title: Asthma and COPD among aboriginals in Alberta, Canada.
abstract: BACKGROUND
  Aboriginals in Canada bear a disproportionately higher burden of some chronic illnesses than nonaboriginals. Although there is a greater prevalence of smoking, poor housing, and overcrowding in aboriginal than nonaboriginal communities, the rates of office and emergency visits for asthma and COPD among aboriginals are not well known.
  
  
  OBJECTIVE
  To determine whether aboriginals require higher rates of asthma and COPD emergency and office visits than nonaboriginals.
  
  
  METHODS
  Population-based cohort of people residing in Alberta, Canada (population 2.8 million) between April 1, 1996, and March 31, 1997.
  
  
  METHODS
  Retrospective cohort study.
  
  
  RESULTS
  We observed that aboriginals were 2.1 times (95% confidence interval [CI], 2.0 to 2.2) and 1.6 times (95% CI, 1.6 to 1.6) more likely to have an emergency and office visit for asthma or COPD, respectively, when compared to age-matched and sex-matched nonaboriginals. However, they were 55% (95% CI, 52 to 58%) less likely to see a specialist and 66% (95% CI, 63 to 70%) less likely to undergo spirometry than nonaboriginals.
  
  
  CONCLUSIONS
  These findings indicate that aboriginals bear a disproportionately higher burden of asthma and COPD than nonaboriginals. However, lower use of spirometry and specialist services suggests that there might be access barriers to quality health care for aboriginals in Canada.
authors.affiliation: Department of Medicine, Pulmonary Division, University of Alberta, Edmonton, Alberta, Canada. don.sin@ualberta.ca
authors.forename: Don D
authors.initials: DD
authors.lastname: Sin
authors.forename: Heather
authors.initials: H
authors.lastname: Wells
authors.forename: Lawrence W
authors.initials: LW
authors.lastname: Svenson
authors.forename: S F Paul
authors.initials: SF
authors.lastname: Man
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007198:Indians, North American; D007223:Infant; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies