Primary care visits due to injuries among the Aboriginal off-reserve population of British Columbia, Canada, 1991–2010

International Journal for Equity in Health

Rod McCormick¹  Christopher E. Lalonde⁵  Mariana Brussoni³  M. Anne George⁴  Andrew Jin² 

[1] Faculty of Human, Social and Educational Development, Thompson Rivers University, Kamloops, British Columbia, Canada;Epidemiology consultant, Surrey, British Columbia, Canada;Current address: BC Injury Research & Prevention Unit, Vancouver, British Columbia, Canada;Current address: Child and Family Research Institute, Room F508, 4480 Oak Street, Vancouver V6H 3V4, BC, Canada;Department of Psychology, Faculty of Social Sciences, University of Victoria, Victoria, British Columbia, Canada

关键词: Population surveillance (MeSH);    Epidemiology (MeSH);    Canada (MeSH);    British Columbia (MeSH);    “First Nations”;    Indigenous population (MeSH);    Indians, North American (MeSH);    Wounds and injuries (MeSH);   

Others  :  1233710
DOI  :  10.1186/s12939-015-0269-5

 received in 2015-03-10, accepted in 2015-11-10,  发布年份 2015

【 摘 要 】

Background

Aboriginal people in British Columbia (BC) have higher injury incidence than the general population. This report describes variability in visits to primary care due to injury, among injury categories, time periods, geographies, and demographic groups.

Methods

We used BC’s universal health care insurance plan as a population registry, linked to practitioner payment and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. Within that population we identified those residing off-reserve according to postal code. We calculated crude incidence and Standardized Relative Risk (SRR) of primary care visit due to injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC.

Results

During 1991 through 2010, the crude rate of primary care visit due to injury in BC was 3172 per 10,000 person-years. The Aboriginal off-reserve rate was 4291 per 10,000 and SRR was 1.41 (95 % confidence interval: 1.41 to 1.42). Northern and non-metropolitan HSDAs had higher SRRs, within both total BC and Aboriginal off-reserve populations. In every age and gender category, the HSDA-standardized SRR was higher among the Aboriginal off-reserve than among the total population. For all injuries combined, and for the categories of trauma, poisoning, and burn, between 1991 and 2010, crude rates and SRRs declined substantially, but proportionally more rapidly among the Aboriginal off-reserve population, so the gap between the Aboriginal off-reserve and total populations is narrowing, particularly among metropolitan residents.

Conclusions

These findings corroborate our previous reports regarding hospitalizations due to injury, suggesting that our observations reflect real disparities and changes in the underlying incidence of injury, and are not merely artefacts related to health care utilization.

【 授权许可】

   
2015 Jin et al.

【 图 表 】

Fig. 1.

