Rheumatic heart disease in Indigenous young peoples

Area of Science:

• Public Health
• Indigenous Health
• Cardiovascular Disease Epidemiology

Background:

• Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) disproportionately affect Indigenous children and young people.
• Significant health inequities persist for Indigenous populations in Australia, New Zealand, and Canada regarding ARF and RHD.

Purpose of the Study:

• To review the epidemiological burden and lived experiences of ARF and RHD among Indigenous young people in Australia, New Zealand, and Canada.
• To examine the drivers of RHD risk and explore mitigation strategies.
• To evaluate the effectiveness of biomedical prevention approaches and advocate for decolonizing strategies.

Main Methods:

• Literature review focusing on epidemiological data and qualitative experiences of ARF and RHD in Indigenous youth.
• Analysis of current primary, secondary, and tertiary prevention initiatives.
• Examination of Indigenous rights-based approaches and decolonizing frameworks.

Main Results:

• Biomedical approaches alone are insufficient for ARF and RHD prevention and control among Indigenous peoples.
• Underlying social determinants and historical trauma contribute significantly to disease burden.
• Decolonizing and Indigenous rights-based approaches are crucial for addressing root causes and achieving elimination goals.

Conclusions:

• Effective strategies for reducing ARF and RHD in Indigenous populations necessitate integrating biomedical interventions with decolonizing principles.
• An Indigenous rights-based framework is essential for sustainable disease control and global health equity.
• Current initiatives require adaptation to incorporate cultural safety and address systemic inequities.