TY - JOUR
T1 - Indigenous and tribal peoples' health (The Lancet–Lowitja Institute Global Collaboration)
T2 - a population study
AU - Anderson, Ian
AU - Robson, Bridget
AU - Connolly, Michele
AU - Al-Yaman, Fadwa
AU - Bjertness, Espen
AU - King, Alexandra
AU - Tynan, Michael
AU - Madden, Richard
AU - Bang, Abhay
AU - Coimbra, Carlos E.A.
AU - Pesantes, Maria Amalia
AU - Amigo, Hugo
AU - Andronov, Sergei
AU - Armien, Blas
AU - Obando, Daniel Ayala
AU - Axelsson, Per
AU - Bhatti, Zaid Shakoor
AU - Bhutta, Zulfiqar Ahmed
AU - Bjerregaard, Peter
AU - Bjertness, Marius B.
AU - Briceno-Leon, Roberto
AU - Broderstad, Ann Ragnhild
AU - Bustos, Patricia
AU - Chongsuvivatwong, Virasakdi
AU - Chu, Jiayou
AU - Deji,
AU - Gouda, Jitendra
AU - Harikumar, Rachakulla
AU - Htay, Thein Thein
AU - Htet, Aung Soe
AU - Izugbara, Chimaraoke
AU - Kamaka, Martina
AU - King, Malcolm
AU - Kodavanti, Mallikharjuna Rao
AU - Lara, Macarena
AU - Laxmaiah, Avula
AU - Lema, Claudia
AU - Taborda, Ana María León
AU - Liabsuetrakul, Tippawan
AU - Lobanov, Andrey
AU - Melhus, Marita
AU - Meshram, Indrapal
AU - Miranda, J. Jaime
AU - Mu, Thet Thet
AU - Nagalla, Balkrishna
AU - Nimmathota, Arlappa
AU - Popov, Andrey Ivanovich
AU - Poveda, Ana María Peñuela
AU - Ram, Faujdar
AU - Reich, Hannah
AU - Santos, Ricardo V.
AU - Sein, Aye Aye
AU - Shekhar, Chander
AU - Sherpa, Lhamo Y.
AU - Skold, Peter
AU - Tano, Sofia
AU - Tanywe, Asahngwa
AU - Ugwu, Chidi
AU - Ugwu, Fabian
AU - Vapattanawong, Patama
AU - Wan, Xia
AU - Welch, James R.
AU - Yang, Gonghuan
AU - Yang, Zhaoqing
AU - Yap, Leslie
N1 - Funding Information:
JJM reports grants from National Heart, Lung and Blood Institute, National Institutes of Health (NIH) (HHSN268200900028C-3-0-1, HHSN268200900033C, U01HL114180); National Institute of Mental Health, NIH (U19MH098780); Grand Challenges Canada (0335-04); Medtronics Foundation; Fogarty International Center, NIH (R21TW009982); CONCYTEC; Inter-American Institute for Global Change Research (CRN3036); IDRC (106887?001); Alliance for Health Policy and Health Systems Research, WHO (HQHSR1206660); and Medical Research Council UK (MR/M007405/1) outside the submitted work. MKa and LY reports grants from Health Resources and Services Administration, Bureau of Health Professions, US Department of Health and Human Services during the conduct of the study. All other authors declare no competing interests.
