Urbanization is Associated with Increased Trends in Cardiovascular Mortality Among Indigenous Populations: the PAI Study

Abstract

BackgroundThe cardiovascular risk burden among diverse indigenous populations is not totally known and may be influenced by lifestyle changes related to the urbanization process.ObjectivesTo investigate the cardiovascular (CV) mortality profile of indigenous populations during a rapid urbanization process largely influenced by governmental infrastructure interventions in Northeast Brazil.MethodsWe assessed the mortality of indigenous populations (≥ 30 y/o) from 2007 to 2011 in Northeast Brazil (Bahia and Pernambuco states). Cardiovascular mortality was considered if the cause of death was in the ICD-10 CV disease group or if registered as sudden death. The indigenous populations were then divided into two groups according to the degree of urbanization based on anthropological criteria:9,10 Group 1 - less urbanized tribes (Funi-ô, Pankararu, Kiriri, and Pankararé); and Group 2 - more urbanized tribes (Tuxá, Truká, and Tumbalalá). Mortality rates of highly urbanized cities (Petrolina and Juazeiro) in the proximity of indigenous areas were also evaluated. The analysis explored trends in the percentage of CV mortality for each studied population. Statistical significance was established for p value < 0.05.ResultsThere were 1,333 indigenous deaths in tribes of Bahia and Pernambuco (2007-2011): 281 in Group 1 (1.8% of the 2012 group population) and 73 in Group 2 (3.7% of the 2012 group population), CV mortality of 24% and 37%, respectively (p = 0.02). In 2007-2009, there were 133 deaths in Group 1 and 44 in Group 2, CV mortality of 23% and 34%, respectively. In 2009-2010, there were 148 deaths in Group 1 and 29 in Group 2, CV mortality of 25% and 41%, respectively.ConclusionsUrbanization appears to influence increases in CV mortality of indigenous peoples living in traditional tribes. Lifestyle and environmental changes due to urbanization added to suboptimal health care may increase CV risk in this population.

Ecocardiografia e Análise de Doenças Cardiovasculares Subclínicas em Povos Indígenas que Vivem em Diferentes Graus de Urbanização: Projeto de Aterosclerose nas Populações Indígenas (Pai)

“…As análises epidemiológicas feitas anteriormente pelo nosso grupo mostraram taxas crescentes de mortalidade CV entre os indígenas no Vale do São Francisco, o que parece estar relacionado ao grau de urbanização. 19 De fato, a urbanização tem estado associada a uma transição epidemiológica em grupos indígenas, caracterizada por uma redução das taxas de mortalidade relacionadas a infecções ou distúrbios de deficiência nutricional e aumento da mortalidade por doenças cardiovasculares. 4,20,21 Ao considerar pessoas tradicionais no processo de mudanças ambientais, as taxas de mortalidade CV estiveram relacionadas a mudanças no estilo de vida que afetam a carga de risco cardiovascular.…”

Anti-chikungunya virus seroprevalence in Indigenous groups in the São Francisco Valley, Brazil

“…Indigenous groups are distributed throughout the vast territory of Brazil, living in various stages of urbanization. The Northeast Region of Brazil, where European colonization began, is home to Indigenous peoples with diverse ethnicities and traditions [10]. However, very few studies have evaluated the impact of new epidemics on Indigenous communities [11].…”

“…In summary, PAI was initiated in 2016 as an observational study, whose primary aim was to access cardiovascular health in two Indigenous groups with different degrees of urbanization and a totally urbanized control group. The PAI study included individuals of both sexes, 30 to 70 years old, without known cardiovascular disease or renal failure requiring hemodialysis, who provided authorization to conduct the study and signed the informed consent term [10,18]. The initial phase of the PAI study was completed in 2017, after including a total of 1061 participants: 321 from Fulni-ô tribe, 351 from Truká tribe, and 389 from the city of Juazeiro.…”

The Effects of Green and Urban Walking in Different Time Frames on Physio-Psychological Responses of Middle-Aged and Older People in Chengdu, China

“…As populations become increasingly urbanized, urban living is associated with a series of stressors, including noise, air pollution, and crowding [ 1 , 2 , 3 ], which have resulted in a range of negative effects on public health, such as the increased risk of cardiovascular diseases and mental problems [ 4 , 5 ]. In response, various attempts have been made to relieve stress and maintain health, and green walking is one of the important solutions, which refers to walking in forests or other natural environments with plants [ 6 ].…”