Mental health in cardiometabolic diseases among Sami and non-Sami in Norway: the SAMINOR Study

Abstract Background Mental health conditions in cardiovascular diseases (CVD) or diabetes mellitus (DM) remain understudied in Indigenous communities including the Sami, who faced a history of assimilation that perpetuate into current healthcare services. This study investigated prevalence of anxiety and/or depression symptoms according to self-reported CVDs or DM in Sami and non-Sami in rural Norway, providing insights for equitable and culturally adjusted healthcare initiatives. Methods We used data from two cross-sectional surveys comprising 14,851 participants in the SAMINOR 1 Study (2003-04) and 11,600 in the SAMINOR 2 Questionnaire Study (2012) from the Population-based Study on Health and Living Conditions in Regions with Sami and Norwegian Populations, the SAMINOR Study. Ethnicity was defined by family background and self-identification. We applied multilevel regression models to estimate prevalence ratios (PR) of anxiety and/or depression, with 95% confidence intervals (CI) according to self-reported CVDs or DM in Sami and non-Sami. The models were also stratified by geographical regions in which participants reside within each ethnic group. Results In SAMINOR 1, adults with self-reported CVDs had higher anxiety and/or depression prevalence than those without CVDs and DM (reference), regardless of ethnicity (Sami: PR 2.07, CI 1.48-2.65; non-Sami: PR 2.01, CI 1.60-2.41). This association was observed only in non-Sami in SAMINOR 2. Self-reported DM did not significantly affect mental health conditions in either group. We found some variations in the associations between CVDs and mental health conditions in Sami between regions with different proportions of Sami and Norwegian populations. Conclusions People with CVDs are twice as likely to report mental health conditions compared to reference, independent of ethnic affiliation, though with some variation in Sami. Our findings indicate that adults with CVDs may need tailored healthcare to avoid depression and anxiety. Key messages • Anxiety and depression prevalence was twice as high in adults with CVDs than those without CVDs in Sami and non-Sami. • Mental health awareness is important for people with CVDs, regardless of ethnicity.