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Bells Corners, Canada

Bhawra J.,University of Waterloo | Cooke M.J.,University of Waterloo | Hanning R.,University of Waterloo | Wilk P.,University of Western Ontario | Gonneville S.L.H.,Metis Nation of Ontario
International Journal for Equity in Health | Year: 2015

Introduction: Aboriginal children in Canada are at a higher risk for overweight and obesity than other Canadian children. In Northern and remote areas, this has been linked to a lack of affordable nutritious food. However, the majority of Aboriginal children live in urban areas where food choices are more plentiful. This study aimed to explore the experiences of food insecurity among Métis and First Nations parents living in urban areas, including the predictors and perceived connections between food insecurity and obesity among Aboriginal children. Methods: Factors influencing children's diets, families' experiences with food insecurity, and coping strategies were explored using focus group discussions with 32 parents and caregivers of Métis and off-reserve First Nations children from Midland-Penetanguishene and London, Ontario. Four focus groups were conducted and transcribed verbatim between July 2011 and March 2013. A thematic analysis was conducted using NVivo software, and second coders ensured reliability of the results. Results: Caregivers identified low income as an underlying cause of food insecurity within their communities and as contributing to poor nutrition among their children. Families reported a reliance on energy-dense, nutrient-poor foods, as these tended to be more affordable and lasted longer than more nutritious, fresh food options. A lack of transportation also compromised families' ability to purchase healthful food. Aboriginal caregivers also mentioned a lack of access to traditional foods. Coping strategies such as food banks and community programming were not always seen as effective. In fact, some were reported as potentially exacerbating the problem of overweight and obesity among First Nations and Métis children. Conclusion: Food insecurity manifested itself in different ways, and coping strategies were often insufficient for addressing the lack of fruit and vegetable consumption in Aboriginal children's diets. Results suggest that obesity prevention strategies should take a family-targeted approach that considers the unique barriers facing urban Aboriginal populations. This study also reinforces the importance of low income as an important risk factor for obesity among Aboriginal peoples. © 2015 Bhawra et al. Source


Shah B.R.,Institute for Clinical Evaluative science | Shah B.R.,University of Toronto | Shah B.R.,Sunnybrook Health science Center | Cauch-Dudek K.,Institute for Clinical Evaluative science | Pigeau L.,Metis Nation of Ontario
Diabetes Care | Year: 2011

OBJECTIVE - The Métis are a distinct Aboriginal people in Canada with a unique history, culture, and language. This study examined diabetes prevalence and care in the Métis of Ontario. RESEARCH DESIGN AND METHODS - The 14,480 people in the citizenship registry of the Métis Nation of Ontario were linked with provincial health care databases to determine diabetes prevalence and processes of care. Rates were compared between the Métis and the general Ontario population. RESULTS - The age/sex standardized prevalence of diabetes for the Métis was 11.2%, nearly 25%higher than that of the general Ontario population. Métis were more likely to be hospitalized (12.7 vs. 10.7%) or require emergency room visits (36.1 vs. 27.7%). CONCLUSIONS - Métis people have an increased burden of diabetes that puts them at risk for complications and morbidity. Ensuring adequate access to and quality of care for diabetes is essential to maintain the health of the Métis people. © 2011 by the American Diabetes Association. Source


Atzema C.L.,Institute for Clinical Evaluative science | Atzema C.L.,Sunnybrook Health science Center | Atzema C.L.,University of Toronto | Khan S.,Institute for Clinical Evaluative science | And 6 more authors.
PLoS ONE | Year: 2015

Background: The burden of cardiovascular disease in the Métis, Canada's fastest growing Aboriginal group, is not well studied. We determined rates of five cardiovascular diseases and associated outcomes in Ontario Métis, compared to the general Ontario population. Methods: Métis persons were identified using the Métis Nation of Ontario Citizenship Registry. Métis citizens aged 20-105 were linked to Ontario health databases for the period of April 2006 to March 2011. Age- and sex-standardized prevalence and incidence of acute coronary syndromes (ACS), congestive heart failure (CHF), cerebrovascular disease (stroke), atrial fibrillation, and hypertension were compared between the Métis and the general population. Secondary outcome measures included one-year hospitalizations and mortality following the incident cardiovascular diagnosis, as well as quality-of-care measures. Results: There were 12,550 eligible Métis persons and 10,144,002 in the general population. The adjusted prevalence of each disease was higher (p<0.05) among the Métis compared to the general population: ACS 5.3% vs. 3.0%; CHF 5.1% vs. 3.9%; stroke 1.4% vs. 1.1%; atrial fibrillation 2.1% vs. 1.4%; hypertension 34.9%vs. 29.8%. Incident ACS, stroke, and atrial fibrillation were also higher (p<0.05) among the Métis: ACS 2.4% vs. 1.5%; stroke 0.8% vs. 0.6%; atrial fibrillation 0.6% vs. 0.3%. One-year all-cause and cardiovascular-related mortality were not significantly different. Hospitalizations were higher for Métis persons with CHF (OR 1.93; 95% CI 1.34-2.78) and hypertension (OR 2.27; 95% CI 1.88 -2.74). Métis with CHF made more emergency department (ED) visits in the year after diagnosis compared to non-Métis with CHF, while Métis aged ≤65 with ACS were more likely to be on beta-blockers following diagnosis. Conclusions: The burden of cardiovascular disease was markedly higher in the Métis compared to the general population: prevalence rates for five cardiovascular conditions were 25% to 77% higher. Métis persons with CHF had more frequent hospitalizations and ED visits following their diagnosis. © 2015 Atzema et al. Source


