title: Incidence and prevalence of chronic obstructive pulmonary disease among aboriginal peoples in Alberta, Canada.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a major respiratory disorder, largely caused by smoking that has been linked with large health inequalities worldwide. There are important gaps in our knowledge about how COPD affects Aboriginal peoples. This retrospective cohort study assessed the epidemiology of COPD in a cohort of Aboriginal peoples relative to a non-Aboriginal cohort.
  
  
  METHODS
  We used linkage of administrative health databases in Alberta (Canada) from April 1, 2002 to March 31, 2010 to compare the annual prevalence, and the incidence rates of COPD between Aboriginal and non-Aboriginal cohorts aged 35 years and older. Poisson regression models adjusted the analysis for important sociodemographic factors.
  
  
  RESULTS
  Compared to a non-Aboriginal cohort, prevalence estimates of COPD from 2002 to 2010 were 2.3 to 2.4 times greater among Registered First Nations peoples, followed by the Inuit (1.86 to 2.10 times higher) and the Métis (1.59 to 1.67 times higher). All Aboriginal peoples had significantly higher COPD incidence rates than the non-Aboriginal group (incidence rate ratio [IRR]: 2.1; 95% confidence interval [CI]: 1.97, 2.27). COPD incidence rates were higher in First Nation peoples (IRR: 2.37; 95% CI: 2.19, 2.56) followed by Inuit (IRR: 1.92; 95% CI: 1.64, 2.25) and Métis (IRR: 1.49; 95% CI: 1.32, 1.69) groups.
  
  
  CONCLUSIONS
  We found a high burden of COPD among Aboriginal peoples living in Alberta; a province with the third largest Aboriginal population in Canada. Altogether, the three Aboriginal peoples groups have higher prevalence and incidence of COPD compared to a non-Aboriginal cohort. The condition affects the three Aboriginal groups differently; Registered First Nations and Inuit have the highest burden of COPD. Reasons for these differences should be further explored within a framework of social determinants of health to help designing interventions that effectively influence modifiable COPD risk factors in each of the Aboriginal groups.
authors: School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors: Maria B
authors: MB
authors: Ospina
authors: School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors: Don
authors: D
authors: Voaklander
authors: School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors: Ambikaipakan
authors: A
authors: Senthilselvan
authors: Division of Pulmonary Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors: Michael K
authors: MK
authors: Stickland
authors: Faculty of Health Sciences; Simon Fraser University, Vancouver, British Columbia, Canada.
authors: Malcolm
authors: M
authors: King
authors: Alberta Health, Edmonton, Alberta, Canada.
authors: Andrew W
authors: AW
authors: Harris
authors: School of Public Health, University of Alberta, Edmonton, Alberta, Canada; Division of Pulmonary Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada; Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors: Brian H
authors: BH
authors: Rowe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000266:history