Abstract
IntroductionThe aim was to study any spatial and/or temporal patterns of ischemic heart disease (IHD) prevalence and measure the effects of selected social determinants on these spatial and space-time patterns.MethodsData were obtained from the Population Research Data Repository housed at the Manitoba Centre for Health Policy to identify persons who were diagnosed with IHD between 1995 and 2018. These persons were geocoded to 96 geographic regions of Manitoba. An area-level socioeconomic factor index (SEFI-2) and the proportion of the population who was Indigenous were calculated for each geographic region using the 2016 Canadian Census data. Associations between these factors and IHD prevalence were measured using Bayesian spatial Poisson regression models. Temporal trends and spatio-temporal trends were measured using Bayesian spatio-temporal Poisson regression models.ResultsUnivariable models showed a significant association with increased regional Indigenous population proportion associated with a higher prevalence of IHD (RR: 0.07, 95% CredInt: (0.05, 0.10)) and for SEFI-2 (RR: 0.17, 95% CredInt: (0.11, 0.23)). Using a multivariable model, after accounting for the proportion of the population that was Indigenous, there was no evidence of an association between IHD prevalence and area-level socioeconomic factor. Spatio-temporal models showed no significant overall temporal trend in IHD prevalence, but there were significant spatially varying temporal trends within the 96 regions.ConclusionsAssociation between Indigenous population proportion and IHD is consistent with previous research. No significant overall temporal trend was measured. However, regions with significantly increasing trends and significantly decreasing trends in IHD prevalence were identified.
Highlights
The aim was to study any spatial and/or temporal patterns of ischemic heart disease (IHD) prevalence and measure the effects of selected social determinants on these spatial and space-time patterns
Indigenous is taken to mean anyone self-identifying as First Nations, Inuit, or Metis.The general provincial trend in Manitoba has been a decline in both IHD prevalence and incidence over time, which is an indication that the burden of disease has lessened over recent years, the 2002-2007 to 2007-2012 time periods [1]
[second version of the] Socio-Economic Factor Index (SEFI-2) differed between the northern regions of Manitoba and central Winnipeg compared with the remainder of the province, with higher values of the index corresponding to greater socioeconomic deprivation in these regions
Summary
The aim was to study any spatial and/or temporal patterns of ischemic heart disease (IHD) prevalence and measure the effects of selected social determinants on these spatial and space-time patterns. Indigenous is taken to mean anyone self-identifying as First Nations, Inuit, or Metis.The general provincial trend in Manitoba has been a decline in both IHD prevalence and incidence over time, which is an indication that the burden of disease has lessened over recent years, the 2002-2007 to 2007-2012 time periods [1]. This is consistent at the national level, with decreasing trends in IHD prevalence and incidence for recent times in Canada [6]. Understanding how a leading cause of premature deaths in Manitoba is affecting some geographic regions differently from others is important as equitable healthcare for all Manitobans is a priority for Manitoba’s health care system
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