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Att leva i två världar: hälsoaspekter bland renskötande samer
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. (Arcum)
2017 (Swedish)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Health aspects among reindeer herders in Sweden : living in two worlds (English)
Abstract [en]

Introduction: There is a gap of knowledge of the health situation among the reindeer herding Sami in Sweden. The Swedish government has also got criticism for not taking responsibility for the Sami health. The aim of this thesis was to get more knowledge to understand the health situation of the reindeer herding Sami in Sweden. Furthermore, gender specific risk factors in the working environment among reindeer herders and their perception of healthcare and social services were investigated.

Method: Cross–sectional questionnaires covering different aspects of health such as musculoskeletal disorders, trust for different healthcare providers and work related psychosocial factors was distributed to reindeer herding Sami and non-Sami populations. Interviews with nine reindeer herding Sami about trust in healthcare and social services were carried out and analyzed with thematic analysis. Sixteen discussion meetings with 80 reindeer herders focusing on psychosocial perspectives of working conditions in Sami communities were performed.

Result: The prevalence of musculoskeletal symptoms from elbow, hand/wrist and lower back from male reindeer herders were higher compared to blue-collar worker. Psychosocial risk factors for health were identified such as high workload on a few herders, difficulties to get relief and support as well as to get appreciation in work and lack of participation in decisionmaking among women were common in the organization of reindeer husbandry. The trust in healthcare and social services was lower among reindeer herding Sami compared to non-Sami majority population. A hypothesis is that healthcare professionals do not know that the "Reindeer cloud" (metaphor to iCloud) affects all parts in the reindeer herders life. The distrust are influenced by historically traumas, reindeer herding Sami experiences from healthcare professionals and healthcare organization and culturally generated norms.

Conclusio: The thesis hypothesized that health disorders, attitude towards healthcare and psychosocial environment are important aspects when trying to understand the health situation among the reindeer herding Sami. There is a need to introduce long-term public health work for all Sami people, to establish ethical guidelines for Sami health research and develop healthcare services that provides access to healthcare for the reindeer herding Sami, on equal terms.

Place, publisher, year, edition, pages
Umeå: Umeå universitet , 2017. , p. 60
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1906
Keywords [en]
Reindeer herding, Sami, reindeer husbandry, health, musculoskeletal, confidence, trust, healthcare, psychiatry, social service, work demand, psychosocial, working conditions.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
URN: urn:nbn:se:umu:diva-138405ISBN: 978-91-7601-746-3 (print)OAI: oai:DiVA.org:umu-138405DiVA, id: diva2:1135045
Public defence
2017-09-15, Sal 135, by 9A, Allmänmedicin, Norrlands universitetssjukhus, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2017-08-25 Created: 2017-08-22 Last updated: 2018-06-09Bibliographically approved
List of papers
1. Psychosocial perspectives on working conditions among reindeer herding Sami in Sweden
Open this publication in new window or tab >>Psychosocial perspectives on working conditions among reindeer herding Sami in Sweden
(Swedish)In: Article in journal (Refereed) Submitted
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-138334 (URN)
Available from: 2017-08-21 Created: 2017-08-21 Last updated: 2018-06-09
2. Musculoskeletal symptoms and perceived work strain among reindeer herders in Sweden
Open this publication in new window or tab >>Musculoskeletal symptoms and perceived work strain among reindeer herders in Sweden
2008 (English)In: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, Vol. 58, no 8, p. 572-579Article in journal (Refereed) Published
Abstract [en]

Background There is a shortage of knowledge on the extent of musculoskeletal symptoms in reindeer husbandry.

Aims To investigate the prevalence and relative risk for musculoskeletal symptoms and perceived psychosocial work strain among reindeer herders.

Methods The prevalence of self-reported musculoskeletal symptoms during the last week and last year, respectively, were obtained from male reindeer herders (n = 74) of northern Sweden. Prevalence ratios (PRs) were calculated using two reference groups-women of reindeer-herding families (n = 53) and men in blue-collar occupations (n = 194). Comparisons were made of perceived job strain between the study and reference groups. Associations between job strain factors and the occurrence of musculoskeletal symptoms from different body regions were analysed with regression statistics.

Results The PRs for musculoskeletal symptoms from the hand/wrist (PR 3.48, 95% CI 1.86-6.50) and lower back (PR 1.44, 95% CI 1.06-1.95) were significantly higher among the reindeer herders in comparison with men working with other blue-collar occupations. The reindeer herders reported significantly higher work demands and decision latitude compared with both reference groups (P < 0.05). Significant associations were observed between demands and prevalence of symptoms from the lower back (OR 1.42, 95 % CI 1.0 1-2. 0 1) and from at least one body region (OR 1.58, 95 % CI 1.07-2.32).

Conclusions The relative risk for musculoskeletal symptoms, particularly from the hands/wrists and lower back, was high among reindeer herders. It is suggested that musculoskeletal symptoms constitute a considerable health problem in modern reindeer husbandry, which calls for implementation of preventive measures addressing psychosocial, physical and socio-economic risk factors.

Place, publisher, year, edition, pages
Oxford: Oxford University Press, 2008
Keywords
decision latitude, hand pain, low back pain, neck pain, reindeer husbandry, Sami, work demand
National Category
Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-117469 (URN)10.1093/occmed/kqn153 (DOI)000263067100012 ()19054753 (PubMedID)
Available from: 2016-03-14 Created: 2016-03-01 Last updated: 2018-06-07Bibliographically approved
3. The confidence in health care and social services in northern Sweden: a comparison between reindeer-herding Sami and the non-Sami majority population
Open this publication in new window or tab >>The confidence in health care and social services in northern Sweden: a comparison between reindeer-herding Sami and the non-Sami majority population
2012 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 6, p. 516-522Article in journal (Refereed) Published
Abstract [en]

Aims: To investigate the confidence in primary health care, psychiatry and social services among the reindeer-herding Sami and the non-Sami population of northern Sweden. Methods: A semi-randomized, cross-sectional study design comprising 325 reindeer-herding Sami (171 men, 154 women) and a control population of 1,437 non-Sami (684 men, 753 women). A questionnaire on the confidence in primary health care, psychiatry, social services, and work colleagues was distributed to members of reindeer-herding families through the Sami communities and to the control population through the post. The relative risk for poor confidence was analyzed by calculating odds ratios with 95% confidence intervals adjusted for age and level of education. Results: The confidence in primary health care and psychiatry was significantly lower among the reindeer-herding Sami compared with the control group. No differences were found between men and women in the reindeer-herding Sami population. In both the reindeer-herding Sami and the control population, younger people (<= 48 years) reported significantly lower confidence in primary health care than older individuals (>48 years). Conclusions: A conceivable reason for the poor confidence in health care organizations reported by the reindeer-herding Sami is that they experience health care staff as poorly informed about reindeer husbandry and Sami culture, resulting in unsuitable or unrealistic treatment suggestions. The findings suggest that the poor confidence constitutes a significant obstacle of the reindeer-herding Sami to fully benefit from public health care services.

Keywords
Confidence, primary health care, psychiatry, reindeer herding, Sami, social services
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-61221 (URN)10.1177/1403494812453971 (DOI)000308652100002 ()
Available from: 2012-11-08 Created: 2012-11-07 Last updated: 2018-06-08Bibliographically approved
4. Lack of trust in health and social services among reindeer herding Sami in Sweden
Open this publication in new window or tab >>Lack of trust in health and social services among reindeer herding Sami in Sweden
(English)In: Article in journal (Refereed) Submitted
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-138335 (URN)
Available from: 2017-08-21 Created: 2017-08-21 Last updated: 2018-06-09

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