Nunavut: A Health System Profile

Copyright Date: 2013
Pages: 140
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  • Book Info
    Book Description:

    Based on extensive research including visits to most health centres and facilities in Nunavut, Gregory Marchildon and Renée Torgerson have produced a comprehensive review of healthcare in Canada's newest territory. Nunavut: A Health System Profile provides an in-depth examination of population health and healthcare in the territory. Little more than a decade old, Nunavut has a population that consists of thirty-thousand residents living in twenty-five widely dispersed communities. No roads connect the territory's isolated populations and nearly all supplies and equipment are transported by air. Consequently, health service delivery in Nunavut is the costliest in Canada and its operation encounters challenges more extreme than those faced elsewhere. Marchildon and Torgerson consider the historical and demographic context of healthcare in Nunavut, as well as the finances, governance, infrastructure, workforce, and program provisions that define the system. Due to a high incidence of suicide and the psychological upheaval associated with rapid societal change, the authors call particular attention to the treatment of mental health and addictions. Filling a gap in our understanding of one of Canada's most important and expensive social policies, Nunavut: A Health System Profile provides the first comprehensive review of the health system in Nunavut and the distinct health issues the territory faces.

    eISBN: 978-0-7735-8884-4
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. Tables and Figures
    (pp. vii-viii)
  4. Preface
    (pp. ix-xii)
    Gregory P. Marchildon
  5. Abbreviations
    (pp. xiii-2)
  6. 1 Nunavut: Health in Comparative Context
    (pp. 3-21)

    Little more than a decade old, Nunavut is the newest political jurisdiction in Canada. It is also unique. As the only substate in Canada in which one Indigenous group makes up a significant majority of the population, its character is defined by it being an Inuit homeland. It is also the only northern territory without any roads connecting even the largest communities, and except for a few weeks in the summer, when shipping is possible, travel between and beyond the territories is limited to air.

    The territory of Nunavut covers one-fifth of Canada’s land mass – in excess of 2.1...

  7. 2 Organizational Structures
    (pp. 22-31)

    The regions of the Eastern Arctic that now comprise the territory of Nunavut were the last in Canada to be affected by modern medicine. Before the Second World War, the Inuit of the Eastern Arctic largely relied on traditional methods of care. There were a few exceptions, mainly the Roman Catholic mission hospital in Chesterfield Inlet, the Anglican mission hospital in Pangnirtung, and the annual summer visits of the Eastern Arctic Patrol ship. Although the main functions of the Eastern Arctic Patrol were to assert Canadian sovereignty in the far north and provide transportation for Hudson’s Bay Company personnel and...

  8. 3 Health Benefits, Funding, and Expenditures
    (pp. 32-44)

    As is the case for all Canadians, residents of Nunavut have access to all “medically necessary” or “medically required” health services free of financial barriers, as required under the Canada Health Act. The Government of Nunavut (gn) provides insured hospital services pursuant to the Hospital Insurance and Health and Social Services Administration Act, and insured medical and related health care services as stipulated in the Medical Care Act (this volume, appendix A; Health Canada 2009a).

    This basket of fully covered services includes all the primary health care services delivered in community health centres and includes physician and hospital services, whether...

  9. 4 Nunavut’s Health Infrastructure
    (pp. 45-56)

    Nunavut’s health infrastructure is largely shaped by the challenge of providing a wide range of health care services to a small population dispersed across a vast geography. It is not feasible to make available in each of Nunavut’s twenty-five communities the wide range of services, especially specialized medical care, that are available in more urban southern locations. At the same time, as the chief funder of health care in the territory, the government of Nunavut has every incentive to reduce its substantial expenditure on medical travel by providing more health services closer to home. In fact, each community is provided...

  10. 5 Nunavut’s Health Workforce
    (pp. 57-84)

    The principle health workforce challenge for Nunavut, which is to ensure the right balance in human resources in order to provide adequate access to health services, is one that taxes every provincial and territorial government in Canada. However, Nunavut faces additional challenges. The lack of any road access between communities means that transportation is expensive and subject to delays owing to weather. This increases the challenges faced by health providers working in isolated communities: community health nurses (CHNs), for example, require the education, training, experience, and confidence to provide a broad range of services with relatively little on-site support from...

  11. 6 Service and Program Provision in Nunavut
    (pp. 85-109)

    Demography and geography do much to shape the mix, type, quality, and accessibility of health services and programs in Nunavut. While the population in Nunavut is young relative to other Canadian jurisdictions, many of the communities are dealing with major health challenges, including high rates of suicide, infant mortality, and communicable diseases (including outbreaks of tuberculosis created by overcrowding, poor housing, and food insecurity). High levels of unemployment and poverty exacerbate these health challenges. At least some of the current burden of disease, including high rates of lung cancer and sexually transmitted infections, is preventable through effective action at the...

  12. 7 Mental Health and Addictions
    (pp. 110-119)

    As a consequence of the high incidence of suicide, as well as substance abuse, there is increasing concern about the state of mental health in Nunavut. Registering a rate of suicide that is among the highest in the world, Nunavut’s communities have become the focus of intensive study (Nunavut et al. 2009). Multi-factor explanations vary, but most studies point to the association between rapid social change brought about by modernization and colonization and the resulting changes in family and community relationships, as well as a decline in self-esteem (Hicks 2007; Law and Hutton 2007). A further complication is the transitory...

  13. 8 Evaluating Policy, Planning, and Performance
    (pp. 120-128)

    Following the analytical description in the previous chapters, it is now possible to present a swot (strengths, weaknesses, opportunities, and threats) analysis of the health system in Nunavut. A final section addresses the potential benefits and challenges of comprehensive health service planning in Nunavut. The reader should be aware that this chapter is highly interpretive in evaluating strengths and weaknesses and necessarily speculative in identifying challenges and opportunities. Also, any identified weaknesses and threats must be put into the context that the territory has existed for a very short time relative to other provinces and even territories.

    The clearest strength...

  14. APPENDIX A Territorial Laws Related to Health and Health Care in Nunavut
    (pp. 131-132)
  15. APPENDIX B Scope of Practice for Community Health Nurses in Nunavut
    (pp. 133-135)
  16. APPENDIX C Links to Websites (current to 2010)
    (pp. 136-138)
  17. Notes
    (pp. 139-150)
  18. Bibliography
    (pp. 151-166)
  19. Index
    (pp. 167-176)