What Is Wellbeing, and What Is Important for Wellbeing? Indigenous Voices from across Canada.

Indigenous peoples' perceptions of wellbeing differ from non-Indigenous constructs. Thus, it is imperative to recognize that Indigenous peoples will conceptualize wellbeing from their perspectives and set their own wellbeing priorities. In keeping with this viewpoint, the aims of the present study were to conceptualize wellbeing and determine what was (and is) important for wellbeing from Canadian Indigenous peoples' perspectives. In this paper, we take a partnership approach based on the elements of respect, equity, and empowerment. One primary data source and two existing data sources were examined and analyzed thematically utilizing a combination approach of deductive and inductive coding. Indigenous leadership and organizations viewed wellbeing holistically and conceptualized wellbeing multidimensionally. From across Canada, wellbeing was communicated as physical, economic, political, social, and cultural. The scaling of wellbeing represented a collectivist perspective, and land was the connecting thread between all types of wellbeing, being a place to practice cultural traditions, reassert one's Indigenous identity, find solace, and pass on Indigenous knowledge and languages. Although wellbeing was discussed in the context of the individual, family, community, and nation, wellbeing was most often discussed at the cultural level by regional and national Indigenous leadership and organizations. Even in acknowledging the great cultural diversity among Canadian Indigenous nations, four concordant themes were identified regionally and nationally, with respect to what was important for cultural wellbeing: land and water, sustainability, and inherent obligations; being on the land, and indigenous languages and knowledge systems; sustainable development; and meaningful involvement in decision-making, and free, prior, and informed consent. Taking into account these themes is foundational for any interaction with Indigenous peoples, especially in the context of land, culture, and development. There needs to be a new beginning on the journey to reconciliation with land and cultural wellbeing at the forefront.

Indigenous land-based approaches to well-being: The Sibi (River) program in subarctic Ontario, Canada.

The Albany River system holds a special significance for the Omushkego Cree of subarctic Ontario, Canada, embodying their cultural roots, history, and the Cree way of life and worldviews. Through the Sibi program, youth learned traditional fishing practices from Elders and on-the-land experts, gaining valuable knowledge on the land and river. The program addressed barriers to being on the land, while also creating a space for the transfer of Indigenous knowledge and revitalising community social networks. The program took place in the summer, following the Omushkego Cree's seasonal cycle and employed community-based participatory research approach. Photovoice and semi-structured interviews were used to identify elements of well-being from an Indigenous perspective. Regardless of age or experience, participants expressed positive emotions while being on the land, highlighting how strengthening social and community networks, intergenerational knowledge transfer, and fostering cultural continuity contribute to improved well-being. Program outcomes emphasize the importance of collaboration with communities to gain insights into their needs, priorities, and values, ultimately creating more sustainable and effective well-being programs. By fostering engagement and recognizing the environment's significance, sustainable and long-term solutions can be pursued to address challenges faced by communities, ultimately advancing health and well-being for both present and future generations.The Albany River system holds a special significance for the Omushkego Cree of subarctic Ontario, Canada, embodying their cultural roots, history, and the Cree way of life and worldviews. Through the Sibi program, youth learned traditional fishing practices from Elders and on-the-land experts, gaining valuable knowledge on the land and river. The program addressed barriers to being on the land, while also creating a space for the transfer of Indigenous knowledge and revitalising community social networks. The program took place in the summer, following the Omushkego Cree's seasonal cycle and employed community-based participatory research approach. Photovoice and semi-structured interviews were used to identify elements of well-being from an Indigenous perspective. Regardless of age or experience, participants expressed positive emotions while being on the land, highlighting how strengthening social and community networks, intergenerational knowledge transfer, and fostering cultural continuity contribute to improved well-being. Program outcomes emphasize the importance of collaboration with communities to gain insights into their needs, priorities, and values, ultimately creating more sustainable and effective well-being programs. By fostering engagement and recognizing the environment's significance, sustainable and long-term solutions can be pursued to address challenges faced by communities, ultimately advancing health and well-being for both present and future generations.

Indigenous Land-Based Approaches to Well-Being: The Niska (Goose) Harvesting Program in Subarctic Ontario, Canada.

