Early-life origins of disparities in chronic diseases among Indigenous youth: pathways to recovering health disparities from intergenerational trauma

Abstract

Indigenous women and children experience some of the most profound health disparities globally. These disparities are grounded in historical and contemporary trauma secondary to colonial atrocities perpetuated by settler society. The health disparities that exist for chronic diseases may have their origins in early-life exposures that Indigenous women and children face. Mechanistically, there is evidence that these adverse exposures epigenetically modify genes associated with cardiometabolic disease risk. Interventions designed to support a resilient pregnancy and first 1000 days of life should abrogate disparities in early-life socioeconomic status. Breastfeeding, prenatal care and early child education are key targets for governments and health care providers to start addressing current health disparities in cardiometabolic diseases among Indigenous youth. Programmes grounded in cultural safety and co-developed with communities have successfully reduced health disparities. More works of this kind are needed to reduce inequities in cardiometabolic diseases among Indigenous women and children worldwide.

A Canadian perspective on the developmental origins of health and disease: understanding the past as a way forward

“…Although the degree of health inequity between Indigenous and non-Indigenous populations are no doubt impacted by social determinants 33 including those listed above, more significantly, they are rooted in the historical and present trauma faced by Indigenous peoples. As Phillips-Beck et al 34 and Bombay et al 35 report in this issue, adverse early life experiences shape the health outcomes of Indigenous women, men, children and youth, notably affecting their risk for cardiometabolic diseases and mental health disorders. In their papers, the authors discuss how to bridge health gaps faced by Indigenous peoples in Canada through culturally sensitive and community-specific interventions across the lifecourse, and especially through interventions that are applied in early life.…”

The Perinatal Mental Health of Indigenous Women: A Systematic Review and Meta-Analysis

“…11 However, because of colonization and assimilation efforts, they now live with structural risks that have contributed to poorer health outcomes than their non-Indigenous counterparts. 12 Although not all Indigenous women develop perinatal mental health problems, it is important to understand the mental health problems experienced by Indigenous women around the world so that those who may be suffering can be helped and the intergenerational transmission of risk to their children can be reduced. Resilience processes can also be examined in Indigenous women and their children who are thriving, so protective factors against the development of mental health problems can be elucidated.…”

An environmental scan of impacts and interventions for women with methamphetamine use in pregnancy and their children

“…As illustrated in Figure 1, a Developmental Origins of Health and Disease (DOHaD) lens demonstrates that effects of environmental stressors such as PME may transmit across several generations [14]. This approach resonates with many Indigenous cultures, aligning with such concepts as Seven Generations, Blood Memory and connectivity across families and generations [15]. This environmental scan was designed to identify academic and grey literature on PME to summarize current knowledge on effects and interventions.…”