Some Indigenous communities in northern Quebec are too short-staffed to perform lifesaving procedures, study finds

Indigenous communities in northern Quebec face significant hurdles to health care access. The Nunavik region is remote, with limited transportation options and extreme weather conditions. As a result, its population faces lower life expectancy and poorer health outcomes.

New findings from McGill University provide a blueprint to address Nunavik's urgent health care needs by offering concrete evidence for discussions with policymakers.

The work, published in the Canadian Journal of Surgery, examines surgical and trauma care capacity in the region, revealing concerning disparities and the importance of expanding telehealth services. The research team assessed key health care facilities, including the Ungava Tulattavik Health Centre (UTHC), the Inuulitsivik Health Centre (IHC), and 12 local community services centers (CLSCs) in villages along the Hudson Bay and Ungava Bay coasts.

Glaring disparities in health care access

The researchers scored the health centers on a 10-point scale based on various factors. Across all facilities, staff and resources emerged as glaring deficiencies, despite equipment and supplies being readily available. As for surgeries, the Inuulitsivik Health Centre (IHC) had the highest capacity at 6.7, while CLSCs in villages along the Ungava Bay coast scored lowest at 5.5. Similarly, the team observed a disparity in hospitals' capacity to handle serious injuries. The IHC scored highest at 7.2, while CLSCs in villages along the Hudson Bay coast scored lowest at 5.5.

"These results will not be surprising to anyone who works in these settings. However, they provide an important baseline for future capacity-building programs, as well as specific targets for improvement, notably the recruitment and retention of skilled personnel," said Dr. Evan Wong, Assistant Professor of Surgery at McGill University, Investigator in the Surgical and Interventional Sciences (SIS) Program at the Research Institute of the McGill University Health Centre (RI-MUHC), and the study's co-author.

Barriers to telehealth

Telehealth services, such as virtual doctor visits, grew significantly during the COVID-19 pandemic and are especially useful in remote regions. This study found that while the need for telehealth is high at all facilities, none are fully prepared to implement it. Researchers point to funding, administrative support, and physical spaces as a few of the significant barriers.

Based on the findings, the research team is advocating for decisive action to address health care inequality in the region. They include making it easier for rural doctors to communicate remotely with urban specialists, creating training programs for health care workers in small towns to manage surgeries and serious injuries, and finding new ways to encourage doctors and nurses to work in remote areas.

"This important work highlights a striking disparity that exists within the Quebec health care system in terms of the Indigenous population and the impact of injuries on their health outcomes. While the conclusions are concerning, they highlight an excellent opportunity for strengthening regional partnerships between hospitals 'down south' and our partner hospitals in Nunavik," explains Dr. Jeremy Grushka, study co-author, who is also a researcher in the SIS Program at the RI-MUHC and an Assistant Professor of Surgery at McGill University.