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Sundvall GM, Eastwood EM, Bäärnhielm S. Samis in the city. A qualitative study of mental health and well-being among Samis in Stockholm. Int J Circumpolar Health 2023; 82:2246644. [PMID: 37581261 PMCID: PMC10431725 DOI: 10.1080/22423982.2023.2246644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 07/27/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023] Open
Abstract
Indigenous people globally suffer from poorer health than majority populations. For the Sami, the indigenous people living in the north of Norway, Sweden, Finland and Russia, physical health conditions seem to be comparable to the population in general, but there are concerns about mental health. Studies have shown a higher risk of suicide, especially for young men active in traditional reindeer herding in the north. There is less knowledge about the mental health of Samis that have migrated to the cities. In this study, we interviewed 25 Samis, recruited through convenience sampling in the Stockholm area, about their perceptions of health and well-being, the importance of the Sami background and culture, their views of mental health services and the need of adapting them to Sami needs. Throughout the process, the researchers collaborated closely with the Stockholm Sami Association, in an approach of participatory research. The interviews were analysed with thematic analysis. For the participants, a secure Sami identity and being treated with respect for their identity was seen as essential for mental health and well-being. Informants' emphasis on respect for their Sami identity and belonging can be seen as a call for restoration of basic human rights. Historical experiences, current harassments and political decisions affected their health. The informants wished caregivers to increase their knowledge of Sami history and traditions.
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Affiliation(s)
- G Maria Sundvall
- National Centre for Suicide Research and Prevention, Department of Learning, Informatics, Management, and Ethics, Karolinska Institute, Stockholm, Sweden
| | | | - Sofie Bäärnhielm
- Transcultural Centre Region Stockholm and Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute & Stockholm Health Care Services, Region Stockholm, Solnavägen 4, Stockholm, Sweden
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2
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Gjernes T, Anderssen J. A sociological study of the significance of identity and ageing in a North Sami community. Int J Circumpolar Health 2023; 82:2196763. [PMID: 36994876 PMCID: PMC10064811 DOI: 10.1080/22423982.2023.2196763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
This article explored experiences of ageing from interviews with a sample drawn from a population living in a North Sami community. Our focus is on older adult's involvement in activities that emphasise and maintain them as participants in specific kinds of activities that require knowledge, skills and mentorship, and to what degree it provides them with social capital and ethnic identity. We present data from in-depth interviews with female and male inhabitants ranging from 29 to 75 years of age. Thematic analysis of the data indicates that social capital and identity are particularly apparent within three contexts: 1. family and social relationships, 2. reindeer herding and other traditional labour and 3. Sami language. We conclude that older people hold vital positions in the local community regarding these three contexts. They transfer and reproduce cultural competence, and they manifest their roles and positions as active and valuable cultural members and practical contributors to the community. Their cultural involvement is not performed for their own advantage but is a regular part of their everyday lives, benefiting their special position within this sociocultural context and creating social capital.
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Affiliation(s)
- Trude Gjernes
- Nord universitet Fakultet for samfunnsvitenskap, UiT Norges arktiske universitet Fakultet forhumaniora samfunnsvitenskap og laerarutdanning, Bodø, Norway
| | - Jorid Anderssen
- Nord universitet Fakultet for samfunnsvitenskap, UiT Norges arktiske universitet Fakultet forhumaniora samfunnsvitenskap og laerarutdanning, Bodø, Norway
- UiT Norges arktiske universitet Fakultet for humaniora, samfunnsvitenskap og laererutdanning, Tromsø, Norway
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3
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Eriksen AMA, Melhus M, Schei B, Skurtveit S, Broderstad AR. Opioid prescriptions among Sami and non-Sami with chronic pain: The SAMINOR 2 Questionnaire Survey and the Norwegian Prescription Database. Int J Circumpolar Health 2023; 82:2241202. [PMID: 37506380 PMCID: PMC10392314 DOI: 10.1080/22423982.2023.2241202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
This study is the first to investigate the prevalence of filled opioid prescriptions among indigenous Sami people with self-reported chronic musculoskeletal pain (CMSP) and compare it with that of non-Sami living in the same area. Baseline data from the SAMINOR 2 Questionnaire Survey (2012) was linked prospectively to the Norwegian Prescription Database. Information on filled opioid prescriptions during 2012-2019 was collected for 4767 persons who reported CMSP in SAMINOR 2. Gender-stratified chi-square tests, two-sample t-tests, Kruskal - Wallis tests, and multinomial logistic regression was applied. Two out of three CMSP respondents received no or only one prescription of opioids during 2012-2019. In each year, 80% of women received no opioids, 7-10% received one prescription of ≤ 180 defined daily doses (DDD), 8-9% received in total ≤ 180 DDD in two or more prescriptions, and 2-3% received > 180 DDD of opioids. Among men, 81-83% received no opioids, 8-11% received one prescription with ≤ 180 DDD, 5-9% received ≤ 180 DDD in two or more prescriptions, and 1-2% received > 180 DDD of opioids in a single year. There were no overall ethnic differences, which indicates a similar prescription policy for opioids for Sami and non-Sami with CMSP.
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Affiliation(s)
- Astrid M A Eriksen
- Centre for Sami Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Berit Schei
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Norwegian University of Science and Technology (NTNU), Department of Obstetrics and Gynecology, Trondheim, Norway
| | - Svetlana Skurtveit
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ann-Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
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Allard C, Curran D. Indigenous Influence and Engagement in Mining Permitting in British Columbia, Canada: Lessons for Sweden and Norway? Environ Manage 2023; 72:1-18. [PMID: 34698921 PMCID: PMC10220105 DOI: 10.1007/s00267-021-01536-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/03/2021] [Indexed: 05/28/2023]
Abstract
Mine developments in Indigenous territories risk disrupting Indigenous cultures and their economies, including spiraling already high levels of conflict. This is the situation in Canada, Sweden, and Norway, as elsewhere, and is fostered by current state legal framework that reflect historical trajectories, although circumstances are gradually changing. Promising institutional changes have taken place in British Columbia (BC), Canada, with respect to new legislative reforms. Notably, new legislation from 2019 intends to implement the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) in the province, by promoting consent-based and collaborative decision-making mechanisms. New environmental assessment legislation is another example; this legislation includes early engagement, collaborative decision-making, and Indigenous-led assessments. The article's aim is, first, to analyze how Indigenous communities can influence and engage in the mining permitting system of BC, and, secondly, to highlight the positive features of the BC system using a comparative lens to identify opportunities for Sweden and Norway regarding mining permitting and Indigenous rights. Applying a legal-scientific and comparative analysis, the article analyzes traditional legal sources. The article concludes that the strong points that the BC regime could offer the two Nordic countries are: the concept of reconciliation, incorporation of UNDRIP, the spectrum of consultation and engagement approaches, and the structure of environmental assessments. All three jurisdictions, however, struggle with balancing mine developments and securing Indigenous authority and influence over land uses in their traditional territories.
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Affiliation(s)
- Christina Allard
- Division of Social Sciences/Law Unit, Luleå University of Technology, Luleå, Sweden.
| | - Deborah Curran
- Faculty of Law and School of Environmental Studies, University of Victoria, Victoria, British Columbia, Canada
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Høilo Granheim IP, Kvernmo S, Silviken A, Lytken Larsen CV. The association between suicidal behaviour and violence, sexual abuse, and parental substance abuse among Sami and Greenlandic adolescents: the WBYG study and the NAAHS. Scand J Child Adolesc Psychiatr Psychol 2023; 11:10-26. [PMID: 37082430 PMCID: PMC10111208 DOI: 10.2478/sjcapp-2023-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Background For young Indigenous people, suicide is one of the leading causes of death, and high rates in Arctic areas indicate serious health and societal concerns. More knowledge is needed, as suicidal behaviour predicts later death by suicide. The aim of this study was to investigate associations between suicidal thoughts and suicide attempts and negative life events, including violence, sexual abuse, and parental substance abuse, in Sami and Greenlandic adolescents, within and between groups and gender. Method Working samples included 442 Sami and 399 Greenlandic Inuit (15-16-year-olds), in The Norwegian Arctic Adolescent Health Study (NAAHS) and the Well-Being among Youth in Greenland (WBYG) study. Multivariable logistic regression explored associations between suicidal behaviour and violence, sexual abuse, and parental substance abuse. Results Across Indigenous groups, suicidal thoughts and attempts were significantly associated with violence and sexual abuse. The association between suicidal behaviour; especially suicidal thoughts, and sexual abuse was significant and strong among Sami females. Sami and Inuit adolescents with a history of childhood violence reported significantly more suicide attempts; the strongest association was found among Sami males. Conclusion To Sami and Greenlandic Inuit, the experiences of negative life events, such as violence or sexual abuse are significant risk factors for suicidal behaviour. Public health programmes and prevention strategies targeting youth mental health and suicide should be culturally sensitive and sensitive to gender differences in the association between negative life events and suicidal behaviour.
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Affiliation(s)
- Ida Pauline Høilo Granheim
- Department of clinical medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Siv Kvernmo
- Department of clinical medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Silviken
- Centre for Sami Health Research, Faculty of Health Sciences, UiT The Arctic University of Norway, Karasjok, Norway
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Davidson RK, Fæste CK, Uhlig S, Tukun FL, Lian H, Solvang HA, Thorvaldsen R, Folkow LP, Sánchez Romano J, Kilvær MV, Holmgren KE, Nymo IH. Pharmacokinetics of a long-acting subcutaneous eprinomectin injection in semi-domesticated reindeer (Rangifer tarandus tarandus) - A pilot study. Environ Toxicol Pharmacol 2023; 97:104041. [PMID: 36535586 DOI: 10.1016/j.etap.2022.104041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Reindeer (Rangifer tarandus tarandus) are exposed to the pathogenic parasitic nematode Elaphostrongylus rangiferi during grazing. The severity of disease is dose-dependent. Prophylactic anthelmintic treatment is needed to improve animal health and reindeer herding sustainability. Herds are traditionally only gathered once during the summer, requiring a drug with a persistent effect. In this study we investigated the suitability of long-acting eprinomectin, given as a single subcutaneous injection at 1 mg/kg bodyweight in adult reindeer and calves. Plasma and faeces concentrations were determined using ultra-high performance liquid chromatography high resolution mass spectrometry (UHPLC-HRMS). Plasma concentrations remained above the presumed effect level of 2 ng/mL for 80 days, demonstrating the drug's potential. Pharmacokinetic parameters were compared to other species using allometric scaling. Calves and adults had slightly different profiles. No viable faecal nematode eggs were detected during treatment. Eprinomectin was measurable in the reindeer faeces up to 100 days, which is of environmental concern.
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Affiliation(s)
- Rebecca K Davidson
- Norwegian Veterinary Institute, Food Safety and Animal Health Research Group, Holtvegen 66, 9016 Tromsø, Norway.
| | | | - Silvio Uhlig
- Norwegian Veterinary Institute, Toxinology Research Group, Ås, Norway
| | - Feng-Ling Tukun
- Norwegian Veterinary Institute, Toxinology Research Group, Ås, Norway
| | - Hans Lian
- UiT The Arctic University of Norway, Department of Arctic and Marine Biology, Tromsø, Norway
| | - Hans Arne Solvang
- UiT The Arctic University of Norway, Department of Arctic and Marine Biology, Tromsø, Norway
| | - Renate Thorvaldsen
- UiT The Arctic University of Norway, Department of Arctic and Marine Biology, Tromsø, Norway
| | - Lars P Folkow
- UiT The Arctic University of Norway, Department of Arctic and Marine Biology, Tromsø, Norway
| | | | | | - Karin Elisabeth Holmgren
- Norwegian Veterinary Institute, Food Safety and Animal Health Research Group, Holtvegen 66, 9016 Tromsø, Norway
| | - Ingebjørg Helena Nymo
- Norwegian Veterinary Institute, Food Safety and Animal Health Research Group, Holtvegen 66, 9016 Tromsø, Norway; UiT The Arctic University of Norway, Department of Arctic and Marine Biology, Tromsø, Norway
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Blix BH, Munkejord MC. Indigenous Sami Family Caregivers' Experiences With Accessing and Collaborating With Municipal Health and Care Services. Glob Qual Nurs Res 2022; 9:23333936221123333. [PMID: 36120534 PMCID: PMC9479542 DOI: 10.1177/23333936221123333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
Previous research has indicated that Indigenous Sami families in Norway
use public home-based care services less often than their non-Sami
peers. Based on qualitative interviews with Sami family caregivers, we
explore what they experience as barriers to accessing public care
services for older adults living with dementia, and how they
experience collaborating with care services providers. Through a
reflexive thematic approach, we identified that rather than a cultural
norm of “taking care of one’s own,” the underuse of public care
services among Sami families were related to several intertwined
circumstances. The Sami family caregivers reported barriers to
accessing public care, such as lack of familiarity with the services
and cultural and language concerns and the legacy of history, and
drivers for continuing family care, such as blurred distribution of
responsibility, lack of continuity of care, and culturally unsafe
caring environments and marginalizing practices.
