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Borch KB, Eliassen BM, Melhus M, Damsgård E, Broderstad AR. Physical activity in Sami and non-Sami populations in rural Northern Norway, the SAMINOR 2 Clinical Survey. BMC Public Health 2021; 21:1665. [PMID: 34521379 PMCID: PMC8438985 DOI: 10.1186/s12889-021-11744-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
Background The Sami people is an indigenous minority population living in the northern parts of Norway and mainly in rural areas. We lack data of contemporary levels of physical activity (PA) in rural regions of Northern Norway and in the Sami population in particular. We aimed to describe the PA levels and investigate whether PA levels differs between Sami and non-Sami and between coastal and inland areas. Methods We used data from the second survey of the Population-based Study on Health and Living Conditions in Regions with Sami and Norwegian Populations – the SAMINOR 2 Clinical Survey (2012–2014) that includes the adult population in 10 municipalities in the counties Troms, Finnmark and Nordland. Participants self-reported on PA, ethnicity and modifiable lifestyle factors. Twelve thousand four hundred fifty-five individuals were invited with a response rate of 48.2% (n = 6004 participants). We tested differences using chi-square tests, two sample t-tests and linear regression models. Results Among 5628 participants, 41.1 and 40.9% of men and women, respectively, were defined as Sami. We found no ethnic differences in PA in men overall. However, Sami men living in Tana, and Nesseby reported higher PA compared to non-Sami men in the same area. For Sami women there was overall lower PA levels compared to non-Sami women, especially pronounced in Kautokeino/ Karasjok. Conclusion This study showed small differences in PA levels between Sami and non-Sami men. Sami women had lower PA levels compared to their non-Sami counterparts. It is important to identify whether there are differences in various ethnic populations, together with other predictors for PA in future planning of public health interventions.
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Affiliation(s)
- Kristin Benjaminsen Borch
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | | | - Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elin Damsgård
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ann Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Young TK, Broderstad AR, Sumarokov YA, Bjerregaard P. Disparities amidst plenty: a health portrait of Indigenous peoples in circumpolar regions. Int J Circumpolar Health 2020; 79:1805254. [PMID: 32865150 PMCID: PMC7480410 DOI: 10.1080/22423982.2020.1805254] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/21/2020] [Accepted: 07/28/2020] [Indexed: 01/23/2023] Open
Abstract
This paper describes the extent and variation in health disparities between Indigenous and non-Indigenous people within Alaska, Greenland and the northern regions of Canada, Russia and the Nordic countries. We accessed official health statistics and reviewed research studies. We selected a few indicators of health status, health determinants and health care to demonstrate the health disparities that exist. For a large number of health indicators Indigenous people fare worse than non-Indigenous people in the same region or nationally, with the exception of the Sami in the Nordic countries whose health profiles are similar to their non-Sami neighbours. That we were unable to produce a uniform set of indicators applicable to all regions is indicative of the large knowledge gaps that exist. The need for ongoing health monitoring for Indigenous people is most acute for the Sami and Russia, less so for Canada, and least for Alaska, where health data specific to Alaska Natives are generally available. It is difficult to produce an overarching explanatory model for health disparities that is applicable to all regions. We need to seek explanation in the broader political, cultural and societal contexts within which Indigenous people live in their respective regions.
