Greenland's success shows Canada's child mortality disgrace

This is an important editorial and worth close reading. We may differ as to why First Nations suffer such poor health and welfare but there is no issue that they do so suffer. The fact Greenland does so much better suggests we can too.

From Monday's Globe and Mail

Greenland faces many of the same challenges as Nunavut. Both have small, dispersed populations spread over cold expanses of land. Both are territories where indigenous peoples have advanced far in self-determination, and both struggle with social ills.

Yet infant mortality - one of the key indicators of a successful health-care system - is dramatically lower in Greenland. At 15.1 deaths per 1,000 live births, Nunavut's infant mortality rate is double Greenland's - and nearly four times the Canadian average. Canada can do much better.

Inuit children in Nunavut also have the highest rate of hospital admission for lower respiratory tract infections in the world.

These statistics are a black eye for Canada. Every Inuit life should be precious, as precious as the lives of other Canadians. The government of Nunavut, and the people of that territory, must confront the reasons for these terrible health outcomes.

Canada, and Nunavut in particular, should look to Greenland, which has succeeded in reducing its infant mortality rate. People there are taking responsibility for their health, and improving their lifestyle.

Greenland has specific programs to remove some of the underlying causes of infant mortality. For example, the country has a successful anti-smoking campaign. Instead of advocating a complete ban on smoking, it educates women not to smoke in front of their children and babies. There has also been a gradual improvement in housing, and a decline in the average number of inhabitants in one dwelling.

In the past 10 years, the country has cut its average alcohol consumption in half; Greenlanders now consume less alcohol on average than Danes. It is also the only Arctic territory to have enacted a national suicide-prevention strategy.

Such southwestern communities as Sisimiut boast thriving fishing industries, and brightly painted houses, in shades of red, blue and yellow nestled in the rocky hills.

In contrast, many homes in Nunavut are shabby, with several family members having to share just two or three rooms. Poor housing contributes to infant mortality, and to respiratory tract infections. A recent study found that other causes include having a mother who smoked during pregnancy; not being breast-fed; and being adopted out at a very young age.

Two-thirds of people living in Nunavut say they smoke - the highest rate by far in Canada, and one-third say they drink heavily. They have the lowest self-reported rate of physical activity in Canada and the lowest consumption of fruits and vegetables. A study by a researcher at McGill University found that 70 per cent of Inuit preschoolers live in homes where there isn't always enough food.

Canada, which boasts one of the best standards of living in the world, should not tolerate such unacceptably poor health practices. Nor should Nunavut.

The territory can use Greenland as a model and break the silence around self-harm. Honest debates around the harm of smoking, drug use, and sexual abuse, will help people learn how to parent better, and raise healthier children.

Of course, Greenland has had several historical advantages. It has had a government of its own longer than Nunavut, and its communities are more geographically concentrated, making it easier to deliver health care. It has also benefited from Denmark's enlightened encouragement of autonomy. The country has had home rule since 1979 and self-government since 2008.

In contrast, Nunavut was established only 11 years ago, after years of plebiscites and lobbying. Its people are still recovering from the residential schools. In just two generations, they have had to change from life on the land to isolated, government-built communities and a cash economy.

However, being in control of your own destiny doesn't automatically result in lower infant mortality, and better housing, warns Kue Young, a University of Toronto epidemiologist. Specific, targeted initiatives aimed at home visits and early intervention are needed.

Greenland can share its expertise and experience at next month's Inuit Circumpolar Council's triennial congress in Nuuk, Greenland's capital.

Nunavut's leaders must break the taboo of silence. The territory needs to catch up not only to Greenland by substantially reducing infant mortality, but also to the rest of Canada, with which the disparities in health status indicators are much, much greater.

The territory should make it a goal to reach Greenland's current infant mortality numbers, halving the current rate. It should then turn its sights on bringing them into line with the rest of Canada. The government can help in this reduction, to make sure the needed supports are in place, and to educate families, but can only go so far. Ultimately, it will be up to individuals to take the decisive steps to save Nunavut's babies.