Electronic letters to:

Research:
Ravi Retnakaran, Anthony J.G. Hanley, Philip W. Connelly, Stewart B. Harris, and Bernard Zinman
Cigarette smoking and cardiovascular risk factors among Aboriginal Canadian youths
CMAJ 2005; 173: 885-889 [Abstract] [Full text] [PDF]
*eLetters: Submit a response to this article

Electronic letters published:

[Read eLetter] Health Research and Aboriginal peoples
Barry D A Lavallee   (25 October 2005)
[Read eLetter] Smoking an indicator
Wenbin Liang   (11 October 2005)

Health Research and Aboriginal peoples 25 October 2005
Previous eLetter Top
Barry D A Lavallee

Send letter to journal:
Re: Health Research and Aboriginal peoples

blavallee{at}ahwc.ca Barry D A Lavallee

In response to the recent article titled" Cigarette smoking and cardiovascular risk factors among Aboriginal Canadian youths" (CMAJ 2005; 173: 885-889) by Retnakaran et al, we would like to applaud these researchers for bringing to the forefront the need for research that explores a modifiable risk factor (smoking) for cardiovascular disease in Aboriginal communities. A recent article published in the British Medical Journal highlighted the paucity of funded research in Canada that examined the high rates of smoking in Canadian Aboriginal communities. (Young 2003) Aboriginal peoples continue to suffer disproportionate burdens of illness, preventable and otherwise, compared to other citizens of Canada.(Smylie 2001)How this is addressed through research activities involving Aboriginal peoples in Canada is more of a concern.(Smith 1999)

The International Network of Indigenous Health Knowledge and Development (INIHKD) group recently held a second gathering in Vancouver, BC from October 1-4/05 involving 300 participants, mostly Indigenous (Canadian First Nations, Metis and Inuit, Australian Aboriginal and Torres Strait Islander, American Indian, Alaskan Native and Native Hawaiian and Maori)from New Zealand, Australia, United States and Canada. The INIHKD is a new international assembly dedicated to improving the health of Indigenous peoples from their respective countries through Indigenous and community-led research, health services and workforce development. "The continuing disparities between the health of Indigenous people and the non-Indigenous settlers of Australia, Canada, New Zealand and the United States of America are a matter of concern within each country..." (http://inihkd.org/)

While the focus of this article rests upon the smoking behavior and associated traditional and non-traditional risk factors in this small Oji-Cree community, the influence of distal factors (racism, colonization, uneven power relations etc) affecting the rates are largely unexplored. We are already well aware of the high rates of smoking in most Aboriginal communities.(Reading and Allard 1999). More so, current literature guides us in understanding the aspirations of Aboriginal peoples and their health and how to operationalize these goals within the broader contexts experienced by Aboriginal peoples.(RCAP 1996)

The aim of Aboriginal health research is to translate new knowledge to real-world applications in order to provide more effective health services, strengthen health care systems, and thereby improve the health of Aborignial peoples. (INIHKD) Adhering to principles of Aboriginal ledership, Aboriginal research and Aboriginal capacity building activities will facilitate meaningful research outcomes for Aboriginal communities. (Schnarch 2004)

Ownership, Control, Access and Possession (OCAP) "is about enhancing First Nations' resources. It is about nation building."

While we recognize and acknowledge the continuing contributions of biomedical sciences and research to further health knowledge, the unique history and ecology of Aboriginal peoples requires broader and holistic perspectives in order to create knowledge that reduces the current health disparities.

Bibliography

1. Young, T. K. (2003). Review of Research on Aboriginal populations in Canada: relevance to their health needs. British Medical Journal, 327: 419-422.

2. Smylie, J. (2001). A Guide for Health Professionals Working with Aboriginal Peoples, Cross-Cultural Understanding. Journal Society of Obstetricians and Gynecologists of Canada, 23(1): 54-68.

3. Smith, L.T. (1999). Decolonizing Methodologies, Research and Indigenous Peoples. Dunedin: University of Otago Press

4. Reading J, Allard Y. "The Tobacco Report" Report of the FNIRHS. Ottawa: First Nations and Inuit Health Survey National Steering Committee, 1999.

5. Schnarch, B. (2004). Ownership, Control, Access, and Possession (OCAP) or Self-Determination Applied to Research, A Critical Analysis of Contemporary First Nations Research and Some Options for First Nations Communities. Journal of Aboriginal Health, 1(1): 80-95.

Dr. Barry Lavallee

Senior Physician

Aboriginal Health and Wellness Center

Winnipeg, Manitoba.

Dr. Lorne Clearsky

Medical Director, Aboriginal Health Clinic

Calgary Health Region

Calgary, Alberta.

Conflict of Interest:

None declared
Smoking an indicator 11 October 2005
Next eLetter Top
Wenbin Liang
taking master of public health Curtin University of Technology

Send letter to journal:
Re: Smoking an indicator

wenbin.liang{at}postgrad.curtin.edu.au Wenbin Liang

Dear Editor,

This study has located a young population, which is at high risk of developing cardiovascular diseases in the future, and interventions do need to be designed and carried out to prevent the possible tragedy. [1]

However cigarette smoking is likely to be positively associated with other unhealthy life style such as high alcohol consumption, unhealthy diet pattern, and low physical activity level. (Though these factors may partly associated with current BMI, but they could be considered as confounders) All of these behavioural factors may have worsened the “cardiovascular risk factors” that measured in the study, and further increase the risk of cardiovascular diseases in the future among the targeted population. Thus, an intervention only focus on smoking cessation may have limited effect.

Reference

1.Retnakaran R. Hanley A, Connelly,P. Harris, S. Zinman B. Cigarette smoking and cardiovascular risk factors among Aboriginal Canadian youths. CMAJ • October 11, 2005; 173 (8). doi:10.1503/cmaj.045159.

Conflict of Interest:

None declared