Abstract
BackgroundChronic obstructive pulmonary disease (COPD) is a major respiratory disorder, largely caused by smoking that has been linked with large health inequalities worldwide. There are important gaps in our knowledge about how COPD affects Aboriginal peoples. This retrospective cohort study assessed the epidemiology of COPD in a cohort of Aboriginal peoples relative to a non-Aboriginal cohort.MethodsWe used linkage of administrative health databases in Alberta (Canada) from April 1, 2002 to March 31, 2010 to compare the annual prevalence, and the incidence rates of COPD between Aboriginal and non-Aboriginal cohorts aged 35 years and older. Poisson regression models adjusted the analysis for important sociodemographic factors.ResultsCompared to a non-Aboriginal cohort, prevalence estimates of COPD from 2002 to 2010 were 2.3 to 2.4 times greater among Registered First Nations peoples, followed by the Inuit (1.86 to 2.10 times higher) and the Métis (1.59 to 1.67 times higher). All Aboriginal peoples had significantly higher COPD incidence rates than the non-Aboriginal group (incidence rate ratio [IRR]: 2.1; 95% confidence interval [CI]: 1.97, 2.27). COPD incidence rates were higher in First Nation peoples (IRR: 2.37; 95% CI: 2.19, 2.56) followed by Inuit (IRR: 1.92; 95% CI: 1.64, 2.25) and Métis (IRR: 1.49; 95% CI: 1.32, 1.69) groups.ConclusionsWe found a high burden of COPD among Aboriginal peoples living in Alberta; a province with the third largest Aboriginal population in Canada. Altogether, the three Aboriginal peoples groups have higher prevalence and incidence of COPD compared to a non-Aboriginal cohort. The condition affects the three Aboriginal groups differently; Registered First Nations and Inuit have the highest burden of COPD. Reasons for these differences should be further explored within a framework of social determinants of health to help designing interventions that effectively influence modifiable COPD risk factors in each of the Aboriginal groups.
Highlights
Chronic obstructive pulmonary disease (COPD) is a respiratory disorder largely caused by smoking and characterized by progressive, not fully reversible airway obstruction, systemic manifestations, and increasing frequency and severity of exacerbations [1]
COPD incidence rates were higher in First Nation peoples (IRR: 2.37; 95% confidence intervals (CI): 2.19, 2.56) followed by Inuit (IRR: 1.92; 95% CI: 1.64, 2.25) and Métis (IRR: 1.49; 95% CI: 1.32, 1.69) groups
We found a high burden of COPD among Aboriginal peoples living in Alberta; a province with the third largest Aboriginal population in Canadian Lung Association; Ottawa (Canada)
Summary
Chronic obstructive pulmonary disease (COPD) is a respiratory disorder largely caused by smoking and characterized by progressive, not fully reversible airway obstruction, systemic manifestations, and increasing frequency and severity of exacerbations [1]. Analyses of community surveys [5] and administrative health data [6,7,8] have suggested that Aboriginal peoples in Canada have higher prevalence and incidence of COPD compared to non-Aboriginal populations. These studies, have used cross-sectional designs with self-reporting of physician diagnoses, spanned relatively short periods of observation, and limited their scope to specific Aboriginal groups (i.e., Registered First Nations or Métis only). There are important gaps in our knowledge about how COPD affects Aboriginal peoples This retrospective cohort study assessed the epidemiology of COPD in a cohort of Aboriginal peoples relative to a non-Aboriginal cohort
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