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Affiliation(s)
- Bodil H Blix
- UiT The Arctic University of Norway, Tromsø, Norway
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8
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Hassan AA, Nøst TH, Brustad M, Sandanger TM. Concentrations and geographical patterns of persistent organic pollutants (POPs) in meat from semi-domesticated reindeer (Rangifer tarandus tarandus L.) in Norway. Sci Total Environ 2021; 798:149278. [PMID: 34340081 DOI: 10.1016/j.scitotenv.2021.149278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 07/12/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
The study aimed at investigating the concentrations and geographical patterns of 11 polychlorinated biphenyls (PCBs) and 15 organochlorine pesticides (OCPs) in reindeer muscle samples (n = 100) collected from 10 grazing districts in Norway, 2009. Concentrations were examined for patterns related to geographical region as well as age and sex of animals. Concentrations measured for PCBs and OCPs in reindeer meat samples were generally low. Geographical patterns were revealed and districts with previous mining activities, military trenches, or those that were in the vicinity of the Russian border exhibited slightly elevated concentrations compared to other districts. Calves (10 months) exhibited higher concentrations than young (1.5 year) and old animals (>2 years) adjusted for sex, whereas males exhibited higher concentrations than females, adjusted for age. All PCB congeners inter-correlated strongly with each other, whereas oxy-chlordane and heptachlor epoxide were the strongest inter-correlated OCP compounds. Concentrations of PCBs and OCPs in reindeer meat were all considerably lower than the maximum levels set for those contaminants in foodstuffs for safe human consumption by the European Commission. Thus, reindeer meat is not likely to be a substantial contributor to the human body burden of persistent organic pollutants.
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Affiliation(s)
- Ammar Ali Hassan
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037 Tromsø, Norway.
| | - Therese Haugdahl Nøst
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037 Tromsø, Norway
| | - Magritt Brustad
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037 Tromsø, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; NILU - Norwegian Institute for Air Research, Fram Centre, N-9296 Tromsø, Norway
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Stoor JPA, Eriksen HA, Silviken AC. "Mapping suicide prevention initiatives targeting Indigenous Sámi in Nordic countries". BMC Public Health 2021; 21:2035. [PMID: 34743691 PMCID: PMC8573914 DOI: 10.1186/s12889-021-12111-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/20/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Suicide is a major public health issue among Indigenous Sámi in Nordic countries, and efforts to prevent suicide in the Sámi context are increasing. However, there is no literature on suicide prevention initiatives among Sámi. The aim of the study was to map suicide prevention initiatives targeting Sámi in Norway, Sweden, and Finland during 2005-2019. METHOD Initiatives were identified and described through utilizing networks among stakeholders in the field of suicide prevention among Sámi, acquiring documentation of initiatives and utilizing the authors first-hand experiences. The described initiatives were analyzed inspired by the "What is the problem represented to be?" (WPR)-approach. RESULTS Seventeen initiatives targeting Sámi were identified during 2005-2019, including nine in Sweden, five in Norway, one in Finland and two international initiatives. Analysis with the WPR-approach yielded 40 problematizations regarding how to prevent suicide among Sámi, pertaining to shortcomings on individual (5), relational (15), community/cultural (3), societal (14) and health systems levels (3). All initiatives were adapted to the Sámi context, varying from tailor-made, culture-specific approaches to targeting Sámi with universal approaches. The most common approaches were the gatekeeper and mental health literacy training programs. The initiatives generally lacked thorough evaluation components. CONCLUSION We argue that the dominant rationales for suicide prevention were addressing shortcomings on individual and relational levels, and raising awareness in the general public. This threatens obscuring other, critical, approaches, such as broadening perspectives in prevention planning, improving health systems for Sámi, and promoting cultural empowerment among Sámi. Nevertheless, the study confirms considerable efforts have been invested into suicide prevention among Sámi during the last 15 years, and future initiatives might include a broader set of prevention rationales. To improve evaluation and identify the most promising practices, increased support regarding development of plans and implementation of evaluation components is needed.
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Affiliation(s)
- Jon Petter A Stoor
- Department of Epidemiology and Global Health, Umeå University, SE-901 87, Umeå, Sweden.
- Centre for Sámi Health Research, Department of Community Medicine, UiT - the Arctic University of Norway, Tromsø, Norway.
| | | | - Anne C Silviken
- Centre for Sámi Health Research, Department of Community Medicine, UiT - the Arctic University of Norway, Tromsø, Norway
- Sámi Norwegian National Advisory Unit for Mental Health and Substance Use, Finnmark Hospital Trust, Karasjok, Norway
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Borch KB, Eliassen BM, Melhus M, Damsgård E, Broderstad AR. Physical activity in Sami and non-Sami populations in rural Northern Norway, the SAMINOR 2 Clinical Survey. BMC Public Health 2021; 21:1665. [PMID: 34521379 PMCID: PMC8438985 DOI: 10.1186/s12889-021-11744-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
Background The Sami people is an indigenous minority population living in the northern parts of Norway and mainly in rural areas. We lack data of contemporary levels of physical activity (PA) in rural regions of Northern Norway and in the Sami population in particular. We aimed to describe the PA levels and investigate whether PA levels differs between Sami and non-Sami and between coastal and inland areas. Methods We used data from the second survey of the Population-based Study on Health and Living Conditions in Regions with Sami and Norwegian Populations – the SAMINOR 2 Clinical Survey (2012–2014) that includes the adult population in 10 municipalities in the counties Troms, Finnmark and Nordland. Participants self-reported on PA, ethnicity and modifiable lifestyle factors. Twelve thousand four hundred fifty-five individuals were invited with a response rate of 48.2% (n = 6004 participants). We tested differences using chi-square tests, two sample t-tests and linear regression models. Results Among 5628 participants, 41.1 and 40.9% of men and women, respectively, were defined as Sami. We found no ethnic differences in PA in men overall. However, Sami men living in Tana, and Nesseby reported higher PA compared to non-Sami men in the same area. For Sami women there was overall lower PA levels compared to non-Sami women, especially pronounced in Kautokeino/ Karasjok. Conclusion This study showed small differences in PA levels between Sami and non-Sami men. Sami women had lower PA levels compared to their non-Sami counterparts. It is important to identify whether there are differences in various ethnic populations, together with other predictors for PA in future planning of public health interventions.
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Affiliation(s)
- Kristin Benjaminsen Borch
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | | | - Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elin Damsgård
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ann Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Eriksen AMA, Melhus M, Jacobsen BK, Schei B, Broderstad AR. Intimate partner violence and its association with mental health problems: The importance of childhood violence - The SAMINOR 2 Questionnaire Survey. Scand J Public Health 2021; 50:1179-1191. [PMID: 34192982 DOI: 10.1177/14034948211024481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS This study aims to estimate the prevalence of intimate partner violence (IPV) and its association with psychological distress and symptoms of post-traumatic stress (PTS) among Sami and non-Sami and to explore whether the association between IPV and mental health is modified by exposure to childhood violence (CV). These issues are scarcely studied among the Sami. METHODS This study was based on the cross-sectional SAMINOR 2 Questionnaire Survey, a part of the Population-based Study on Health and Living Conditions in Regions with Sami and Norwegian Populations (SAMINOR). Chi-square tests and two-sample t-tests were used to test differences between groups. Multiple linear regression analysis was applied to explore the association between IPV/CV and continuous scores of psychological distress and symptoms of post-traumatic stress. RESULTS Experiences of IPV (emotional, physical, and/or sexual) were reported by 12.8% of women and 2.0% of men. A significantly higher proportion of Sami women reported exposure to emotional (12.4 v. 9.5%, p = 0.003), physical (11.6 v. 6.9%, p < 0.001), and any IPV (17.2 v. 11.8%, p < 0.001) compared to non-Sami women. There were no ethnic differences in sexual IPV among women (2%). Exposure to IPV was associated with a higher score of psychological distress and PTS and was highest among those exposed to both IPV and CV. CONCLUSIONS Sami women reported the highest prevalence of IPV. The association between IPV/CV and mental health problems did not differ by ethnicity or gender. The most severe mental health problems were observed for those who were exposed to both IPV and CV.
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Affiliation(s)
- Astrid M A Eriksen
- Centre for Sami Health Research, UiT The Arctic University of Norway, Norway
| | - Marita Melhus
- Centre for Sami Health Research, UiT The Arctic University of Norway, Norway
| | - Bjarne K Jacobsen
- Centre for Sami Health Research, UiT The Arctic University of Norway, Norway.,Department of Community Medicine, UiT The Arctic University of Norway, Norway
| | - Berit Schei
- Department of Public Health, NTNU, Norway.,Department of Obstetrics and Gynecology, St. Olav`s Hospital, Trondheim University Hospital, Norway
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Eriksen H, Rautio A, Johnson R, Koepke C, Rink E. Ethical considerations for community-based participatory research with Sami communities in North Finland. Ambio 2021; 50:1222-1236. [PMID: 33454885 PMCID: PMC8068735 DOI: 10.1007/s13280-020-01459-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/28/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
This study examines the perspectives of Sami community members and university researchers regarding the ethical considerations for engagement in Community-Based Participatory Research (CBPR) with Sami communities in northern Finland. Key informant interviews were conducted with Sami people from Finland who were exposed to or participated in research in their communities as well as with researchers who have conducted research with the Sami in Finland across diverse topics. Five themes were identified: establishing trust, research preparation, research comprehension, research ethics, and inclusion in research. The differences in participant perspectives were compared based on their community versus researcher roles. Our findings emphasize the need for (1) strategies to develop and maintain trust between Sami communities and researchers; (2) methods to bridge concepts of bias projected onto Sami communities and researchers by the others' differing world views and beliefs about research; and (3) increased education in community-engaged methods for social and natural scientists working with Sami communities. This study supports the need for the development of formalized ethical protocols for conducting community-based engaged research with and for Sami people in Finland that ensure mutually beneficial research for all involved.
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Affiliation(s)
| | - Arja Rautio
- University of Oulu, P.O. Box 7300, 90014 Oulu, Finland
| | - Rhonda Johnson
- University of Alaska Anchorage, BOC3, Suite 220, 3211 Providence Drive, Anchorage, AK 99508-4614 USA
| | - Catherine Koepke
- University of Alaska Anchorage, BOC3, Suite 220, 3211 Providence Drive, Anchorage, AK 99508-4614 USA
| | - Elizabeth Rink
- Montana State University, 318C Herrick Hall, Bozeman, MT 59717-3540 USA
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Granheim IPH, Silviken A, Larsen CVL, Kvernmo S. Socio-demographic, psychosocial and environmental factors associated with suicidal behaviour in Indigenous Sami and Greenlandic Inuit adolescents; the WBYG and NAAHS studies. Int J Circumpolar Health 2021; 80:1913939. [PMID: 33856268 PMCID: PMC8057081 DOI: 10.1080/22423982.2021.1913939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Background. For young Indigenous people, suicide is one of the leading causes of death, and high rates in Arctic areas indicate serious health- and societal concerns. More knowledge is needed, as suicidal behaviour predictslater death by suicide.Objectives. The objective was to study associations between suicidal thoughts and suicide attempts and socio-demographic, psychosocial, and environmental factors in Sami and Greenlandic adolescents, within and between groups and gender.Methods. Working samples included 442 Sami and 399 Greenlandic Inuit (15-16-year-olds), in "The Norwegian Arctic Adolescent Health Study" (NAAHS) and "Well-being among Youth in Greenland" (WBYG). Multivariable logistic regression explored associations between suicidal behaviour and family , ethnic language , school, friendship, and suicide in close relations.Results. Across Indigenous groups, suicidal behaviour was associated with the female gender, relationships with parents, suicide of friends, and rural living. Sami adolescents in stepparent families reported more suicidal behaviour. Inuit adolescents living outside the family and with poor school performance reported more suicidal thoughts. Inuit adolescents spending less time with friends reported more attempts. Gender differences occurred in both groups.Conclusion. To Sami and Greenlandic Inuit, family and peer relations are important factors of suicidal behaviour. Prevention programmes should be sensitive to gender and bereavement.