Historically, goose harvesting provided a source of culturally significant, safe, and nutritious food for the Omushkego Cree of subarctic Ontario, Canada. Disruptions stemming from colonization and climate change have led to a decrease in harvesting, resulting in higher rates of food insecurity. The aim of the Niska program was to reconnect Elders and youth to revitalize goose harvesting activities and associated Indigenous knowledge within the community. The program and evaluation were built using a two-eyed seeing (Etuaptmumk) and community-based participatory research approach. Salivary cortisol, a biomedical measure of stress, was collected before (n = 13) and after (n = 13) participation in the spring harvest. Likewise, cortisol samples were collected before (n = 12) and after (n = 12) the summer harvest. Photovoice and semi-directed interviews were employed after the spring (n = 13) and summer (n = 12) harvests to identify key elements of well-being from an Indigenous perspective. The changes observed in cortisol levels for the spring (p = 0.782) and summer (p = 0.395) harvests were not statistically significant. However, there was a noteworthy increase in the subjective well-being observed through the qualitative measures (semi-directed interviews and photovoice), highlighting the importance of using multiple perspectives when assessing well-being, especially in Indigenous peoples. Future programs should incorporate multiple perspectives when addressing complex environmental and health issues, such as food security and environmental conservation, especially in Indigenous homelands worldwide.

A probabilistic hazard and risk assessment of exposure to metals and organohalogens associated with a traditional diet in the Indigenous communities of Eeyou Istchee (northern Quebec, Canada).

Hunting, trapping, and fishing are part of an Indigenous lifestyle in subarctic Canada. However, this lifestyle may be a route of exposure to contaminants and may pose a risk for the people who rely on a subsistence diet. Monte Carlo simulations for the chemical concentration of eight game species and one fish species were carried out by randomly sampling 10,000 samples from the contaminant measures for each species. We then calculated a probabilistic non-carcinogenic hazard quotient or carcinogenic risk values to estimate the human health risk of exposure to contaminants. Of the species examined, ducks were of concern for potential carcinogenic risk. There was a modeled probabilistic 95th-percentile risk associated with the consumption of ducks and polybrominated biphenyl (PBB) congener 153 in boys, women, and men (1.09 × 10-6, 1.57 × 10-6, and 2.17 × 10-6, respectively) and, to a lesser extent, with geese and polychlorinated biphenyl (PCB) congener 153 in men (1.19 × 10-6). Contaminant concentration in the intake rate (food consumption) for PBB congener 153 exposure risk was more important than that for PCB congener 153, where intake rate had greater relevance. The consumption of waterfowl may increase the exposure to organohalogens; however, there are health and wellness benefits associated with the harvesting and consumption of subsistence foods that must also be considered. We recommend follow-up species-specific studies focused on ducks to clarify and elucidate the results in the present study.

Indigenous Land-Based Approaches to Well-Being: The Amisk (Beaver) Harvesting Program in Subarctic Ontario, Canada.

The act of decolonizing knowledge systems involves recovering and renewing traditional, non-commodified cultural patterns, such as the sustenance of intergenerational relationships and traditional practices. A decline in beaver harvesting, which was once an integral part of the Omushkego Cree culture, has resulted in an overabundance of beavers and dams, which has negatively affected communities by increasing the local flooding events and impacting the water quality. The aim of the Amisk (beaver) program was to reconnect the Elders and youth to revitalize traditional on-the-land activities and, in the present case, beaver harvesting and associated activities within the community. The program and evaluation were built using a two-eyed seeing (Etuaptmumk) and community-based participatory research approach. Salivary cortisol, a biomedical measure of stress, was collected before and after participation in the program. Photovoice, along with semi-directed interviews, were employed to identify the key elements of well-being from a First Nations' perspective. For the beaver harvesting activities, the changes observed in the cortisol concentrations were not statistically significant (p = 0.094). However, the act of beaver dam removal was associated with a statistically significant increase in the post-participation cortisol concentration (p = 0.021). It was noteworthy that increased stress during the removal of the beaver dams-as indicated by the elevated post-activity cortisol levels-were not reflected in a decrease in the qualitative measures (semi-directed interviews and photovoice) of well-being from an Indigenous perspective. In fact, there was a noted increase in the subjective well-being of the participants, which highlights the importance of multiple perspectives when assessing well-being, especially in Indigenous peoples. However, the cortisol findings of the present pilot project need to be interpreted with caution, due to the limited sample sizes.

