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Canadian Journal of Public Health

, Volume 96, Supplement 1, pp S45–S50 | Cite as

Demographic Risk Factors for Fracture in First Nations People

  • William D. LeslieEmail author
  • Shelley A. Derksen
  • Colleen Metge
  • Lisa M. Lix
  • Elizabeth A. Salamon
  • Pauline Wood Steiman
  • Leslie L. Roos
Article

Abstract

Background

Recently, First Nations people were shown to be at high fracture risk compared with the general population. However, factors contributing to this risk have not been examined. This analysis focusses on geographic area of residence, income level, and diabetes mellitus as possible explanatory variables since they have been implicated in the fracture rates observed in other populations.

Methods

A retrospective, population-based matched cohort study of fracture rates was performed using the Manitoba administrative health data (1987-1999). The First Nations cohort included all Registered First Nations adults (20 years or older) as indicated in either federal and/or provincial files (n=32,692). Controls (up to three for each First Nations subject) were matched by year of birth, sex and geographic area of residence. After exclusion of unmatched subjects, analysis was based upon 31,557 First Nations subjects and 79,720 controls.

Results

Overall and site-specific fracture rates were significantly higher in the First Nations cohort. Income quintile, geographic area of residence, and diabetes were fracture determinants but the excess fracture risk of First Nations ethnicity persisted even after adjustment for these factors.

Conclusion

First Nations people are at high risk for fracture but the causal factors contributing to this are unclear. Further research is needed to evaluate the importance of other potential explanatory variables.

MeSH terms

Ethnic group fractures Indians North American medical records systems, computerized osteoporosis 

Résumé

Contexte

On a récemment démontré que le risque de fracture était plus élevé chez les membres des Premières nations que dans la population générale. Cependant, les facteurs pouvant contribuer à ce risque n’ont pas été examinés. La présente étude porte sur la région de résidence, le niveau de revenu et le diabète sucré, qui pourraient être des variables explicatives, car elles jouent un rôle dans les taux de fracture observés dans d’autres populations.

Méthode

À l’aide des données administratives sur la santé du Manitoba (1987-1999), nous avons mené une étude de cohortes représentative et rétrospective portant sur les taux de fracture. La cohorte des Premières nations comprenait tous les membres des Premières nations d’âge adulte (20 ans et plus) désignés comme étant „ inscrits ” dans les bases de données fédérales et/ou provinciales (n = 32 692). Les témoins (jusqu’à trois pour chaque sujet des Premières nations) ont été assortis aux cas selon l’année de naissance, le sexe et la région de résidence. Après avoir exclu les cas non assortis, notre analyse s’est fondée sur 31 557 sujets des Premières nations et 79 720 témoins.

Résultats

Les taux de fracture globaux et par site étaient sensiblement plus élevés dans la cohorte des Premières nations. Le quintile de revenu, la région de résidence et le diabète étaient des déterminants du taux de fracture, mais il subsiste un risque de fracture plus élevé chez les membres des Premières nations, même après ajustement selon ces trois facteurs.

Conclusion

Les membres des Premières nations présentent un risque de fracture élevé, mais les facteurs causals de cette situation ne sont pas clairs. Il faudrait pousser la recherche pour évaluer l’importance d’autres variables explicatives possibles.

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Copyright information

© The Canadian Public Health Association 2005

Authors and Affiliations

  • William D. Leslie
    • 1
    Email author
  • Shelley A. Derksen
    • 2
  • Colleen Metge
    • 2
  • Lisa M. Lix
    • 2
  • Elizabeth A. Salamon
    • 1
  • Pauline Wood Steiman
    • 3
  • Leslie L. Roos
    • 2
  1. 1.Department of MedicineUniversity of ManitobaWinnipegCanada
  2. 2.Manitoba Centre for Health Policy, Department of Community Health SciencesUniversity of ManitobaWinnipegCanada
  3. 3.Assembly of Manitoba Chiefs’ Health Information and Research CommitteeCanada

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