Health Of Indigenous Populations Research Articles

Social Determinants Influencing Nutrition Behaviors and Cardiometabolic Health in Indigenous Populations: A Scoping Review of the Literature.

Nutrition behavior is influenced by a large number of factors, including social and cultural factors. This scoping review aims to summarize how social determinants of health (SDoH) influence nutrition behaviors in Indigenous populations affected by or at risk of cardiometabolic diseases. Following the PRISMA-ScR guidelines, we conducted a systematic search in six databases-PubMed, Web of Science, CINAHL, PsycINFO, Cochrane Library, and World Health Organization Global Index Medicus-limiting results to studies published in English up to 27 October 2023. A descriptive synthesis was conducted. We identified 1490 articles, and after screening, 31 of them met our inclusion criteria. We found that nutritional behavior is impacted by various SDoH domains, including economic stability, neighborhood and built environment, education, health and healthcare, and social and community context. The shift from traditional diets to Westernized diets and from subsistence-based food gathering to reliance on store-bought and processed foods reflects changes in SDoH, affecting both nutrition behaviors and health outcomes. Although not all included studies examined every SDoH domain in our review, future research should consider all domains to gain a comprehensive understanding of how they impact nutritional behavior. This approach will better inform interventions and policies, ultimately promoting health equity in Indigenous communities.

Health Disparities Among Indigenous Peoples: Exploring the Roles of Evolutionary and Developmental Mismatch on Cardiometabolic Health

The health of Indigenous populations suffers compared with that of non-Indigenous neighbors in every country. Although health deficits have long been recognized, remedies are confounded by multifactorial causes, stemming from persistent social and epidemiological circumstances, including inequality, racism, and marginalization. In light of the global morbidity and mortality burden from heart disease, stroke, and diabetes, cardiometabolic health needs to be a target for building scientific understanding and designing health outreach and interventions among Indigenous populations. We first describe health disparities in cardiometabolic diseases and risk factors, focusing on Indigenous populations outside of high-income contexts that are experiencing rapid but heterogeneous lifestyle change. We then evaluate two evolutionary frameworks that can help improve our understanding of health disparities in these populations: (a) evolutionary mismatch, which emphasizes the role of recent lifestyle changes in light of past genetic adaptations, and (b) developmental mismatch, which emphasizes the long-term contribution of early-life environments to adult health and the role of within-lifetime environmental change.

Weaving Promising Practices to Transform Indigenous Population Health and Wellness Reporting by Indigenizing Indicators in First Nations Health

In Canada and across the globe, indicators play a fundamental role in measuring, tracking, and reporting on the overall health of the population. Mainstream population health indicators used to measure the health and well-being of First Nations peoples are constrained by the Western biomedical paradigm which focuses solely on illness and disease. These indicators are limited and fail to capture aspects of cultural, spiritual, and interconnected aspects of Indigenous health such as spirit, ceremony, and the connection to land. To advance First Nations self-determination in the healthcare system, it is essential for Indigenous narratives and knowledges to thrive in population health data and reporting. Five promising practices are shared to guide the development of First Nations health and wellness indicators and reporting: (1) be culturally relevant and centred on First Nations worldviews on health and wellness (2) must honour Indigenous knowledges and methods; (3) must involve respectful relationships & meaningful engagement with Indigenous peoples’; (4) “Nothing about us, without us”- Indigenous leadership and self-determination at all stages of indicator development; and (5) taking a strength-based approach & contextualizing indicators within historical, socio-political contexts. The co-development of indicators between the [First Nations Health Organization] and the [Office of the Executive Health Officer] in the Province of [Name of Canadian Province] are discussed as promising practices in action. Celebrating the strength and resilience of First Nations health which is required to pave a new way forward in Indigenous grounded population health.

