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Canadian Journal of Cardiology

Confronting the Growing Crisis of Cardiovascular Disease and Heart Health Among Aboriginal Peoples in Canada

  • Author Footnotes
    ∗ Jeffrey Reading is Mohawk from Tyendinega First Nation in Ontario and the Interim Director of the Waakebiness-Bryce Institute for Indigenous Health at the University of Toronto's Dalla Lana School of Public Health.
    Jeffrey Reading
    Correspondence
    Corresponding author: Dr Jeffrey Reading, Waakebiness-Bryce Institute for Indigenous Health, Dalla Lana School of Public Health, University of Toronto, 155 College St, 5th Floor, Toronto, Ontario M5T 3M7, Canada.
    Footnotes
    ∗ Jeffrey Reading is Mohawk from Tyendinega First Nation in Ontario and the Interim Director of the Waakebiness-Bryce Institute for Indigenous Health at the University of Toronto's Dalla Lana School of Public Health.
    Affiliations
    Waakebiness-Bryce Institute for Indigenous Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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  • Author Footnotes
    ∗ Jeffrey Reading is Mohawk from Tyendinega First Nation in Ontario and the Interim Director of the Waakebiness-Bryce Institute for Indigenous Health at the University of Toronto's Dalla Lana School of Public Health.

      Abstract

      Although the prevalence of cardiovascular disease (CVD) has been decreasing worldwide, Aboriginal populations of Canada (including First Nations, Métis, and Inuit Peoples) continue to experience a rapidly growing burden of CVD morbidity and mortality. This article provides a succinct summary of the current crisis of CVD among Canadian Aboriginal peoples, including how and why it originated, elucidates the underlying population health risks driving higher rates of aboriginal CVD, and articulates the urgent need for community-engagement solutions and innovations in the areas of prevention, treatment and care, rehabilitation services, aboriginal-specific CVD surveillance, and advanced knowledge. In the past, particularly in rural and remote communities, Aboriginal Peoples' survival depended (and often still does) on hunting, fishing, and other forms of traditional food-gathering. However, the traditional life is being changed for many Aboriginal communities, resulting in significantly impaired dietary options and the undermining of a long-established way of life that was healthy and physically active. Reclaiming CVD health and well-being requires replacement of the calorie-dense and nutritionally inadequate diets of highly processed store-bought foods with fresh and nutritionally balanced diets and addressing the physically inactive lifestyles that together have contributed to an increase in CVD prevalence. Furthermore, disparities exist for hospital-based treatment experiences for patients from areas with high proportions of Aboriginal Peoples vs those with low proportions of Aboriginal Peoples. It is crucial to investigate and develop concrete plans to reduce the burden of CVDs among Aboriginal Peoples by improved prevention and treatment in a community-centred way.

      Résumé

      Bien que la prévalence des maladies cardiovasculaires (MCV) ait diminué à travers le monde, les populations autochtones du Canada (y compris les Premières nations, les Métis et les Inuits) continuent de subir une augmentation rapide du fardeau de la morbidité et de la mortalité liées aux MCV. Cet article fournit un résumé succinct de la crise actuelle des MCV chez les peuples autochtones du Canada, y compris comment et pourquoi cela à commencé, met en évidence les risques sous-jacents pour la santé de la population conduisant à des taux plus élevés de MCV chez les autochtones, et articule le besoin urgent de solutions communautaires pour un engagement et des innovations dans les domaines de la prévention, le traitement et les soins, les services de réadaptation, la surveillance particulière des MCV chez les autochtones, et des connaissances avancées. Par le passé, en particulier dans les collectivités rurales et éloignées, la survie des peuples autochtones dépendait (et c’est encore souvent le cas) sur la chasse, la pêche et d'autres formes de cueillette traditionnelle. Toutefois, ce mode de vie traditionnel est en cours de changements pour de nombreuses communautés autochtones, entrainant un choix alimentaire significativement diminué et en une remise en cause d'un mode de vie établi de longue date qui était sain et physiquement actif. Un rétablissement de la santé cardiovasculaire et d’un certain bien-être nécessite le remplacement des régimes alimentaires inadéquats riches en calories faits de nourritures commerciales hautement transformées par des régimes alimentaires équilibrés avec des produits frais et nutritionnels et de traiter les modes de vie physiquement inactifs qui, ensemble, ont contribué à une augmentation de la prévalence des MCV. En outre, des disparités existent concernant des expériences de traitement en milieu hospitalier pour les patients des zones avec de fortes proportions de populations Autochtones vs celles ayant de faibles proportions de peuples autochtones. Il est crucial d'étudier et d'élaborer des plans concrets pour réduire le fardeau des MCV chez les peuples autochtones par une prévention et un traitement améliorés de façon centrée sur la communauté.
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