“Unwieldy, fragmented and logistically stretched system is not sustainable.”

Nunavut needs to invest in community health to reduce its dependence on southern hospitals and expensive medical travel, says a new social development report from Nunavut Tunngavik Inc.

The study found that Nunavut spends more than $7,450 per person annually on health care. That's 21 per cent of Nunavut's gross domestic product. The Canadian average is 10 per cent.

"[The health system's] funds are insufficient to pay for a system that is so widely spread out and so heavily dependent on southern hospitals and medical professionals," the report states. "This unwieldy, fragmented and logistically stretched bio-medical system is not sustainable."

The system focuses too much on treating illness instead of prevention, the report says. Amongst 20 recommendations, NTI says the GN should provide core funding to community health groups, ensure government nurses aren't paid less than agency nurses, deliver more services in Inuit languages and fill vacant community health representative positions.

Nunavummiut are funnelled from their home communities through health centres in Iqaluit, Rankin Inlet or Cambridge Bay, and then on to hospitals in Ottawa, Montreal, Yellowknife, Edmonton and Winnipeg.

Transport alone costs Health and Social Services some $45 million a year, and the NTI study says travel sucked up $51.2 million of the $100 million the federal Non-Insured Health Benefits program spent in Nunavut between 1996 and 2006.

Paul Kaludjak, NTI's president, said money that's going to medical travel could be used to support local programs and services that could help reduce the need for expensive medical flights.

"You're spending so much on transportation and infrastructure and salaries, that [it] leaves very little for care," he said.

Of the report's recommendations, Kaludjak said the GN's priorities should be the development of a territorial suicide prevention strategy and ways to keep people from getting sick in the first place. That's especially challenging in remote communities where people don't have regular access to doctors, Kaludjakk said.

"People get attention or discover they have an illness way too late," he said.

Among the report's other findings:

• Teenage smoking rates are more than double those of the rest of Canada;
• Seventy per cent of pregnant Inuit women smoke daily, while 30 per cent drink "significant" amounts of alcohol during their pregnancy;
• Nunavut has the highest rates of chlamydia and gonorrhea in the country; and
• Nearly half the territory's households report not having enough food.

Despite the struggles, the report says there are health care success stories, citing programs like Clyde River's Ilisaqsivik Society, which runs a host of programs including land-based healing camps, the midwifery program and birthing centre in Rankin Inlet and has "frontline workers who are enthusiastic and thrive on challenges."

Kaludjak said officials from NTI were to meet in Ottawa with federal health minister and Nunavut MP Leona Aglukkaq next week.

He said he's optimistic that a new territorial government in Iqaluit and an Inuk health minister in Ottawa will help focus federal attention, and money, on Nunavut's health system.