Metis Nation Public Health Surveillance Project

Let Them Know You Are Mètis

2013-05-13T13:09:00.000-07:00

Family, friends, neighbourhoods, communities and nations are groups we all belong too. Belonging to groups is very good for us, it makes us healthier. Being part of a group provides us with many healthful advantages; for instance, helping others, sharing information, making others feel welcome and laughing together all have been shown to improve health. An important part of belonging and reaping the health benefits associated to belonging is acknowledging and sharing with other that you belong.

Sharing that you belong may be as simple as making a phone call to your Mom, writing a note to a friend or writing a letter to a government official all demonstrates that you belong. Demonstrating that you belong also supports your health in ways that you may not expect. For instance, when you share that you belong to the Mètis nation you support the Mètis community by telling people that Mètis culture and community are important.

When you share your Mètis identity by consenting to the Mètis Public Health Surveillance Program you are supporting your own health, the health of Mètis community members and improving the health of all Canadians. Showing how a community stays strong and resilient can help others in the community to pursue their health goals and can inform other communities and their health promotion programs.

The Mètis Public Health Surveillance Program needs as many Mètis Citizens to participate as possible so please take part and demonstrate that you belong. Or, if you have already participated by completing the consent form please talk to your Mètis Citizen friends and make sure that they too have consented.

Together we are stronger.

2013-01-31T11:32:00.001-08:00

Making Strides Toward Improving Mètis Health

The Mètis Nation British Columbia Mètis Population Health Surveillance Program is moving forward with gaining access to Mètis information held by British Columbia Provincial Agencies. Currently the MNBC is working with the BC Cancer Agency to refine a proposal for submission to the MNBC Ethics Committee. This research proposal describes the necessity to investigate the incidence of cancer amongst Mètis in BC. The number of Mètis with Cancer in Canada is not accurately described by any research project. Cancer rates amongst First Nation, Mètis and Inuit communities are also infrequently reported, but when it is reported the incidence of cancer is comparable to the remaining Canadian population on a yearly basis. Some research in Quebec demonstrated that Aboriginal people in Quebec have a higher mortality rate as a result of cancer when examined over long periods of time. In BC 15% of Mètis Citizen Households have had someone within the household experience cancer. The current information provides very little insight into how prevalent cancer is amongst Mètis communities. The necessity to gain more information on Mètis communities experience with cancer is crucial because of the lack of available information. Without the appropriate information health care providers cannot address health issues within the community.

To improve the health of the Mètis community MNBC is continuing to work with the BC Ministry of Health. MNBC just received the case definitions for the chronic conditions under investigation. The case definitions provide the boundaries of how chronic diseases are classified and are shared between provinces across Canada to ensure reliable comparisons. Once the case definitions are incorporated into the Mètis Ethics committee research proposal the proposal will be reviewed for approval or resubmission. MNBC plans to hold an ethics committee meeting in March, coinciding with the MNBC health forum.

Improving Mètis health will not come with knowing how many Mètis experience chronic conditions. Chronic diseases are determined by many things, including biology, age, gender and many social and behavioral factors. While information held by those agencies who treat people with diseases is invaluable it is also important to know about the social and behavioural influences of health. The Mètis Nation BC has developed a comprehensive survey to inform health care providers of the social context and health behaviours that Mètis communities participate in. The survey is online to reduce costs of mail outs and telephone interviews. Invitations to complete the survey will be forwarded to Mètis people very soon. Currently MNBC is working on providing incentives for people to complete the survey. Once the incentives are established MNBC will forward the invitation to complete the survey to Mètis across BC.

If you have any questions regarding the progress of these projects please feel free to contact Dr. Peter Hutchinson, Chronic Diseases Surveillance Program Manager, phutchinons@mnbc.ca or 250-215-0190.

One good reason to participate in the MNBC Public Health Surveillance Project

2012-09-12T18:28:00.000-07:00

Many Metis are participating in this vital project, they may recognize the importance of knowing how healthy the Metis community is; they may recognize the importance of evidence in developing policy and programs to support all Metis people; or, they may recognize who this information will effect including future generations of Metis and Metis Elders.

