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Canadian Journal of Public Health

, Volume 96, Supplement 1, pp S33–S38 | Cite as

Mortality Comparisons of First Nations to All Other Manitobans

A Provincial Population-based Look at Health Inequalities by Region and Gender
  • Patricia J. Martens
  • Doreen Sanderson
  • Laurel S. Jebamani
Article

Abstract

Background

To examine inequalities in health status of Registered First Nations Manitobans compared to all other Manitobans.

Methods

Three mortality indicators - premature mortality rate (PMR) defined as an age-and sex-adjusted rate of death before age 75 years; life expectancy from birth; and potential years of life lost (PYLL) - are compared between Registered First Nations (RFN) people and all other Manitobans (AOM) by geographical areas of Manitoba. Data were derived from the Population Health Research Data Repository, linked to the federal Status Verification System (SVS) files for the years 1995 through 1999.

Results

First Nations experienced double the PMR compared to all other Manitobans (6.6 versus 3.3 deaths per thousand, p<0.05), an eight-year gap in life expectancy (males: 68.4 versus 76.1 years; females 73.2 versus 81.4 years), and over twice the PYLL (males 158.3 versus 62.5 years of life lost per thousand; females 103.3 versus 36.5). RFN male life expectancy was geographically-related (better health status in the north), and inversely related to the corresponding regional AOM life expectancy (r = -0.61, 9 df, one-tailed, p<0.03). As regional percentage of RFN decreased, male life expectancy decreased (r = 0.77, 9 df, one-tailed, p<0.003). In contrast, RFN female indicators showed no such relationship.

Conclusion

The inequality in health status between RFN and all other Manitobans is large, but also shows differential geographical and gender effects.

MeSH terms

Indians North American health services research mortality health status indicators medical records Canada gender differential 

Résumé

Contexte

Nous avons étudié les inégalités sur le plan de la santé chez les membres inscrits des Premières nations manitobaines par rapport au reste de la population du Manitoba.

Méthode

Nous avons comparé trois indices de mortalité - le taux de mortalité prématurée (TMP), défini comme étant le taux de décès avant 75 ans ajusté selon l’âge et le sexe; l’espérance de vie à la naissance; et les années potentielles de vie perdues (APVP) - pour les membres inscrits des Premières nations et le reste de la population du Manitoba selon les zones géographiques de la province. Les données ont été dérivées d’un registre, le Population Health Research Data Repository, lié au Système de vérification du statut (SVS) fédéral, pour la période de 1995 à 1999.

Résultats

Chez les membres des Premières nations, le TMP était le double de celui du reste de la population du Manitoba (6,6 c. 3,3 décès p. 1 000, p<0,05), l’espérance de vie était inférieure de huit ans (chez les hommes, 68,4 c. 76,1 ans; chez les femmes, 73,2 c. 81,4 ans), et les APVP étaient plus de deux fois supérieures (chez les hommes, 158,3 c. 62,5 années de vie perdues p. 1 000; chez les femmes, 103,3 c. 36,5). Chez les hommes, l’espérance de vie des membres inscrits des Premières nations était liée à la zone géographique (l’état de santé était meilleur dans le Nord) et réciproquement liée à l’espérance de vie du reste de la population du Manitoba dans la zone correspondante (r = 0,61, degré de liberté = 9, test unilatéral, p<0,03). À mesure que le pourcentage régional des membres inscrits des Premières nations diminue, l’espérance de vie des hommes diminue (r = 0,77, degré de liberté = 9, test unilatéral, p<0,003). Par contre, les indices concernant les femmes inscrites des Premières nations ne permettent pas d’établir de tels liens.

Conclusion

Les inégalités entre les membres inscrits des Premières nations et le reste de la population du Manitoba sur le plan de l’état de santé sont importantes, mais elles diffèrent selon la zone géographique et le sexe.

