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An Introduction to Aboriginal Health: What Determines Aboriginal Health in Canada and Around the World?

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An Introduction to Aboriginal Health: What Determines Aboriginal Health in Canada and Around the World? Brown Bag Speaker Series on Aboriginal Health – PowerPoint PPT presentation

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Title: An Introduction to Aboriginal Health: What Determines Aboriginal Health in Canada and Around the World?


1
An Introduction to Aboriginal Health What
Determines Aboriginal Health in Canada and Around
the World?
  • Brown Bag Speaker Series on Aboriginal Health
  • October 14, 2010
  • Centre fro Aboriginal Health Research
  • Jeff Reading PhD
  • Professor and Director,
  • Centre for Aboriginal Health Research
  • School of Public Health and Social Policy
  • University of Victoria

2
Chronic Diseases
  • In 2005 of the 58 million deaths worldwide
    approximately 60 were due to chronic diseases
  • 4 out of 5 deaths will be in low and middle
    income countries
  • In these countries people tend to develop
    diseases younger, suffer longer, and die sooner

3
Chronic Diseases
  • In Canada Aboriginal people face a similar
    situation
  • Earn less than the non-Aboriginal population
  • Suffer from higher rates of many chronic diseases
    and associated risk factors
  • Have a shorter life expectancy
  • Internationally Canada ranks highly in health and
    well being, while the Aboriginal population is
    much less fortunate

4
Diabetes
  • Historically of low prevalence in the Aboriginal
    population
  • Changes in lifestyle and diet, adoption of
    Western habits has resulted in an increase in
    diabetes
  • Similar trajectory to Cardiovascular Disease and
    other chronic conditions

5
Diabetes Risk factors
  • Not all risk factors have been well studied in
    the Aboriginal population
  • Less is known about risk factors in the urban
    Aboriginal population

6
Chronic Disease Risk Factors
  • The most common risk factors for Chronic disease
    studied among Aboriginals are
  • Impaired glucose tolerance (IGT)
  • Type 2 diabetes
  • Obesity (over-eating and lack of exercise)
  • Cigarette smoking.

7
Diabetes Risk Factors
  • Diabetes prevalence is much higher in the
    Aboriginal population than the non-Aboriginal
    population
  • Diabetes occurs at a much younger age
  • Incidence is increasing

8
Diabetes Prevalence Rates
9
Diabetes Prevalence Rates
10
Diabetes Prevalence Rates
11
Chronic Disease Risk Factors
  • 46 of First Nations people are daily smokers
  • This rises to 54 in the 18-29 age group and if
    occasional smokers are included rises to 70

12
Chronic Disease Risk Factors
  • In youth the rates are also very high
  • Occasional and daily smokers 16 years of age
  • 44 male and 67 female
  • Occasional and daily smokers 17 years of age
  • 56 male and 67 female

13
Chronic Disease Risk Factors
  • From the 2002/03 Regional Health Survey
  • 42 of men and 31 of women are overweight
  • 29 of men and 34 of women are obese
  • 3 of men and 7 of women are morbidly obese

14
Chronic Disease Risk Factors
  • According to the 2002/03 Regional Health Survey
    First Nations peoples self reported rate of
    hypertension
  • 20.4 vs. 16.4 in the non-Aboriginal population
  • In the 50-59 age group this rises to 30.5 vs.
    22.4

15
Adult Risk Factors
  • Attempts to address problems of chronic diseases
    usually focuses on changing patterns of adult
    risk factors
  • Unfortunately this does not address the next
    generation and prevention of chronic disease

16
Life Course Epidemiology
  • Life course epidemiology has been defined as the
    study of long-term effects of physical or social
    exposures during gestation, childhood,
    adolescence, young adulthood, and adult life on
    ones developmental health and later disease risk

17
Diabetes, Chronic Disease and Life Course
Epidemiology
  • Life course epidemiology goes beyond traditional
    risk factors and questions the importance of
    intrauterine nutrition, birth weight, childhood
    obesity, smoking initiation ages and rates,
    adolescent blood pressure, and socioeconomic
    status across an individual and communitys life
    course.

