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拉丁美洲原住民的健康差异:一项范围综述

Health disparities among indigenous populations in Latin America: a scoping review.

作者信息

Garza Mariana, Miguel Lucía Abascal

机构信息

University of Texas at Austin, Austin, TX, USA.

University of California, San Francisco, CA, USA.

出版信息

Int J Equity Health. 2025 Apr 30;24(1):119. doi: 10.1186/s12939-025-02495-2.

Abstract

BACKGROUND

Health disparities persist among Indigenous populations in Latin America, reflecting systemic inequities and historical marginalization. These disparities span infectious diseases, malnutrition, and chronic conditions, necessitating a comprehensive understanding to inform equitable public health strategies. This scoping review aims to map health disparities affecting Indigenous populations in Latin America, identify research gaps, and inform policy recommendations.

METHODS

Following PRISMA-ScR guidelines, we systematically searched PubMed, Embase, and Scielo for studies with data collected between May 2014 and May 2024. Studies were included if they examined health disparities among Indigenous populations in Latin America, contained a comparator related to disparities, and presented quantitative data. We excluded studies on oral health, risk factors, genetic disparities, health system access, and ecological studies, as well as non-research articles such as commentaries and letters to the editor. Data were synthesized narratively, summarizing key themes.

RESULTS

Of 1,116 identified articles, 35 met inclusion criteria, spanning nine Latin American countries. Most studies were cross-sectional (n = 18) or cohort-based (n = 16). Infectious diseases and malnutrition were the most studied topics, consistently showing higher incidence and mortality rates among Indigenous populations. Many papers highlighted COVID-19 disparities, with Indigenous groups experiencing higher incidence and mortality. Malnutrition, particularly stunting and anemia, was significantly more prevalent among Indigenous children and women. Studies on overweight and obesity showed mixed results. Chronic diseases, including chronic kidney disease and cardiovascular issues, showed notable disparities, while mental health and cancer were underrepresented.

CONCLUSION

Indigenous populations in Latin America face a dual burden of infectious and chronic diseases, compounded by structural barriers such as poverty, geographic isolation, and systemic discrimination. Addressing these disparities requires culturally tailored interventions, structural reforms, and policy prioritization. This scoping review is limited by database restrictions, search term variability, language and time frame constraints, the absence of a methodological quality assessment, inconsistencies in defining Indigenous status, exclusion of grey literature, and a focus on disease prevalence rather than disparities in risk factors, diagnosis, and treatment, which may result in an incomplete representation of Indigenous health disparities in Latin America. Future research should incorporate mental health outcomes to provide a more comprehensive understanding of Indigenous health disparities.

摘要

背景

拉丁美洲原住民群体中健康差距持续存在,反映出系统性不平等和历史边缘化问题。这些差距涵盖传染病、营养不良和慢性病,需要全面了解以制定公平的公共卫生战略。本范围综述旨在梳理影响拉丁美洲原住民群体的健康差距,识别研究空白,并提出政策建议。

方法

遵循PRISMA-ScR指南,我们系统检索了PubMed、Embase和Scielo数据库,查找2014年5月至2024年5月期间收集数据的研究。若研究考察了拉丁美洲原住民群体中的健康差距,包含与差距相关的对照,并呈现定量数据,则纳入研究。我们排除了关于口腔健康、风险因素、遗传差距、卫生系统可及性的研究以及生态研究,以及评论和致编辑信等非研究性文章。对数据进行叙述性综合,总结关键主题。

结果

在1116篇检索到的文章中,35篇符合纳入标准,涉及九个拉丁美洲国家。大多数研究为横断面研究(n = 18)或队列研究(n = 16)。传染病和营养不良是研究最多的主题,始终显示原住民群体的发病率和死亡率较高。许多论文强调了新冠疫情方面的差距,原住民群体的发病率和死亡率更高。营养不良,尤其是发育迟缓与贫血,在原住民儿童和妇女中更为普遍。关于超重和肥胖的研究结果不一。包括慢性肾病和心血管问题在内的慢性病存在显著差距,而心理健康和癌症方面的研究较少。

结论

拉丁美洲原住民群体面临传染病和慢性病的双重负担,贫困、地理隔离和系统性歧视等结构性障碍使情况更加复杂。解决这些差距需要针对文化定制干预措施、进行结构性改革并优先制定政策。本范围综述受数据库限制、检索词变化、语言和时间框架限制、缺乏方法学质量评估、原住民身份定义不一致、排除灰色文献以及关注疾病患病率而非风险因素、诊断和治疗方面的差距等因素影响,可能无法完整呈现拉丁美洲原住民健康差距情况。未来研究应纳入心理健康结果,以更全面地了解原住民健康差距。

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