Are sport and traditional Inuit games identified as tools in current Inuit suicide prevention strategies?: A content analysis

ABSTRACT

Eekeeluak Avalak, an 18-year-old Inuk wrestler who won the first-ever gold medal for Nunavut at the Canada Summer Games in 2022, dedicated his win to his late brother who died by suicide in 2015. Avalak openly attributed sport – specifically wrestling – to saving his own life. This story raises important questions about the role of sport and traditional games in Inuit suicide prevention strategies. Few studies have examined the role of sport or traditional games in Inuit suicide prevention strategies. In an attempt to reduce Inuit suicide rates, in addition to the National Inuit Prevention Strategy, three of the four land claim regions that constitute Inuit Nunangat have suicide prevention strategies. In this study, we used settler colonial theory, critical Inuit studies, and content analysis to examine if and how sport and Inuit traditional games are identified as prevention tools in these Inuit suicide prevention strategies. The results demonstrate that sport and traditional games have largely been overlooked as protective factors in current Inuit-wide and land-claim specific suicide prevention strategies. Moving forward, evidence-based and community-driven approaches could be funded, created, implemented, and evaluated as culturally-safe Inuit mental health intervention models to address the disproportionately high suicide rates among Inuit in Inuit Nunangat.

KEYWORDS:

• Inuit
• sport
• traditional games
• suicide prevention

Eekeeluak Avalak, an 18-year-old Inuit wrestler who won the first-ever gold medal for Nunavut at the Canada Summer Games in 2022, dedicated his win to his late brother who died by suicide in 2015 [1]. Avalak openly attributed sport – specifically wrestling – to saving his own life [1]. Jordin Tootoo, the first Inuk to play in the National Hockey League (NHL) and whose brother died by suicide, also shared that hockey saved his life [2]. Terry Aknavigak and Daisy Eyegetok stepped back from coaching basketball in Cambridge Bay, Nunavut, several years ago, but former athletes have said that the couple helped to save lives by giving students a place to go, making them feel like they belonged, and showing them a wider world outside of their community [3]. These three stories highlight the suicide crisis in Inuit communities, but they also raise important questions about the role of sport and Inuit traditional games in Inuit suicide prevention strategies. Troublingly, Inuit have the highest suicide rates in Canada. Inuit Tapiriit Kanatami [4] reported that they range between five to 25 times the national suicide rates in Canada in any given year. Few studies have considered the use of sport or Inuit traditional games as viable and culturally-safe mental health interventions. While there is some evidence to suggest that sport and traditional games may play a role in suicide prevention for Indigenous peoples in Canada [5], or First Nations peoples specifically [6], a paucity of evidence exists that focuses only on Inuit.

In an attempt to address the high suicide among Inuit, in addition to the national suicide prevention strategy developed by ITK [4], three of the four land claim regions that constitute Inuit Nunangat (the Inuit homeland) – the Inuvialuit Settlement Region (ISR), Nunavut, Nunavik, and Nunatsiavut – have land-claim specific suicide prevention strategies. The purpose of this study was to examine if and how sport and Inuit traditional games are identified as meaningful tools in these Inuit suicide prevention strategies. Following a review of the literature, we outline our theoretical framework, which is informed by settler colonial theory and critical Inuit studies, and our methodological approach of content analysis. The results demonstrate that sport and traditional games have been largely overlooked as protective factors in current Inuit-wide and land-claim specific suicide prevention strategies. Moving forward, community-driven, culturally-safe, and evidence-based approaches that use sport and traditional Inuit games could be created, implemented, and evaluated as Inuit mental health intervention tools to address the disproportionately high suicide rates among Inuit in Inuit Nunangat.

Literature review

Inuit and suicide

Inuit have experienced profound historical and contemporary traumas linked to colonialism [7]. Colonial policies and practices such as forced re-settlement, residential schools, and the slaughter of Inuit sled dogs have led to social inequities, intergenerational trauma, loss of cultural practices, and mental distress and illness [7,8]. These traumas have resulted in alarmingly high suicide rates, particularly among Inuit youth, who make up the largest youth population in Canada [9]. Affleck et al. [8] reported that from 2009–2013, the suicide rate in Canada was 11 per 100,000, whereas in Inuit Nunangat, rates ranged from 60 per 100,000 in the ISR to 275 per 100,000 in Nunatsiavut during the same period. Inuit males, especially those aged 15–29, face an elevated risk compared to their southern Canadian counterparts, with young Inuit men being nearly 40 times more likely to die by suicide [4,8].