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Affiliation(s)
- T. Kue Young
- School of Public Health, University of Alberta, Edmonton, Canada
| | | | - Yury A. Sumarokov
- Department of International Cooperation, Northern State Medical University, Arkhangelsk, Russian Federation
| | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Storm Mienna C, Axelsson P. Somatic health in the Indigenous Sami population - a systematic review. Int J Circumpolar Health 2020; 78:1638195. [PMID: 31262241 PMCID: PMC6610513 DOI: 10.1080/22423982.2019.1638195] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The objective of this systematic review was to survey the current scientific knowledge regarding the state of somatic health among the Indigenous Sami people in Norway, Finland, Sweden and the Kola Peninsula in Russia; and assess the quality of the identified studies. A systematic search in the databases Pubmed, EBSCOhost (AMED, Medline, Cinahl) and Svemed was conducted from January 2000, through December 2017. This systematic search identified 399 articles. After screening abstracts, 93 articles were reviewed in full text, 32 of which met the inclusion criteria. The scientific quality of the evidence was rated according to the Newcastle–Ottawa scale. Based on the studies with moderate to high scientific quality, there is evidence for stating that the majority of the Sami included in this review experience good health. Mortality and life expectancy are similar, with only minor differences, to those of a non-Sami population. The cancer risk rate among Sami was lower than that of the general population of Norway, Sweden and Finland. Self-reported myocardial infarction prevalence was similar between Sami and non-Sami, but Angina pectoris was more prevalent among Sami. In Sweden, cardiovascular disease rates were similar between Sami and non-Sami. Musculoskeletal pain symptoms are common among the Sami population, as are obesity and overweight. To conclude, there are knowledge gaps in regard to the somatic health situation of the Indigenous Sami in the circumpolar area, especially in Russia, Finland and Sweden; as current knowledge is mainly based on publications from the SAMINOR study in Norway. No study obtained the highest quality score, suggesting a need to implement longitudinal prospective studies.
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Affiliation(s)
- Christina Storm Mienna
- a Department of Odontology/Clinical Oral Physiology , Umeå University , Umeå , Sweden.,b Vaartoe-Centre for Sami Research , Umeå University , Umeå , Sweden
| | - Per Axelsson
- b Vaartoe-Centre for Sami Research , Umeå University , Umeå , Sweden.,c Department of historical, philosophical and religious studies , Umeå University , Umeå , Sweden
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Siri SRA, Eliassen BM, Jacobsen BK, Melhus M, Broderstad AR, Michalsen VL, Braaten T. Changes in conventional cardiovascular risk factors and the estimated 10-year risk of acute myocardial infarction or cerebral stroke in Sami and non-Sami populations in two population-based cross-sectional surveys: the SAMINOR Study. BMJ Open 2019; 9:e028939. [PMID: 31326934 PMCID: PMC6661668 DOI: 10.1136/bmjopen-2019-028939] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To describe changes in cardiovascular risk factors and in the estimated 10-year risk of acute myocardial infarction (AMI) or cerebral stroke (CS) between SAMINOR 1 (2003-2004) and SAMINOR 2 (2012-2014), and explore if these changes differed between Sami and non-Sami. DESIGN Two cross-sectional surveys. SETTING Inhabitants of rural Northern Norway. PARTICIPANTS Participants were aged 40-79 years and participated in SAMINOR 1 (n=6417) and/or SAMINOR 2 (n=5956). PRIMARY OUTCOME MEASURES Generalised estimating equation regressions with an interaction term were used to estimate and compare changes in cardiovascular risk factors and 10-year risk of AMI or CS between the two surveys and by ethnicity. RESULTS Mean cholesterol declined by 0.50, 0.43 and 0.60 mmol/L in women, Sami men and non-Sami men, respectively (all p<0.001). Sami men had a small decline in mean high-density lipoprotein (HDL) cholesterol and an increase in mean triglycerides (both p<0.001), whereas non-Sami showed no change in these variables. Non-Sami women had an increase in mean HDL cholesterol (p<0.001) whereas Sami women had no change. Triglycerides did not change in non-Sami and Sami women. Systolic and diastolic blood pressure declined by 3.6 and 1.0 mm Hg in women, and 3.1 and 0.7 in men, respectively (all p<0.01). Mean waist circumference increased by 6.7 and 5.9 cm in women and men, respectively (both p<0.001). The odds of being a smoker declined by 35% in women and 46% in men (both p<0.001). Estimated 10-year risk of AMI or CS decreased in all strata of sex and ethnicity (p<0.001), however, Sami women had a smaller decline than non-Sami did. CONCLUSIONS Independent of ethnicity, there was a decline in mean cholesterol, blood pressure, smoking, hypertension (women only) and 10-year risk of AMI or CS, but waist circumference increased. Relatively minor ethnic differences were found in changes of cardiovascular risk factors.
