Aboriginals make up 10 per cent of Manitoba's population, but account for two-thirds of the people in intensive care for swine flu. Nunavut, which is 85 per cent Inuit, has a disproportionately high rate of H1N1 infections. And the first person to die from swine flu in Australia was a young aboriginal man in one of the country's most remote communities, leaving Australian officials worried that aboriginals are at a higher risk for swine flu.
Why do aboriginal people face a greater threat from the new H1N1 virus?
A study published earlier this month in the medical journal The Lancet reported the answer is not found in the flu virus or the genetics of aboriginal people, but rather the social conditions on reserves.
Poverty, poor nutrition, overcrowded housing and a lack of clean water all contribute to the rapid spread of the new virus, said Malcolm King, one of the report's authors and scientific director of Alberta's Institute of Aboriginal Peoples' Health at the Canadian Institutes of Health Research.
"Already in this first phase of the swine flu epidemic, aboriginal people have fared badly," Dr. King said Tuesday. "The prospects of a disproportionate health burden in the next phase of the pandemic are looming over us."
Manitoba aboriginal leaders have declared a state of emergency in their communities because of swine flu, and called on the federal and provincial governments to act.
Fears of the 1918 Spanish flu still haunt many on reserves. The disease wiped out villages.
Since then, public health officials have done more to fight the disease. But there's still work to do because the new virus could be devastating to aboriginal people, Dr. King said. The latest victim was a 25-year-old aboriginal mother who was visiting family in Yellow Quill, Sask.
"We really can't afford to have a segment of our population with high infection rates because it increases the risk for everyone. So we really need to put our resources and energy into dealing with the flu problem in vulnerable communities," Dr. King said.
There's also an economic self-interest, he added. Sickness is more expensive than health, and it costs more to airlift a sick person from a remote community for critical care treatment.
Dr. King suggested that aboriginal leaders should be more involved in the primary surveillance of flu cases, to keep the situation from getting out of hand. And over a longer-term, the social situation on reserves needs to be improved.
"Why should milk cost several times what it does in our big cities, and fresh fruit vegetables barely available? And yet pop and chips are almost the same cost? Health researchers need to get involved in looking at the health effects of social determinants interventions, such as housing and education and economic development," Dr. King said.
