The Evolution of Health Status and Health Determinants in the Cree Region (Eeyou Istchee): Eastmain 1-A Powerhouse and Rupert Diversion Sectoral Report Volume 1: Context and Findings Series 4 Number 3: Report on the health status of the population Cree Board of Health and Social Services of James Bay The Evolution of Health Status and Health Determinants in the Cree Region (Eeyou Istchee): Eastmain-1-A Powerhouse and Rupert Diversion Sectoral Report Volume 1 Context and Findings Jill Torrie Ellen Bobet Natalie Kishchuk Andrew Webster Series 4 Number 3: Report on the Health Status of the Population. Public Health Department of the Cree Territory of James Bay Cree Board of Health and Social Services of James Bay The views expressed in this document are those of the authors and do not necessarily reflect those of the Cree Board of Health and Social Services of James Bay. Authors Jill Torrie Cree Board of Health & Social Services of James Bay (Montreal) [email protected] Ellen Bobet Confluence Research and Writing (Gatineau) [email protected] Natalie Kishchuk Programme evaluation and applied social research consultant (Montreal) [email protected] Andrew Webster Analyst in health negotiations, litigation, and administration (Ottawa) [email protected] Series editor & co-ordinator: Jill Torrie, Cree Public Health Department Cover design: Katya Petrov [email protected] Photo credit: Catherine Godin This document can be found online at: www.Creepublichealth.org Reproduction is authorised for non-commercial purposes with acknowledgement of the source. Document deposited on Santécom (http://www. Santecom.qc.ca) Call Number: INSPQ-2005-18-2005-001 Legal deposit – 2nd trimester 2005 Bibliothèque Nationale du Québec National Library of Canada ISSN: 2-550-443779-9 © April 2005. All rights reserved Cree Board of Health & Social Services of James Bay, Chisasibi, Quebec JOM 1E0 FOREWORD TO THE PUBLIC HEALTH REPORT SERIES The Public Health Report Series includes publications of the Department of Public Health of the Cree Territory of James Bay on major activities of the Department: annual reports, immunizations and/or notifiable diseases, diabetes and reports on the health status of the population. SERIES 4: REPORTS ON THE HEALTH STATUS OF THE POPULATION (PERIODIC) Number 1: Health and What Affects it in the Cree Communities of Eeyou Istchee: A Compilation of Recent Statistics. 2001. (added retrospectively). Number 2: How Healthy are the Eeyouch in 2002: An Update. (added retrospectively) Number 3: The Evolution of Health Status and Health Determinants in the Cree Region (Eeyou Istchee): Eastmain 1-A Powerhouse and Rupert Diversion Sectoral Report. 2005. The Series 4 reports are the Department’s principal publications about the health status of the regional population. The Public Health Act (2001) of Québec highlights surveillance as a priority because it is through surveillance that all public health priorities become identified and defined, and long-term impacts of interventions can be assessed. FOREWORD TO THE EVOLUTION OF HEALTH STATUS AND HEALTH DETERMINANTS IN THE CREE REGION This document was produced under contract to Hydro-Québec as background information for the development of their Eastmain-1-A Powerhouse and Rupert Diversion Project Impact Statement. The Department accepted the contract because the request from Hydro-Québec fell into its regular mandate to produce reports on the health status of the population. The contract provided extra resources to develop this summary document to bring together data from all known studies, reports, and data banks. The completion of this final version of the Sectoral Report is greatly overdue. The substantive work for the document was in draft form one year ago. The delay in producing this final version is entirely my responsibility and not that of the other authors. Nonetheless, we are all hopeful that this comprehensive work will interest a wide readership. This document, and future updates, can be found online at www.creepublichealth.org. I would especially like to commend everyone who worked on this report for the excellent quality of their work, and especially Ellen Bobet, Natalie Kishchuk and Andrew Webster. The three decades following 1970 were tumultuous for all the stakeholders, but from this turmoil arose impressive improvements in the populations’ health and in the health services available. It is appropriate that this documentation of this history and effort is appearing now, more than a quarter century after these first aboriginal health services in Canada were established. In coming decades, the CBHSSJB will be able to take a more Cree focussed and community controlled direction. Now that the negotiations with Québec have been successfully completed, the CBHSSJB finally has the resources to fully implement Section 14 of the James Bay and Northern Québec Agreement (1975), our first modern treaty. Jill Torrie Director of Specialised Services Public Health Department of the Cree Territory of Eeyou Istchee Cree Board of Health and Social Services of James Bay Region 18, Québec Ministry of Health and Social Services April 2005 i Contents of Volume 1 Glossary ..................................................................................................................................................vii Chapter 1- Introduction..................................................................................................................1 1.1. Background........................................................................................................................................1 1.2. The Sectoral Report in Context..........................................................................................................1 1.3. Mandate from Hydro-Québec ............................................................................................................2 1.4. The Project Team...............................................................................................................................3 1.5. Organisation of the Report ................................................................................................................3 1.5.1. Organisation of Volume 1...........................................................................................................4 1.5.2. Organisation of Volume 2...........................................................................................................5 Chapter 2 - Methodology................................................................................................................6 2.1. General ..............................................................................................................................................6 2.2. Analytical Framework........................................................................................................................6 2.3. Continuity and Reliability of the Available Data...............................................................................9 2.4. Data Sources - General......................................................................................................................9 2.5. Data Sources - Specific....................................................................................................................10 2.6. Specific Sources of Population Data ...............................................................................................15 2.6.1. The Influence of Maps in Describing the Cree Population.......................................................16 2.6.2. Sources for Population Counts.................................................................................................16 2.6.3. The Current and Projected Cree Population..............................................................................17 Chapter 3- Literature Review: Health and Social Impacts of Large Development Projects on Small Remote Communities ................................................20 3.1. Introduction......................................................................................................................................20 3.2. Methodology ....................................................................................................................................21 3.3. Background......................................................................................................................................23 3.3.1. Background: The Eastmain-1-A Powerhouse and Rupert Diversion Project ...........................23 3.3.2. Background: Legislative and Regulatory Environment............................................................24 3.3.3. Background: The Cree Community of Nemaska......................................................................25 3.4. Results of the Literature Review ......................................................................................................26 3.4.1. Effects on Income and Social Status.........................................................................................26 3.4.2. Effects on Employment and Working Conditions ....................................................................27 3.4.3. Effects on Education .................................................................................................................28 3.4.4. Effects on the Social Environment............................................................................................29 3.4.5. Effects on Personal Health Practices