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Mortality Comparisons of First Nations to All Other Manitobans: A Provincial Population-based Look at Health Inequalities by Region and Gender

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Abstract

Background

To examine inequalities in health status of Registered First Nations Manitobans compared to all other Manitobans.

Methods

Three mortality indicators - premature mortality rate (PMR) defined as an age-and sex-adjusted rate of death before age 75 years; life expectancy from birth; and potential years of life lost (PYLL) - are compared between Registered First Nations (RFN) people and all other Manitobans (AOM) by geographical areas of Manitoba. Data were derived from the Population Health Research Data Repository, linked to the federal Status Verification System (SVS) files for the years 1995 through 1999.

Results

First Nations experienced double the PMR compared to all other Manitobans (6.6 versus 3.3 deaths per thousand, p<0.05), an eight-year gap in life expectancy (males: 68.4 versus 76.1 years; females 73.2 versus 81.4 years), and over twice the PYLL (males 158.3 versus 62.5 years of life lost per thousand; females 103.3 versus 36.5). RFN male life expectancy was geographically-related (better health status in the north), and inversely related to the corresponding regional AOM life expectancy (r = -0.61, 9 df, one-tailed, p<0.03). As regional percentage of RFN decreased, male life expectancy decreased (r = 0.77, 9 df, one-tailed, p<0.003). In contrast, RFN female indicators showed no such relationship.

Conclusion

The inequality in health status between RFN and all other Manitobans is large, but also shows differential geographical and gender effects.

Résumé

Contexte

Nous avons étudié les inégalités sur le plan de la santé chez les membres inscrits des Premières nations manitobaines par rapport au reste de la population du Manitoba.

Méthode

Nous avons comparé trois indices de mortalité - le taux de mortalité prématurée (TMP), défini comme étant le taux de décès avant 75 ans ajusté selon l’âge et le sexe; l’espérance de vie à la naissance; et les années potentielles de vie perdues (APVP) - pour les membres inscrits des Premières nations et le reste de la population du Manitoba selon les zones géographiques de la province. Les données ont été dérivées d’un registre, le Population Health Research Data Repository, lié au Système de vérification du statut (SVS) fédéral, pour la période de 1995 à 1999.

Résultats

Chez les membres des Premières nations, le TMP était le double de celui du reste de la population du Manitoba (6,6 c. 3,3 décès p. 1 000, p<0,05), l’espérance de vie était inférieure de huit ans (chez les hommes, 68,4 c. 76,1 ans; chez les femmes, 73,2 c. 81,4 ans), et les APVP étaient plus de deux fois supérieures (chez les hommes, 158,3 c. 62,5 années de vie perdues p. 1 000; chez les femmes, 103,3 c. 36,5). Chez les hommes, l’espérance de vie des membres inscrits des Premières nations était liée à la zone géographique (l’état de santé était meilleur dans le Nord) et réciproquement liée à l’espérance de vie du reste de la population du Manitoba dans la zone correspondante (r = 0,61, degré de liberté = 9, test unilatéral, p<0,03). À mesure que le pourcentage régional des membres inscrits des Premières nations diminue, l’espérance de vie des hommes diminue (r = 0,77, degré de liberté = 9, test unilatéral, p<0,003). Par contre, les indices concernant les femmes inscrites des Premières nations ne permettent pas d’établir de tels liens.

Conclusion

Les inégalités entre les membres inscrits des Premières nations et le reste de la population du Manitoba sur le plan de l’état de santé sont importantes, mais elles diffèrent selon la zone géographique et le sexe.

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Authors and Affiliations

  1. Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, 4th Floor, Room 408, 727 McDermot Avenue, Winnipeg, MB, R3E 3P5, Canada

    Patricia J. Martens PhD & Laurel S. Jebamani MSc

  2. Health Information Research Committee of the Assembly of Manitoba Chiefs, Canada

    Doreen Sanderson

Authors
  1. Patricia J. Martens PhD
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  2. Doreen Sanderson
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  3. Laurel S. Jebamani MSc
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Corresponding author

Correspondence to Patricia J. Martens PhD.

Additional information

The full report “The Health and Health Care Use of Registered First Nations People Living in Manitoba: A Population-Based Study” on which this article is based is available from the Manitoba Centre for Health Policy at the above address or on-line at: http://www.umanitoba.ca/centres/mchp/reports.htm

Acknowledgements of Sources of Support: This work was supported as part of a project on First Nations health in Manitoba, one of several projects undertaken each year by the Manitoba Centre for Health Policy under contract to Manitoba Health. The results and conclusions are those of the authors and no official endorsement by Manitoba Health was intended or should be inferred. Dr. Martens is also supported by a Community Alliances for Health Research Program grant from the Canadian Institutes of Health Research (CIHR), as well as a CIHR New Investigator’s Award. The authors are indebted to Health Information Services, Manitoba Health, First Nations and Inuit Health Branch, Indian and Northern Affairs Canada, and the Office of Vital Statistics in the Agency of Consumer and Corporate Affairs for the provision of data. Thanks to the Health Information Research Committee of the Assembly of Manitoba Chiefs, who acted as the Working Group (1999-2002) for the First Nations Report from which this paper was derived.

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Martens, P.J., Sanderson, D. & Jebamani, L.S. Mortality Comparisons of First Nations to All Other Manitobans: A Provincial Population-based Look at Health Inequalities by Region and Gender. Can J Public Health 96 (Suppl 1), S33–S38 (2005). https://doi.org/10.1007/BF03405314

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