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Gray M, Williams K, Oster RT, Bruno G, Cooper A, Healy C, Rich R, Scott Claringbold S, Teare G, Wessel S, Henderson RI. Indigenous identity identification in administrative health care data globally: A scoping review. J Health Serv Res Policy 2024; 29:210-221. [PMID: 38099443 PMCID: PMC11151709 DOI: 10.1177/13558196231219955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
OBJECTIVE Both Indigenous and non-Indigenous governments and organizations have increasingly called for improved Indigenous health data in order to improve health equity among Indigenous peoples. This scoping review identifies best practices, potential consequences and barriers for advancing Indigenous health data and Indigenous data sovereignty globally. METHODS A scoping review was conducted to capture the breadth and nature of the academic and grey literature. We searched academic databases for academic records published between 2000 and 2021. We used Google to conduct a review of the grey literature. We applied Harfield's Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT) to all original research articles included in the review to assess the quality of health information from an Indigenous perspective. RESULTS In total, 77 academic articles and 49 grey literature records were included. Much of the academic literature was published in the last 12 years, demonstrating a more recent interest in Indigenous health data. Overall, we identified two ways for Indigenous health data to be retrieved. The first approach is health care organizations asking clients to voluntarily self-identify as Indigenous. The other approach is through data linkage. Both approaches to improving Indigenous health data require awareness of the intergenerational consequences of settler colonialism along with a general mistrust in health care systems among Indigenous peoples. This context also presents special considerations for health care systems that wish to engage with Indigenous communities around the intention, purpose, and uses of the identification of Indigenous status in administrative databases and in health care settings. Partnerships with local Indigenous nations should be developed prior to the systematic collection of Indigenous identifiers in health administrative data. The QAT revealed that many research articles do not include adequate information to describe how Indigenous communities and stakeholders have been involved in this research. CONCLUSION There is consensus within the academic literature that improving Indigenous health should be of high priority for health care systems globally. To address data disparities, governments and health organizations are encouraged to work in collaboration with local Indigenous nations and stakeholders at every step from conceptualization, data collection, analysis, to ownership. This finding highlights the need for future research to provide transparent explanation of how meaningful Indigenous collaboration is achieved in their research.
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Affiliation(s)
- Mandi Gray
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kienan Williams
- Indigenous Wellness Core, Alberta Health Services, Canada, Edmonton, AB, Canada
| | - Richard T. Oster
- Indigenous Wellness Core, Alberta Health Services, Canada, Edmonton, AB, Canada
| | - Grant Bruno
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Annelies Cooper
- Indigenous Health and Environmental Justice, Critical Health and Social Action Lab., University of Toronto, Toronto, ON, Canada
| | - Chyloe Healy
- Blackfoot Confederacy Tribal Council, Calgary, AB, Canada
| | | | - Shayla Scott Claringbold
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Gary Teare
- Provincial Population and Public Health, Alberta Health Services, Calgary, AB, Canada
| | - Samara Wessel
- Counselling Psychology, Department of Educational Psychology, University of Calgary, Calgary, AB, Canada
| | - Rita I. Henderson
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Griffiths KE, Blain J, Vajdic CM, Jorm L. Indigenous and Tribal Peoples Data Governance in Health Research: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10318. [PMID: 34639617 PMCID: PMC8508308 DOI: 10.3390/ijerph181910318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/23/2022]
Abstract
There is increasing potential to improve the research and reporting on the health and wellbeing of Indigenous and Tribal peoples through the collection and (re)use of population-level data. As the data economy grows and the value of data increases, the optimization of data pertaining to Indigenous peoples requires governance that defines who makes decisions on behalf of whom and how these data can and should be used. An international a priori PROSPERO (#CRD42020170033) systematic review was undertaken to examine the health research literature to (1) identify, describe, and synthesize definitions and principles; (2) identify and describe data governance frameworks; and (3) identify, describe, and synthesize processes, policies and practices used in Indigenous Data Governance (ID-GOV). Sixty-eight articles were included in the review that found five components that require consideration in the governance of health research data pertaining to Indigenous people. This included (1) Indigenous governance; (2) institutional ethics; (3) socio-political dynamics; (4) data management and data stewardship; and (5) overarching influences. This review provides the first systematic international review of ID-GOV that could potentially be used in a range of governance strategies moving forward in health research.
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Affiliation(s)
- Kalinda E. Griffiths
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW 2052, Australia; (J.B.); (C.M.V.); (L.J.)
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Tiwi, NT 0812, Australia
- Centre for Health Equity, University of Melbourne, Parkville, VIC 3010, Australia
| | - Jessica Blain
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW 2052, Australia; (J.B.); (C.M.V.); (L.J.)
| | - Claire M. Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW 2052, Australia; (J.B.); (C.M.V.); (L.J.)