These are very good reasons. The one good reason that I would like to share is that all Metis Citizens who do not participate will be included with the remaining BC population. I'll repeat that, those Citizens not participating in the project will be included with the general population of BC. Why, because the BC ministry of health already accesses your health information and includes it in the reports they generate about residents of BC. And, we will be comparing Metis Citizens health with the general population of BC. Generally speaking the population that does not self-identify as Metis are healthier than Metis people, this we know from other Metis populations across Canada. So, if you are a Metis Citizen that is not participating in this project you are being included with the general population and quite possibly changing the overall health status of both the general population and the Metis population.

So, support the Metis people, support your elders, your children and your family and participate in this project. MNBC will never hold your personal health information, we respect peoples rights to privacy. All you have to do is complete the consent package available online at the MNBC CDSP website, look for the blue buffalo.

MNBC Public Health Surveillance Program Update

2012-09-12T17:36:00.001-07:00

Mètis Citizens continue to show support for the Mètis Nation Public Health Surveillance Program (we also call it the Chronic Disease Surveillance Program). MNBC is continuously promoting and delivering consent packages for MNBC Citizens. And, in return MNBC Citizens continue to provide their consent to participate in the project. Currently over 25% of Mètis Citizens have decided to participate in this important research project.
MNBC has also had discussions with our Ministry of Health counterparts in this project to begin the data matching and information collecting. The data matching will be carried out by the Ministry of Health, this step is when MNBC provides the personal information shared by MNBC Citizens to the BC Ministry of Health. The BC Ministry of Health will then create a file that has all consenting MNBC citizens and will develop and anonymous file with this information in order to begin looking at the information related to their BC personal healthcare numbers. Then the BC Ministry of Health will begin to analyse the data of the Mètis community who have provided consent. After the Mètis community health information is put together we will be begin to write reports on Mètis health in BC. Our current timeline is to have a report prepared for early 2013.
Working with the BC Ministry of Health we are currently preparing a research proposal to submit to the MNBC Ethics Committee. The research proposal details the process for developing reports regarding Cardio Vascular Diseases amongst the Mètis Citizens. Cardio Vascular Diseases include hypertension (high blood pressure), heart attacks, strokes and other diseases related to the blood and heart. These diseases account for the highest portion of mortality in Canada amongst all populations and are substantially higher amongst Mètis in Manitoba and Ontario.
Below are a few graphs showing the population of MNBC Citizens that have participated in the MNBC Public Health Surveillance Program.

Figure 1 Average age and standard deviation of males and females by MNBC region who have provided their consent.

Figure 2 Percent of Metis Citizens by region who are participating in the MNBC Public Health Surveillance Project.

Thinking of Suicide amongst Metis Adults

2012-08-07T15:06:00.000-07:00

A recently published manuscript that asked the question - how many Metis think of committing suicide and what are the factors that influence or prevent such thought has been posted online by the International Journal of Circumpolar Health. Take a look at what the data is describing.

Mètis Citizens Exceed Expectations Striving for Better Health: Information Sharing Agreement Spurs Citizenship Participation

