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Aboriginal peoples, health and healing approaches: the effects of age and place on health.

https://arctichealth.org/en/permalink/ahliterature139688
Source
Soc Sci Med. 2011 Feb;72(3):355-64
Publication Type
Article
Date
Feb-2011
Author
Kathi Wilson
Mark W Rosenberg
Sylvia Abonyi
Author Affiliation
University of Toronto Mississauga, Department of Geography, 3359 Mississauga Road North, Mississauga, Ontario L5L 1C6, Canada. kathi.wilson@utoronto.ca
Source
Soc Sci Med. 2011 Feb;72(3):355-64
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Canada
Cohort Studies
Delivery of Health Care - utilization
Female
Health Status Disparities
Health Surveys
Humans
Indians, North American - statistics & numerical data
Inuits - statistics & numerical data
Male
Medicine, Traditional - methods
Middle Aged
Social Identification
Young Adult
Abstract
For demographic reasons and as a result of a number of high profile health incidents in recent years, much of the health research and policy focus is on the younger cohorts of Aboriginal peoples in Canada. A critical examination of recent demographic trends reveals, however, that older cohorts of the Aboriginal population are increasing at a faster rate than younger cohorts, primarily due to improvements in life expectancy and declining fertility rates. Yet, there are surprisingly few health studies that have recognized the aging of the Aboriginal population. The overall goal of this paper is to examine differences in health status, use of conventional health care and traditional approaches to healing between older and younger cohorts of the Aboriginal population as well as to examine the importance of age as a determinant of health and health care use. Using data from the 2001 Statistics Canada Aboriginal Peoples Survey and contingency tables and logistic regression, the results demonstrate that older Aboriginal people face unique challenges - e.g. loss of traditional approaches to healing, geographic isolation, identity politics, constitutional and legal divisions within the Aboriginal community - with respect to their health and access to health services. These outcomes result from a colonial past and contemporary policies that affect all Aboriginal people.
PubMed ID
21036444 View in PubMed
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Access to ambulatory care for American Indians and Alaska Natives; the relative importance of personal and community resources.

https://arctichealth.org/en/permalink/ahliterature6151
Source
Soc Sci Med. 1995 Feb;40(3):393-407
Publication Type
Article
Date
Feb-1995
Author
P J Cunningham
L J Cornelius
Author Affiliation
Agency for Health Care Policy and Research, Rockville, MD 20852.
Source
Soc Sci Med. 1995 Feb;40(3):393-407
Date
Feb-1995
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alaska - ethnology
Ambulatory Care - utilization
Female
Health Care Reform - standards
Health Services Accessibility - statistics & numerical data
Health Services Needs and Demand - statistics & numerical data
Hospitalization
Humans
Indians, North American - statistics & numerical data
Insurance, Health
Inuits - statistics & numerical data
Least-Squares Analysis
Male
Medically underserved area
Middle Aged
Multivariate Analysis
Rural Population
Socioeconomic Factors
Time Factors
Abstract
The debate on health care reform in the United States has been greatly influenced by various national studies showing a strong relationship between lack of public or private health care coverage and inadequate access to health services. There is also much concern about deficiencies in the availability and delivery of services to certain population groups--especially for those living in the most remote and sparsely populated areas of the country. However, national studies have generally not demonstrated that the use of health services is strongly associated with urban/rural residence or the supply of medical providers. In this study, we show that national studies can obscure the problems of certain population groups including American Indians and Alaska Natives. Using data from the 1987 National Medical Expenditure Survey, the findings show that the availability of medical providers as well as place of residence were strongly associated with the use of health care by American Indians and Alaska Natives. Although American Indians and Alaska Natives included in this study were eligible to receive health care free of charge from the Indian Health Service (IHS), financial factors were also significantly associated with use due to the use of services other than those provided or sponsored by IHS. Also, the results show that while geographic and supply factors have only modest effects on the average travel time to medical providers for the U.S. population as a whole, travel times are dramatically longer for American Indians and Alaska Natives living in rural areas and where there are few medical providers. In addition, there appear to be fewer hospitalizations in areas where there are IHS outpatient services. We conclude by discussing the need for health care reform to take into account the diversity of a large country such as the U.S., and the special needs of population groups that are usually not adequately represented in national studies.
PubMed ID
7899951 View in PubMed
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Access to care in the Indian Health Service.

