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


CONCLUSIONS
First Nations people are a previously unidentified group at high risk for fracture.
Leslie
William D
WD
Department of Medicine, University of Manitoba, Winnipeg, Man. bleslie@sbgh.mb.ca
Derksen
Shelley
S
Metge
Colleen
C
Lix
Lisa M
LM
Salamon
Elizabeth A
EA
Wood Steiman
Pauline
P
Roos
Leslie L
LL
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050723:Fractures, Bone / Q000208:ethnology*; D006801:Humans; D015994:Incidence; D007198:Indians, North American; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D016555:Matched-Pair Analysis; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D017678:Sex Distribution