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Chang AB, Kovesi T, Redding GJ, Wong C, Alvarez GG, Nantanda R, Beltetón E, Bravo-López M, Toombs M, Torzillo PJ, Gray DM. Chronic respiratory disease in Indigenous peoples: a framework to address inequity and strengthen respiratory health and health care globally. THE LANCET. RESPIRATORY MEDICINE 2024; 12:556-574. [PMID: 38677306 DOI: 10.1016/s2213-2600(24)00008-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 01/04/2024] [Accepted: 01/12/2024] [Indexed: 04/29/2024]
Abstract
Indigenous peoples around the world bear a disproportionate burden of chronic respiratory diseases, which are associated with increased risks of morbidity and mortality. Despite the imperative to address global inequity, research focused on strengthening respiratory health in Indigenous peoples is lacking, particularly in low-income and middle-income countries. Drivers of the increased rates and severity of chronic respiratory diseases in Indigenous peoples include a high prevalence of risk factors (eg, prematurity, low birthweight, poor nutrition, air pollution, high burden of infections, and poverty) and poor access to appropriate diagnosis and care, which might be linked to colonisation and historical and current systemic racism. Efforts to tackle this disproportionate burden of chronic respiratory diseases must include both global approaches to address contributing factors, including decolonisation of health care and research, and local approaches, co-designed with Indigenous people, to ensure the provision of culturally strengthened care with more equitable prioritisation of resources. Here, we review evidence on the burden of chronic respiratory diseases in Indigenous peoples globally, summarise factors that underlie health disparities between Indigenous and non-Indigenous people, propose a framework of approaches to improve the respiratory health of Indigenous peoples, and outline future directions for clinical care and research.
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Affiliation(s)
- Anne B Chang
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia; NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
| | - Tom Kovesi
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
| | - Gregory J Redding
- School of Medicine, University of Washington, Seattle, WA, USA; Pediatric Pulmonary Division, Seattle Children's Hospital, Seattle, WA, USA
| | - Conroy Wong
- Department of Respiratory Medicine, Te Whatu Ora Counties Manukau, Auckland, New Zealand; School of Medicine, University of Auckland, Auckland, New Zealand
| | - Gonzalo G Alvarez
- Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Rebecca Nantanda
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Edgar Beltetón
- Centro Pediátrico de Guatemala, Guatemala City, Guatemala
| | - Maynor Bravo-López
- Centro Pediátrico de Guatemala, Guatemala City, Guatemala; Department of Pediatrics, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Maree Toombs
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Paul J Torzillo
- Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia; Nganampa Health Council, Alice Springs, NT, Australia
| | - Diane M Gray
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Brown B, Holt S, Dindinger-Hill K, Wolff EM, Javid S, Nyame Y, Gore JL. Urgent versus elective surgical disparities among American Indian and Alaska Native patients. World J Surg 2024; 48:1037-1044. [PMID: 38497974 DOI: 10.1002/wjs.12132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/20/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND American Indian and Alaska Native (AIAN) health issues are understudied despite documentation of lower-than-average life expectancy. Urgent surgery is associated with higher rates of postsurgical complications and postoperative death. We assess whether American Indian and Alaska Native (AIAN) patients in Washington State are at greater risk of requiring urgent rather than elective surgery compared with non-Hispanic Whites (NHW). METHODS We accessed data for the period 2009-2014 from the Washington State Comprehensive Hospital Abstract Reporting System (CHARS) database, which captures all statewide hospital admissions, to examine three common surgeries that are performed both urgently and electively: hip replacements, aortic valve replacements, and spinal fusions. We extracted patient race, age, insurance status, comorbidity, admission type, and procedures performed. We then constructed multivariable logistic regression models to identify factors associated with use of urgent surgical care. RESULTS AIAN patients had lower mean age at surgery for all three surgeries compared with NHW patients. AIAN patients were at higher risk for urgent surgery for hip replacements (OR = 1.49, 95% CI 1.19-1.88), spinal fusions (OR = 1.39, 95% CI 1.04-1.87), and aortic valve replacements (OR = 2.06, 95% CI 1.12-3.80). CONCLUSION AIAN patients were more likely to undergo urgent hip replacement, spinal fusion, and aortic valve replacement than NHW patients. AIAN patients underwent urgent surgery at younger ages. Medicaid insurance conferred higher risks for urgent surgery across all surgeries studied. Further research is warranted to more clearly identify the factors contributing to disparities among AIAN patients undergoing urgent surgery.
