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

Jin, Andrew; George, M. Anne; Brussoni, Mariana; Lalonde, Christopher E.; McCormick, Rod

doi:10.1186/s12939-015-0269-5

Cited by 2 publications

(7 citation statements)

References 13 publications

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“…In both time periods (1999–2003 and 2004–2008) the total population’s SRR of injury is one, because SRR is relative to the total population of BC during the same period . This removes the effect of the secular trend of declining injury risk in BC (George et al 2015a ; Jin et al 2015a ).…”

Section: Resultsmentioning

confidence: 99%

“…Deaths 2011b ). We previously described this method, and discussed the quality of the population registry, and validity and limitations of the Aboriginal identification (George et al 2015a ; Jin et al 2015a ).…”

Section: Methodsmentioning

confidence: 99%

“…As in previously reported analyses (Brussoni et al 2014 , 2016 ; Jin et al 2014 , 2015a , b ; George et al 2015a , b ), we calculated standardized relative risk (SRR) of hospitalization relative to the risk of hospitalization in the reference population (the total population of BC) using the method of indirect standardization (Kahn and Sempos 1989 ), standardizing by gender and 5-year age group. The SRR is analogous to the Standardized Mortality Ratio (if death is the event counted), and could also be called the Standardized Incidence Ratio.…”

Section: Methodsmentioning

confidence: 99%

“…As hypothesized risk markers, we selected socio-economic, housing, and geographic indicators previously developed by Statistics Canada and Aboriginal Affairs and Northern Development Canada. We previously published definitions and reasons for selection of the markers (Brussoni et al 2014 , 2016 ; Jin et al 2014 , 2015a , b ; George et al 2015a , b ).…”

Section: Methodsmentioning

confidence: 99%

“…Previously, we reported disparities in injury risk between Aboriginal and total British Columbia (BC) populations for all injuries, and that time trends indicated a narrowing gap for all injuries combined (George et al 2015a ; Jin et al 2015a ), including among children and youth under age 25 (George et al 2015b ). By category of injury, the gap risk has narrowed for unintentional falls (Jin et al 2015b ) but not for iatrogenic injuries (medical/surgical mishaps) (Jin et al 2016 ).…”

Section: Introductionmentioning

confidence: 98%

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Ecological analyses of the associations between injury risk and socioeconomic status, geography and Aboriginal ethnicity in British Columbia, Canada

et al. 2016

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BackgroundThe current study examines what factors contribute to higher injury risk among Aboriginal peoples, compared to the total British Columbia (BC) population. We explore socioeconomic, geographic, and cultural factors, and combinations of these factors, that contribute to increased injury risk for Aboriginal peoples. This follows from our previously reported findings of improvements in injury risk over time for both the total and Aboriginal populations.Data and methodsWe use provincial population-based linked health care databases of hospital discharge records. We identify three population groups: total BC population, and Aboriginal populations living off-reserve, or on-reserve. For each group we calculate age and gender-standardized relative risks (SRR) of injury-related hospitalization, relative to the total population of BC, for two 5-year time periods (1999–2003, and 2004–2008). We use custom data from the 2001 and 2006 long-form Censuses that described income, education, employment, housing conditions, proportion of urban dwellers, proportion of rural dwellers, and prevalence of Aboriginal ethnicity. We use multivariable linear regression to examine the associations between the census characteristics and SRR of injury.ResultsThe best-fitting model was an excellent fit (R2 = 0.905, p < 0.001) among the three population groups within Health Service Delivery Areas of BC. We find indicators in all three categories (socioeconomic, geographic, and cultural) are associated with disparity in injury risk. While the socioeconomic indicators (income, education, housing, employment) were shown to be highly correlated, only living in housing that needs major repair and occupational hazardousness, along with rural residence and Aboriginal ethnicity, remained in the final model. Our data show that cultural density is not associated with injury risk for Aboriginal peoples, and that living off-reserve is associated with reduced injury by improving socioeconomic and geographic conditions (compared to living on-reserve). Finally, our analyses show that Aboriginal status itself is associated with injury risk.ConclusionsOur findings confirm previous research indicating that geographical differences differentiate injury risk, including for Aboriginal populations, and that socioeconomic determinants are associated with health risks. Our analyses showing that Aboriginal status itself contributes to injury risk is new, but we can only speculate about pathway, and whether the causes are direct or indirect.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Ecological analyses of the associations between injury risk and socioeconomic status, geography and Aboriginal ethnicity in British Columbia, Canada

et al. 2016

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Intentional injury among the indigenous and total populations in British Columbia, Canada: trends over time and ecological analyses of risk

George

Jin²,

Brussoni

et al. 2017

Int J Equity Health

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BackgroundOur objective was to explore intentional injury disparity between Indigenous populations and the total population in the province of British Columbia (BC), Canada. We focus on hospitalizations, including both self-inflicted injuries and injuries inflicted by others.MethodsWe used data from BC’s universal health care insurance plan, 1991 to 2010, linked to Vital Statistics databases. Indigenous people were identified through the insurance premium group, and birth and death records. Place of residence was identified through postal code. We calculated crude hospitalization incidence rates and the Standardized Relative Risk (SRR) of hospitalization, standardized by gender, 5-year age group, and Health Service Delivery Area (HSDA). With HSDA populations as the units of observation, linear regression was used to test hypothesized associations of Indigenous ethnicity, geographic, and socio-economic characteristics with SRR of injury.ResultsDuring the period 1991–2010, the crude rate of hospitalization for intentional injuries was 8.4 per 10,000 person-years (95% confidence interval (CI): 8.3 to 8.5) for the total BC population, compared to 45.3 per 10,000 (95% CI: 44.5 to 46.1) for the Indigenous population. For both populations, risk declined over the period for injuries self-inflicted and inflicted by others. The linear regression model predicts that the off-reserve Indigenous population will have SRR of intentional injury 3.98 greater, and the on-reserve Indigenous population 4.17, greater than the total population. The final model was an excellent fit (R2 = 0.912, F = 177.632, p < 0.001), and found that three variables - occupational risk, high school diploma, and university degree – each provide independent effects when interacting multiplicatively with Indigenous ethnicity.ConclusionsThe observation of substantially declining rates of intentional injury for both the Indigenous and total BC populations is off-set by the high disparity in risk between the two populations, which will likely continue until Canada reduces disparity with respect to discriminatory practices, and physical, social, and economic conditions.

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

Cited by 2 publications

References 13 publications

Ecological analyses of the associations between injury risk and socioeconomic status, geography and Aboriginal ethnicity in British Columbia, Canada

Ecological analyses of the associations between injury risk and socioeconomic status, geography and Aboriginal ethnicity in British Columbia, Canada

Intentional injury among the indigenous and total populations in British Columbia, Canada: trends over time and ecological analyses of risk

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