2012-07-26T13:15:00.001-07:00

Over the last 8 months all Mètis Citizens have received a consent package asking them to participate in data sharing agreements that would increase the knowledge about the Mètis community. This knowledge helps inform the development of policies, programs and evaluation that would better serve all Mètis people. Currently the program seeks to increase the collective knowledge of the Mètis communities' health, specifically how many Mètis have a chronic disease. We recognize that the Mètis communities know what their community's health status is but we would like to share this information between communities so that we can learn from each other on how to improve our own health. Many Mètis Citizens have recognized the importance of increasing this knowledge and have agreed to participate in the program.
The Mètis community should be proud of its civic participation. Currently 23% of Mètis Citizens have agreed to participate in the program (Figure 1). Mètis citizens have received one consent package and one reminder post card. When similar research is conducted amongst the total population only 9% would participate if they received a telephone call. And, to achieve the percentages produced by the Mètis community we would have to pay people to participate, contact people several times by mail, telephone and by sending people out to people's homes but still not achieve 23% participation. There is some regional variation but overall Mètis Citizens have demonstrated that they know how important it is to represent the Mètis community.
Mètis Citizens of the Kootenay/Boundary participated at a higher rate than any other region in the province. (Figures 2 & 3) The consent process needs to be further refined in order to increase participation in the North Central, North West and North East regions. Fundamentally the Mètis Citizens who have agreed to participate accurately represent the Mètis population. The average age for those participating, keeping in mind that we only asked those over 18 to participate, was 53 years old (Figure 4). The majority of people who consented are between the ages of 37 and 69. There are several Mètis Citizens who have lived over one hundred years. More Mètis men need to participate.
With increased participation from the remaining Mètis Citizens we would increase the confidence in the knowledge of the Mètis community. Also with increased participation the knowledge could be more specific to regions and communities. To protect people's privacy knowledge can only be reported on communities that are large enough to provide anonymity to its members.
In conversation with some community members some misconceptions about the program have been identified. The most recurring misconception is that MNBC would receive individual citizen's health information. This is not accurate; MNBC will only receive health information on Mètis communities large enough to ensure anonymity amongst its members. So, no one MNBC Citizen will be identifiable by anyone at MNBC within the health information that they receive.
This information sharing agreement with the BC Ministry of Health is only a fraction of the information that is available to help improve Mètis participation in Canadian society. The Federal and Provincial governments collect information every time we utilize a public service such as educational institutions, employment insurance, and purchase fishing and hunting licenses to name a few. All this information is held and utilized to guide public policy, programs and evaluations. Without a Mètis voice within these data sets the Mètis Community will continue to be underrepresented within Canadian society, the Mètis will remain within the margins.
Legend for Figures.
Region 1 - Vancouver Island
Region 2 - Lower Mainland
Region 3 - Thompson/Okanagan
Region 4 - Kootenays
Region 5 - North Central
Region 6 - Northwest
Region 7 - Northeast

Metis Citizens shape Metis health narratives

2012-05-01T13:03:00.001-07:00

Often times as an academic I get this sideways look from people that asks "What did you just say?" And most often it's not a reaction to some controversial statement; it is a genuine look that asks if I am from another planet because whatever I just said is not from earth. This is why I am working with Metis Citizens to create the Metis health narrative resulting from the CDSP project. These admirable Metis Citizens work together as the MNBC CDSP Ethics Committee. They provide valuable direction and feedback in the progress of the CDSP. The Ethics Committee met over the weekend in Richmond, BC to hear about the recent consent process success and developments in the CDSP within BC and across Canada. The Ethics Committee also provided valuable insight into the development of the research proposals and resulting reports and knowledge produced by the data matching process. I look forward to working with the Ethics Committee throughout this process as we create a new method for the creation of ethical health narratives.

There have been a lot of updates on Facebook and new tweets on twitter from the MNBC CDSP project so be sure to check these out.

Metis Citizens Embrace Sharing Their Metis Identity

2012-04-25T12:56:00.001-07:00

This has been a busy couple of months. After delivery of over 5500 consent packages and over 3000 reminder postcards to Metis in BC we received over 1700 packages in response to the call for participation. Over 1100 Metis Citizens have agreed to share their Metis identity with the Provincial government's Ministry of Health. This has required that we enter information for each Metis Citizen that has responded. When most other populations are asked to participate in a project like this the response rate is much lower than the third of the Metis Citizen population that have participated. With this high response rate there is anticipation that the response to the reminder postcard will also exceed expectations.

MNBC is currently in discussions with the BC Ministry of Health to start sharing the identities of those who have consented. With this information the people who help others try to maintain a high quality of life by providing health and social services that are relevant to the Metis people will be much better prepared to achieve their goals. The information produced will also help Metis people directly, when a people's culture and community are recognized by others their quality of life goes up. This may be a result of an individual feeling part of a collective and recognizing the benefits of social support or it may be a result of the larger society recognizing the need to maintain equity and developing services particularly for marginalized peoples.