In response to the high suicide rates that disproportionately affect Inuit, Inuit Tapiriit Kanatami [4], developed the National Inuit Suicide Prevention Strategy, identifying six key risk and protective factors: historical trauma, community distress, wounded family, traumatic stress and early adversity, mental stress, and acute stress or loss. Preventative factors included cultural continuity, social equity, family strength, healthy development, mental wellness, and coping with acute stress [4]. Beaudoin et al. [10] demonstrated that Inuit in Nunavut without suicide attempts displayed more protective factors over their lifespan than those who died by suicide or attempted it. Further, Kral [11] highlighted community-driven programmes as the most effective in suicide reduction and promoting suicide prevention among Inuit.

Inuit participation in sport and traditional games

Inuit participate in both Inuit traditional games (also called Arctic sports) and Euro-Canadian sports. “Arctic sports” refer to Inuit traditional games, such as knuckle hop, airplane, and a variety of kicking games, which are played both locally and at major sporting events such as the Northern Games, Arctic Winter Games, and the World Eskimo Indian Olympics. They have been played since time immemorial and have close links to skills needed to survive on the land and often emphasise cooperation over competition (Heine, 2013). Inuit have displayed great resilience and resourcefulness in keeping their traditional games alive, even when they have faced constraints such as a lack of funding and perceived illegitimacy [12]. For example, Paraschak [12] noted that Arctic sports were included only as demonstration events at the first two Arctic Winter Games in 1970 and 1972, and they were only added as full-fledged events in 1974.

Inuit also participate in mainstream, Euro-Canadian sports such a hockey, basketball, volleyball, soccer, etc., both locally and at events like the Arctic Winter Games and Canada Games. Paraschak [12,13] and Forsyth [14] have argued that Euro-Canadian sporting practices have often been used as tools of assimilation. Forsyth [14] discussed the use of a regimented calisthenic exercise programme introduced into Indian residential schools in 1910 to demonstrate the use of military-style training as a form of assimilation: “the link between military training and nationalism was unmistakable, as the drills were designed to replace tribal allegiances with a sense of patriotic duty” (p. 23). When Inuit children began attending residential schools in large numbers in the 1950s, they were subjected to continued assimilative exercise practices in schools. Further assimilative practices were paralleled by the inception of the Native Sport and Recreation Program (NSRP) in 1970 in Canada, which aimed to improve Indigenous athletes’ success in mainstream sport so they could compete alongside other Canadians at an elite level [13]. Paraschak [13] highlighted that the NSRP was ultimately discontinued because it “lack[ed] the special expertise needed to effectively deal with the unique social and cultural characteristics of native [sic] communities … which must be taken into account if meaningful programs are to be developed” (p. 12). It is unsurprising that colonial programmes failed to flourish in Indigenous communities, including Inuit communities, considering the federal agenda did not coincide with the purpose of Indigenous participants, who aspired to use their agency to “develop a people – not a sport”, and not the other way around [13]p. 8).

Importantly, Inuit participation in mainstream sport has been somewhat limited due to infrastructure gaps in the North. Nunavut Tunngavik Incorporated [15], which is the legal body that implements the Nunavut Land Claims Agreement, stated that recreation and sport facilities are essential to promoting active living and development, and it subsequently identified “community, culture, and recreation” as a priority area for infrastructure development in Nunavut. Challenges with infrastructure also exist in other Inuit land claim regions. For example, the gymnasium at the Mangilaluk school in Tuktoyaktuk, which is in the ISR, has been under renovation and thus out of use since 2021 [16]. Resident Noah Gruben, a 36-year-old father who has played basketball since his youth, voiced his concern about the closure, noting its impacts on his mental and physical health, as well as that of the Tuktoyaktuk community at large: “At the end of the day … we have minimal resources in the community, minimal infrastructure. You take something this big [basketball] away, it’s got a huge impact on the community” [16].

Benefits of youth participation in sport and traditional games

According to Statistics Canada [17], 18.4% of Inuit are under the age of 25. In comparison, 17.5% of First Nations peoples, 16% of Métis peoples, and 12.0% of non-Indigenous peoples are under 25 years of age [17]. Understanding the potential role of participation in sport and traditional games within existing suicide prevention strategies is crucial for Inuit youth, an age group that is vulnerable to suicide.

Physical and mental health benefits

Youth involvement in sport and traditional games has been linked to numerous physical and psychosocial benefits Janssen and LeBlanc [18] found that Canadian school-aged children and youth (aged 5–17 years old) experienced reduced obesity risk, improved metabolic profiles, and increased muscular strength. Eime et al”.s [19] systematic review of the psychosocial benefits of sport participation among children and adolescents who primarily resided in the United States indicated enhanced self-esteem, social interactions, and reduced depressive symptoms in participants, with team sports being particularly conducive to improving adolescents” psychosocial well-being. Further, several studies have identified sport participation as a protective factor against depression, suicidal ideation, and suicide risk [20,21].

Sport has been used as a medium to improve overall health status and combat social inequities amongst Inuit. For example, in Aupaluk, the smallest region in Nunavik, the week-long Grind Now Shine Later programme was used basketball to help 27 young leaders to become coaches in their respective communities. In an interview, organiser Russ Johnson noted, “We want to use sports, and basketball specifically, with what we’re trying to do to help combat dropout rates and suicide rates” [22]para. 6).

While global studies have underlined the overall advantages of Indigenous youth’s involvement in recreational sports and physical activities, several Canadian researchers have also examined the benefits of Indigenous youth participating in traditional games [5,23,24]. Akbar et al. [23] found that Indigenous youth across North America, Australia, and New Zealand emphasised the holistic benefits of traditional physical activities, including spiritual, emotional, mental, and some physical benefits. They viewed these activities ways to connect with the land, ancestry, and community, and to establish healthy habits.

Focusing on Indigenous traditional games in the Northwest Territories, Canada, Dubnewick et al. [25] examined participants’ involvement in the Traditional Games Championships, which are meant to increase the awareness and participation of Inuit and Dene games at the territorial level, and concluded that traditional games enhanced Indigenous youth’s experiences by promoting cultural pride, connecting with Elders, supporting a connection to the land, developing personal characteristics, and establishing a foundation for movement” (p. 207). These findings indicate potential for Inuit organisations to utilise sport and traditional games for improved physical and mental health, which have important links to suicide prevention. There are some important caveats, however.

Potential negative consequences

Though there exist many benefits to be accrued from youth’s sport and traditional games participation, it is important to recognise its potential drawbacks such as injuries and harassment (i.e. verbal, physical, and sexual abuse), which may make youth more vulnerable to depressive and/or suicidal thoughts [26]. For example, Davina McLeod, a Gwich’in and Inuvialuk hockey player of the Southern Alberta Institute of Technology Trojans, became an anti-racism advocate after being the target of an anti-Indigenous racial slur wielded by an opposing player in a game against Red Deer College in February 2020 [27]. This incident displayed the pervasive issues of racism in the Canadian sport landscape, “both in its blatant manifestations and the myriad microaggressions that sustain white supremacy” (p. 87). Indigenous peoples’ participation in sport in Canada can be harmful if organisations do not actively engage with antiracism and antidiscrimination policies and practices (Author 2, under review). Further, programmes that are offered to Indigenous youth may not be congruent with Indigenous ways of being. For example, Essa et al. [28] examined Promoting Life-skills in Aboriginal Youth, a sport for development programme for Indigenous youth in Canada that is delivered by Right To Play, an international non-governmental organisation. They found that the programme appears to be “caught in a culture of competitiveness and anchored in a funding mentality that privileges growth and numbers; a logic that is often in sharp contrast with Indigenous ways of being and youth needs” (p. 307).

Cultural safety is a term that challenges other approaches – cultural sensitivity, cultural relevancy, and cultural competency – to understanding culture in Indigenous communities by “focusing less on sensitivity and awareness and more on safety and the risk of failing to provide a safe environment” [29]p. e318). It was developed by Māori nurses as a critique of other approaches of dealing with cultural “difference”, but it has been applied in other settings, such as sport [29].

