Mortality in the Sami population of North Norway, 1970-98

AIMS: The pattern of mortality among many groups of indigenous people has been shown to be disadvantageous in comparison with the general population. Knowledge regarding causes of death among the Sami population in the northern part of Norway is limited. The Sami constitute an ethnic minority whose lifestyle diverges from that of the rest of the population. METHODS: A cohort of 19,801 persons of Sami origin was followed up to evaluate specific causes of mortality during the period 1970-98. Standardized mortality rates (SMR) were calculated using the rural population of the three Norwegian counties included in the study as a reference population. RESULTS: Among Sami, 5,955 total deaths were observed, as opposed to 5,537 expected (SMR = 1.08). For both Sami women and men a significantly higher SMR for cerebrovascular diseases was found, which was more pronounced for women. For Sami men, an excess SMR for violent death was observed (SMR 1.32, 95% confidence interval (CI) 1.20-1.46); this was highest among Sami men living in a reindeer-breeding family. For both genders, mortality from all malignant neoplasms combined was lower than in the reference population. SMRs were 0.86 (95% CI 0.79-0.94) and 0.89 (95% CI 0.80-0.99) for men and women, respectively. Low SMRs were also observed for chronic liver diseases, 0.18 (95% CI 0.02-0.63) and 0.12 (95% CI 0.00-0.68) for Sami men and women, respectively. To be a member of a reindeer breeding household appeared to offer protection from mortality caused by circulatory system diseases in men, especially mortality from ischaemic heart disease. CONCLUSIONS: The total mortality in the North Norway Sami population, an ethnic minority in Norway, was slightly higher when compared with a regional reference population. The differences observed when evaluating mortality by diagnosis might be due to lifestyle, diet, psychosocial, and/or genetic factors.