Explaining the variability in cardiovascular risk factors among First Nations communities in Canada: a population-based study
Summary: Background: Historical, colonial, and racist policies continue to influence the health of Indigenous people, and they continue to have higher rates of chronic diseases and reduced life expectancy compared with non-Indigenous people. We determined factors accounting for variations in cardiov...
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Online Access: | https://doi.org/10.1016/S2542-5196(19)30237-2 https://doaj.org/article/18f929a6ac4c46d3b216681383db3596 |
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ftdoajarticles:oai:doaj.org/article:18f929a6ac4c46d3b216681383db3596 2023-05-15T16:15:49+02:00 Explaining the variability in cardiovascular risk factors among First Nations communities in Canada: a population-based study Sonia S Anand, ProfMD Sylvia Abonyi, PhD Laura Arbour, ProfMD Kumar Balasubramanian, MSc Jeffrey Brook, PhD Heather Castleden, PhD Vicky Chrisjohn Ida Cornelius, RN Albertha Darlene Davis, RN Dipika Desai, MSc Russell J de Souza, ScD Matthias G Friedrich, ProfMD Stewart Harris, ProfMD James Irvine, MD Jean L'Hommecourt Randy Littlechild Lisa Mayotte, RN Sarah McIntosh, MSc Julie Morrison, Med Richard T Oster, PhD Manon Picard, BSc Paul Poirier, ProfMD Karleen M Schulze, MMath Ellen L Toth, ProfMD 2019-12-01T00:00:00Z https://doi.org/10.1016/S2542-5196(19)30237-2 https://doaj.org/article/18f929a6ac4c46d3b216681383db3596 EN eng Elsevier http://www.sciencedirect.com/science/article/pii/S2542519619302372 https://doaj.org/toc/2542-5196 2542-5196 doi:10.1016/S2542-5196(19)30237-2 https://doaj.org/article/18f929a6ac4c46d3b216681383db3596 The Lancet Planetary Health, Vol 3, Iss 12, Pp e511-e520 (2019) Environmental sciences GE1-350 article 2019 ftdoajarticles https://doi.org/10.1016/S2542-5196(19)30237-2 2022-12-31T03:34:09Z Summary: Background: Historical, colonial, and racist policies continue to influence the health of Indigenous people, and they continue to have higher rates of chronic diseases and reduced life expectancy compared with non-Indigenous people. We determined factors accounting for variations in cardiovascular risk factors among First Nations communities in Canada. Methods: Men and women (n=1302) aged 18 years or older from eight First Nations communities participated in a population-based study. Questionnaires, physical measures, blood samples, MRI of preclinical vascular disease, and community audits were collected. In this cross-sectional analysis, the main outcome was the INTERHEART risk score, a measure of cardiovascular risk factor burden. A multivariable model was developed to explain the variations in INTERHEART risk score among communities. The secondary outcome was MRI-detected carotid wall volume, a measure of subclinical atherosclerosis. Findings: The mean INTERHEART risk score of all communities was 17·2 (SE 0·2), and more than 85% of individuals had a risk score in the moderate to high risk range. Subclinical atherosclerosis increased significantly across risk score categories (p<0·0001). Socioeconomic advantage (–1·4 score, 95% CI −2·5 to −0·3; p=0·01), trust between neighbours (–0·7, −1·2 to −0·3; p=0·003), higher education level (–1·9, −2·9 to −0·8, p<0·001), and higher social support (–1·1, −2·0 to −0·2; p=0·02) were independently associated with a lower INTERHEART risk score; difficulty accessing routine health care (2·2, 0·3 to 4·1, p=0·02), taking prescription medication (3·5, 2·8 to 4·3; p<0·001), and inability to afford prescription medications (1·5, 0·5 to 2·6; p=0·003) were associated with a higher INTERHEART risk score. Collectively, these factors explained 28% variation in the cardiac risk score among communities. Communities with higher socioeconomic advantage and greater trust, and individuals with higher education and social support, had a lower INTERHEART risk score. ... Article in Journal/Newspaper First Nations Directory of Open Access Journals: DOAJ Articles Canada The Lancet Planetary Health 3 12 e511 e520 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Environmental sciences GE1-350 |
spellingShingle |
Environmental sciences GE1-350 Sonia S Anand, ProfMD Sylvia Abonyi, PhD Laura Arbour, ProfMD Kumar Balasubramanian, MSc Jeffrey Brook, PhD Heather Castleden, PhD Vicky Chrisjohn Ida Cornelius, RN Albertha Darlene Davis, RN Dipika Desai, MSc Russell J de Souza, ScD Matthias G Friedrich, ProfMD Stewart Harris, ProfMD James Irvine, MD Jean L'Hommecourt Randy Littlechild Lisa Mayotte, RN Sarah McIntosh, MSc Julie Morrison, Med Richard T Oster, PhD Manon Picard, BSc Paul Poirier, ProfMD Karleen M Schulze, MMath Ellen L Toth, ProfMD Explaining the variability in cardiovascular risk factors among First Nations communities in Canada: a population-based study |
topic_facet |