Calls for improvements to the ways in which Indigenous peoples experience sport can be found in the Truth and Reconciliation Commission’s [30] Calls to Action. Rajwani et al. [31] conducted a summative content analysis to examine the ways, if any, in which National Sport Organizations (NSOs) in Canada have implemented the five sport-related Calls to Action. The results indicated a lack of response by most NSOs, which the authors argued represents settler silence. As such, while sport can have many benefits, it is also important to understand its potential to (re)produce harm.

Below, we outline the theoretical framework and method that we used to examine if and how sport and Inuit traditional games are identified as prevention tools in Inuit suicide prevention strategies.

Theoretical framework

It is important to situate sport and traditional games among Inuit within a settler colonial theoretical framework. Coulthard and Alfred [32] described settler colonialism as a structure that uses settler-colonial relationships motivated by territoriality to reproduce social hierarchies. Coulthard and Alfred [32] defined these settler-colonial relationships as,

a particular form of domination; that is, it is a relationship where power – in this case, interrelated discursive and nondiscursive facets of economic, gendered, racial, and state power – has been structured into a relatively secure or sedimented set of hierarchical social relations that continue to facilitate the dispossession of Indigenous peoples of their lands and self-determining authority. (p. 6)

In this respect, settler-colonial relationships operate on the basis of Indigenous repression through which settlers aim to replace longstanding Indigenous traditions, practices, and cultural views with oppressive colonial domination that is meant to assimilate Indigenous peoples into the larger invasive settler society [32]. It is through inherently eliminatory [33] settler-colonial relationships that the Canadian government deemed mainstream and Euro-Canadian sport to be the legitimate, thus constructing it as more “appropriate” than traditional games [14]. Traditional games, too, have been at times subjected to settler colonial forces, with demands for standardisation for major events [34].

While we recognise that sport can be a tool of settler colonialism, some scholars in Canada have argued that, under the right conditions, sport and particularly traditional games can also promote Indigenous resurgence [28,35] [36; 37]. Arellano and Downey [35] used the example of lacrosse to examine how sport can play an active role in the empowerment of Indigenous communities and act as a form of resurgence. They concluded that,

there is considerable opportunity for Indigenous communities to re-empower their nationhood by utilizing resurgence-based programming. In the case of lacrosse, it is not simply the game that will facilitate re-empowerment but rather the centring of that game in its rightful epistemology – or traditionalism – by Indigenous nations and community members that will see it play a role in resurgence. (pp. 472–473)

McCourt [36], who self-identifies as Métis, argued that sport, games, and physical activity can offer a vehicle to heal members of Indigenous communities because these activities have served as assets that “promoted traditional values, spirituality, or medicine” (p. 16). McCourt [36] further argued that weaving culture and sport together could help with Indigenous identity navigation and cultural resurgence. Identification with one’s culture can strengthen an Indigenous person’s mental health and, in turn, act as a protective factor against suicide.

It is also important to situate this work within critical Inuit studies. If we take seriously the ideas that stories hold meaning – as it does in Inuit Qaujimajatuqangit (IQ), also known as “Inuit traditional knowledge”, and in critical Inuit studies – Inuit stories ought to be treated as legitimate forms of data that can be used in examining the role of sport and traditional games in Inuit mental health. Importantly, as a settler scholars, we do not claim to hold IQ. We do, however, believe that Inuit voices, including those of Inuit athletes, deserve attention. Inuit scholars have not to date published on sport as a potential form of Inuit resurgence; however, several prominent Inuit athletes have spoken about the ways in which sport has played a role in promoting their mental health. Inuit athletes like Eekeeluak Avalak and Jordin Tootoo have identified sport as a positive outlet central to their mental health and well-being. Following his gold-medal win at the Canada Summer Games, Avalak said, “Wrestling didn’t just change my life, it saved me … Wrestling was able to help get all that anger out … that was my outlet to escape all the trauma and stuff that I’ve gone through” [1]para. 5). In an interview with CBC Radio about his memoir, Tootoo stated, “If it wasn’t for the game of hockey, I don’t think I would have stood a chance” [2]para. 2). These are just two examples in which Inuit athletes shared their stories to suggest that sport had a positive impact on their mental health. It is these same stories that inform our research on the use of sport and Inuit traditional games as potential intervention tools in suicide prevention strategies.

