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Increasing Incidence and Prevalence of Diabetes among the Status Aboriginal Population in Urban and Rural Alberta, 1995–2006

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Abstract

Objective

To compare changes in diagnosed diabetes prevalence and incidence among Status Aboriginal men and women living in urban and rural areas of Alberta.

Methods

We compared trends in diabetes prevalence and incidence from 1995 to 2006 based on diagnostic codes from Alberta Health and Wellness (AHW) administrative records for adults aged 20 years and older. The AHW Registry file was used to determine registered Aboriginal status, as well as rural and urban residence (based on postal code). Multivariable logistic regression was used to compare diabetes rates over time, by sex and location of residence.

Results

Age- and sex-adjusted diabetes prevalence increased 35% in rural Status Aboriginals, from 10.9 (10.4–11.5) per 100 in 1995 to 14.7 (14.2–15.2) per 100 in 2006. Rates in urban Status Aboriginals increased 22% in the same time period from 9.4 (8.5–10.3) per 100 in 1995 to 11.5 (10.9–12.1) per 100 in 2006. The increases in prevalence were greater (p<0.001) for men (43% and 40%) compared to women (30% and 12%) in rural and urban settings, respectively. Diabetes incidence increased 45% in Status Aboriginal men, from 7.4 (4.9–10.6) per 1000 in 1995 to 10.7 (8.3–13.5) per 1000 in 2006 in urban locations, compared to a 35% increase among Status Aboriginal men living in rural locations (p=0.628). Among Status Aboriginal women, incidence increased by 25% for those living in urban locations, but did not change for those in rural locations (p=0.109).

Conclusions

Prevalence and incidence of diagnosed diabetes were highest in Status Aboriginal women, but these rates have increased faster in men over the past decade, regardless of their location of residence.

Résumé

Objectif

Comparer les changements de taux de prévalence et d’incidence du diabète diagnostiqué chez les hommes et les femmes qui appartiennent à la population autochtone et qui résident dans les régions urbaines et rurales de l’Alberta.

Méthodes

Nous avons comparé les tendances des taux de prévalence et d’incidence du diabète de 1995 à 2006, selon les codes de diagnostic des dossiers administratifs conservés par Alberta Health and Wellness (AHW) pour les adultes âgés de 20 ans ou plus. Les fichiers du registre d’AHW ont été utilisés pour déterminer le statut de personne inscrite comme Autochtone, en plus de sa résidence rurale ou urbaine (selon le code postal). Une analyse de régression logistique multidimensionnelle a été utilisée pour comparer les taux de diabète au fil des ans, selon le sexe et le lieu de résidence.

Résultats

Le taux de prévalence du diabète, rajusté pour tenir compte de l’âge et du sexe, a augmenté de 35 % chez les Autochtones qui résident en milieu rural, de 10,9 (10,4 à 11,5) par 100 habitants en 1995 à 14,7 (14,2 à 15,2) par 100 habitants en 2006. Le taux de prévalence du diabète chez les Autochtones qui résident en milieu urbain a augmenté de 22 % au cours de la même période, de 9,4 (8,5 à 10,3) par 100 habitants en 1995 à 11,5 (10,9 à 12,1) par 100 habitants en 2006. Les augmentations des taux de prévalence (p<0,001) chez les hommes (43 % et 40 %) ont été supérieures à celles des femmes (30 % et 12 %) dans les milieux ruraux et urbains, respectivement. Le taux d’incidence du diabète a augmenté de 45 % chez les hommes autochtones, de 7,4 (4,9 à 10,6) par 1000 habitants en 1995 à 10,7 (8,3 à 13,5) par 1000 habitants en 2006 dans les régions urbaines, comparativement à une augmentation de 35 % chez les hommes autochtones des régions rurales (p=0,628). Chez les femmes autochtones, le taux d’incidence a augmenté de 25 % dans les régions urbaines, mais il est demeuré le même dans les régions rurales (p=0,109).

Conclusions

Les taux de prévalence et d’incidence du diabète diagnostiqué étaient plus élevés chez les femmes autochtones, mais ces taux ont augmenté plus rapidement chez les hommes autochtones au cours de la dernière décennie, peu importe le lieu de résidence.

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Author information

Authors and Affiliations

  1. Department of Public Health Sciences, University of Alberta, Edmonton, AB, Canada

    Jeffrey A. Johnson PhD

  2. Institute of Health Economics, Edmonton, AB, Canada

    Jeffrey A. Johnson PhD, Stephanie U. Vermeulen MSc & Greg Hugel MSc

  3. Department of Medicine, University of Alberta, Edmonton, AB, Canada

    Ellen L. Toth MD, FRCPC, Kelli Ralph-Campbell BA & Malcolm King PhD

  4. Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada

    Brenda R. Hemmelgarn PhD, MD

  5. Department of Family Medicine, University of Calgary, Calgary, AB, Canada

    Lynden Crowshoe MD

Authors
  1. Jeffrey A. Johnson PhD
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  2. Stephanie U. Vermeulen MSc
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  3. Ellen L. Toth MD, FRCPC
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  4. Brenda R. Hemmelgarn PhD, MD
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  5. Kelli Ralph-Campbell BA
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  6. Greg Hugel MSc
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  7. Malcolm King PhD
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  8. Lynden Crowshoe MD
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Corresponding author

Correspondence to Jeffrey A. Johnson PhD.

Additional information

Acknowledgements: Dr. Johnson is a Health Scholar with the Alberta Heritage Foundation for Medical Research (AHFMR) and is a Canada Research Chair in Diabetes Health Outcomes; he is also Chair of an Emerging Team grant to the Alliance for Canadian Health Outcomes Research in Diabetes (ACHORD). The ACHORD Team grant is sponsored by the CIHR–Institute of Nutrition, Metabolism and Diabetes. Dr. Hemmelgarn is an AHFMR Population Health Investigator and a CIHR New Investigator.

This research was carried out in partnership with the Alberta ACADRE Network for Aboriginal Health Research (http://www.uofaweb.ualberta.ca/acadre/). The Network abides by a set of principles that include seeking participation and partnerships with Aboriginal people, respecting their diversity and unique cultural issues, and recognizing the importance of carrying out research that is relevant and of benefit.

Funding for the Alberta Diabetes Surveillance System comes from Alberta Health and Wellness. This study is based in part on de-identified data provided by Alberta Health and Wellness. We acknowledge Larry Svenson and Fred Ackah from Alberta Health and Wellness for their contribution to this analysis. The interpretation and conclusions contained herein do not necessarily represent those of the Government of Alberta or Alberta Health and Wellness.

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Johnson, J.A., Vermeulen, S.U., Toth, E.L. et al. Increasing Incidence and Prevalence of Diabetes among the Status Aboriginal Population in Urban and Rural Alberta, 1995–2006. Can J Public Health 100, 231–236 (2009). https://doi.org/10.1007/BF03405547

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  • DOI: https://doi.org/10.1007/BF03405547

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