Community Setting as a Determinant of Health for Indigenous Peoples Living in the Prairie Provinces of Canada: High Rates and Advanced Presentations of Tuberculosis

IF 0.8 Q3 ANTHROPOLOGY
M. Mayan, R. Gokiert, T. Robinson, M. Tremblay, S. Abonyi, Kirstyn Morley, R. Long
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引用次数: 5

Abstract

Indigenous Peoples in Canada experience disproportionately high tuberculosis (TB) rates, and those living in the Prairie Provinces have the most advanced TB presentations (Health Canada, 2009). The community settings (i.e., urban centres, non-remote reserves, remote reserves, and isolated reserves) where Indigenous Peoples live can help explain high TB rates. Through qualitative description, we identify how community setting influenced Indigenous people’s experiences by (a) delaying accurate diagnoses; (b) perpetuating shame and stigma; and (c) limiting understanding of the disease. Participants living in urban centres experienced significant difficulties obtaining an accurate diagnosis. Reserve community participants feared being shamed and stigmatized. TB information had little impact on participants’ TB knowledge, regardless of where they lived. Multiple misdiagnoses (primarily among urban centre participants), being shamed for having the disease (primarily reserve community participants), and a lack of understanding of TB can all contribute to advanced presentations and high rates of the disease among Indigenous Peoples of the Prairie Provinces.
社区环境是加拿大草原省份土著人民健康的决定因素:结核病发病率高和发病率高
加拿大土著人民的肺结核发病率高得不成比例,而生活在草原省份的土著人民的结核病发病率最高(加拿大卫生部,2009年)。土著人民居住的社区环境(即城市中心、非偏远保护区、偏远保护区和孤立保护区)有助于解释结核病发病率高的原因。通过定性描述,我们确定了社区环境如何通过(a)延迟准确诊断来影响土著人的经历;(b) 使耻辱和耻辱永久存在;以及(c)限制对该疾病的了解。生活在城市中心的参与者在获得准确诊断方面遇到了重大困难。预备役社区的参与者害怕被羞辱和污名化。结核病信息对参与者的结核病知识几乎没有影响,无论他们住在哪里。多次误诊(主要是在城市中心参与者中)、因患有结核病而感到羞耻(主要是后备社区参与者)以及对结核病缺乏了解,都可能导致草原省土著人民对结核病的发病率高。
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来源期刊
CiteScore
1.90
自引率
0.00%
发文量
12
审稿时长
16 weeks
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