The MNBC CDSP Facebook and Twitter feeds are active and would like more traffic so please "Like" the MNBC CDSP Facebook page and follow the Twitter feed. The twitter feed shares news stories that address Metis, First Nations and Inuit especially those that concern their health. The Facebook page has information on health programs, how to stay healthy tips, and health research. And of course the MNBC CDSP blog, which has received over 300 reader and the MNBC CDSP websites have also had over 700 visitors. The CDSP use of new media is growing and hopes to expand to draw more Metis to visits on a regular basis through providing regular easy to achieve health tips. Please complete the poll on the Facebook page or provide feedback here for suggestions on how to improve Metis participation.

The MNBC Ethics Committee will be meeting this month to discuss the progress of the CDSP and to discuss its future. The Ethics committee will review documents that have been produced by other Metis organizations in similar programs. This information should inform how the MNBC CDSP continues forward in their sharing of information resulting from the data sharing project.

MNBC CItizens Citizens Respond Eagerly to Consent Process

2012-01-31T11:18:00.000-08:00

The Chronic Disease Surveillance program consent process is in full swing. All Metis Nation BC Citizens should have received a consent form by now. If you have not please download the consent material off the Ethics and Consent web page. Over the last two months, since the consent forms have been mailed out MNBC has received numerous phone calls and emails asking questions about the consent process. We greatly appreciate the interest in the CDSP program and are always happy to answer your questions or talk about the program. All my telephone conversations have been very nice, I really like hearing from the Metis Citizens and talking with them about the program. These conversations are the best part of my day.

The conversations I have had with Citizens have all been positive. Citizens have asked for a basic overview of the program, specific questions about completing the forms how the information will be used and the range of the program. Some citizens would just like to talk about the CDSP program, they like to discuss the necessity of such information and how happy they are that MNBC is working to establish an information base on Metis in BC. Other citizens are concerned about their information and how it will be used, for instance they ask about the necessity of including their personal health number or email address. We do not need either but having the Personal Health Number increases the odds that the Ministry of Health will make a direct match with your personal information. We also do not need an email but we would like to share the results of the program with those who have invested their own time into the program and it is much more efficient and cost effective to share information with Metis. The range of the program is currently restricted to adults, 18 and over. Many people have asked if it will include their children, unfortunately at this time we will be limiting it to adults. Hopefully in the near future we will be able to include youth and children.

I was also able to attend the Golden Ears Metis Society meeting to promote the program. I have informed all the Metis community presidents that I would be willing to come to a local meeting or a regional meeting to discuss the CDSP and answer any questions. The GEMS meeting was fabulous, Lisa Shepherd and the GEMS board were very gracious and helped immensely explaining the program. Thank you Lisa and all those who attended the meeting.

The CDSP is also undergoing a comprehensive evaluation. Health Director, Tanya Davoren and Myself went to West Vancouver to meet with the evaluation team. The evaluation will be an ongoing process that will look at the processes, infrastructure, and outcomes of the CDSP.

This is just a brief overview of all the work that is ongoing in the CDSP. Stay tuned for more updates regarding the extensive work that is continuing within the CDSP.

My Freezer may be empty but my hard drive is packed.

2011-12-08T10:28:00.000-08:00

Métis harvesters have been contributing extensively to a MNBC and University of British Columbia Okanagan research partnership. So far over 840 hours of biometric and GPS data have been collected from Métis while they are harvesting. The biometric data includes heart rate, acceleration and deceleration. This information can tell us how much energy is used while harvesting. The global positioning systems data will verify the activity and be able to demonstrate the different demands in different harvesting situations.

Accompanying these numbers are the experiences of 3 researchers who joined a Métis hunting camp this fall. The researchers documented their trip and experience on video and are currently creating several short videos to highlight their experiences. The videos will address the physical, spiritual, emotional, intellectual, social, historical, and ecological aspects of harvesting. The intent of the video is to promote participation in cultural activities for their health benefit. So, one of the researchers also focused her lens and discussion on expectations of participating in a hunting trip. Thank you to Mark and Cindy Carlson and Ron McDougall for their hospitality and mentorship!

