Lifestyle at root of health problems
When I first started working as a physician in the Canadian Arctic I felt overwhelmed by the sheer volume and complexity of health care problems among the Inuit.
Apart from the expected acute illnesses and injuries, I had never seen so many people with chronic diseases that were so poorly managed.
Chronic obstructive lung disease, diabetes, high blood pressure and mental diseases topped the list affecting many relatively young people.
That begged the question, why the vast difference between the south and the Arctic?
It didn’t take long to figure out that lifestyle was at the root of many problems the local population faced. The relatively few Inuit who managed to adhere to their traditional way of life were generally a lot healthier than those who obtained most of their food in the local store.
When I say “traditional way of life,” I mean the obtaining of most of their food from hunting and fishing and eating a large part of that bounty raw like they have done for centuries.
With the arrival of both the beneficial and the harmful aspects of our North American culture, the traditional way of life has become nearly impossible to pursue. Less than a century ago, most of the Inuit were nomads traveling in small groups following the caribou herds or hunting walrus, beluga, narwhal, seal. In wintertime, they lived in igloos, and in summer in tents made of caribou hides. The population was relatively stable, since only the fittest did survive in that harsh environment.
Now they live in settlements of several hundred to up to 2,000 people. They have taxpayer-funded houses, schools, supermarkets and health care. The modern amenities have resulted in a population explosion and the disappearance of many of the amazing centuries-old traditions and skills they needed to stay alive.
On the other hand, our governments, politicians and bureaucrats alike, have failed to provide the Inuit with the education and skills to function in a modern society. The result is widespread unemployment, poverty, overcrowding, alcoholism and violence, all contributing to the many social and health care problems.
Since living off the land is no longer possible for most, and the total absence of roads in Nunavut, virtually all food has to be flown in. That means extremely high food costs for families. For example a loaf of brown bread will cost $1.49 in Winnipeg and $4.79 in Rankin Inlet, Nunavut. All other essentials are two or three times more expensive than we pay in the south.
The result is that at least one third of the Nunavut population lacks food security. Many children live in homes where many a day there is no food at all and they come to school mainly because there is a breakfast program. That may well be the only food they get all day, since there is no lunch program. No child can learn much with an empty stomach and therefore few will graduate, continuing the cycle of lack of education and poverty.
This appalling situation has resulted in Canada being the first wealthy nation to warrant a probe by the United Nations Special Rapporteur on the right to food. We are now joining Haiti, Ethiopia, Ghana and Uganda on the list of nations failing to look after our own.
We are the only G8 country without a nationally-funded school meal program – one effective way to ensure that food is accessible and adequate for a vulnerable and marginalized group.
Not just the Inuit, but Canada-wide there are an estimated two and a half million fellow citizens who are food insecure, a euphemism for inadequate nutrition. That is one out of every 12 Canadians.
There is mounting evidence that food insecurity forces eating poor quality food. That in turn brings with it with chronic disease, including Type 2 diabetes, high blood pressure and is associated with higher levels of depression, stress, anxiety, social isolation, eating disorders, impaired brain development and learning.
Little wonder health care professionals and facilities are kept extremely busy looking after the fall-out of food insecurity.
Moreover food insecurity also affects families. It is linked to lower levels of positive parent-child interactions, poorer infant feeding practices, poorer psychological health among children, and depression and suicidal tendencies in adolescents especially among the Inuit where suicide rate is 11 times more common than the national average.
We are sending more of our agricultural production out of the country than ever before, quadrupling exports in the past 20 years.
And yet allowing inadequate nutrition for so many is a shame for a country that prides itself in providing good government.
What we need is a national food policy, making sure all people have access to adequate healthy nutrition, making food banks a thing of the past and enjoying a vastly healthier population with a sharply reduced demand for health care.
Dr. Marco Terwiel is a retired family physician who lives in Maple Ridge.