Gershon A.S.,Sunnybrook Health science Center | Gershon A.S.,Institute for Clinical Evaluative science | Gershon A.S.,University of Toronto | Khan S.,Institute for Clinical Evaluative science | And 12 more authors.
PLoS ONE | Year: 2014

Introduction: Chronic respiratory diseases cause a significant health and economic burden around the world. In Canada, Aboriginal populations are at increased risk of asthma and chronic obstructive pulmonary disease (COPD). There is little known, however, about these diseases in the Canadian Métis population, who have mixed Aboriginal and European ancestry. A population-based study was conducted to quantify asthma and COPD prevalence and health services use in the Métis population of Ontario, Canada's largest province. Methods: The Métis Nation of Ontario Citizenship Registry was linked to provincial health administrative databases to measure and compare burden of asthma and COPD between the Métis and non-Métis populations of Ontario between 2009 and 2012. Asthma and COPD prevalence, health services use (general physician and specialist visits, emergency department visits, hospitalizations), and mortality were measured. Results: Prevalences of asthma and COPD were 30% and 70% higher, respectively, in the Métis compared to the general Ontario population (p<0.001). General physician and specialist visits were significantly lower in Métis with asthma, while general physician visits for COPD were significantly higher. Emergency department visits and hospitalizations were generally higher for Métis compared to non-Métis with either disease. All-cause mortality in Métis with COPD was 1.3 times higher compared to non-Métis with COPD (p = 0.01). Conclusion: There is a high burden of asthma and COPD in Ontario Métis, with significant prevalence and acute health services use related to these diseases. Lower rates of physician visits suggest barriers in access to primary care services. © 2014 Gershon et al. Source


Jandoc R.,University of Toronto | Jembere N.,Institute for Clinical Evaluative science | Khan S.,Institute for Clinical Evaluative science | Russell S.J.,Metis Nation of Ontario | And 3 more authors.
Archives of Osteoporosis | Year: 2015

Half of Métis citizens, compared to less than 10 % of the general population of Ontario, reside in northern regions, with little access to bone mineral density (BMD) testing. Métis citizens had lower sex-specific and age-standardized rates of BMD testing, yet similar rates of fracture (both sexes) and pharmacotherapy (women only). Purpose: To examine osteoporosis management and common osteoporosis-related fractures among Métis citizens compared to the general population of older adults residing in Ontario. Methods: We linked healthcare (medical and pharmacy) utilization and administrative (demographic) databases with the Métis Nation of Ontario citizenship registry to estimate osteoporosis management (bone mineral density [BMD] testing, pharmacotherapy) and fractures (hip, humerus, radius/ulna) among adults aged ≥50 years, from April 1, 2006 to March 31, 2011. Pharmacotherapy data were limited to residents aged ≥65 years. Sex-specific and age-standardized rates were compared between the Métis and the general population. Multivariable logistic regression was used to compare rates of BMD testing after controlling for differences in age and region of residence between the Métis and the general population. Results: We studied 4219 Métis citizens (55 % men), and 140 (3 %) experienced a fracture. Half of Métis citizens, compared to less than 10 % of the general population of Ontario, resided in northern regions. We identified significantly lower sex-specific and age-standardized rates of BMD testing among Métis compared to the general population, yet found little difference in fracture rates (both sexes) or pharmacotherapy (women only). Differences in BMD testing disappeared after adjusting for region of residence among women yet remained significant among men. Conclusions: Despite finding significantly lower rates of osteoporosis management among men, Métis men and women were found to have similar age-standardized fracture rates to the general population. © 2015, The Author(s). Source

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