https://arctichealth.org/en/permalink/ahliterature6178
Source
Health Aff (Millwood). 1993;12(3):224-33
Publication Type
Article
Date
1993
Author
P J Cunningham
Author Affiliation
Center for General Health Services Intramural Research, Agency for Health Care Policy and Research, Rockville, MD.
Source
Health Aff (Millwood). 1993;12(3):224-33
Date
1993
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Child
Child, Preschool
Eligibility Determination
Employment
Female
Health Care Reform
Health Services Accessibility - statistics & numerical data
Humans
Indians, North American - statistics & numerical data
Infant
Male
Middle Aged
Socioeconomic Factors
United States
United States Indian Health Service - utilization
Abstract
The Indian Health Service (IHS) is unique among U.S. private and public health programs in that free comprehensive health services are provided to eligible American Indians and Alaska Natives regardless of their ability to pay. However, resource limitations may compel some eligible persons to go outside of the IHS system to receive health care. Although IHS eligibles have comparatively low rates of private or public health care coverage, and much of this population lives in underserved areas, over half of IHS-eligible persons had some type of out-of-plan use in 1987. Furthermore, services received through private providers appear to supplement those received through IHS-sponsored providers. Overall, persons who use both IHS and non-IHS providers have higher levels of health care use than do those who rely exclusively on the IHS.
PubMed ID
8244235 View in PubMed
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Access to health care among status Aboriginal people with chronic kidney disease.

https://arctichealth.org/en/permalink/ahliterature154422
Source
CMAJ. 2008 Nov 4;179(10):1007-12
Publication Type
Article
Date
Nov-4-2008
Author
Song Gao
Braden J Manns
Bruce F Culleton
Marcello Tonelli
Hude Quan
Lynden Crowshoe
William A Ghali
Lawrence W Svenson
Sofia Ahmed
Brenda R Hemmelgarn
Author Affiliation
Department of Medicine, Division of Nephrology, University of Calgary, Calgary, AB.
Source
CMAJ. 2008 Nov 4;179(10):1007-12
Date
Nov-4-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alberta - epidemiology
Chronic Disease
Creatinine - blood
Delphi Technique
Female
Glomerular Filtration Rate
Health Services Accessibility
Healthcare Disparities
Humans
Indians, North American - statistics & numerical data
Kidney Diseases - epidemiology
Male
Middle Aged
Nephrology
Office visits - statistics & numerical data
Patient Admission - statistics & numerical data
Registries
Severity of Illness Index
Abstract
Ethnic disparities in access to health care and health outcomes are well documented. It is unclear whether similar differences exist between Aboriginal and non-Aboriginal people with chronic kidney disease in Canada. We determined whether access to care differed between status Aboriginal people (Aboriginal people registered under the federal Indian Act) and non-Aboriginal people with chronic kidney disease.
We identified 106 511 non-Aboriginal and 1182 Aboriginal patients with chronic kidney disease (estimated glomerular filtration rate less than 60 mL/min/1.73 m(2)). We compared outcomes, including hospital admissions, that may have been preventable with appropriate outpatient care (ambulatory-care-sensitive conditions) as well as use of specialist services, including visits to nephrologists and general internists.
Aboriginal people were almost twice as likely as non-Aboriginal people to be admitted to hospital for an ambulatory-care-sensitive condition (rate ratio 1.77, 95% confidence interval [CI] 1.46-2.13). Aboriginal people with severe chronic kidney disease (estimated glomerular filtration rate
Notes
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Cites: BMJ. 2003 Aug 23;327(7412):419-2212933728
Cites: Nephrol Dial Transplant. 2004 Jul;19(7):1808-1415199194
Cites: CMAJ. 2004 Sep 14;171(6):577-8215367459
Cites: Health Rep. 1993;5(2):179-888292757
Cites: Am J Public Health. 1996 Apr;86(4):520-48604782
Cites: CMAJ. 1996 Dec 1;155(11):1569-788956834
Cites: Health Econ. 1997 Mar-Apr;6(2):197-2079158971
Cites: Health Rep. 1998 Spring;9(4):49-58(Eng); 51-61(Fre)9836880
Cites: Ann Intern Med. 1999 Mar 16;130(6):461-7010075613
Cites: Am J Kidney Dis. 1999 Apr;33(4):728-3310196016
Cites: J Am Soc Nephrol. 2005 Feb;16(2):459-6615615823
Cites: Can J Public Health. 2005 Jan-Feb;96 Suppl 1:S39-4415686152
Cites: J Am Soc Nephrol. 2007 Nov;18(11):2953-917942955
Comment In: CMAJ. 2008 Nov 4;179(10):985-618981431
PubMed ID
18981441 View in PubMed
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Access to primary care from the perspective of Aboriginal patients at an urban emergency department.

