Jump to full article: Canadian Medical Association Journal (ca), 2009-07-17
Author: Pamela H. Orr, MSc MD
Intro: Lower respiratory tract infection is a major cause of illness and death among the Inuit children of Nunavut. . . .
The search for risk factors for lower respiratory tract infection in Inuit children has taken researchers to the 3 corners of the epidemiologic triangle: environment, host and agent. In this issue of CMAJ, Kovesi and colleagues6 explore the relation between environmental indoor air quality and lower respiratory tract infection in Inuit children. . . .
The prevalence of smokers in the study sample (93.9% of households) and a failure to differentiate the location of smoking (inside or outside the house) precluded any meaningful analysis of this variable as a risk factor for lower respiratory tract infection in the household child. . . .
Well-designed prospective community studies to determine the full spectrum of infectious causes of respiratory tract infection in Inuit children are lacking. With regard to the host, we have an incomplete understanding of genetic markers for susceptibility or resistance to infectious and inflammatory disease among the Inuit. Deficiencies in humoral and cell-mediated host genetic response to infections and to selected vaccines have been identified among the Inuit.4,15
Apparently heeding the admonishment of the Old Testament prophet Isaiah to "Set thine house in order" (Isaiah 38:1), the government of Nunavut developed the Nunavut Ten-Year Inuit Housing Action Plan,9 which calls on the federal government to honour its obligations to the Inuit of Nunavut. The word "thine" should be understood to encompass joint "ownership" of the task on the part of funders, designers, builders and occupants. The word "order" defines an environment that supports and promotes health in its broadest sense. . . .
Key points
* Inuit children experience high rates of illness and death from lower respiratory tract infection
* Overcrowding (due to an undersupply of housing) and inadequate ventilation (because of high occupant density, construction problems and harsh climate) of houses have been identified as associated factors
* Healthy housing in northern communities is required to improve the health and well-being of Inuit children
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