Highlights
- Inuit face many challenges when deciding whether to travel from a remote location to an urban centre for cancer care.
- Inuit must navigate complex social, historical and political systems when seeking treatment.
- There are many opportunities for improving cancer care for Inuit.
A study has shown that the decision for Inuit to travel from remote settings to access cancer services is difficult due to the many challenges they face in seeking treatment.[1] To get optimal healthcare, Indigenous people must negotiate complex social, historical and political systems. For many Inuit, accessing healthcare also involves decisions about commuting or moving from remote communities to major urban centres and leaving dependents, their home, employment and other community roles. The alternative is to opt out of treatment. A retrospective review of cancer treatments and outcomes among Inuit referred from Nunavut shows that only 70% of those who are living with cancer travel to urban centres for treatment.[2]
Using an approach that engaged those who will use the research, the team of researchers collaborated with Inuit service organizations and healthcare providers (collectively, “the team”). The team sought to understand the experiences of Inuit in the cancer care system who travel from Nunavut, specifically from Qikiqtaaluk (Baffin Island), to receive cancer care in Ottawa, Ontario. The team also wanted to gain an understanding of how these experiences impact opportunities to participate in decisions during the journey to receive cancer care.
A number of clients (n=8) and medical escorts (n=6) (“participants”) were interviewed about their journeys to receive cancer care. The team then mapped the journey and divided the interview findings into 4 themes:
- It is hard to take part in decisions about getting healthcare.
- No one explains the decisions you will need to make.
- There is a duty to make decisions that support family and community.
- The lack of knowledge impacts opportunities to engage in decision-making.
Participants described themselves as directed in what to do, with little or no support, and sought opportunities to collaborate with others on the journey to receive cancer care.
The team described the journey to receive cancer care as a “decision chain,” which is a series of events that lead to care. The team identified opportunities in the decision chain that could better prepare Inuit to participate in decisions related to their cancer care. Additionally, there are opportunities to build more healthcare system capacity to support Inuit and enable their participation in making decisions related to their cancer care, while upholding and incorporating Inuit knowledge.
Inuit are resilient. They have demonstrated self-determination and the ability to navigate and adapt to harsh and changing environments. Inuit live in many locations, including urban environments, although most Inuit in Canada live in the traditional territory called Inuit Nunangat.[3]
Inuit Nunangat is a region that consists of:
- the western edge of the Northwest Territories (the Inuvialuit Settlement Region)
- the territory of Nunavut
- northern Quebec (Nunavik)
- northeastern Labrador (Nunatsiavut)
There is an urgent need to improve Inuit access to and use of healthcare for Inuit living in these remote locations, and to do so in ways that promote self-determination.