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

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

Research output: Contribution to journalJournal articleResearchpeer-review

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.

Original languageEnglish
JournalThe Lancet
Volume388
Issue number10040
Pages (from-to)131-57
ISSN0140-6736
DOIs
Publication statusPublished - 9. Jul 2016

Keywords

  • Adult
  • Child
  • Child Nutrition Disorders
  • Educational Status
  • Fetal Macrosomia
  • Global Health
  • Health Status Disparities
  • Humans
  • Infant
  • Infant Mortality
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Life Expectancy
  • Maternal Mortality
  • Obesity
  • Pediatric Obesity
  • Population Groups
  • Poverty
  • Socioeconomic Factors
  • Journal Article
  • Research Support, Non-U.S. Gov't

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