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Background
Keywords
Findings
Author
What is already known on this subject?
What does this study add?

Text begins

Background

Infant mortality and stillbirth rates among Aboriginal people are higher than in the rest of Canada, but little is known on the perinatal health status of First Nations people living on reserves. This study examines stillbirth and infant mortality rates among Aboriginal people in Quebec, notably, First Nations people living on reserves, and compares these rates with those of the province’s non-Aboriginal population.

Data and methods

Data on live births and stillbirths in Quebec from 1989 to 2008 were extracted from Statistics Canada’s Infant Birth-Death Linked File. Postal codes were used to identify births and stillbirths on First Nations reserves, in the Cree and Naskapi communities (not on reserves), and in Inuit communities. Associations between type of community and mortality were measured using logistic regression models.

Results

Aboriginal people had a higher stillbirth rate than non-Aboriginal people in Quebec, but this difference was not significant after adjusting for socio-demographic characteristics (mothers’ age and education, community size and isolation). Neonatal mortality was also higher among the Inuit. Post-neonatal mortality was higher among Aboriginal people, and was unrelated to differences in the mothers’ age and education or to community size and isolation. Adjusted odds ratios (95% confidence intervals) for post-neonatal mortality on reserves, in the Cree and Naskapi communities, and in Inuit communities were, respectively, 1.57 (1.16 - 2.12), 3.01 (2.14 - 4.24) and 4.29 (3.09 - 5.97).

Interpretation

Stillbirth and infant mortality are higher among Aboriginal people than non-Aboriginal people in Quebec. The differences in post-neonatal mortality are particularly pronounced.

Keywords

Databases, data linkage, First Nations, Inuit, vital statistics

Findings

Several studies have shown that infant mortality and stillbirth rates are higher among First Nations and Inuit people than in the rest of the Canadian population. In these studies, Aboriginal people were identified on the basis of residence in an area with a large percentage of Aboriginal people, census data, self-identification on birth records (British Columbia), or mother tongue of the mother (Quebec). [Full Text]

Author

When this study was conducted, Nicolas Gilbert (Nicolas.Gilbert@phac-aspc.gc.ca) was with the Quebec Regional Office of the First Nations and Inuit Health Branch, Health Canada, Montreal, Quebec.  Nathalie Auger is with the University of Montreal Hospital Research Centre, Montreal, Quebec. Michael Tjepkema is with the Health Analysis Division at Statistics Canada, Ottawa, Ontario.

What is already known on this subject?

  • Infant mortality and stillbirth rates are higher among Aboriginal people than among the rest of the Canadian population.

What does this study adds?

  • In Quebec, the Inuit, the Cree and the Naskapi (First Nations in the north of the province), and First Nations people living on reserves in the south of the province have stillbirth and post-neonatal mortality rates exceeding those of the rest of the province.
  • The excess neonatal mortality is independent of mothers’ age and education and the size and isolation of communities.
  • Post-neonatal mortality on First Nations reserves in southern Quebec is greater than that of the province's non-Aboriginal population, including non-Aboriginal communities that are isolated and socio-economically disadvantaged.
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