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Affiliation(s)
- Ida Pauline Høilo Granheim
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsoe; the Arctic University of Norway, Tromsoe, Norway
| | - Anne Silviken
- Sámi Norwegian National Advisory Unit for Mental Health and Substance Use, Sámi Klinihkka, Finnmark Hospital Trust, Karasjok, Norway.,Centre of Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, University of Tromsoe; the Arctic University of Norway, Tromsoe, Norway
| | - Christina Viskum Lytken Larsen
- Centre for Public Health in Greenland, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
| | - Siv Kvernmo
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsoe; the Arctic University of Norway, Tromsoe, Norway
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14
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Dahl IK, Dalgård C. Sami dietary habits and the risk of cardiometabolic disease: a systematic review. Int J Circumpolar Health 2021; 80:1873621. [PMID: 33463398 PMCID: PMC7832988 DOI: 10.1080/22423982.2021.1873621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
This systematic literary review investigates if an association between Sami dietary habits and cardiometabolic outcomes exists, and examines the dietary characteristics and cardiometabolic status of the Sami population. Included were all articles assessing Sami dietary habits and cardiometabolic disease or risk factors. Embase, Medline and SweMed were searched on 26 September 2019 and articles were screened for eligibility in October 2019. Data were extracted according to Moose Guidelines and the Newcastle Ottawa Scale (NOS) was used to assess risk of bias. The initial search generated 4,195 articles in total. Nine articles met all inclusion criteria. Two were cohort studies and seven were cross-sectional. Rating by NOS ranked from 2/7 to 8/9 stars. The studies were largely descriptive and only few had results regarding a direct association between Sami dietary habits and cardiometabolic outcomes. The findings demonstrated no association between consumption of certain Sami food items and blood-lipids or mortality from CVD/CHD. A higher intake of fat, protein, reindeer-meat and coffee and a slightly lower blood pressure and mortality from CVD/CHD was seen among Sami compared with non-Sami. The limited amount and descriptive nature of the eligible articles indicate that resaerch within the fielt is limited. Thus, additional longitudinal studies are suggested.
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Affiliation(s)
- I K Dahl
- Cand.med., University of Southern Denmark , Odense C, Denmark
| | - C Dalgård
- IST - Clinical Pharmacology, Pharmacy and Environmental Medicine and the Danish Twin Registry, University of Southern Denmark , Odense C, Denmark
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Damsgård E, Thrane G, Fleten N, Bagge J, Sørlie T, Anke A, Broderstad AR. Persistent pain associated with socioeconomic and personal factors in a Sami and Non-Sami population in Norway: an analysis of SAMINOR 2 survey data. Int J Circumpolar Health 2020; 79:1787022. [PMID: 32780007 PMCID: PMC7480428 DOI: 10.1080/22423982.2020.1787022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 11/12/2022] Open
Abstract
In international studies, higher prevalence of persistent pain has been reported in indigenous populations compared to majority populations. The present study aimed to determine the prevalence of persistent pain within a Sami and a non-Sami population in northern Norway, with adjustment for the confounding factors of age, sex, marital status, education, income, mental health, smoking status and ethnic background. Using SAMINOR 2 survey data including Sami and non-Sami populations, we analysed 5,546 responses, from individuals aged 40-79 years, to questions concerning persistent pain (≥ 3 months). In total, 2,426 (43.7%) participants reported persistent pain with differences between Sami women and non-Sami women (44.1% versus 51.1%, respectively), but none between Sami men and non-Sami men (38.7% versus 38.2%, respectively). Elderly Sami women were less likely to report persistent pain than were elderly non-Sami women. In men, no ethnic differences in pain were observed according to age-group. Marital status, education levels, household income, psychological distress, and smoking status did not influence the association between ethnicity and pain. Pain severity and location did not differ between Sami and non-Sami participants. In this study, we found only minor ethnic differences in persistent pain. Similar living conditions and cultural features may explain these findings.
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Affiliation(s)
- Elin Damsgård
- Department of Health and Care Sciences, UiT the Arctic University of Norway , Tromsø, Norway
| | - Gyrd Thrane
- Department of Health and Care Sciences, UiT the Arctic University of Norway , Tromsø, Norway
| | - Nils Fleten
- Department of Community Medicine, UiT the Arctic University of Norway , Tromsø, Norway
| | - Johan Bagge
- Department of Health and Care Sciences, UiT the Arctic University of Norway , Tromsø, Norway
| | - Tore Sørlie
- UiT the Arctic University of Norway , Tromsø, Norway
| | - Audny Anke
- UiT the Arctic University of Norway , Tromsø, Norway
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Abstract
This study analyses suicides amongst reindeer herding Sámi in Sweden using information from the database of the National Board of Forensic Medicine. Suicides were identified using registers (39 suicides from 1961–2000) and key informants (11 suicides from 2001–2017). A great majority of cases were males (43 males, 7 females), and 50% occurred in the northernmost region. The mean age was 37.4 years with a peak in the group 20–29 years of age. Shooting was the most common (56%) method, followed by hanging. Blood alcohol concentration measures available from 1993 were above 0.2 g/l in 76% of the cases. There was a maximum incidence of suicides between 1981 and 1990. An accumulation of suicides in the months of May (N = 8) and November (N = 7) was seen. The annual suicide rate was estimated to be between 17.5 and 43.9 per 100 000 population. There was a clear gradient in suicide incidence with the highest being in the southernmost region (Jämtland/Härjedalen) and the lowest in the northernmost county (Norrbotten). For strengthened suicide prevention in this group, future research should address sex differences, the role of alcohol use and the general conditions for reindeer herding.
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Affiliation(s)
- Lars Jacobsson
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
| | - Jon Petter A Stoor
- Sámi Norwegian National Advisory Unit for Mental Health and Substance Use, Finnmark Hospital Trust, Karasjok, Norway
| | - Anders Eriksson
- Department of Community Medicine and Rehabilitation, Forensic Medicine, Umeå University, Umeå, Sweden
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17
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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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Abstract
This qualitative study explores Sami and non-Sami clinicians' assumptions about Sami culture and their experiences in providing mental health services to Sami patients. The aim is to better understand and improve the ways in which culture is incorporated into mental health services in practice. Semi-structured interviews were conducted with 20 clinicians in mental health outpatient clinics in the northern Sami area in Troms and Finnmark County in Norway. The findings show that clinicians' conceptualizations of culture influence how they take cultural considerations about their Sami patients into account. To better integrate culture into clinical practice, the cultures of both patient and clinician, as well as of mental health care itself, need to be assessed. Finally, the findings indicate a lack of professional team discussions about the role of Sami culture in clinical practice.
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Stoor JPA, Berntsen G, Hjelmeland H, Silviken A. "If you do not birget [manage] then you don't belong here": a qualitative focus group study on the cultural meanings of suicide among Indigenous Sámi in arctic Norway. Int J Circumpolar Health 2020; 78:1565861. [PMID: 30675809 PMCID: PMC6346707 DOI: 10.1080/22423982.2019.1565861] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Suicide is a major public health issue across the Arctic, especially among Indigenous Peoples. The aim of this study was to explore and describe cultural meanings of suicide among Sámi in Norway. Five open-ended focus group discussions (FGDs) were conducted with 22 Sámi (20) and non-Sámi (2) participants in South, Lule, Marka, coastal and North Sámi communities in Norway. FGDs were recorded, transcribed verbatim and analysed employing thematic analysis. Six themes were developed from the analysis: “Sámi are treated negatively by the majority society”, “Some Sámi face negative treatment from other Sámi”, “The historic losses of the Sámi have turned into a void”, “Sámi are not provided with equal mental health care”, “The strong Sámi networks have both positive and negative impacts” and “‘Birgetkultuvvra’ might be a problem”. The findings indicate that the participants understand suicide among Sámi in relation to increased problem load for Sámi (difficulties in life not encountered by non-Sámi) and inadequate problem-solving mechanisms on different levels, including lack of equal mental health care for Sámi and cultural values of managing by oneself (“ieš birget”). The findings are important when designing suicide prevention initiatives specifically targeting Sámi.
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Affiliation(s)
- Jon Petter Anders Stoor
- a Sámi Norwegian National Advisory Unit on Mental Health and Substance Use , Finnmark Hospital Trust , Karasjok , Norway
| | - Gro Berntsen
- b Northern Norway Violence, Traumatic Stress and Suicide Prevention Resource Centre , University Hospital of North Norway , Tromsø , Norway
| | - Heidi Hjelmeland
- c Department of Mental Health , Norwegian University of Science and Technology , Trondheim , Norway
| | - Anne Silviken
- a Sámi Norwegian National Advisory Unit on Mental Health and Substance Use , Finnmark Hospital Trust , Karasjok , Norway.,d Centre for Sámi Health Research, Department of Community Medicine , UiT - the Arctic University of Norway , Tromsø , Norway
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20
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Kvaløy K, Melhus M, Silviken A, Broderstad AR. Weight underestimation linked to anxiety and depression in a cross-sectional study of overweight individuals in a Sami and non-Sami Norwegian population: the SAMINOR Study. BMJ Open 2019; 9:e031810. [PMID: 31722948 PMCID: PMC6858251 DOI: 10.1136/bmjopen-2019-031810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Underestimation of overweight/obesity may prevent weight loss attempts, resulting in further weight gain and maintenance of overweight. Mental health benefits may nevertheless surpass negative consequences. Our main objective was to study the association between underestimation of overweight/obesity and symptoms of anxiety and depression in Sami and non-Sami populations. DESIGN Population-based cross-sectional study. SETTING The SAMINOR 2 Clinical Study with participants from 10 municipalities in Northern Norway enrolled between 2012 and 2014. PARTICIPANTS The study included 3266 adults of multiethnic rural origin with overweight/obesity (body mass index (BMI) ≥25 kg/m2) whereof 1384 underestimated their weight (42%). PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measure was symptoms of anxiety and depression and secondary outcome measures were BMI and the demographic variables: sex, age, education and marital status. RESULTS A higher proportion of Sami men compared with non-Sami men were obese, and reported more symptoms of anxiety and depression. More men than women, and a higher proportion of Sami women compared with non-Sami women, underestimated their weight. Multivariable-adjusted analyses showed that women were less likely to underestimate their weight compared with men (OR 0.43, 95% CI 0.33 to 0.55 in Sami and OR 0.33, 95% CI 0.26 to 0.42 in non-Sami), higher BMI was protective against weight underestimation (OR 0.72, 95% CI 0.69 to 0.75 in Sami and OR 0.63, 95% CI 0.60 to 0.67 in non-Sami), slightly higher odds of weight underestimation were observed with increasing age in both ethnic groups (OR 1.03, 95% CI 1.01 to 1.05 in Sami and OR 1.02, 95% CI 1.00 to 1.03 in non-Sami), while higher education lowered the odds in non-Sami (OR 0.69, 95% CI 0.55 to 0.87). Weight underestimation was protectively associated with anxiety and depression in Sami men (OR 0.48, 95% CI 0.27 to 0.84) and in non-Sami women (OR 0.44, 95% CI 0.25 to 0.78) adjusted for age, BMI, education and marital status. CONCLUSIONS Independent of ethnicity, more men than women underestimated their weight. Underestimation of weight was protectively associated with anxiety and depression in Sami men and non-Sami women.