Evolução espaço-temporal da incidência de tuberculose em indígenas e não indígenas no Brasil, no período de 2011 a 2022

ABSTRACT Objective: To describe the space-time evolution of TB incidence rates (TI) in indigenous and non-indigenous people, according to the Federative Units (UF) of Brazil, from 2011 to 2022. Methods: Ecological, temporal, and spatial study on new tuberculosis cases in Brazil among indigenous and non-indigenous populations. Data from the Notifiable Diseases Information System (Sinan) were collected from 2011 to 2022 and stratified by Federal Unit, explored and statistically analyzed using R software version 4.2.3. Results: The mean TI among indigenous populations in Brazil was 71.7 new cases per 100,000 inhabitants, while for non-indigenous populations it was 28.6/100,000 inhabitants. The regions of the country that presented the highest (mean) incidence among indigenous populations were: Central-West (102.8/100,000 inhabitants), Southeast (99.6/100,000 inhabitants), and North (79.9/100,000 inhabitants). For non-indigenous populations the highest incidence was in the North region (36.5/100,000 inhabitants), followed by the Southeast (31.3/100,000), and the Northeast (27,4/100,000 inhabitants). The analysis showed that the highest incidence of TB cases among indigenous populations occurred in the states of: SP, RO, RJ, MS, MT e PA. Conclusion: High incidence of the disease compared to the non-indigenous population show the need for a specific approach to address the health needs of these populations. Regional disparities in incidence indicate the need to address socioeconomic and infrastructure issues that affect the health of indigenous populations.

ASSISTÊNCIA DE ENFERMAGEM À SAÚDE DAS POPULAÇÕES INDÍGENAS: REVISÃO DE ESCOPO

ABSTRACT Objective: to identify in the literature the nursing care actions for the health of indigenous populations. Method: this is a scoping review, whose search was conducted in September 2022 in the following databases: Nursing Database (BDENF), CAPES Theses and Dissertations Catalog, Google Scholar, Latin American and Caribbean Literature on Health Sciences (LILACS), Pan American Health Organization (PAHO), National Library of Medicine and National Institutes of Health (PUBMED) and Scientific Electronic Library Online (SCIELO). The results were evaluated by summarizing the selected articles. Results: the main actions directed to the indigenous population were nursing consultations and health promotion and prevention activities. The main difficulty encountered in relation to indigenous peoples is the language barrier. Conclusion: the nursing team encounters difficulties, such as: the difficult location of the villages; high work overload due to the lack of medical professionals; language barrier; and inadequate conditions.

Indigenous health in Brazil: from vulnerable to protagonists

Indigenous peoples usually have worse social and health conditions than their non-Indigenous counterparts.1 The worse health of Indigenous populations stems from the processes of colonisation that caused ruptures in traditional ways of life, loss of territories, environmental degradation, racial discrimination, and socioeconomic and political marginalisation.2,3 Migration and urbanisation result in housing instability and affect the wellbeing and health of Indigenous populations through weakening social cohesion and networks, loss of identity, and spiritual and emotional bonds.

Health beyond the tribes: a literature review on nursing actions with Brazilian women of indigenous culture

Introduction: Nowadays, the health of indigenous women has been getting its space, being designated by the creation of women's care policies. Objective: To identify the actions of the nursing team in a population of indigenous women. Method: This is a quantitative, descriptive data analysis study. It has as inclusion criteria articles in Portuguese, taken from the last 10 years, with the main subject: women's health, health of indigenous populations and nursing. Results: Three full-text articles were collected from national databases in Portuguese by the Banco de Dados de Enfermagem (BDENF). The inclusion criteria were articles from the last ten years, complete and indexed containing as main subject: women's health, health of indigenous populations and nursing. Conclusion: It is concluded that due to the facts mentioned that the information on indigenous women's health and nursing care to this population are still few, in view of the errors in the health model offered in these assistance and administrative issues, which affect the health and quality of life, bringing a concern in the health of indigenous women. And the challenges for the professional to work at the village site, due to improvisation and the insecurity of the indigenous women for fear and insecurity of the unknown due to their culture and lack of basic information

Psycho-social correlates of depression and anxiety disorder among Bhil indigenous population of India

ABSTRACT Objective Mental health of indigenous populations is a greatly understudied area in India. The study aims to estimate the prevalence of depression and anxiety and also to assess the association of various psycho-social variables with depression and anxiety, among the Bhil indigenous populations of India. Methods A total of 386 participants aged between 25 and 65 years who were unrelated up to first cousins belonging to Bhil indigenous population were recruited for the present study. Depression, anxiety disorder, perceived stress, perceived loneliness and perceived social support were assessed using pre-tested, translated and validated scales. Data related to socio-demographic variables were collected using pre-tested interview schedules. Results The present study reveals a very high prevalence rate of depression (35%) and anxiety disorder (29.8%) among the studied indigenous population. Psycho-social variables such as older age, disturbed marital status, unemployment, lower level of social support, higher level of perceived stress and perceived loneliness were found to be significantly associated with depression and anxiety disorder. Further analysis shows that when the adversities are combined with each other, the severity of depression and anxiety disorder increases dramatically in the studied indigenous population. Discussion Mental health problems are prevalent among indigenous populations, especially among those groups like Bhil, who are residing in close proximity to urban areas. The present study is the first population-based study on the mental health of Bhil indigenous population. The present study contributes to the limited literature on the mental health of the indigenous population in India.

