Health Reports, February 2014

Wednesday, February 19, 2014

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Unintentional injury hospitalizations and socio-economic status in areas with a high percentage of First Nations identity residents

Rates of hospitalization for unintentional injuries are higher in areas where a large percentage of residents report a First Nations identity, compared with areas where a low percentage of residents report an Aboriginal identity (First Nations, Métis and Inuit).

According to the new study “Unintentional injury hospitalizations and socio-economic status in areas with a high percentage of First Nations identity residents” in Health Reports, socio-economic conditions and remote location accounted for some, but not all, of the differences in unintentional injury hospitalizations between residents of high-percentage First Nations identity and low-percentage Aboriginal identity areas during the period from 2004/2005 to 2009/2010.

This suggests that factors not measured in this analysis — such as environmental or behavioural factors — play an additional role in area-level unintentional injury hospitalization risk.

Unintentional injuries are injuries for which there is no intent to harm, on the part of the victim or anyone else. Unintentional injuries are based on the external cause of the injury, and are considered predictable and preventable when proper safety measures are in place.

Hospitalization rates for unintentional injuries were higher in the least affluent and the most remote areas. However, when areas with the same socio-economic status and location were compared, the risk of being hospitalized because of an unintentional injury was greater in areas where a high percentage of residents reported a First Nations identity.

For example, in less socio-economically advantaged areas, injury hospitalization rates were 1.9 to 3.5 times greater in areas that had a higher percentage of First Nations identity residents. Trends were similar in areas with more favourable socio-economic conditions — injury hospitalization rates were at least two times greater in areas that had a high percentage of residents reporting a First Nations identity.

In remote areas, injury hospitalization rates were 1.3 to 2.6 times greater in areas with a higher percentage of First Nations identity residents. Similar findings were observed in urban areas, where injury hospitalization rates were 1.8 to 3.4 times greater in areas that had a high percentage of residents reporting a First Nations identity.

Almost without exception, the relationship between the percentage of area residents reporting an Aboriginal identity and unintentional injury hospitalization rates prevailed at all age groups examined and among both sexes.

Note to readers

The data used in the study were obtained using the hospital Discharge Abstract Database for 2004/2005 to 2009/2010 and the 2006 Census. Each hospital record contains information on the patient’s age, sex, diagnosis and residential postal code. Hospital records for the province of Quebec were not used in this study, because they contain only the first three digits of the six-digit postal code, and as a result, could not be linked geographically with sufficient precision.

Census dissemination areas (DAs) where 33% or more of the residents identified as Aboriginal in the 2006 Census were classified as high-percentage Aboriginal identity areas. DAs where fewer than 33% of residents reported an Aboriginal identity were classified as low-percentage Aboriginal identity areas. High-percentage Aboriginal DAs were further classified as First Nations, Métis, or Inuit areas based on the predominant Aboriginal group.

DAs were classified by socio-economic status, based on census data on income, education, labour force activity and housing conditions.

The remoteness of a DA was based on the percentage of the employed population who commute to work in a census metropolitan area or a census agglomeration.

Because individual Aboriginal identifiers are not available on hospital records, hospitalizations of Aboriginal people per se cannot be ascertained. Furthermore, the populations of DAs are comprised of Aboriginal and non-Aboriginal identity residents, so the results of this study pertain to all residents of those DAs and are not specific to First Nations people.

The study “Unintentional injury hospitalizations and socio-economic status in areas with a high percentage of First Nations identity residents” is available in the February 2014 online issue of Health Reports, Vol. 25, no. 2 (Catalogue number82-003-X) from theBrowse by key resource module of our website under Publications.

To enquire about the concepts, methods or data quality of this article, contact Evelyne Bougie (613-951-4765;evelyne.bougie@statcan.gc.ca) or Philippe Finès (514-283-6847; philippe.fines@statcan.gc.ca), Health Analysis Division.

This issue of Health Reports also contains a methodological article, “Estimating relative survival for cancer: An analysis of bias introduced by outdated life tables.” To enquire about the concepts, methods or data quality of this article, contact Larry F. Ellison (613-951-5244; larry.ellison@statcan.gc.ca), Health Statistics Division.

For more information, contact us (toll-free 1-800-263-1136; 514-283-8300; infostats@statcan.gc.ca).

For information about Health Reports, contact Janice Felman (613-951-6446; janice.felman@statcan.gc.ca), Health Analysis Division.

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