Crighton Eric J, Wilson Kathi, Senécal Sacha
Department of Geography, University of Ottawa, Ottawa, ON K1N 7Z5, Canada.
Int J Circumpolar Health. 2010 Apr;69(2):138-50. doi: 10.3402/ijch.v69i2.17435. Epub 2010 Mar 29.
To examine the prevalence, exacerbations and management of asthma among Canada's Aboriginal populations, and its relationship to socio-economic and geographic factors.
Secondary analysis of a national cross-sectional questionnaire survey.
Data were collected in 2000 and 2001 through a survey of Aboriginal children and adults residing on- and off-reserve as part of the 2001 Aboriginal People's Survey (APS). The asthma related outcome variables - physician-diagnosed asthma, attack in past year and regular use of inhalants - were examined in relation to socio-economic and geographic factors such as income, education, housing and location of residence. Statistical analyses were based on weighted univariate and multivariate logistic regressions.
The results show variations in asthma diagnosis, attacks and inhalant use across geographic location, socio-economic and demographic characteristics. Geographic location was found to be significantly associated with asthma for both adults and children, with those living in the northern territories, on-reserve or rural locations being the least likely to be diagnosed. Geographic location and Aboriginal identity were also found to be significantly associated with asthma medication use.
While these findings may suggest a "healthier" population in more remote locations, they alternatively point to a general pattern of under-diagnosis, potentially due to poor health care access, as is typical in more remote locations.
调查加拿大原住民人群中哮喘的患病率、病情加重情况及管理方式,及其与社会经济和地理因素的关系。
对一项全国性横断面问卷调查进行二次分析。
作为2001年原住民调查(APS)的一部分,于2000年和2001年通过对居住在保留地和非保留地的原住民儿童及成人进行调查来收集数据。研究了与哮喘相关的结果变量——医生诊断的哮喘、过去一年的发作情况以及吸入剂的常规使用情况——与收入、教育、住房和居住地点等社会经济和地理因素的关系。统计分析基于加权单变量和多变量逻辑回归。
结果显示,哮喘诊断、发作情况和吸入剂使用情况因地理位置、社会经济和人口特征而异。研究发现,地理位置与成人和儿童的哮喘均显著相关,居住在北部地区、保留地或农村地区的人被诊断出哮喘的可能性最小。地理位置和原住民身份也与哮喘药物使用显著相关。
虽然这些发现可能表明在更偏远地区的人群“更健康”,但它们也指向了一种普遍的诊断不足模式,这可能是由于在更偏远地区通常存在的医疗服务可及性差所致。