Addressing cardiovascular health risk factors in American Indian/Alaska Native Children: A narrative review

Cardiovascular disease (CVD) is common in American Indian/Alaska Native (AI/AN) adults and represents the leading cause of mortality. Risk factors for CVD in AI/AN adults are well-described, and a growing body of evidence reports the inequitable prevalence of factors associated with the development of CVD in AI/AN children, including obesity, physical inactivity, and diabetes mellitus (DM).

This article organizes and summarizes the evidence describing CVD risk factors in AI/AN children, discusses the social drivers of health impacting these risks, and highlights several programs that have demonstrated effectiveness in improving AI/AN child health.

Fortunately, multiple community- and Tribal-based programs have aimed to mitigate the impact of obesity, diabetes, and physical activity in AI/AN youth, given that nascent CVD begins in the pediatric years. These efforts include screening, lifestyle choices, including diet and exercise, and, importantly, culturally relevant programming to promote cardiovascular health in AI/AN children.

Though at a disproportionate risk for CVD based on biological and social drivers of health, AI/AN children are being prioritized by their communities, and there are many ongoing efforts to support their cardiovascular health. However, further investigation and investment is warranted to protect this population and address ongoing disparities in AI/AN CVD.