Exploring the Impacts of COVID-19 on Indigenous Peoples in the Northwest Territories
Creators: Qadri, Ali H
Publisher: name: University of Alberta Library
Year: 2024

<p>Background<br>
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. <br>
Methods<br>
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).<br>
(1) GNWT COVID-19 Dataset<br>
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. <br>
(2) Interviews with Indigenous Elders<br>
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.<br>
(3) Social Harms of COVID-19<br>
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.<br><br>
Results<br>
(1) GNWT COVID-19 Dataset<br>
        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&lt;0.001), and for all sex, age-group and regional strata, except for the 0-4 age group strata.<br>
        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&lt;0.001; Mortality IRR 4.07, 95% CI 1.77, 9.33, p&lt;0.001).<br>
(2) Interviews with Indigenous Elders<br>
Four interviews were conducted, and four themes and thirteen sub-themes were identified after thematic analysis. The four overarching themes were (i) Social &amp; 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.<br>
(3) Social Harms of COVID-19<br>
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. <br>
Discussion<br>
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.</p>