Two-Eyed Seeing and developmental origins of health and disease studies with indigenous partners.

Globally, mortality of Indigenous persons is greater than that of their non-Indigenous counterparts, which has been shown to be disproportionately attributable to non-communicable diseases. The historically subordinate position that Indigenous Knowledge (IK) held in comparison to Western science has shifted over the last several decades, with the credibility and importance of IK now being internationally recognized. Herein, we examine how Marsahall's (2014) Two-Eyed Seeing can foster collaborative and culturally relevant Developmental Origins of Health and Disease (DOHaD) studies for health and well-being by using '..the best in Indigenous ways of knowing…[and] the best in Western (or mainstream) ways of knowing…and learn to use both these eyes for the benefit of all.' At its core, Two-Eyed Seeing also includes the principles of ownership, control, access and possession, and Community-Based Participatory Research, which further reinforces the critical role of Indigenous peoples taking active roles in DOHaD research. Additionally, we also present a partnership model for working with Indigenous communities that includes the principles of respect, equity and empowerment. As researchers begin to fill the gap in Indigenous health, we outline how Two-Eyed Seeing should form the basis of DOHaD studies involving Indigenous communities. This model can be used to develop and guide projects that result in robust and meaningful participatory partnerships that have impactful uptake of research findings.

Environmental contaminants and the disproportionate prevalence of type-2 diabetes mellitus among Indigenous Cree women in James Bay Quebec, Canada.

Indigenous populations are disproportionately affected by type 2 diabetes (T2DM) compared to non-Indigenous people. Of importance, the prevalence of T2DM is greater amongst females than males in First Nations communities, in contrast to higher male prevalence reported in non-Indigenous Canadians. Therefore, in this study we extend our previously published work with respect to females, and the potential association between environmental exposures to organochlorine pesticides, such as dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichloroethylene (DDE) to explain the greater prevalence of T2DM among Indigenous females compared to males. Using data from the Multi-Community Environment-and-Health Study, Principal Component Analysis (PCA), examined 9-polychlorinated biphenyl congeners, 7-organic pesticides, and 4-metal/metalloids. Modified Poisson regression with robust error variance estimated adjusted prevalence ratios (PR) and corresponding 95% confidence intervals (95% CI), regressing prevalent T2DM on the newly derived principal components (PC), adjusting for a priori covariates, including parity. We further examined the relationship between high detection concentrations of DDT and tertials of categorized DDE exposures on T2DM among Indigenous Cree women. Among 419 female participants, 23% (n = 95) had physician-diagnosed T2DM. PCA analysis show that DDT and Lead (Pb) loaded highly on the second axis (PC-2), although in opposite directions, indicating the different exposure sources. As previously published, T2DM was significantly associated with PC-2 across adjusted models, however, after further adjusting for parity in this analysis, T2DM was no longer significantly associated with increasing PC-2 scores (PR = 0.88, 95% 0.76, 1.03). Furthermore, we found that the highest detectable levels of DDT, and tertiles of DDE were significantly associated with prevalent T2DM in the fully adjusted model (PR = 1.93, 1.17, 3.19), and (PR = 3.58, 1.10, 11.70), respectively. This cross-sectional analysis suggests organochlorines, specifically, detectable high exposure concentrations of DDT and DDE are associated with prevalent type 2 diabetes, signifying a possible important link between parity and environmental organochlorines pesticides among Indigenous Cree women.

The Impact of Land-Based Physical Activity Interventions on Self-Reported Health and Well-Being of Indigenous Adults: A Systematic Review.