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW 2052, Australia; (J.B.); (C.M.V.); (L.J.)
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4
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Storm Mienna C, Axelsson P. Somatic health in the Indigenous Sami population - a systematic review. Int J Circumpolar Health 2020; 78:1638195. [PMID: 31262241 PMCID: PMC6610513 DOI: 10.1080/22423982.2019.1638195] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The objective of this systematic review was to survey the current scientific knowledge regarding the state of somatic health among the Indigenous Sami people in Norway, Finland, Sweden and the Kola Peninsula in Russia; and assess the quality of the identified studies. A systematic search in the databases Pubmed, EBSCOhost (AMED, Medline, Cinahl) and Svemed was conducted from January 2000, through December 2017. This systematic search identified 399 articles. After screening abstracts, 93 articles were reviewed in full text, 32 of which met the inclusion criteria. The scientific quality of the evidence was rated according to the Newcastle–Ottawa scale. Based on the studies with moderate to high scientific quality, there is evidence for stating that the majority of the Sami included in this review experience good health. Mortality and life expectancy are similar, with only minor differences, to those of a non-Sami population. The cancer risk rate among Sami was lower than that of the general population of Norway, Sweden and Finland. Self-reported myocardial infarction prevalence was similar between Sami and non-Sami, but Angina pectoris was more prevalent among Sami. In Sweden, cardiovascular disease rates were similar between Sami and non-Sami. Musculoskeletal pain symptoms are common among the Sami population, as are obesity and overweight. To conclude, there are knowledge gaps in regard to the somatic health situation of the Indigenous Sami in the circumpolar area, especially in Russia, Finland and Sweden; as current knowledge is mainly based on publications from the SAMINOR study in Norway. No study obtained the highest quality score, suggesting a need to implement longitudinal prospective studies.
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Affiliation(s)
- Christina Storm Mienna
- a Department of Odontology/Clinical Oral Physiology , Umeå University , Umeå , Sweden.,b Vaartoe-Centre for Sami Research , Umeå University , Umeå , Sweden
| | - Per Axelsson
- b Vaartoe-Centre for Sami Research , Umeå University , Umeå , Sweden.,c Department of historical, philosophical and religious studies , Umeå University , Umeå , Sweden
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6
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Sarfati D, Garvey G, Robson B, Moore S, Cunningham R, Withrow D, Griffiths K, Caron NR, Bray F. Measuring cancer in indigenous populations. Ann Epidemiol 2018; 28:335-342. [PMID: 29503062 DOI: 10.1016/j.annepidem.2018.02.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/16/2018] [Accepted: 02/10/2018] [Indexed: 02/06/2023]
Abstract
It is estimated that there are 370 million indigenous peoples in 90 countries globally. Indigenous peoples generally face substantial disadvantage and poorer health status compared with nonindigenous peoples. Population-level cancer surveillance provides data to set priorities, inform policies, and monitor progress over time. Measuring the cancer burden of vulnerable subpopulations, particularly indigenous peoples, is problematic. There are a number of practical and methodological issues potentially resulting in substantial underestimation of cancer incidence and mortality rates, and biased survival rates, among indigenous peoples. This, in turn, may result in a deprioritization of cancer-related programs and policies among these populations. This commentary describes key issues relating to cancer surveillance among indigenous populations including 1) suboptimal identification of indigenous populations, 2) numerator-denominator bias, 3) problems with data linkage in survival analysis, and 4) statistical analytic considerations. We suggest solutions that can be implemented to strengthen the visibility of indigenous peoples around the world. These include acknowledgment of the central importance of full engagement of indigenous peoples with all data-related processes, encouraging the use of indigenous identifiers in national and regional data sets and mitigation and/or careful assessment of biases inherent in cancer surveillance methods for indigenous peoples.
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Affiliation(s)
- Diana Sarfati
- Cancer and Chronic Conditions (C3) Research Group, Department of Public Health, University of Otago Wellington, Wellington, New Zealand.
