Exploring the Impacts of COVID-19 on Indigenous Peoples in the Northwest Territories

• Author / Creator

  Qadri, Ali H

• Background
  COVID-19 has impacted health and well-being globally; some populations have been disproportionately impacted. The experience of Indigenous peoples living in Northern Canada during the COVID-19 pandemic is influenced by their cultural and geographical context. Indigenous peoples in Canada have experienced high disease burden from previous pandemics and epidemics, as a result of colonial practices and adverse social determinants of health. Northern communities in Canada are more vulnerable to COVID-19, due to limited healthcare access, geographic isolation, and lack of infrastructure, such as housing. Thus, COVID-19 may pose a greater health risk to Indigenous peoples in Northern Canada. This thesis explores the experiences of Indigenous peoples living in Northern Canada during the COVID-19 pandemic, and aims to provide high-level policy recommendations for future pandemic response.
  Methods
  This research used a mixed methods research (MMR) study design. Components of the study design included: (1) a secondary data analysis of a GNWT COVID-19 dataset, (2) individual interviews with Indigenous Elders, using a descriptive qualitative approach; and (3) a literature review to identify unintended consequences of COVID-19 public health measures in the NWT. MMR was chosen as it allowed the research area to be studied from different perspectives, and provided appropriate contextualization (Regnault, 2018).
  (1) GNWT COVID-19 Dataset
  Secondary analysis of a COVID-19 case dataset maintained by the Government of Northwest Territories was performed. The age, sex, and regional distributions of COVID-19 cases and severe outcomes for Indigenous and non-Indigenous populations were described. COVID-19 case and severe outcome cumulative incidences for Indigenous and non-Indigenous populations were compared using Fisher’s Exact test.
  (2) Interviews with Indigenous Elders
  A descriptive qualitative approach was used to explore the experience of Indigenous people during COVID-19 in the Northwest Territories. Purposive sampling was used to identify and select Indigenous individuals who had rich knowledge and understanding of COVID-19 in the Northern context. Semi-structured individual interviews were conducted with Indigenous Elders and Knowledge Holders. Interviews were recorded by audio and handwritten notes, and analyzed using inductive thematic analysis.
  (3) Social Harms of COVID-19
  A review of published and gray literature was conducted to identify social harms and unintended consequences of COVID-19 public health measures in the NWT.
  
  Results
  (1) GNWT COVID-19 Dataset
  There were 9,294 cases of COVID-19 cases in the NWT between March 1, 2020 and March 31, 2022; 6,206 (67%) were Indigenous and 3,086 (33%) were non-Indigenous. Indigenous peoples had a higher cumulative incidence of COVID-19 than the non-Indigenous population overall (RR 2.12, 95% CI 2.04, 2.20, p<0.001), and for all sex, age-group and regional strata, except for the 0-4 age group strata.
  180 cases between March 2020 and March 2023 experienced a severe outcome associated with COVID-19; 146 (81%) were Indigenous and 34 (19%) were non-Indigenous. There were 34 deaths associated with COVID-19 cases, 27 (79%) were Indigenous and 7 (21%) were non-Indigenous. Indigenous peoples experienced cumulative incidences of severe outcomes and deaths that were over four times higher than those of non-Indigenous people (Severe Outcomes IRR 4.89, 95% CI 3.51, 6.83, p<0.001; Mortality IRR 4.07, 95% CI 1.77, 9.33, p<0.001).
  (2) Interviews with Indigenous Elders
  Four interviews were conducted, and four themes and thirteen sub-themes were identified after thematic analysis. The four overarching themes were (i) Social & Health Inequities due to colonization have been exacerbated by COVID-19 (ii) COVID-19 has adversely impacted relationships and community, and resulted in social harms (iii) Effective communication, planning and preparedness are crucial and (iv) Indigenous peoples are sovereign.
  (3) Social Harms of COVID-19
  Five sources of gray literature were identified in the literature review. Social harms identified in this review were categorized into three categories: education, substance use, and mental health.
  Discussion
  Available data shows disproportionately outcomes from the COVID-19 pandemic for Indigenous peoples. Limitations include lack of COVID-19 testing and medical comorbidities data. Moving forward, we need an intersectoral approach to address the harms from the COVID-19 pandemic and to address these inequities. This approach must be co-created with Indigenous communities, respecting Indigenous sovereignty and knowledge systems. This approach should incorporate considerations around, but not limited to: Indigenous research capacity, Indigenous sovereignty, health, and emergency preparedness.

• Subjects / Keywords

  • COVID-19
  • Indigenous
  • Northwest Territories

• Graduation date

  Spring 2024

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-7a8g-pt72

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.