American Indians/Alaska Natives and Cardiovascular Disease: Outcomes, Interventions, and Areas of Opportunity
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RACE AND ETHNIC DISPARITIES (M. ALBERT, SECTION EDITOR)
American Indians/Alaska Natives and Cardiovascular Disease: Outcomes, Interventions, and Areas of Opportunity Selina A. Mohammed 1 & Wadiya Udell 2
Published online: 17 January 2017 # Springer Science+Business Media New York 2017
Abstract Purpose of Review Cardiovascular disease (CVD) is a reported leading cause of death among American Indians and Alaska Natives (AI/ANs) and takes a disproportionate toll on these populations. Using the electronic database PubMed, the purpose of this review is to summarize findings from CVD morbidity/mortality outcome studies, as well as CVD and CVD risk factor intervention studies among AI/ANs, published in 2014 and 2015. Recent Findings Eighteen empirical studies that focused on CVD outcomes and CVD/CVD risk factor interventions were reviewed. Four of five studies on CVD mortality found that CVD is a leading or second leading cause of death among AI/ ANs and that CVD mortality is still disproportionately high compared to whites. Three studies examined smoking or highfat diets and found an association between these risk factors and CVD. Two CVD prevalence studies did not find statistically significant differences between AI/ANs and whites; however, this may be due to specific sample characteristics of these particular studies. Seven of eight CVD/CVD risk This article is part of the Topical Collection on Race and Ethnic Disparities * Selina A. Mohammed [email protected] Wadiya Udell [email protected] 1
School of Nursing and Health Studies, University of Washington Bothell, 18115 Campus Way NE, Box 358532, Bothell, WA 98011, USA
2
School of Interdisciplinary Arts and Sciences, University of Washington Bothell, 18119 Campus Way NE, Box 358530, Bothell, WA 98011, USA
factor intervention studies, ranging in type of interventions delivered and outcomes measured, found beneficial CVD/ CVD risk factor outcomes. One study uniquely underscored historical trauma and social determinants of health as barriers to healthy living. Summary CVD disproportionately burdens AI/AN communities. Large-scale studies that oversample for AI/ANs are needed to document the continuing effects of CVD among Indigenous communities and monitor their disparity status in CVD morbidity/mortality. More interventions with control or comparison groups are also needed to address CVD and CVD risk factors among AI/AN communities and document their effectiveness. In addition, collaborative community-based interventions that tackle root issues of CVD-related disparities and attend to social determinants of health are needed. Keywords American Indians . Alaska Natives . Cardiovascular disease . Cardiovascular disease risk factors . Health disparities
Introduction Cardiovascular disease (CVD) is a formidable and global public health challenge [1•]. In the USA, CVD is the leading cause of death [2]. Although USA rates of death attributable to CVD have recently declined, CVD-related mortality and the burden of CVD and its associated risk factors remain high [3]. Furthermore,
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