Otitis media: health and social consequences for aboriginal youth in Canada's north.

OBJECTIVES. Otitis media is endemic among Inuit, First Nations and Metis children in northern Canada, with prevalence rates in some communities as high as 40 times that found in the urban south. Hearing impairment, much of it attributable to chronic otitis media, is the most common health problem in parts of the arctic, and conductive hearing loss among children may affect as many as two-thirds. STUDY DESIGN AND METHODS: There is a need for systematic data based on consistent disease definitions and measures, and taking account of cross-cultural methodological issues and sampling. RESULTS: Otitis media is most likely to develop in infancy. Susceptibility has been linked to immune defects and to a variety of environmental factors. Among the most significant are diet, the decline in initiation and maintenance of breastfeeding, and exposure to cigarette smoke. Hearing loss has been related to difficulties in language acquisition, and to subsequent issues with literacy and school achievement, including learning disabilities and attention deficits. The economic and social costs of otitis media are substantial. CONCLUSION: Approaches to treatment and prevention have enjoyed limited success. Public health and medical practice need to be informed by the traditional knowledge and practices of indigenous peoples