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Objectives: Canadian Aboriginal infants experience poor health compared with other Canadian infants. Breastfeeding protects against many infant infections that Canadian Aboriginals disproportionately experience. The objective of our research was to estimate the proportion of select infant infection and mortality outcomes that could be prevented if all Canadian Aboriginal infants were breastfed., Methods: We used Levin's formula to estimate the proportion of three infectious outcomes and one mortality outcome that could be prevented in infancy by breastfeeding. Estimates were calculated for First Nations (both on- and off-reserve), Métis and Inuit as well as all Canadian infants for comparison. We extracted prevalence estimates of breastfeeding practices from national population-based surveys. We extracted relative risk estimates from published meta-analyses., Results: Between 5.1% and 10.6% of otitis media, 24.3% and 41.4% of gastrointestinal infection, 13.8% and 26.1% of hospitalizations from lower respiratory tract infections, and 12.9% and 24.6% of sudden infant death could be prevented in Aboriginal infants if they received any breastfeeding., Conclusion: Interventions that promote, protect and support breastfeeding may prevent a substantial proportion of infection and mortality in Canadian Aboriginal infants.

Until the last half of the 20th century, infectious diseases dominated the health profile of northern North American Aboriginal communities. Research on the 1918 influenza pandemic exemplifies some of the ways in which the social context of European contact and ensuing economic developments affected the nature of infectious disease ecology as well as the frequency and severity of the problem. To understand these impacts it is necessary to consider the web of interactions among multiple pathogens, the biology of the human host, and the social environment in which people lived. At the very least, an understanding of the history of the impact of infectious diseases on northern North American communities requires attention not only to potential interactions among cocirculating pathogens, but their links to key social, historical, and economic factors that exacerbated their adverse effects and contributed to excess mortality.

The applicability of A. R. Omran's 'epidemiologic transition' theory to subarctic Indians in Canada is examined in a historical review of health and demographic data. The major trends since the time of European contact include the rise-and-fall of infectious diseases, the emergence of chronic, degenerative diseases, and the preeminence of the social pathologies in the post-World War II era. The divergences of the Amerindian experience from the 3 models in the epidemiologic transition theory and their implications for health care delivery are discussed.