https://arctichealth.org/en/permalink/ahliterature139323
Source
Qual Health Res. 2011 Mar;21(3):333-48
Publication Type
Article
Date
Mar-2011
Author
Annette J Browne
Victoria L Smye
Patricia Rodney
Sannie Y Tang
Bill Mussell
John O'Neil
Author Affiliation
School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada. annette.browne@nursing.ubc.ca
Source
Qual Health Res. 2011 Mar;21(3):333-48
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Adult
Anthropology, Cultural
British Columbia
Canada
Emergency Service, Hospital - statistics & numerical data - utilization
Female
Health Knowledge, Attitudes, Practice
Health Services Accessibility - statistics & numerical data
Health services needs and demand
Health Status Disparities
Humans
Indians, North American - statistics & numerical data
Male
Middle Aged
Primary Health Care - statistics & numerical data
Time Factors
Triage
Urban Population - statistics & numerical data
Young Adult
Abstract
In this article, we discuss findings from an ethnographic study in which we explored experiences of access to primary care services from the perspective of Aboriginal people seeking care at an emergency department (ED) located in a large Canadian city. Data were collected over 20 months of immersion in the ED, and included participant observation and in-depth interviews with 44 patients triaged as stable and nonurgent, most of whom were living in poverty and residing in the inner city. Three themes in the findings are discussed: (a) anticipating providers' assumptions; (b) seeking help for chronic pain; and (c) use of the ED as a reflection of social suffering. Implications of these findings are discussed in relation to the role of the ED as well as the broader primary care sector in responding to the needs of patients affected by poverty, racialization, and other forms of disadvantage.
PubMed ID
21075979 View in PubMed
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Access to the Indian health service care system is not associated with early enrollment in medicaid for American Indian and Alaska Natives with cancer.

https://arctichealth.org/en/permalink/ahliterature259101
Source
Cancer Epidemiol Biomarkers Prev. 2014 Feb;23(2):362-4
Publication Type
Article
Date
Feb-2014
Author
Andrea N Burnett-Hartman
Mark E Bensink
Kristin Berry
David G Mummy
Victoria Warren-Mears
Carol Korenbrot
Scott D Ramsey
Source
Cancer Epidemiol Biomarkers Prev. 2014 Feb;23(2):362-4
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Alaska
Female
Health Services Accessibility - statistics & numerical data
Health services needs and demand
Humans
Indians, North American - statistics & numerical data
Male
Medicaid - statistics & numerical data
Middle Aged
United States
United States Indian Health Service - statistics & numerical data
Young Adult
Abstract
For uninsured American Indians and Alaskan Natives (AIAN) diagnosed with cancer, prompt enrollment in Medicaid may speed access to treatment and improve survival. We hypothesized that AIANs who were eligible for the Indian Health Service Care System (IHSCS) at cancer diagnosis may be enrolled in Medicaid sooner than other AIANs.
Using Washington, Oregon, and California State Cancer Registries, we identified AIANs with a primary diagnosis of lung, breast, colorectal, cervical, ovarian, stomach, or prostate cancer between 2001 and 2007. Among AIANs enrolled in Medicaid within 365 days of a cancer diagnosis, we linked cancer registry records with Medicaid enrollment data and used a multivariate logistic regression model to compare the odds of delayed Medicaid enrollment between those with (n = 223) and without (n = 177) IHSCS eligibility.
Among AIANs who enrolled in Medicaid during the year following their cancer diagnosis, approximately 32% enrolled >1 month following diagnosis. Comparing those without IHSCS eligibility to those with IHSCS eligibility, the adjusted odds ratio (OR) for moderately late Medicaid enrollment (between 1 and 6 months after diagnosis) relative to early Medicaid enrollment (=1 month after diagnosis) was 1.10 [95% confidence interval (CI), 0.62-1.95] and for very late Medicaid enrollment (>6 months to 12 months after diagnosis), OR was 1.14 (CI, 0.54-2.43).
IHSCS eligibility at the time of diagnosis does not seem to facilitate early Medicaid enrollment.
Because cancer survival rates in AIANs are among the lowest of any racial group, additional research is needed to identify factors that improve access to care in AIANs.
PubMed ID
24296857 View in PubMed
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Accounting for vulnerability to illness and social disadvantage in pandemic critical care triage.

