Inuit infants die at a rate three times higher than babies in the rest of Canada.

That’s according to a new study published January in the Canadian Medical Association Journal, called “Birth outcomes in the Inuit-inhabited areas of Canada”.

The study looked at births in Canada’s four Inuit-inhabited regions – Nunavut, Nunavik (northern Quebec), Nunatsiavut (Labrador) and Inuvialuit (western Arctic) – over a 10-year period.

Of those four regions, Nunavik’s infant mortality rate – defined as death within the first year of life – was the highest.

One of the study’s authors, Université de Montréal researcher Dr. Zhong-Cheng Luo, said birth outcomes are worse in Aboriginal populations in many developed countries, where geography and socio-economic status are often a factor.

“In relatively isolated areas, it’s harder to access natal care,” Luo said. “Women usually have to fly out for care.

“Essentially, poor regions have a higher incidence of infant mortality. We need more efforts to improve prenatal care in Inuit regions.”

Researchers collected data from over four million births between 1990 and 2000. They found the four Inuit-inhabited regions experienced an average of 16.2 deaths per 1000 live births, well over three times the Canadian average of 4.6 deaths.

The western Arctic region of Inuvialuit registered the lowest rate of the four regions with 13.4 infant deaths per 1000 births, while Nunavik’s was the highest at 18.1 deaths per 1000 births.

Those figures come as no surprise to Dr. Serge Déry, Nunavik’s director of public health. In 2001, a Quebec government study found that the infant mortality in Nunavik registered at four times higher than the rest of Quebec.

The same study also found the pregnancy rate for adolescents in Nunavik was more than four times higher than the rest of the province – not unlike the ratio between Inuit regions and the rest of Canada.

“I could say that we arrived at the same conclusion as this (more recent) study,” Déry said. “Newborns here are being born in relatively good shape…but when we look at their first year of life, there is a deterioration.”

Déry said that many infants are hospitalized in their first year of life, often for respiratory problems. Pre- and post-natal exposure to alcohol, drugs and smoking could be a factor, Déry said, only aggravated by overcrowding in the region’s housing.

The good news is that many of these infant deaths can be prevented.

Maternal smoking, a big risk factor for infection, is more significant among Inuit women than women in the rest of Canada. Anti-smoking programs, as well as those to promote breastfeeding are strongly recommended, concluded the study.

The study also suggests educating mothers to place their babies on their backs for sleeping to avoid crib deaths.

“A lot has been put into place since the study’s data was collected,” Déry said. “Several programs have been developed at the school and community level to inform pregnant women of the risks.”

Midwifery services are now offered in three Nunavik communities, with potential for expansion. Women in those communities receive care from early pregnancy to the post-partum period without having to fly out of their communities.

Nunavut’s food insecurity

If high infant mortality rates isn’t enough to cope with, another study in the same journal found that almost 70% of Inuit preschoolers aren’t getting enough to eat.

In 2007 and 2008, information gathered from 16 Nunavut communities found that children aged three to five experience hunger at a rate 10 times greater than children in the rest of the country.

Children living in homes that reported high food insecurity were found to consume many processed foods, which are high in energy and poor in nutrients.

The long-term effects of a poor diet can result in tooth decay, obesity, behaviour problems and poor development, the study concluded.