Inuit youth face challenges in maintaining their wellbeing, stemming from continued impacts of colonisation. Recent work documented that urban centres, such as Winnipeg Canada, have large Inuit populations comprised of a high proportion of youth. However, youth lack culturally appropriate health and wellbeing services. This review aimed to scan peer-reviewed and grey literature on Inuit youth health and wellbeing programming in Canada. This review is to serve as an initial phase in the development of Inuit-centric youth programming for the Qanuinngitsiarutiksait program of research. Findings will support further work of this program of research, including the development of culturally congruent Inuit-youth centric programming in Winnipeg. We conducted an environmental scan and used an assessment criteria to assess the effectiveness of the identified programs. Results showed that identified programs had Inuit involvement in creation framing programming through Inuit knowledge and mostly informed by the culture as treatment approach. Evaluation of programs was diffcult to locate, and it was hard to discren between programming, pilots or explorative studies. Despite the growing urban population, more non-urban programming was found. Overall, research contributes to the development of effective strategies to enhance the health and wellbeing of Inuit youth living in Canada.

Halogenated organophosphate esters (OPEs) are increasingly used as flame retardants to replace polybrominated diphenyl ethers (PBDEs), which have been phased out due to their confirmed persistence, toxicity, and ability to undergo long range atmospheric transport. Non-halogenated OPEs are primarily used as plasticizers. While human exposure to PBDEs in the Canadian Arctic is well documented, it is not the case for OPEs. To assess the exposure to OPEs in Inuit living in Nunavik (northern Québec, Canada), we measured 16 metabolites of halogenated and non-halogenated OPEs in pooled urine samples from the last population health survey conducted in Nunavik, the Qanuilirpitaa? 2017 Inuit Health Survey (Q2017). Urine samples (n = 1266) were pooled into 30 pools by sex (female; male), age groups (16-19; 20-29; 30-39; 40-59; 60+ years old) and regions (Hudson Bay; Hudson Strait; Ungava Bay). Q2017 geometric means and 95 % confidence intervals were compared with data from the Canadian Health Measures Survey Cycle 6 (2018-2019) (CHMS). Halogenated OPEs were systematically detected and generally found at higher concentrations than non-halogenated OPEs in both Q2017 and CHMS. Furthermore, urinary levels of BCIPP and BDCIPP (halogenated) were lower in Q2017 compared to CHMS while concentrations of DPhP, DpCP and DoCP (non-halogenated) were similar between Q2017 and CHMS. Across the 16 metabolites measured in Q2017, BCIPHIPP (halogenated) had the highest levels (geometric mean: 1.40 μg/g creatinine). This metabolite was not measured in CHMS and should be included in future surveys. Overall, our results show that Inuit in Nunavik are exposed to lower or similar OPEs levels than the rest of the general Canadian population suggesting that the main current exposure to OPEs may be from consumer goods containing flame retardants and imported from the south rather than long-range atmospheric transport to the Arctic.

Disease prevalence and mean phenotype values differ between many populations, including Inuit and Europeans. Whether these differences are partly explained by genetic differences or solely due to differences in environmental exposures is still unknown, because estimates of the genetic contribution to these means, which we will here refer to as mean genotypic values, are easily confounded, and because studies across genetically diverse populations are lacking.
Leveraging the unique genetic properties of the small, admixed and historically isolated Greenlandic population, we estimated the differences in mean genotypic value between Inuit and European genetic ancestry using an admixed sibling design. Analyses were performed across 26 metabolic phenotypes, in 1474 admixed sibling pairs present in a cohort of 5996 Greenlanders.
After FDR correction for multiple testing, we found significantly lower mean genotypic values in Inuit genetic ancestry compared to European genetic ancestry for body weight (effect size per percentage of Inuit genetic ancestry (se), -0.51 (0.16) kg/%), body mass index (-0.20 (0.06) kg/m2/%), fat percentage (-0.38 (0.13) %/%), waist circumference (-0.42 (0.16) cm/%), hip circumference (-0.38 (0.11) cm/%) and fasting serum insulin levels (-1.07 (0.51) pmol/l/%). The direction of the effects was consistent with the observed mean phenotype differences between Inuit and European genetic ancestry. No difference in mean genotypic value was observed for height, markers of glucose homeostasis, or circulating lipid levels.
We show that mean genotypic values for some metabolic phenotypes differ between two human populations using a method not easily confounded by possible differences in environmental exposures. Our study illustrates the importance of performing genetic studies in diverse populations.

