non-Indigenous Populations Research Articles

Use of Outpatient Health Services by Mexicans Aged 15 Years and Older, According to Ethnicity.

The aim of this study was to estimate the prevalence of health needs and use of outpatient services for indigenous (IP) and non-indigenous (NIP) populations aged ≥15 years, and to explore the associated factors and types of need. A cross-sectional study was conducted based on the 2018-19 National Health and Nutrition Survey. The population aged ≥15 years who had health needs and used outpatient services was identified. Logistic models were developed to explore the factors underlying the use of outpatient services. For both populations, being a woman increased the likelihood of using health services, and having health insurance was the most important variable in explaining the use of public health services. Compared to the NIP, a lower proportion of IP reported health needs during the month prior to the survey (12.8% vs. 14.7%); a higher proportion refrained from using outpatient services (19.6% vs. 12.6%); and a slightly higher proportion used public health services (56% vs. 55.4%). For the NIP, older age and belonging to a household that had received cash transfers from a social program, had few members, a high socioeconomic level, and a head with no educational lag, all increased the likelihood of using public health services. It is crucial to implement strategies that both increase the use of public health services by the IP and incorporate health-insurance coverage as a universal right.

Urbanization and cardiovascular health among Indigenous groups in Brazil

BackgroundWe described the prevalence of cardiovascular risk factors in groups of Brazilian Indigenous people at different degrees of urbanization.MethodsThe Project of Atherosclerosis among Indigenous populations (Projeto de Aterosclerose em Indígenas; PAI) is a cross-sectional study conducted in Northeast Brazil between August 2016–June 2017. It included three populations: Fulni-ô Indigenous people (lowest degree of urbanization), Truká Indigenous people (greater urbanization), and a highly urbanized non-Indigenous local cohort (control group). Participants were assessed to register sociodemographic, anthropometric, as well as clinical and laboratory-derived cardiovascular (CV) risk parameters. Age-adjusted prevalence of hypertension was also computed. Nonparametric tests were used for group comparisons.ResultsHere we included 999 participants, with a predominance of females in all three groups (68.3% Control group, 65.0% Fulni-ô indigenous group, and 60.1% Truká indigenous group). Obesity was present in 45.6% of the urban non-Indigenous population, 37.7% Truká and in 27.6% Fulni-ô participants. The prevalence of hypertension was 29.1% (n = 297) with lower prevalence in the less urbanized Fulni-ô people (Fulni-ô – 18.2%; Truká – 33.9%; and Control – 33.8%; p < 0.001). In the elderly male population, the prevalence of hypertension was 18.7% in the Fulni-ô, 45.8% in the Truká, and 54.5% in the control group. Of the 342 participants that self-reported hypertension, 37.5% (n = 68) showed uncontrolled blood pressure (BP). Uncontrolled BP was more prevalent among Truká people when compared to Fulni-ô people and non-Indigenous participants (45.4%, 22.9%, and 40.7%, respectively; p < 0.001).ConclusionsWe found a higher cardiovascular risk in communities with a higher degree of urbanization, suggesting that living in towns and cities may have a negative impact on these aspects of cardiovascular health.

Abstract 140: The Incidence Of Stroke In Indigenous Populations Of Countries With A Very High Human Development Index: A Systematic Review.

Introduction: Despite known socioeconomic and health disparities affecting Indigenous populations in developed countries, stroke incidence data are sparse. With Indigenous Advisory Board oversight, we undertook a systematic review to compare Indigenous with non-Indigenous stroke incidence rates in countries with a very high Human Development Index (HDI). Methods: We identified population-based stroke incidence studies published from 1990-2022 in Indigenous adult populations of developed countries using PubMed, EMBASE and Global Health databases, without language restriction. We excluded non-peer-reviewed sources, studies with &lt;10 Indigenous people, or studies not covering a 35-64 year minimum age range. Two reviewers independently screened titles, abstracts, and full texts, and extracted data. We assessed quality using "ideal" criteria for population-based stroke incidence studies, the Newcastle-Ottawa Scale for risk of bias, and CONSIDER criteria for Indigenous research. Results: Among 13,041 publications, 24 studies (19 full text, 5 abstracts) from 7 countries met inclusion criteria. Compared with respective non-Indigenous populations (Fig 1), age-standardised incidence rates were greater in Aboriginal and Torres Strait Islander Australians (ratios ranging from 1.7-3.2), American Indians (1.2), Sámi of Sweden/Norway (1.08-2.14), and Singaporean Malay (1.7-1.9), with higher rate ratios at younger ages. Studies had substantial heterogeneity in design and risk of bias. Few investigators reported Indigenous stakeholder involvement. Conclusions: In countries with a very high HDI, available data suggest marked disparities in stroke incidence in Indigenous populations, although there are gaps in data availability and quality. Indigenous stakeholder involvement in studies is infrequently reported. A greater understanding of stroke incidence in these populations is imperative for informing effective societal responses.

