Abstract
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Background
Research that has examined Aboriginal children’s hospitalization rates at the national level has been limited to analyses of areas with large percentages of Aboriginal residents, rather than of Aboriginal individuals. This study uses linked census and administrative data to describe hospitalization patterns among children and youth aged 0 to 19, by Aboriginal identity, for all provinces and territories except Quebec.
Data and methods
The 2006 Census was linked to the 2006/2007-to-2008/2009 Discharge Abstract Database, which contains hospital records from all acute care facilities (except Quebec). Hospital records were examined by Aboriginal identity, as reported to the census, according to International Classification of Diseases chapters based on “the most responsible diagnosis.” Age-standardized hospitalization rates (ASHRs) were calculated per 100,000 population, and age-standardized rate ratios (RRs) were calculated for Aboriginal groups relative to non-Aboriginal people.
Results
ASHRs were consistently higher among Aboriginal children and youth relative to their non-Aboriginal counterparts; rates for children aged 0 to 9 were 1.4 to 1.8 times higher; for youth aged 10 to 19, 2.0 to 3.8 times higher. For all children aged 0 to 9, the leading cause of hospitalization was “diseases of the respiratory system,” but RRs for Aboriginal children ranged from 1.7 to 2.5, compared with non-Aboriginal children. Disparities between Aboriginal and non-Aboriginal 10- to 19-year-olds were pronounced for injuries due to assaults (RRs from 4.8 to 10.0), self-inflicted injuries (RRs from 2.7 to 14.2), and pregnancy, childbirth and the puerperium (RRs from 4.1 to 9.8).Interpretation
Additional research is needed to examine reasons for the disparities in hospitalization rates between Aboriginal and non-Aboriginal children and youth.
Keywords
Assault, First Nations, Inuit, Métis, respiratory, self-inflicted injury
Findings
Research has shown less favourable health outcomes for Aboriginal children and youth compared with their non-Aboriginal contemporaries. Analyses of provincial administrative data have also found higher rates of hospitalization for young Aboriginal people. Two studies reported an elevated rate of hospitalization for injury (intentional and unintentional) among children in areas with higher percentages of Aboriginal residents for all of Canada (excluding Quebec). However, geographic approaches tend to underestimate hospitalizations among subpopulations. [Full Text]
Authors
Gisèle Carrière (gisele.carriere@canada.ca) is with the Health Analysis Division at Statistics Canada, Vancouver, British Columbia. Anne Guèvremont, Evelyne Bougie and Dafna Kohen are with the Health Analysis Division at Statistics Canada, Ottawa, Ontario.
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What is already known on this subject?
- Previous studies based on geographic approaches have shown that Aboriginal children and youth experience less favourable health than non-Aboriginal children and youth.
- Geographic approaches tend to underestimate hospitalizations among subpopulations, because of omissions, misclassifications, and other errors.
What does this study add?
- This study examines national hospitalization rates (excluding Quebec) of Aboriginal children and youth at the individual level.
- Age-standardized hospitalization rates were consistently higher among Aboriginal children and youth relative to their non-Aboriginal contemporaries.
- The leading cause of hospitalization for both Aboriginal and non-Aboriginal 0- to 9-year-olds was conditions related to diseases of the respiratory system, but rates were higher for Aboriginal children.
- Disparities in hospitalization rates between Aboriginal and non-Aboriginal 10- to 19-year-olds were apparent for conditions related to intentional injuries (self-inflicted and assaults) and to pregnancy, childbirth, and the puerperium.
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