UNASSIGNED: Previous studies have identified the consumption of country foods (hunted/harvested foods from the land) as the primary exposure source of perfluoroalkyl acids (PFAA) in Arctic communities. However, identifying the specific foods associated with PFAA exposures is complicated due to correlation between country foods that are commonly consumed together.
UNASSIGNED: We used venous blood sample data and food frequency questionnaire data from the Qanuilirpitaa? (\"How are we now?\") 2017 (Q2017) survey of Inuit individuals ≥16 y of age residing in Nunavik (n=1,193). Adaptive elastic net, a machine learning technique, identified the most important food items for predicting PFAA biomarker levels while accounting for the correlation among the food items. We used generalized linear regression models to quantify the association between the most predictive food items and six plasma PFAA biomarker levels. The estimates were converted to percent changes in a specific PFAA biomarker level per standard deviation increase in the consumption of a food item. Models were also stratified by food type (market or country foods).
UNASSIGNED: Perfluorooctanesulfonic acid (PFOS), perfluorodecanoic acid (PFDA), and perfluoroundecanoic acid (PFUnDA) were associated with frequent consumption of beluga misirak (rendered fat) [14.6%; 95% confidence interval (CI): 10.3%, 18.9%; 14.6% (95% CI: 10.1%, 19.0%)], seal liver [9.3% (95% CI: 5.0%, 13.7%); 8.1% (95% CI: 3.5%, 12.6%)], and suuvalik (fish roe mixed with berries and fat) [6.0% (95% CI: 1.3%, 10.7%); 7.5% (95% CI: 2.7%, 12.3%)]. Beluga misirak was also associated with higher concentrations of perfluorohexanesulphonic acid (PFHxS) and perfluorononanoic acid (PFNA), albeit with lower percentage changes. PFHxS, perfluorooctanoic acid (PFOA), and PFNA followed some similar patterns, with higher levels associated with frequent consumption of ptarmigan [6.1% (95% CI: 3.2%, 9.0%); 5.1% (95% CI: 1.1%, 9.1%); 5.4% (95% CI: 1.8%, 9.0%)]. Among market foods, frequent consumption of processed meat and popcorn was consistently associated with lower PFAA exposure.
UNASSIGNED: Our study identifies specific food items contributing to environmental contaminant exposure in Indigenous or small communities relying on local subsistence foods using adaptive elastic net to prioritize responses from a complex food frequency questionnaire. In Nunavik, higher PFAA biomarker levels were primarily related to increased consumption of country foods, particularly beluga misirak, seal liver, suuvalik, and ptarmigan. Our results support policies regulating PFAA production and use to limit the contamination of Arctic species through long-range transport. https://doi.org/10.1289/EHP13556.

The Circumpolar region, comprising the Arctic territories encircling the North Pole, is home to diverse Indigenous cultures facing unique socio-economic challenges. Indigenous communities such as the Inuit, Sámi, Athabaskan, Gwitchin, and Russian Arctic groups exhibit rich traditions and adaptive practices tied to their environments. Environmental diversity, from icy tundra to boreal forests, influences livelihoods and biodiversity, while significant socio-economic disparities persist, impacting access to healthcare, education, and economic opportunities. Against this backdrop, the global COVID-19 pandemic accentuated the intersection of environment, culture, and health in remote Arctic regions, presenting distinct challenges and opportunities. Initiated by a collaborative research project led by Fulbright Arctic Initiative Alumni, this special issue of the International Journal of Circumpolar Health explores the impacts of COVID-19 on Arctic Indigenous and rural communities. Building on previous work and recommendations, the issue features community case studies, highlighting community experiences and collaborative approaches to understand and address the pandemic\'s effects. The authors highlight both positive and negative societal outcomes, presenting community-driven models and evidence-based practices to inform pan-Arctic collaboration and decision-making in public health emergencies. Through sharing these insights, the special issue aims to privilege local and Indigenous knowledge systems, elevates community responses to complex and multifaceted challenges, and contributes to the evidence base on global pandemic response.

