Nunavut Inuit experience higher rates of health complications after surgery than other Canadians, study finds

Nunavut Inuit are 25 per cent more likely to experience a serious complication within one month after surgery than non-Inuit patients, a new study has found.

The percentage rises to 58 per cent when it comes to elective surgeries, and to 63 per cent for cancer surgeries.

A team of Canadian researchers, including Inuit and other Indigenous researchers, believe it's because Nunavut Inuit experience barriers in accessing timely and culturally appropriate healthcare.

The researchers matched Inuit patients from the Qikiqtaaluk region, which includes Iqaluit, with non-Inuit patients who had similar surgeries, age, and medical conditions over a seven-year period. They looked at their outcomes within 30 days of having surgery at the Ottawa Hospital, which serves the region. 

The peer-reviewed study, published in CMAJ Open, is the first one to look at the surgical outcomes of Inuit.

In addition to the higher rates of complications, the researchers also found higher rates of being readmitted to hospital within those 30 days or staying in hospital longer compared to non-Inuit patients, according to Dr. Donna May Kimmaliardjuk, the first Inuk cardiac surgeon in Canada, who is one of the study's authors.

She added that the higher rates resulted in higher costs of hospital care "and a greater chance of being discharged to a long-term care or assisted-living facility rather than being able to go straight back home."

Systemic barriers

Dr. Jason McVicar, a Métis anesthesiologist at Ottawa Hospital and assistant professor at the University of Ottawa who led the study, said that the healthier patients are when they arrive for surgery, the better their outcomes.

He said because Inuit in Nunavut face systemic barriers, including just accessing primary care, they often come to surgery when their diseases are more advanced compared to other Canadians.

"It makes the surgery harder and increases our risk of complications afterwards," added Kimmaliardjuk.

Policy changes

Kimmaliardjuk said she's hoping the study will drive policy changes and improve outcomes for Inuit.

She said she'd love to see fully-staffed health centres in Nunavut communities, along with more resources that allow things like blood tests, X-rays or ultrasounds to take place.

She also would like to see continued investment in the Iqaluit Hospital, so more patients could be diagnosed and treated in the North. 

She said she'd also like to see investments in telehealth so people could access specialists, like heart surgeons, much sooner and more cost effectively.

She said that while Inuit face more barriers than non-Inuit, including racism, they need to be their own best advocates.

"I know it is very difficult when you encounter a health-care provider who is racist or who is not taking your complaint seriously. And we know this exists," she said. 

But she encourages Inuit to keep pushing health care providers until they get the health care they know they need.

"Don't settle for less," she said. 

"Just because of where you live should not mean that you have less equitable access to care in Canada, a first world country. [It's] what everybody in Canada deserves, regardless of where you live or your ethnicity."