Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada.
Département de pédiatrie, Faculté de Médecine, Université Laval, Québec, QC, Canada.
Can J Public Health. 2024 Jan;115(Suppl 1):97-113. doi: 10.17269/s41997-023-00750-z. Epub 2023 Apr 20.
Distress and associated health problems reported by Nunavik Inuit emanate from heterogeneous roots, including adverse childhood experiences. This study aims to (1) identify distinct childhood adversity profiles and (2) examine associations between these profiles and sex, socioeconomic characteristics, social support, and community involvement among Nunavimmiut.
In a sample of 1109 adult Nunavimmiut, sex, socioeconomic characteristics, support, community involvement, residential school attendance, and 10 forms of adverse childhood experiences (ACEs) were documented using questionnaires. Latent class analyses and weighted comparisons were performed for three subgroups: 18-49 years; 50 years and above with experience of residential school; and 50 years and above without experience of residential school. The analysis design, the manuscript drafts, and the key findings were discussed and co-interpreted with the collaboration of community representatives, taking into consideration Inuit culture and needs.
A total of 77.6% of Nunavimmiut reported having experienced at least one form of childhood adversity. Three ACE profiles were identified among the 18-49-year-olds: low ACEs (43.0%), household stressors (30.7%), and multiple ACEs (26.3%). Two profiles characterized ACEs experienced among the 50-year-olds and over with and without history of residential schooling: low ACEs (80.1% and 77.2%, respectively) and multiple ACEs (19.9% and 22.8%, respectively). Among the group of 18-49-year-olds, as compared to the low ACE profile, the profile with household stressors included proportionally more women (odds ratio [OR] = 1.5) and was associated with lower involvement in volunteering and community activities (mean score reduced by 0.29 standard deviation [SD]) and lower family cohesion (SD = - 0.11), while the multiple ACE profile was related to a lower rate of employment (OR = 0.62), lower family cohesion (SD = - 0.28), and lower satisfaction with ability to practice traditional activities (SD = - 0.26).
Childhood adversities among Nunavimmiut do not occur in isolation and experiencing multiple forms of childhood adversities predicts lower socioeconomic status, support, and community involvement in adulthood. Implications for the planning of health and community services in Nunavik are discussed.
努纳武特因纽特人报告的困扰和相关健康问题源于多种根源，包括不良的童年经历。本研究旨在：(1)确定不同的儿童逆境特征；(2) 研究这些特征与性别、社会经济特征、社会支持以及努纳武特人社区参与之间的关系。
在 1109 名成年努纳武特人样本中，使用问卷记录了性别、社会经济特征、支持、社区参与、寄宿学校就读情况以及 10 种形式的儿童期逆境经历（ACEs）。对三个亚组进行潜在类别分析和加权比较：18-49 岁；有寄宿学校经历的 50 岁及以上；无寄宿学校经历的 50 岁及以上。分析设计、手稿草稿和主要发现与社区代表进行了讨论和共同解释，同时考虑了因纽特文化和需求。
77.6%的努纳武特人报告至少经历过一种形式的儿童逆境。在 18-49 岁的人群中确定了三种 ACE 特征：低 ACEs（43.0%）、家庭压力源（30.7%）和多种 ACEs（26.3%）。有和没有寄宿学校经历的 50 岁及以上人群中存在两种 ACE 特征：低 ACEs（分别为 80.1%和 77.2%）和多种 ACEs（分别为 19.9%和 22.8%）。在 18-49 岁的人群中，与低 ACE 特征相比，有家庭压力源的特征比例更高的女性（优势比[OR] = 1.5），与参与志愿服务和社区活动减少（平均分数减少 0.29 标准差[SD]）和家庭凝聚力降低（SD = -0.11）有关，而多种 ACE 特征与较低的就业率（OR = 0.62）、较低的家庭凝聚力（SD = -0.28）和较低的传统活动实践能力满意度（SD = -0.26）有关。
努纳武特儿童的逆境并非孤立发生，经历多种形式的儿童逆境预示着成年后社会经济地位、支持和社区参与度较低。讨论了对努纳武特卫生和社区服务规划的影响。