For many Indigenous communities, decreased participation in traditional land-based activities has led to higher rates of chronic disease and a decrease in well-being. This systematic review explores how traditional land-based activities impact self-reported health and well-being of Indigenous adults, using Indigenous and Western perspectives. A search of three electronic databases (PubMed, Scopus, and Web of Science) identified nine studies which explored the experiences and perspectives of Indigenous adults taking part in land-based subsistence and ceremonial activities. A thematic analysis of these studies identified many interconnected physical, spiritual, mental, emotional, and community benefits. Community engagement throughout all stages of the interventions was an important factor in effectively addressing challenges and barriers stemming from colonization, decreased knowledge transfer, and increased use of technology. Participants reported developing more effective stress management techniques, a greater awareness of modifiable risk factors along with increased engagement with Elders. Ultimately, land-based subsistence and ceremonial activities were identified as playing an influential role in the lives of Indigenous adults. The involvement of community members allowed for the development of more culturally relevant interventions. Future community-specific research is needed to increase engagement in traditional physical-activities, improve well-being and overall reduce the risk of chronic disease.

Associations between the spatiotemporal distribution of Kawasaki disease and environmental factors: evidence supporting a multifactorial etiologic model.

The etiology of Kawasaki Disease (KD), the most common cause of acquired heart disease in children in developed countries, remains elusive, but could be multifactorial in nature as suggested by the numerous environmental and infectious exposures that have previously been linked to its epidemiology. There is still a lack of a comprehensive model describing these complex associations. We present a Bayesian disease model that provides insight in the spatiotemporal distribution of KD in Canada from 2004 to 2017. The disease model including environmental factors had improved Watanabe-Akaike information criterion (WAIC) compared to the base model which included only spatiotemporal and demographic effects and had excellent performance in recapitulating the spatiotemporal distribution of KD in Canada (98% and 86% spatial and temporal correlations, respectively). The model suggests an association between the distribution of KD and population composition, weather-related factors, aeroallergen exposure, pollution, atmospheric concentration of spores and algae, and the incidence of healthcare encounters for bacterial pneumonia or viral intestinal infections. This model could be the basis of a hypothetical data-driven framework for the spatiotemporal distribution of KD. It also generates novel hypotheses about the etiology of KD, and provides a basis for the future development of a predictive and surveillance model.

Health measures of Eeyouch (Cree) who are eligible to participate in the on-the-land Income Security Program in Eeyou Istchee (northern Quebec, Canada).

BACKGROUND: Participation in on-the-land programs that encourage traditional cultural activities may improve health and well-being. The Income Security Program (ISP) - a financial incentive-based on-the-land program - for Eeyouch (Cree) hunters and trappers in Eeyou Istchee was created as a result of the 1975 James Bay and Northern Quebec Agreement to help mitigate the effects of hydroelectric development on the Cree people of northern Quebec, Canada. Beyond the ISP's financial incentives, little is known about the health measures of those who are eligible to participate in the ISP (i.e. spent ≥120 days on-the-land during the previous year). Therefore, this paper's objective was to assess the health measures of northern Quebec Cree, who were eligible for participation in the ISP. METHODS: Using participant data (n = 545) compiled from the Nituuchischaayihtitaau Aschii Multi-Community Environment-and-Health Study, we assessed 13 different health measures in generalized linear models with the independent variable being the eligibility to participate in the ISP. RESULTS: Participants in the present study who were eligible for the ISP had significantly higher levels of vigorous and moderate activity per week, and higher concentrations of omega-3 polyunsaturated fatty acids in the blood compared to those ineligible for the ISP (i.e. spent ≤119 days on-the-land during the previous year). Encouragingly, following model adjustment for age and sex, participants eligible for the ISP did not have higher blood concentrations of mercury than those who were not eligible for the ISP. CONCLUSIONS: Our results suggest that the participants eligible for participation in the ISP are likely to be healthier than those who are ineligible to participate - and are promising for on-the-land programs for Indigenous peoples beyond a financial incentive - with no apparent higher risk of increasing contaminant body burden through traditional on-the-land-activities (e.g. fish consumption).

Environmental Contaminant Body Burdens and the Relationship with Blood Pressure Measures Among Indigenous Adults.

