Brussoni Mariana, George M Anne, Jin Andrew, Amram Ofer, McCormick Rod, Lalonde Christopher E
Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
PLoS One. 2018 Jan 26;13(1):e0191384. doi: 10.1371/journal.pone.0191384. eCollection 2018.
Worldwide, Indigenous people have disproportionately higher rates of transport injuries. We examined disparities in injury-related hospitalizations resulting from transport incidents for three population groups in British Columbia (BC): total population, Aboriginal off-reserve, and Aboriginal on-reserve populations. We also examined sociodemographic, geographic and ethnic risk markers for disparities.
We identified Aboriginal people through BC's universal health care insurance plan insurance premium group and birth and death record notations. We calculated crude incidence rate and Standardized Relative Risk (SRR) of hospitalization for unintentional transport injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with SRR of transport injury by multivariable linear regression.
During the period 1991-2010, the SRR for the off-reserve Aboriginal population was 1.77 (95% CI: 1.71 to 1.83); and 2.00 (95% CI: 1.93 to 2.07) among those living on-reserve. Decline in crude rate and SRRs was observed over this period among both the Aboriginal and total populations of BC, but was proportionally greater among the Aboriginal population. The best-fitting multivariable risk marker model was an excellent fit (R2 = 0.912, p<0.001), predicted SRRs very close to observed values, and retained the following terms: urban residence, population per room, proportion of the population with a high school certificate, proportion of the population employed; and multiplicative interactions of Aboriginal ethnicity with population per room and proportion of the population employed.
Disparities in risk of hospitalization due to unintentional transport injury have narrowed. Aboriginal ethnicity modifies the effects of socioeconomic risk factors. Continued improvement of socioeconomic conditions and implementation of culturally relevant injury prevention interventions are needed.
在全球范围内，原住民遭受交通伤害的比例格外高。我们研究了不列颠哥伦比亚省（BC）三个群体因交通事件导致的与伤害相关的住院差异：总人口、非保留地原住民和保留地原住民。我们还研究了导致差异的社会人口、地理和种族风险指标。
我们通过BC省的全民医疗保险计划保险费组以及出生和死亡记录注释来识别原住民。我们计算了非故意伤害性交通伤害住院的粗发病率和标准化相对风险（SRR），针对年龄、性别和卫生服务提供区域（HSDA）进行标准化，相对于BC省的总人口。我们通过多变量线性回归测试了原住民社区的地理、社会经济和就业相关特征与交通伤害SRR之间的假设关联。
在1991 - 2010年期间，非保留地原住民人口的SRR为1.77（95%置信区间：1.71至1.83）；保留地居住者的SRR为2.00（95%置信区间：1.93至2.07）。在此期间，BC省的原住民和总人口的粗发病率和SRR均有所下降，但原住民人口下降幅度更大。最佳拟合多变量风险指标模型拟合度极佳（R2 = 0.912，p<0.001），预测的SRR与观察值非常接近，并保留了以下因素：城市居住、每间房居住人数、拥有高中证书人口比例、就业人口比例；以及原住民种族与每间房居住人数和就业人口比例的相乘交互作用。
因非故意伤害性交通伤害导致的住院风险差异已缩小。原住民种族改变了社会经济风险因素的影响。需要持续改善社会经济状况并实施与文化相关的伤害预防干预措施。