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Affiliation(s)
- Kirsti Kvaløy
- Centre for Sami Health Research, Department of Community Medicine, UiT Arctic University of Norway, Tromsø, Norway
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine, UiT Arctic University of Norway, Tromsø, Norway
| | - Anne Silviken
- Centre for Sami Health Research, Department of Community Medicine, UiT Arctic University of Norway, Tromsø, Norway
- Sámi Norwegian National Advisory Unit on Mental Health and Substance Abuse (SANKS), Finnmarkssykehuset HF, Karasjok, Norway
| | - Ann Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, UiT Arctic University of Norway, Tromsø, Norway
- University Hospital of North Norway Harstad Site, Harstad, Norway
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21
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Naseribafrouei A, Eliassen BM, Melhus M, Svartberg J, Broderstad AR. Estimated 8-year cumulative incidence of diabetes mellitus among Sami and non-Sami inhabitants of Northern Norway - The SAMINOR Study. BMC Endocr Disord 2019; 19:66. [PMID: 31234837 PMCID: PMC6591838 DOI: 10.1186/s12902-019-0399-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 06/19/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The aim of the study was to estimate and compare the 8-year cumulative incidence of diabetes mellitus (DM) among Sami and non-Sami inhabitants of rural districts in Northern Norway. METHODS Longitudinal study based on linkage of two cross-sectional surveys, the SAMINOR 1 Survey (2003-2004) and the SAMINOR 2 Clinical Survey (2012-2014). Ten municipalities in rural Northern Norway were included in the study. DM-free participants aged 30 and 36-71 years in SAMINOR 1 were followed from 2 years after SAMINOR 1 to attendance in SAMINOR 2. The average follow-up time was 8.1 years. Of 5875 subjects who had participated in SAMINOR 1 and could potentially be followed to SAMINOR 2, 3303 were included in the final analysis. Self-reported DM and/or HbA1c ≥ 6.5% were used to identify incident cases of DM. RESULTS At baseline, body mass index (BMI) and waist-to-height ratio (WHtR) were higher among Sami than among their non-Sami counterparts. After 8 years of follow-up, 201 incident cases of DM were identified (6.1% both Sami and non-Sami subjects). No statistically significant difference was observed in the cumulative incidence of DM between the Sami and non-Sami. CONCLUSIONS No statistically significant difference in the 8-year cumulative incidence of DM among Sami and non-Sami was observed, although Sami men and women had higher baseline BMI and WHtR.
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Affiliation(s)
- Ali Naseribafrouei
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Box 6050 Langnes, N-9037 Tromsø, Norway
| | | | - Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Box 6050 Langnes, N-9037 Tromsø, Norway
| | - Johan Svartberg
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ann Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Box 6050 Langnes, N-9037 Tromsø, Norway
- Department of Medicine, University Hospital of North Norway, Harstad, Norway
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22
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Eriksen AMA, Hansen KL, Schei B, Sørlie T, Stigum H, Bjertness E, Javo C. Childhood violence and mental health among indigenous Sami and non-Sami populations in Norway: a SAMINOR 2 questionnaire study. Int J Circumpolar Health 2019; 77:1508320. [PMID: 30112962 PMCID: PMC6104612 DOI: 10.1080/22423982.2018.1508320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The main objectives of this study were to investigate the association between childhood violence and psychological distress and post-traumatic stress symptoms (PTS) among Sami and non-Sami adults, and to explore a possible mediating effect of childhood violence on any ethnic differences in mental health. This study is part of a larger questionnaire survey on health and living conditions in Mid- and Northern Norway (SAMINOR 2) which included 2116 Sami and 8674 non-Sami participants. A positive association between childhood violence and psychological distress and PTS in adulthood was found regardless of ethnicity. For women, childhood violence may have mediated some of the ethnic differences in psychological distress (53.2%) and PTS (31.4%). A similar pattern was found for men as to psychological distress (45.5%) and PTS (55.5%). The prevalence of psychological distress was significantly higher in the Sami than in the non-Sami group: 15.8% vs. 13.0% for women, and 11.4% vs. 8.0% for men. Likewise, PTS showed a higher prevalence in the Sami group, both for women (16.2% vs. 12.4%) and for men (12.2% vs. 9.1). CONCLUSION A positive association between childhood violence and adult mental distress was found for both Sami and Norwegian adults. More mental problems were found among the Sami. Childhood violence may have mediated some of the ethnic differences.
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Affiliation(s)
- Astrid M A Eriksen
- a Sami National Centre for Mental Health and Substance Abuse (SANKS) Finnmarkssykehuset HF , Karasjok , Norway.,b Centre for Sami Health Research , UiT, The Arctic University of Norway , Tromsoe , Norway.,c Faculty of Health Sciences, OsloMet , Oslo Metropolitan University , Oslo , Norway
| | - Ketil Lenert Hansen
- d Regional Centre for Child and Youth Mental Health and Child Welfare North (RKBU Nord) , UiT The Arctic University of Norway , Tromsoe , Norway
| | - Berit Schei
- e Department of Public Health , NTNU , Trondheim , Norway.,f Department of Obstetrics and Gynecology , St.Olav`s Hospital, Trondheim University Hospital , Trondheim , Norway
| | - Tore Sørlie
- g Department of Clinical Medicine , University of Tromsoe - The Arctic University of Norway , Tromsø , Norway.,h Department of Mental Health and Substance Abuse , University Hospital of North Norway , Tromsoe , Norway
| | - Hein Stigum
- i Institute of Health and Society, Department of Community Medicine , University of Oslo , Oslo , Norway
| | - Espen Bjertness
- i Institute of Health and Society, Department of Community Medicine , University of Oslo , Oslo , Norway
| | - Cecilie Javo
- a Sami National Centre for Mental Health and Substance Abuse (SANKS) Finnmarkssykehuset HF , Karasjok , Norway
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Abstract
Music as a possible health-promoting agent has attained increasing academic and scientific interest over the last decades. Nonetheless, possible connections between indigenous singing traditions and health beyond traditional ceremonial healing practices are still under-researched worldwide. The Sami, the indigenous people living in Northern Fennoscandia, have a distinct ancient vocal music tradition called “yoik” practiced from immemorial times. The Sami share a history of assimilation with many indigenous people. During this period of nearly 400 years, yoik alongside other cultural markers was under hard pressure and even banned at times. Compared to other indigenous people in the Arctic, Sami public health shows few significant unfavourable differences to the majority population. The potential role of yoik as a protective health and resilience factor within the Sami culture is the topic of this review. We suggest a two stage model for the health promoting effects of yoik through i) emotion regulation and stress relief on the level of the individual, and ii) as a socio-cultural resilience factors within the Sami population. This review is to be understood as theory-building review article striving for a scholarly review of the literature.
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Affiliation(s)
- Soile Hämäläinen
- a National Research Center in Complementary and Alternative Medicine, Departement of Community Medicine, Faculty of Health Sciences , UiT The Arctic university of Norway , Tromsø , Norway
| | - Frauke Musial
- a National Research Center in Complementary and Alternative Medicine, Departement of Community Medicine, Faculty of Health Sciences , UiT The Arctic university of Norway , Tromsø , Norway
| | - Anita Salamonsen
- b RKBU North - Regional Centre for Child and Youth Mental Health and Child Welfare , Faculty of Health Sciences at UiT the Arctic University of Norway , Tromsø , Norway
| | - Ola Graff
- c Department of Cultural Sciences , The University Museum of Tromsø, UiT The Arctic university of Norway , Tromsø , Norway
| | - Torjer A Olsen
- d Centre for Sami Studies (SESAM), Faculty of Humanities, Social Sciences and Education , UiT The Arctic University of Norway , Tromsø , Norway
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Gjertsen H. Mental health among Sami people with intellectual disabilities. Int J Circumpolar Health 2019; 78:1565860. [PMID: 30664403 PMCID: PMC6346717 DOI: 10.1080/22423982.2019.1565860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The first living condition-survey among people with intellectual disability in Sami areas in Norway was conducted in 2017. The purpose of this article is to present and discuss results from the living-condition study, with a focus on the results related to mental health and bullying as a risk factor for poor mental health among people with intellectual disability and a Sami background. We have conducted a questionnaire survey among people with intellectual disability in Sami areas, with and without a Sami background (N = 93). People with intellectual disability have poorer mental health compared to the population in general and those with Sami background have the poorest mental health. Bullying is one of several factors that increase the risk of poor mental health among people with intellectual disability and Sami background. Having a Sami background makes people with intellectual disability more disposed to poor mental health.
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Affiliation(s)
- Hege Gjertsen
- a Institute of Social Education, Campus Harstad , UiT, the Arctic University of Norway , Harstad , Norway
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25
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Langås-Larsen A, Salamonsen A, Kristoffersen AE, Hamran T, Evjen B, Stub T. "We own the illness": a qualitative study of networks in two communities with mixed ethnicity in Northern Norway. Int J Circumpolar Health 2018; 77:1438572. [PMID: 29466927 PMCID: PMC5827718 DOI: 10.1080/22423982.2018.1438572] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 02/05/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND When people in Northern Norway get ill, they often use traditional medicine. The global aim of this study was to examine the extended family networks' function and responsibility in cases of illness in the family, in two Northern Norwegian communities with a population of mixed ethnicity. METHODS Semi-structured individual interviews with 13 participants and 4 focus group interviews with total 11 participants were conducted. The text data was transcribed verbatim and analysed based on the criteria for content analysis. RESULTS The participants grew up in areas where it was common to seek help from traditional healers. They were organized in networks and shared responsibility for the patient and they provided practical help and support for the family. According to the networks, health-care personnel should make room for the entire network to visit the patient in severe and life-threatening situations. CONCLUSION Traditional networks are an extra resource for people in these communities. The networks seem to be essential in handling and disseminating hope and manageability on an individual as well as a collective level. Health personnel working in communities with mixed ethnicity should have thorough knowledge of the mixed culture, including the importance of traditional network to the patients.
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Affiliation(s)
- Anette Langås-Larsen
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, The Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Anita Salamonsen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU North), The Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Agnete Egilsdatter Kristoffersen
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, The Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Torunn Hamran
- Department of Health and Care Sciences. Centre for Care Research, The Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Bjørg Evjen
- Centre for Sami Studies, The Faculty of Humanities, Social Sciences and Education, UiT the Arctic University of Norway, Tromsø, Norway
| | - Trine Stub
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, The Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
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Petrenya N, Skeie G, Melhus M, Brustad M. Food in rural northern Norway in relation to Sami ethnicity: the SAMINOR 2 Clinical Survey. Public Health Nutr 2018; 21:2665-77. [PMID: 29808789 DOI: 10.1017/S1368980018001374] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To estimate current food intake in the population of northern Norway and to investigate the impact of self-perceived Sami ethnicity and region of residence on food intake. DESIGN The data are part of the second cross-sectional survey of the Population-based Study on Health and Living Conditions in Regions with Sami and Norwegian Populations (the SAMINOR 2 Clinical Survey, 2012-2014). Food intake was assessed by an FFQ. Ethnic and regional differences in food intake were studied by sex-specific, multivariable-adjusted quantile regression models. SETTING Ten municipalities (rural northern Norway). SUBJECTS Males (n 2054) and females (n 2450) aged 40-69 years (2743 non-Sami, 622 multi-ethnic Sami, 1139 Sami). RESULTS The diet of Sami participants contained more reindeer meat, moose meat, food made with animal blood and freshwater fish; and contained less lean fish and vegetables. In the inland region, the consumption of reindeer meat was greatest in Sami participants, followed by multi-ethnic Sami participants and non-Sami participants, who had the lowest consumption (median 25, 12 and 8 g/d, respectively). Compared with the inland region, fish roe/liver intake was higher in the coastal region and lean fish intake was twice as high (41 and 32 g/d in males and females, respectively). CONCLUSIONS When compared with non-Sami participants, those with solely self-perceived Sami ethnicity reported a significantly different intake of several foods, especially reindeer meat in the inland region. Multi-ethnic Sami tended to have similar diets to non-Sami. Residence in the coastal region predicted higher fish and roe/liver intake.
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Hermansen R, Broderstad AR, Jacobsen BK, Mähönen M, Wilsgaard T, Morseth B. The impact of changes in leisure time physical activity on changes in cardiovascular risk factors: results from The Finnmark 3 Study and SAMINOR 1, 1987-2003. Int J Circumpolar Health 2018; 77:1459145. [PMID: 29656696 PMCID: PMC5912188 DOI: 10.1080/22423982.2018.1459145] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective: The aim of this study was to examine the associations between changes in leisure time physical activity and changes in cardiovascular risk factors over 16 years and whether they differ between two ethnic groups in Norway. Methods: Data were extracted from two population-based studies. Altogether, 3671 men and women participated in both surveys, and 30% reported being of Sami ethnicity. Leisure time physical activity was self-reported, and cardiovascular risk factors were measured. ANCOVA analysis was used to examine associations between changes in physical activity and changes in cardiovascular risk factors. Results: After adjustment for age, sex, smoking, ethnicity and respective baseline values, favourable changes in body mass index (BMI) and levels of triglycerides were most pronounced in those who were active in both surveys (p < 0.05) whereas the opposite was the situation for cholesterol levels (p = 0.003). Changes in systolic blood pressure, diastolic blood pressure and resting heart rate were not significantly associated with change in physical activity. Ethnicity did not influence the associations between physical activity and cardiovascular risk factors. Conclusion: Traditional cardiovascular risk factors were to a small extent associated with change in leisure time physical activity. Persistent physical activity was associated with beneficial changes in BMI and triglycerides.