【 参考文献 】

• [1]Bell N, Schuurman N, Hameed SM, Caron N. Are we homogenising risk factors for public health surveillance? Variability in severe injuries on First Nations reserves in British Columbia, 2001–5. Inj Prev. 2011; 17:394-400.
• [2]Regional Analysis of Health Statistics for Status Indians in British Columbia, 1992–2002. Birth-related and mortality statistics for British Columbia and 16 Health Service Delivery Areas. 2004.
• [3]British Columbia, Provincial Health Officer (2009). Pathways to Health and Healing – 2nd Report on the Health and Well-being of Aboriginal People in British Columbia. Provincial Health Officer’s Annual Report 2007. Victoria, BC: Ministry of Healthy Living and Sport. Available at: http://www.health.gov.bc.ca/pho/pdf/abohlth11-var7.pdf. (accessed November 12, 2015).
• [4]Bridges FS, Kunselman JC. Premature mortality due to suicide, homicide and motor vehicle accidents in Health Service Delivery Areas: Comparison of status Indians in British Columbia, Canada with all other residents. Psychol Rep. 2005; 97:739-49.
• [5]Chandler MJ, Lalonde C. Cultural continuity as a hedge against suicide in Canada’s First Nations. Transcult Psychiatry. 1998; 35(2):191-219.
• [6]Desapriya E, Sones M, Ramanzin T, Weinstein S, Scime G, Pike I. Injury prevention in child death review: child pedestrian fatalities. Inj Prev. 2011; 17 Suppl 1:i4-9.
• [7]George MA, McCormick R, Jin A, Lalonde CE, Brussoni M. The RISC research project: injury in First Nations communities in British Columbia, Canada. Int J Circumpolar Health. 2013; 72:21182.
• [8]Brussoni M, Jin A, George MA, Lalonde CE. Aboriginal community-level predictors of injury-related hospitalizations in British Columbia, Canada. Prev Sci. 2014; doi:10.1007/s11121-014-0503-1
• [9]Jin A, George MA, Brussoni B, Lalonde CE. Worker compensation injuries among the Aboriginal population of British Columbia, Canada: incidence, annual trends, and ecological analysis of risk markers, 1987–2010. BMC Public Health. 2014; 14:710. BioMed Central Full Text
• [10]George MA, Jin A, Brussoni M, Lalonde CE. Is the injury gap closing between the Aboriginal and general populations of British Columbia? Health Rep. 2015; 26(1):3-14.
• [11]Jin A, Lalonde CE, Brussoni M, McCormick R, George MA. Injury hospitalizations due to unintentional falls among the Aboriginal population of British Columbia, Canada: Incidence, changes over time, and ecological analysis of risk markers, 1991–2010. PLoS One. 2015;10(3):e0121694. doi:10.1371/journal.pone.0121694.
• [12]Fantus D, Shah BR, Qiu F, Hux J, Rochon P. Injury in First Nations communities in Ontario. Can J Public Health. 2009; 100(4):258-62.
• [13]Alaghenhbandan R, Sikdar K, MacDonald D, Collins KD, Rossignol AM. Unintended injuries among children and adolescents in Aboriginal and non-Aboriginal communities, Newfoundland and Labrador, Canada. Int J Circumpolar Health. 2010; 69(1):61-71.
• [14]Finès P, Bougie E, Oliver LN, Kohen DE. Hospitalizations for unintentional injuries among Canadian adults in areas with high percentage of Aboriginal-identity residents. Chronic Dis Inj Can. 2013; 33(4):204-16.
• [15]Oliver LN, Kohen DE. Unintentional injury hospitalizations among children and youth in areas with a high percentage of Aboriginal identity residents: 2001/2002 to 2005/2006. Health Rep. 2012; 23(3):7-15.
• [16]BC Stats. (2007). British Columbia Statistical Profile of Aboriginal Peoples 2006, With Emphasis on Labour Market and Post Secondary Issues: Aboriginal Peoples Compared to the non-Aboriginal Population. http://www.bcstats.gov.bc.ca/StatisticsBySubject/AboriginalPeoples/CensusProfiles.aspx. (accessed November 12, 2015).
• [17]Browne AJ, McDonald H, Elliot D. A Report for the First Nations Centre, National Aboriginal Health Organization. National Aboriginal Health Organization, Ottawa; 2009. First Nations Urban Aboriginal Health Research Discussion Paper
• [18]Tjepkema M, Wilkins R, Pennock J, Goedhuis N. Potential years of life lost at ages 25 to 74 among Status Indians, 1991 to 2001. Health Rep. 2011; 22(1):25-36.
• [19]Kim K, Ozegovic D, Voaklander DC. Differences in incidence of injury between rural and urban children in Canada and the USA: a systematic review. Inj Prev. 2012; 18(4):264-71.
• [20]BC Ministry of Health [creator], 2012: Consolidation File (MSP Registration & Premium Billing). V2012. Population Data BC [publisher]. Data extract. MOH (2012). Available at: https://www.popdata.bc.ca/data. (accessed November 12, 2015).
• [21]BC Vital Statistics Agency [creator], 2011: Vital Statistics Births. Population Data BC [publisher]. Data extract. BC Vital Statistics Agency (2011). Available at: https://www.popdata.bc.ca/data. (accessed November 12, 2015).
• [22]BC Vital Statistics Agency [creator], 2011: Vital Statistics Deaths. Population Data BC [publisher]. Data extract. BC Vital Statistics Agency (2011). Available at: https://www.popdata.bc.ca/data. (accessed November 12, 2015).
• [23]BC Ministry of Health [creator], 2011: Medical Services Plan (MSP) Payment Information File. Population Data BC [publisher]. Data extract. MOH (2011). Available at: https://www.popdata.bc.ca/data. (accessed November 12, 2015).
• [24]BC Stats. Reference Maps: Health Boundaries. Available at: http://www.bcstats.gov.bc.ca/statisticsbysubject/geography/referencemaps/health.aspx. (accessed November 12, 2015).
• [25]Statistics Canada. Census Profile. Available at: http://www12.statcan.gc.ca/census-recensement/2011/dp-pd/prof/index.cfm?Lang=E. (accessed November 12, 2015).
• [26]Kahn HA, Sempos CT. Statistical Methods in Epidemiology. Oxford University Press, Oxford; 1989.
• [27]Allin K, Sayer P. A Demographic and Socio-Economic Portrait of Aboriginal Populations in Canada. Minister of Indian Affairs and Northern Development and Federal Interlocutor for Métis and Non-Status Indians, Ottawa, 2009. Available at: http://publications.gc.ca/collections/collection_2010/ainc-inac/R3-109-2009-eng.pdf. (accessed November 12, 2015).