Blood pressure (BP) increase cardiovascular disease (CVD) risk. Indigenous Canadians experience slightly higher CVD compared with nonIndigenous Canadians. This study examined the role of polychlorinated biphenyls (PCBs), other organic compound concentrations (OCs), and toxic metals on blood pressure measures among Indigenous Canadians. METHODS: Using data from the Environment-and-Health Study, the sample was restricted to adults with valid BP measures and detectable body burden mixtures. In total, n = 759 participants were eligible, of which, n = 447(59%) were females. Principal Component Analysis (PCA) was used to reduce the complexity of the contaminant data. Orthogonal principal component (PC) variables, and sum (∑) of contaminant compounds were used as independent predictors in modified Poisson regression models with robust variance estimation, deriving prevalence ratios (PR) for hypertension, that is, systolic BP (SBP) ≥140 ml of mercury (mmHg), or diastolic BP ≥90 mm Hg. Additionally, using multivariable generalized linear regression, sex-stratified continuous SBP measure was regressed on ∑ contaminant compounds. RESULTS: Two PCs were extracted from the PCA analysis. PCBs and OCs positively highly loaded on the first axis (PC-1). Lead loaded positively on the second (PC-2) axis. Hypertension was consistently associated with PC-1 across models, PR = 1.08 (95% confidence intervals = 1.003 to 1.172) fully adjusted model. Examining ∑ of contaminants, the strength of association with hypertension was strongest for ∑OCs compared with ∑PCBs. The measure of effect for continuous SBP measures with ∑ dichlorodiphenyltrichloroethane(p,p'-DDT) and dichlorodiphenyldichloroethylene(p,p'-DDE) concentrations although small was similar for both females and males, ß = 0.04 (95% confidence intervals = 0.005 to 0.075) among females; however, for males the estimate is imprecise after adjusting for body mass index. CONCLUSION: This cross-sectional analysis found that PCBs and OCs were associated with associated prevalent hypertension; and exposure to OC pesticides, particularity DDT/DDE were found to be associated with prevalent SBP measures among females and not males.

The self-reported behaviour of Iiyiyiu Aschii Cree and the worry about pollution from industrial and hydroelectric development in northern Quebec, Canada.

Worry is influenced by environmental pollution and affects individual health and well-being; however, little is known about this association in Indigenous communities. Using logistic regression models, we examined self-reported responses among Cree adults to the question "Are you worried about the pollution of the environment (land, water or air) in Iiyiyiu Aschii?" to assess if increased worry was associated with proximity to industrial and hydroelectric development, whether increased worry was associated with self-reported behavioural changes of water consumption type in the community or bush, and days spent on-the-land. Proximity to multiple industrial and hydroelectric development sites was associated with increased worry about pollution. Notably, the decreased consumption of tap water in the community was significantly associated with increased worry, but time-on-the land was not. Overall, our study provides new findings concerning development in a Cree territory in northern Quebec, Canada, and the worry about pollution's association with self-reported behavioural changes.

Examining chronic inflammatory markers on blood pressure measures in the presence of vitamin D insufficiency among indigenous cree adults: results from the cross-sectional Multi-Community Environment-and-Health Study in Eeyou Istchee, Quebec, Canada.