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Affiliation(s)
- Benjamin Brown
- Department of Urology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Sarah Holt
- Department of Urology, University of Washington, Seattle, Washington, USA
| | | | - Erika M Wolff
- Department of Urology, University of Washington, Seattle, Washington, USA
| | - Sara Javid
- Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Yaw Nyame
- Department of Urology, University of Washington, Seattle, Washington, USA
| | - John L Gore
- Department of Urology, University of Washington, Seattle, Washington, USA
- Department of Surgery, University of Washington, Seattle, Washington, USA
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Pan S, Chen S, Fretts AM, Ali T. Associations of pedometer-measured ambulatory activity with incidence of atherosclerotic cardiovascular diseases: Strong heart family study. Prev Med 2023; 177:107781. [PMID: 37984645 PMCID: PMC10872869 DOI: 10.1016/j.ypmed.2023.107781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE Coronary heart disease has several risk factors that require a multifactorial community intervention approach in prevention efforts. Prevalence of coronary heart disease and its risk factors have been disproportionately high among American Indians. The objective of this study is to evaluate the impact of ambulatory activity levels on the development of coronary heart disease in this population. METHODS Using pedometer data and other lifestyle and clinical factors from 2492 participants in the Strong Heart Family Study, we examined the associations of average daily step counts with incident coronary heart disease during an 18 to 20 year follow-up. RESULTS After adjusting for potential confounders, participants with daily step counts in the 4th quartile (>7282 steps per day) had significantly lower odds of developing coronary heart disease compared to those in the 1st quartile (<3010 steps per day) (p = 0.035). CONCLUSIONS Higher daily step count (over 7282 steps per day) is significantly associated with lower incidence of coronary heart disease among American Indian participants of the Strong Heart Family Study in a 20-year follow-up period.
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Affiliation(s)
- Steven Pan
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Sixia Chen
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Amanda M Fretts
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Tauqeer Ali
- Department of Biostatistics and Epidemiology, Center for American Indian Health Research, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Madden C, Ferber M, Cantwell S, Xaverius P, Christopher KM. Maternal Malnutrition During Pregnancy Among Women with Metabolic and Bariatric Surgery. Obes Surg 2023; 33:2276-2281. [PMID: 37329409 DOI: 10.1007/s11695-023-06678-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/30/2023] [Accepted: 06/08/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION As the utilization of metabolic and bariatric surgery (MBS) continues to rise, it is important to address the nutritional needs of women who had MBS who become pregnant. Not meeting those nutritional needs could lead to complications associated with malnutrition. To better understand the relationship between MBS, pregnancy, and malnutrition, this study sought to determine whether differences exist in the presence of malnutrition during pregnancy in women with a history of MBS compared to women without a history of MBS. METHODS This cross-sectional study used the National Inpatient Sample (NIS) from 2012 to 2017, which samples 20% of hospital discharges in the USA. Multivariate logistic regression models were fitted, and odds rations and 95% confidence intervals were calculated with obesity and MBS as the independent variables and malnutrition during pregnancy as the dependent variable. Covariates included in the multivariate model were age, primary payer, hypertension, hyperlipidemia, and depression. RESULTS Compared to women who did not have MBS, women who had MBS had higher odds of malnutrition during pregnancy (aOR = 8.33, 95% CI 7.30-9.50), this result was moderated by racial category (aORBlack = 6.35, 95% CI 4.97-8.13; aORwhite = 8.25, 95% CI 7.00-9.73; aORLatina = 10.93, 95% CI 8.38-14.25). Women with obesity also had higher odds of malnutrition during pregnancy. CONCLUSIONS The increased odds of malnutrition among women with MBS suggests that it is important to consider tailoring nutrition recommendations to address the different nutritional needs of pregnant women who had MBS and may be at risk for malnutrition.
