Abstracts
Abstract
This study tested the assumption that geographical isolation is associated with poorer population health outcomes among First Nations in Manitoba. Our results show higher premature mortality rates (PMR) in northern communities, declining slower than for any other Manitoba communities. Our results also show lower ambulatory care sensitive conditions (ACSC) hospitalization rate in the North, suggesting barriers to prevention and early diagnosis. There remains a large gap in ACSC hospitalization rates between First Nations and all Manitobans. Further research is warranted to understand the relationship between the changes in the rates of ACSC and the difference in the rates between northern and southern communities.
Keywords:
- primary care,
- primary health care,
- Aboriginal,
- Indigenous,
- avoidable hospitalizations,
- mental health,
- chronic conditions,
- geography,
- remoteness,
- First Nations
Download the article in PDF to read it.
Download
Appendices
Bibliography
- Alasia, A., Bédard, F., Bélanger, J., Guimond, E., & Penney, C. (2017). Measuring remoteness and accessibility: A set of indices for Canadian communities. https://www150.statcan.gc.ca/n1/pub/18-001-x/18-001-x2017002-eng.htm
- Ansari, Z., Carson, N., Serraglio, A., Barbetti, T., & Cicuttini, F. (2002). The Victorian Ambulatory Care Sensitive Conditions Study: Reducing demand on hospital services in Victoria. Australian Health Review, 25(2), 71-77. https://doi.org/10.1071/ah020071
- Billings, J., Zeitel, L., Lukomnik, J., Carey, T. S., Blank, A. E., & Newman, L. (1993). Impact of socioeconomic status on hospital use in New York City. Health Affairs, 12(1), 162-173. https://doi.org/10.1377/hlthaff.12.1.162
- Blignault, I., Hunter, J., & Mumford, J. (2018). Integration of Indigenous healing practices with Western biomedicine in Australia, Canada, New Zealand and the United States of America: A scoping review protocol. JBI Database of Systematic Reviews and Implementation Reports, 16(6), 1354-1360. https://doi.org/10.11124/jbisrir-2017-003468
- Bombay, A. (2015). A call to end mental health disparities for Indigenous people. The Lancet Psychiatry, 2(10), 861-862. https://doi.org/10.1016/s2215-0366(15)00352-1
- Browne, A. J., Varcoe, C., Ford-Gilboe, M., Wathen, N., Smye, V., Jackson, B. E., Wallace, B., Pauly, B., Herbert, C. P., Lavoie, J. G., Wong, S., & Blanchet Garneau, A. (2018). Disruption as opportunity: Impacts of an organizational-level health equity intervention in primary care clinics. International Journal for Equity in Health, 17 (1), 154. https://doi.org/10.1186/s12939-018-0820-2
- Browne, A. J., Varcoe, C., Lavoie, J. G., Smye, V., Wong, S. T., Krause, M., Tu, D., Goodwin, O., Khan, K., & Fridkin, A. (2016). Enhancing health care equity with Indigenous populations: Evidence-based strategies from an ethnographic study. BMC Health Services Research, 16(544), 16. https://doi.org/10.1186/s12913-016-1707-9
- Busby, J., Purdy, S., & Hollingworth, W. (2015). A systematic review of the magnitude and cause of geographic variation in unplanned hospital admission rates and length of stay for ambulatory care sensitive conditions. BMC Health Services Research, 15, 324. https://doi.org/10.1186/s12913-015-0964-3
- Campbell, R., Martire, J., Upitis, I., Hudon, J., Nelson, K., & Tremblay, M. (2015). Report 4—Access to health services for remote First Nations communities (2015 spring reports of the Auditor General of Canada). https://www.oag-bvg.gc.ca/internet/English/parl_oag_201504_04_e_40350.html
- Canadian Institute for Health Information. (2006). Pan-Canadian primary health care indicators. (Report 1, Volume 1: Pan-Canadian Primary Health Care Indicator Development Project). https://www.cihi.ca/sites/default/files/document/pdf_phc_indi_report1vol1fin_en.pdf_ga=2.20411768.1152479327.1611163777-1608162406.1611163777