Method

Qualitative content analysis is a multidisciplinary analytic method widely used in qualitative research to examine language as a form of communication and extract insights about its contextual significance [38]. Krippendorff [39] asserted that qualitative approaches to content analysis share these characteristics: they require close scrutiny of small text samples, followed by their reinterpretation into new narratives within specific academic circles and, finally, researchers must recognise that their own cultural perspectives play a role in their interpretations (an interactive hermeneutic approach). To put it simply, the process involves generating codes, partly through inductive reasoning, applied to the dataset to extract meaningful insights [40].

Qualitative content analysis based on frequency counts further enhances this method by integrating elements of both qualitative and quantitative analysis. It involves identifying themes, patterns, or categories in textual or visual data and quantifying their frequency to reveal underlying patterns. These patterns in turn aid in decontextualising, recontextualizing, and interpretating the data’s significance.

For this study, we conducted a qualitative content analysis based on frequency counts to understand the presence – or absence – of sport and Inuit traditional games in existing Inuit suicide prevention strategies. We manually searched for key terms in the National Inuit Suicide Prevention Strategy [4], in addition to three regional frameworks from the Inuvialuit Settlement Region [41], Nunavut [42], and Nunavik [43]. Nunatsiavut was excluded from this list as the region currently lacks its own suicide prevention strategy. The key search terms used included the following related to sport, traditional games, and potential synonyms for each: sport, sports, traditional sport, traditional sports, game, games, traditional game, traditional games, physical activity, physical inactivity, northern games, arctic sports, and exercise. Though we acknowledge that on-the-land activities are physically demanding, we did not include them due to their focus on subsistence.

Results

Our search terms appeared six times across the different frameworks (see Table 1); however, only three of the contexts in which the search terms were mentioned were relevant to our research question (see Table 2). For example, the key search term game was used twice to reference animals hunted for food and sport, meanwhile the term exercise was used once as a verb to suggest the application of a process. As such, we omitted these three instances from the analysis. In comparison, we included sport, physical activity, and exercise in our findings because they were used as nouns in contexts relating to an activity, or lack thereof, requiring physical exertion and skill.

Table 1. Frequency count overview.

Key search terms	Number of times the key search terms appeared in the various Inuit suicide prevention strategies	Number of relevant times the key search terms appeared in the various Inuit suicide prevention strategies
Sport	0	0
Sports	1	1
Traditional sport	0	0
Traditional sports	0	0
Game	2	0
Games	0	0
Traditional game	0	0
Traditional games	0	0
Physical activity	0	0
Physicalinactivity	1	1
Northern games	0	0
Arctic sports	0	0
Exercise	2	1
Total	6	3

Table 2. Analysis of Inuit suicide prevention strategies.

Region	Framework	Citation	Frequency of relevant key search terms across Inuit suicide prevention strategies	Mention of key search terms
InuitNunangat	National Inuit Suicide Prevention Strategy	[4]	2	” … smoking, severe obesity, physical inactivity, depression, and suicide attempts increased as the number of childhood exposures to these adverse experiences increased” (p. 22) “Healthy lifestyle choices including exercise, nutrition, and sleep can protect against depression” (p. 25)
Inuvialuit Settlement Region	Inuvialuit Settlement Region Suicide Prevention Strategy	[41]
Nunavut	Nunavut Suicide Prevention Strategy	[42]	1	”. the Partners commit to provide training opportunities for youth to cope with negative emotions, such as providing anger management courses, mental health related school supports, and greater access to healthy activities such as sports or on the land camps” (p. 18)
Nunavik	Pamphlet: Nunavik Suicide Prevention Strategy Fact Sheet: What is being done? Action Plan: 5 Priorities Process – Timeline	[43] [44] [45] [46]
Nunatsiavut

Discussion

Our results show that current Inuit-wide and land-claim specific suicide prevention strategies largely overlook involvement in sport and/or traditional games as potential protective factors. Since Indigenous youth’s participation in sport and traditional games has been associated with many emotional, mental, physical, and spiritual benefits [5,25], this current gap within specific frameworks provides an opportunity to consider the ways in which sport and/or traditional games could possibly enhance existing Inuit suicide prevention strategies.

