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. 2021 Jul 29;80(1):1946324. doi: 10.1080/22423982.2021.1946324
PULMONARY DISEASES (n = 27)
Main author (year, journal) Setting Topic Populations’ characteristics Outcomes Main results STROBE
Alaghehbandan (2005, Am J of Epidemiology) (49)

  • Newfoundland and Labrador

  • Retrospective

 Pneumonia
Hospitalisation

  • Indigenous people (Gr 1)

  • Non-Indigenous people (Gr 2)

  • All ages

  • F/M

 Hospitalisation rates (/1000) (p < 0.0001)
In-hospital mortality
Length of stay		 Gr 1: 11.6 (Innu: 16.9; Inuit 8.4); Gr 2: 3.0
Lower for Indigenous
Shorter for Indigenous		 7/11
Alaghehbandan (2007, Int J Infect Dis) (50)

  • Newfoundland and Labrador

  • Retrospective

 Pneumonia
Hospitalisation

  • Innu and Inuit from Labrador (Gr 1)

  • Non-Indigenous people from Newfoundland (Gr 2)

  • All ages

  • F/M

 Standardised hospitalisations rates (/1000) (95% CI)
Mortality (p < 0.00001)
Median length of stay (days)		 Gr 1: 4.82 (4.21-5.37); Gr 2: 1.03 (0.96-1.
Gr 1: 2.1%; Gr 2: 10.1%
Gr 1: 3.0; Gr 2: 5.0		 18/22
Alharbi (2012, BMC Infect Dis) (105)

  • Manitoba

  • Retrospective

 LRTI
ED visits

  • Indigenous people

  • <5 y.o.

  • F/M

 ED visits rates
Mortality		 112/193 (58%)
0%		 15/22
Banerji (2001, CMAJ) (35)

  • Nunavut

  • Prospective

 LRTI
Hospitalisation

  • Inuit

  • <6 months old

  • F/M

 Annualised incidence rate of admission (/1000) 484 12/22
Banerji (2001, Int J Circumpol Heal) (34)

  • Nunavut

  • Prospective

 Bronchiolitis
Hospitalisation

  • Inuit

  • <1 y.o.

  • F/M

 Rate of hospital admission (/1000) 306 10/22
Banerji, Greenberg et al (2009, Pediatr Infect Dis J) (51)

  • Nunavut

  • Retrospective

 LRTI
Hospitalisation

  • Inuit

    Baffin Island (Gr 1)

  • Iqaluit (Gr 2)

  • Rural communities (Gr 3)

  • High-risk communities (Gr 4)

  • <1 y.o.

  • F/M

 Odds ratio for hospitalisation (95% CI)
Average cost per admission (< 1 year old/ < 6 months old)
Annual admission rate/1000 live births without use of Palivizumab (<1 year old/ <6 months old)		 Inuit: 3.8 (1.1-12.8)
Gr 1: 19,014$/21,145$; Gr 2: 3915$/ 3621$;
Gr 3: 21,345$/23,030$; Gr 4: 20,770$/ 22,673$
Gr 1: 166/245; Gr 2: 63/72; Gr 3: 216/328; Gr 4: 349/512		 14/22
Banerji (2013, Int J Circumpol Heal) (36)

  • Nunavut, Quebec, Northwest territory

  • Prospective

 LRTI
Hospitalisation

  • Inuit

    Northwest Territory (Gr 1)

  • Nunavut (Gr 2)

  • Nunavik (Gr 3)

  • <1 y.o.

  • F/M

 Hospitalisation rates/1000 live births
Median length of stay (days)
Cost per admission		 Gr 1: 38; Gr 2: 236; Gr 3: 445
Gr 1: 5; Gr 2: 6; Gr 3: 5
Gr 1: 36,542$; Gr 2: 55,265$; Gr 3: 23,203$		 14/22
Charland (2011, Epidemiol Infect) (98)

  • Quebec

  • Retrospective

 Influenza, Bronchitis, Pneumonia
ED visits

  • Mohawks of Kahnawá:ke reserve

  • Non-Indigenous people

  • All ages

  • F/M

 Standardised Risk Ratios to visit ED for Mohawks all ages (95% CI) Influenza: 1.58 (1.49-1.67)
Influenza + Pneumonia: 1.51 (1.44-1.58)
Influenza + Bronchitis: 1.48 (1.44-1.53)
Respiratory infection: 1.21 (1.19-1.23)		 15/22
Creery (2005, Int J Circumpol Heal) (37)

  • Nunavut

  • Retrospective

 Bronchiolitis
Hospitalisation

  • Inuit

  • < 1 y.o.