https://arctichealth.org/en/permalink/ahliterature96997
Source
J Clin Ethics. 2010;21(1):23-9
Publication Type
Article
Date
2010
Author
Chris Kaposy
Author Affiliation
Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. christopher.kaposy@med.mun.ca
Source
J Clin Ethics. 2010;21(1):23-9
Date
2010
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Critical Care
Cultural Characteristics
Disaster Planning - trends
Disease Outbreaks
Health Care Rationing - ethics
Health Policy - trends
Humans
Indians, North American - statistics & numerical data
Influenza A Virus, H1N1 Subtype - isolation & purification
Influenza, Human - ethnology - mortality - virology
Intensive Care Units - organization & administration - standards
Inuits - statistics & numerical data
Newfoundland and Labrador - epidemiology
Patient Selection - ethics
Prognosis
Risk assessment
Social Class
Triage - methods - organization & administration - standards - trends
Vulnerable Populations
Abstract
In a pandemic situation, resources in intensive care units may be stretched to the breaking point, and critical care triage may become necessary. In such a situation, I argue that a patient's combined vulnerability to illness and social disadvantage should be a justification for giving that patient some priority for critical care. In this article I present an example of a critical care triage protocol that recognizes the moral relevance of vulnerability to illness and social disadvantage, from the Canadian province of Newfoundland and Labrador.
PubMed ID
20465071 View in PubMed
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Acculturation stress among Maya in the United States.

https://arctichealth.org/en/permalink/ahliterature121282
Source
J Cult Divers. 2012;19(2):58-64
Publication Type
Article
Date
2012
Author
Eugenia Millender
Author Affiliation
Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA. emillend@fau.edu
Source
J Cult Divers. 2012;19(2):58-64
Date
2012
Language
English
Publication Type
Article
Keywords
Acculturation
Cultural Characteristics
Cultural Diversity
Health Promotion - methods
Humans
Indians, North American - statistics & numerical data
Mexico - ethnology
Nursing Research
Stress, Psychological - ethnology
United States - epidemiology
Abstract
Abstract: As health care disparities become more evident in our multicultural nation, culture sensitive health research needs to be a priority in order for good health care to take place. This article will explore the literature related to acculturation stress and mental health disparities among the Mayan population. Literatures of similar but distinct groups are included due to the limited amount of research of the Mayan population. Using Leiniger's Transcultural nursing theory, these findings suggest that nurses have a large gap to fill to address the mental health disparities of specific cultural groups like the indigenous Maya, thereby satisfying their nursing obligations.
PubMed ID
22924204 View in PubMed
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Actinic prurigo: clinical features and prognosis.