Facial Fractures in Indigenous and Non-indigenous Populations of South Australia.

Maxillofacial trauma in indigenous populations is complex with sociocultural factors, access to health care, and poorer general health issues that impact outcomes. Assaults and road traffic accidents are disproportionately experienced by indigenous persons compared with non-indigenous. A retrospective review was conducted from January 2012 to January 2017 at the Women and Children's Hospital and Royal Adelaide Hospital, Adelaide. All maxillofacial fractures that attended or were referred to the unit were included in this study. The primary objective was to analyze epidemiological trends of facial fractures and clinical outcomes in the South Australian indigenous and non-indigenous populations. Maxillofacial fractures in indigenous persons were less than in non-indigenous (31.2 versus 38.2y, P < 0.001) with 3.8 odds of a facial fracture. Assault was 2.9 times more likely to result in a facial fracture, falls 40.9% less likely, and sports 29.4% less likely compared with non-indigenous ( P < 0.001). Alcohol-related facial fractures had significantly higher rates [odds ratio (OR = 3.8)] compared with non-indigenous. Indigenous from most disadvantaged areas and very remote areas also had significantly higher odds of a facial fracture. Indigenous persons had higher operative rates (OR = 2.8), postoperative complications (OR = 3.1), and a 3.7-day mean difference for the length of stay (6.6 versus 2.9d, P < 0.001). Indigenous people are more likely to experience facial fractures from assault resulting in mandibular fractures, whereas non-indigenous people are likely to have sport or fall-related midface fractures. Young indigenous women from outer regional and very remote areas have greater odds of facial fractures caused by assault and alcohol with higher operative rates, postoperative complications, and extended length of stay.

Identifying the key characteristics of a culturally safe mental health service for Aboriginal and Torres Strait Islander peoples: A qualitative systematic review protocol.

Mental health inequities between Indigenous and non-Indigenous populations are well documented. There is growing recognition of the role that culturally safety plays in achieving equitable outcomes. However, a clear understanding of the key characteristics of culturally safe mental health care is currently lacking. This protocol outlines a qualitative systematic review that aims to identify the key characteristics of culturally safe mental health care for Aboriginal and Torres Strait Islander peoples, at the individual, service, and systems level. This knowledge will improve the cultural safety of mental health care provided to Indigenous peoples, with a focus on Aboriginal and Torres Strait Islander peoples in Australia. Through a review of academic, grey, and cultural literature, we will identify the key characteristics of culturally safe mental health care for Aboriginal and Torres Strait Islander peoples in Australia. We will consider the characteristics of culturally safe care at the individual practitioner, service, and systems levels. CRD42021258724.

Acknowledging colonialism in the room: Barriers to culturally safe care for Indigenous Peoples

Indigenous peoples worldwide continue to face health inequities compared to non-Indigenous populations. Frameworks like cultural safety can be used to mitigate these inequities; however, this is not widely implemented in healthcare settings. Thus, additional research into barriers to providing culturally safe care are critical. To address this need, we examined the existing barriers to culturally safe care for Indigenous peoples in Canada, and Māori in Aotearoa New Zealand, through the perspectives of key informants. Major issues identified by key informants included systemic racism, lack of organisational accountability and/or buy-in, ineffective health-provider education, funding, health system structure, undervaluing Indigenous knowledge, negative framing, terminology, and changes to the concept of cultural safety over time. When examined closely, systemic racism and ongoing settler colonialism are the key driving forces underpinning many of the barriers identified. Findings from this research point to barriers at every level and require a system-wide, intersectoral approach in order to provide culturally safe care for Indigenous peoples and advance Indigenous health equity.

