Abstract
Background: Despite an abundance of data and analysis of First Nations morbidity and mortality rates, accurate data have not been available to serve the First Nations community in Eastern Canada.
Methods: Data for Eskasoni, the largest Mi’kmaq community, were obtained for 1996 through 1999 and Cape Breton and Nova Scotia were used as regional and provincial reference populations respectively. Age-adjusted relative risks (AARR) were calculated for overall mortality and disease-specific hospital admissions.
Results: Eskasoni’s mortality AARR was greater than 1.0 in 3 of the 4 years studied, although the data may understate Eskasoni’s mortality rates. Eskasoni’s total admission AARRs were significantly greater than the two reference populations. Neoplasm admission rates were generally lower, while circulatory disease admission AARRs were significantly higher. A rise in diabetic admission rates was noted with the AARR reaching statistical significance in the final years of the study. Respiratory disease was the leading cause of hospitalization with significantly greater rates of admission than regional or provincial rates. Pneumonia and influenza accounted for more than one half of respiratory admissions. Infectious disease admissions were more prevalent in Eskasoni while rates of liver disease were generally low.
Conclusion: Results suggest that members of the largest Mi’kmaq band are at greater risk for a number of disease categories and health promotion should be targeted toward respiratory ailments, circulatory disease and diabetic management. Further analysis, however, remains an important priority.
Résumé
Contexte: En dépit d’une abondance de données et d’analysation de morbidité et des taux de mortalité des Premières Nations, les données précises n’ont pas été disponibles pour servir les communautés de Première Nations dans l´est du Canada.
Méthodes: Des données pour Eskasoni, la plus grande communauté de Mi’kmaq, ont été obtenues pour les années 1996 à 1999 et Cape Bréton et la Nouvelle-Écosse ont été employés respectivement comme populations de référence régionale et provinciale. Les risques relatifs ajustés pour l’âge (RRAA) ont été calculés pour des admissions d’hôpital spécifiquement pour les taux de mortalité et de maladie.
Résultats: La mortalité RRAA d’Eskasoni était 1,0 dans 3 des 4 années étudiées, quoique les données ont la possibilité d’amoindrir la mortalité d’Eskasoni. Les RRAA d’admission d’Eskasoni étaient sensiblement plus grands que les populations de référence. Les taux d’admission de néoplasme étaient généralement inférieurs, alors que les RRAA d´admission de la maladie circulatoires étaient sensiblement plus hauts. Une élévation des taux d’admission diabétiques a été notée avec les RRAA atteignant la signification statistique en années finales de l’étude. La maladie respiratoire était la principale cause de l’hospitalisation avec des taux d’admission sensiblement plus grands. La pneumonie et la grippe ont constitué plus d’une moitié des admissions respiratoires. Les admissions infectieuses de la maladie étaient plus répandues dans Eskasoni tandis que les taux d’infection hépatique étaient généralement bas.
Conclusions: Les résultats suggèrent que les membres de la plus grande bande de Mi’kmaq soient à un plus grand risque pour un certain nombre de catégories de la maladie et la promotion de santé devrait être visée vers la maladie respiratoire et la gestion diabétique. Plus d’analysation demeure une priorité importante.
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