title: Healthcare use for acute gastrointestinal illness in two Inuit communities: Rigolet and Iqaluit, Canada.
abstract: BACKGROUND
  The incidence of self-reported acute gastrointestinal illness (AGI) in Rigolet, Nunatsiavut, and Iqaluit, Nunavut, is higher than reported elsewhere in Canada; as such, understanding AGI-related healthcare use is important for healthcare provision, public health practice and surveillance of AGI.
  
  
  OBJECTIVE
  This study described symptoms, severity and duration of self-reported AGI in the general population and examined the incidence and factors associated with healthcare utilization for AGI in these 2 Inuit communities.
  
  
  METHODS
  Cross-sectional survey data were analysed using multivariable exact logistic regression to examine factors associated with individuals' self-reported healthcare and over-the-counter (OTC) medication utilization related to AGI symptoms.
  
  
  RESULTS
  In Rigolet, few AGI cases used healthcare services [4.8% (95% CI=1.5-14.4%)]; in Iqaluit, some cases used healthcare services [16.9% (95% CI=11.2-24.7%)]. Missing traditional activities due to AGI (OR=3.8; 95% CI=1.18-12.4) and taking OTC medication for AGI symptoms (OR=3.8; 95% CI=1.2-15.1) were associated with increased odds of using healthcare services in Iqaluit. In both communities, AGI severity and secondary symptoms (extreme tiredness, headache, muscle pains, chills) were significantly associated with increased odds of taking OTC medication.
  
  
  CONCLUSIONS
  While rates of self-reported AGI were higher in Inuit communities compared to non-Inuit communities in Canada, there were lower rates of AGI-related healthcare use in Inuit communities compared to other regions in Canada. As such, the rates of healthcare use for a given disease can differ between Inuit and non-Inuit communities, and caution should be exercised in making comparisons between Inuit and non-Inuit health outcomes based solely on clinic records and healthcare use.
authors.affiliation: Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada; harpers@uoguelph.ca.
authors.forename: Sherilee L
authors.initials: SL
authors.lastname: Harper
authors.affiliation: Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada.|Office of Public Health Practice, Public Health Agency of Canada, Guelph, Ontario, Canada.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Edge
authors.affiliation: Department of Geography, McGill University, Montreal, Quebec, Canada.
authors.forename: James
authors.initials: J
authors.lastname: Ford
authors.affiliation: Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada.|Centre for Food-borne, Environmental & Zoonotic Infectious Diseases, Public Health Agency of Canada, Guelph, Ontario, Canada.
authors.forename: M Kate
authors.initials: MK
authors.lastname: Thomas
authors.affiliation: Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Pearl
authors.affiliation: Nunavut Research Institute, Iqaluit, Nunavut, Canada.
authors.forename: Jamal
authors.initials: J
authors.lastname: Shirley
authors.affiliation: Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada.
authors.forename: Scott A
authors.initials: SA
authors.lastname: McEwen
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006303:Health Services, Indigenous / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D004930:Inuit / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020957:Nunavut / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D018570:Risk Assessment; D057566:Self Report; D012720:Severity of Illness Index
keywords: Aboriginal health; Indigenous health; Inuit health; Nunatsiavut; Nunavut; gastrointestinal illness; healthcare utilization