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Indigenous and tribal peoples' health (The Lancet–Lowitja Institute Global Collaboration): a population study

2016; Elsevier BV; Volume: 388; Issue: 10040 Linguagem: Inglês

10.1016/s0140-6736(16)00345-7

1474-547X

Ian Anderson, Bridget Robson, Michele Connolly, Fadwa Al‐Yaman, Espen Bjertness, Alexandra King, Michael Tynan, Richard Madden, Abhay Bang, Carlos Ε. A. Coimbra, M. Amalia Pesantes, Hugo Amigo, Sergey Andronov, Blas Armién, Daniel Ayala Obando, Per Axelsson, Zaid Bhatti, Zulfiqar A Bhutta, Peter Bjerregaard, Marius B Bjertness, Roberto Briceño‐León, Ann Ragnhild Broderstad, Patricia Bustos, Virasakdi Chongsuvivatwong, Jiayou Chu, Deji, Jitendra Gouda, Harikumar Rachakulla, Thein Thein Htay, Aung Soe Htet, Chimaraoke Izugbara, Martina Kamaka, Malcolm King, Mallikharjuna Rao Kodavanti, Macarena Lara, Avula Laxmaiah, Claudia Patricia Henao Lema, Ana María León Taborda, Tippawan Liabsuetrakul, Andrey Lobanov, Marita Melhus, Indrapal I. Meshram, J. Jaime Miranda, Thet Thet Mu, Nagalla Balakrishna, Nimmathota Arlappa, Andrey I. Popov, Ana María Peñuela Poveda, Faujdar Ram, Hannah Reich, Ricardo Ventura Santos, Aye Aye Sein, Chander Shekhar, Lhamo Yangchen Sherpa, Peter Sköld, S. Tano, Asahngwa Tanywe, Chidi Ugwu, Fabian O. Ugwu, Patama Vapattanawong, Xia Wan, James R. Welch, Gonghuan Yang, Zhaoqing Yang, Leslie Yap,

Food Security and Health in Diverse Populations

Summary Background International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries. Methods Collaborators with expertise in Indigenous health data systems were identified for each country. Data were obtained for population, life expectancy at birth, infant mortality, low and high birthweight, maternal mortality, nutritional status, educational attainment, and economic status. Data sources consisted of governmental data, data from non-governmental organisations such as UNICEF, and other research. Absolute and relative differences were calculated. Findings Our data (23 countries, 28 populations) provide evidence of poorer health and social outcomes for Indigenous peoples than for non-Indigenous populations. However, this is not uniformly the case, and the size of the rate difference varies. We document poorer outcomes for Indigenous populations for: life expectancy at birth for 16 of 18 populations with a difference greater than 1 year in 15 populations; infant mortality rate for 18 of 19 populations with a rate difference greater than one per 1000 livebirths in 16 populations; maternal mortality in ten populations; low birthweight with the rate difference greater than 2% in three populations; high birthweight with the rate difference greater than 2% in one population; child malnutrition for ten of 16 populations with a difference greater than 10% in five populations; child obesity for eight of 12 populations with a difference greater than 5% in four populations; adult obesity for seven of 13 populations with a difference greater than 10% in four populations; educational attainment for 26 of 27 populations with a difference greater than 1% in 24 populations; and economic status for 15 of 18 populations with a difference greater than 1% in 14 populations. Interpretation We systematically collated data across a broader sample of countries and indicators than done in previous studies. Taking into account the UN Sustainable Development Goals, we recommend that national governments develop targeted policy responses to Indigenous health, improving access to health services, and Indigenous data within national surveillance systems. Funding The Lowitja Institute.