1 Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba.
2 Manitoba FASD Centre, Winnipeg, Manitoba.
Can J Psychiatry. 2019 Sep;64(9):611-620. doi: 10.1177/0706743718816064. Epub 2018 Dec 30.
To examine health services, social services, education, and justice system outcomes among First Nations children and youth with fetal alcohol spectrum disorder (FASD).
In this retrospective cohort study, health and social services, education, and justice data were linked with clinical records on First Nations (FN) individuals aged 1 to 25 and diagnosed with FASD between 1999 and 2010 ( = 743). We compared the FN FASD group to non-FN individuals with FASD (non-FN FASD; = 315) and to First Nations individuals (matched on age, sex, and income) not diagnosed with FASD (FN non-FASD; = 2229). Rates and relative risks (RRs) were calculated using generalized linear models.
FN FASD individuals had similar health services use to non-FN FASD individuals but had greater involvement with child welfare (RR, 1.20; 95% confidence interval [CI], 1.02 to 1.41) and the justice system (RR, 1.37; 95% CI, 1.07 to 1.74) and were more likely to be charged with a crime (RR, 1.40; 95% CI, 1.05 to 1.86). There were no suicides/suicide attempts among the non-FN FASD individuals during the study, but the crude rate/100 person-years of suicides among FN FASD individuals (0.22 for females; 1.06 for males) was substantially higher than for FN non-FASD individuals (0.08 for females; 0.32 for males). There were no significant differences between groups in the education outcomes we measured.
Young people with FASD are at risk for poor health, education, and social outcomes, but First Nations young people with FASD face comparably higher risks, particularly with child welfare and justice system involvement. The study emphasizes a critical need for appropriate resources for First Nations children with FASD.
研究胎儿酒精谱系障碍（FASD）患儿和青少年的卫生服务、社会服务、教育和司法系统结局。
在这项回顾性队列研究中，将卫生和社会服务、教育和司法数据与临床记录相联系，对 1999 年至 2010 年间诊断为 FASD 的 1 至 25 岁的原住民（FN）个体进行了分析（=743）。我们将 FN FASD 组与患有 FASD 的非 FN 个体（非 FN FASD；=315）和未被诊断为 FASD 的 FN 个体（按年龄、性别和收入相匹配；FN 非 FASD；=2229）进行了比较。使用广义线性模型计算了比率和相对风险（RR）。
FN FASD 个体的卫生服务使用情况与非 FN FASD 个体相似，但与儿童福利（RR，1.20；95%置信区间[CI]，1.02 至 1.41）和司法系统（RR，1.37；95%CI，1.07 至 1.74）的关联度更高，且更有可能被指控犯罪（RR，1.40；95%CI，1.05 至 1.86）。非 FN FASD 个体在研究期间没有自杀/自杀未遂，但是 FN FASD 个体的自杀率/100 人年（女性 0.22；男性 1.06）明显高于 FN 非 FASD 个体（女性 0.08；男性 0.32）。我们测量的教育结果在组间没有显著差异。
患有 FASD 的年轻人面临健康、教育和社会结局不佳的风险，但 FN 患有 FASD 的年轻人面临更高的风险，特别是在儿童福利和司法系统参与方面。该研究强调了为 FN 患有 FASD 的儿童提供适当资源的迫切需要。
