| Summary: | The Sami people are the Natives of northern Scandinavia. The knowledge of the health and living conditions of the Swedish Sami is extremely limited which is in contrast to the large amount of detailed information on health and socioeconomic issues that is available for other circumpolar Natives. The encounter with the western society and the acculturation process has for many native populations had serious health consequences, causing a dramatic increase of lifestyle related diseases such as cancer, diabetes, stroke, obesity and hypertension as well as a dramatic increase of suicide and drug abuse. The overall objective of this thesis was to investigate the health conditions of the Sami population of Sweden using causes of death and incidences of cancer and cardiovascular diseases (CVD) as health indicators, and to evaluate their possible association with acculturative factors such as assimilation, integration, separation and marginalization. A Sami population was identified containing a total of 41 721 individuals. Specific cohorts were selected from this population for the different studies. A four times as large demographically matched non-Sami control population was used for comparisons. A study of causes of death, 1961-2000, showed small differences in overall mortality and life expectancy between the Sami and the non-Sami. However, Sami men showed significantly lower mortality risks for cancers but higher for external cause of injury and Sami women higher risks for diseases of the circulatory system (CVD) and of the respiratory system. An increased risk of dying from subarachnoid haemorrhage (SAH) was observed among both Sami men and women. The increased risk of dying from accidents among male reindeer herders is suggested to be caused by the increased socioeconomic pressure and the extensive use of terrain vehicles. It is concluded that commercial reindeer management is one of the most dangerous occupations in Sweden. In a study of the cancer risk among the reindeer herding Sami between 1961-1997, an ...
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