History is in Our Blood: Systemic Sclerosis in the Oklahoma Choctaw

Abstract

Systemic sclerosis is a rare connective tissue disease characterized by skin hardening, damage to vasculature, autoimmunity, and internal organ involvement. A high prevalence of systemic sclerosis has been reported in the Oklahoma Choctaw. Unfortunately, the only reported prevalence comes from Arnett et al.’s 1996 study: much is unknown about the disease in the Choctaw today. For the present research, data was obtained from the Talihina Service Unit of the Choctaw Nation to calculate an updated prevalence of systemic sclerosis in the Choctaw. Analyses on the nature of the disease and its related diagnoses in the Choctaw were also investigated. The prevalence of systemic sclerosis in the Choctaw was calculated to be 63 per 100,000 (95% CI: 39 – 96), not statistically different from the 1996 result of 66 per 100,000 (p = 0.88). The prevalence in non-Choctaw Native Americans was 27 per 100,000 (95% CI: 3 – 638). For full-blood Choctaw, the prevalence was 115 per 100,000 (95% CI: 6 – 80). The prevalence of systemic sclerosis in the Choctaw was found to be significantly different than that of the U.S. general population (odds ratio = 2.58, 95% CI: 1.63 - 3.86, p = 0.00013). These updated calculations strengthen previous indications that the prevalence of systemic sclerosis in the Oklahoma Choctaw is atypically high. This research also offers insights into the various symptoms of systemic sclerosis by investigating their possible relationships to the disease and providing analyses of their nature among the Choctaw.