18
Life Course Intervention
  • The Goal
  • To optimize the developmental trajectory over
    entire life course

19
Life Course Intervention
  • What matters
  • Address the complex interaction of health
    determinants, in particular Aboriginal contexts,
    over entire life course

20
Life Course Risk Factors
  • Birth weight
  • Low birth weight has been associated with an
    increased risk of heart disease and hypertension
  • Low or high birth weight has been associated with
    increased risk for diabetes
  • First Nations babies are twice as likely to be
    high birth weight babies

21
Life Course Risk Factors
  • Maternal Diabetes
  • Gestational diabetes rates are higher in
    Aboriginal women
  • Children born to diabetic mothers are at
    increased risk for impaired glucose tolerance,
    childhood obesity, and diabetes

22
Life Course Risk Factors
  • Childhood and adolescent obesity
  • Increases the risk for adult obesity
  • Aboriginal children are lacking in sports and
    recreation facilities in their communities

23
Social Determinants of Health
  • That population level factors which determine
    health and well-being for any collectivity have
    their origins in upstream historic, cultural,
    social, economic and political forces affecting
    the lives of Indigenous peoples, has been
    articulated for almost a decade.
  • Young, 1988 Young, 1994 INAC, 1996.

24
Many determinants of health are beyond the scope
of the health care system
  • Changing diets from traditional to
    non-traditional foods
  • Food insecurity
  • Stress due to economic factors
  • Pollution
  • Global capitalism etc...

25
A word about Words
  • Social Exclusion
  • Marginalization
  • Inequality
  • Risk
  • Vulnerability

26
Social Determinants of Health
  • The social determinants are often referred to as
    the causes of the causes
  • Affect rates of individual level risk factors
    such as smoking, obesity, substance abuse
  • Social determinants require social remedies

27
END POVERTY NOW!!
  • Poverty eradication as the most important
    determination of health, because it is through
    income that other determinants of health are
    purchased, such as adequate housing, access to
    health services and education, potable water and
    nutritious food etc.

28
Experiencing Major depressive Episode by
household Low income level and off-reserve health
status
  • Charlotte Loppie Reading and Fred Wein, Health
    Inequities and Social Determinants of Aboriginal
    peoples Health. NCCAD, PHAC, 2009

29
Experiencing Major depressive Episode by
household Low and High income level and
off-reserve health status
Low Medium High
  • Charlotte Loppie Reading and Fred Wein, Health
    Inequities and Social Determinants of Aboriginal
    peoples Health. NCCAD, PHAC, 2009

30
Social Determinants of Health
  • Many studies have demonstrated a connection
    between socioeconomic status and health
  • Aboriginal population has lower levels of
    education, income, and employment
  • These conditions are associated with increased
    rates of obesity, chronic conditions and diabetes

31
Social Determinants of Health
  • Can observe a health gradient within the
    Aboriginal population - poorer health associated
    with lower SES
  • Effects of colonialism
  • Effects of residential school system

32
Demographic Trends
  • Aboriginal population is much younger than the
    rest of Canada
  • Risk factors are more prevalent and increasing
    and occurring in ever younger Aboriginal people
  • As the youthful Aboriginal population ages
    increased rates and numbers of people with
    diabetes and chronic conditions disease can be
    expected

33
Actions
  • Seek commitment to a multi-year dialogue to
    explore common issues and agendas for action in
    Aboriginal health and well being.
  • Facilitate and accelerate the dissemination,
    transfer and translation of knowledge into
    potential applications and benefits through
    policies, interventions, services and products.
  • Encourage multi-lateral collaborative ventures
    among communities and institutions concerned with
    improving the health and well being of Indigenous
    peoples. Promote multi-disciplinary,
    multi-institutional, and multi-sectored
    collaborations and to build upon existing
    networks of policy-makers and researchers to
    further develop capacities on Indigenous peoples
    health in areas of mutually shared priorities.

34
Conclusion
  • A plethora of health indicators demonstrate that
    Aboriginal Peoples in Canada endure a profound
    public health and socioeconomic burden when
    compared to mainstream populations.
  • Such a pattern is observed globally as Aboriginal
    populations are the poorest of the poor and
    correspondingly vulnerable to high rates of
    preventable disability, disease and premature
    death.

35
How to Contact Us
  • If you would like to visit our website and sign
    up for our mailing list please visit
    http//cahr.uvic.ca
  • Recordings of the entire Brown Bag Aboriginal
    Health Speaker Series will be posted online on
    our website
  • (for our online viewers if you would like to fill
    out a feedback form and be entered in our draw
    please email Bianka at bsaravan_at_uvic.ca)
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