Wes Lambert’s heart stopped at his wedding reception in Saskatoon 15 years ago.
“I got up to go to the podium, and I did not make it,” he recalls.
He was 50 years old, an unusually young age for a cardiac arrest.
Lambert, a member of the Flying Dust First Nation, is not alone.
A study of cardiac arrests in the First Nations population, believed to be the first of its kind, published last December in the Canadian Journal of Emergency Medicine, shows the average age of victims is 46, which is 19 years younger than other Canadians.
The research looked at cardiac arrests within the ambulance catchment area of Saskatoon’s Royal University Hospital. But Dr. Philip Davis, the lead author and a Saskatoon emergency physician, suspects his study highlights a much broader problem.
“I have worked in Quebec, Nova Scotia, Ontario, Alberta. Anecdotally it’s the same everywhere,” Davis says. “But we don’t have the data.”
The term cardiac arrest describes a condition where the heart stops beating. It is often fatal. A common reason is a heart attack caused by narrowing blood vessels that supply oxygen and nutrients to the heart. However, most heart attacks do not lead to cardiac arrest.
Davis’s team is now reviewing data on all heart attack victims admitted to the Royal University Hospital, which services the northwestern part of Saskatchewan. Like cardiac arrest, early findings suggest that First Nations people tend to be struck at a younger age — 10 years younger than other Canadians.
It is well-known that risk factors that lead to heart attacks, such as diabetes, smoking and high blood pressure, are higher in the Indigenous population. A Public Health Agency of Canada report indicates that diabetes rates are three to five times higher for First Nations people who live on reserves than for the general population.
Experts, including those with the World Health Organization, ascribe this gap to higher rates of poverty and poor access to food. An article published in the Lancet in December 2019 showed on-reserve grocery stores carry fewer fruit, vegetable, meat and dairy products than neighbouring communities, and food on reserve is often more expensive, as much as twice the national average on some reserves.
For years there have been calls for a national database detailing the high rate of cardiac arrests in the Indigenous population, or the underlying causes. As recently as last March, Dr. Steven Lin, an emergency physician at Toronto’s St. Michael’s Hospital, and his co-authors wrote in the Canadian Journal of Emergency Medicine “there is a need for a national strategy to address the knowledge gaps regarding sudden cardiac death in Indigenous peoples.”
In Davis’s study, the survival rate for cardiac arrest was similar among First Nations and non-First Nations populations — about 15 per cent.
Lambert, who works as a potash miner, did not suffer from high blood pressure or diabetes, and he is not a smoker. His doctors chalked his event up to electrolyte abnormalities, perhaps due to working long hours in the mines.
Now 65, he is still working 12-hour shifts at BHP’s Jansen operation, east of Saskatoon.
Elmer Campbell, chief of the Buffalo Dene River Nation, a community 550 kilometres north of Saskatoon, had a heart attack when he was 50.
Like Lambert, Campbell did not have normal risk factors such as high blood pressure, diabetes or smoking. Doctors told him his heart attack was the result of years of stress serving as chief, and eating too much processed and fast food.
He says some of his friends have suffered heart attacks at as young as 44.
Fruit and vegetables are delivered to Buffalo Dene River Nation once a week. But they are pricey, and supplies often run out or spoil so locals have little choice but to rely on processed foods.
The community has tried a nurse-led initiative to increase the number of fruit and vegetable deliveries each week. But it has been unable to secure government funding for the program.
Marcia Mirasty, senior director of health and social development for the Meadow Lake Tribal Council, which represents nine First Nation reserves in northwestern Saskatchewan, notes that many First Nations communities are making strides toward healthier food options by encouraging vegetable gardens, school greenhouses, and Indigenous ways of hunting, fishing, food preparation and cooking. Interest is growing.
“A lot of young people did not see it as interesting, but now they are smoking fish, and drying meat, and making rabbit soup. Our Indigenous knowledge is being reintroduced,” says Mirasty.
Campbell says he has also changed his eating habits by turning to more wild food from hunting and fishing.
Dr. Nazanin Meshkat is an emergency physician and associate professor at University of Toronto. She is currently completing her certificate in the health impact journalism program at the Dalla Lana School of Public Health at the University of Toronto.
Nazanin Meshkat, The Canadian Press
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