Iatrogenic Injury among the Aboriginal and Total Populations of British Columbia, Canada, 1991-2010: Inequities Associated with Ethnicity and Socioeconomic Status.

PURPOSE

Measure population health impact, and socioeconomic, geographic, and ethnic predictors of iatrogenic injury.

METHODS

Within three groups (total population, Aboriginal off-reserve, and Aboriginal on-reserve) in each of 16 Health Service Delivery Areas (HSDAs) of British Columbia, Canada we calculated crude incidence and Standardized Relative Risk (SRR) of hospitalization for iatrogenic injury. We tested hypothesized associations between HSDA census characteristics and SRR, by multivariable regression.

RESULTS

Among hospitalizations due to any injury, 22.2% were iatrogenic. Crude rate of iatrogenic injury hospitalization was 20.4 per 10,000 person-years. Aboriginal rate was 24.4 per 10,000 and SRR was 1.57 (1.76 among females, 1.38 among males). Non-metropolitan HSDAs had higher SRRs. The best-fitting regression model was an excellent fit (R=0.836, p<.001) and included education, income, house needs major repairs, population per room, and Aboriginal ethnicity.

CONCLUSIONS

Iatrogenic injury has significant population health impact. Aboriginal people, especially females, have higher risk. Ethnicity and socioeconomic factors explain regional disparities.