The Association Between Mode of Delivery and Later Educational Outcomes

Abstract

IntroductionA 2002 report described the gap in health status between First Nations (FN) and all other Manitobans (AOM). That report was widely quoted in the context of other initiatives recognizing the inequities in Canadian society.
 Objectives and ApproachWe analyzed linked administrative data held in the Manitoba Population Research Data Repository to determine the health status and health care use of First Nations people. To provide context to the findings we compared First Nations to all other Manitobans, disaggregated by on-reserve off-reserve status, and presented our findings by Region and Tribal Council area. The 35 indicators were chosen to address First Nations priorities and providecomparisons with the previous study. Results were age and sex adjusted.
 ResultsThe gap between FN and AOM has grown. Premature mortality rates are 3x higher for FN compared to AOM. Rates of death by suicides and suicide attempts are 5x higher for FN compared to AOM. Rates of opioid prescribing are 2.5x higher for single prescription, and 4.5x higher for multiple prescriptions for FN compared to AOM. Colorectal cancer screening rates are 2x higher among all other Manitobans compared to FN. Continuity of care is much lower in FN than in AOM. For FN, primary care is less likely to be provided close to home than for AOM
 Conclusion / ImplicationsDespite initiatives like the Truth and Reconciliation Commission, and Indian Residential School survivors pursuing healing, the gap in health outcomes has increased. Underlying causes such as ongoing systemic racism and colonialism within health governance should be addressed.