加拿大原住民中与吸烟和酗酒相关的社区及个人层面因素。
Community- and individual-level factors associated with smoking and heavy drinking among Aboriginal people in Canada.
作者信息
Kyu Hmwe Hmwe, Georgiades Katholiki, MacMillan Harriet L, Boyle Michael H
机构信息
Institute for Health Metrics and Evaluation, University of Washington.
出版信息
Can J Public Health. 2015 Feb 3;106(2):e22-8. doi: 10.17269/cjph.106.4663.
OBJECTIVES
- To examine the association between place of residence (i.e., on- versus off-communities and between provinces) and daily smoking and heavy drinking among Aboriginal people in Canada; and 2) to identify community- and individual-level factors that may account for these associations.
METHODS
Data were from the Aboriginal Peoples Survey (2001). The sample included 52,110 Aboriginal people (≥ 15 years of age). Community-level variables included: place of residence, community socio-economic status (SES) and perceived community social problems. Individual-level variables included: age, sex, education, income, employment status, marital status, Aboriginal heritage and social support. Multilevel logistic regressions were conducted to analyze the data.
RESULTS
Living in First Nations communities (compared with living off-communities) was associated with daily smoking, and this association was accounted for by perceived community social problems. However, the association between Inuit communities and daily smoking remained after controlling for all covariates (odds ratio (OR) = 1.97, 95% confidence intervals (CI) = 1.44-2.70). Residence in First Nations communities was associated with heavy drinking (OR = 1.54, 95% CI = 1.17-2.04), however this risk became evident only after controlling for community SES, which was also positively associated with heavy drinking (OR = 1.46, 95% CI = 1.26-1.69). Compared with Saskatchewan, Aboriginal people in Atlantic Provinces (OR = 2.80, 95% CI = 2.08-3.78) or Territories (OR = 1.39, 95% CI = 1.01-1.92) were more likely to engage in heavy drinking.
CONCLUSION
Studies are needed to better understand the increased risk for smoking in Inuit communities and heavy drinking in First Nations communities, Atlantic Provinces and Territories, and to identify possible reasons for the positive association between community SES and heavy drinking among Aboriginal people.
目的
1）研究加拿大原住民的居住地点（即保留地与非保留地以及不同省份之间）与每日吸烟及酗酒之间的关联；2）确定可能解释这些关联的社区层面和个人层面因素。
方法
数据来自《原住民调查》（2001年）。样本包括52110名原住民（年龄≥15岁）。社区层面变量包括：居住地点、社区社会经济地位（SES）以及感知到的社区社会问题。个人层面变量包括：年龄、性别、教育程度、收入、就业状况、婚姻状况、原住民血统以及社会支持。采用多水平逻辑回归分析数据。
结果
居住在第一民族社区（与居住在非保留地相比）与每日吸烟有关，这种关联可由感知到的社区社会问题来解释。然而，在控制所有协变量后，因纽特社区与每日吸烟之间的关联仍然存在（优势比（OR）=1.97，95%置信区间（CI）=1.44 - 2.70）。居住在第一民族社区与酗酒有关（OR = 1.54，95% CI = 1.17 - 2.04），然而，只有在控制了社区SES后，这种风险才变得明显，而社区SES也与酗酒呈正相关（OR = 1.46，95% CI = 1.26 - 1.69）。与萨斯喀彻温省相比，大西洋省份（OR = 2.80，95% CI = 2.08 - 3.78）或地区（OR = 1.39，95% CI = 1.01 - 1.92）的原住民更有可能酗酒。
结论
需要开展研究以更好地理解因纽特社区吸烟风险增加以及第一民族社区、大西洋省份和地区酗酒风险增加的情况，并确定原住民中社区SES与酗酒之间正相关的可能原因。
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