title: Systematic review of rheumatic disease epidemiology in the indigenous populations of Canada, the United States, Australia, and New Zealand.
abstract: Past publications have highlighted an excess rheumatic disease incidence and prevalence in indigenous populations of Canada (First Nations, Inuit, and Métis), and the United States of America (Alaska Native and American Indian). We have updated these reviews and expanded the scope to include New Zealand (Maori) and Australia (Aborigine) indigenous populations.
  
  
  
  We performed a broad search using medical literature databases, indigenous specific online indexes, and government websites to identify publications reporting the incidence and/or prevalence of arthritis conditions (rheumatoid arthritis, spondyloarthropathies, gout, osteoarthritis, systemic autoimmune rheumatic diseases, and juvenile idiopathic arthritis) in the indigenous populations of Canada, America, New Zealand, and Australia. A narrative synthesis by type of arthritis was prepared given the heterogeneity of study designs used in the primary studies.
  
  
  
  Of 5269 titles and abstracts, 88 met inclusion criteria. Osteoarthritis was found to affect up to 17% of American Indian/Alaska Native women, 22% of Canadian First Nations, 32% of Australian Aborigine, and 6% of New Zealand Maori populations. The prevalence of rheumatoid arthritis, systemic lupus erythematosus, and juvenile idiopathic arthritis was consistently significantly higher in indigenous populations. Several studies describing the prevalence of spondyloarthropathy in North American northern populations were identified, but with no comparison populations the relative frequency could not be commented on. Gout was more prevalent in Maori compared to general population New Zealanders.
  
  
  
  This comprehensive summary describes rheumatic disease burden in indigenous populations in four countries with similar disparities in social determinants of health, to inform clinical service requirements to meet population need.
authors.affiliation: Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta, Canada T2N 4N1.
authors.forename: Cairistin
authors.initials: C
authors.lastname: McDougall
authors.affiliation: Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta, Canada T2N 4N1.
authors.forename: Kelle
authors.initials: K
authors.lastname: Hurd
authors.affiliation: Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta, Canada T2N 4N1. Electronic address: ccbarnab@ucalgary.ca.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Barnabe
mesh_terms: D001315:Australia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D012216:Rheumatic Diseases / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: Epidemiology; Incidence; Indigenous; Prevalence; Rheumatic disease