TB rate 185 times higher for Inuit than others

Tuberculosis remains a serious health problem in Canada's North, with the infection rate among Inuit 185 times greater than for others born in the country, a national analysis shows.

Canada's four main Inuit regions have a TB incidence rate of 157.5 for every 100,000 people, according to the first national analysis of 2008 data by the Public Health Agency of Canada. The rate in southern Canada is 0.8 per 100,000.

TB poses a public health threat because those infected can spread it when they cough, sneeze or talk.

First Nations and Inuit continue to experience the legacy of colonization, when TB spread widely in their communities since they lacked any immunity. Elders who lived through an age of sanatoriums are now at risk for reactivation of their infections, said Gail Turner, head of Inuit Tapirisat's national health committee.

"TB will never be eliminated until housing is improved, food security is improved, and the access to health care for Inuit is closer to what other Canadians take for granted," she told a news conference in Ottawa on Wednesday.

"This is our lived reality. Canada must own the problem. TB in Inuit is TB in Canada."

Eighty-seven Inuit, in a community of only 55,000, had tuberculosis in 2008. In the non-aboriginal, non-immigrant population of Canada, there were 209 cases that year.

The largest number of infections was among foreign-born residents, at 985 cases, according to the Public Health Agency of Canada.

Poor living conditions

The figures reflect active cases of tuberculosis and do not include those who have been exposed to the disease but haven't developed infection, Turner noted.

Tuberculosis can flourish in overcrowded homes where one infected person may live with 11 others, affordable, nutritious food is less available and smoking rates are high, said Turner. In the North, patients may need to be flown out for health services such as chest X-rays, and housing can be ill suited to the Arctic climate, she said.

Catherine Moise of Lac Brochet First Nation in northern Manitoba was a patient at a TB sanatorium for weeks in 1964. She later lost a newborn, Agnes, to TB.

"I didn't see my little girl's body. Nothing. She was just took away like that," Moise said. She only found out where her daughter was buried a few months ago.

Moise pointed to poor living conditions, such as mouldy homes, as one of the main reasons for the higher rates of TB in First Nations communities. Moise also underlined the importance of taking medications as prescribed to prevent infections from returning, noting three of her other children have also had tuberculosis.

"The main reasons that First Nations suffer from high rates of tuberculosis are the same reasons that cause First Nations to be particularly vulnerable, as an example, to the spread of H1N1 last year," said AFN Regional Chief Angus Toulouse, who holds the group's national portfolio for health. "Overcrowded housing, a lack of access to clean water and a lack of access to quality medical care."

Toulouse asked for federal and provincial governments and members of all political parties to confront the problem, noting 26 per cent of First Nations people live in overcrowded dwellings.

The federal government has granted stimulus funds specifically for native housing, and last week's federal budget promised more money to improve native education and to fix drinking water issues on reserves.

One in five First Nations adults weren't able to see a doctor or nurse over the course of a year, Toulouse said, a problem that hasn't been addressed.

Likewise, Judy Wasylycia-Leis, the NDP health critic and MP for Winnipeg North, called for an emergency debate, urging the federal government to come up with a plan to address the problem.

Health Minister Leona Aglukkaq said Wednesday that her government is working closely with the provinces and territories to curb the spread of the disease in aboriginal populations.