scholarly journals How integration of the federal Indian Register has enhanced First Nations-specific analysis of ICES data

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Sue Schultz ◽  
Carmen Jones ◽  
Jennifer Walker
Keyword(s):  
First Nations ◽  
Urban Areas ◽  
Population Level ◽  
Postal Code ◽  
Population Estimates ◽  
Data Governance ◽  
Level Data ◽  
Specific Analysis ◽  
First Nations People ◽  
The Impact

IntroductionIn Ontario, First Nations are increasingly seeking population-level data about the health of their citizens. However, First Nations people are not readily identified in standard health administrative data and indirect strategies, such as the use of on-reserve addresses, are limited in scope and validity. Objectives and ApproachThe Chiefs of Ontario entered into a Data Governance Agreement with the Institute for Clinical Evaluative Sciences (ICES) that enabled the linkage of the federal Indian Register (IR) to data at ICES. This study examined the impact of the IR linkage on First Nations population estimates and location of residence, measured by postal code or residence code. Overall, and for each First Nation community in Ontario, we compared First Nations population estimates from the ICES data with and without the IR linkage to estimates available from Indigenous and Northern Affairs Canada (INAC). ResultsWithout the IR, using only Ontario residence codes or postal codes that were unique to a given community, 62,242 individuals were identified as living in First Nations communities. This is approximately 30% lower than the current INAC on-reserve population estimate of 92,234 for First Nations communities in Ontario. Adding the IR allowed the use of non-unique postal codes as well, resulting in the identification of an additional 15,183 First Nations individuals. It also allowed the identification of over 113,000 First Nations individuals who live outside of First Nations communities, especially in urban areas. Finally, the combination of residence information and the IR permits communities to identify their registered member living within and outside their communities. Conclusion/ImplicationsUsing the IR in combination with geographic residence information, made possible through the Data Governance Agreement signed between Chiefs of Ontario and ICES, will provide First Nations communities with more accurate and complete population estimates, which is key to the production of useful and relevant First Nations-specific health research.

scholarly journals Methodology of Natsal-COVID Wave 1: a large, quasi-representative survey with qualitative follow-up measuring the impact of COVID-19 on sexual and reproductive health in Britain

2021 ◽  
Vol 6 ◽  
pp. 209
Author(s):  
Emily Dema ◽  
Andrew J Copas ◽  
Soazig Clifton ◽  
Anne Conolly ◽  
Margaret Blake ◽  
...  
Keyword(s):  
General Population ◽  
Reproductive Health ◽  
Sexual Behaviour ◽  
Sexual And Reproductive Health ◽  
Service Use ◽  
Population Data ◽  
Population Level ◽  
Level Data ◽  
The Impact

Background: Britain’s National Surveys of Sexual Attitudes and Lifestyles (Natsal) have been undertaken decennially since 1990 and provide a key data source underpinning sexual and reproductive health (SRH) policy. The COVID-19 pandemic disrupted many aspects of sexual lifestyles, triggering an urgent need for population-level data on sexual behaviour, relationships, and service use at a time when gold-standard in-person, household-based surveys with probability sampling were not feasible. We designed the Natsal-COVID study to understand the impact of COVID-19 on the nation’s SRH and assessed the sample representativeness. Methods: Natsal-COVID Wave 1 data collection was conducted four months (29/7-10/8/2020) after the announcement of Britain’s first national lockdown (23/03/2020). This was an online web-panel survey administered by survey research company, Ipsos MORI. Eligible participants were resident in Britain, aged 18-59 years, and the sample included a boost of those aged 18-29. Questions covered participants’ sexual behaviour, relationships, and SRH service use. Quotas and weighting were used to achieve a quasi-representative sample of the British general population. Participants meeting criteria of interest and agreeing to recontact were selected for qualitative follow-up interviews. Comparisons were made with contemporaneous national probability surveys and Natsal-3 (2010-12) to understand bias. Results: 6,654 participants completed the survey and 45 completed follow-up interviews. The weighted Natsal-COVID sample was similar to the general population in terms of gender, age, ethnicity, rurality, and, among sexually-active participants, numbers of sexual partners in the past year. However, the sample was more educated, contained more sexually-inexperienced people, and included more people in poorer health. Conclusions: Natsal-COVID Wave 1 rapidly collected quasi-representative population data to enable evaluation of the early population-level impact of COVID-19 and lockdown measures on SRH in Britain and inform policy. Although sampling was less representative than the decennial Natsals, Natsal-COVID will complement national surveillance data and Natsal-4 (planned for 2022).