Influencia de los determinantes sociales en la salud oral en poblaciones indígenas de las Américas. Revisión de literatura

Indigenous populations frequently have their oral and general health affected due to cultural conditions, social marginalization, and geographic separation from urbanized areas. The degree of health achieved by a population is the result of multiple environmental, social, behavioral, genetic and health service determinants. The determinants depend, in turn, on economic and social policies and, above all, on the organized social response to health and disease phenomena. Health determinants such as: educational level, economic income, accessibility to health services, have a negative or positive influence on population health status. Likewise, characteristics such as the distribution of health professionals in the territory, cultural conditions such as linguistic, cultural and worldview barriers of indigenous peoples, hinder the health care received by this population group considered as vulnerable. It is concluded that the influence of health determinants on oral health in indigenous populations should be considered for inclusion in the design of preventive dental models, according to their reality. Cultural differences in terms of language and communication, values, beliefs, ways of life, organization of time, as well as considerations of the social determinants of health and health behaviors, contribute significantly to oral health conditions and to the design of primary health care models or preventive models for vulnerable population groups, thus contributing to the inclusion and promotion of health.

Socio-Cultural Determinants of Mental Health of Indigenous Population: A Case Study of Eastern India

Socio-Cultural Determinants of Mental Health of Indigenous Population: A Case Study of Eastern India

COVID-19, mental health and Indigenous populations in Brazil: The epidemic beyond the pandemic.

The aim of this paper was to report on factors contributing to the deterioration of the mental health of Indigenous populations (IP) in Brazil. Five factors seem to have a direct impact on the mental health of IP in Brazil: (1) The absence of public policies; (2) Intellectual production; (3) Psychiatric medical care for remote areas (e.g., telemedicine) aimed at promoting the mental health of Brazil’s IP, which causes a huge gap in the process of assistance and social, psychological, economic and cultural valorization of native peoples; (4) The dissemination of fake news, which exposed, above all, older IP to risk behaviors in the pandemic, such as refusal of vaccination; and (5) The violence carried out on IP lands due to economic interests with mining/agribusiness.

First Nations Response to Covid‐19 Pandemic

Stanley et al. describe the successes of the Aboriginal and Torres Strait Islander (TSI) communities as global exemplars of controlling the COVID-19 pandemic.1 Despite challenges similar to those facing Indigenous populations world-wide, the authors conclude that the remarkably low morbidity and mortality in these communities due to COVID-19 can be attributed to rapid implementation of best practices and Indigenous leadership alongside transparent communication and collaboration with governmental partners.1, 2 Unfortunately, American Indian/Alaska Native (AI/AN) communities in the United States have suffered disproportionately from COVID-19. According to the Centers for Disease Control, AI/AN people were three to five times more likely to be diagnosed with COVID-19, with twice the mortality rate of non-Hispanic white people.3 This demonstrates the impact of suboptimal health-care delivery due to decades of severe social inequities and limited access to resources.1 Although there is no uniform Indigenous experience, some factors that consistently predispose AI/AN people to health inequity include living in food deserts, crowded, multi-generational households, unemployment, lack of access to technology, distance from health centres and distrust of health-care systems and governments due to historical traumas.3 While data describing COVID-19 in paediatric patients in AI/AN communities are currently limited, extrapolation of the literature allows us to conclude that the burden of the disease may also disproportionately affect the AI/AN children relative to their non-Hispanic white counterparts. Stanley et al. contend that permitting First Nations communities' decision-making power to improve outcomes and effectively partner with governmental and other resources was critical in the success of the Aboriginal and TSI response to COVID-19.1 Based on the achievements of Australian First Nations communities, one may reasonably infer that granting similar trust and control of resources and leadership to AI/AN populations may serve to improve health outcomes in the context of COVID-19 and beyond. All providers who serve AI/AN children must also seek opportunities to partner with local tribes to better understand the priorities, needs and historical experiences of the population, ensure adequate training in culturally sensitive care, thoroughly evaluate the social determinants of health, and leverage cultural assets and resilience to preserve Indigenous identity while improving overall health.4 The Aboriginal and TSI response to COVID-19 offers a stellar example of the strength and success of permitting decision-making by First Nations communities which may provide a means to improve the health of Indigenous populations across the globe.

