Thank you, Mr. Chair.
Mr. Chair, members of the committee, thank you for having us here to talk to you today about an important issue for us from the health perspective. This issue has been a preoccupation of the Nunavik Regional Board of Health and Social Services for many years. My objective today is to relate to you a decision in regard to health issues that we are facing in Nunavik.
The Nunavik Regional Board of Health and Social Services was created following the James Bay and Northern Quebec Agreement. Our board of directors is made up of 14 representatives from the 14 communities of Nunavik region.
I am the director of public health. As the medical officer of health, I am responsible for all the programs related to promotion, protection, and prevention. As well, the board is responsible for all the planning of health and social services for the region. We also have two hospitals in Nunavik, one on the Hudson Bay coast and one on the Ungava Bay coast. Each village has a community health clinic providing 24-hour services.
Today my statement will include the remarks of Mr. Watt, who is not able to be present today. For us, the housing crisis in Nunavik has been an issue. It's reflected in the overcrowding of many houses and the poor shape of the existing housing and the need for major repairs.
This housing crisis has consequences for all age groups: children, youth, adults, and elders in Nunavik. Considering it from the children's perspective, the Nunavik population, as was mentioned to you, is a very young population. Roughly 40% of our population is under 19 years of age.
Acknowledging that, more than half of them are growing up in overcrowded houses; yet children are among the most vulnerable to inappropriate housing conditions. They are particularly vulnerable to infectious disease. We have some of the highest rates of infectious disease hospitalization rates in Quebec for children under two years old, and we can't escape talking about the psychosocial problems that some adults may demonstrate at home and that have repercussions for our children.
As for our youth, many young Inuit today have moved south to study or work, but they have a hard time when trying to come back. There is no housing available for them. This is a huge loss for Nunavik workplaces, because we can't benefit from their education and experience. Our objective is always to be able to develop Inuit competencies in health care, so that one day my job will not have to be filled by a white halunak from the south. This situation prevents other youth from also pursuing their education down south, because they're not encouraged that way.
In contrast, many adults try to escape the situation. Many move to Montreal, growing the itinerant population of Montreal homeless. Some, sadly, in fact end up on the streets, as they're poorly prepared for urban life.
The elders in Nunavik are the official tenants of their house, and the housing shortage often leads them to share their house, willingly or not, with some of their adult children or grandchildren who have nowhere else to go. Sadly, sometimes this leads to elder abuse situations.
There is a very well-documented body of evidence that housing circumstances affect the health and well-being of both family and individuals. I think you all have the brief that we have prepared and summarized. I will talk briefly about it today.
Increased humidity leads to increased mould growth and exposure, which could lead, we know, to asthma and other respiratory conditions. Household quality and density have well-documented implications for the spread of infectious disease.
Overcrowding, however, can also have an impact on mental health, with the possible health outcomes including depression, sleep deprivation, and family problems. In a situation in which individuals are already vulnerable, the situation only fuels psychosocial problems.
There's also a negative association between crowded living conditions and educational outcomes. How can a child do homework and concentrate in an overcrowded household?
Women, children, and elders who need alternative housing arrangements are often victims of family violence.
I want to talk specifically about an issue that has kept me and my team really busy in the last years and that is the recurrence of tuberculosis in the north. There is a strong resurgence right now of tuberculosis in Nunavik and the correlation between the housing situation and this resurgence is getting clearer.
First, there is a growing evidence base to substantiate the strong pathways between the incidence of TB and various social and economic determinants, including malnutrition, crowded housing, inadequate ventilation, low levels of sanitation, low socio-economic status, poverty, alcohol and drug abuse, high levels of stress, and poor access to health care.
Transmission of tuberculosis occurs most frequently as a result of prolonged contact and sharing a close environment with an infectious person. Persons who are at the greatest risk of exposure to tuberculosis are those who live and sleep in the same household as an infected person.
Since the beginning of 2000, the incidence of tuberculosis has been rising steadily in Nunavik after decades of decline. We see a strong relationship between the housing crisis we face and the tuberculosis resurgence in Nunavik. It has quickly overwhelmed our health care system.
The health board efforts to contain the recent TB outbreaks will not suffice if the social conditions that contribute to the transmission of the disease are not changed. We are in an endemic situation where each community right now is vulnerable to tuberculosis outbreaks.
In conclusion, for over a century public health in our country has targeted poor sanitation, overcrowding, and inadequate ventilation to reduce infectious disease transmission. While today most Canadians benefit from adequate housing and living conditions, and infectious diseases such as tuberculosis has almost disappeared in our southern parts, the housing situation remains critical in Nunavik, along with the situation with tuberculosis right now.