The University of Melbourne, Melbourne, Australia.
Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago, Dunedin, New Zealand.
Lancet. 2016 Jul 9;388(10040):131-57. doi: 10.1016/S0140-6736(16)00345-7. Epub 2016 Apr 20.
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.
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.
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.
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.
The Lowitja Institute.
国际上对原住民和部落民族的健康状况进行了研究，为公共卫生提供了重要的信息。制定政策和提供卫生服务需要可靠的数据。以往的研究表明，与基准人群相比，原住民的健康状况和社会地位较差，但这些研究在覆盖的国家或健康指标的范围方面都受到了限制。我们的目标是描述样本国家中原住民和部落民族的健康和社会地位相对于基准人群的情况。
为每个国家确定了在原住民健康数据系统方面具有专业知识的合作者。获取了人口、出生时预期寿命、婴儿死亡率、低出生体重和高出生体重、孕产妇死亡率、营养状况、教育程度和经济状况的数据。数据来源包括政府数据、儿基会等非政府组织的数据以及其他研究。计算了绝对差异和相对差异。
我们的数据（23 个国家、28 个人群）表明，原住民的健康和社会状况比非原住民差。然而，情况并非完全如此，而且比率差异的大小也不同。我们记录了原住民在以下方面的较差结果：18 个人群中有 16 个人群的出生时预期寿命差异大于 1 年，其中 15 个人群的差异大于 1 年；19 个人群中有 18 个人群的婴儿死亡率差异大于每 1000 例活产 1 例，其中 16 个人群的差异大于 1 例；10 个人群中的孕产妇死亡率；3 个人群中低出生体重的比例差异大于 2%；1 个人群中高出生体重的比例差异大于 2%；16 个人群中有 10 个人群的儿童营养不良率差异大于 10%，其中 5 个人群的差异大于 10%；12 个人群中有 8 个人群的儿童肥胖率差异大于 5%，其中 4 个人群的差异大于 5%；13 个人群中有 7 个人群的成人肥胖率差异大于 10%，其中 4 个人群的差异大于 10%；27 个人群中有 26 个人群的教育程度差异大于 1%，其中 24 个人群的差异大于 1%；18 个人群中有 15 个人群的经济地位差异大于 1%，其中 14 个人群的差异大于 1%。
我们系统地收集了比以往研究更广泛的国家和指标的数据。考虑到联合国可持续发展目标，我们建议各国政府制定针对原住民健康的有针对性的政策对策，改善获得卫生服务的机会，并在国家监测系统中纳入原住民数据。
洛维蒂亚研究所。
