Poster #14 - Using Canadian Linked Administrative Health Data to Examine Health Disparities for Aboriginal and non-Aboriginal Children

• In Event: 3-001 - Poster Session 2 during Breakfast

Abstract

Aboriginal children and youth are among Canada’s most vulnerable, facing conditions of poverty and poor outcomes in early childhood and throughout the life course. This study uses Canadian linked administrative data to better understand health, health disparities, and patterns of health care use by Aboriginal children and youth. Previous studies examining patterns of hospitalizations have been limited to areas with large concentrations of Aboriginal residents or have been based on survey data. To date, it has not been possible to examine hospitalizations for Aboriginal children and youth at the national level, because hospital administrative data do not uniformly include information about Aboriginal identity. This study does so by linking hospital discharge data with the Canadian Census. Study findings will be important to understand differences in health outcomes and provide an evidence base to target policies and interventions for vulnerable children and youth.

Data and methods: The 2006 Canadian Census was linked to the 2006/2007-to-2008/2009 Discharge Abstract Database, which contains hospital records from all acute care facilities in Canada (except Quebec). Analyses included a comparison of hospitalization records by Aboriginal identity, as reported to the census, and grouped by International Classification of Diseases (ICD-10) chapters based on “the most responsible diagnosis.” Age-standardized hospitalization rates (ASHR) were calculated per 100,000 population, and rate ratios (RR) were calculated for Aboriginal groups relative to non-Aboriginal people.

Results: Hospitalization rates were consistently higher among Aboriginal children and youth relative to their non-Aboriginal counterparts, with rates for children aged 0 to 9 1.5 times higher and rates for 10 to 19 year olds 2.0 to 3.8 times higher. For all children, the leading cause of hospitalization was “diseases of the respiratory system,” but RRs for Aboriginal children ranged from 1. 7 to 2. 5. For 10 to 19 year olds, disparities existed between Aboriginal and non-Aboriginal for a number of conditions, including injury due to assaults (RRs from 4.8 to 10.0), self-inflicted (RR 2.7 to 14.2), and pregnancy and childbirth (RR 4.1 to 9.8).

Discussion: This study demonstrates the health disparities for vulnerable populations of children such as Indigenous children. Physicians and policy makers should be aware of both intentional and unintentional injuries as well as pregnancy as areas of focus of improved health for children and youth in this population.

Authors

• Dafna Kohen, Statistics Canada/University of Ottawa
  Presenting Author

• Evelyne Bougie, Statistics Canada

• Gisele Carriere, Statistics Canada

• Anne Guevremont, Statistics Canada