December 4, 2015 - Indigenous Health

Question 1

What is the prevalence of RA in indiginous populations in Canada, relative to the general population?

Answer 1

Up to 3 times more

(Can be up to 7 times in America)

Question 2

Lupus and Scleroderma (FN vs non-FN)

Answer 2

Higher rates in FN populations.

Question 3

Why do FN Have Higher Rates?

Answer 3

1. Genetics
2. Environment (smoking & oral health)
3. Colonialism

Question 4

Genetics: The Shared Epitope

Answer 4

Certain HLA alleles confer an increased risk of rheumatoid arthritis.

There is a high prevalence of shared epitope in Aboriginal populations.

Question 5

Environmental Factors for RA

Answer 5

Smoking and oral health.

Many First Nations smoke (59%) compared to 11% in the general population.

Question 6

Optimization of RA Treatment

Answer 6

1. Early treatment initiation. The window of opportunity is 12 weeks where we can reduce damage by 50% and increase the chance of full remission by 70%.

2. Treat to target