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Affiliation(s)
| | | | - Bjarne K Jacobsen
- Department of Community Medicine, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, 9037, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marita Melhus
- Department of Community Medicine, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, 9037, Norway
| | - Ann Ragnhild Broderstad
- Department of Community Medicine, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, 9037, Norway
| | - Vilde Lehne Michalsen
- Department of Community Medicine, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, 9037, Norway
| | - Tonje Braaten
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Naseribafrouei A, Eliassen BM, Melhus M, Svartberg J, Broderstad AR. Estimated 8-year cumulative incidence of diabetes mellitus among Sami and non-Sami inhabitants of Northern Norway - The SAMINOR Study. BMC Endocr Disord 2019; 19:66. [PMID: 31234837 PMCID: PMC6591838 DOI: 10.1186/s12902-019-0399-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 06/19/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The aim of the study was to estimate and compare the 8-year cumulative incidence of diabetes mellitus (DM) among Sami and non-Sami inhabitants of rural districts in Northern Norway. METHODS Longitudinal study based on linkage of two cross-sectional surveys, the SAMINOR 1 Survey (2003-2004) and the SAMINOR 2 Clinical Survey (2012-2014). Ten municipalities in rural Northern Norway were included in the study. DM-free participants aged 30 and 36-71 years in SAMINOR 1 were followed from 2 years after SAMINOR 1 to attendance in SAMINOR 2. The average follow-up time was 8.1 years. Of 5875 subjects who had participated in SAMINOR 1 and could potentially be followed to SAMINOR 2, 3303 were included in the final analysis. Self-reported DM and/or HbA1c ≥ 6.5% were used to identify incident cases of DM. RESULTS At baseline, body mass index (BMI) and waist-to-height ratio (WHtR) were higher among Sami than among their non-Sami counterparts. After 8 years of follow-up, 201 incident cases of DM were identified (6.1% both Sami and non-Sami subjects). No statistically significant difference was observed in the cumulative incidence of DM between the Sami and non-Sami. CONCLUSIONS No statistically significant difference in the 8-year cumulative incidence of DM among Sami and non-Sami was observed, although Sami men and women had higher baseline BMI and WHtR.
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Affiliation(s)
- Ali Naseribafrouei
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Box 6050 Langnes, N-9037 Tromsø, Norway
| | | | - Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Box 6050 Langnes, N-9037 Tromsø, Norway
| | - Johan Svartberg
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ann Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Box 6050 Langnes, N-9037 Tromsø, Norway
- Department of Medicine, University Hospital of North Norway, Harstad, Norway
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Michalsen VL, Kvaløy K, Svartberg J, Siri SRA, Melhus M, Broderstad AR. Change in prevalence and severity of metabolic syndrome in the Sami and non-Sami population in rural Northern Norway using a repeated cross-sectional population-based study design: the SAMINOR Study. BMJ Open 2019; 9:e027791. [PMID: 31201190 PMCID: PMC6576075 DOI: 10.1136/bmjopen-2018-027791] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To examine the change in both the prevalence and severity of metabolic syndrome (MetS) in the Sami and non-Sami in Northern Norway due to a lack of knowledge regarding the development of MetS in this population. DESIGN Repeated cross-sectional study. SETTING The study is based on data from the SAMINOR 1 Survey (2003-2004, n=6550) and the SAMINOR 2 Clinical Survey (2012-2014, n=6004), conducted in 10 municipalities in Northern Norway. PARTICIPANTS Men and women aged 40-79 years were invited. We excluded participants not handing in the questionnaire and with missing information concerning ethnicity questions or MetS risk factors resulting in a final sample of 6308 (36.0% Sami) subjects in SAMINOR 1 and 5866 (40.9% Sami) subjects in SAMINOR 2. OUTCOME MEASURES MetS prevalence was determined using the harmonised Adult Treatment Panel III (ATP-III) criteria, and severity was assessed with the MetS severity Z-score. Generalised estimating equations with an interaction term (survey × ethnicity) were used to compare prevalence and severity between the two surveys while accounting for partly repeated measurements. RESULTS The overall, age-standardised ATP-III-MetS prevalence was 31.2% (95% CI: 29.8 to 32.6) in SAMINOR 1 and 35.6% (95% CI: 34.0 to 37.3) in SAMINOR 2. Both the ATP-III-MetS prevalence and the mean MetS severity Z-score increased between the surveys in all subgroups, except the ATP-III-MetS prevalence in non-Sami women, which remained stable. Over time, Sami men showed a slightly larger increase in MetS severity than non-Sami men (p<0.001): the score increased by 0.20 (95% CI: 0.14 to 0.25) and 0.06 (95% CI: 0.01 to 0.10) in Sami and non-Sami men, respectively. Abdominal obesity increased markedly between the surveys in all subgroups. CONCLUSION The prevalence and severity of MetS increased over time in rural Northern Norway. Abdominal obesity appeared to drive the increase in ATP-III-MetS prevalence. Sami men had a slightly larger increase in severity than non-Sami.