Many oil wells, one evil: comprehensive assessment of toxic metals concentration, seasonal variation and human health risk in drinking water quality in areas surrounding crude oil exploration facilities in rivers state, Nigeria

Background: Oil and natural gas extraction have produced environmental pollution at levels that affect reproductive health of indigenous populations. Accordingly, polluted drinking water from physical, chemical and heavy metals can result in serious health problems, like anemia, kidney failure, immunosuppression, neurological impairments, gastrointestinal as well as respiratory irritation, skeletal system abnormalities, liver inflammation, liver cancer, cardiovascular diseases after chronic exposure and other cancer diseases with negative health effects. These diseases types remain associated to high amounts of heavy metal elements such as lead, chromium, zinc, copper, cadmium, manganese as well as nickel etc. Objectives: Compare differences in water quality parameters in the study area (determine the level of pollutions in the different sites). Methodology: The investigation made use of standard analytical methodologies. All sampling, conservation, transportation as well as analysis followed the usual APHA procedures (2012). To prevent degradation of the organic substances, all obtained samples were transferred to the laboratory, while keeping in an icebox. Results: Result shows that during wet season, the mean values obtained for water quality parameters were significantly lower in site 9 compared with that obtained in other sites (p<0.05) with the exemptions of temperature, DO, BOD, COD, acidity, TH, TDS, K, Mg, Zn, Mn, Cd, Pb, Cu, Cr, NH3, NO2, NO3, Ni though slightly lower in most cases in site 9 were not significantly different (p>0.05) and both alkalinity and SO4 which were significantly higher in site 9 than site 1 (p<0.05). Result obtained during dry season reveals that there is no remarkable difference in pH, acidity, Pb and Ni between the nine sites (p>0.05) while other water quality parameters were significantly lower in site 9 than other sites excluding Cl and Mg which were both significantly higher in site 9 than site 8 (p<0.05). Conclusion: To guarantee quality groundwater supply for various purposes in Nigeria's core Niger Delta region, extra efforts must be taken to fully understand hydrogeochemical features and its suitability. Thus, this study will aid in the development of a quantitative understanding of the effects of diverse causes on groundwater level fluctuations in any aquifer around the world. Also, this analysis reinforces a valuable resource for researchers, activists and public officials seeking to help enhance community awareness, planning and performance. The verdicts would remain a valuable guideline for policymakers, the Ministry of Water Resources and development practitioners, as this highlights the requirement for suitable approaches toward mitigating toxic element of water resources contamination in the core Niger Delta toward safeguarding health of the public from carcinogenic as well as non-carcinogenic risks.

The SEEDS of Indigenous population health data linkage.

IntroductionGlobally, the ways that Indigenous data are collected, used, stored, shared, and analyzed are advancing through Indigenous data governance movements. However, these discussions do not always include the increasingly sensitive nature of linking Indigenous population health (IPH) data. During the International Population Data Linkage Network Conference in September of 2018, Indigenous people from three countries (Canada, New Zealand, and the United States) gathered and set the tone for discussions around Indigenous-driven IPH data linkage.ObjectivesCentering IPH data linkage and research priorities at the conference led to budding discussions from diverse Indigenous populations to share and build on current IPH data linkage themes. This paper provides a braided summary of those discussions which resulted in the SEEDS principles for use when linking IPH data.MethodsDuring the Conference, two sessions and a keynote were Indigenous-led and hosted by international collaborators that focused on regional perspectives on IPH data linkage. A retrospective document analysis of notes, discussions, and artistic contributions gathered from the conference resulted in a summary of shared common approaches to the linkage of IPH data.ResultsThe SEEDS Principles emerge as collective report that outlines a living and expanding set of guiding principles that: 1) prioritizes Indigenous Peoples’ right to Self-determination; 2) makes space for Indigenous Peoples to Exercise sovereignty; 3) adheres to Ethical protocols; 4) acknowledges and respects Data stewardship and governance, and; 5) works to Support reconciliation between Indigenous nations and settler states.ConclusionEach of the elements of SEEDS need to be enacted together to create a positive data linkage environment. When implemented together, the SEEDS Principles can lead to more meaningful research and improved Indigenous data governance. The mindful implementation of SEEDS could lead to better measurements of health progress through linkages that are critical to enhancing health care policy and improving health and wellness outcomes for Indigenous nations.

