Housing and respiratory health among Indigenous peoples in Canada

AbstractIndigenous (First Nations, Metis and Inuit) peoples bear a disproportionate burden of infectious and noninfectious respiratory disease in rural and urban communities in Canada. Biologic and behavioral determinants exist and have relevance, but the primary determinants are socioeconomic, environmental and political. Although Canada has recently declared a national housing crisis, crowded and poor-quality housing, or no housing at all, has been experienced by generations of Indigenous peoples. Crowding in homes or shelters increases risk of exposure and dose to infectious agents. Indoor air pollutants are due to housing defects, sources of heat and smoke, and include mold, endotoxin, mite allergens, gases and particulate matter, which in turn are associated with respiratory irritation and disease. Environmental radon is a noted risk factor for lung cancer in communities located in high risk regions. Studies have demonstrated that interventions in Indigenous communities on both the social and biomedical fronts, to improve housing and health care, result in improved well-being, of which respiratory health is only one component.