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Affiliation(s)
- Vilde L Michalsen
- Department of Community Health, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kirsti Kvaløy
- Department of Community Health, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Public Health and Nursing, HUNT Research Centre, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Johan Svartberg
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Susanna R A Siri
- Department of Community Health, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marita Melhus
- Department of Community Health, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ann R Broderstad
- Department of Community Health, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway
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Eliassen BM, Melhus M, Tell GS, Borch KB, Braaten T, Broderstad AR, Graff-Iversen S. Validity of self-reported myocardial infarction and stroke in regions with Sami and Norwegian populations: the SAMINOR 1 Survey and the CVDNOR project. BMJ Open 2016; 6:e012717. [PMID: 27903562 PMCID: PMC5168490 DOI: 10.1136/bmjopen-2016-012717] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Updated knowledge on the validity of self-reported myocardial infarction (SMI) and self-reported stroke (SRS) is needed in Norway. Our objective was to compare questionnaire data and hospital discharge data from regions with Sami and Norwegian populations to assess the validity of these outcomes by ethnicity, sex, age and education. DESIGN Validation study using cross-sectional questionnaire data and hospital discharge data from all Norwegian somatic hospitals. PARTICIPANTS AND SETTING should read ‘16 865 men and women aged 30 and 36–79 years participated in the first survey of the Population-based Study on Health and Living Conditions in Sami and NorwegianPopulations (the SAMINOR 1 Survey) in 2003–2004. Information on SMI and SRS was available from self-administered questionnaires for 15 005 and 15 088 of these participants, respectively. We compared this information with hospital discharge data from 1994 until SAMINOR 1 Survey attendance. PRIMARY AND SECONDARY OUTCOMES Sensitivity, specificity, positive predictive value (PPV), negative predictive value and κ. RESULTS The sensitivity and PPV of SMI were 90.1% and 78.9%, respectively; the PPV increased to 93.1% when all ischaemic heart disease (IHD) diagnoses were included. The SMI prevalence estimate was 2.3% and hospital-based 2.0%. The sensitivity and PPV of SRS were 81.1% and 64.3%, respectively. The SRS prevalence estimate was 1.5% and hospitalisation-based 1.2%. Moderate to no variation was observed in validity according to ethnicity, sex, age and education. CONCLUSIONS The sensitivity and PPV of SMI were high and moderate, respectively; for SRS, both of these measures were moderate. Our results show that SMI from the SAMINOR 1 Survey may be used in aetiological/analytical studies in this population due to a high IHD-specific PPV. The SAMINOR 1 questionnaire may also be used to estimate the prevalence of acute myocardial infarction and acute stroke.
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Affiliation(s)
- Bent-Martin Eliassen
- Faculty of Health Sciences, Department of Community Medicine, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marita Melhus
- Faculty of Health Sciences, Department of Community Medicine, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Institute of Public Health, Bergen, Norway
| | - Kristin Benjaminsen Borch
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tonje Braaten
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ann Ragnhild Broderstad
- Faculty of Health Sciences, Department of Community Medicine, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Medicine, University Hospital of Northern Norway, Harstad, Norway
| | - Sidsel Graff-Iversen
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Norwegian Institute of Public Health, Oslo, Norway
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