Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
BMC Public Health. 2021 Dec 30;21(1):2325. doi: 10.1186/s12889-021-12369-1.
The aim was to study any spatial and/or temporal patterns of ischemic heart disease (IHD) prevalence and measure the effects of selected social determinants on these spatial and space-time patterns.
Data were obtained from the Population Research Data Repository housed at the Manitoba Centre for Health Policy to identify persons who were diagnosed with IHD between 1995 and 2018. These persons were geocoded to 96 geographic regions of Manitoba. An area-level socioeconomic factor index (SEFI-2) and the proportion of the population who was Indigenous were calculated for each geographic region using the 2016 Canadian Census data. Associations between these factors and IHD prevalence were measured using Bayesian spatial Poisson regression models. Temporal trends and spatio-temporal trends were measured using Bayesian spatio-temporal Poisson regression models.
Univariable models showed a significant association with increased regional Indigenous population proportion associated with a higher prevalence of IHD (RR: 0.07, 95% CredInt: (0.05, 0.10)) and for SEFI-2 (RR: 0.17, 95% CredInt: (0.11, 0.23)). Using a multivariable model, after accounting for the proportion of the population that was Indigenous, there was no evidence of an association between IHD prevalence and area-level socioeconomic factor. Spatio-temporal models showed no significant overall temporal trend in IHD prevalence, but there were significant spatially varying temporal trends within the 96 regions.
Association between Indigenous population proportion and IHD is consistent with previous research. No significant overall temporal trend was measured. However, regions with significantly increasing trends and significantly decreasing trends in IHD prevalence were identified.
本研究旨在探讨缺血性心脏病（IHD）患病率的时空模式，并衡量选定社会决定因素对这些时空模式的影响。
从曼尼托巴省卫生政策中心的人口研究数据存储库中获取数据，以确定 1995 年至 2018 年间被诊断患有 IHD 的人员。将这些人员进行地理编码，划分到曼尼托巴省的 96 个地理区域。使用 2016 年加拿大人口普查数据，为每个地理区域计算了一个区域社会经济因素指数（SEFI-2）和土著人口比例。使用贝叶斯空间泊松回归模型来衡量这些因素与 IHD 患病率之间的关联。使用贝叶斯时空泊松回归模型来衡量时间趋势和时空趋势。
单变量模型显示，区域土著人口比例与 IHD 患病率呈显著正相关（RR：0.07，95%可信区间：（0.05，0.10）），与 SEFI-2 也呈显著正相关（RR：0.17，95%可信区间：（0.11，0.23））。在多变量模型中，在考虑了土著人口比例后，IHD 患病率与区域社会经济因素之间没有关联的证据。时空模型显示，IHD 患病率没有显著的总体时间趋势，但在 96 个区域内存在显著的时空变化趋势。
土著人口比例与 IHD 之间的关联与先前的研究一致。没有测量到 IHD 患病率的总体时间趋势。然而，确定了一些 IHD 患病率呈显著增加和显著下降趋势的区域。
