Massive inequity shown in first study to quantify impact of influenza among Indigenous populations around the world

Indigenous people in a range of different countries, including Australia, are more likely to be hospitalised with, and die of, influenza than the general population, according to a new study.

The meta-analysis, published in PLOS Global Public Health, examined three dozen previously-published studies on influenza.

It found that Indigenous Australians were three times more likely to be hospitalised with influenza than the general population in an ordinary year, and six times more likely during the 2009 H1N1 influenza pandemic (the swine flu).

Indigenous populations in Canada were nearly six times more likely to be hospitalised than the general population, and Indigenous populations in New Zealand were five times more likely.

There was also a consistent inequity in mortality from the disease.

“The fact that we observed consistently higher hospitalisation and mortality rates among different First Nations populations globally, suggests that common social determinants of health are at play here – such as poverty, overcrowding and racism,” says lead author Dr Juliana Betts, a research fellow at Monash University’s School of Public Health and Preventative Medicine.

The Australian team of researchers collected data from 36 high-quality influenza studies to do their analysis.

“This review did require a significant amount of work to plan and carry out the search in a robust way, with multiple reviewers to limit bias,” says Betts.

These studies covered populations in Australia, New Zealand, Canada, the US, and Brazil.

Each of the five countries recorded more severe influenza cases among their Indigenous populations, although there was only one study in the pool from Brazil, and most of the studies they examined focussed on the 2009 pandemic.

In their paper, the researchers point out that they couldn’t find any eligible studies from low- and middle-income countries to include in the review – partially because they relied on laboratory-test confirmed cases of influenza to analyse.

Influenza infects more than 50 million people each year, and kills more than 100,000.

This study is the first to try and quantify the influenza inequity among Indigenous populations on a global scale.

“These inequities are demonstrative of the ongoing health impacts of colonisation,” says Betts.

Read more: Stolen Generations survivors still face poorer health outcomes

“To reduce this disparity, governments should focus on improving the social determinants of health and work with First Nations communities to effectively design and deliver Indigenous-led solutions, including improving healthcare access, targeted influenza response plans and better uptake of influenza vaccines.

“Working in partnership with First Nations communities will ensure that solutions are locally tailored and suitable for the particular country or regional context.”