OBJECTIVE: Indigenous public health theory and the voices of Canadian Indigenous communities remain under-represented in the literature despite the Canadian Truth and Reconciliation Calls to Action, and the perspectives of Inuit are further under-represented in this literature. The goal of this paper is to explore the perspectives of Iqalungmiut (people of Iqaluit), frontline staff, and decision-makers on the management of the COVID-19 outbreak in Iqaluit in April to June 2021 and to identify lessons learned and contributions to public health policy and practice specific to Inuit populations in Canada.
METHODS: This study used the Piliriqatigiinniq Community Health Research Model which was developed by Nunavummiut to guide community-based health and well-being research. Interviews were conducted with 44 individuals: 22 community members and shelter users; 17 frontline workers; and 5 decision-makers representing municipal and territorial government. Participants were asked about their experiences during the outbreak, sources of information, and strengths and challenges during outbreak management.
RESULTS: Challenges included overcrowding, physical disconnection from family members, and mental health and trauma. Community-identified strengths included strong interagency cooperation, food hamper and COVID-19 care kit deliveries, and travel restrictions. Several Inuit positive health-protective pathways were identified including Ilaginniq; Silativut; Inuuqatigiittiarniq; Piliriqatigiinniq; Ikajurniq; and Pijitsirniq.
CONCLUSIONS: Outbreaks of infectious illness are not new to Nunavut communities and Inuit protective pathways have and continue to be critical avenues to adapt to and mitigate such challenges. This exploratory study provides clear direction for Inuit public health policy and practice in Canada, while contributing to the body of literature on Indigenous public health theory.
RéSUMé: OBJECTIFS: La théorie de la santé publique autochtone et les voix des communautés autochtones canadiennes sont encore sous-représentées dans la littérature scientifique malgré les Appels à l’action de la Commission de vérité et réconciliation du Canada; les points de vue des Inuits sont encore moins représentés dans cette littérature. Notre article vise à explorer les points de vue des Iqalungmiut (les habitantes et les habitants d’Iqaluit), des personnels de première ligne et des décideurs et décideuses au sujet de la gestion de l’éclosion de COVID-19 à Iqaluit entre avril et juin 2021, ainsi qu’à recenser les leçons apprises et les contributions aux politiques et aux pratiques de santé publique propres aux populations inuites du Canada. MéTHODE: L’étude a fait appel au modèle de recherche en santé communautaire Piliriqatigiinniq, élaboré par des Nunavummiut pour orienter la recherche sur la santé et le bien-être des communautés. Des entretiens ont été menés auprès de 44 personnes : 22 résidentes et résidents et utilisateurs et utilisatrices de refuges; 17 intervenantes et intervenants de première ligne; et 5 décideurs et décideuses représentant l’administration municipale et le gouvernement territorial. Ces personnes ont été interrogées au sujet de leurs expériences pendant l’éclosion, de leurs sources d’informations et de leurs forces et leurs limites durant la gestion de l’éclosion. RéSULTATS: Les difficultés rencontrées ont été l’entassement, la séparation physique des autres membres de la famille, les problèmes de santé mentale et les traumatismes. Les forces citées par la communauté ont été la solidité de la coopération interservices, les livraisons de paniers alimentaires et de trousses de soins de la COVID-19, et les restrictions des déplacements. Plusieurs voies inuites de protection de la santé ont été recensées : Ilaginniq; Silativut; Inuuqatigiittiarniq; Piliriqatigiinniq; Ikajurniq et Pijitsirniq. CONCLUSION: Les éclosions de maladies infectieuses n’ont rien de nouveau pour les communautés du Nunavut, et les voies protectrices inuites continuent d’être des moyens essentiels pour ces communautés d’aplanir les difficultés de la sorte et de s’y adapter. Notre étude préliminaire fournit une orientation claire pour les politiques et les pratiques de santé publique inuites au Canada tout en contribuant au corpus de recherche sur la théorie de la santé publique autochtone.

