Advertisement

Canadian Journal of Public Health

, Volume 99, Issue 1, pp 41–45 | Cite as

Health Disparities in Chickenpox or Shingles in Alberta?

  • M. L. Russell
  • D. P. Schopflocher
  • L. W. Svenson
Article

Abstract

Objective

Exploring for evidence of socio-economic health disparities in chickenpox and shingles in Alberta, Canada.

Methods

Chickenpox and shingles cases were identified from administrative data from Alberta’s universal health care insurance system for 1994–2002. Incident cases were those with the earliest dated utilization of a health service (chickenpox: ICD9-CM 052/ ICD10-CA B01; shingles: ICD9-CM 053/ ICD10-CA B02). Crude and age-specific rates were estimated for each year by an indicator of socio-demographic status based upon the nature of the payer and eligibility for health care premium subsidy (SES-proxy) for the provincial health care insurance system.

Results

Among young children there is a gradient of disparity in chickenpox rates prior to the year in which publicly funded vaccination programs were implemented. After this point, disparities decline but less so for First Nations children than for others. There was no evidence of disparity by SES-proxy for shingles.

Conclusion

Publicly funded vaccination programs may effectively contribute to reduction in disease disparities for vaccine-preventable diseases. Further study is required to ascertain why disparities continue for First Nations children.

Keywords

Herpes zoster chickenpox Canada population surveillance social class income Indians North American 

Résumé

Objectif

Prouver l’existence de disparités socioéconomiques sur le plan de la santé en matière de varicelle et de zona en Alberta (Canada).

Méthode

Les cas de varicelle et de zona ont été repérés à partir des données administratives du système universel d’assurance-maladie de l’Alberta pour la période de 1994 à 2002. L’incidence des cas a été déterminée en fonction de la date la plus ancienne d’utilisation des services de santé (varicelle: CIM9-MC 052/ CIM10-CA B01; zona: CIM9-MC 053/ CIM10-CA B02). Les taux bruts et par âge ont été estimés pour chaque année selon un substitut du statut socioéconomique (SSE): un indicateur du statut sociodémographique fondé sur la nature du payeur et l’admissibilité au programme de subvention des primes versées en vertu du système provincial d’assurance-maladie.

Résultats

Chez les jeunes enfants, on observe un gradient de disparité dans les taux de varicelle avant l’année d’instauration des programmes de vaccination subventionnés par l’État. Après cette date, les disparités diminuent, mais dans une moindre mesure pour les enfants des Premières nations que pour les autres enfants. Aucune disparité selon le substitut du SSE n’est observée pour le zona.

Conclusion

Les programmes de vaccination subventionnés par l’État peuvent effectivement contribuer à réduire les disparités à l’égard des maladies évitables par la vaccination. D’autres études sont nécessaires pour vérifier pourquoi des disparités persistent chez les enfants des Premières nations.

Motsclés

zona varicelle Canada surveillance dans la population classe sociale revenu Amérindiens 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Health Disparities Task Group of the Federal/Provincial/Territorial Advisory Committee on Population Health and Health Security. December 2004. Public Health Agency of Canada. Reducing Health Disparities - Roles of the Health Sector: Discussion Paper. Available online at: https://doi.org/www.phac-aspc.gc.ca/ph-sp/disparities/ddp_2_e.html (Accessed July 20, 2006).
  2. 2.
    Sin DD, Svenson LW, Cowie RL, Paul Man SF. Can universal access to health care eliminate health inequities between children of poor and nonpoor families? Chest 2003;124(1):51–56.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Health Canada First Nations & Inuit Health. A Statistical Profile on the Health of First Nations in Canada for the Year 2000. Available online at: https://doi.org/www.hc-sc.gc.ca/fnih-spni/pubs/gen/stats_profil_e.html (Accessed March 7, 2007).
  4. 4.
    Alberta Health and Wellness. Population projections for Alberta and its health regions: Models and methods. Edmonton, Alberta Health and Wellness, 1998.Google Scholar
  5. 5.
    Sin DD, Wells H, Svenson LW, Man SF. Asthma and COPD among aboriginals in Alberta, Canada. Chest 2002;121(6):1841–46.CrossRefPubMedGoogle Scholar
  6. 6.
    Russell ML, Schopflocher DP, Svenson LW, Yiannakoulias N, Grimsrud K, Virani SN. The changing epidemiology of chickenpox in Alberta. Vaccine 2005;23(46–47):5398–403.CrossRefGoogle Scholar
  7. 7.
    SPSS Inc., Chicago, Il, USA.Google Scholar
  8. 8.
    Indian and Northern Affairs Canada. Comparison of Socio-economic conditions, 1996 and 2001. Available online at: https://doi.org/www.ainc-inac.gc.ca/pr/sts/csc/index_e.html (Accessed March 6, 2007).
  9. 9.
    Indian and Northern Affairs Canada. The Indian Register. Available online at: https://doi.org/www.ainc-inac.gc.ca/pr/info/tir_e.html (Accessed March 6, 2007).
  10. 10.
    John TJ, Samuel R. Herd immunity and herd effect: New insights and definitions. Eur J Epidemiol 2000;16(7):601–6.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Thomas SL, Hall AJ. What does epidemiology tell us about risk factors for herpes zoster? Lancet Infect Dis 2004;4:26–33.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Asada Y, Kephart G. Equity in health services use and intensity of use in Canada. BMC Health Serv Res 2007;11(7):41.CrossRefGoogle Scholar
  13. 13.
    Dunlop S, Coyte PC, McIsaac W. Socio-economic status and the utilisation of physicians’ services: Results from the Canadian National Population Health Survey. Soc Sci Med 2000;51(1):123–33.CrossRefPubMedGoogle Scholar
  14. 14.
    Quan H, Fong A, De Coster C, Wang J, Musto R, Noseworthy TW, Ghali WA. Variation in health services utilization among ethnic populations. CMAJ 2006;174(6):787–91.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Currie RJ. Health and health care: Manitoba’s First Nations. Available online at: https://doi.org/www.umanitoba.ca/centres/mchp/reports/reports_02/rfn.htm (Accessed April 10, 2007).
  16. 16.
    Donahue JG, Choo PW, Manson JE, Platt R. The incidence of herpes zoster. Arch Intern Med 1995;155:1605–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Mullooly JP, Riedlinger K, Chun C, Weinmann S, Houston H. Incidence of herpes zoster, 1997–2002. Epidemiol Infect 2005;133(2):245–53.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Phipps S. The impact of poverty on health: A scan of research literature. June, 2003. Canadian Institute for Health Information. Available online at: https://doi.org/secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=GR_323_E (Accessed July 21, 2006).Google Scholar

Copyright information

© The Canadian Public Health Association 2008

Authors and Affiliations

  • M. L. Russell
    • 1
  • D. P. Schopflocher
    • 1
    • 2
    • 3
  • L. W. Svenson
    • 1
    • 2
    • 3
  1. 1.Department of Community Health SciencesUniversity of CalgaryCalgaryCanada
  2. 2.Public Health Surveillance & Environmental HealthAlberta Health and WellnessCanada
  3. 3.Department of Public Health SciencesUniversity of AlbertaEdmontonCanada

Personalised recommendations