Irnisursiriartutuq nunaringngitamini (birthing outside the community): Childbirth evacuation, perinatal depression and health outcomes of Nunavimmiut mothers and their infants. In partnership with the Nunavik Regional Board of Health and Social Services, I am the principal investigator of a longitudinal observational cohort study that examines the short-term and long-term effects of childbirth evacuation on maternal perinatal health and infant development among 300+ Nunavimmiut Inuit mother-infant pairs. We will compare and contrast childbirth evacuees’ outcomes with a comparison group of 200+ Inuit mothers who remain in Nunavik for childbirth. Specifically, the project (i) investigates whether and how childbirth evacuation affects stress and depression during pregnancy; (ii) assesses the association between both prenatal and postpartum depression and infant growth/development; and (iii) implements an integrated knowledge transfer (iKT) plan with community members and organizational partners to raise awareness of perinatal depression, promote healthy pregnancies, and improve support for Inuit women and their families. The study results will have direct relevance to healthcare policy and service delivery in Nunavik and will also be pertinent to Inuit communities in other parts of Inuit Nunangat and the circumpolar north (e.g., Greenland, Alaska, and Russia). Research Team: PI Z. Vang; co-PI R. Gagnon; CIs E.Chachamovich, E. Labranche, L. Kirmayer; Collaborators K. Bertrand, A. Navickas.
Funding: CIHR ($1,315,800)


Mind the gap: Disparities in perinatal health among foreign-born women in Canada. I am the principal investigator of a study on immigrant perinatal health that makes use of novel administrative and vital statisics data linkages. Migration is a gendered process with differential exposures to health risks for men and women at different stages of immigration. Reproductive age migrant women are a unique population in terms of health challenges because of the added vulnerability that occurs during pregnancy and the postpartum period. Prior research, conducted by members of our team, reveals that maternal health is particularly poor among immigrants in Canada. Immigrant women have worse self -rated health, more postpartum health complications, and higher rates of perinatal depression than Canadian-born women. Immigrant women also do not consistently have better pregnancy outcomes compared to native-born women. This study utilizes linked administrative databases—vital statistics, hospital discharge data, and immigrant landing records—to estimate crude and age-standardized non-delivery antenatal hospitalization rates, adverse birth outcomes, stillbirth, and infant mortality by nativity status. Antenatal hospitalization is a well established indicator of maternal morbidity. Further, given the observed link between mother's and children’s well-being, it is also an important predictor of fetal morbidities. Within the immigrant population, we also examine variations in these perinatal health indicators by immigrant category (refugee vs. economic class), duration of residence in Canada, age at migration, and country/region of origin. We also investigate whether pre-migration gender inequality experienced in the country of origin continue to have lasting perinatal health consequences once immigrant women have settled in Canada. Research Team: PI Z. Vang; CIs S. Yang, B. Vissandjee; Collaborator E. Ng
Funding: CIHR ($351,901)


A pilot test of the Edinburgh Postnatal Depression Scale for Cree (EPDS-Cree). The usage of Eurocentric psychosocial measures in cross-cultural settings is problematic because psychological constructs such as depression, anxiety and distress are culturally specific. As such, a psychosocial measure that was developed for one cultural group may not be appropriate for another population with a different culture. Although a handful of depression questionnaires have been validated for use with First Nations, Inuit and Métis (e.g., the Kessler Psychological Distress Scale), a psychosocial measure specific to perinatal depression has not been cross-culturally adapted and validated for use with Indigenous populations in Canada. In collaboration with the Cree Board of Health and Social Services of James Bay, I am the principal investigator of a validation study for the EPDS-Cree, a cross-culturally adapted version of the Edinburgh Postnatal Depression Scale (EPDS) that my team and I developed; the EPDS is one of the most widely used screening tools for perinatal depression. The EPDS-Cree will be validated with childbearing age women in the Eeyou Istchee communities of northern Quebec. Research Team: PI Z. Vang; CIs R. Gagnon, E. Chachamovich, K. Wou, J. Torrie, D. Gauthier, L. Neeposh
Funding: Health Canada via the Health Care Access for Linguistic Minorities (HCALM) Network ($20,000)


Decolonizing childbirth with Nunavik Inuit women transferred to high-risk hospitals for childbirth: A co-designed pilot intervention. I am a co-investigator on study that utilizes participatory research approaches to co-design and pilot an intervention with Nunavimmiut women, their families and community members, as well as perinatal healthcare providers and policy makers in Nunavik and Montreal. The intervention is aimed at improving perinatal health for Inuit by mobilizing and affirming Inuit knowledges and values of childbirth and engaging Inuit voices in service delivery improvement to support culturally safe childbirth in southern maternities. Research Team: PI N. Andersson; CIs A. Cockcroft, Z. Vang; Collaborators H. Silver, R. Budgell, A. Alaku, B. Epoo, J. Stonier, K. Moorehouse, V. Van Wagner, J. Tremblay-Pouliot, F. Pernet, M. Bourassa, R. Fusco
Funding: CIHR ($100,000)


Socioeconomic and ethnocultural disparities in perinatal health in Canada: Current pattern and changes over time. I am a co-investigator on a study examining socioeconomic and ethnocultural disparities in perinatal health in Canada using a novel linked dataset that combines information from birth records with the 2016 census (2016 CanBCC). The 2016 CanBCC permits national-level population-based analysis of birth outcomes, stillbirth and infant mortality for all women in Canada, including immigrants and Indigenous women. Combined with the 1996 CanBCC and 2006 CanBCC, datasets that were previously created in another study, we will produce policy-relevant national trends in perinatal outcomes by socioeconomic gradients and for different populations that span two decades. Research Team: PI Y. Yang; CIs T. Bushnik, J.Kaufman, A. Mashford-Pringle, G. Shapiro, C. Shirt, Z. Vang
Funding: CIHR ($321,300).