title: Inflammatory Arthritis Prevalence and Health Services Use in the First Nations and Non-First Nations Populations of Alberta, Canada.
abstract: To estimate prevalence of rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic disease (PsD), and crystal-related arthritis and health care use for inflammatory arthritis in First Nations and non-First Nations patients in Alberta, Canada.
  
  
  
  Population-based cohorts of adults with RA, AS, PsD, and crystal-related arthritis were defined, with First Nations determination by premium payer status, to estimate prevalence rates. Rates of outpatient primary care, specialist visits, and hospitalizations (all-cause, inflammatory-arthritis specific) were estimated.
  
  
  
  RA affected 3 times as many First Nations residents compared to non-First Nations residents (standardized rate ratio [SRR] 3.2, 95% confidence interval [95% CI] 2.9-3.4). AS and PsD were more prevalent in First Nations (AS 0.6 per 100 residents; SRR 2.7, 95% CI 2.3-3.2 and PsD 0.3 per 100 residents; SRR 1.5, 95% CI 1.3-1.9), whereas crystal-related arthritis was less prevalent (SRR 0.7, 95% CI 0.6-0.7). First Nations patients were more likely to have primary care visits (SRR 1.7, 95% CI 1.6-1.8) and less likely to have specialist visits (SRR 0.6, 95% CI 0.6-0.7) for RA relative to non-First Nations individuals. In PsD and crystal-related arthritis, First Nations people had higher rates of cause-specific hospitalizations.
  
  
  
  The estimated prevalence of RA, AS, and PsD was higher in the First Nations population, while crystal-related arthritis was less prevalent compared to the non-First Nations population. First Nations people were more likely to see primary care physicians and were less likely to see specialists for inflammatory arthritis care.
authors.affiliation: University of Calgary, Calgary, Alberta, Canada.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Barnabe
authors.affiliation: University of Alberta, Edmonton, Alberta, Canada.
authors.forename: C Allyson
authors.initials: CA
authors.lastname: Jones
authors.affiliation: Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Sasha
authors.initials: S
authors.lastname: Bernatsky
authors.affiliation: University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Peschken
authors.affiliation: University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Don
authors.initials: D
authors.lastname: Voaklander
authors.affiliation: University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Homik
authors.affiliation: University of Calgary, Calgary, Alberta, Canada.
authors.forename: Lynden F
authors.initials: LF
authors.lastname: Crowshoe
authors.affiliation: University of British Columbia, Vancouver, Canada, Arthritis Research Centre of Canada, Richmond, British Columbia, Canada, and University of Queensland, Australia.
authors.forename: John M
authors.initials: JM
authors.lastname: Esdaile
authors.affiliation: University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Hani
authors.initials: H
authors.lastname: El-Gabalawy
authors.affiliation: University of Calgary, Calgary, Alberta, Canada.
authors.forename: Brenda
authors.initials: B
authors.lastname: Hemmelgarn
mesh_terms: D000416:Alberta / Q000453:epidemiology; D000553:Ambulatory Care / Q000706:statistics & numerical data; D044467:American Indian or Alaska Native; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D000070657:Crystal Arthropathies / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D016208:Databases, Factual; D006295:Health Resources / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology*; D006760:Hospitalization; D006801:Humans; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012423:Rural Health / Q000208:ethnology; D013167:Spondylitis, Ankylosing / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D013997:Time Factors; D014504:Urban Health / Q000208:ethnology