References

  1. 1.
    Carstairs V, Morris R. Deprivation and Health in Scotland. Aberdeen, Scotland: Aberdeen University Press, 1991.Google Scholar
  2. 2.
    Eyles J, Birch S, Chambers S, Hurley J, Hutchinson B. A needs-based methodology for allocating health care resources in Ontario, Canada: Development and an application. Soc Sci Med 1991;33(4):489–500.CrossRefGoogle Scholar
  3. 3.
    Eyles J, Birch S. A population needs-based approach to health care resource allocation and planning in Ontario: A link between policy goals and practice? Can J Public Health 1993;84(2):112–17.PubMedGoogle Scholar
  4. 4.
    Reid RJ, Roos NP, MacWilliam L, Frohlich N, Black C. Assessing population health care need using a claims-based ACG morbidity measure: A validation analysis in the province of Manitoba. Health Serv Res 2002;37(5):1345–64.CrossRefGoogle Scholar
  5. 5.
    Martens PJ, Frohlich N, Carriere KC, Derksen S, Brownell M. Embedding child health within a framework of regional health: Population health status and sociodemographic indicators. Can J Public Health 2002:93(Suppl 2):S15–S20.Google Scholar
  6. 6.
    Martens PJ, Bond R, Jebamani LS, Burchill CA, Roos NP, Derksen SA, et al. The Health and Health Care Use of Registered First Nations People Living in Manitoba: A Population-Based Study. Winnipeg: Manitoba Centre for Health Policy, 2002.Google Scholar
  7. 7.
    Martin JD, Uh SH. A vital statistics system for determining births and mortality in the First Nations population of British Columbia, Canada. Int J Circumpolar Health 2002;61(2):92–97.CrossRefGoogle Scholar
  8. 8.
    Rosenberg HM, Maurer JD, Sorlie PD, Johnson NJ, MacDorman MF, Hoyert DL, et al. Quality of death rates by race and Hispanic origin: A summary of current research, 1999. Vital Health Stat 2 1999;128:1–13.Google Scholar
  9. 9.
    Epstein M, Moreno R, Bacchetti P. The underreporting of deaths of American Indian children in California, 1979 through 1993. Am J Public Health 1997;87(8):1363–66.CrossRefGoogle Scholar
  10. 10.
    Hallett B, Nemeth M, Stevens H, Steward D. Aboriginal people in Manitoba 2000. Available on-line at: https://doi.org/www.gov.mb.ca/ana/apm2000/apm2000.pdf. (Accessed January 12, 2004)Google Scholar
  11. 11.
    Young TK. Population Health: Concepts and Methods. Oxford: Oxford University Press, 1998.Google Scholar
  12. 12.
    Health and Welfare Canada. Users Guide to 40 Community Health Indicators. Ottawa, Ontario: Community Health Division, Health Services and Promotion Branch, Health and Welfare Canada, 1992.Google Scholar
  13. 13.
    Carriere K, Roos LL. A method of comparison for standardized rates of low-incidence events. Med Care 1997;35(1):57–69.CrossRefGoogle Scholar
  14. 14.
    Health Canada. A Statistical Profile on the Health of First Nations in Canada. Ottawa, Ontario: Health Canada, 2003. Available on-line at: https://doi.org/www.hc-sc.gc.ca/fnihb/sppa/hia/Google Scholar
  15. 15.
    MacMillan HL, MacMillan AB, Offord DR, Dingle JL. Aboriginal health. CMAJ 1996;155(11):1569–78.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Young TK. The Health of Native Americans: Toward a Biocultural Epidemiology. New York: Oxford University Press, 1994.Google Scholar
  17. 17.
    Blandford AA, Chappell NL. Subjective well-being among Native and non-Native elderly persons: Do differences exist? Can J Aging 1990;9(4):386–99.CrossRefGoogle Scholar
  18. 18.
    Tjepkema M. The health of the off-reserve Aboriginal population. Health Rep 2002;13(Suppl):73–88.Google Scholar
  19. 19.
    Nickens HW. Race/ethnicity as a factor in health and health care. Health Serv Res 1995;30(1):151–62.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Williams R, Wright W, Hunt K. Social class and health: The puzzling counter-example of British South Asians. Soc Sci Med 1998;47(9):1277–88.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2005

Authors and Affiliations

  • Patricia J. Martens
    • 1
  • Doreen Sanderson
    • 2
  • Laurel S. Jebamani
    • 1
  1. 1.Manitoba Centre for Health Policy, Department of Community Health SciencesUniversity of ManitobaWinnipegCanada
  2. 2.Health Information Research Committee of the Assembly of Manitoba ChiefsCanada

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