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Affiliation(s)
- Rune Hermansen
- a Department of Community Medicine , UiT The Arctic University of Norway , Tromsø , Norway.,b Finnmark Hospital Trust , Kirkenes Hospital , Kirkenes , Norway
| | - Ann Ragnhild Broderstad
- a Department of Community Medicine , UiT The Arctic University of Norway , Tromsø , Norway.,c Centre for Sámi Health Research, Department of Community Medicine , UiT The Arctic University of Norway , Tromsø , Norway
| | - Bjarne K Jacobsen
- a Department of Community Medicine , UiT The Arctic University of Norway , Tromsø , Norway
| | - Markku Mähönen
- b Finnmark Hospital Trust , Kirkenes Hospital , Kirkenes , Norway.,d Faculty of Medicine , University of Oulu , Oulu , Finland
| | - Tom Wilsgaard
- a Department of Community Medicine , UiT The Arctic University of Norway , Tromsø , Norway
| | - Bente Morseth
- a Department of Community Medicine , UiT The Arctic University of Norway , Tromsø , Norway.,e School of Sport Sciences , UiT The Arctic University of Norway , Tromsø , Norway
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Abstract
Background: Yoik is an old vocal music tradition of Sami, the indigenous people inhabiting Northern Fennoscandia and Kola peninsula in Russia. Studies of music therapy (MT) and especially singing have documented improvements in social and overall functioning in people with severe mental disorders and positive effect on depressive symptoms and sleep quality. Possible connections between yoik and health are so far underexplored. Objectives: The overall aim of this study was to explore whether yoik may have the potential to positively influence people’s health and well-being. The research questions were: 1. What are different persons’ experiences with yoik? 2. Can yoik experiences be related to health outcomes? Methods: Explorative, qualitative interviews with 13 participants were conducted in the Norwegian counties Finnmark, Troms, Nordland, and Trøndelag. Findings: The findings suggest qualities in yoik that are comparable to positive effects of Music Therapy (MT) in general. Yoik may contribute to emotion management, i.e. processing negative emotions and inducing positive ones in people acknowledging yoik as something positive. Conclusion: Yoik may be considered an important marker of social and cultural belonging for many Sami people. Yoik seems to have an underresearched potential as an intervention in culture sensitive healthcare and health promotion work that deserves to be further investigated.
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Affiliation(s)
- Soile Hämäläinen
- a National Research Center in Complementary and Alternative Medicine, Departement of Community Medicine, Faculty of Health Sciences , UiT The Arctic University of Norway , Tromsø , Norway
| | - Frauke Musial
- a National Research Center in Complementary and Alternative Medicine, Departement of Community Medicine, Faculty of Health Sciences , UiT The Arctic University of Norway , Tromsø , Norway
| | - Ola Graff
- b The University Museum of Tromsø , UiT The Arctic University of Norway , Tromsø , Norway
| | - Torjer A Olsen
- c Centre for Sami Studies (SESAM), Faculty of Humanities, Social Sciences and Education , UiT The Arctic University of Norway , Tromsø , Norway
| | - Anita Salamonsen
- a National Research Center in Complementary and Alternative Medicine, Departement of Community Medicine, Faculty of Health Sciences , UiT The Arctic University of Norway , Tromsø , Norway
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Karlsson L. Indigenous Infant Mortality by Age and Season of Birth, 1800-1899: Did Season of Birth Affect Children's Chances for Survival? Int J Environ Res Public Health 2017; 15:E18. [PMID: 29295484 DOI: 10.3390/ijerph15010018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/01/2017] [Accepted: 12/20/2017] [Indexed: 11/17/2022]
Abstract
This paper focuses on the influence of season of birth on infant mortality among the Sami and non-Sami populations in northern Sweden during the nineteenth century. The source material is a set of data files from the Demographic Data Base at Umeå University, making it possible to combine age at death (in days), month of death, and month of birth over the course of the entire century. Cox regression models reveal that for the first week of life, season of birth had no influence on the risk of mortality. For the Sami, the results showed that being born during winter was related to a higher risk of neonatal mortality, and being born during summer was related to a higher risk of mortality after six months of age. Furthermore, for the Sami, the neonatal mortality showed a U-shaped pattern with a minimum in June–August, whereas the corresponding pattern among the non-Sami was flatter. The findings shed light on vulnerability in two populations sharing the same environment, but diverging in terms of social, economic, and cultural factors.
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Kristoffersen AE, Stub T, Melhus M, Broderstad AR. Prevalence and associations for use of a traditional medicine provider in the SAMINOR 1 Survey: a population-based study on Health and Living Conditions in Regions with Sami and Norwegian Populations. Altern Ther Health Med 2017; 17:530. [PMID: 29233186 PMCID: PMC5728044 DOI: 10.1186/s12906-017-2037-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 11/28/2017] [Indexed: 12/03/2022]
Abstract
Background In Northern Norway, traditional medicine (TM) is shaped by both Christianity and traditional Sami nature worship. The healing rituals may include prayer and the use of tools such as moss, water, stones, wool and soil. Examples of TM modalities offered is cupping, blood-stemming, laying on of hands, healing prayers, and rituals. The purpose of this study was to investigate the prevalence of the use of TM in areas with predominantly Sami and Norwegian populations, and the influence of ethnicity, geography, gender, age, education, household income, religiosity and self-reported health on such use. Methods The study is based on data collected in the first SAMINOR Survey (SAMINOR 1) conducted in 2003/2004, including three self-administered questionnaires, clinical measures, and blood analyses. Data was collected in 24 municipalities in Norway known to have a substantial population of Sami. All residents aged 30 and 36–78/79 years in the predefined regions were invited regardless of ethnic background (N = 27,987). Of these, 16,865 (60.3%) accepted to participate and gave their consent to medical research. Results Of the 16,544 people responding to the question about TM use, 2276 (13.8%) reported to have used TM once or more during their lifetime. The most outstanding characteristic of the TM users was the affiliation to the Laestadian church, where 34.3% (n = 273) reported such use, followed by an inner Finnmark residence (31.1%, n = 481) and a Sami ethnicity (25.7%, n = 1014). Women were slightly more likely to use TM compared to men (15.9% and 11.5% accordingly, p < 0.001), and the TM users were slightly younger than the non-TM users (mean age 52.3 versus 54.3 years, p < 0.001). The TM users also had lower income (p < 0.001) than the non-TM users. We found no significant differences between the TM users and the non-TM users concerning years of education, and whether the participants were living with a spouse/partner or not. Conclusion Further studies are necessary to examine the development of TM use in Norway over time, and use in areas with mainly Norwegian inhabitants. There is also a lack of studies quantifying TM use among Sami people in Sweden, Finland and Russia.
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Kvaløy K, Melhus M, Silviken A, Brustad M, Sørlie T, Broderstad AR. Disordered eating in Sami and non-Sami Norwegian populations: the SAMINOR 2 Clinical Survey. Public Health Nutr 2018; 21:1094-105. [PMID: 29223188 DOI: 10.1017/S1368980017003597] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objective The present study aimed to investigate disordered eating (DE) among Sami compared with non-Sami residing in northern Norway. Design In a cross-sectional design, stratified by sex and ethnicity, associations were tested between DE (Eating Disturbance Scale; EDS-5) and age, education level, BMI category, anxiety and depression, physical activity and consumption of snacks. Setting The SAMINOR 2 Clinical Survey (2012–2014) based on the population of ten municipalities in northern Norway. Subjects Adults aged 40–69 years; 1811 Sami (844 male, 967 female) compared with 2578 non-Sami (1180 male, 1398 female) individuals. Results No overall significant ethnic difference in DE was identified, although comfort eating was reported more often by Sami individuals (P=0·01). Regardless of ethnicity and sex, symptoms of anxiety and depression were associated with DE (P<0·001). Furthermore, DE was more common at lower age and higher BMI values. Education levels were protectively associated with DE among Sami men (P=0·01). DE was associated (OR, 95% CI) with low physical activity in men in general and in non-Sami women (Sami men: 2·4, 1·4, 4·0; non-Sami men: 2·2, 1·4, 3·6; non-Sami women: 1·8, 1·2, 2·9) and so was the consumption of snacks (Sami men: 2·6, 1·3, 5·0; non-Sami men: 1·9, 1·1, 3·1; non-Sami women: 2·1, 1·3, 3·4). Conclusions There were no significant differences regarding overall DE comparing Sami with non-Sami, although Sami more often reported comfort eating. There were significant sex and ethnic differences related to DE and physical activity, snacking and education level.
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Abstract
BACKGROUND Little is known about connections between adolescent suicide attempts (SA) and concurrent adversities. AIMS In a cross-sectional study, the authors wanted to investigate prevalences, additive effects of adversities, family and peer relations, gender, divorce and poverty, and ethnic differences between Sami and non-Sami youth. METHODS In an adolescent community population encompassing 4881 adolescents of 15-16 years of age, youth with and without self-reports of attempted suicide the last year were compared on 12 concurrent adversities, on scales assessing family and peer functioning, and on sociodemographic variables. RESULTS The prevalence of attempted suicide the last year was 5.3%, and more girls (8.8%) than boys (1.8%). All 12 concurrent adversities were strongly related to SA. The suicide attempters reported two and a half times as many adversities as non-attempters. A strong multiple additive relationship was found. Multivariately, among boys, the strongest risk factors were suicide among friends (OR = 9.4), and suicide in the family or in the neighbourhood (OR = 4.8). Among girls, sexual abuse (OR = 5.2) and parent mental problems (OR = 4.6) were strongest related to SA. Suicide attempters reported more divorce and poverty, more conflicts with parents, and less family support and involvement. Totally, Sami youth reported more SA and more concurrent adversities than non-Sami peers. CONCLUSION Adolescent suicide attempters are heavily burdened with concurrent adversities. Clinicians should be aware of gender differences in risk factors, and should ask about abuse and suicide or attempts among relatives and peers. A family perspective in clinical work is needed.
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Affiliation(s)
- Bjørn Reigstad
- a Department of Research, Division of Research and Patient Safety , Nordlandssykehuset , Bodø , Norway
| | - Siv Kvernmo
- b Department of Clinical Medicine, Faculty of Health Sciences , University of Tromsø, The Arctic University of Norway , Tromsø , Norway
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Abstract
Background: This study was part of the international research project “Circumpolar Indigenous Pathways to Adulthood” (CIPA). Objectives: To explore ethnic identity negotiation, an unexplored theme, among indigenous North Sami youth living in a majority Sami community context in Arctic Norway. Methods: A qualitative design was followed using open-ended, in-depth interviews conducted in 2010 with 22 Sami adolescents aged 13–19 years, all reporting Sami self-identification. Grounded theory, narrative analysis, theories of ethnic identity and ecological perspectives on resilience were applied in order to identify the themes. Findings: All 22 youth reported being open about either their Sami background (86%) and/or ethnic pride (55%). Ethnic pride was reported more often among females (68%) than males (27%). However, a minority of youth (14%) with multi-ethnic parentage, poor Sami language skills, not having been born or raised in the community and with a lack of reindeer husbandry affiliation experienced exclusion by community members as not being affirmed as Sami, and therefore reported stressors like anger, resignation, rejection of their Sami origins and poor well-being. Sami language was most often considered as important for communication (73%), but was also associated with the perception of what it meant to be a Sami (32%) and “traditions” (23%). Conclusion: Ethnic pride seemed to be strong among youth in this majority Sami context. Denial of recognition by one’s own ethnic group did not negatively influence ethnic pride or openness about ones’ ethnic background, but was related to youth experience of intra-ethnic discrimination and poorer well-being. As Sami language was found to be a strong ethnic identity marker, effective language programmes for Norwegian-speaking Sami and newcomers should be provided. Language skills and competence would serve as an inclusive factor and improve students’ well-being and health. Raising awareness about the diversity of Sami identity negotiations among adolescents in teacher training and schools in general should be addressed.
