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Aboriginal populations vulnerable to H1N1: report

Shiloh

Editor, Senior Moderator
Source: http://www.vancouversun.com/busines...ons+vulnerable+H1N1+report/1753673/story.html

Aboriginal populations vulnerable to H1N1: report


By Mike Barber, Canwest News Service July 2, 2009 5:01 PM

The author of study to be published in the next issue of the medical journal Lancet said swine flu could devastate indigenous populations around the world due to their sensitivity to infectious disease.

Dr. Michael Gracey, a medical adviser to Unity of First People of Australia, an aboriginal non-profit organization, suggests that the world's almost 400 million indigenous peoples ? including about 1.2 million in Canada ? are particularly at risk for contracting swine flu because they often live in remote, impoverished communities with limited access to medical infrastructure.

First Nations communities in Manitoba and northern Ontario have already been hit by the highly communicable H1N1 virus. Despite comprising just 10 per cent of the population in Manitoba, natives make up about a third of the 685 swine flu cases in that province.

The spread of the virus on reserves prompted aboriginal leaders around Manitoba to declare states of emergency last week to help free funds for federal assistance.

Gracey said the lack of hospitals and medical workers in isolated aboriginal communities means that while they are often introduced to viruses later than the rest of the population, the effects can be quick and punishing.

"I am rather fearful that there will be more deaths from this illness in indigenous populations," he said, adding that the first person to die from swine flu in Australia was a young, desert-dwelling aboriginal man living hundreds of kilometres away from a hospital.

"The underlying factor is that indigenous people are susceptible to infections because they have low immunity, they're often undernourished, and they often have pre-existing illnesses."

Gracey's article, to be released Friday, focused on disease patterns in indigenous groups around the world.

Gracey said his concern is that if natives in developed countries such as Canada are being hit harder than the general population, the impact on indigenous peoples in the developing world, from China to Chile, could be catastrophic.

"These countries have very large indigenous populations and they do not have the underlying public health infrastructure and preventive programs and the capability for dealing with pandemics that Canada, Australia, and the U.S. do."

He cited the Spanish Flu pandemic of 1918 as an example of how native communities were decimated by a virus that originated in Europe before spreading the furthest reaches of the globe.

"It's a word of caution, a word of warning, that this may happen again."

With files from the Winnipeg Free Press
 
Re: Aboriginal populations vulnerable to H1N1: report

This dog don't hunt for me.

Sure all the factors he cites might be playing a role but why are they getting sick more than others and why when sick become critical when other non-Aboriginal Canadians have "mild flu" and get well at home without even seeing the doctor.

There is no question that the First Nations people have gotten a raw deal ever since we Europeans invaded their land, killed as many as we could, then rounded the rest up and put them on reservations. If their increased morbidity and mortality from flu can be used to help these people get a better life, I am all for it.

However what we are seeing among the First Nations is not something that can be explained away this simply. They are being devastated by the novel strain. While poverty is one reason, IMO it is not THE REASON and it does no one any good especially the aboriginal people of Canada and elsewhere to spin fairy tales for political purposes as true when they are not. Where's the proof? The Lancet is supposed to be a peer reviewed medical journal but apparently it has now become a venue for opinion pieces lobbying for worthy liberal causes. Hey, he has my vote, I am a liberal but what about the truth?

There is a lot more here than their social condition. IMO, even if they all lived in Ontario penthouses we would be seeing the same devastation we are seeing on the reservation.

While public policy is important and disadvantaged people everywhere deserve our care, help, and respect it is of no help to them or anyone to misrepresent the truth even in a good cause.

GW
 
Re: Aboriginal populations vulnerable to H1N1: report

With respect to pre-existing illnesses:

Rates of diabetes among Aboriginal people in Canada are three to five times higher than those of the general Canadian population. Aboriginal children are also now being diagnosed with type 2 diabetes, a condition that in the past occurred mainly in older persons. Inuit rates of diabetes are not as high as those of other Aboriginal populations; however, there is concern that the rates of type 2 diabetes are increasing among Inuit as well.

http://www.hc-sc.gc.ca/fniah-spnia/diseases-maladies/diabete/index-eng.php
 
Re: Aboriginal populations vulnerable to H1N1: report

This report has been getting media before its publication in the Lancet. Here is a comment I made previously about this on another FT thread.

GW
Re: Australia's Aborigines at Risk as Swine Flu Outbreak Escalates
Obviously this is a big concern and has been for quite a while here on FTs.

It would be of interest to compare the outcomes of AU's aboriginal people who remain in the primitive outback compared to those who live in the cities and have adopted European lifestyles.

Since these Caucasian people are dark skinned, it can be expected that those following a traditional way of life will have exceeding healthy vitamin D levels, probably in the 70ng/ml to 80ng/ml area which should provide them with protection for influenza and its complications if indeed the hypothesis that vitamin D is useful for this purpose proves correct as I hope it will.

OTOH, those who suit up everyday to go to work, remaining indoors most of the time and consume a European rather than traditional diet can be expected to have a high incidence of vitamin D deficiency.

What makes this natural experiment compelling is the fact that while genetically, the two groups are very similar their lifestyles are very different. What's more the aboriginal who lives in the city has the advantage of having access to a first rate national health system with all the bells and whistles while the outback aboriginal does not.

If there are significant differences in influenza incidence and outcomes between these two groups in favor of those living in the outback, this would be strong circumstantial evidence for their being a protective link between vitamin D and influenza.

What would be of interest is to search the literature for evidence that the assumption mentioned above that aboriginals who live in the cities have low vitamin D levels while those living a traditional lifestyle in the outback have high levels. This obviously is something that would be very important to establish when interpreting the findings of this observational case control study. What's more, if you are an industrious young investigator living in AU, you might quickly write up a research proposal for this study so that it can be a prospective case control study rather than a retrospective one. Included in the design should be a survey of vitamin D levels in a representative sample of these two groups if this data is not already available.

A prospective case control study is a more powerful research tool, second only to a randomized clinical trial giving the results of such an investigation added weight.

Grattan Woodson, MD

__________________
 
Re: Aboriginal populations vulnerable to H1N1: report

There is a lot more here than their social condition. IMO, even if they all lived in Ontario penthouses we would be seeing the same devastation we are seeing on the reservation.
I think another of your posts explains one reason they're being affected more severely:
Since these Caucasian people are dark skinned, it can be expected that those following a traditional way of life will have exceeding healthy vitamin D levels, probably in the 70ng/ml to 80ng/ml area which should provide them with protection for influenza and its complications if indeed the hypothesis that vitamin D is useful for this purpose proves correct as I hope it will.
This comment was about Australian aboriginals, but the references to lifestyle and diet are pertinent. How many of the First Nations people in Canada are following a traditional way of life and eating their traditional diet? None, I would guess, or at least very very few.

It doesn't make sense to me that if you removed all the environmental factors (put them all in penthouses in Ontario, to use your example), they would be affected just as badly. I don't think it's possible to discount poor diet, poor living conditions, poor preventive health care, poor emotional health, and the isolated life that keeps them from being exposed to a wide range of organisms to begin with.

But it does seem likely that a person whose ancestry adapted to a specific environment would do poorly when removed from that environment, forced into a completely different diet and lifestyle, and exposed to a novel virus.
 
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