Ralph-Campbell Kelli, Pohar Sheri L, Guirguis Lisa M, Toth Ellen L
Department of Medicine, University of Alberta, Edmonton, AB.
Can J Public Health. 2006 Jul-Aug;97(4):305-9. doi: 10.1007/BF03405609.
OBJECTIVE/BACKGROUND: Aboriginals constitute a substantial portion of the population of Northern Alberta. Determinants such as poverty and education can compound health-care accessibility barriers experienced by Aboriginals compared to non-Aboriginals. A diabetes care enhancement study involved the collection of baseline and follow-up data on Aboriginal and non-Aboriginal patients with known type 2 diabetes in two rural communities in Northern Alberta. Analyses were conducted to determine any demographic or clinical differences existing between Aboriginals and non-Aboriginals.
394 diabetes patients were recruited from the Peace and Keeweetinok Lakes health regions. 354 self-reported whether or not they were Aboriginal; a total of 94 self-reported being Aboriginal. Baseline and follow-up data were collected through interviews, standardized physical assessments, laboratory testing and self-reporting questionnaires (RAND-12 and HUI3).
Aboriginals were younger, with longer duration of diabetes, more likely to be female, and less likely to have completed high school. At baseline, self-reported health status was uniformly worse, but the differences disappeared with adjustments for sociodemographic confounders, except for perceived mental health status. Aboriginals considered their mental health status to be worse than non-Aboriginals at baseline. Some aspects of health utilization were also different.
While demographics were different and some utilization differences existed, overall this analysis demonstrates that "Aboriginality" does not contribute to diabetes outcomes when adjusted for appropriate variables.
目的/背景:原住民占阿尔伯塔省北部人口的很大一部分。与非原住民相比,贫困和教育等决定因素会加剧原住民在医疗保健可及性方面遇到的障碍。一项糖尿病护理改善研究收集了阿尔伯塔省北部两个农村社区中已知患有2型糖尿病的原住民和非原住民患者的基线和随访数据。进行分析以确定原住民和非原住民之间存在的任何人口统计学或临床差异。
从皮斯湖和基韦廷诺克湖健康区域招募了394名糖尿病患者。354人自行报告了他们是否为原住民;共有94人自称是原住民。通过访谈、标准化身体评估、实验室检测和自我报告问卷(RAND-12和HUI3)收集基线和随访数据。
原住民更年轻,糖尿病病程更长,女性比例更高,完成高中学业的可能性更小。在基线时,自我报告的健康状况普遍较差,但在对社会人口学混杂因素进行调整后,差异消失了,除了感知到的心理健康状况。原住民认为他们在基线时的心理健康状况比非原住民更差。健康利用的一些方面也有所不同。
虽然人口统计学不同且存在一些利用差异,但总体而言,该分析表明,在对适当变量进行调整后,“原住民身份”对糖尿病结局没有影响。