OBJECTIVE: High blood pressure (BP) is a risk factor for cardiovascular disease. Examining the role of inflammatory mediators on BP is important since vitamin D (VD) is a modifiable risk factor, which possibly modulates inflammatory cytokines. This study simulated what are known as average 'controlled direct effects (CDE)' of inflammatory markers, C reactive protein (CRP), tumour necrosis factor-α (TNF-α), and interlukin-6 (IL-6) on continuous BP measures, while fixing VD, an intermediate variable to specific level. DESIGN: Cross-sectional study. SETTING: We analysed data from the Multi-Community Environment-and-Health Study, 2005-2009, conducted in Eeyou Istchee, Quebec, Canada. PARTICIPANTS: This study recruited 1425 study Indigenous Cree participants from seven Cree communities. Only adults with serum VD levels, inflammatory markers and BP measures were included in this data analysis. PRIMARY AND SECONDARY OUTCOMES MEASURES: Inflammatory markers examined the top 25th exposure percentiles. VD 'insufficiency' (ie, 25-hydroxyvitamin-D levels<50 nmol/L) defined by the Institute of Medicine. CDE for each inflammatory marker in the presence and absence of population VD insufficiency simulated the average direct effect change for systolic and diastolic BP (SBP and DBP) measures. All models were adjusted for exposure-and-mediator outcome relationship. RESULTS: Among 161 participants, 97 (60 %) were female. The prevalence of VD insufficiency was 32%. CDE estimates show in the presence and absence of population vitamin D insufficiency, inflammatory markers have a slightly different association on BP. TNF-α significantly and inversely associated with SBP in the presence of vitamin D insufficiency, fully adjusted model ß = -13.61 (95% CI -24.42 to -2.80); however, TNF-α was not associated with SBP in the absence of vitamin D insufficiency. CRP, IL-6 were also not significantly associated with BP measures, although the magnitude of association was greater for those with elevated inflammation and VD insufficiency. CONCLUSION: This novel analysis shows in the presence of VD insufficiency, inflammation (particularly TNF-α) may affect SBP. Additional research is needed to elucidate these findings, and the temporal relationship between these variables.

Potential obesogenic effect of a complex contaminant mixture on Cree First Nations adults of Northern Québec, Canada.

BACKGROUND: Obesity incidence and prevalence is of increasing concern in First Nations communities around Canada. In addition to diet and physical activity, environmental pollutants have been suggested as a potential contributory factor to obesity associated morbidity. Owing to the exposure of Cree First Nations people to various persistent organic pollutants (POPs) and toxic metals, it is important to examine the association between obesity in these communities, and contaminant body burdens. OBJECTIVE: To determine whether selected morphometry measures (body mass index [BMI], waist circumference [WC] and body fat percentage) are associated with body burdens of 10 POPs and toxic metals. METHODS: Using data from the Nituuchischaayihtitaau Aschii Multi-community Environment-and-Health study in the eastern James Bay (Eeyou Istchee) Cree communities, this cross-sectional study examined morphometric and contaminant measures of 695 eligible participants. Sex stratified principal component analysis was conducted on blood plasma concentrations of 10 POPs and toxic metals. BMI, WC, body fat percent, and resultant contaminant components were used to create generalized linear models, and adjusted for covariates (age, total lipids, smoking, and n-3 fatty acids). RESULTS: Two principal components (PCs; PC-1 and PC-2) were extracted for both males and females. For females, PC-1 explained 73.3% and PC-2 explained 10.5%, and for males, PC-1 explained 71.6% and PC-2 explained 11.2% of the variance in contaminant burden. For both sexes, PC-1 loaded highly for polychlorinated biphenyl (PCB) congeners, organochlorine pesticides and, to a lesser extent, mercury and lead. PC-2 loaded highly for cadmium for females, and cadmium and lead for males. After adjusting for covariates, the generalized linear model showed that PC-2 was significantly and negatively associated with BMI, body fat percent, and WC in males and females. CONCLUSIONS: Our cross-sectional analysis indicates a negative association between cadmium with various obesity measures in both males and females. Null associations were found between PCBs and organochlorine pesticides and morphometry.

Heart rate variation and human body burdens of environmental mixtures in the Cree First Nation communities of Eeyou Istchee, Canada.