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Affiliation(s)
- Kristine Nystad
- a Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine , University of Oslo , Oslo , Norway
| | - Anna Rita Spein
- b Center for Sami Health Research, Faculty of Health Sciences , UiT - The Arctic University of Norway , Tromsø , Norway
| | - Asta Mitkija Balto
- a Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine , University of Oslo , Oslo , Norway.,c Department of Duodji and Teacher Education , Sámi University of Applied Sciences , Kautokeino , Norway
| | - Benedicte Ingstad
- a Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine , University of Oslo , Oslo , Norway
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Bania EV, Kvernmo SE. Tertiary education and its association with mental health indicators and educational factors among Arctic young adults: the NAAHS cohort study. Int J Circumpolar Health 2017; 75:32086. [PMID: 28156413 PMCID: PMC5040818 DOI: 10.3402/ijch.v75.32086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Completed tertiary education is closely associated with employment and influences income, health and personal well-being. Objective The purpose of the study is to explore predictors for completed tertiary education among indigenous Sami and non-indigenous young people in relation to mental health indicators and educational factors in sociocultural rural and urban contexts across the Arctic part of Norway. Design The Norwegian Arctic Adolescent Health Study (NAAHS) is a cross-sectional, school-based survey that was conducted in 2003–2005. Of all 5,877 10th graders (aged 15–16 years) in north Norway, 83% from all 87 municipalities participated; 450 (9.2%) reported indigenous Sami ethnicity, and 304 (6.2%) reported Laestadian affiliation. Data from NAAHS were merged with registry data from the National Education Database and Norwegian Patient Register for 3,987 adolescents who gave their consent for follow-up studies. Results Completion of upper secondary school is the only common predictor of a completed tertiary education degree for both genders. Among females, conduct problems was a significant predictor of lower level education, typically vocational professions, while among males severe mental health problems requiring treatment by the specialist health care system reduced the opportunity to complete tertiary education at intermediate and higher level. Parental higher educational level was associated with less lower education among females and less higher education among males. Men residing in the northernmost and remote areas were less likely to complete education on higher level. Males’ completion of higher level education was strongly but not significantly associated (p=0.057) with higher average marks in lower secondary school. Conclusions The gender differences found in this study emphasize the need for gender-specific interventions to encourage, support and empower young people to attend and complete tertiary education. Young females with conduct problems choose lower or intermediate education, and males in need of specialist mental health care have half the chance to complete intermediate tertiary education compared with males not in contact with the mental health service. Closer cooperation between low threshold social services, general practitioners, mental health services and higher study institutions can help young male adults complete tertiary education.
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Affiliation(s)
- Elisabeth Valmyr Bania
- a Department of Clinical Medicine Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway , Tromsø , Norway
| | - Siv Eli Kvernmo
- a Department of Clinical Medicine Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway , Tromsø , Norway.,b Division of Child and Adolescent Health Department of Child and Adolescent Psychiatry, University Hospital of North Norway , Tromsø , Norway
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Langås-Larsen A, Salamonsen A, Kristoffersen AE, Hamran T, Evjen B, Stub T. "There are more things in heaven and earth!" How knowledge about traditional healing affects clinical practice: interviews with conventional health personnel. Int J Circumpolar Health 2017; 76:1398010. [PMID: 29130420 PMCID: PMC5700539 DOI: 10.1080/22423982.2017.1398010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/21/2017] [Indexed: 11/03/2022] Open
Abstract
People with Sami and Norwegian background are frequent users of traditional folk medicine (TM). Traditional healing, such as religious prayers of healing (reading) and the laying on of hands, are examples of commonly used modalities. The global aim of this study is to examine whether health personnel's knowledge, attitudes and experiences of traditional healing affect their clinical practice. Semi-structured individual interviews (n=32) and focus group interviews (n=2) were conducted among health personnel in two communities in Northern Norway. The text data was transcribed verbatim and analysed based on the criteria for content analysis. Six themes were identified. The participants had acquired their knowledge of traditional healing through their childhood, adolescence and experience as health personnel in the communities. They all expressed that they were positive to the patients' use of traditional healing. They justified their attitudes, stating that "there are more things in heaven and earth" and they had faith in the placebo effects of traditional healing. The health personnel respected their patients' faith and many facilitated the use of traditional healing. In some cases, they also applied traditional healing tools if the patients asked them to do so. The health personnel were positive and open-minded towards traditional healing. They considered reading as a tool that could help the patients to handle illness in a good way. Health personnel were willing to perform traditional healing and include traditional tools in their professional toolkit, even though these tools were not documented as evidence-based treatment. In this way they could offer their patients integrated health services which were tailored to the patients' treatment philosophy.
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Affiliation(s)
- Anette Langås-Larsen
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT, the Arctic University of Norway, Tromsø, Norway
| | - Anita Salamonsen
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT, the Arctic University of Norway, Tromsø, Norway
| | - Agnete Egilsdatter Kristoffersen
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT, the Arctic University of Norway, Tromsø, Norway
| | - Torunn Hamran
- Department of Health and Care Sciences, Centre for Care Research, Faculty of Health Sciences, UiT, the Arctic University of Norway, Tromsø, Norway
| | - Bjørg Evjen
- Centre for Sami Studies, Faculty of Humanities, Social Sciences and Education, UiT, the Arctic University of Norway, Tromsø, Norway
| | - Trine Stub
- The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT, the Arctic University of Norway, Tromsø, Norway
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Blix BH, Hamran T. "They take care of their own": healthcare professionals' constructions of Sami persons with dementia and their families' reluctance to seek and accept help through attributions to multiple contexts. Int J Circumpolar Health 2017; 76:1328962. [PMID: 28587573 PMCID: PMC5497550 DOI: 10.1080/22423982.2017.1328962] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/02/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Norwegian government white papers have stated that the Sami population is reluctant to seek help from healthcare services and has traditions of self-help and the use of local networks. OBJECTIVE In this article we explore healthcare professionals' discursive constructions of Sami persons with dementia and their families' reluctance to seek and accept help from healthcare services. DESIGN The article is based on an analysis of focus group interviews with healthcare professionals (n = 18) in four municipalities in Northern Norway with multiethnic populations. A narrative context analysis, which involved an examination of sequences of discourse, was employed. RESULTS Reluctance to seek and accept help among Sami service users and assumptions about self-support were recurring themes in the focus groups. The reluctance was attributed to macro contexts, such as socio-historical processes and cultural norms, and to micro contexts, such as individual and interpersonal factors including the healthcare professionals' cultural backgrounds and language competence. The healthcare professionals' positioning as insiders or outsiders (Sami or non-Sami) affected their attributions. CONCLUSIONS Local healthcare professionals are at the front line for providing and assessing service users' needs for healthcare services. Consequently, their perceptions of service users' needs are pivotal for achieving equity in healthcare. The established opinion that Sami "take care of their own" and are reluctant to seek and accept help may lead to omissions or neglect. Healthcare professionals' awareness about how present encounters in healthcare settings are framed and shaped by the service users' previous and prevailing experiences of marginalisation and subordination is crucial to avoid omissions or neglect resulting from assumptions about cultural preferences. Discursively shaped boundaries and differences between groups may create the impression that the distance between the groups is too wide to traverse, which in turn may lead to further marginalisation of service users in healthcare encounters.
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Affiliation(s)
- Bodil Hansen Blix
- Centre for Care Research, north, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromso, Norway
| | - Torunn Hamran
- Centre for Care Research, north, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromso, Norway
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Buchanan A, Reed MG, Lidestav G. What's counted as a reindeer herder? Gender and the adaptive capacity of Sami reindeer herding communities in Sweden. Ambio 2016; 45:352-362. [PMID: 27878539 PMCID: PMC5120026 DOI: 10.1007/s13280-016-0834-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Researchers of adaptive capacity and sustainable livelihoods have frequently used social, cultural, human, economic and institutional capitals to better understand how rural and resource-dependent communities address environmental, social and economic stresses. Yet few studies have considered how men and women contribute differently to these capitals to support community resilience overall. Our research sought to understand the differential contributions of Sami men and women to the adaptive capacity of reindeer husbandry and reindeer herding communities in northern Sweden. Our focus revealed a gendered division of labour in reindeer herding as an economic enterprise as well as gendered contributions to a broader conceptualization of reindeer husbandry as a family and community-based practice, and as a livelihood and cultural tradition. Based on our results, we recommend that community resilience be enhanced by generating more opportunities for men to achieve higher levels of human and economic capital (particularly outside of herding activities) and encouraging women to contribute more directly to institutional capital by participating in the formation and implementation of legislation, policies and plans.
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Affiliation(s)
- Astri Buchanan
- University of Saskatchewan, 117 Science Place, Saskatoon, SK S7N 5C8 Canada
| | - Maureen G. Reed
- University of Saskatchewan, 117 Science Place, Saskatoon, SK S7N 5C8 Canada
| | - Gun Lidestav
- Department of Forest Resource Management, Swedish University of Agricultural Sciences, 901 83 Umeå, Sweden
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Dagsvold I, Møllersen S, Stordahl V. "You never know who are Sami or speak Sami" Clinicians' experiences with language-appropriate care to Sami-speaking patients in outpatient mental health clinics in Northern Norway. Int J Circumpolar Health 2016; 75:32588. [PMID: 27836018 PMCID: PMC5106464 DOI: 10.3402/ijch.v75.32588] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 09/30/2016] [Accepted: 10/07/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The Indigenous population in Norway, the Sami, have a statutory right to speak and be spoken to in the Sami language when receiving health services. There is, however, limited knowledge about how clinicians deal with this in clinical practice. This study explores how clinicians deal with language-appropriate care with Sami-speaking patients in specialist mental health services. OBJECTIVES This study aims to explore how clinicians identify and respond to Sami patients' language data, as well as how they experience provision of therapy to Sami-speaking patients in outpatient mental health clinics in Sami language administrative districts. METHOD Data were collected using qualitative method, through individual interviews with 20 therapists working in outpatient mental health clinics serving Sami populations in northern Norway. A thematic analysis inspired by systematic text reduction was employed. FINDINGS Two themes were identified: (a) identification of Sami patients' language data and (b) experiences with provision of therapy to Sami-speaking patients. CONCLUSION Findings indicate that clinicians are not aware of patients' language needs prior to admission and that they deal with identification of language data and offer of language-appropriate care ad hoc when patients arrive. Sami-speaking participants reported always offering language choice and found more profound understanding of patients' experiences when Sami language was used. Whatever language Sami-speaking patients may choose, they are found to switch between languages during therapy. Most non-Sami-speaking participants reported offering Sami-speaking services, but the patients chose to speak Norwegian. However, a few of the participants maintained language awareness and could identify language needs despite a patient's refusal to speak Sami in therapy. Finally, some non-Sami-speaking participants were satisfied if they understood what the patients were saying. They left it to patients to address language problems, only to discover patients' complaints in retrospect. Consequently, language-appropriate care depends on individual clinicians' language assessment and offering of language choice.
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Affiliation(s)
- Inger Dagsvold
- Sami Norwegian National Advisory Board on Mental Health and Substance Abuse (SANKS), Finnmark Hospital Trust, Karasjok, Norway.,Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway;
| | - Snefrid Møllersen
- Sami Norwegian National Advisory Board on Mental Health and Substance Abuse (SANKS), Finnmark Hospital Trust, Karasjok, Norway
| | - Vigdis Stordahl
- Sami Norwegian National Advisory Board on Mental Health and Substance Abuse (SANKS), Finnmark Hospital Trust, Karasjok, Norway.,Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
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Eriksen AMA, Schei B, Hansen KL, Sørlie T, Fleten N, Javo C. Childhood violence and adult chronic pain among indigenous Sami and non-Sami populations in Norway: a SAMINOR 2 questionnaire study. Int J Circumpolar Health 2016; 75:32798. [PMID: 27802844 PMCID: PMC5090132 DOI: 10.3402/ijch.v75.32798] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 02/04/2023] Open
Abstract
Background Internationally, studies have shown that childhood violence is associated with chronic pain in adulthood. However, to date, this relationship has not been examined in any indigenous population. Objective The main objectives of this study were to investigate the association between childhood violence and reported chronic pain, number of pain sites and the intensity of pain in adulthood in indigenous Sami and non-Sami adults, and to explore ethnic differences. Design The study is based on the SAMINOR 2 questionnaire study, a larger population-based, cross-sectional survey on health and living conditions in multiethnic areas with both Sami and non-Sami populations in Mid- and Northern Norway. Our study includes a total of 11,130 adult participants: 2,167 Sami respondents (19.5%) and 8,963 non-Sami respondents (80.5%). Chronic pain was estimated by reported pain located in various parts of the body. Childhood violence was measured by reported exposure of emotional, physical and/or sexual violence. Results Childhood violence was associated with adult chronic pain in several pain sites of the body regardless of ethnicity and gender. Childhood violence was also associated with increased number of chronic pain sites and higher pain intensity compared to those not exposed to childhood violence. However, among Sami men, this association was only significant for pain located in chest, hips/legs and back, and non-significant for increased number of chronic pain sites (adjusted model), and higher pain intensity. Conclusion Respondents exposed to childhood violence reported more chronic pain in several parts of the body, increased number of chronic pain sites and more intense pain in adulthood than respondents reporting no childhood violence. However, among Sami men, this association was weaker and also not significant for increased number of chronic pain sites and higher pain intensity.