| | - Gail Garvey
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin Ukniversity, Spring Hill, QLD
| | - Bridget Robson
- Te Rōpū Rangahau Hauora e Eru Pōmare, University of Otago Wellington, Wellington, New Zealand
| | - Suzanne Moore
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin Ukniversity, Spring Hill, QLD
| | - Ruth Cunningham
- Cancer and Chronic Conditions (C3) Research Group, Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Diana Withrow
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Kalinda Griffiths
- Sydney Centre for Aboriginal and Torres Strait Islander Statistics, University of Sydney, Casuarina, NT, Australia
| | - Nadine R Caron
- Centre for Excellence in Indigenous Health and Northern Medical Program, University of British Columbia, Prince George, Canada
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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Benoit AC, Younger J, Beaver K, Jackson R, Loutfy M, Masching R, Nobis T, Nowgesic E, O'Brien-Teengs D, Whitebird W, Zoccole A, Hull M, Jaworsky D, Rachlis A, Rourke S, Burchell AN, Cooper C, Hogg R, Klein MB, Machouf N, Montaner J, Tsoukas C, Raboud J. A comparison of virological suppression and rebound between Indigenous and non-Indigenous persons initiating combination antiretroviral therapy in a multisite cohort of individuals living with HIV in Canada. Antivir Ther 2016; 22:325-335. [PMID: 27925609 DOI: 10.3851/imp3114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study compared time to virological suppression and rebound between Indigenous and non-Indigenous individuals living with HIV in Canada initiating combination antiretroviral therapy (cART). METHODS Data were from the Canadian Observational Cohort collaboration; eight studies of treatment-naive persons with HIV initiating cART after 1/1/2000. Fine and Gray models were used to estimate the effect of ethnicity on time to virological suppression (two consecutive viral loads [VLs] <50 copies/ml at least 3 months apart) after adjusting for the competing risk of death and time until virological rebound (two consecutive VLs >200 copies/ml at least 3 months apart) following suppression. RESULTS Among 7,080 participants were 497 Indigenous persons of whom 413 (83%) were from British Columbia. The cumulative incidence of suppression 1 year after cART initiation was 54% for Indigenous persons, 77% for Caucasian and 80% for African, Caribbean or Black (ACB) persons. The cumulative incidence of rebound 1 year after suppression was 13% for Indigenous persons, 6% for Caucasian and 7% for ACB persons. Indigenous persons were less likely to achieve suppression than Caucasian participants (aHR=0.58, 95% CI 0.50, 0.68), but not more likely to experience rebound (aHR=1.03, 95% CI 0.84, 1.27) after adjusting for age, gender, injection drug use, men having sex with men status, province of residence, baseline VL and CD4+ T-cell count, antiretroviral class and year of cART initiation. CONCLUSIONS Lower suppression rates among Indigenous persons suggest a need for targeted interventions to improve HIV health outcomes during the first year of treatment when suppression is usually achieved.
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Affiliation(s)
- Anita C Benoit
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.,Building Bridges Team, Toronto, ON & Vancouver, BC, Canada
| | - Jaime Younger
- Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,Toronto General Research Institute, University Health Network, Toronto, ON, Canada
| | | | - Randy Jackson
- Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,McMaster University, Hamilton, ON, Canada
| | - Mona Loutfy
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.,Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,Maple Leaf Medical Clinic, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Renée Masching
- Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,Canadian Aboriginal AIDS Network, Dartmouth, NS, Canada
| | - Tony Nobis
- Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,Ontario Aboriginal HIV/AIDS Strategy, Toronto, ON, Canada
| | - Earl Nowgesic
- Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Doe O'Brien-Teengs
- Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,Lakehead University, Thunder Bay, ON, Canada
| | - Wanda Whitebird
- Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,Ontario Aboriginal HIV/AIDS Strategy, Toronto, ON, Canada
| | - Art Zoccole
- Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,2-Spirited People of the 1st Nations, Toronto, ON, Canada
| | - Mark Hull
- Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Denise Jaworsky
- Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Sean Rourke
- Ontario HIV Treatment Network, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, ON, Canada.,Department of Psychiatry, St Michael's Hospital, Toronto, ON, Canada
| | - Ann N Burchell
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Family and Community Medicine, St Michael's Hospital, Toronto, ON, Canada.,Centre for Urban Health Solutions, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Curtis Cooper
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Robert Hogg
- Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Marina B Klein
- Department of Medicine, McGill University Health Centre Research Institute, Montréal, QC, Canada.,CIHR Canadian HIV Trials Network, Vancouver, BC, Canada
| | - Nima Machouf
- Clinique Médicale L'Actuel, Montréal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Julio Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chris Tsoukas
- Experimental Medicine, McGill University, Montréal, QC, Canada
| | - Janet Raboud
- Building Bridges Team, Toronto, ON & Vancouver, BC, Canada.,Toronto General Research Institute, University Health Network, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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8
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Coleman C, Elias B, Lee V, Smylie J, Waldon J, Hodge FS, Ring I. International Group for Indigenous Health Measurement: Recommendations for best practice for estimation of Indigenous mortality. ACTA ACUST UNITED AC 2016. [DOI: 10.3233/sji-161023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Clare Coleman
- Sydney Centre for Aboriginal and Torres Strait Islander Statistics, University of Sydney, Sydney, Australia
| | - Brenda Elias
- Faculty of Medicine, Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Vanessa Lee
- Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Janet Smylie
- Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - John Waldon
- 2 Tama Ltd, Palmerston North, New Zealand
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | | | - Ian Ring
- Research and Innovation Division, University of Wollongong, Wollongong, Australia
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