Environmental sciences GE1-350 |
description |
Summary: Background: Historical, colonial, and racist policies continue to influence the health of Indigenous people, and they continue to have higher rates of chronic diseases and reduced life expectancy compared with non-Indigenous people. We determined factors accounting for variations in cardiovascular risk factors among First Nations communities in Canada. Methods: Men and women (n=1302) aged 18 years or older from eight First Nations communities participated in a population-based study. Questionnaires, physical measures, blood samples, MRI of preclinical vascular disease, and community audits were collected. In this cross-sectional analysis, the main outcome was the INTERHEART risk score, a measure of cardiovascular risk factor burden. A multivariable model was developed to explain the variations in INTERHEART risk score among communities. The secondary outcome was MRI-detected carotid wall volume, a measure of subclinical atherosclerosis. Findings: The mean INTERHEART risk score of all communities was 17·2 (SE 0·2), and more than 85% of individuals had a risk score in the moderate to high risk range. Subclinical atherosclerosis increased significantly across risk score categories (p<0·0001). Socioeconomic advantage (–1·4 score, 95% CI −2·5 to −0·3; p=0·01), trust between neighbours (–0·7, −1·2 to −0·3; p=0·003), higher education level (–1·9, −2·9 to −0·8, p<0·001), and higher social support (–1·1, −2·0 to −0·2; p=0·02) were independently associated with a lower INTERHEART risk score; difficulty accessing routine health care (2·2, 0·3 to 4·1, p=0·02), taking prescription medication (3·5, 2·8 to 4·3; p<0·001), and inability to afford prescription medications (1·5, 0·5 to 2·6; p=0·003) were associated with a higher INTERHEART risk score. Collectively, these factors explained 28% variation in the cardiac risk score among communities. Communities with higher socioeconomic advantage and greater trust, and individuals with higher education and social support, had a lower INTERHEART risk score. ... |
format |
Article in Journal/Newspaper |
author |
Sonia S Anand, ProfMD Sylvia Abonyi, PhD Laura Arbour, ProfMD Kumar Balasubramanian, MSc Jeffrey Brook, PhD Heather Castleden, PhD Vicky Chrisjohn Ida Cornelius, RN Albertha Darlene Davis, RN Dipika Desai, MSc Russell J de Souza, ScD Matthias G Friedrich, ProfMD Stewart Harris, ProfMD James Irvine, MD Jean L'Hommecourt Randy Littlechild Lisa Mayotte, RN Sarah McIntosh, MSc Julie Morrison, Med Richard T Oster, PhD Manon Picard, BSc Paul Poirier, ProfMD Karleen M Schulze, MMath Ellen L Toth, ProfMD |
author_facet |
Sonia S Anand, ProfMD Sylvia Abonyi, PhD Laura Arbour, ProfMD Kumar Balasubramanian, MSc Jeffrey Brook, PhD Heather Castleden, PhD Vicky Chrisjohn Ida Cornelius, RN Albertha Darlene Davis, RN Dipika Desai, MSc Russell J de Souza, ScD Matthias G Friedrich, ProfMD Stewart Harris, ProfMD James Irvine, MD Jean L'Hommecourt Randy Littlechild Lisa Mayotte, RN Sarah McIntosh, MSc Julie Morrison, Med Richard T Oster, PhD Manon Picard, BSc Paul Poirier, ProfMD Karleen M Schulze, MMath Ellen L Toth, ProfMD |
author_sort |
Sonia S Anand, ProfMD |
title |
Explaining the variability in cardiovascular risk factors among First Nations communities in Canada: a population-based study |
title_short |
Explaining the variability in cardiovascular risk factors among First Nations communities in Canada: a population-based study |
title_full |
Explaining the variability in cardiovascular risk factors among First Nations communities in Canada: a population-based study |
title_fullStr |
Explaining the variability in cardiovascular risk factors among First Nations communities in Canada: a population-based study |
title_full_unstemmed |
Explaining the variability in cardiovascular risk factors among First Nations communities in Canada: a population-based study |
title_sort |
explaining the variability in cardiovascular risk factors among first nations communities in canada: a population-based study |
publisher |
Elsevier |
publishDate |
2019 |
url |
https://doi.org/10.1016/S2542-5196(19)30237-2 https://doaj.org/article/18f929a6ac4c46d3b216681383db3596 |
geographic |
Canada |
geographic_facet |
Canada |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
The Lancet Planetary Health, Vol 3, Iss 12, Pp e511-e520 (2019) |
op_relation |
http://www.sciencedirect.com/science/article/pii/S2542519619302372 https://doaj.org/toc/2542-5196 2542-5196 doi:10.1016/S2542-5196(19)30237-2 https://doaj.org/article/18f929a6ac4c46d3b216681383db3596 |
op_doi |
https://doi.org/10.1016/S2542-5196(19)30237-2 |
container_title |
The Lancet Planetary Health |
container_volume |
3 |
container_issue |
12 |
container_start_page |
e511 |
op_container_end_page |
e520 |
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1766001686440050688 |