UNASSIGNED: Health research in Greenlanders is challenged by a small population, few dedicated researchers and limited funding. Some research areas have proven impactful but gaps in knowledge are unknown. We aimed to quantify health research in Greenland, providing insights for researchers, policymakers and funding agencies to guide future research.
UNASSIGNED: We identified all peer-reviewed health research publications with the term \'Greenland***\' in title or abstract from 2001 to 2020 through the platform entitled The Lens. Our bibliometric analysis included number of publications, publication rate, research types, research topics, citations and author affiliations, as well as funding.
UNASSIGNED: From 2001 to 2020, a total of 640 health research publications concerning Greenland or Greenlanders were identified, with an average annual publication growth rate of 2.9%. The major health research topics studied in Greenland were infectious diseases, environmental health and general health. Several research fields, including rheumatology, nephrology and dermatology among others proved understudied at best. Three Danish universities contributed with 33% of all publications, with the International Journal of Circumpolar Health (N=176, 28%) being the top journal destination. The most productive author had 119 article authorships during the period.
UNASSIGNED: During the past 20 years, Greenland\'s annual publication rate has been steadily increasing, with an average of 32 articles about health research published each year, which is a higher publication rate than world average. The health research in Greenland is primarily epidemiologic with infectious disease being the most studied research area. Most publications were anchored in Denmark and centred around a few highly productive authors.

The goal of this study was to examine and address critical knowledge gaps and develop an understanding of both the positive and negative societal outcomes resulting from the public health measures associated with the COVID-19 pandemic in Nunavut and the interventions being undertaken to promote positive well-being. Data collection for this study included narrative, in-person interviews in Iqaluit, Rankin Inlet, Baker Lake, and Cambridge Bay between September 2022 and January 2023. A total of 70 participants were interviewed for this study. Community highlighted challenges, such as crowding and food insecurity, and concern for the collective wellbeing of the community. Strengths included financials supports, food sharing, and maintaining community connections over a distance. Recommendations included a focus on holistic health such as 1) public education and awareness about communicable disease, 2) financial supports, 3) housing, 4) access to healthcare, 5) focus on Inuit Qaujimajatuqangit, 6) mental-health and addiction supports, and 7) community spaces. Community members described both strengths and challenges they believe impacted their experiences and service delivery as well as recommendations for the future.

Globally and historically, Indigenous healthcare is efficacious, being rooted in Traditional Healing (TH) practices derived from cosmology and place-based knowledge and practiced on the land. Across Turtle Island, processes of environmental dispossession and colonial oppression have replaced TH practices with a colonial, hospital-based system found to cause added harm to Indigenous Peoples. Growing Indigenous health inequities are compounded by a mental health crisis, which begs reform of healthcare institutions. The implementation of Indigenous knowledge systems in hospital environments has been validated as a critical source of healing for Indigenous patients and communities, prompting many hospitals in Canada to create Traditional Healing Spaces (THSs). After ten years, however, there has been no evaluation of the effectiveness of THSs in Canadian hospitals in supporting healing among Indigenous Peoples. In this paper, our team describes THSs within the Center for Addiction and Mental Health (CAMH), Canada\'s oldest and largest mental health hospital. Analyses of 22 interviews with hospital staff and physicians describe CAMH\'s THSs, including what they look like, how they are used, and by whom. The results emphasize the importance of designating spaces with and for Indigenous patients, and they highlight the wholistic benefits of land-based treatment for both clients and staff alike. Transforming hospital spaces by implementing and valuing Indigenous knowledge sparks curiosity, increases education, affirms the efficacy of traditional healing treatments as a standard of care, and enhances the capacity of leaders to support reconciliation efforts.

Since 1993, dietary assessment has been carried out in Greenland as part of recurrent population health surveys. In preparation for the next survey in 2024, 91 participants from the survey in 2018 were selected for a validation study of the Food Frequency Questionnaire (FFQ). The 91 participants were reinterviewed 38-50 months after the first FFQ and invited to complete a food diary. As part of the 2018 survey, blood was analysed for mercury. The food diary was completed by 65 participants. The agreement between the two FFQ interviews was very good for macronutrients and fatty acids (p > 0.20), whereas the calculated intake of mercury was 22% higher in the second FFQ (p = 0.04) due to a higher intake of whale meat and muktuk (whale skin). The agreement between the second FFQ and the food diary was good for local food, imported meat and cakes/sweets/snacks but fruit and vegetables, dairy products, beverages and added sugar were significantly underreported in the food diary. Food items not included in the FFQ were identified from the food diaries. The correlation between the intake of marine mammals and blood mercury was moderate (Spearman\'s rho = 0.41-0.50; p < 0.0001). The results will inspire future dietary studies in the circumpolar North.