Indigenous and tribal peoples’ health (The Lancet–Lowitja Institute Global Collaboration): a population study
ackground International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries. Methods Collaborators with expertise in Indigenous health data systems were identifi ed for each country. Data were obtained for population, life expectancy at birth, infant mortality, low and high birthweight, maternal mortality, nutritional status, educational attainment, and economic status. Data sources consisted of governmental data, data from non-governmental organisations such as UNICEF, and other research. Absolute and relative diff erences were calculated. Findings Our data (23 countries, 28 populations) provide evidence of poorer health and social outcomes for Indigenous peoples than for non-Indigenous populations. However, this is not uniformly the case, and the size of the rate diff erence varies. We document poorer outcomes for Indigenous populations for: life expectancy at birth for 16 of 18 populations with a diff erence greater than 1 year in 15 populations; infant mortality rate for 18 of 19 populations with a rate diff erence greater than one per 1000 livebirths in 16 populations; maternal mortality in ten populations; low birthweight with the rate diff erence greater than 2% in three populations; high birthweight with the rate diff erence greater than 2% in one population; child malnutrition for ten of 16 populations with a diff erence greater than 10% in fi ve populations; child obesity for eight of 12 populations with a diff erence greater than 5% in four populations; adult obesity for seven of 13 populations with a diff erence greater than 10% in four populations; educational attainment for 26 of 27 populations with a diff erence greater than 1% in 24 populations; and economic status for 15 of 18 populations with a diff erence greater than 1% in 14 populations. Interpretation We systematically collated data across a broader sample of countries and indicators than done in previous studies. Taking into account the UN Sustainable Development Goals, we recommend that national governments develop targeted policy responses to Indigenous health, improving access to health services, and Indigenous data within national surveillance systems.