title: Prevalence of asthma and chronic obstructive pulmonary disease in Aboriginal and non-Aboriginal populations: a systematic review and meta-analysis of epidemiological studies.
abstract: BACKGROUND
  Asthma and chronic obstructive pulmonary disease (COPD) have considerable potential for inequities in diagnosis and treatment, thereby affecting vulnerable groups.
  
  
  OBJECTIVE
  To evaluate differences in asthma and COPD prevalence between adult Aboriginal and non-Aboriginal populations.
  
  
  METHODS
  MEDLINE, Embase, specialized databases and the grey literature up to October 2011 were searched to identify epidemiological studies comparing asthma and COPD prevalence between Aboriginal and non-Aboriginal adult populations. Prevalence ORs (PORs) and 95% CIs were calculated in a random-effects meta-analysis.
  
  
  RESULTS
  Of 132 studies, eight contained relevant data. Aboriginal populations included Native Americans, Canadian Aboriginals, Australian Aboriginals and New Zealand Maori. Overall, Aboriginals were more likely to report having asthma than non-Aboriginals (POR 1.41 [95% CI 1.23 to 1.60]), particularly among Canadian Aboriginals (POR 1.80 [95% CI 1.68 to 1.93]), Native Americans (POR 1.41 [95% CI 1.13 to 1.76]) and Maori (POR 1.64 [95% CI 1.40 to 1.91]). Australian Aboriginals were less likely to report asthma (POR 0.49 [95% CI 0.28 to 0.86]). Sex differences in asthma prevalence between Aboriginals and their non-Aboriginal counterparts were not identified. One study compared COPD prevalence between Native and non-Native Americans, with similar rates in both groups (POR 1.08 [95% CI 0.81 to 1.44]).
  
  
  CONCLUSIONS
  Differences in asthma prevalence between Aboriginal and non-Aboriginal populations exist in a variety of countries. Studies comparing COPD prevalence between Aboriginal and non-Aboriginal populations are scarce. Further investigation is needed to identify and account for factors associated with respiratory health inequalities among Aboriginal peoples.
authors.affiliation: School of Public Health, Faculty of Medicine and Dentisttry, University of Alberta, Edmonton, Alberta.
authors.forename: Maria B
authors.initials: MB
authors.lastname: Ospina
authors.forename: Donald C
authors.initials: DC
authors.lastname: Voaklander
authors.forename: Michael K
authors.initials: MK
authors.lastname: Stickland
authors.forename: Malcolm
authors.initials: M
authors.lastname: King
authors.forename: Ambikaipakan
authors.initials: A
authors.lastname: Senthilselvan
authors.forename: Brian H
authors.initials: BH
authors.lastname: Rowe
mesh_terms: D000328:Adult; D001249:Asthma / Q000208:ethnology*; D002170:Canada / Q000453:epidemiology; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data*; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000208:ethnology*