Stroke Incidence Higher Among Indigenous People

TOPLINE:

Indigenous people in high-income countries have a significantly higher incidence of stroke than non-Indigenous people, a new systematic review showed.

METHODOLOGY:

Investigators systematically reviewed 24 population-based stroke incidence studies in seven countries published between 1990 and 2022 among Indigenous adult populations in developed countries.Pooled meta-analysis was not possible due to heterogeneity in methods of the studies.Indigenous populations included Aboriginal and Torres Strait Islanders (Australia, n=7); Maori (New Zealand, n=6); American Indian, Alaska Natives, and Navajo Peoples (the United States, n=3); Métis (Canada, n=1); Sámi (Norway, Sweden, n=4); and Singaporean, and Malay (Singapore).The study was overseen by an Indigenous Advisory Board of Indigenous researchers from around the world to ensure it was undertaken in a culturally responsive manner.

TAKEAWAY:

Stroke incidence within regions was typically, although not universally, greater in Indigenous populations than their respective non-Indigenous counterparts, with greater age-standardized stroke incidence rates occurring in Aboriginal Australians (rate ratio [RR], 1.7-3.2 overall and 4.4-13.6 in groups IN PRACTICE:

“Health interventions have been less effective in many Indigenous populations, often because they are delivered with a ‘Western lens’ of health, without acknowledging Indigenous Peoples’ framing of health,” the authors wrote. “This highlights the need to address not only stroke risk factors but also the social determinants of health and ongoing cultural barriers, with capacity building of Indigenous health providers, guided by Indigenous voices.”

SOURCE:

Anna H. Balabanski, MBBS, PhD, of Monash University, Melbourne, Australia, was the lead and corresponding author of the study. It was published online on February 14 in Neurology.

LIMITATIONS:

Results are subject to the limitation of the individual studies, including potential under-ascertainment of Indigenous peoples, due to selection bias.