Geospatial patterns of comorbidity prevalence among people with osteoarthritis in Alberta Canada

• Published in: BMC Public Health
• Main Authors: Xiaoxiao Liu, Rizwan Shahid, Alka B. Patel, Terrence McDonald, Stefania Bertazzon, Nigel Waters, Judy E. Seidel, Deborah A. Marshall
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2020
• Subjects: Osteoarthritis; Comorbidity; Spatial analysis; Rural; Disparities; Public aspects of medicine; RA1-1270; Canada; First Nations; inuit
• Online Access: https://doi.org/10.1186/s12889-020-09599-0; https://doaj.org/article/1df780a9be824584b1615426a04bda0d

Abstract Background Knowledge of geospatial pattern in comorbidities prevalence is critical to an understanding of the local health needs among people with osteoarthritis (OA). It provides valuable information for targeting optimal OA treatment and management at the local level. However, there is, at present, limited evidence about the geospatial pattern of comorbidity prevalence in Alberta, Canada. Methods Five administrative health datasets were linked to identify OA cases and comorbidities using validated case definitions. We explored the geospatial pattern in comorbidity prevalence at two standard geographic areas levels defined by the Alberta Health Services: descriptive analysis at rural-urban continuum level; spatial analysis (global Moran’s I, hot spot analysis, cluster and outlier analysis) at the local geographic area (LGA) level. We compared area-level indicators in comorbidities hotspots to those in the rest of Alberta (non-hotspots). Results Among 359,638 OA cases in 2013, approximately 60% of people resided in Metro and Urban areas, compared to 2% in Rural Remote areas. All comorbidity groups exhibited statistically significant spatial autocorrelation (hypertension: Moran’s I index 0.24, z score 4.61). Comorbidity hotspots, except depression, were located primarily in Rural and Rural Remote areas. Depression was more prevalent in Metro (Edmonton-Abbottsfield: 194 cases per 1000 population, 95%CI 192–195) and Urban LGAs (Lethbridge-North: 169, 95%CI 168–171) compared to Rural areas (Fox Creek: 65, 95%CI 63–68). Comorbidities hotspots included a higher percentage of First Nations or Inuit people. People with OA living in hotspots had lower socioeconomic status and less access to care compared to non-hotspots. Conclusions The findings highlight notable rural-urban disparities in comorbidities prevalence among people with OA in Alberta, Canada. Our study provides valuable evidence for policy and decision makers to design programs that ensure patients with OA receive optimal health management tailored ...