Planting the S.E.E.D.S of Indigenous Population Health Data Linkage

IntroductionThe increasing accessibility of data through digitization and linkage has resulted in Indigenous and allied individuals, scholars, practitioners, and data users recognizing a need to advance ways that assert Indigenous sovereignty and governance within data environments. Advances are being talked about around the world for how Indigenous data is collected, used, stored, shared, linked, and analysed.
 Objectives and ApproachDuring the International Population Data Linkage Network Conference in September of 2018, two sessions were hosted and led by international collaborators that focused on regional Indigenous health data linkage. Notes, discussions, and artistic contributions gathered from the conference led to collaborative efforts to highlight the common approaches to Indigenous data linkage, as discussed internationally. This presentation will share the braided culmination of these discussions and offer S.E.E.D.S as a set of guiding Indigenous data linkage principles.
 ResultsS.E.E.D.S emerges as a living and expanding set of guiding principles that: 1) prioritizes Indigenous Peoples’ right to Self-determination; 2) makes space for Indigenous Peoples to Exercise sovereignty; 3) adheres to Ethical protocols; 4) acknowledges and respects Data stewardship and governance, and; 5) works to Support reconciliation between Indigenous Peoples and settler states. S.E.E.D.S aims to centre and advance Indigenous-driven population data linkage and research while weaving together common global approaches to Indigenous data linkage.
 Conclusion / ImplicationsEach of the five elements of S.E.E.D.S interweave and need to be enacted together to create a positive Indigenous data linkage environment. When implemented together, the primary goals of the S.E.E.D.S Principles is to guide positive Indigenous population health data linkage in an effort to create more meaningful research approaches through improved Indigenous-based research processes. The implementation of these principles can, in turn, lead to better measurements of health progress that are critical to enhancing health care policy and improving health and wellness outcomes for Indigenous populations.

The Health of Indigenous Populations in South Asia: A Critical Review in a Critical Time.

Despite South Asia's promising social inclusion processes, staggering social and health inequalities leave indigenous populations largely excluded. Marginalization in the South Asian polity, unequal power relations, and poor policy responses deter Adivasi populations' rights and opportunities for health gains and dignity. The ongoing COVID-19 pandemic is likely to result in a disproportionate share of infections and deaths among the Adivasis, given poor social conditions and exclusions. Poor health of indigenous people, inequalities between indigenous and non-indigenous groups, and failures in enforcing constitutional and legal provisions to reclaim indigenous land and cultural identity herald deeper structural and political fractures. This article unravels health inequalities between the Adivasis and non-Adivasi populations in their social context based on a critical review of secondary sources. We call for intersectoral policies and integrated health care services to address systemic inequalities, discrimination, power asymmetries, and consequent poor health outcomes. The current COVID-19 pandemic should be viewed as a window to pursue real change.

Adopting a Rights-based Approach to Non-communicable Diseases among Indigenous Peoples in Africa

This article examines non-communicable diseases (ncds) as a challenge among indigenous population in Africa. From a rights-based perspective, the article considers some of the social determinants of health and other challenges that can aggravate ncds among indigenous groups in Africa. It further examines the recognition of the right to health of indigenous populations under international law. This is followed by a discussion on some of the barriers to addressing ncds among indigenous peoples in the region. It concludes by urging African governments to be more proactive in adopting measures grounded in human rights standards to address the rising incidence of ncds among indigenous peoples in the region.