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.

A Successful Model of Acculturation: Historic Overview of Baloch Migration from West and South Asia to East Africa

By examining the historic settlement of the Balochi people from West Asia to East Africa, this article seeks to study and examine their past immigration patterns, presence and current socio-political situation as a minority Muslim population. The Balochi people are an Indo-European ethnic Sunni Muslim minority population located in a region currently shared and divided by modern Islamic republics of Iran in West Asia and Pakistan in South Asia. The Balochis have formed a significant part of the non-indigenous Muslim population in East Africa since the late 17th century. Yet, there is not much written on them as a distinct Sunni Muslim minority group originating from historic Iran (including parts of South Asia) to Africa. Being part of a larger project, this study will explore the chief reasons behind the immigration of the Balochis to the regions of East Africa and how did their presence affect the local population and vice versa. The hypothesis is that the Balochis were formerly welcomed by the indigenous and non-indigenous population of East Africa and established amicable relationships with them. Using the method of qualitative content analysis combined with historical analysis, this article highlights the reciprocal impacts of the Balochi immigrants and indigenous people of East Africa.

The frequency of metabolic syndrome and its components in the non-indigenous population of South Yakutia

The frequency of metabolic syndrome and its components in the non-indigenous population of South Yakutia

Ethnic features of multipathology in elderly and senile patients of the Republic of Sakha suffering from chronic brain ischemia

To study ethnic characteristics of multipathology in elderly and senile patients with chronic cerebral ischemia living in the Republic of Sakha (Yakutia). The study included 522 inpatients, aged 60 to 89 years, who were divided into subgroups depending on the stage of chronic cerebral ischemia, ethnicity (Evens, Yakuts and Russians) and age (elderly and senile). In addition to vascular cerebral pathology, comorbidities were identified in patients of older age groups. At the same time, polymorbidity was less pronounced in the Evens, the indigenous inhabitants of the northern regions of Yakutia, than in the Yakuts and representatives of the non-indigenous population - Russians. The relatively rare occurrence of comorbid pathologies in Evens is presumably associated with greater adaptation to the extreme climatic conditions of the North.

Cultural adaptation considerations of a comprehensive housing outreach program for Indigenous youth exiting homelessness.

Generalist health interventions that aim to reduce chronic health disparities between Indigenous and non-Indigenous populations can be culturally adapted to better meet the needs of Indigenous people in Canada; however, little is known regarding best practices in implementing these adaptations. The present study first provides a review of the research process used to adapt a previous evidence-based housing initiative for Indigenous youth in Northwestern Ontario. Second, it includes an overview of the adaptations that were made and the associated rationale for such adaptations. Third, it examines the experiences of participants and staff involved in the cultural adaptation of the Housing Outreach Program Collaborative (HOP-C), a health intervention re-designed to improve physical and mental health outcomes, wellbeing, and social support for formerly homeless Indigenous youth as they secure housing. Qualitative feedback from interviews with 15 participants and eight program staff, in addition to one focus group with an additional six frontline workers, described perceived outcomes of the program's cultural adaptations. Modifications to the overall program structure, specific roles within the program (including counseling services, peer mentorship, cultural services, and case management), and adaptations to general implementation within the health organization providing the intervention were described by participants and staff as effective and helpful adaptations. The focus of Indigenous values at an organizational level led to consistent adaptations in counseling and case management to best meet the unique needs of the youth involved. Based upon participant interviews, recommendations to future adaptations are provided.

Data and model bias in artificial intelligence for healthcare applications in New Zealand