As Inuit traditional games are already embedded within Inuit culture, their link to cultural pride and cultural resurgence is clear. Nevertheless, if sport and/or traditional games are to be utilised in Inuit youth suicide prevention, it is important that a culturally-safe approach is taken to minimise potential harms that may occur as a result sport participation. Thus, sport programmes cannot be transferred from southern, non-Inuit settings without careful considerations first being made. Importantly, however, the historic colonial, assimilative practices associated with mainstream sport does not mean that Inuit must choose between traditional games and Euro-Canadian sport. As athletes like Eekeeluak Avalak and Jordin Tootoo have shown, Inuit can participate in Euro-Canadian sport and derive benefits by bringing their values, beliefs, and culture to the practice and by participating in it on their own terms as Inuit. Having trained and caring coaches who prioritise cultural safety is an important factor in creating a sporting space in which Inuit youth can thrive [47].

In addition to being conscious of the ways in which sport and traditional games are delivered in Inuit communities, it is also important to consider the targeted demographic of these sport and traditional games programmes. Since young Inuit males (aged 15–29 years old) are the most at-risk group for suicide [4], we argue that programmes in Inuit Nunangat should focus on this demographic. In Inuit Nunangat, the ISR [41], Nunavut [42], and Nunavik [44], authors of suicide prevention strategies have noted the importance of focusing on this specific demographic.

While existing Inuit suicide strategies may not explicitly name traditional games and sport, there are clear opportunities to augment current strategies through the targeted and intentional implementation of culturally-safe sport and Inuit traditional games programmes that are grounded in healing, culture, and supported by sustainable funding structures. For example, in its fourth strategic direction in its suicide prevention strategy – Strengthening Families and Healthy Relationships – the Inuvialuit Regional Corporation [41], identified the need to “help Inuvialuit men to access and use programs and services and improve their overall wellbeing” and, more specifically, “to transform existing and develop new programs and services to encourage Inuvialuit men to participate in healthy and healing activities” (p. 56). Certainly, development and provision of sport and traditional games could fall into these categories.

Similarly, the Government of Nunavut et al. stated that suicide prevention has “increasingly been linked with … ‘embracing life’ initiatives” (p. 12), which have included hip-hop workshops. Such initiatives could also include sport and traditional games. Further, the Nunavik Regional Board of Health and Social Services [45], identified the need to strengthen protective factors such as cultural connections to ensure healthy development for children and youth. Again, sport and traditional games could be an important facet of achieving this goal. In the future, researchers could evaluate the extent to which sport and traditional games can serve as “embracing life” initiatives that may act as protective factors for suicide prevention.

Sustainable funding is important for any initiative. In Canada, the federal government offers the Sport for Social Development in Indigenous Communities (SSDIC) funding programme that is meant provide Indigenous communities additional opportunities to engage in community-level sport and reap its potential social benefits []. Currently, three streams of funding – SSDIC-streams 1, 2, and 3 – aim to deliver sport for social development projects in Indigenous communities across Canada as specific components of the Sport Support Program available to Indigenous communities []. The SSDIC programme was developed in response to the Truth and Reconciliation Commission of Canada [30], Calls to Action, in which sport was highlighted as a powerful agent for social change and innovation to help achieve key social development outcomes in Indigenous communities [48]. Programmes like SSDIC are in their infancy, but they could help to advance funding available to Inuit for promoting sport and traditional games as suicide prevention tools. While this programme remains within a colonial framework of funding that is controlled by the federal government, it could nevertheless be used strategically by Inuit to meet their self-determined goal of reducing suicide rates. Future research could focus on the community-based design, implementation, and evaluation of such programmes.

Conclusion

The findings in this paper demonstrate that sport and traditional games have largely been overlooked as protective factors in current Inuit-wide and land-claim specific suicide prevention strategies. Inuit athletes have spoken about the positive relationship between sport and mental health. Their lived experiences warrant an in-depth examination of the potential role of sport and traditional games in Inuit-led mental health initiatives, such as the Inuit-specific suicide prevention strategies. More specifically, sport-as-resurgence programmes could hold promise in promoting cultural continuity, which is known as a protective factor against suicide risk [28,35–37]. Although culturally-safe sport and traditional games will not serve as definitive remedies for the suicide crisis in Inuit communities, they could potentially serve as important protective factors for certain individuals and/or groups. Thus, it is important to acknowledge their potential contribution while also recognising the need for comprehensive, multi-faceted, community-based approaches to addressing this complex issue.

Disclosure statement

No potential conflict of interest was reported by the author(s).