Multiple sclerosis (MS) is a disease that does not discriminate – it can affect anyone at any time, often in the prime of their lives. In 2020, the Atlas of MS report published estimates that there are 2.8 million people diagnosed with MS globally – 90,000 people with MS in Canada.1 Early studies in MS have showed a higher risk of MS diagnosis in White populations of European descent, however, studies in other jurisdictions have suggested the rising incidence of MS in populations historically considered at lower risk of MS, such as in the African American/Black community.2
Indigenous Peoples represent 4.9 per cent of the overall population in Canada, but our knowledge of MS in this population remains limited.3 A 2018 study led by Dr. Ruth Ann Marrie looked at First Nations Peoples in Manitoba using population-based administrative data over a 25-year period (between 1984 to 2011) and showed that although rates of MS in First Nations populations are lower than the general population, prevalence of MS is increasing at a dramatic rate – a 351 per cent increase over this period amongst First Nations peoples versus a 225 per cent increase the non-First Nations population. Additionally, prevalence of MS in this Indigenous population is higher than other First Nations populations outside of Canada.4 Prevalence of MS in First Nations populations in Alberta follows a similar trend and is considered high as compared to worldwide figures, but is lower than the general population in Alberta.5
Research is needed to better understand whether the risk factors for MS are in the same in First Nations populations as non-First Nations populations. Research is also needed into potential differences in MS onset and progression. A small pilot study looking at MS in First Nations peoples in Manitoba found that they may have earlier onset of disease, are diagnosed earlier potentially due to the severity of symptoms at onset (e.g. motor symptoms), and have a five-fold increased odds of having a comorbid psychiatric disease compared to the non-First Nations MS population.6 Another study of Indigenous Peoples in British Columbia found that Indigenous Peoples had more rapid disability progression as compared to non-Indigenous Peoples.7
Indigenous populations are facing increasing rates of MS while also experiencing other systemic barriers in receiving needed health care. Dr. Rheanna Robinson, a professor at UNBC, diagnosed with MS, speaks about her experiences as a Métis woman navigating health care systems here.
Greater awareness and attention is now needed to better understand Indigenous experiences of MS. To further our understanding of MS in Indigenous Peoples, it is critical to build partnerships and ongoing collaboration with communities and engage Indigenous researchers who can bring Indigenous perspectives in order to improve the health and wellness of First Nations, Inuit, and Métis Peoples. More research in this area will help us better understand the experiences of Indigenous Peoples with MS to improve prevention and awareness strategies, diagnoses and treatment and care. The MS Society of Canada encourages investigator-led research as part of our Annual Research Competition which aims to further our knowledge of MS communities across Canada.
1 https://mssociety.ca/resources/news/article/atlas-of-ms-report-shows-28-million-people-worldwide-live-with-multiple-sclerosis https://mssociety.ca/resources/news/article/atlas-of-ms-report-shows-28-million-people-worldwide-live-with-multiple-sclerosis
2 Langer-Gould, A., Brara, S. M., Beaber, B. E., & Zhang, J. L. (2013). Incidence of multiple sclerosis in multiple racial and ethnic groups. Neurology, 80(19), 1734-1739.
3 Aboriginal peoples in Canada: Key results from the 2016 Census https://www150.statcan.gc.ca/n1/daily-quotidien/171025/dq171025a-eng.htm?indid=14430-1&indgeo=0.
4 Marrie, R. A., Leung, S., Yu, N., & Elliott, L. (2018). Lower prevalence of multiple sclerosis in First Nations Canadians. Neurology: Clinical Practice, 8(1), 33-39.
5 Svenson, L. W., Warren, S., Warren, K. G., Metz, L. M., Patten, S. B., & Schopflocher, D. P. (2007). Prevalence of multiple sclerosis in First Nations people of Alberta. Canadian journal of neurological sciences, 34(2), 175-180.
6 Marrie, R. A., Hall, N., & Sadovnick, A. D. (2016). Multiple sclerosis in First Nations Canadians: a pilot comparison study. Multiple Sclerosis Journal–Experimental, Translational and Clinical, 2, 2055217316666093.
7 Saeedi, J., Rieckmann, P., Yee, I., Tremlett, H., & UBC MS clinic neurologists. (2012). Characteristics of multiple sclerosis in aboriginals living in British Columbia, Canada. Multiple Sclerosis Journal, 18(9), 1239-1243.