IntroductionDevelopments in Artificial Intelligence (AI) are adopted widely in healthcare. However, the introduction and use of AI may come with biases and disparities, resulting in concerns about healthcare access and outcomes for underrepresented indigenous populations. In New Zealand, Māori experience significant inequities in health compared to the non-Indigenous population. This research explores equity concepts and fairness measures concerning AI for healthcare in New Zealand.MethodsThis research considers data and model bias in NZ-based electronic health records (EHRs). Two very distinct NZ datasets are used in this research, one obtained from one hospital and another from multiple GP practices, where clinicians obtain both datasets. To ensure research equality and fair inclusion of Māori, we combine expertise in Artificial Intelligence (AI), New Zealand clinical context, and te ao Māori. The mitigation of inequity needs to be addressed in data collection, model development, and model deployment. In this paper, we analyze data and algorithmic bias concerning data collection and model development, training and testing using health data collected by experts. We use fairness measures such as disparate impact scores, equal opportunities and equalized odds to analyze tabular data. Furthermore, token frequencies, statistical significance testing and fairness measures for word embeddings, such as WEAT and WEFE frameworks, are used to analyze bias in free-form medical text. The AI model predictions are also explained using SHAP and LIME.ResultsThis research analyzed fairness metrics for NZ EHRs while considering data and algorithmic bias. We show evidence of bias due to the changes made in algorithmic design. Furthermore, we observe unintentional bias due to the underlying pre-trained models used to represent text data. This research addresses some vital issues while opening up the need and opportunity for future research.DiscussionsThis research takes early steps toward developing a model of socially responsible and fair AI for New Zealand's population. We provided an overview of reproducible concepts that can be adopted toward any NZ population data. Furthermore, we discuss the gaps and future research avenues that will enable more focused development of fairness measures suitable for the New Zealand population's needs and social structure. One of the primary focuses of this research was ensuring fair inclusions. As such, we combine expertise in AI, clinical knowledge, and the representation of indigenous populations. This inclusion of experts will be vital moving forward, proving a stepping stone toward the integration of AI for better outcomes in healthcare.

Experiences of Health Care Access Challenges for Back Pain Care Across the Rural-Urban Continuum in Canada: Protocol for Cross-sectional Research

Back pain is common and costly, with negative impacts on both individuals and the health care system. Rural, remote, and Indigenous populations are at greater risk of experiencing back pain compared to urban and non-Indigenous populations. Potential barriers to health care access among Canadians with chronic back pain (CBP) have been identified; however, no study has used lived experiences of people with CBP to drive the selection, analysis, and interpretation of variables most meaningful to patients. The aims of this study are to (1) engage with rural, remote, and urban Indigenous and non-Indigenous patients, health care providers, and health system decision makers to explore lived experiences among people with CBP in Saskatchewan, Canada; (2) cocreate meaningful indicators of CBP care access and effectiveness; and (3) identify program and policy recommendations to overcome access barriers to CBP care. In phase 1, one-on-one interviews with 30 people with current or past CBP and 10 health care providers residing or practicing in rural, remote, or urban Saskatchewan communities will be conducted. We will recruit Indigenous (n=10) and non-Indigenous (n=20) rural, remote, and urban people. In phase 2, findings from the interviews will inform development of a population-based telephone survey focused on access to health care barriers and facilitators among rural, remote, and urban people; this survey will be administered to 383 residents with CBP across Saskatchewan. In phase 3, phase 1 and 2 findings will be presented to provincial and national policy makers; health system decision makers; health care providers; rural, remote, and urban people with CBP and their communities; and other knowledge users at an interactive end-of-project knowledge translation event. A World Café method will facilitate interactive dialogue designed to catalyze future patient-oriented research and pathways to improve access to CBP care. Patient engagement will be conducted, wherein people with lived experience of CBP, including Indigenous and non-Indigenous people from rural, remote, and urban communities (ie, patient partners), are equal members of the research team. Patient partners are engaged throughout the research process, providing unique knowledge to ensure more comprehensive collection of data while shaping culturally appropriate messages and methods of sharing findings to knowledge users. Participant recruitment began in January 2021. Phase 1 interviews occurred between January 2021 and September 2022. Phase 2 phone survey was administered in May 2022. Final results are anticipated in late 2022. This study will privilege patient experiences to better understand current health care use and potential access challenges and facilitators among rural, remote, and urban people with CBP in Saskatchewan. We aim to inform the development of comprehensive measures that will be sensitive to geographical location and relevant to culturally diverse people with CBP, ultimately leading to enhanced access to more patient-centered care for CBP. DERR1-10.2196/42484.