- Dehghani, K., Lan, Z., Li, P., Michelsen, S. W., Waites, S., Benedetti, A., Lejeune, P., Torrie, J., Robinson, E., Vejvoda, B., Mullah, M., Redwood, D., Cooper, M., Fanning, A., Yacoub, W., Alvarez, G. G., Søborg, B., Long, R., & Menzies, D. (2018). Determinants of tuberculosis trends in six Indigenous populations of the USA, Canada, and Greenland from 1960 to 2014: A population-based study. Lancet Public Health, 3(3), e133-e142. https://doi.org/10.1016/s2468-2667(18)30002-1
- Drost, J. L. (2019). Developing the alliances to expand traditional Indigenous healing practices within Alberta Health Services. The Journal of Alternative and Complementary Medicine, 25(S1), S69-S77. https://doi.org/10.1089/acm.2018.0387
- Fijal, D., & Beagan, B. L. (2019). Indigenous perspectives on health: Integration with a Canadian model of practice. Canadian Journal of Occupational Therapy, 86(3), 220-231. https://doi.org/10.1177/0008417419832284
- Gao, J., Moran, E., Li, Y. F., & Almenoff, P. L. (2014). Predicting potentially avoidable hospitalizations. Medical Care, 52(2), 164-171. https://doi.org/10.1097/mlr.0000000000000041
- Gibson, O. R., Segal, L., & McDermott, R. A. (2013). A systematic review of evidence on the association between hospitalisation for chronic disease related ambulatory care sensitive conditions and primary health care resourcing. BMC Health Services Research, 13, 336. https://doi.org/10.1186/1472-6963-13-336
- Green, M. E., Wong, S. T., Lavoie, J. G., Kwong, J., MacWilliam, L., Peterson, S., Liu, G., & Katz, A. (2013). Admission to hospital for pneumonia and influenza attributable to 2009 pandemic A/H1N1 influenza in First Nations communities in three provinces of Canada. BMC Public Health, 13, 1029. https://doi.org/10.1186/1471-2458-13-1029
- Health Canada & First Nations and Inuit Health Branch (FNIHB). (2003). Health Facility Classification Policy, working draft.
- Health Canada & First Nations and Inuit Health Branch (FNIHB). (2012). First Nations and Inuit Health Facilities and Capital Program—Cluster evaluation, final report. https://www.canada.ca/en/health-canada/corporate/about-health-canada/accountability-performance-financial-reporting/evaluation-reports/first-nations-inuit-health-facilities-capital-program-cluster-evaluation.html
- The Jordan’s Principle Working Group. (2015). Without denial, delay, or disruption: Ensuring First Nations children’s access to equitable services through Jordan’s Principle. Assembly of First Nations. https://www.afn.ca/uploads/files/jordans_principle-report.pdf
- Katz, A., Kinew, K. A., Star, L., Taylor, C., Koseva, I., Lavoie, J. G., Burchill, C., Urquia, M. L., Basham, A., Rajotte, L., Ramayanam, V., Jarmasz, J., & Burchill, S. (2019). The health status of and access to healthcare by Registered First Nation Peoples in Manitoba. http://umanitoba.ca/faculties/health_sciences/medicine/units/chs/departmental_units/mchp/Landing-FNAtlas.html
- Kyoon-Achan, G., Lavoie, J. G., Kinew, K. A., Philips-Beck, W., Ibrahim, N., Sinclair, S., & Katz, A. (2018). Innovating for transformation in First Nations health using community-based participatory research. Qualitative Health Research, 28(7), 1036-1049. https://doi.org/10.1177/1049732318756056
- Kyoon-Achan, G., Lavoie, J. G., Phillips-Beck, W., Kinew, K. A., Ibrahim, N., Sinclair, S., & Katz, A. (2019). What changes would Manitoba First Nations like to see in the primary healthcare they receive? A qualitative investigation. Healthcare Policy, 15(2), 85-99. https://doi.org/10.12927/hcpol.2019.26069
- Kyoon-Achan, G., Philips-Beck, W., Lavoie, J. G., Eni, R., Sinclair, S., Avery Kinew, K., Ibrahim, N., & Katz, A. (2018). Looking back, moving forward: A culture-based framework to promote mental wellness in Manitoba First Nations communities. International Journal of Culture and Mental Health, 11(4), 679-692. https://doi.org/10.1080/17542863.2018.1556714
- Lavoie, J. G. (2018). Medicare and the care of First Nations, Métis and Inuit. Journal of Health Economics, Policy and Law, 13(3-4), 280-298. https://doi.org/10.1017/s1744133117000391
- Lavoie, J. G., Boyer, Y., & Kornelsen, D. (2018). Patchy and southern-centric: Health policies for northern and Indigenous Canadians. In R. Schiff & H. Møller (Eds.), Health and healthcare in the Canadian North. UBC Press.