INTRODUCTION: Heart rate variability (HRV) is a measure of cardiac autonomic regulation that examines the variation in beat-to-beat fluctuations in heart rate. While many exposure-based studies have examined the effects of single or similar groups of contaminants on HRV parameters, none have examined the association between complex environmental mixtures, including organic and elemental contaminants, and HRV. METHODS: Using data collected from the Multi-Community Environment-and-Health Study in Eeyou Istchee (Quebec, Canada), we assessed HRV in two time domain measures: root mean square of successive differences (RMSSD) and standard deviation of the N-N (RR) intervals (SDNN); and in three frequency domains: high frequency (HF), low-frequency (LF), and very-low frequency (VLF) in 443 participants. We first examined mixture effects of nineteen organic and metal contaminants in blood using principal component analysis (PCA) and a multivariable general linear regression on HRV responses, adjusting for age, sex, body mass index, smoking status, and kidney disease covariates. We subsequently assessed HRV outcome response variables using Bayesian kernel machine regression (BKMR) to further examine individual contaminant contribution and overall mixture effects. RESULTS: In the PCA, a significant positive association was observed between RMSSD and principal component (PC) axis 2, which was highly positively-loaded for nickel and moderately negatively-loaded for mercury. A negative association between SDNN and PC-1, which was highly positively-loaded for all PCBs (polychlorinated biphenyls) and organochlorines and moderately positively-loaded for mercury, was observed. Additionally, a significant and positive association was observed between PC-2 and SDNN and a significant and negative association between PC-3 (negatively loaded for cadmium) and LF. Associations with contaminants were not observed for HF or VLF. BKMR results suggest that trans-nonachlor and cis-nonachlor are primarily responsible for reductions in HRV; however, their contributions to HRV deficits was non-significant when examined as a complete mixture. CONCLUSIONS: While PCA results suggested that organochlorines, mercury, nickel, and cadmium may all play a role in altering various HRV, subsequent BKMR analysis illustrated the individual components driving these effects may be trans- and cis-nonachlor and nickel and likely not mercury or cadmium. However, other contaminants appear to temper this effect when the entire mixture of chemicals is assessed as a whole. This study expands our knowledge of the effects of environmental contaminant mixtures on HRV, which is especially important in exposed populations such as those in the Eeyou Istchee territory, whilst utilizing novel statistical methods such as PCA and BKMR to examine co-exposures concurrently.

Health and Wellness Impacts of Traditional Physical Activity Experiences on Indigenous Youth: A Systematic Review.

Traditional physical activities have numerous physiological and psychosocial benefits for Indigenous youth around the world. Little is known about the positive health and wellness impacts of traditional physical activity experiences on Indigenous youths. The aim of this systematic review is to explore the holistic health and wellness impacts of traditional physical activities on Indigenous youth from certain North American and Oceania geographic areas. A systematic search of four electronic databases (PubMed, ERIC, Scopus and Web of Science) was conducted to identify peer-reviewed publications of qualitative research exploring the diverse health experiences of traditional physical activities for Indigenous youth in Canada, the United States of America, New Zealand and Australia. A qualitative synthesis of studies between 2006 and 2018 were included, and findings were synthesized using an integrated Indigenous-ecological model, which broadly captures health and wellness impacts under intrapersonal, interpersonal, organizational, community and policy level outcomes using medicine wheel teachings. In total, nine studies were identified via this search. Overall, the literature described numerous emotional, mental and spiritual benefits of traditional physical activity, and youth experiences were affected by familial and communal relationships, and systemic factors. Among Indigenous youth, this research shows the importance of including traditional physical activity in future programs and partnerships with community expertise.

Harvest Programs in First Nations of Subarctic Canada: The Benefits Go Beyond Addressing Food Security and Environmental Sustainability Issues.

By breaking down barriers that impacted the ability of subarctic First Nations people to harvest waterfowl, the Sharing-the-Harvest program provided a safe, nutritious, and culturally appropriate food (i.e., geese) to James Bay Cree communities while also helping to protect the environment by harvesting overabundant geese. However, the impacts extend beyond those described above. Thus, the objectives of the present paper are twofold: to document the food sharing networks of the Sharing-the-Harvest program; and to examine the benefits associated with the harvest program beyond food security and environmental sustainability issues, as revealed through semi-directed interviews. In the regional initiative, harvested geese were shared with all James Bay communities; sharing is an important part of Cree culture. Where detailed information was collected, the goose-sharing network reached 76% of the homes in one of the communities. Likewise, in the local initiative, the goose-sharing network had a 76% coverage rate of the homes in the community. Although decreasing food insecurity was an important focus of the harvest-sharing programs, there were other benefits, from an Indigenous perspective, of being on the land, as identified by the Cree harvesters through semi-directed interviews (e.g., the transmission of Indigenous knowledge, the strengthening of social networks, and the feeling of wellness while out on-the-land). Thus, by participating in the on-the-land harvest programs, the Cree gained benefits beyond those solely related to strengthening food security and contributing in part to environmental sustainability. The Sharing-the-Harvest protocol has the potential to be adapted and employed by other Indigenous (or marginalized) groups worldwide, to help improve health and wellness, while, also protecting the environment from overabundant and/or invasive species.