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Affiliation(s)
- Colleen Madden
- Marion County Public Health Department, 3838 N Rural St, Indianapolis, IN, 46205, USA
| | - Megan Ferber
- College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO, 63104, USA
| | - Sophia Cantwell
- Medical Family Therapy Program, Department of Family and Community Medicine, Saint Louis University, 3700 Lindell Blvd, Morrissey Hall Suite 1127, Saint Louis, MO, 63108, USA
| | - Pamela Xaverius
- University of Health Sciences and Pharmacy in St. Louis, 1 Pharmacy Place, Saint Louis, MO, 63110, USA
| | - Kara M Christopher
- Souers Stroke Institute, Department of Neurology, Saint Louis University, 1008 S. Spring Ave, 3rd Floor, Saint Louis, MO, 63110, USA.
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Crocetti AC, Cubillo (Larrakia) B, Lock (Ngiyampaa) M, Walker (Yorta Yorta) T, Hill (Torres Strait Islander) K, Mitchell (Mununjali) F, Paradies (Wakaya) Y, Backholer K, Browne J. The commercial determinants of Indigenous health and well-being: a systematic scoping review. BMJ Glob Health 2022; 7:bmjgh-2022-010366. [PMID: 36319033 PMCID: PMC9628540 DOI: 10.1136/bmjgh-2022-010366] [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: 08/08/2022] [Accepted: 10/04/2022] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Health inequity within Indigenous populations is widespread and underpinned by colonialism, dispossession and oppression. Social and cultural determinants of Indigenous health and well-being are well described. Despite emerging literature on the commercial determinants of health, the health and well-being impacts of commercial activities for Indigenous populations is not well understood. We aimed to identify, map and synthesise the available evidence on the commercial determinants of Indigenous health and well-being. METHODS Five academic databases (MEDLINE Complete, Global Health APAPsycInfo, Environment Complete and Business Source Complete) and grey literature (Australian Indigenous HealthInfoNet, Google Scholar, Google) were systematically searched for articles describing commercial industry activities that may influence health and well-being for Indigenous peoples in high-income countries. Data were extracted by Indigenous and non-Indigenous researchers and narratively synthesised. RESULTS 56 articles from the USA, Canada, Australia, New Zealand, Norway and Sweden were included, 11 of which were editorials/commentaries. The activities of the extractive (mining), tobacco, food and beverage, pharmaceutical, alcohol and gambling industries were reported to impact Indigenous populations. Forty-six articles reported health-harming commercial practices, including exploitation of Indigenous land, marketing, lobbying and corporate social responsibility activities. Eight articles reported positive commercial industry activities that may reinforce cultural expression, cultural continuity and Indigenous self-determination. Few articles reported Indigenous involvement across the study design and implementation. CONCLUSION Commercial industry activities contribute to health and well-being outcomes of Indigenous populations. Actions to reduce the harmful impacts of commercial activities on Indigenous health and well-being and future empirical research on the commercial determinants of Indigenous health, should be Indigenous led or designed in collaboration with Indigenous peoples.
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Affiliation(s)
- Alessandro Connor Crocetti
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Beau Cubillo (Larrakia)
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Mark Lock (Ngiyampaa)
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Troy Walker (Yorta Yorta)
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Karen Hill (Torres Strait Islander)
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | | | - Yin Paradies (Wakaya)
- Deakin University Alfred Deakin Institute for Citizenship and Globalisation, Burwood, Victoria, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Jennifer Browne
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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