Community Nutrition in Transition in Nunavut, Canada
Date of Award
Spring 2023
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Public Health
First Advisor
Dubrow, Robert
Abstract
In the Canadian Arctic territory of Nunavut, the majority of residents are Inuit. This Indigenous population has thrived for millennia by subsistence harvest of wildlife (called “country food”). During the second half of the 20th century, a wage-based economy began to take root across the territory. This mixture of subsistence and wage-based economic frameworks is interconnected with the Inuit food system (including food insecurity, which is prevalent), community nutrition, and public health. Climate and environmental change are impacting Inuit traditional knowledge and harvesting practices, further eroding food sovereignty and security. As a result of these dynamics, a nutrition transition has been taking place, meaning the population dietary shift away from nutrient-rich country food and toward often highly processed, more convenient store-bought foods. The latter now constitute most of daily dietary energy intake, with diet-related conditions like obesity and diabetes on the rise. Research at the nexus of food security and nutrition in Nunavut can help stakeholders parse and tackle key challenges and opportunities. The overall aim of this mixed methods dissertation was to examine socio-environmental determinants and effects of country food insecurity and—on the other side of the contemporary Inuit dietary coin—population nutrition and grocery sales patterns among store-bought foods sold in one of the two main grocery chains present in most communities in Nunavut. The first study qualitatively investigated causes and effects of low-yield harvest periods in two High Arctic communities in the territory. The research found that determinants of these periods covered environmental, weather, socioeconomic, policy, and other phenomena; many were interrelated, affirming the dynamism and complexity of the Inuit foodshed. One of the most commonly cited adaptive practices—that community members respond to leaner times by grocery shopping—inspired the acquisition of sales data from Nunavut’s market-dominant grocery chain for the second and third studies. After linking each grocery item sold across 21 stores in Nunavut to its food composition data, the second study was performed; this culminated in the first analysis of nutrient-linked grocery sales data anywhere in the Arctic. Patterns of energy and nutrients sold were examined across the 6 Inuit-defined seasons and 5 community size levels (the territorial capital of Iqaluit and 4 quartiles of 5 of each of the other communities of focus). Outcomes of interest were daily energy, macronutrients, and fiber sold per capita; energy density of food and, separately, of beverages sold; and food category contributions to energy, each macronutrient, and fiber sold. While differences in mean energy and nutrients sold per capita per day between Inuit seasons were not dietetically meaningful (despite statistical significance among the 20 non-Iqaluit communities), differences in these estimates among the community size levels were both clinically meaningful and statistically significant. Results suggested healthier, less energy-dense food and beverage purchasing patterns in the largest community size quartile and in Iqaluit. Finally, the third paper presents the first-ever quantitative model of the relationship between harvesting trail inaccessibility and grocery sales. Trail inaccessibility on a particular day meant no trail (land and either sea ice or open water) was safe for use nearby a community; this was quantified using a model developed by Ford et al. and Inuit harvesters in communities across the Canadian Arctic—13 of which overlapped with our grocery sales dataset. Trail inaccessibility (and the resultant inability to harvest country food) was not found to be associated with our anticipated increases in daily grocery expenditure and in the volume sold per capita per day of meat and meat products relative to trail-accessible days; instead, only a few small decreases were observed—and only in some communities and on certain consecutive days of trail inaccessibility. Notably, the wage-based economic covariates in our model (e.g., Government of Nunavut payday, monthly Canada Child Benefit payment dates) yielded strong, statistically significant, positive associations with our two grocery sales outcomes. These findings touch on the ongoing decline of day-to-day dependence on subsistence in Nunavut and the sensitivity of these communities to wage-based economic stimuli in their consumer food purchasing behavior. While the two quantitative analyses point to an advanced state of the nutrition transition in Nunavut, the qualitative study underscores the robust cultural significance of and dietary preference for country food among Inuit in the territory. Community-engaged research approaches were central to each step: study design, interview guide and model refinement, co-interpretation, and co-dissemination. Continual dialogue with multisectoral project partners and knowledge transfer and exchange activities throughout this dissertation critically augmented its ethics, rigor, and reach of impact.
Recommended Citation
Gilbert, Sappho Zoe, "Community Nutrition in Transition in Nunavut, Canada" (2023). Yale Graduate School of Arts and Sciences Dissertations. 969.
https://elischolar.library.yale.edu/gsas_dissertations/969