Population-level effects of diet, lifestyle, and health environment on obesity and non-communicable diseases in India

2019 ◽  
Author(s):  
Kuhu Joshi ◽  
Devesh Roy ◽  
Lora Iannotti ◽  
Aishwarya Nagar ◽  
Avinash Kishore
Keyword(s):  
Urban Areas ◽  
Population Level ◽  
Overweight And Obesity ◽  
Lifestyle Changes ◽  
Exact Matching ◽  
Rapid Urbanization ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Linear Probability ◽  
The Impact

Abstract Background: Obesity is rising in developing countries like India and is associated with an increase in cardiometabolic problems. Rising incomes, rapid urbanization, and mechanization have induced lifestyle changes like consumption of more obesogenic foods and sedentary habits at work and leisure, contributing to a transition from under- to over-nutrition. This study maps the prevalence of adult (15-49 years) overweight and obesity across regions and socioeconomic groups in India, and estimates its association with lifestyle, health environment, dietary patterns, diabetes, and hypertension.Methods: We employ a combination of 3 latest nationally representative datasets with over 700,000 adults. We use a linear probability regression model to identify the correlates of overweight/obesity and their relative magnitudes. We use intra-household regression to identify differences between men and women and coarsened exact matching to causally estimate the impact of obesity on diabetes and hypertension.Results: Overweight/obesity rates have increased across all states, in rural and urban areas, and for all wealth levels. Women are more likely to be overweight/obese than men, even in the same household. Improved health environment (toilets, piped water, clean cooking fuel), urban jobs, television watching, and processed snacks increase the risk of overweight/obesity. Adults who are overweight/obese have a 5.6% higher risk of diabetes and a 9.7% higher risk of hypertension.Conclusions: Our results underscore the need for policy intervention to reduce the burden of obesity and NCD’s in India.

scholarly journals Comparing cancer incidence, stage at diagnosis and outcomes of First Nations and all other Manitobans: a retrospective analysis

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Tara C. Horrill ◽  
Lindsey Dahl ◽  
Esther Sanderson ◽  
Garry Munro ◽  
Cindy Garson ◽  
...  
Keyword(s):  
First Nations ◽  
Cancer Incidence ◽  
Population Level ◽  
Stage At Diagnosis ◽  
Epidemiological Evidence ◽  
Cox Proportional Hazard ◽  
Registry System ◽  
Underlying Causes ◽  
Cox Proportional Hazard Regression ◽  
The Impact

Abstract Background Globally, epidemiological evidence suggests cancer incidence and outcomes among Indigenous peoples are a growing concern. Although historically cancer among First Nations (FN) peoples in Canada was relatively unknown, recent epidemiological evidence reveals a widening of cancer related disparities. However evidence at the population level is limited. The aim of this study was to explore cancer incidence, stage at diagnosis, and outcomes among status FN peoples in comparison with all other Manitobans (AOM). Methods All cancers diagnosed between April 1, 2004 and March 31, 2011 were linked with the Indian Registry System and five provincial healthcare databases to compare differences in characteristics, cancer incidence, and stage at diagnosis and mortality of the FN and AOM cohorts. Cox proportional hazard regression models were used to examine mortality. Results The FN cohort was significantly younger, with higher comorbidities than AOM. A higher proportion of FN people were diagnosed with cancer at stages III (18.7% vs. 15.4%) and IV (22.4% vs. 19.9%). Cancer incidence was significantly lower in the FN cohort, however, there were no significant differences between the two cohorts after adjusting for age, sex, income and area of residence. No significant trends in cancer incidence were identified in either cohort over time. Mortality was generally higher in the FN cohort. Conclusions Despite similar cancer incidence, FN peoples in Manitoba experience poorer survival. The underlying causes of these disparities are not yet understood, particularly in relation to the impact of colonization and other determinants of health.

scholarly journals Loss of Trust Among First Nation People: Implications when Implementing Child Protection Treatment Initiatives

2020 ◽  
Vol 3 (4) ◽  
pp. 50-58 ◽  
Author(s):  
Steven Thibodeau ◽  
Faye North Peigan
Keyword(s):  
First Nations ◽  
Social Workers ◽  
Health Care Providers ◽  
Child Protection ◽  
Social Issues ◽  
First Nation ◽  
Care Providers ◽  
Nations People ◽  
First Nations People ◽  
The Impact

Social workers and other health care providers have been asked to develop and implement innovative and culturally sensitive treatment initiatives in First Nation communities. However, because of traumatization and oppression, many First Nations people face troubling psycho-social issues which have resulted in a diminished capacity to trust. If this loss of trust is not dealt with skillfully, it can impede the ability of social workers to implement initiatives. Through a process of person-centred interviewing, 36 participants identified four levels of trust that have been diminished among many First Nations people. The impact of this phenomenon on the development and implementation of community based initiatives is discussed in this article.

scholarly journals Impact of increasing vegetarian availability on meal selection and sales in cafeterias