Ethno-confessional and socio-political views of indigenous and non-indigenous Muscovites (sociological experience)

The article deals with the problems associated with the intensification of migration processes in the largest megacities. Both positive and negative consequences of uncontrolled large-scale migration flows are determined. The focus of this article is concentrated on the study of the nature and degree of manifestation of tolerance/intolerance in the ethno-confessional and socio-cultural interaction of various groups of indigenous and non-indigenous population (with varying degrees of involvement in assimilation processes) Moscow; based on a comparative analysis of religious, socio-cultural and socio-political views of the indigenous residents of the capital and migrants. The results of monitoring by ISPR FCTAS RAS and IDR FCTAS RAS prove that uncontrolled migration processes contribute to the development of social risks. Ethno-confessional interaction is marked by the attitudes of the capital's indigenous inhabitants towards ethnocentrism, national and confessional exclusivity ("adherence to mono-national and mono-confessional marriages"). A significant difference in the socio-political, patriotic and confessional orientations of the typological groups studied ("indigenous" Muscovites and "newcomers") was revealed. Thus, the results of a sociological survey show that native Muscovites are more optimistic about the socio-economic and socio-political situation in the country, the political reform of society compared to migrants. In addition, when comparing assessments of the role of religious organizations and, in particular, the ROC in modern society, a group of "newcomers" Muscovites is less tolerant than a group of "indigenous" residents of the capital. The revealed consequences of the negative phenomena of the uncontrolled migration process (for example, the illegal involvement of migrants in labor relations contributes to the growth of the shadow economy and corruption in the labor market, etc.) indicates the relevance of studying the integration, assimilation of migrants and tolerance/intolerance in the ethno-confessional and socio-cultural interaction of indigenous Muscovites and newcomers. It is noted that taking into account "social risks" in the practice of national policy can help minimize the potential of interethnic and interfaith tensions in the metropolitan metropolis.

Epidemiology of invasive Haemophilus influenzae serotype a disease in the North American Arctic, 2006–2017

ABSTRACT Invasive Haemophilus influenzae type a (iHia) disease was detected in Alaska and Northern Canada in 2002 and 2000, respectively. From 2006 to 2017, 164 iHia cases (Alaska=53, Northern Canada=111) were reported. Rates of iHia disease per 100,000 persons were higher in Northern Canada compared to Alaska and were significantly higher in Indigenous (Alaska 2.8, Northern Canada 9.5) compared to non-Indigenous populations (Alaska 0.1, Northern Canada=0.4). Disease rates were highest in Indigenous children <2 years of age (Alaska 56.2, Northern Canada=144.1) and significantly higher than in non-Indigenous children <2 (Alaska 0.1, Northern Canada 0.4). The most common clinical presentation in children <5 years was meningitis of age and pneumonia in persons ≥5 years old. Most patients were hospitalised (Alaska=87%, Northern Canada=89%) and fatality was similar (Alaska=11%, Northern Canada=10%). MLST testing showed sequence types ST23 and ST576 in Northern Canada and ST576, ST23 and ST56 in Alaska. Alaska and Northern Canada have high rates of iHia disease. A vaccine is needed in these regions to protect young children.

Creating ‘safe spaces’: A qualitative study to explore enablers and barriers to culturally safe end-of-life care

Background: Internationally, efforts are being made to promote equity in palliative and end-of-life care for Indigenous peoples. There is a need to better understand the experiences of Indigenous service users and staff. Aim: To explore the views of Māori health practitioners and whānau (family group) caregivers regarding barriers and enablers to culturally safe palliative and end-of-life care. Design: A Kaupapa Māori qualitative study. Setting/participants: Interviews were conducted with 103 participants from four areas of the North Island of Aotearoa New Zealand. Participants comprised bereaved whānau (family) of Māori with a life limiting illness and Māori health practitioners. Results: Māori health practitioners undertake cultural and connecting work to promote culturally safe palliative and end-of-life care for Māori patients and their whānau. This work is time-consuming and emotionally and culturally demanding and, for most, unpaid and unrecognised. Non-Māori staff can support this work by familiarising themselves with te reo Māori (the Māori language) and respecting cultural care customs. However, achieving culturally safe end-of-life care necessitates fundamental structural change and shared decision-making. Conclusions: Our findings indicate that efforts to support equitable palliative care for Indigenous people should recognise, and support, the existing efforts of health practitioners from these communities. Colleagues from non-Indigenous populations can support this work in a range of ways. Cultural safety must be appropriately resourced and embedded within health systems if aspirations of equitable palliative and end-of-life care are to be realised.

Challenges and opportunities in providing dementia care for Aboriginal and Torres Strait Islander peoples living in rural and remote areas.