Gender variations in the relationship between social capital and mental health outcomes among the Indigenous populations of Canada

BackgroundIn this paper we examine the relationship between social capital and two mental health outcomes—self-rated mental health (SRMH) and heavy episodic drinking (HED)—among the Indigenous populations of Canada. We operationalize a unique definition of social capital from Indigenous specific sources that allows for an analysis of the importance of access to Indigenous networks and communities. We also examine gender variations in the relationship between social capital and the two outcomes, as there is a noticeable lack of research examining the influence of gender in the recent literature on the mental health of Indigenous populations in Canada.MethodsUsing data from the 2012 cycle of the Aboriginal Peoples Survey, logistic regression models were estimated to assess if gender was a significant predictor of either SRMH or HED among the entire Indigenous sample. The sample was then stratified by gender and the relationship between two social capital variables—one general and one indigenous-specific—and each mental health outcome was assessed separately among male and female respondents. All analyses were also further stratified into specific Indigenous groups—First Nations, Métis, or Inuit—to account for the unique cultures, histories, and socioeconomic positions of the three populations.ResultsFemale respondents were more likely to report fair or poor SRMH in the total sample as well as the First Nations and Métis subsamples (OR = 1.48, CI = 1.14–1.91; OR = 1.63, CI = 1.12–2.36; OR = 1.44, CI = 1.01–2.05 respectively). However, female respondents were less likely than males to engage in weekly HED in all three of the same populations (OR = 0.43, CI = 0.35–0.54, all respondents; OR = 0.42, CI = 0.31–0.58, First nations; OR = 0.39, CI = 0.27–0.56, Métis). Social capital from sources specific to Indigenous communities was associated with lower odds of weekly HED, but only among Indigenous men. Meanwhile the strength of family ties was associated with lower odds of reporting fair/poor SRMH among both Indigenous men and women. However, these results vary in strength and significance among the different Indigenous populations of Canada.ConclusionsThe results of this paper address a critical gap in the literature on gender differences in SRMH and HED among the Indigenous populations of Canada, and reveal gendered variations in the relationship between social capital and SRMH and HED. These findings support further investigation into the role that social capital and particularly Indigenous-specific forms of social capital may play as a determinant of health. This research could contribute to future mental health initiatives aimed at strengthening the social capital of Indigenous populations and promoting resilient Indigenous communities with strong social connections.

Ensino e pesquisa sobre saúde dos povos indígenas: experiências acadêmicas

Objetivo: Refletir sobre o ensino e pesquisa da saúde indígena por meio de experiências acadêmicas. Relato de experiência: Relato de experiência baseado na execução de disciplinas e de criação e participação em grupos de estudos e pesquisas que contemplavam o estudo da saúde de populações indígenas em instituições de ensino superior localizadas na região metropolitana do Estado do Pará. A construção do trabalho direcionado por meio da matriz curricular com presença de disciplina especificas possibilitou maior engajamento para este tema, mas foi possível construir conhecimento pela pesquisa, por meio de estudo de casos clínicos quando da ausência disciplinar. Considerações finais: A experiência assistencial possibilitou que se ampliasse de modo satisfatório à interdisciplinaridade por meio do ensino e pesquisa, e afirmou mais uma vez que a experiência em campo possibilita novos horizontes acadêmicos. Os discentes envolvidos conseguiram produzir academicamente por meio dos eventos científicos.

Mental health issues among indigenous communities and the role of traditional medicine.

Mental health in indigenous communities is a relevant issue for the World Health Organization (WHO). These communities are supposed to live in a pure, clean and intact environment. Their real condition is far different from the imaginary; they are vulnerable populations living in difficult areas, exposed to pollution, located far from the health services, exposed to several market operations conducted to extract natural resources, facing criminal groups or illegal exploitation of land resources. These factors may have an impact on mental health of indigenous population. We reviewed all papers available on PubMed, EMBASE and The Cochrane Library until December 2018. We focused on those factors affecting the changes from a traditional to a post-modern society and reviewed data available on stress-related issues, mental distress affecting indigenous/aboriginal communities and the role of Traditional Medicine (TM). We reviewed articles from different countries hosting indigenous communities. The incidence of mental distress and related phenomena (e.g. collective suicide, alcoholism and violence) among indigenous populations is affected by political and socio-economic variables. The mental health of these populations is poorly studied and described even if mental illness indicators are somewhat alarming. TM still seems to have a role in supporting affected people and may reduce deficiencies due to poor access to medical insurance/coverage, psychiatry and psychotherapy. It would be helpful to combine TM and modern medicine in a healthcare model to face indigenous populations' health needs. This review confirms the impact of societal changes, environmental threats and exploitation of natural resources on the mental health of indigenous populations. Global Mental Health needs to deal with the health needs of indigenous populations as well as psychiatry needs to develop new categories to describe psychopathology related to social variance as recently proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5).