2019 ◽  
Vol 116 (42) ◽  
pp. 20923-20929 ◽  
Author(s):  
Emma E. Garnett ◽  
Andrew Balmford ◽  
Chris Sandbrook ◽  
Mark A. Pilling ◽  
Theresa M. Marteau
Keyword(s):  
Large Scale ◽  
Population Level ◽  
Field Studies ◽  
Individual Level ◽  
Rebound Effects ◽  
Percentage Points ◽  
Physical Environments ◽  
Meat Meal ◽  
Level Data ◽  
The Impact

Shifting people in higher income countries toward more plant-based diets would protect the natural environment and improve population health. Research in other domains suggests altering the physical environments in which people make decisions (“nudging”) holds promise for achieving socially desirable behavior change. Here, we examine the impact of attempting to nudge meal selection by increasing the proportion of vegetarian meals offered in a year-long large-scale series of observational and experimental field studies. Anonymized individual-level data from 94,644 meals purchased in 2017 were collected from 3 cafeterias at an English university. Doubling the proportion of vegetarian meals available from 25 to 50% (e.g., from 1 in 4 to 2 in 4 options) increased vegetarian meal sales (and decreased meat meal sales) by 14.9 and 14.5 percentage points in the observational study (2 cafeterias) and by 7.8 percentage points in the experimental study (1 cafeteria), equivalent to proportional increases in vegetarian meal sales of 61.8%, 78.8%, and 40.8%, respectively. Linking sales data to participants’ previous meal purchases revealed that the largest effects were found in the quartile of diners with the lowest prior levels of vegetarian meal selection. Moreover, serving more vegetarian options had little impact on overall sales and did not lead to detectable rebound effects: Vegetarian sales were not lower at other mealtimes. These results provide robust evidence to support the potential for simple changes to catering practices to make an important contribution to achieving more sustainable diets at the population level.

First Nations Community Well-Being Research and Large Data Sets: A Respectful Caution

2017 ◽  
Vol 12 (2) ◽  
pp. 15-24 ◽  
Author(s):  
Alexandra S. Drawson ◽  
Aislin R. Mushquash ◽  
Christopher J. Mushquash
Keyword(s):  
First Nations ◽  
Social Determinants ◽  
Large Data ◽  
Well Being ◽  
Large Data Sets ◽  
Data Sets ◽  
Nations People ◽  
Level Data ◽  
Traditional Language ◽  
First Nations People

Health researchers are increasingly encouraged to use large, community-level data sets to examine factors that promote or diminish health, including social determinants. First Nations people in Canada experience disparity in a range of social determinants of health that result in relatively low community well-being scores, when compared to non-First Nations people. However, First Nations people also possess unique protective factors that enhance well-being, such as traditional language usage. Large data sets offer First Nations a new avenue for advocating for supports and services to decrease health inequity while developing culture-based evidence. However, care must be taken to ensure that these data are interpreted appropriately. In this paper, we respectfully offer a cautionary note on the importance of understanding culture and context when conducting First Nations health research with large data sets. We have framed this caution through a narrative presentation of a simple and concrete example. We then outline some approaches to research that can ensure appropriate development of research questions and interpretation of research findings.

scholarly journals An Assessment of the Access to Credit-Welfare Nexus: Evidence from Mauritania

2017 ◽  
Vol 12 (9) ◽  
pp. 77 ◽  
Author(s):  
Alessandra Amendola ◽  
Marinella Boccia ◽  
Gianluca Mele ◽  
Luca Sensini
Keyword(s):  
Rural Areas ◽  
Financial Services ◽  
Urban Areas ◽  
Credit Access ◽  
Access To Credit ◽  
Household Level ◽  
Support Strategies ◽  
Level Data ◽  
The Impact ◽  
The Relationship

This paper evaluates the impact of access to credit from banks and other financial institutions on household welfare in Mauritania. Household level data are used to evaluate the relationship between credit access, a range of household characteristics, and welfare indicators. To address the threats of potential endogeneity, an index of household isolation is used to instrument access to credit. Evidence on the validity of the exclusion restriction is provided showing that household isolation is unrelated with households and area characteristics six years prior to the measurements on which this analysis is based. Results show that households with older and more educated heads are more likely to access financial services, as are households living in urban areas. In addition, greater financial access is associated with a reduced dependence on household production and increased investment in human capital. The policy conclusions from our analysis support strategies for expanding financial infrastructures in underserved rural areas of Mauritania.

scholarly journals Racial and socioeconomic disparities in outcomes following pediatric cerebrospinal fluid shunt procedures

2015 ◽  
Vol 15 (6) ◽  
pp. 560-566 ◽  
Author(s):  
Frank J. Attenello ◽  
Alvin Ng ◽  
Timothy Wen ◽  
Steven Y. Cen ◽  
Nerses Sanossian ◽  
...  
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Population Level ◽  
Socioeconomic Disparities ◽  
Csf Shunt ◽  
Health Care Outcomes ◽  
Shunt Procedure ◽  
Level Data ◽  
Csf Shunting ◽  
The Impact

