Peripheral Arterial Disease Among First Nations People with Diabetes in Ontario, Canada: Linkage of Population-Level Healthcare Data
Introduction Indigenous people worldwide are overrepresented and adversely effected by diabetes. Peripheral arterial disease and amputation are among the most feared complications of diabetes, leading to profound impacts on patients’ quality of life. This study linked population-level healthcare dat...
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Swansea University
2020
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ftdoajarticles:oai:doaj.org/article:1a6906bef5364bf5b378adb6ca5e3220 2023-05-15T16:14:00+02:00 Peripheral Arterial Disease Among First Nations People with Diabetes in Ontario, Canada: Linkage of Population-Level Healthcare Data Baiju R Shah Eliot Frymire Carmen R Jones Shahriar Khan Morgan Slater Jennifer D Walker Mike Green 2020-12-01T00:00:00Z https://doi.org/10.23889/ijpds.v5i5.1523 https://doaj.org/article/1a6906bef5364bf5b378adb6ca5e3220 EN eng Swansea University https://ijpds.org/article/view/1523 https://doaj.org/toc/2399-4908 doi:10.23889/ijpds.v5i5.1523 2399-4908 https://doaj.org/article/1a6906bef5364bf5b378adb6ca5e3220 International Journal of Population Data Science, Vol 5, Iss 5 (2020) Demography. Population. Vital events HB848-3697 article 2020 ftdoajarticles https://doi.org/10.23889/ijpds.v5i5.1523 2022-12-31T08:21:01Z Introduction Indigenous people worldwide are overrepresented and adversely effected by diabetes. Peripheral arterial disease and amputation are among the most feared complications of diabetes, leading to profound impacts on patients’ quality of life. This study linked population-level healthcare data to assess the risk of peripheral arterial disease among First Nations people in Ontario with diabetes. Objectives and Approach We linked individual-level population-based healthcare administrative datasets with the Indian Register. The latter provides information on all registered or Status First Nations people in Canada. We compared First Nations people with diabetes with other people in Ontario with diabetes . Age and sex-adjusted rates peripheral revascularization procedures and lower-extremity amputations were calculated for each 12-month period from April 1, 1995, to March 31, 2015. Mortality among those with amputation was determined. Results First Nations people received revascularization procedures at a comparable rate to other people in Ontario. However, they had lower-extremity amputations at 3- to 5-times the frequency of other Ontario residents. First Nations people had increased mortality after lower-extremity amputation (adjusted hazard ratio 1.15, 95% confidence interval 1.05 to 1.26), with median survival of only 3.5 years. Conclusion / Implications First Nations people with diabetes in Ontario had a comparable rate of revascularization but a markedly increased risk for lower-extremity amputation compared to other people in Ontario. This discordance suggests that peripheral arterial disease may be underdiagnosed or undertreated among First Nations people in Ontario, and demonstrates an important health inequity faced by First Nations people. Article in Journal/Newspaper First Nations Directory of Open Access Journals: DOAJ Articles Canada Indian International Journal of Population Data Science 5 5 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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English |
topic |
Demography. Population. Vital events HB848-3697 |
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Demography. Population. Vital events HB848-3697 Baiju R Shah Eliot Frymire Carmen R Jones Shahriar Khan Morgan Slater Jennifer D Walker Mike Green Peripheral Arterial Disease Among First Nations People with Diabetes in Ontario, Canada: Linkage of Population-Level Healthcare Data |
topic_facet |
Demography. Population. Vital events HB848-3697 |
description |
Introduction Indigenous people worldwide are overrepresented and adversely effected by diabetes. Peripheral arterial disease and amputation are among the most feared complications of diabetes, leading to profound impacts on patients’ quality of life. This study linked population-level healthcare data to assess the risk of peripheral arterial disease among First Nations people in Ontario with diabetes. Objectives and Approach We linked individual-level population-based healthcare administrative datasets with the Indian Register. The latter provides information on all registered or Status First Nations people in Canada. We compared First Nations people with diabetes with other people in Ontario with diabetes . Age and sex-adjusted rates peripheral revascularization procedures and lower-extremity amputations were calculated for each 12-month period from April 1, 1995, to March 31, 2015. Mortality among those with amputation was determined. Results First Nations people received revascularization procedures at a comparable rate to other people in Ontario. However, they had lower-extremity amputations at 3- to 5-times the frequency of other Ontario residents. First Nations people had increased mortality after lower-extremity amputation (adjusted hazard ratio 1.15, 95% confidence interval 1.05 to 1.26), with median survival of only 3.5 years. Conclusion / Implications First Nations people with diabetes in Ontario had a comparable rate of revascularization but a markedly increased risk for lower-extremity amputation compared to other people in Ontario. This discordance suggests that peripheral arterial disease may be underdiagnosed or undertreated among First Nations people in Ontario, and demonstrates an important health inequity faced by First Nations people. |
format |
Article in Journal/Newspaper |
author |
Baiju R Shah Eliot Frymire Carmen R Jones Shahriar Khan Morgan Slater Jennifer D Walker Mike Green |
author_facet |
Baiju R Shah Eliot Frymire Carmen R Jones Shahriar Khan Morgan Slater Jennifer D Walker Mike Green |
author_sort |
Baiju R Shah |
title |
Peripheral Arterial Disease Among First Nations People with Diabetes in Ontario, Canada: Linkage of Population-Level Healthcare Data |
title_short |
Peripheral Arterial Disease Among First Nations People with Diabetes in Ontario, Canada: Linkage of Population-Level Healthcare Data |
title_full |
Peripheral Arterial Disease Among First Nations People with Diabetes in Ontario, Canada: Linkage of Population-Level Healthcare Data |
title_fullStr |
Peripheral Arterial Disease Among First Nations People with Diabetes in Ontario, Canada: Linkage of Population-Level Healthcare Data |
title_full_unstemmed |
Peripheral Arterial Disease Among First Nations People with Diabetes in Ontario, Canada: Linkage of Population-Level Healthcare Data |
title_sort |
peripheral arterial disease among first nations people with diabetes in ontario, canada: linkage of population-level healthcare data |
publisher |
Swansea University |
publishDate |
2020 |
url |
https://doi.org/10.23889/ijpds.v5i5.1523 https://doaj.org/article/1a6906bef5364bf5b378adb6ca5e3220 |
geographic |
Canada Indian |
geographic_facet |
Canada Indian |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
International Journal of Population Data Science, Vol 5, Iss 5 (2020) |
op_relation |
https://ijpds.org/article/view/1523 https://doaj.org/toc/2399-4908 doi:10.23889/ijpds.v5i5.1523 2399-4908 https://doaj.org/article/1a6906bef5364bf5b378adb6ca5e3220 |
op_doi |
https://doi.org/10.23889/ijpds.v5i5.1523 |
container_title |
International Journal of Population Data Science |
container_volume |
5 |
container_issue |
5 |
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1765999838345822208 |