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Affiliation(s)
- Astrid M A Eriksen
- Sami National Centre for Mental Health and Substance Use (SANKS) Finnmarkssykehuset HF, Karasjok, Norway.,Faculty of Health Science, Oslo and Akershus University College of Applied Science, Oslo, Norway;
| | - Berit Schei
- Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Public Health, NTNU, Trondheim, Norway.,Department of Obstetrics and Gynecology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ketil Lenert Hansen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Tore Sørlie
- Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.,Department of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway
| | - Nils Fleten
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Cecilie Javo
- Sami National Centre for Mental Health and Substance Use (SANKS) Finnmarkssykehuset HF, Karasjok, Norway
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Bania EV, Lydersen S, Kvernmo S. Non-completion of upper secondary school among female and male young adults in an Arctic sociocultural context; the NAAHS study. BMC Public Health 2016; 16:960. [PMID: 27618990 PMCID: PMC5020482 DOI: 10.1186/s12889-016-3644-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 09/06/2016] [Indexed: 11/24/2022] Open
Abstract
Background Education is closely associated with health. Non-completion of upper secondary school influences academic achievement, employment, income and personal well-being. The purpose of the study is to explore predictors of non-completion of upper secondary school among female and male young adults in relation to mental health and educational factors in a socio-cultural, Arctic context. Methods The Norwegian Arctic Adolescent Health Study (NAAHS) is a cross-sectional, school-based survey that was conducted in 2003–2005. Eighty-three percent of the population of 5,877 10th graders participated; 49.1%females, 450 reported indigenous Sami ethnicity, and 304 reported Laestadian affiliation. Data from NAAHS were merged with registry data from the National Education Database (NUDB) Norway for 3,987 adolescents who gave their consent for follow-up studies. Results Non-completion of upper secondary school was 36.9 % among females and 36.6 % among males. Among females, predictors for non-completion were related to mental health symptoms, and among males, to residency in the northernmost and remote areas and self-reported functional difficulties at school, home and in leisure activities due to mental health problems. There was marginal significance between ethnicity and non-completion of upper secondary school, measured at 41.3 % for Sami and 36.8 % for non-Sami, respectively. Conclusions The gender differences found in this study emphasize the need for gender-specific interventions in preventing non-completion of upper secondary school. There is a need to recognize and treat extensive pro-social behaviour and social problems in young females. Young males from remote areas and those who in early adolescence struggle with functional impairment due to mental health problems need early interventions in lower secondary school. Enhancing parents’ and teachers’ ability to detect symptoms and problems as well as low-threshold health services starting in primary school can be effective means. Education, mental health and social inclusion are prominent factors for future employment, income and independent living for young people. Future research should focus more on gender-specific patterns of risk and protective factors for completion of upper secondary school.
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Affiliation(s)
- Elisabeth Valmyr Bania
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsoe; The Arctic University of Norway, N-9037, Tromsoe, Norway.
| | - Stian Lydersen
- Faculty of Medicine, Regional Centre for Child and Youth Mental Health and Child Welfare, (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), N-7491, Trondheim, Norway
| | - Siv Kvernmo
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsoe; The Arctic University of Norway, N-9037, Tromsoe, Norway.,Department of Child and Adolescent Psychiatry, Division of Child and Adolescent Health, University Hospital North Norway, N-9038, Tromsoe, Norway
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Melbøe L, Hansen KL, Johnsen BE, Fedreheim GE, Dinesen T, Minde GT, Rustad M. Ethical and methodological issues in research with Sami experiencing disability. Int J Circumpolar Health 2016; 75:31656. [PMID: 27396747 PMCID: PMC4938889 DOI: 10.3402/ijch.v75.31656] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 03/18/2016] [Accepted: 05/19/2016] [Indexed: 11/14/2022] Open
Abstract
Background A study of disability among the indigenous Sami people in Norway presented a number of ethical and methodological challenges rarely addressed in the literature. Objectives The main study was designed to examine and understand the everyday life, transitions between life stages and democratic participation of Norwegian Sami people experiencing disability. Hence, the purpose of this article is to increase the understanding of possible ethical and methodological issues in research within this field. The article describes and discusses ethical and methodological issues that arose when conducting our study and identifies some strategies for addressing issues like these. Methods The ethical and methodological issues addressed in the article are based on a qualitative study among indigenous Norwegian Sami people experiencing disability. The data in this study were collected through 31 semi-structured in-depth interviews with altogether 24 Sami people experiencing disability and 13 next of kin of Sami people experiencing disability (8 mothers, 2 fathers, 2 sister and 1 guardian). Findings and discussion The researchers identified 4 main areas of ethical and methodological issues. We present these issues chronologically as they emerged in the research process: 1) concept of knowledge when designing the study, 2) gaining access, 3) data collection and 4) analysis and accountability. Conclusion The knowledge generated from this study has the potential to benefit future health research, specifically of Norwegian Sami people experiencing disability, as well as health research concerning indigenous people in general, providing scientific-based insight into important ethical and methodological issues in research with indigenous people experiencing disability.
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Affiliation(s)
- Line Melbøe
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway;
| | - Ketil Lenert Hansen
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway
| | - Bjørn-Eirik Johnsen
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway
| | - Gunn Elin Fedreheim
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway
| | - Tone Dinesen
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway
| | - Gunn-Tove Minde
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway
| | - Marit Rustad
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway
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Young TK, Kelly JJ, Friborg J, Soininen L, Wong KO. Cancer among circumpolar populations: an emerging public health concern. Int J Circumpolar Health 2016; 75:29787. [PMID: 26765259 PMCID: PMC4712322 DOI: 10.3402/ijch.v75.29787] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 12/09/2015] [Accepted: 12/09/2015] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES To determine and compare the incidence of cancer among the 8 Arctic States and their northern regions, with special focus on 3 cross-national indigenous groups--Inuit, Athabaskan Indians and Sami. METHODS Data were extracted from national and regional statistical agencies and cancer registries, with direct age-standardization of rates to the world standard population. For comparison, the "world average" rates as reported in the GLOBOCAN database were used. FINDINGS Age-standardized incidence rates by cancer sites were computed for the 8 Arctic States and 20 of their northern regions, averaged over the decade 2000-2009. Cancer of the lung and colon/rectum in both sexes are the commonest in most populations. We combined the Inuit from Alaska, Northwest Territories, Nunavut and Greenland into a "Circumpolar Inuit" group and tracked cancer trends over four 5-year periods from 1989 to 2008. There has been marked increase in lung, colorectal and female breast cancers, while cervical cancer has declined. Compared to the GLOBOCAN world average, Inuit are at extreme high risk for lung and colorectal cancer, and also certain rare cancers such as nasopharyngeal cancer. Athabaskans (from Alaska and Northwest Territories) share some similarities with the Inuit but they are at higher risk for prostate and breast cancer relative to the world average. Among the Sami, published data from 3 cohorts in Norway, Sweden and Finland show generally lower risk of cancer than non-Sami. CONCLUSIONS Cancer among certain indigenous people in the Arctic is an increasing public health concern, especially lung and colorectal cancer.
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Affiliation(s)
- T Kue Young
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada;
| | - Janet J Kelly
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Jeppe Friborg
- Department of Clinical Oncology, Rigshospitalet, Copenhagen, Denmark
| | - Leena Soininen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Kai O Wong
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Stoor JPA, Kaiser N, Jacobsson L, Renberg ES, Silviken A. "We are like lemmings": making sense of the cultural meaning(s) of suicide among the indigenous Sami in Sweden. Int J Circumpolar Health 2015; 74:27669. [PMID: 26333721 PMCID: PMC4558272 DOI: 10.3402/ijch.v74.27669] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 08/04/2015] [Accepted: 08/07/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Suicide is a widespread problem among indigenous people residing in the circumpolar Arctic. Though the situation among the indigenous Sami in northern Scandinavia is better than among some other indigenous people, suicide is still regarded as a major public health issue. To adapt prevention strategies that are culturally attuned one must understand how suicide is understood within context. That is, the cultural meaning(s) of suicide. OBJECTIVE To explore and make sense of the cultural meaning(s) of suicide among Sami in Sweden. DESIGN Open-ended focus group discussions (FGDs) on the topic "suicide among Sami" were carried out in 5 Sami communities in Sweden, with in total 22 strategically selected Sami participants. FGDs were recorded, transcribed verbatim and analyzed through employing content analysis. RESULTS From the FGDs 4 themes emerged including "The Sami are fighting for their culture and the herders are in the middle of the fight," "Suicide as a consequence of Sami losing (or having lost) their identity," "A wildfire in the Sami world" and "Difficult to get help as a Sami." CONCLUSIONS Findings indicate that Sami in Sweden make sense of suicide in relation to power and identity within a threatened Sami cultural context. Suicide is then understood as an act that takes place and makes sense to others when a Sami no longer has the power to maintain a Sami identity, resulting in being disconnected from the Sami world and placed in an existential void where suicide is a solution. The findings are useful in development of culturally attuned suicide prevention among Sami in Sweden.
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Affiliation(s)
- Jon Petter A Stoor
- Sami Norwegian National Advisory Board on Mental Health and Substance Abuse (SANKS), Finnmark Hospital Trust, Karasjok, Norway;
| | - Niclas Kaiser
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Lars Jacobsson
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | | | - Anne Silviken
- Sami Norwegian National Advisory Board on Mental Health and Substance Abuse (SANKS), Finnmark Hospital Trust, Karasjok, Norway.,Centre for Sami Health Research, Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
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Dagsvold I, Møllersen S, Stordahl V. What can we talk about, in which language, in what way and with whom? Sami patients' experiences of language choice and cultural norms in mental health treatment. Int J Circumpolar Health 2015; 74:26952. [PMID: 25976741 PMCID: PMC4432021 DOI: 10.3402/ijch.v74.26952] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 03/30/2015] [Accepted: 04/06/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The Sami in Norway have a legal right to receive health services adapted to Sami language and culture. This calls for a study of the significance of language choice and cultural norms in Sami patients' encounters with mental health services. OBJECTIVES To explore the significance of language and cultural norms in communication about mental health topics experienced by Sami patients receiving mental health treatment to enhance our understanding of linguistic and cultural adaptation of health services. METHODS Data were collected through individual interviews with 4 Sami patients receiving mental health treatment in Northern Norway. A systematic text reduction and a thematic analysis were employed. FINDINGS Two themes were identified:(I) Language choice is influenced by language competence, with whom one talks and what one talks about.Bilingualism was a resource and natural part of the participants' lives, but there were limited possibilities to speak Sami in encounters with health services. A professional working relationship was placed on an equal footing with the possibility to speak Sami. CONCLUSION Sami patients' language choice in different communication situations is influenced by a complexity of social and cultural factors. Sami patients have varying opinions about and preferences for what they can talk about, in which language, in what way and with whom. Bilingualism and knowledge about both Sami and Norwegian culture provide latitude and enhanced possibilities for both patients and the health services. The challenge for the health services is to allow for and safeguard such individual variations within the cultural framework of the patients.
