Vol 11: What is the comparative health status and associated risk factors for the Mtis A population-based study in Manitoba, Canada.Report as inadecuate



 Vol 11: What is the comparative health status and associated risk factors for the Mtis A population-based study in Manitoba, Canada.


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This article is from BMC Public Health, volume 11.AbstractBackground: Métis are descendants of early 17th century relationships between North American Indians and Europeans. This studys objectives were: 1 to compare the health status of the Métis people to all other residents of Manitoba, Canada; and 2 to analyze factors in predicting the likelihood of diabetes and related lower limb amputation. Methods: Using de-identified administrative databases plus the Métis Population Database housed at the Manitoba Centre for Health Policy, age-sex-adjusted rates of mortality and disease were calculated for Métis n = 73,016 and all other Manitobans n = 1,104,672. Diseases included: hypertension, arthritis, diabetes, ischemic heart disease age 19+; osteoporosis age 50+; acute myocardial infarction AMI and stroke age 40+; total respiratory morbidity TRM, all ages. Using logistic regression, predictors of diabetes 2004-05-2006-07 and diabetes-related lower-limb amputations 2002-03-2006-07 were analyzed. Results: Disease rates were higher for Métis compared to all others: premature mortality before age 75 4.0 vs. 3.3 per 1000, p .001; total mortality 9.7 vs. 8.4 per 1000, p .001; injury mortality 0.58 vs. 0.51 per 1000, p .03; Potential Years of Life Lost 64.6 vs. 54.6 per 1000, p .001; all-cause 5-year mortality for people with diabetes 20.8% vs. 18.6%, p .02; hypertension 27.9% vs. 24.8%, p .001; arthritis 24.2% vs. 19.9%, p .001, TRM 13.6% vs. 10.6%, p .001; diabetes 11.8% vs. 8.8%, p .001; diabetes-related lower limb amputation 24.1 vs. 16.2 per 1000, p .001; ischemic heart disease 12.2% vs. 8.7%, p .001; osteoporosis 12.2% vs. 12.3%, NS, dialysis initiation 0.46% vs. 0.34%, p .001; AMI 5.4 vs. 4.3 per 1000, p .001; stroke 3.6 vs. 2.9 per 1000, p .001. Controlling for geography, age, sex, income, continuity of care and comorbidities, Métis were more likely to have diabetes aOR = 1.29, 95% CI 1.25-1.34, but not diabetes-related lower limb amputation aOR = 1.13, 95% CI 0.90-1.40, NS. Continuity of care was associated with decreased risk of amputation both provincially aOR = 0.71, 95% CI 0.62-0.81 and for Métis alone aOR = 0.62, 95% CI 0.40-0.96. Conclusion: Despite universal healthcare, Métis illness and mortality rates are mostly higher. Although elevated diabetes risk persists for the Métis even after adjusting for sociodemographic, healthcare and comorbidity variables, the risk of amputation for Métis appears more related to healthcare access rather than ethnicity.



Author: Martens, Patricia J; Bartlett, Judith G; Prior, Heather J; Sanguins, Julianne; Burchill, Charles A; Burland, Elaine MJ; Carter, Sheila

Source: https://archive.org/



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