Intentional injury hospitalizations in geographical areas with a high percentage of Aboriginal-identity residents, 2004/2005 to 2009/2010

Abstract

Introduction This study describes rates of self-inflicted and assault-related injury hospitalizations in areas with a relatively high percentage of residents identifying as First Nations, Métis and Inuit, by injury cause, age group and sex. Methods All separation records from acute in-patient hospitals for Canadian provinces and territories excluding Quebec were obtained from the Discharge Abstract Database. Dissemination areas with more than 33% of residents reporting an Aboriginal identity in the 2006 Census were categorized as high-percentage Aboriginal-identity areas. Results Overall, in high-percentage Aboriginal-identity areas, age-standardized hospitalization rates (ASHRs) for self-inflicted injuries were higher among females, while ASHRs for assault-related injuries were higher among males. Residents of high-percentage Aboriginal-identity areas were at least three times more likely to be hospitalized due to a self-inflicted injury and at least five times more likely to be hospitalized due to an assault-related injury compared with those living in low-percentage Aboriginal-identity areas. Conclusion Future research should examine co-morbidities, socio-economic conditions and individual risk behaviours as factors associated with intentional injury hospitalizations.

Intentional injury among the indigenous and total populations in British Columbia, Canada: trends over time and ecological analyses of risk

“…In spite of differing methods to identify the Indigenous populations, our data showing disparity for self-inflicted injuries are consistent with those of Oliver et al [ 18 ], although they found even greater disparity for assaults by another person than did our data. These consistent findings regarding disparity indicate that national and international concern remains warranted [ 15 – 24 ].…”

“…Higher rates of intentional injuries have been reported amongst Indigenous, compared to non-Indigenous, populations in other colonized countries; for example, resulting from interpersonal violence in Australia [ 13 ] and for self-inflicted injuries in New Zealand [ 14 ]. In Canada, data have shown that Indigenous peoples are at higher risk than non-Indigenous populations of intentional injuries that result in either mortality [ 15 – 17 ] or hospitalization [ 18 ]. Oliver et al [ 18 ] found that risk of self-inflicted injury was at least three times higher and assaults at least five times higher for those living in geographic areas with high, compared to low, concentrations of people who identify as Indigenous.…”

“…In Canada, data have shown that Indigenous peoples are at higher risk than non-Indigenous populations of intentional injuries that result in either mortality [ 15 – 17 ] or hospitalization [ 18 ]. Oliver et al [ 18 ] found that risk of self-inflicted injury was at least three times higher and assaults at least five times higher for those living in geographic areas with high, compared to low, concentrations of people who identify as Indigenous. In Alberta, Canada, self-inflicted injury rates were found to be highest among people supported by social assistance and for those with Indigenous status [ 19 ].…”

“…We use hospitalization data rather than mortality data because this is a much larger dataset since injury resulting in hospitalization is more common than injury resulting in death. We have improved methods for identification of the Indigenous population compared to previous studies in Canada (e.g., [ 18 ]) that use geography to identify the population, thereby making the assumption that all people living in specific places (e.g., reserves) are Indigenous. Instead, we have employed a method that identifies Indigenous people by record linkage to the provincial health insurance premium database and to Vital Statistics birth and death records.…”

Acute health care among Indigenous patients in Canada: a scoping review

“…As for unintentional injuries, 8 articles presented higher hospitalisation rates [57][58][59][60][61][62][63][64] whereas two articles mentioned no difference [65,66]. Three articles studied intentional injuries, two of which showed an increased hospitalisation rate for Indigenous patients [64,67] while the other showed no difference [60]. With regards to poisonings, two articles published in 2007 by Myers mentioned a risk ratio for hospitalisation for acetaminophen overdose of approximately 4 [68,69].…”