Funding Information:
We thank the countless individuals who have contributed to reviewing this study in various capacities. Funding for the study was provided by The Lowitja Institute, Australia's national institute for Aboriginal and Torres Strait Islander health research. Funding provided by the Lowitja Intitute supported the meetings of contributors in New York and London in 2014. BR would like to thank Gordon Purdie (biostatistician), Department of Public Health, University of Otago, Wellington, New Zealand (for calculating low birthweight and high birthweight from unit record data). FA-Y would like to acknowledge the assistance of Tracy Dixon, Helen Johnstone, and Indrani Pieris-Caldwell from the Indigenous and Children's Group at the Australian Institute of Health and Welfare. EB, GY, XW, and Deji would like to thank Network for University Co-operation Tibet–Norway, University of Oslo, Oslo, Norway for providing support to data collections among adults and children in Tibet. They would also like to thank the China Medical Board Fund, Centre of Disease Prevention and Control of Tibet Autonomous Region (TAR), Centre of Disease Prevention and Control of China, Statistic Bureau of TAR, Health Bureau of TAR, and the Institute of Basic Medical Science at China Academy of Medical Science for providing census, communicable disease, and disease of surveillance points system data in Tibet and mainland China. AB wishes to thank the Office of the Registrar General and Census Commissioner, Government of India (for the national census data including those for tribal people); The International Institute of Population Sciences, Mumbai (for the segregated data on tribal people in India); The National Nutrition Monitoring Bureau, Indian Council of Medical Research, Hyderabad, India (for the data on the nutritional status of tribal people); and the National Sample Survey Office, Ministry of Statistics and Program Implementation, Government of India (for the economic and educational status of tribal people). LYS would like to thank the Himalayan Health and Environmental Services Solukhumbu for providing the maternal and child health data and Prof Om Gurung (Head of the Central Department of Sociology/Anthropology, Tribhuwan University, Nepal). TTH, AAS, MBB, ASH, TTM, and EB acknowledge the Norwegian Programme for Capacity Development in Higher Education and Research for Development and the project MY-NORTH for providing support to data collections among adults in Myanmar. The SAMINOR study (ARB, MM) was funded by the Norwegian Ministry of Health and Care Services, the Norwegian Directorate of Health, Northern Norway Regional Health Authority, the Regional Research Council of Northern Norway, the Sami Parliament, Sami National Centre for Mental Health Karasjok, and the Troms, Finnmark, and Nordland County Councils. The Knut and Alice Wallenberg Foundation: Wallenberg Academy Fellows and the Swedish Research Council Grant Dnr 2012-5490 fund the work of PA and ST. AT acknowledges the Centre for Behavioural and Social Research, Cameroon and the Cameroon Centre for Evidence Based Healthcare for granting access to information on Pygmy health in Cameroon. Core support for the Chief Investigator was provided by the African Population and Health Research Centre by Sida and the Hewlett Foundation. MAP has a postdoctoral fellowship funded by the Peruvian National Council of Science and Technology. AMLT thanks Lía Marcela Güiza for assistance with health indicators. MC, MKa, and LY wish to thank Sam Notzon for his contributions to the sections on data sources and data issues. CEAC, RVS, and JRW acknowledge the support of the Brazilian Association of Public Health and the Brazilian National Council for Scientific and Technological Development.
Funding Information:
JJM reports grants from National Heart, Lung and Blood Institute, National Institutes of Health (NIH) ( HHSN268200900028C-3-0-1, HHSN268200900033C, U01HL114180 ); National Institute of Mental Health, NIH ( U19MH098780 ); Grand Challenges Canada ( 0335-04 ); Medtronics Foundation; Fogarty International Center, NIH ( R21TW009982 ); CONCYTEC; Inter-American Institute for Global Change Research ( CRN3036 ); IDRC ( 106887–001 ); Alliance for Health Policy and Health Systems Research, WHO ( HQHSR1206660 ); and Medical Research Council UK ( MR/M007405/1 ) outside the submitted work. MKa and LY reports grants from Health Resources and Services Administration, Bureau of Health Professions, US Department of Health and Human Services during the conduct of the study. All other authors declare no competing interests.
Publisher Copyright:
© 2016 Elsevier Ltd
PY - 2016/7/9
Y1 - 2016/7/9
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84982859363&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(16)00345-7
DO - 10.1016/S0140-6736(16)00345-7
M3 - Article
C2 - 27108232
AN - SCOPUS:84982859363
SN - 0140-6736
VL - 388
SP - 131
EP - 157
JO - The Lancet
JF - The Lancet
IS - 10040
ER -