- Lavoie, J. G., Forget, E. L., Dahl, M., Martens, P. J., & O'Neil, J. D. (2011). Is it worthwhile to invest in home care? Healthc Policy, 6(4), 35-48. http://doi.org/10.12927/hcpol.2011.22395
- Lavoie, J. G., Forget, E. L., Prakash, T., Dahl, M., Martens, P. J., & O’Neil, J. D. (2010). Have investments in on-reserve health services and initiatives promoting community control improved First Nations’ health in Manitoba? Social Science & Medicine, 71(4), 717-724. https://doi.org/10.1016/j.socscimed.2010.04.037
- Lavoie, J. G., Kaufert, J. M., Browne, A. J., Mah, S., & O'Neil, J. D. (2015). Negotiating barriers, navigating the maze: First Nation Peoples’ experience of medical relocation. Canadian Public Administration, 58(2), 295–314. https://doi.org/10.1111/capa.12111
- Lavoie, J. G., Kornelsen, D., Boyer, Y., & Wylie, L. (2016). Lost in maps: Regionalization and Indigenous health services. Healthcare Papers, 16(1), 63-73. https://doi.org/10.12927/hcpap.2016.24773
- Lavoie, J. G., O'Neil, J. D., Sanderson, L., Elias, B., Mignone, J., Bartlett, J., Forget, E. L., Burton, R., Schmeichel, C., & McNeil, D. (2005). The evaluation of the First Nations and Inuit health transfer policy. Centre for Aboriginal Health Research. http://publications.gc.ca/collections/collection_2016/sc-hc/H14-191-2006-eng.pdf
- Lavoie, J. G., Phillips-Beck, W., Kinew, K. A., Kyoon-Achan, G., Sinclair, S., & Katz, A. (2020). The relationship between rates of hospitalization for ambulatory care sensitive conditions and local access to primary healthcare in Manitoba First Nations communities. Canadian Journal of Public Health, 2020. https://doi.org/10.17269/s41997-020-00421-3
- Lavoie, J. G., Ward, A. Wong, S. T., Ibrahim, N., Morton, D. O'Neil, J., & Green, M. (2018). Hospitalization for mental health related ambulatory care sensitive conditions: What are the trends for First Nations Peoples living on-reserve in British Columbia? International Journal for Equity in Health, 17, 156. https://doi.org/10.1186/s12939-018-0860-7
- Lavoie, J. G., Wong, S. T., Ibrahim, N., O’Neil, J. D., Green, M., & Ward, A. (2019). Underutilized and undertheorized: The use of hospitalization for ambulatory care sensitive conditions for assessing the extent to which primary healthcare services are meeting needs in British Columbia First Nation communities. BMC Health Services Research, 19(1), 50. https://doi.org/10.1186/s12913-018-3850-y
- Lavoie, J. G., Wong, S., Katz, A., & Sinclair, S. (2016). Opportunities and barriers to rural, remote and First Nation health services research in Canada: Comparing access to administrative claims data in Manitoba and British Columbia. Healthcare Policy, 12(1), 52-58. https://doi.org/10.12927/hcpol.2016.24775
- Logan, L., McNairn, J., Wiart, S., Crowshoe, L., Henderson, R., & Barnabe, C. (2020). Creating space for Indigenous healing practices in patient care plans. Canadian Medical Education Journal, 11(1), e5-e15. https://doi.org/10.36834/cmej.68647
- Longman, J. M., Passey, M. E., Ewald, D. P., Rix, E., & Morgan, G. G. (2015). Admissions for chronic ambulatory care sensitive conditions—A useful measure of potentially preventable admission? BMC Health Services Research, 15, 472. https://doi.org/10.1186/s12913-015-1137-0
- Lux, M. K. (2016). Separate beds: A history of Indian hospitals in Canada, 1920s-980s. University of Toronto Press. https://doi.org/10.3138/9781442663114
- Lyons, K. J., Ezekowitz, J. A., Liu, W., McAlister, F. A., & Kaul, P. (2014). Mortality outcomes among status Aboriginals and Whites with heart failure. Canadian Journal of Cardiolology, 30(6), 619-626. https://doi.org/10.1016/j.cjca.2014.03.004
- Martens, P. J., Sanderson, D., & Jebamani, L. (2005). Health services use of Manitoba First Nations people: Is it related to underlying need? Canadian Journal of Public Health, 96 (Suppl. 1), S39-S44. https://doi.org/10.1007/bf03405315
