Fracture risk among First Nations people: a retrospective matched cohort study

Leslie, William D.; Derksen, Shelley; Metge, Colleen; Lix, Lisa M.; Salamon, Elizabeth A.; Steiman, Pauline Wood; Roos, Leslie L.
October 2004
CMAJ: Canadian Medical Association Journal;10/12/2004, Vol. 171 Issue 8, p869
Academic Journal
Background: Canadian First Nations people have unique cultural, socioeconomic and health-related factors that may affect fracture rates. We sought to determine the overall and site-specific fracture rates of First Nations people compared with non-First Nations people. Methods: We studied fracture rates among First Nations people aged 20 years and older ( n = 32 692) using the Manitoba administrative health database (1987-1999). We used federal and provincial sources to identify ethnicity, and we randomly matched each First Nations person with 3 people of the same sex and year of birth who did not meet this definition of First Nations ethnicity ( n= 98 076). We used a provincial database of hospital separations and physician billing claims to calculate standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for each fracture type based on a 5-year age strata. Results: First Nations people had significantly higher rates of any fracture (age- and sex-adjusted SIR 2.23, 95% CI 2.18-2.29). Hip fractures (SIR 1.88, 95% CI 1.61-2.14), wrist fractures (SIR 3.01, 95% CI 2.63-3.42) and spine fractures (SIR 1.93, 95% CI 1.79-2.20) occurred predominantly in older people and women. In contrast, craniofacial fractures (SIR 5.07, 95% CI 4.74-5.42) were predominant in men and younger adults. Interpretation: First Nations people are a previously unidentified group at high risk for fracture.


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