Protocol for the HALDI study-conceptual framework for investigating health and living conditions in an arctic area of Sweden with a multiethnic population.

Abstract

Objectives: Despite increasing research interest in the health and well-being of the Indigenous Sámi people, knowledge remains fragmented and insufficient. The HALDI study aims to examine health status, well-being, and associated determinants within a multi-ethnic context, focusing on the Sámi people in Sweden. This protocol outlines the study's objectives, design, and methodology, with the goal of generating representative data to inform future research, policy, and interventions targeting Sámi health.

Design: To ensure relevance, initial focus groups discussions identified key health issues for the Sámi people in Swedish Sápmi. Based on these findings, a comprehensive questionnaire was developed, encompassing socioeconomic status, ethnicity, psychiatric and somatic disorders, and self-perceived health. All adults in Jokkmokk municipality (n = 4077) were invited to participate. The following year, a clinical examination was conducted, including measures such as blood pressure, pulse, height, weight, blood sampling, and an updatet questionnaire on health status, dietary habits, and, for those aged 65 years and above, assessments of frailty and cognition. A total of 1682 individuals (41%) responded to the first questionnaire; 68% identified as Swedish, 22% as Sámi, and 7% with other ethnic identities. In the clinical study, 706 participated with similar ethnic proportions.

Conclusion: This is the first study in Sweden to incorporate ethnic self-identification in a multi-ethnic population. By presenting the study protocol and sample characteristics, we highlight the potential for future analyses to inform evidence-based health interventions and policy to improve outcomes for the multi-ethnic Arctic population.