[Ngo-emwg] Indigenous populations worldwide face chronic disease, mental health, and poverty-related challenges

[Vern Weitzel]

Subject: [procor] Indigenous populations worldwide face chronic disease, mental 
health, and poverty-related challenges
Date: Thu, 09 Jul 2009 09:33:11 -0400
From: ProCor <procor at procor.org>
Reply-To: Global Dialogue <procor at list.procor.org>
To: Global Dialogue <procor at list.procor.org>

"In some Indigenous populations rates of lifestyle-related chronic diseases are 
increasing by more than 25% per decade. This is looming as an international 
public health catastrophe," states a Lancet press release announcing two key 
review articles on the health of Indigenous people in the 4 July 2009 issue 
(Lancet 2009; 374: 65-85).

Among the world's almost 400 million indigenous people, chronic disease is 
increasing as a result of the adoption of more western lifstyles; mental health 
issues persist; and malnutrition and poverty contribute to overall poor health. 
In 2006, The Lancet published a landmark series highlighting the poor health 
status of indigenous populations worldwide. The 4 July 2009 issue provides an 
update on the health of indigenous people with two key review articles.

Part 1 examines determinants and disease patterns:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60914-4/fulltext

Part 2 explores the underlying causes of the health gap:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60827-8/fulltext

Both are open access after free registration and login (www.thelancet.com).

Excerpted from The Lancet's press release:

"Westernisation of Indigenous populations has caused an alarming upsurge in 
chronic diseases related to lifestyle factors. High-calorie, high-fat, high-salt 
diets, combined with decreasing physical activity and genetic predisposition, 
mean that, for example, 40% of all Aboriginal adults in northwest Australia have 
diabetes, and this goes to 60% when looking at those aged 35 and over. Some 
children become overweight and insulin resistant as early as 5 years old. And 
Aboriginal children up to 17 years of age in Western Australia have a diagnosis 
rate for diabetes 18 times higher than their non-Indigenous counterparts. Heart 
disease and problems related to drug, tobacco, and alcohol use are also 
increasing sharply. Alarmingly, in some Indigenous populations rates of 
lifestyle-related chronic diseases are increasing by more than 25% per decade. 
This is looming as an international public health catastrophe.

"A total of 11 risk factors collectively explained 37% of the Australian 
Indigenous disease burden. These were tobacco use, alcohol, drug use, high body 
mass, physical inactivity, low intake of fruit and vegetables, high blood 
pressure, high cholesterol, unsafe sex, child abuse, and intimate partner abuse. 
These factors can all contribute to disease or injuries and violence.

"To illustrate the Indignenous Health Gap, the authors quoted health statistics 
of 193 countries. All Australian men aged 15-60 years combined had the seventh 
lowest and all Australian women combined had the 12th lowest probability of 
dying in 2003. But looking at Indigenous Australians alone, they were down at 
131st in the list - below East Timor.

"The authors say: 'The [Australian] Government is now committed to closing this 
gap and other forms of long-term disadvantage that Indigenous Australians 
have...These gaps will probably not be closed by the target date of 2030 despite 
our best efforts and irrespective of various strategies, social and medical, 
that have been proposed...Regrettably, inadequate attention seems to have been 
given to potential gains that could be achieved through more meaningful 
involvement of Indigenous Australians and their communities in this task.'

"The authors propose a range of interventions, across maternal and child health, 
nutrition, infectious diseases, and lifestyle diseases to help close the gap, 
and conclude: ' Health standards of Indigenous peoples are unacceptably poor, 
but there is no need to despair; correction of the present situation needs a 
radical reorientation of previous strategies that have been ineffective or 
virtually non-existent. Apart from the approaches we propose...also important is 
to enable, train, and encourage Indigenous people to take responsibility for 
programmes and services that affect their health and for them to work closely 
with existing health-care systems. Emphasis on the urgent need for local, 
regional, and international statistics about Indigenous health is important to 
allow assessment of future trends and usefulness of interventions...At present 
most countries have no statistics or only unreliable information about the 
health of their indigenous groups. It is virtually impossible to measure 
progress over time without adequate data."

Catherine Coleman
Editor in Chief, ProCor