youtube.com/watch?v=DCoPLvWO0QM 19 19 Environmental Health Hazards/Benefits Model and Approach: Biological Hazards: e.g. bacteria, viruses, parasites and other pathogenic organisms Benefits: e.g. traditional food species, traditional plants Chemical Hazards: e.g. toxic metals, air pollutants, solvents, pesticides Benefits: e.g. nutrients, anti-oxidants other critical elements of traditional plants, foods and other medicines Physical Hazards: e.g. radiation, temperature, sounds (noise) Benefits: e.g. temperature, sound (music) Mechanical Hazards: e.g. motor vehicle, home, agriculture, workplace injury Benefits: e.g. motor vehicle, traditional form of transportation, home, workplace (traditional and contemporary) benefits Psychosocial Hazards: e.g. stress, lifestyle disruption, effects of social change, marginalization, unemployment Benefits: e.g. stress-relief, balance, identity, cultural connection 20 20 10 Psychosocial Benefits Certainty, lack of ‘worry’, feeling of control, happiness, often leads to a “relaxed state”, sense of balance Psychosocial Benefits – “Those things that create a social environment of certainty, lack of concern, happiness, and a sense of control and balance” 21 21 Psychosocial Hazards Uncertainty, anxiety and a lack of feeling of control often to lead to “stress” Stress – human response to stressors Psychosocial Hazards – “Those stressors that create a social environment of uncertainty, anxiety and a lack of control (e.g. Anxiety of survival from violence, uncertainty of future health effects of radiation or chemical exposure)” (Yassi et al., 2001; pg 102) 22 22 11 Psychosocial Hazards Sources: Work, personal life, loss, threat/danger of any kind Many other forms of environmental hazards may also act as psychosocial hazards too as one might worry or be anxious about them Health Effects: Physiological – increased heart rate, blood pressure, respiration, blood transport to muscles, increased digestive activity, production of stress hormones (adrenalin-increases HR, BP, energy supplies) (cortisol-increases sugar in blood, enhances brain use of glucose, supresses digestion, reproductive system etc) Stressor Coping Ability Result 23 23 Psychosocial Hazards Stressor Coping Ability Result Cardiovascular disease (arterial hypertension, ischemic heart disease) Peptic ulcer Bronchial asthma Rheumatoid arthritis Self-inflicted injury Diabetes Science of Stress https://www.youtube.com/watch?v=gi-LNQVhDPc 24 24 12 Psychosocial Stress-Intergenerational Trauma and Indigenous Health Intergenerational Trauma in Australia: https://www.youtube.com/watch?v=iQMZZ8ng7oI Epigenetics: Why inheritance is weirder than we thought: https://www.youtube.com/watch?v=AvB0q3mg4sQ Can Trauma be inherited?: https://www.youtube.com/watch?v=NuIM39dcUs4 See: Brockie et al., 2013; O’Neill et al., 2018 25 25 History and Psychosocial Transition Cunningham and Stanley 2003 • Dislocation of from lands through colonisation has contributed to the effects of newly introduced diseases on health and significant psychosocial stress and anxiety • Now perpetuated by other forces (both internal and external forces to the ‘community’)-e.g. modernity, sedentary lifestyle, wage economy activities, environmental change • See Kirmayer et al., 2003. Healing Traditions: culture community and mental health…in the supplementary readings folder • See Middleton et al. 2021. Temperature and place associations with Inuit mental health in the context of climate change….in the supplementary readings folder 26 26 13 Psychosocial Benefits: Therapeutic Landscapes / Healing Power of the Land It doesn’t just happen, you have to feel connected She (Mother Earth) is something that heals you if you let it. You don’t always feel it. You have to be thinking about it. You can’t just go out for a walk and feel it. You have to be spiritually connected to feel her. The power of ceremony involving the land One way to get in tune with the earth is to go to a sweat lodge. The lodge represents Mother Earth’s belly, her womb. You go into the sweat praying and sweating. It is a cleansing and the whole time you are in there, you are praying. When you crawl out, it is like you are re-born, like a child. You feel so good when you come out of there. …and everyday activities I hunt, I camp, I fish and I have always done that and I always feel good when I’m out there in the bush. To me it’s almost like a cleansing. I can go out there and I just feel so good, like my mind gets so cleared. I love it. Wilson 2003 27 27 Psychosocial Benefits and Connections: Skownan First Nation, MB; Nunatsiavut, NL http://www.youtube.com/watch?v=EzBv_tS11mk (View 18:18-19:32) http://www.youtube.com/watch?v=7snzQ0dl8f8 https://www.youtube.com/watch?v=yi7QTyHERjY 28 28 14 Psychosocial Benefits: Environmental Psychology Healing mental fatigue Proven nature based therapies Human preference for natural spaces Positive effect on outlook and life satisfaction Improves ability to handle stress Improves concentration Value of knowing it just exists 29 Maller et al. 2006 29 Supplementary Readings • Brockie, et al. 2013. A framework to examine the role of epigenetics in health disparities among Native Americans, Nursing Research and Practice, s http://dx.doi.org/10.1155/2013/410395 • Carr, AC. 1998. Therapeutic properties of New Zealand and Australian Tea Trees, New Zealand Pharmacy, Feb 1998, Vol 18 #2 • Cunningham, C and F. Stanley. 2003. Indigenous by definition, experience or world view, BMJ: 2003: 327: 403-404. • Leach, A.J. 1999. Otitis media in Australian Aboriginal children: an overview. Int J P.O. (49 S1): 173-178 • O’Neill et al. 2018. Hidden Burdens: A review of intergenerational, historical and complex trauma, implications for Indigenous families, J child & adol. Trauma, 11(2):6 173-186. • Middleton, J., Cunsolo, A., Pollock, N., Jones-Bitton, A., Wood, M., Shiwak, I., Flowers, C., Harper,SL. 2021. Temperature and place associations with Inuit mental health in the context of climate change,Environmental Research, Vol 198 (1), doi.org/10.1016/j.envres.2021.111166 • Proulx, J.F. et al. 2002. Novel prevention program for trichinellosis in Inuit Communities. CID, 2003, 34: 1508-1514 • Pruss-Ustun, A., Wolf, J., Corvalanc, C., Bos, R., and Neira, M. 2016. Preventing disease through healthy environments: A global assessment of the burden of disease from environmental risks, World Health Organization (http://apps.who.int/iris/bitstream/10665/204585/1/9789241565196_eng.pdf?ua=1) • Smith et al 2006. Public health evaluation of drinking water systems for First Nations reserves in Alberta, J of Environ. Eng. Scie. 5:S1-S17. • Wilson, K. 2003. Therapeutic landscapes and First Nations peoples: an exploration of culture, health and place, Health & Place, 89-93. • Yassi et al. 2001. Chapter 2 30 30 15 Reminders • Seminar – The Gift of Diabetes – Last Seminar Assignment due in 2 weeks (Dec 12th) • Assignment #2 due (unless you have an extension) • Reflections writing assignment for visit from Beedhabin Peltier due today • Exam review – next class, Dec 5th (fun class, be sure to come!, bring a cup for warm beverages) • Exam – Monday Dec 20th , 3pm, ENW 103 31 31 Seminar – Film & Questions ‘The Gift of Diabetes’ • Available at http://www.nfb.ca/film/gift_of_diabetes# • Watch film and answer questions in Seminar Folder • Due Dec 12th via Blackboard 32 32 16