School of Social Work, University of Windsor, Ontario, Canada.
School of Social Work, Wichita State University, Wichita, Kansas, USA.
Can J Rural Med. 2022 Apr-Jun;27(2):51-60. doi: 10.4103/cjrm.cjrm_42_21.
Indigenous Peoples are much more likely than non-Indigenous Peoples to be seriously injured or die in motor vehicle collisions (MVCs). This study updates and extends a previous systematic review, suggesting that future research ought to incorporate social-environmental factors.
We conducted a systematic review and meta-analysis of the published and grey literature on MVCs involving Indigenous Peoples in Canada between 2010 and 2020. We focussed on personal (e.g. driving an old vehicle) and community social-environmental-economic factors (e.g. prevalent low socioeconomic status).
Eleven comparative cohorts that resulted in 23 at minimum, age-standardised, mortality or morbidity rate outcomes were included in our meta-analysis. Indigenous Peoples were twice as likely as non-Indigenous Peoples to be seriously injured (rate ratio [RRpooled] = 2.18) and more than 3 times as likely to die (RR = 3.40) in MVCs. Such great risks to Indigenous Peoples do not seem to have diminished over the past generation. Furthermore, such risks were greater on-reserves and in smaller, rural and remote, places.
Such places may lack community resources, including fewer transportation and healthcare infrastructural investments, resulting in poorer road conditions in Indigenous communities and longer delays to trauma care. This seems to add further evidence of geo-structural violence (geographical and institutional violence) perpetrated against Indigenous Peoples in yet more structures (i.e. institutions) of Canadian society. Canada's system of highways and roadways and its remote health-care system represent legitimate policy targets in aiming to solve this public health problem.
与非原住民相比，原住民在机动车碰撞（MVC）中更有可能受重伤或死亡。本研究对之前的系统综述进行了更新和扩展，表明未来的研究应该纳入社会环境因素。
我们对 2010 年至 2020 年期间在加拿大发生的涉及原住民的 MVC 的已发表和灰色文献进行了系统评价和荟萃分析。我们专注于个人（例如驾驶旧车辆）和社区社会环境经济因素（例如普遍存在的低社会经济地位）。
我们的荟萃分析纳入了 11 项比较队列研究，这些研究至少产生了 23 项年龄标准化的死亡率或发病率结果。与非原住民相比，原住民在 MVC 中受重伤的可能性是其两倍（pooled 率比 [RR] = 2.18），死亡的可能性是其三倍以上（RR = 3.40）。在过去的一代人中，原住民面临的此类巨大风险似乎并未减少。此外，此类风险在保留地以及较小的农村和偏远地区更大。
这些地方可能缺乏社区资源，包括交通和医疗保健基础设施投资较少，导致原住民社区的道路状况较差，创伤护理的延迟时间更长。这似乎进一步证明了针对原住民的地缘结构暴力（地理和机构暴力）在加拿大社会的更多结构（即机构）中持续存在。加拿大的高速公路和道路系统及其偏远的医疗保健系统是解决这一公共卫生问题的合法政策目标。