  • F/M

 Annual admission rate of children <1 year old
Average length of stay (days)
Overall average cost per admission
Cost per admission to Baffin Regional Hospital
Cost per admission to CHEO		 197/1000
5.7
14,273$
12,029$
45,688$		 17/22
Gershon (2014, PLoS One) (40)

  • Ontario

  • Retrospective

 Asthma, COPD
Hospitalisation,
ED visits

  • Metis of Ontario (Gr 1)

  • Other Ontarians (Gr 2)

  • ≥ 20 y.o.

  • F/M

 Standardised rates/1000 for people with Asthma (95% CI)
Standardised rates /1000 for people with COPD (95% CI)
Standardised all-cause mortality/1000
Metis/Ontarians		 All-cause ED visits:
Gr 1: 761.7 (729.0-795.8); Gr 2: 563.9 (562.9-565.0)
Asthma ED visits:
Gr 1: 26.3 (21.2-32.2); Gr 2: 21.5 (21.3-21.7)
All-cause hospitalisations:
Gr 1: 118.9 (104.5-134.7); Gr 2: 93.1 (92.6-93.5)
Asthma hospitalisations:
Gr 1: 5.8 (3.2-9.8); Gr 2: 4.7 (4.6-4.8)
All-cause ED visits:
Gr 1: 910.7 (861.3-962.2); Gr 2: 674.3 (672.5-676.2)
COPD ED visits:
Gr 1: 26.7 (20.4-34.3); Gr 2: 32.2 (31.9-32.5)
All-cause hospitalisations:
Gr 1: 176.3 (155.9-198.5); Gr 2: 132.7 (132.0-133.4)
COPD hospitalisations:
Gr 1: 32.9 (25.1-42.3); Gr 2: 25.0 (24.7-25.3)
Asthma: 68.0/65.0 (p = 0.67)
COPD: 39.0/29.0 (p = 0.01)		 21/22
Houston (1979, CMAJ) (114)

  • Saskatchewan

  • Prospective

 Pneumonia
Hospitalisation

  • Indigenous people (Gr 1)

  • Whites (Gr 2)

  • <14 y.o.

  • F/M

 Mortality
Average length of stay (days)		 Gr 1: 4/102; Gr 2: 0/64 Whites
Gr 1: 26.9; Gr 2: 8.7		 11/22
Hui (2016, Pediatr Infect Dis J) (54)

  • All provinces

  • Prospective

 LRTI
Hospitalisation,
ICU admissions

  • Indigenous people (Gr 1)

  • Non-Indigenous people (Gr 2)

  • <1 y.o.

  • F/M

 Hazard ratio of hospitalisation (95% CI; p)
% of ICU admission (p = 0.334)
Mean Length of stay (days) (p = 0.598)		 Gr 1: 1.2 (0.7-2.2; p = 0.383)
Gr 1: 17.4%; Gr 2: 21.5%
Gr 1: 9.0; Gr 2: 8.3		 16/22
Jung (2011, Am J Resp Crit Care) (115)

  • All provinces

  • Prospective

 H1N1 Influenza A
Hospitalisation
ICU admissions

  • Indigenous people (Gr 1)

  • Non-Indigenous people (Gr 2)

  • All ages

  • F/M

 Hospitalised critically ill patients (384 patients)
Mortality (p = 0.25)
Frequency of reception of antivirals (p = 0.50)
Mean ICU length of stay (days) (p = 0.72)
Mean hospital length of stay (days) (p = 0.20)		 Gr 1: 16.7%
Gr 1: 15.6%; Gr 2: 23.8%
Gr 1: 92.2%; Gr 2: 94.4%
Gr 1: 17.0; Gr 2: 14.6
Gr 1: 23.2; Gr 2: 24.4		 9/11
Marrie (2004, Can Respir J) (22)

  • Alberta

  • Retrospective

 Pneumonia
Hospitalisation

  • First Nations people (Gr 1)

  • Non-First Nations people (Gr 2)

  • ≥ 18 y.o.