Fisher's Linear Discriminant Function Analysis and its Potential Utility as a Tool for the Assessment of Health-and-Wellness Programs in Indigenous Communities.

Diabetes mellitus is a growing public health problem affecting persons in both developed and developing nations. The prevalence of type 2 diabetes mellitus (T2DM) is reported to be several times higher among Indigenous populations compared to their non-Indigenous counterparts. Discriminant function analysis (DFA) is a potential tool that can be used to quantitatively evaluate the effectiveness of Indigenous health-and-wellness programs (e.g., on-the-land programs, T2DM interventions), by creating a type of pre-and-post-program scoring system. As the communities of the Eeyou Istchee territory, subarctic Quebec, Canada, have varying degrees of isolation, we derived a DFA tool for point-of-contact evaluations to aid in monitoring and assessment of health-and-wellness programs in rural and remote locations. We developed several DFA models to discriminate between those with and without T2DM status using age, fasting blood glucose, body mass index, waist girth, systolic and diastolic blood pressure, high-density lipoprotein, triglycerides, and total cholesterol in participants from the Eeyou Istchee. The models showed a ~97% specificity (i.e., true positives for non-T2DM) in classification. This study highlights how varying risk factor models can be used to discriminate those without T2DM with high specificity among James Bay Cree communities in Canada.

Using a geographic information system to assess local scale methylmercury exposure from fish in nine communities of the Eeyou Istchee territory (James Bay, Quebec, Canada).

Exposure to methylmercury is a concern for those who rely on fish as a traditional food in the Eeyou Istchee territory of James Bay, Quebec, Canada, because industrial land uses overlap with community water bodies where fish are harvested. Consequently, this study assessed if traditional practices, particularly fishing, increased the risk of exposure to methylmercury from the consumption of locally harvested fish. We designed a geographic information system (GIS) that included land use and fish methylmercury tissue concentrations to assess clustering of potential hot spots. We also used generalized linear models to assess the association of fish consumption to blood organic-mercury concentrations, and logistic regression models to assess the probability of fish exceeding the safety threshold for methylmercury tissue concentrations in areas of high intensity land use. The GIS demonstrated significant clustered hot spots around regions of hydroelectric and mining land use. Our results also revealed that adult consumption of pike, lake trout and/or walleye, and child consumption of pike or walleye were significantly associated with blood organic-mercury concentrations. Further, large fish harvested in a community with high intensity land use yielded a 77% probability that the fish exceeded the safety threshold. From a human exposure perspective, our study highlights the need for further research on children who consume fish from this region.

Subsistence fishing in the Eeyou Istchee (James Bay, Quebec, Canada): A regional investigation of fish consumption as a route of exposure to methylmercury.

Fishing is part of the traditional activities of Indigenous people in Canada. However, it is also a route of exposure to methylmercury, a known neurotoxicant, and this is a concern for those who rely on fish as part of their diet. The probable weekly intake (PWI) of methylmercury from six species of fish was calculated for Indigenous community members (N = 1406), grouped by age and sex, and compared to Canadian and international provisional reference doses to assess exposure. Mixed-effects regression models were also used to estimate the input of methylmercury into the blood, and Hazard Quotients (HQ) were used to assess potential effects. Of the species of fish in our study, walleye and lake trout contributed the most to methylmercury intake. There was a positive association between the consumption of walleye and the total blood mercury concentrations of mercury in women and men (R2A = 0.40 and 0.47, respectively), and to a lesser extent, children. Similar results were observed for the consumption of lake trout. The 95th-percentile HQ for girls (3.16) and boys (3.18) from the consumption of lake trout was relatively high, and to a lesser extent, so was the HQ for walleye and pike. The consumption of some species of fish increases the exposure to methylmercury, however, taking a balanced approach, there are health benefits associated with the consumption of fish that must be considered. To mitigate future exposure to methylmercury, we recommend follow-up blood monitoring and local-geospatial-based assessments.