Birth Outcomes and Infant Mortality by the Degree of Rural Isolation Among First Nations and Non-First Nations in Manitoba, Canada

Luo, Zhong‐Cheng; Wilkins, Russell; Heaman, Maureen; Martens, Patricia J.; Smylie, Janet; Hart, L. Gary; Simonet, Fabienne; Wassimi, Spogmai; Wu, Yuquan; Fraser, William D.

doi:10.1111/j.1748-0361.2010.00279.x

Cited by 16 publications

(12 citation statements)

References 26 publications

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“…This might reflect the socio-economic features of rural Manitoba. 8,9 It is known that impoverished rural communities, many of which are populated by First Nations, suffer from a higher frequency of drowning, 10 suicide, [11][12][13] infant mortality 14 and severe trauma. [15][16][17] Injury (including road traffic injuries, falls and assault) is the leading cause of deaths and hospitalizations among Canadian adolescents.…”

Section: Discussionmentioning

confidence: 99%

Traumatic and other non-natural childhood deaths in Manitoba, Canada: A retrospective autopsy analysis (1989–2010)

Herath

Kalikias

Phillips

et al. 2014

Can J Public Health

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anner of death is categorized as natural, accident, suicide, homicide and undetermined. Death may be due to disease (i.e., natural) or external factors. Statistics Canada reported that during the period 2004-08, the leading causes of death in children were accidental injuries (~30%), malignant neoplasms (~16%), congenital anomalies (~8%), suicide (~4%), heart disease (~4%) and assault (~3%). 1 Injuries are the leading cause of childhood death in developed nations, accounting for almost 40% of deaths between 1 and 14 years. 2 In Canada in 2004, there were >13,000 deaths and 211,000 hospitalizations due to injury with a total cost of CAD $19.8 billion; children aged 15-19 years accounted for a substantial proportion of these. 3,4 In Manitoba, 1994-97 administrative data indicate that injuries accounted for >50% of all deaths at 1-9 years of age and 70% of deaths at 10-19 years of age. 5 Most mortality statistics are derived from administrative databases, which are subject to coding errors. Retrospective autopsy review potentially offers more detailed and accurate information. Statistics Canada data indicate that the percentage of deaths subjected to autopsy in 1991 was 16.9% and had declined to a national average of 5.7% in 2007. In Manitoba, the autopsy rate was considerably higher, at 10.5%, although comparisons for the pediatric population are not available. 6 Manitoba has highly centralized health care. The death investigation system is coordinated by the Office of the Chief Medical Examiner (OCME). In Manitoba, all child deaths (nonnatural and natural deaths of individuals <19 years of age) are reportable to the OCME. Manitoba has Canada's oldest multidisciplinary child death review committee, formed in 1992 through the Provincial Advisory Committee on Child Abuse. Because of the centralized death investigation system, it is possible to analyze all childhood deaths retrospectively. During the study period, almost all autopsies were performed in two universityaffiliated hospitals in Winnipeg and a small proportion in a third hospital in Brandon. More than 95% of the pediatric autopsies were done at a single centre in Winnipeg. Most were performed by pathologists with broad forensic experience, often in consultation with a neuropathologist. The goals of analyzing all non-natural childhood deaths in Manitoba for the 22-year period are to document temporal trends that might be influenced by changes in society and to highlight preventable causes of death.

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Section: Discussionmentioning

confidence: 99%

Traumatic and other non-natural childhood deaths in Manitoba, Canada: A retrospective autopsy analysis (1989–2010)

Herath

Kalikias

Phillips

et al. 2014

Can J Public Health

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“…Luo et al [ 38 ] report infant mortality rates that are twice as high among First Nations than non-First Nations in British Columbia, with greater disparity in rural areas (13.8 versus 6.1 deaths per 1000 live births in rural areas; 12.7 versus 6.1 deaths per 1000 live births in urban areas). Results from Manitoba reveal the infant mortality rate for First Nations was twice that of non-First Nations in Manitoba (9.8 versus 5.0 per 1000, respectively) [ 39 ].…”

Section: Contemporary Patterns Of Aboriginal Healthmentioning

confidence: 99%

Creating conditions for Canadian aboriginal health equity: the promise of healthy public policy

Richmond

Cook

2016

Public Health Rev

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In the Canadian context, the persistence and growth of Aboriginal health and social inequity signals that we are at a critical public health policy juncture; current policy reflects an historic relationship between Aboriginal people and Canada that fails the contemporary health needs of Canada’s Aboriginal peoples. In this review, we highlight the need for healthy public policy that recognizes and prioritizes the rights of Canada’s Aboriginal people to achieve health equity. Drawing from a structural approach, we examine the historical scope and comprehensive breadth of the Indian Act in shaping modern Aboriginal health and social inequities. Canada’s failure to implement a national public policy for Aboriginal health reflects the proliferation of racism in modern day Canada, and a distinctly lacking political will at the federal level. Despite these structural challenges, there is great promise in community self-determination in health care and the role of community-led research as advocacy for policy reform. In our conclusion, we turn to the Report on the Truth and Reconciliation Commission of Canada (2015) and draw upon the concept of reconciliation as a fundamental precursor for Aboriginal health equity. The burden of systemic change needed to promote healthy public policy cannot be carried by any single group of advocates; it is a shared responsibility that will require the collaboration and integration of various actors and knowledges.

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“…Ages and educational attainments of US American Indian mothers vary by region (Alexander et al, 2008). American Indian births in rural, isolated areas of Canada were less likely to be pre-term or LBW compared to urban American Indian births (Luo et al, 2010). American Indian births in counties with a reservation demonstrated lower rates of VLBW (very low birth weight, a birth weight less than 1500g) compared to American Indian births in counties without a reservation suggesting that reporting bias by locale plays a role in the rates (Heck et al, 1999), or that risk factors for poor outcomes are more severe in non-reservation counties.…”

Section: Birth Sizementioning

confidence: 99%

Overweight and obesity among North American Indian infants, children, and youth

Schell

Gallo

2012

American J Hum Biol

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The frequency of overweight and obesity among North American Indian children and youth exceeds that of other ethnic groups in the United States. This observation is based on studies using body mass index as the primary measure of overweight and obesity. In the mid-20th century, there were regional differences among North American Indian groups in sub-adults’ size and shape and only a few Southwestern groups were characterized by high rates of overweight and obesity. In most populations, the high prevalence of overweight and obesity developed in the last decades of the 20th century. Childhood obesity may begin early in life as many studies report higher birth weights and greater weight-for-height in the preschool years. Contributing factors include higher maternal weights, a nutritional transition from locally caught or raised foods to store bought items, psychosocial stress associated with threats to cultural identity and national sovereignty, and exposure to obesogenic pollutants, all associated to some degree with poverty. Obesity is part of the profile of poor health among Native Americans in the US and Canada, and contributes to woefully high rates of diabetes, cardiovascular disease, and early mortality. Interventions that are culturally appropriate are needed to reduce weights at all points in the lifespan.

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Birth Outcomes and Infant Mortality by the Degree of Rural Isolation Among First Nations and Non-First Nations in Manitoba, Canada

Cited by 16 publications

References 26 publications

Traumatic and other non-natural childhood deaths in Manitoba, Canada: A retrospective autopsy analysis (1989–2010)

Traumatic and other non-natural childhood deaths in Manitoba, Canada: A retrospective autopsy analysis (1989–2010)

Creating conditions for Canadian aboriginal health equity: the promise of healthy public policy

Overweight and obesity among North American Indian infants, children, and youth

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