Dementia rates within Australian Aboriginal and Torres Strait Islander populations are estimated to be three to five times higher than non-Indigenous populations. Geographical and cultural barriers demand creative ways of delivering culturally appropriate effective dementia care. Focus groups and interviews with people (N = 73) from three Aboriginal Medical Services and communities explored attitudes toward, and experiences of dementia care and services. A thematic analysis highlighted the juxtaposition between biomedical and culturally appropriate models of dementia care. Services at the cultural interface can be adapted to facilitate appropriate dementia care at a local level allowing people to stay on Country, supported by people within one's own Community.

A year and a half into the pandemic in Mexico: evidence of differences in COVID-19 mortality between Indigenous and non-Indigenous populations continues to accumulate.

Among the groups most vulnerable to COVID-19 are Indigenous populations around the world, and in particular, the Mexican Indigenous population. We used public data made available by the General Directorate of Epidemiology of the Mexican Ministry of Health to compare the risk of COVID-19 mortality among the Indigenous and non-Indigenous Mexican population one and a half years into the pandemic. The analytical sample comprises 3,545,952 Mexicans who were diagnosed as infected with severe acute respiratory syndrome coronavirus-2 between March 18, 2020, and September 16, 2021, of which 1.0% (36,195) are Indigenous. Based on parametric survival models, our results show that the risk of death among Indigenous individuals is 52% higher than that of their non-Indigenous counterparts, regardless of age, sex, area of residence, health service, number of chronic diseases, and obesity status. These results suggest that certain structural conditions of the Mexican Indigenous population increase their vulnerability to the pandemic.

Mortality trends in indigenous working-age population of the Koryak Okrug and the population of the Arctic monotown in 1968–1991

AIM: The purpose of this study was to determine the primary indicators and main causes of mortality of the indigenous small-number peoples of the North (ISNPN) of the Koryak Okrug. We studied peoples of working age and the impact of various factors on the generalized mortality rates of the regional population. We then compared these mortality rates with those of the same age categories of the nonindigenous immigrant population of Kirovsk, an industrial city, with high mortality rate in a highly urbanized region of the Arctic Zone of the Russian Federation (Murmansk Oblast). Kirovsk has similar natural and climatic conditions but significant differences in the level of socioeconomic development, based on published scientific sources that study such mortality and socioeconomic trends during current times.&#x0D; MATERIALS AND METHODS: We used the official death registrations archived in the Regional Government Registry Offices of three districts of the Koryak Okrug (3720 records) and the city of Kirovsk, Murmansk Oblast (2394 records) for the years from 1968 to 1991. The average annual mortality rates per 100 thousand of the studied population aged from 20 to 59 years were calculated based on the All-Union USSR Population Census of 1979+. The resulting indicators were standardized according to European standards.&#x0D; RESULTS: The calculation of generalized regional mortality rates adopted in official statistics does not give a realistic model for the mortality rate and main causes of death of the ISNPN. Mortality rates of the ISNPN significantly exceeded similar indicators of the nonindigenous immigrant population in all classes of diseases. The maximum contribution to mortality rates of the ISNPN comes from the high level of addictive alcoholization, which causes death both as a result of its direct toxic effects, and indirectly, by being the cause of murders, suicides and accidents. Currently, obtaining data for calculating the population mortality rates of ISNPN poses significant difficulties and requires specially prepared and structured statistical diagnostic studies.

Shades of social mobility: Colorism, ethnic origin and intergenerational social mobility

In this paper, I study the difference in intergenerational mobility patterns between the indigenous and non-indigenous Mexican populations, analyzing the role played by the variability in skin tones inside both groups. I employ a composite sample based on two recent surveys with the same sampling frame and questionnaire design. I obtained three main results based on rank-rank regressions and transition matrices for both the economic and educational dimensions. First, the indigenous population faces a higher degree of intergenerational persistence and remains concentrated at the bottom of the distribution of economic resources. Secondly, there is a skin tone gradient for the indigenous and non-indigenous populations, where lighter skin tones tend to remain at a higher rank in the distribution of economic resources than darker skin tones. Thirdly, the association between ethnic origin, skin tone and economic mobility persist even after controlling for the intergenerational educational mobility experienced by the person.