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Affiliation(s)
- Inger Dagsvold
- Sámi Norwegian National Advisory Unit on Mental Health and Substance Use, Finnmark Hospital Trust, Hammerfest, Norway.,Centre for Sami Health Research, The Faculty of Health Science, UiT The Arctic University of Norway, Tromsø, Norway;
| | - Snefrid Møllersen
- Sámi Norwegian National Advisory Unit on Mental Health and Substance Use, Finnmark Hospital Trust, Hammerfest, Norway
| | - Vigdis Stordahl
- Sámi Norwegian National Advisory Unit on Mental Health and Substance Use, Finnmark Hospital Trust, Hammerfest, Norway.,Centre for Sami Health Research, The Faculty of Health Science, UiT The Arctic University of Norway, Tromsø, Norway
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Stordahl V, Tørres G, Møllersen S, Eira-Åhren IM. Ethical guidelines for Sami research: the issue that disappeared from the Norwegian Sami Parliament's agenda? Int J Circumpolar Health 2015; 74:27024. [PMID: 25862334 PMCID: PMC4393421 DOI: 10.3402/ijch.v74.27024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/27/2015] [Accepted: 03/08/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In recent decades many indigenous communities, policy makers and researchers worldwide have criticized the academic community for not being aware of the specific challenges these communities have faced and still are facing with regard to research. One result of the decades of discourse in indigenous communities is the development in many Western countries of indigenously sensitive ethical research guidelines. In 1997 the Sami Parliament (SP) in Norway reached a unanimous decision that ethical guidelines for Sami research had to be drawn up. Such guidelines are however still to be created. OBJECTIVES The objectives of this article are to enquire into what happened to the Norwegian SP's decision of 1997 and to reflect on why the issue seems to have disappeared from the SP's agenda. Finally, we consider whether research ethics is to be a subject for the research community only. METHODS A review of parliamentary white papers on research and SP documents relating to research ethics. FINDINGS The response to the SP's decision in 1997 took place in two different channels, both of them national, namely the research ethics channel and the political channel. Thus, there were actually two parallel processes taking place. In spite of nearly two decades of reports, the concept of the participation of indigenous communities in research is still not an integral part of Norwegian ethical guidelines. CONCLUSIONS The issue of indigenously sensitive research ethics seems to have disappeared from the SP's agenda and the research ethics review system with regard to Sami research is with minor adjustments the same as when the SP asked for a revision.
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Affiliation(s)
- Vigdis Stordahl
- Sámi Norwegian National Advisory Unit on Mental Health and Substance Use, Finnmark Hospital Trust, Hammerfest, Norway;
| | - Grete Tørres
- Sámi Norwegian National Advisory Unit on Mental Health and Substance Use, Finnmark Hospital Trust, Hammerfest, Norway
| | - Snefrid Møllersen
- Sámi Norwegian National Advisory Unit on Mental Health and Substance Use, Finnmark Hospital Trust, Hammerfest, Norway
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Hansen KL, Brustad M, Johnsen K. Prevalence of self-reported stomach symptoms after consuming milk among indigenous Sami and non-Sami in Northern- and Mid-Norway - the SAMINOR study. Int J Circumpolar Health 2015; 74:25762. [PMID: 25694052 PMCID: PMC4332738 DOI: 10.3402/ijch.v74.25762] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 01/08/2015] [Accepted: 01/12/2015] [Indexed: 12/15/2022] Open
Abstract
Objective The main purpose of this work was to identify the prevalence of self-reported stomach symptoms after consuming milk among Sami and non-Sami adults. Study design A cross-sectional population-based study (the SAMINOR study). Data were collected by self-administrated questionnaires. Method SAMINOR is a population-based study of health and living conditions conducted in 24 municipalities in Northern Norway during 2003 and 2004. The present study included 15,546 individuals aged between 36 and 79, whose ethnicity was categorized as Sami (33.4%), Kven (7.3%) and Norwegian majority population (57.2%). Results Sami respondents had a higher prevalence of self-reported stomach symptoms after consuming milk than the Norwegian majority population. The reporting was highest among Sami females (27.1%). Consumption of milk and dairy products (yoghurt and cheese) was high among all the ethnic groups. However, significantly more Sami than non-Sami never (or rarely) consume milk or cheese, and individuals who reported stomach symptoms after consuming milk had an significant lower intake of dairy products than those not reporting stomach symptoms after consuming dairy products. Sami reported general abdominal pain more often than the majority population. The adjusted models show a significant effect of Sami ethnicity in both men and women on self-reported stomach symptoms after consuming milk. In females, the odds ratio (OR)=1.77 (p=0.001) and in males OR=1.64 (p=0.001). Conclusion Our study shows that the Sami population reported more stomach symptoms after consuming milk, suggesting a higher prevalence of milk intolerance among the Sami population than the Norwegian majority population.
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Affiliation(s)
- Ketil Lenert Hansen
- Centre for Sami Health Research, Institute of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway;
| | - Magritt Brustad
- Institute of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Knut Johnsen
- The Finnmark Clinic, University Hospital of Northern Norway, Karasjok, Norway
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Hansen KL. Ethnic discrimination and health: the relationship between experienced ethnic discrimination and multiple health domains in Norway's rural Sami population. Int J Circumpolar Health 2015; 74:25125. [PMID: 25683064 PMCID: PMC4329315 DOI: 10.3402/ijch.v74.25125] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 12/15/2014] [Accepted: 01/09/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Self-reported ethnic discrimination has been associated with a range of health outcomes. This study builds on previous efforts to investigate the prevalence of self-reported ethnic discrimination in the indigenous (Sami) population, and how such discrimination may be associated with key health indicators. STUDY DESIGN The study relies on data from the 2003/2004 (n=4,389) population-based study of adults (aged 36-79 years) in 24 rural municipalities of Central and North Norway (the SAMINOR study). Self-reported ethnic discrimination was measured using the question: "Have you ever experienced discrimination due to your ethnic background?" Health indicators included questions regarding cardiovascular disease, diabetes, chronic muscle pain, metabolic syndrome and obesity. Logistic regression was applied to examine the relationship between self-reported ethnic discrimination and health outcomes. RESULTS The study finds that for Sami people living in minority areas, self-reported ethnic discrimination is associated with all the negative health indicators included in the study. CONCLUSION We conclude that ethnic discrimination affects a wide range of health outcomes. Our findings highlight the importance of ensuring freedom from discrimination for the Sami people of Norway.
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Affiliation(s)
- Ketil Lenert Hansen
- Centre for Sami Health Research, Institute of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway;
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Omma L, Petersen S. Health-related quality of life in indigenous Sami schoolchildren in Sweden. Acta Paediatr 2015; 104:75-83. [PMID: 25169118 DOI: 10.1111/apa.12786] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 07/02/2014] [Accepted: 08/19/2014] [Indexed: 11/29/2022]
Abstract
AIM To investigate health-related quality of life (HRQOL) in indigenous Sami schoolchildren in Sweden and its associations with sex, age, enculturation and ethnicity-related negative treatment. METHODS The study population was comprised of all children in grades 6-12 (ages 12-18 years) who attended specific Sami school programmes in Sweden. HRQOL was measured by the Kidscreen-52 self-report form, which was filled in at school (n = 121). RESULTS The indigenous Sami children in Sweden experienced lower HRQOL than Swedish children in general, with regard to their school situation, financial resources, parents' relations, physical well-being and social support from peers. In Sami children, functioning and well-being generally decreased by older age group and girls reported lower physical well-being, more negative feelings and more negative self-perception than boys. Finally, more than half of the Sami children had experienced ethnicity-related negative treatment, and these children reported a robustly lower functioning and well-being compared with those without this experience. CONCLUSION In some aspects of HRQOL, indigenous Sami schoolchildren with an explicit ethnic identity experienced less favourable functioning and well-being than Swedish children in general, which is worrisome. A high degree of ethnicity-related negative treatment may partly explain this lower HRQOL in Sami children.
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Affiliation(s)
- Lotta Omma
- Division of Psychiatry; Department of Clinical Sciences; Umeå University; Umeå Sweden
| | - Solveig Petersen
- Division of Child and Adolescent Psychiatry; Department of Clinical Sciences; Umeå University; Umeå Sweden
- Division of Epidemiology and Global Health; Department of Public Health and Clinical Medicine; Umeå University; Umeå Sweden
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Brustad M, Hansen KL, Broderstad AR, Hansen S, Melhus M. A population-based study on health and living conditions in areas with mixed Sami and Norwegian settlements - the SAMINOR 2 questionnaire study. Int J Circumpolar Health 2014; 73:23147. [PMID: 24971230 PMCID: PMC4064248 DOI: 10.3402/ijch.v73.23147] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 03/28/2014] [Accepted: 05/19/2014] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To describe the method, data collection procedure and participation in The Population-based Study on Health and Living Conditions in Areas with both Sami and Norwegian Settlements - the SAMINOR 2 questionnaire study. STUDY DESIGN Cross-sectional and semi-longitudinal. METHODS In 2012, all inhabitants aged 18-69 and living in selected municipalities with both Sami and Norwegian settlements in Mid and Northern Norway were posted an invitation to participate in a questionnaire survey covering several topics related to health and living conditions. The geographical area was similar to the area where the SAMINOR 1 study was conducted in 2003/2004 with the exception of one additional municipality. Participants could alternatively use a web-based questionnaire with identical question and answer categories as the posted paper version. RESULTS In total, 11,600 (27%) participated (16% used the web-based questionnaire), with a higher participation rate among those over 50 (37% for women and 32% for men). Some geographical variation in participation rates was found. In addition, for those invited who also participated in the SAMINOR 1 study, we found that the participation rates increased with the level of education and income, while there was little difference in participation rates across ethnic groups. CONCLUSION The knowledge generated from future theme-specific research utilizing the SAMINOR 2 database has the potential to benefit the general population in this geographical area of Norway, and the Sami people in particular, by providing knowledge-based insight into the health and living conditions of the multi-ethnic population in these parts of Norway.
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Affiliation(s)
- Magritt Brustad
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ketil Lenert Hansen
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ann Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Medicine, University Hospital of Northern Norway, Harstad, Norway
| | - Solrunn Hansen
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Eliassen BM, Graff-Iversen S, Melhus M, Løchen ML, Broderstad AR. Ethnic difference in the prevalence of angina pectoris in Sami and non-Sami populations: the SAMINOR study. Int J Circumpolar Health 2014; 73:21310. [PMID: 24422205 PMCID: PMC3889176 DOI: 10.3402/ijch.v73.21310] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 11/22/2013] [Accepted: 11/26/2013] [Indexed: 12/28/2022] Open
Abstract
Objective To assess the population burden of angina pectoris symptoms (APS), self-reported angina and a combination of these, and explore potential ethnic disparity in their patterns. If differences in APS were found between Sami and non-Sami populations, we aimed at evaluating the role of established cardiovascular risk factors as mediating factors. Design Cross-sectional population-based study. Methods A health survey was conducted in 2003–2004 in areas with Sami and non-Sami populations (SAMINOR). The response rate was 60.9%. The total number for the subsequent analysis was 15,206 men and women aged 36–79 years (born 1925–1968). Information concerning lifestyle was collected by 2 self-administrated questionnaires, and clinical examinations provided data on waist circumference, blood pressure and lipid levels. Results This study revealed an excess of APS, self-reported angina and a combination of these in Sami relative to non-Sami women and men. After controlling for age, the odds ratio (OR) for APS was 1.42 (p<0.001) in Sami women and 1.62 (p<0.001) for men. When including relevant biomarkers and conventional risk factors, little change was observed. When also controlling for moderate alcohol consumption and leisure-time physical activity, the OR in women was reduced to 1.24 (p=0.06). Little change was observed in men. Conclusion This study revealed an excess of APS, self-reported angina and a combination of these in Sami women and men relative to non-Sami women and men. Established risk factors explained little or none of the ethnic variation in APS. In women, however, less moderate alcohol consumption and leisure-time physical activity in Sami may explain the entire ethnic difference.
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Affiliation(s)
- Bent-Martin Eliassen
- Faculty of Health Sciences, Department of Community Medicine, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sidsel Graff-Iversen
- Norwegian Institute of Public Health, Nydalen Oslo, Norway ; Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marita Melhus
- Faculty of Health Sciences, Department of Community Medicine, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ann Ragnhild Broderstad
- Faculty of Health Sciences, Department of Community Medicine, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway ; Department of Medicine, University Hospital of Northern Norway, Harstad, Norway
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