https://arctichealth.org/en/permalink/ahliterature223861
Source
J Am Acad Dermatol. 1992 May;26(5 Pt 1):683-92
Publication Type
Article
Date
May-1992
Author
P R Lane
D J Hogan
M J Martel
B. Reeder
J. Irvine
Author Affiliation
Division of Dermatology, University of Saskatchewan, Saskatoon, Canada.
Source
J Am Acad Dermatol. 1992 May;26(5 Pt 1):683-92
Date
May-1992
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Analysis of Variance
Child
Child, Preschool
Female
Humans
Indians, North American - statistics & numerical data
Male
Middle Aged
Photosensitivity Disorders - diagnosis - epidemiology
Prognosis
Prurigo - diagnosis - epidemiology
Questionnaires
Saskatchewan - epidemiology
Sunlight - adverse effects
Abstract
Actinic prurigo, an idiopathic familial photodermatosis, has been described in Amerindians in Manitoba, Canada, as well as in the United States, Mexico, and South America.
Our purpose was to describe the clinical features and prognosis of actinic prurigo in Amerindians in Saskatchewan, Canada.
Clinical examinations, questionnaires, phototesting, and laboratory tests were used.
We present a series of 93 Amerindian patients. The face is the most commonly involved area. A hereditary tendency, cheilitis, and pruritus are prominent features. One third of patients report some lesions, often minor, during the winter. The majority of patients phototested were sensitive to ultraviolet A light.
We find the age of onset of actinic prurigo to be the most important feature in determining the type of eruption and the prognosis for the patient. In general the younger ages of onset (up to 20 years of age) are associated with cheilitis and more acute eruptions and are more likely to improve over 5 years. Those who develop actinic prurigo as adults (21 years of age and older) tend to have a milder and more persistent dermatosis.
Notes
Comment In: J Am Acad Dermatol. 1997 Mar;36(3 Pt 1):504-59091504
PubMed ID
1583166 View in PubMed
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Acute care hospitalization of Aboriginal children and youth.

https://arctichealth.org/en/permalink/ahliterature295326
Source
Health Rep. 2017 Jul 19; 28(7):11-17
Publication Type
Journal Article
Date
Jul-19-2017
Author
Anne Guèvremont
Gisèle Carrière
Evelyne Bougie
Dafna Kohen
Author Affiliation
Health Analysis Division, Statistics Canada, Ottawa, Ontario.
Source
Health Rep. 2017 Jul 19; 28(7):11-17
Date
Jul-19-2017
Language
English
Publication Type
Journal Article
Keywords
Acute Disease
Adolescent
Canada - epidemiology
Censuses
Child
Child, Preschool
Female
Hospitalization - statistics & numerical data
Humans
Indians, North American - statistics & numerical data
Infant
Infant, Newborn
Inuits
Male
Patient Discharge
Young Adult
Abstract
Research that has examined Aboriginal children's hospitalization rates at the national level has been limited to analyses of areas with large percentages of Aboriginal residents, rather than of Aboriginal individuals. This study uses linked census and administrative data to describe hospitalization patterns among children and youth aged 0 to 19, by Aboriginal identity, for all provinces and territories except Quebec.
The 2006 Census was linked to the 2006/2007-to-2008/2009 Discharge Abstract Database, which contains hospital records from all acute care facilities (except Quebec). Hospital records were examined by Aboriginal identity, as reported to the census, according to International Classification of Diseases chapters based on "the most responsible diagnosis." Age-standardized hospitalization rates (ASHRs) were calculated per 100,000 population, and age-standardized rate ratios (RRs) were calculated for Aboriginal groups relative to non-Aboriginal people.
ASHRs were consistently higher among Aboriginal children and youth relative to their non-Aboriginal counterparts; rates for children aged 0 to 9 were 1.4 to 1.8 times higher; for youth aged 10 to 19, 2.0 to 3.8 times higher. For all children aged 0 to 9, the leading cause of hospitalization was "diseases of the respiratory system," but RRs for Aboriginal children ranged from 1.7 to 2.5, compared with non-Aboriginal children. Disparities between Aboriginal and non-Aboriginal 10- to 19-year-olds were pronounced for injuries due to assaults (RRs from 4.8 to 10.0), self-inflicted injuries (RRs from 2.7 to 14.2), and pregnancy, childbirth and the puerperium (RRs from 4.1 to 9.8).
Additional research is needed to examine reasons for the disparities in hospitalization rates between Aboriginal and non-Aboriginal children and youth.
PubMed ID
28722747 View in PubMed
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729 records – page 1 of 73.