Abstract
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Background
Respiratory diseases are among the leading causes of acute care hospitalization for First Nations people. Poor housing conditions are associated with respiratory disorders and may be related to the likelihood of hospitalization. This analysis examines whether First Nations identity is associated with higher odds of hospitalization for respiratory conditions relative to non-Aboriginal persons, and whether such differences in hospitalization rates remain after consideration of housing conditions.
Data and methods
Data from the 2006 Census linked to the Discharge Abstract Database were used to analyze differences in hospitalization for respiratory tract infections and asthma between First Nations and non-Aboriginal people when housing conditions were taken into account.
Results
Rural on-reserve First Nations people were more likely than non-Aboriginal people to be hospitalized for a respiratory tract infection (1.5% versus 0.5%) or for asthma (0.2% versus 0.1%). For respiratory tract infection hospitalizations, adjustment for housing conditions, household income and residential location reduced differences, but the odds remained nearly three times higher for on-reserve First Nations people (OR = 2.83; CI: 2.69 to 2.99) and two times higher for off-reserve First Nations people (OR = 2.03; CI: 1.87 to 2.21), compared with the non-Aboriginal cohort. For asthma hospitalizations, adjustment for household income reduced the odds more than did adjustment for housing conditions. Even with full adjustment, the odds of asthma hospitalization relative to non-Aboriginal people remained significantly higher for First Nations people.
Interpretation
First Nations people are significantly more likely than non-Aboriginal people to be hospitalized for respiratory tract infections and asthma, even when housing conditions, household income and residential location are taken into account. While housing conditions are associated with such hospitalizations, household income may be more important.
Keywords
Aboriginal identity, asthma, crowding, data linkage, dwelling conditions, hospital records, respiratory tract infections
Findings
Diseases of the respiratory system are among the leading causes of acute care hospitalization for Aboriginal people in Canada, particularly First Nations people. These hospitalizations contribute to overall differences in acute care hospital use between the First Nations and non-Aboriginal populations, a finding consistent with American studies. [Full Text]
Authors
Gisèle M. Carrière (gisele.carriere@canada.ca), Rochelle Garner and Claudia Sanmartin are with the Health Analysis Division at Statistics Canada, Ottawa, Ontario.
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What is already known on this subject?
- Respiratory diseases are among the leading causes of acute care hospitalization for First Nations people.
- Poor housing conditions have been linked to respiratory diseases.
- Associations between housing conditions and respiratory-related hospitalization must account for the possible confounding effects of income and place of residence.
What does this study add?
- This study used 2006 Census of the Population data linked to the hospital Discharge Abstract Database to examine associations between housing conditions and respiratory-related acute care hospitalizations among First Nations and non-Aboriginal people.
- The analysis adjusted for location of residence (on/off reserves, rural/urban) and household income.
- While housing conditions were associated with the likelihood of hospitalization for respiratory tract infections and asthma, household income could be more important.
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