There continues to be much discussion in academic circles about the role of country foods amongst Aboriginal populations. These discussions include toxicity levels in country foods (not a problem in most areas), the relationship between diabetes and a contemporary store bought diet, food security related to country foods (accessibility, availability, acceptability and adequacy) and how healthy land results in health populations. These discussions help to shape provincial and federal policies regarding a variety of issues. The Métis People of BC should be proud of their contribution to this important area of discussion. As a researcher I am very grateful to all those who have participated in the project, agreeing to wear heart rate monitors, and GPS’s, provided guidance and insight, and mentorship.

Métis Citizens Embrace Métis Health Surveillance Program; Participation below Average Response Rate

2011-12-01T07:37:00.001-08:00

The Métis Nation British Columbia Métis Health Surveillance Program is well underway. To date over 290 citizens have completed and returned their consent package and returned them to Métis Nation BC. The 16% that returned the consent package are greatly appreciated.

To facilitate the process of consent mail out it has been divided into two waves of consent mailing. The first wave is completed with 94% of the mailed consent forms reaching their destination. Those that were completed and returned were done within the 1^st week of receiving the consent form. If you are a Métis Citizen who has moved recently please provide the MNBC Registrar (1.800.940.1150) with your new address. The second wave will be completed within the following month.

The return rate is on the lower end of an average response rate, an average response rate is between 15 and 30%. And, if this return rate continues the health information produced as a result from the data sharing with the Ministry of Health will not be as helpful as hoped. With more Métis Citizen participation we are able to produce better health statistics that can demonstrate the needs and strengths of the Métis community.

To improve return rate we encourage each Métis Citizen to ask questions about the program (contact Peter Hutchinson 250-215-0190), to share with other Métis Citizens the importance of completing and returning the consent form and to help elders and those who may have problems with the consent form.

We understand the concerns of citizens that have asked us questions after receiving the consent package. The majority of questions have been in regard to privacy. Citizen privacy is MNBC priority; there are several checks and balances that ensure the protection of Citizen privacy.

To help with participation and to provide valuable information to Métis citizen on health related topics the MNBC CDSP have developed a facebook page and a twitter account (@mnbc_cdsp). Please visit these sites regularly for exciting information, calls for proposals for communities and researchers and advancements in Métis health.

Consent Process Begins

2011-10-31T13:11:00.000-07:00

By now approximately 2200 Métis citizens have received a Consent Package for the Chronic Disease Surveillance Program data matching project. The remaining 3100 citizens will receive their consent package in the following months. Due to the large number of consent packages that need to be delivered MNBC has pursued the most economic method to have these packages delivered. This has required that the consent mail out process be broken into two large consent package releases.
The CDSP manager, Pete Hutchinson, has been busy with the consent package mail out, mid year reporting, communicating with Métis Citizens and communities about the CDSP, data collection for the Harvesting Research Project, writing and reviewing manuscripts for scientific journals, writing community engagement grants, participating in curriculum working groups and research groups investigating neurological disorders, cultural safety in hospital settings and cultural safety in children and family services.
Things to look forward too include the completion of the consent mail out, a report on the data collection process for the Harvesting Research Project, an article describing a Métis specific method of research, and some interesting work coming out of the National Aboriginal Health Organization, Métis Centre on Métis mental health.
If you have any questions regarding the CDSP please contact Peter Hutchinson: phutchinson@mnbc.ca or 250-215-0190.

Major mile stone passed

2011-09-29T15:19:00.000-07:00

The Métis Nation BC AGM was very exciting for me and all those who have worked diligently to see the Information Sharing Agreement signed by the BC Minister of Health, Michael DeJong; the BC Chief Data Steward, Chris Norman; MNBC President, Bruce Dumont; and, MNBC Minister responsible for Health, Lissa Smith. The MNBC AGM was also attended by Dr. Shannon M. Mcdonald, Executive Director for the BC Ministry of Health Population and Public Health, Aboriginal Healthy Living Branch. Tanya Davoren, Director of Health, lead the group though the signing of the ISA. Sukhy Sidhu, Policy Program Analyst for the same department also attended to watch the signing.

