A/HRC/30/41 sometimes child bearers mean that they have to leave school. Thirdly, indigenous girls may face the risk of sexual violence and rape during long journeys to school, as evidenced in the report of the Working Group on Discrimination against Women in Law and in Practice on its visit to Peru.7 The significance of this barrier to education is exacerbated by the presence of legislation in some States that prohibits women and girls from being able to seek abortion services, even if they become pregnant following rape.8 Right to health 29. There are examples of profound physical and mental health inequalities between indigenous and non-indigenous people. For example: (a) In the United States of America, a Native American is 600 times more likely to contract tuberculosis than a non-Native American; (b) Worldwide, over 50 per cent of indigenous adults suffer from type 2 diabetes; (c) Indigenous peoples’ life expectancy is up to 20 years lower than their nonindigenous counterparts; (d) Indigenous peoples experience disproportionately high levels of maternal and infant mortality, malnutrition, cardiovascular illnesses, HIV/AIDS and other infectious diseases, such as malaria and tuberculosis; (e) Suicide rates of indigenous peoples, particularly among youth, are considerably higher in many countries. For example, the suicide rate for Inuit in Canada is around 11 times the national average; (f) Child mortality rates among indigenous communities are usually above the national average.9 30. Many of those poor health outcomes are influenced by modifiable risk factors, such as drug abuse, poor nutrition and alcoholism, which have worryingly increased within indigenous communities. The increase in risk factors has been identified as being strongly connected with the historical colonization and dispossession of indigenous peoples, which has resulted in the fragmentation of their social, cultural, economic and political institutions.10 31. Against the backdrop of growing physical and mental health concerns, nonindigenous health systems often do not take into account the indigenous concept of health, and therefore create barriers to access by indigenous people. Epidemiological data often fails to capture information on indigenous communities and the socioeconomic determinants of health, thereby making them “invisible”. If data is included, it is generally not disaggregated, so that the specific needs of indigenous women are not understood in the context of national healthcare policy and planning. In addition, there are often no clear integration mechanisms for health care personnel, communities, traditional healers, policy makers and government officials. Furthermore, the facilities available to indigenous communities and women are also often not suitable to their specific needs and cultural preferences. 32. Women acutely feel the low levels of health within indigenous communities. They are disproportionately affected by illness owing to reduced coping capacity caused by the 7 8 9 10 A/HRC/29/40/Add.2. Ibid. Permanent Forum on Indigenous Issues, State of the world’s Indigenous peoples, 2010. Ibid. 9