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...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Swansea University
2020-12-01
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| Series: | International Journal of Population Data Science |
| Online Access: | https://ijpds.org/article/view/1523 |
| _version_ | 1797427619566714880 |
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| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-09T08:47:33Z |
| format | Article |
| id | doaj.art-1a6906bef5364bf5b378adb6ca5e3220 |
| institution | Directory Open Access Journal |
| issn | 2399-4908 |
| language | English |
| last_indexed | 2024-03-09T08:47:33Z |
| publishDate | 2020-12-01 |
| publisher | Swansea University |
| record_format | Article |
| series | International Journal of Population Data Science |
| spelling | doaj.art-1a6906bef5364bf5b378adb6ca5e32202023-12-02T15:06:22ZengSwansea UniversityInternational Journal of Population Data Science2399-49082020-12-015510.23889/ijpds.v5i5.1523Peripheral Arterial Disease Among First Nations People with Diabetes in Ontario, Canada: Linkage of Population-Level Healthcare DataBaiju R Shah0Eliot Frymire1Carmen R Jones2Shahriar Khan3Morgan Slater4Jennifer D Walker5Mike Green6University of Toronto Department of MedicineQueens UniversityChiefs of OntarioQueen’s UniversityQueens Department of Family MedicineLaurentian UniversityQueens Department of Family MedicineIntroduction 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.https://ijpds.org/article/view/1523 |
| spellingShingle | 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 International Journal of Population Data Science |
| title | 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_short | 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 |
| url | https://ijpds.org/article/view/1523 |
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