The ISA is the corner stone to the Chronic Disease Surveillance Program. Once Métis Citizens consent to sharing their Métis Identity with the BC Government then we will be able to produce reliable and timely information on the health and well-being of the Métis People in BC. 136 Citizens who attend the MNBC AGM receive a consent package. A consent package includes the consent form, personal information form, information brochure, and a reply envelope. 36 Citizens completed the consent package and returned them by Sunday afternoon. The next step is to process the remaining 5202 consent packages.

Data is also being collected at Métis harvesting camps across the province. The Canadian Institute for Health Research funded “Implications for Health: Harvesting Amongst Métis in BC” has shared resources with MNBC to see to it that biometric and GPS data are collected from Métis harvesters. Two graduate students, Carlene Dingwall and Gabrielle Legault will be producing a short video of their experience of attending a Métis Harvesting camp for the first time.

Fall Flurry

2011-09-13T14:41:00.000-07:00

The past month and a half have seen quite the flurry of activity in preparing several research projects simultaneously. The Information Sharing Agreement is starting to near its final stage and is currently with the BC Ministry of Health for final review. Once this review is complete the ISA will be signed by the Chief Data Steward for the BC Government and by MNBC President Bruce Dumont. The MNBC team and BC MoH team are preparing an event for the MNBC AGM this fall. Please check back after the AGM to see what MBC and the BC MoH put together.
The informed consent process will also begin this month at the MNBC AGM. We will have consent packages available for MNBC Citizens attending the AGM ready to sign and return to MNBC. Citizen consent is necessary for the CDSP to be successful so I (Pete Hutchinson) will be in attendance at the AGM to answer any questions and to hand out consent packages. If you are not able to attend the MNBC AGM and are a Métis Citizen you will receive a consent package in the mail, or alternatively you can download the package from the CDSP website.
I also traveled to Toronto to work with Aboriginal researchers from across Canada to develop a research project on neurological conditions amongst Aboriginal Women. This research project is led by Carrie Bourassa who works from the First Nations University of Canada and Billie Allan who works for the Native Women's Association of Canada. The research team includes elders from across Canada, notable scholars and established community activists. The project will talk with Aboriginal women from across Canada who have a neurological disorder or provide support and care to someone with a neurological condition. So, if you would like to participate in this research project please contact me (Pete Hutchinson, 250-215-0190).
Two other research projects have also been coming to the data collection phase, which results in very anxious and long days. The Implications for Health: Harvesting Amongst Métis in BC research project is currently in full data collection mode. UBCO and MNBC agreed to hire someone from MNBC to be the field research assistant and is currently with Métis Harvesters collecting data. I will be joining a hunting camp in early October in the Flat Head area of south east BC with 2 graduate students to collect some more information. The other research project that is in full data collection mode is investigating what cultural safety means to Aboriginal Children and Family support workers. This project is led by Dr. Dixon Sookraj of UBCO's School of Social Work.

What is this all about?

2011-07-21T09:01:00.000-07:00

The MNBC CDSP website is finally off the ground and available for anyone to explore. The CDSP Blog will be used to provide updates of work that is ongoing in the program. I am excited about this opportunity to share with everyone what it is we do within this program. And, I am also excited to read any comments and answer any questions that you may have regarding the program. So, please feel free to add comments and ask questions, I will do my best to answer your questions and respond to any concerns. I will try to make this space a humorous and informative dialogue.

Over the last month we have had some great news from our BC Government partners at the Ministry of Health Services. Our Ministry counterpart informed us that the BC Attorney General's office reviewed a draft of the Information Sharing Agreement (ISA) (the agreement sets out what and how information will be shared between MNBC and the BC Ministry of Health Services) and approved the project. Currently the ISA is with the Ministry of Health Services for further review and final approval. Once this step is completed the ISA will be shared with MNBC to review and approve.

Other exciting developments (warning: what is exciting for a researcher may not be exciting to everyone) include the final pilot test of the MNBC Comprehensive Survey. I have been conducting preliminary data analysis on the surveys completed during the pilot test and have been making alterations to the survey. These alterations are derived from the feedback provided from MNBC Citizens who completed the survey, I am so thankful for those who have participated in improving the survey. The participation from these individuals and the Métis community makes me proud to be Métis.

Thanks for Visiting the CDSP website, and please return regularly for future updates on CDSP.