- Mossialos, E., & Wenzl, M. (2016). International profiles of health care systems: Australia, Canada, Denmark, England, France, Germany, Italy, Japan, The Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, and the United States. https://doi.org/10.15868/socialsector.25100
- Muenchberger, H., & Kendall, E. (2010). Predictors of preventable hospitalization in chronic disease: Priorities for change. Journal Public Health Policy, 31(2), 150-163. https://doi.org/10.1057/jphp.2010.3
- National Advisory Committee on SARS and Public Health. (2003). Learning from SARS: Renewal of public health in Canada—A report of the National Advisory Committee on SARS and Public Health October 2003. Health Canada. https://www.canada.ca/en/public-health/services/reports-publications/learning-sars-renewal-public-health-canada.html
- Ospina, M. B., Voaklander, D., Senthilselvan, A., Stickland, M. K., King, M., Harris, A. W., & Rowe, B. H. (2015). Incidence and prevalence of chronic obstructive pulmonary disease among Aboriginal Peoples in Alberta, Canada. PLoS One, 10(4). https://doi.org/10.1371/journal.pone.0123204
- Patel, A. (2019). Access to mental healthcare in Indigenous communities across Canada. Global Health: Annual Review, 4, 40-43. https://journals.mcmaster.ca/ghar/article/view/2116
- Ricketts, T. C., Randolph, R., Howard, H. A., Pathman, D., & Carey, T. (2001). Hospitalization rates as indicators of access to primary care. Health Place, 7(1), 27-38. https://doi.org/10.1016/s1353-8292(00)00035-6
- Riediger, N. D., Lukianchuk, V., & Bruce, S. G. (2015). Incident diabetes, hypertension and dyslipidemia in a Manitoba First Nation. International Journal of Circumpolar Health, 74, 27712. https://doi.org/10.3402/ijch.v74.27712
- Rosano, A., Loha, C. A., Falvo, R., van der Zee, J., Ricciardi, W., Guasticchi, G., & de Belvis, A. G. (2013). The relationship between avoidable hospitalization and accessibility to primary care: A systematic review. The European Journal of Public Health, 23(3), 356-360. https://doi.org/10.1093/eurpub/cks053
- Smylie, J., & Anderson, M. (2006). Understanding the health of Indigenous Peoples in Canada: Key methodological and conceptual challenges. Canadian Medical Association Journal, 175(6), 602-605. https://doi.org/10.1503/cmaj.060940
- Spoont, M., Greer, N., Su, J., Fitzgerald, P., Rutks, I., & Wilt, T. J. (2011). Rural vs. urban ambulatory health care: A systematic review. Department of Veterans Affairs. https://www.ncbi.nlm.nih.gov/books/NBK56144/pdf/Bookshelf_NBK56144.pdf
- Starfield, B., Shi, L., & Macinko, J. (2005). Contribution of primary care to health systems and health. The Milbank Quarterly, 83(3), 457-502. https://doi.org/10.1111/j.1468-0009.2005.00409.x
- Truth and Reconciliation Commission of Canada. (2015). Honouring the truth, reconciling for the future: Summary of the final report of the Truth and Reconciliation Commission of Canada. http://www.trc.ca/assets/pdf/Executive_Summary_English_Web.pdf
- Van Loenen, T., Faber, M. J., Westert, G. P., & Van den Berg, M. J. (2016). The impact of primary care organization on avoidable hospital admissions for diabetes in 23 countries. Scandinavian Journal of Primary Health Care, 34(1), 5-12. https://doi.org/10.3109/02813432.2015.1132883
- Van Loenen, T., Van den Berg, M. J., Westert, G. P., & Faber, M. J. (2014). Organizational aspects of primary care related to avoidable hospitalization: A systematic review. Family Practice, 31(5), 502-516. https://doi.org/10.1093/fampra/cmu053
- Wakerman, J. (2004). Defining remote health. Australian Journal of Rural Health, 12(5), 210-214. https://doi.org/10.1111/j.1440-1854.2004.00607.x
- World Health Organisation. (2008). Integrating mental health into primary care: A global perspective. https://www.who.int/mental_health/policy/services/integratingmhintoprimarycare/en/