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

Published in The Lancet, v. 388(10040):131-157 
Authors

Anderson, I., Robson, B., Connolly, M., Al-Yaman, F., Bjertness, E., King, A., Tynan, M., Madden, R., Bang, A., Coimbra, C.E.A., Pesantes, M.A., Amigo, H., Andronov, S., Armien, B., Obando, D.A., Axelsson, P., Bhatti, Z.S., Bhutta, Z.A., Bjerregaard, P., Bjertness, M.B., Briceno-Leon, R., Broderstad, A.R., Bustos, P., Chongsuvivatwong, V., Chu, J., Deji, Gouda, J., Harikumar, R., Htay, T.T., Htet, A.S., Izugbara, C., Kamaka, M., King, M., Kodavanti, M.R., Lara, M., Laxmaiah, A., Lema, C., Taborda, A.M.L., Liabsuetrakul, T., Lobanov, A., Melhus, M., Meshram, I., Miranda, J.J., Mu, T.T., Nagalla, B., Nimmathota, A., Popov, A.I., Poveda, A.M.P., Ram, F., Reich, H., Santos, R.V., Sein, A.A., Shekhar, C., Sherpa, L.Y., Skold, P., Tano, S., Tanywe, A., Ugwu, C., Ugwu, F., Vapattanawong, P., Wan, X., Welch, J.R., Yang, G., Yang, Z. and Yap, L.
Publication year 2016
DOI https://doi.org/10.1016/S0140-6736(16)00345-7
Affiliations
  • The University of Melbourne, Melbourne, Australia. 
  • Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago, Dunedin, New Zealand.
  • International Group on Indigenous Health Measurement, USA.
  • Indigenous and Children's Group, Australian Institute of Health and Welfare, Canberra, Australia.
  • University of Oslo, Institute of Health and Society, Department of Community Medicine, Oslo, Norway.
  • Simon Fraser University, Burnaby, BC, Canada.
  • The Lowitja Institute, Melbourne, Australia.
  • The University of Sydney, Sydney, Australia.
  • Society for Education, Action and Research in Community Health, Gadchiroli, Maharashtra, India.
  • Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
  • Salud Sin Límites Perú, Lima, Peru Center for Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Universidad de Chile, Santiago, Chile.
  • Scientific Research Centre of the Arctic, Salekhard, Russia.
  • The Gorgas Memorial Institute for Health Studies, Universidad Interamericana de Panamá, Panama City, Panama.
  • Departamento Administrativo Nacional de Estadística, Bogotá, Colombia.
  • Centre for Sami Research, Umeå University, Umeå, Sweden.
  • Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan.
  • Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan SickKids Center for Global Child Health, Toronto, Canada.
  • National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
  • LACSO, Social Science Laboratory, Central University of Venezuela, Caracas, Venezuela.
  • Centre for Sami Health Research, Faculty of Health, UiT The Arctic University of Norway, Tromsø, Norway.
  • Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
  • Institute of Medical Biology, Chinese Academy of Medical Sciences, Kunming, China.
  • Department of Preventive Medicine, Tibet University Medical College, Lhasa, Tibet, China.
  • International Institute for Population Sciences, Deemed University, Mumbai, India.
  • National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India.
  • Ministry of Health, Nay Pyi Taw, Myanmar.
  • University of Oslo, Institute of Health and Society, Department of Community Medicine, Oslo, Norway Ministry of Health, Nay Pyi Taw, Myanmar.
  • Population Dynamics and Reproductive Health Program, African Population and Health Research Center, Nairobi, Kenya.
  • Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
  • CIHR-Institute of Aboriginal Peoples' Health, Simon Fraser University, Burnaby, BC, Canada.
  • Salud Sin Límites Perú, Lima, Peru.
  • Ministerio de Salud y Protección Social, Bogotá, Colombia.
  • Center for Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • The University of Melbourne, Melbourne, Australia.
  • Arctic Research Centre, Umeå University, Umeå, Sweden.
  • School of Business and Economy, Umeå University, Umeå, Sweden.
  • Cameroon Centre for Evidence-Based Health Care, Yaounde, Cameroon.
  • Department of Sociology/Anthropology, University of Nigeria, Nsukka, Nigeria.
  • Department of Psychology, Federal University, Ndufu-Alike, Nigeria.
  • Institute for Population and Social Research, Mahidol University Salaya, Phuttamonton, Nakhon Pathom, Thailand.
  • Institute of Basic Medical Sciences at Chinese Academy of Medical Sciences & School of Basic Medicine at Peking Union Medical College, Beijing, China.
  • Native Hawaiian Center of Excellence, John A Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
IAI Program

CRN3
IAI Project CRN3036
Keywords
health
social status
Indigenous and tribal peoples

Abstract

  • 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.