Acculturation and self-rated health among Arctic indigenous peoples: a population-based cross-sectional study

BMC Public Health

Ann Ragnhild Broderstad²  Ketil Lenert Hansen¹  Marita Melhus¹  Tonje Braaten³  Bent-Martin Eliassen¹ 

[1] Department of Community Medicine, Centre for Sami Health Research, University of Tromsø, Tromsø, N-9037, Norway;Department of Medicine, University Hospital of Northern Norway, Harstad, N-9480, Norway;Department of Community Medicine, University of Tromsø, Tromsø, N-9037, Norway

关键词: SLiCA;    Living conditions;    Indigenous peoples;    Inuit;    Sami;    Iñupiat;    Kalaallit;    Acculturation;    Self-rated health;   

Others  :  1162881
DOI  :  10.1186/1471-2458-12-948

 received in 2012-07-05, accepted in 2012-10-31,  发布年份 2012

【 摘 要 】

Background

Acculturation is for indigenous peoples related to the process of colonisation over centuries as well as the on-going social transition experienced in the Arctic today. Changing living conditions and lifestyle affect health in numerous ways in Arctic indigenous populations. Self-rated health (SRH) is a relevant variable in primary health care and in general public health assessments and monitoring. Exploring the relationship between acculturation and SRH in indigenous populations having experienced great societal and cultural change is thus of great importance.

Methods

The principal method in the Survey of Living Conditions in the Arctic (SLiCA) was standardised face-to-face interviews using a questionnaire. Very high overall participation rates of 83% were obtained in Greenland and Alaska, whilst a more conventional rate of 57% was achieved in Norway. Acculturation was conceptualised as certain traditional subsistence activities being of lesser importance for people’s ethnic identity, and poorer spoken indigenous language ability (SILA). Acculturation was included in six separate gender- and country-specific ordinal logistic regressions to assess qualitative effects on SRH.

Results

Multivariable analyses showed that acculturation significantly predicted poorer SRH in Greenland. An increased subsistence score gave an OR of 2.32 (P<0.001) for reporting poorer SRH among Greenlandic men, while an increased score for Greenlandic women generated an OR of 1.71 (P=0.01). Poorer SILA generated an OR of 1.59 in men (p=0.03). In Alaska, no evidence of acculturation effects was detected among Iñupiaq men. Among Iñupiaq women, an increased subsistence score represented an increased odds of 73% (p=0.026) for reporting poorer SRH. No significant effects of acculturation on SRH were detected in Norway.

Conclusions

This study shows that aggregate acculturation is a strong risk factor for poorer SRH among the Kalaallit of Greenland and female Iñupiat of Alaska, but our cross-sectional study design does not allow any conclusion with regard to causality. Limitations with regard to wording, categorisations, assumed cultural differences in the conceptualisation of SRH, and confounding effects of health care use, SES and discrimination, make it difficult to appropriately assess how strong this effect is though.

【 授权许可】

   
2012 Eliassen et al.; licensee BioMed Central Ltd.

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