OBJECT Racial and socioeconomic disparities within the US health care system are a growing concern. Despite extensive research and efforts to narrow such disparities, minorities and economically disadvantaged patients continue to exhibit inferior health care outcomes. Disparities in the delivery of pediatric neurosurgical care are understudied. Authors of this study examine the impact of race and socioeconomic status on outcomes following pediatric CSF shunting procedures. METHODS Discharge information from the 2000, 2003, 2006, and 2009 Kids' Inpatient Database for individuals (age < 21 years) with a diagnosis of hydrocephalus who had undergone CSF shunting procedures was abstracted for analysis. Multivariate logistic regression analyses, adjusting for patient and hospital factors and annual CSF shunt procedure volume, were performed to evaluate the effects of race and payer status on the likelihood of inpatient mortality and nonroutine hospital discharge (that is, not to home). RESULTS African American patients (p < 0.05) had an increased likelihood of inpatient death and nonroutine discharge compared with white patients. Furthermore, Medicaid patients had a significantly higher likelihood of nonroutine discharge (p < 0.05) as compared with privately insured patients. CONCLUSIONS Findings in this study, which utilized US population-level data, suggest the presence of racial and socioeconomic status outcome disparities following pediatric CSF shunting procedures. Further studies on health disparities in this population are warranted.

Putting Indigenous Harm Reduction to Work: Developing and Evaluating “Not Just Naloxone”

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Andrea Medley ◽  
Sarah Levine ◽  
Alexa Norton
Keyword(s):  
Harm Reduction ◽  
First Nations ◽  
Access To Health Services ◽  
Community Members ◽  
Local Leadership ◽  
Train The Trainer ◽  
Nations People ◽  
Training Materials ◽  
First Nations People ◽  
The Impact

First Nations people and communities have long been championing the provision of holistic, self-determining, culturally safe, and responsive health care. In April 2016, a catastrophic rise in illicit drug overdose deaths in the province of British Columbia (BC), Canada, led to the declaration of a public health emergency. Due to the compounding historical and ongoing impacts of colonialism, including trauma and inequitable access to health services, First Nations people in BC are disproportionately impacted by this crisis. In response, the First Nations Health Authority created Not Just Naloxone (NJN), a train-the-trainer workshop designed to build Indigenous harm reduction knowledge and skills within First Nations communities. This article describes the NJN program and presents the results of a follow-up evaluation of 37 participants from six NJN workshops held between December 2017 and October 2018. Core strengths of the training included an Indigenized approach and the opportunity to build networks of support. Respondents reported increased knowledge and confidence presenting about harm reduction and feeling more prepared to respond to overdoses. Areas for improvement included maintaining up-to-date training materials and navigating emotional triggers for participants. Trainees went on to train over 2,400 community members in naloxone and Indigenous harm reduction, and reported that communities’ awareness and attitudes around harm reduction began to change. Challenges providing community trainings included buy-in from local leadership and persistent abstinence-based beliefs. This evaluation demonstrates the impact of holistic, culturally safe harm reduction training and the need for a connected community of Indigenous harm reduction champions.

scholarly journals Indigenous and Tribal Peoples Data Governance in Health Research: A Systematic Review

2021 ◽  
Vol 18 (19) ◽  
pp. 10318
Author(s):  
Kalinda E. Griffiths ◽  
Jessica Blain ◽  
Claire M. Vajdic ◽  
Louisa Jorm
Keyword(s):  
Systematic Review ◽  
Health Research ◽  
A Priori ◽  
Population Level ◽  
Research Literature ◽  
Data Governance ◽  
Institutional Ethics ◽  
Level Data ◽  
Governance Strategies ◽  
Data Stewardship

There is increasing potential to improve the research and reporting on the health and wellbeing of Indigenous and Tribal peoples through the collection and (re)use of population-level data. As the data economy grows and the value of data increases, the optimization of data pertaining to Indigenous peoples requires governance that defines who makes decisions on behalf of whom and how these data can and should be used. An international a priori PROSPERO (#CRD42020170033) systematic review was undertaken to examine the health research literature to (1) identify, describe, and synthesize definitions and principles; (2) identify and describe data governance frameworks; and (3) identify, describe, and synthesize processes, policies and practices used in Indigenous Data Governance (ID-GOV). Sixty-eight articles were included in the review that found five components that require consideration in the governance of health research data pertaining to Indigenous people. This included (1) Indigenous governance; (2) institutional ethics; (3) socio-political dynamics; (4) data management and data stewardship; and (5) overarching influences. This review provides the first systematic international review of ID-GOV that could potentially be used in a range of governance strategies moving forward in health research.

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