Addressing social determinants of health is a priority for managing COVID-19 in Arctic Indigenous communities: results of a scoping review

Abstract

Abstract Background. Arctic Indigenous communities are unique, geographically remote and/or isolated, and currently among the most susceptible populations in the world to the effects of the coronavirus disease 2019 (COVID-19) pandemic. Since colonization, Indigenous communities have been particularly susceptible to infectious disease outbreaks. Methods. This study reviewed current knowledge regarding social determinants of health (SDH) and pandemics in Arctic Canada and highlighted the implications of the current COVID-19 pandemic on individuals, families, and communities in Arctic Canada.Studies published in English and French pertaining to SDH or pandemics in the Canadian Arctic were located using key search words in three databases (PubMed, Medline, and CINAHL) as well as reference tracking of relevant articles up to September 2021. Studies were categorized according to infectious disease (COVID-19, H1N1 influenza, and tuberculosis) or SDH (healthcare access, food security, mental health, socioeconomic status, cultural continuity, housing, and community infrastructure). NVivo was used to theme and sub-theme findings of selected studies.Results. One hundred studies were included in this scoping review. Two articles related to COVID-19, five to influenza, and five to TB; 27 healthcare access, 19 to food security, 17 to mental health, nine to SES, seven to cultural continuity, six to housing, and three to community infrastructure. Documented lessons learned from previous pandemics in Arctic communities provides evidence to inform public health policies and culturally safe programs for the current COVID-19 pandemic where many SDH exist as challenges for Indigenous communities. The SDH included limited healthcare access, food insecurity, mental health challenges, low socioeconomic status, limited cultural considerations in healthcare, and suboptimal housing. These findings are also relevant to Indigenous communities in other Arctic regions facing similar challenges due to the pandemic.Conclusions.: It is essential to understand how SDH underlie the health and wellbeing of Indigenous communities in the Arctic and to utilize this information to inform critical policy and practice decisions for COVID-19 prevention, management, and treatment. This review indicated that many SDH are unique to Canadian Arctic settings and pose specific challenges for the prevention and management of infectious diseases, such as COVID-19.