  • F/M

 Hospital discharge rate for community acquired pneumonia/1000 (95% CI)
Hospital discharge rate for aspiration pneumonia/1000 (95% CI)
Mean distance to closest hospital (km)
Mortality odds ratio (95% CI)
Median length of stay (days)
Odds ratio for daily hospital cost higher than the median cost of 722.71$ (95% CI)		 Gr 1: 22.1 (20.7-23.6); Gr 2: 4.4 (4.4-4.5)
Gr 1: 1.29 (0.96-1.6); Gr 2: 0.27 (0.26-0.29)
Gr 1: 21; Gr 2: 6
Gr 1: 0.49 (0.37-0.66)
Gr 1: 6.1; Gr 2: 7.8
Gr 1: 1.25 (1.14-1.36)		 14/22
McCuskee (2014, Pediatr Infect Dis J) (52)

  • Ontario

  • Retrospective

 Bronchiolitis, Pneumonia
Hospitalisation

  • First Nations people of Sioux Lookout Zone (Gr 1)

  • Non-First Nations people (Gr 2)

  • <1 y.o.

  • F/M

 Admission rate for < 1 year old (p = 0.011)
Admission rate for <6 months old
Mean length of stay		 Gr 1: 4.4%; Gr 2: 2.5%
Gr 1: 5.6%
3.2 days		 17/22
Morrison (2014, Health Place) (23)

  • Manitoba

  • Retrospective

 H1N1 Influenza A
Hospitalisation

  • First Nations people on-reserve

  • All ages

  • F/M

 Access to care (p<0.001)
Odds ratio for hospitalisation		 On-reserve First Nations have a longer delay between infection and hospitalisation.
OR = 2.34 (1.16-4.73)		 18/22
Mostaco-Guidolin (2013, Am J Public Health) (53)

  • Manitoba

  • Retrospective

 H1N1 Influenza A
Hospitalisation

  • First Nations people

  • Non-First Nations people

  • All ages

  • F/M

 Hospitalisation risk ratio (p < 0.001) In all First Nations age groups during the first wave, they were significantly higher than those in non-First Nations age groups. 15/22
Ospina (2015, Am J Resp Crit Care) (92)

  • Alberta

  • Retrospective

 COPD
Hospitalisation

  • Indigenous (Gr 1)

    First Nations (Gr 2)

  • Metis (Gr 3)

  • Inuit (Gr 4)

  • Non-Indigenous (Gr 5)

  • All ages

  • F/M

 Risk ratios for hospitalisation for all causes (95% CI)
Risk ratios for hospitalisation for AECOPD (95% CI)
Median hospital length of stay (days)		 Gr 1: 1.31 (1.24-1.37); Gr 2:1.60 (1.52-1.69); Gr 3: 0.80 (0.72-0.88); Gr 4: 0.71 (0.64-0.79)
Gr 2: 1.44 (1.26-1.65); Gr 3: 1.10 (0.89-1.36); Gr 4: 0.67 (0.52-0.86)
Gr 2: 5; Gr 3: 5; Gr 4: 4
All shorter than for Non-Aboriginals.		 10/11
Ospina (2016, CJEM) (93)

  • Alberta

  • Retrospective

 COPD
ED visits

  • Indigenous (Gr 1)

    First Nations (Gr 2)

  • Métis (Gr 3)

  • Inuit (Gr 4)

  • Non-Indigenous (Gr 5)

  • ≥ 35 y.o.

  • F/M

 Adjusted Risk Ratio for ED visits rates (95% CI)
Median ED length of stay (hours)		 Gr 1: 1.72 (1.67-1.77); Gr 2: 2.02 (1.97-2.08);
Gr 3: 1.28 (1.22-1.35); Gr 4: 0.94 (0.90-0.98)
Gr 1: 2.8; Gr 2: 2.9; Gr 3: 2.4; Gr 4: 2.2; Gr 5: 3.7		 16/22