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Published on: June 20, 2020
Chronic complex conditions and functional limitations among Métis children in Alberta, Canada: a retrospective cohort
Jesus Serrano-Lomelin1, Reagan Bartel2, Ashton Anderson2
1Department of Public Health Sciences, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
Insights
Complex chronic conditions (CCC) and functional limitations (FL) affect 13.7% and 4.0% of Métis children, respectively. Early onset highlights the need for improved medical services and equitable care.
Area of Science:
- Pediatric Health
- Epidemiology
- Indigenous Health
Background:
- Complex chronic conditions (CCC) and functional limitations (FL) represent a significant health burden in childhood.
- Understanding the epidemiology of CCC and FL in Indigenous populations is crucial for addressing health disparities.
Purpose of the Study:
- To assess the epidemiology of complex chronic conditions (CCC) and functional limitations (FL) among Métis children in Alberta.
- To examine associated maternal and neonatal factors, health care utilization, and medication prescriptions in this population.
Main Methods:
- Population-based retrospective cohort study utilizing administrative health data from 2006-2016 in Alberta.
- Follow-up of Métis children from birth to age 10, calculating period prevalence and incidence rates for CCC and FL.
- Regression analyses were used to estimate associations with maternal/neonatal factors, healthcare utilization, and prescriptions.
Main Results:
- Prevalence of CCC was 13.7% and FL was 4.0% among 7853 Métis children.
- Highest incidence rates for CCC and FL occurred in the first year of life.
- Common CCC included prematurity/neonatal issues, neoplasms, and cardiovascular conditions; common FL included ADHD, language disorder, and respiratory congenital malformations.
- Incidence rates were higher in urban vs. rural areas, and children with CCC/FL had increased healthcare utilization and medication prescriptions.
Conclusions:
- The study reveals a substantial burden of early-onset CCC and FL among Métis children in Alberta.
- Findings underscore the necessity for ongoing monitoring and evaluation of medical services.
- Ensuring responsive and equitable care is critical for this population.
Objectives:
To assess the epidemiology of complex chronic conditions (CCC) and functional limitations (FL) among Métis children in Alberta, and to examine associated maternal and neonatal factors, health care utilization, and medication prescriptions.
Methods:
Population-based retrospective cohort study using administrative health data for all singleton livebirths to Métis mothers in Alberta between 2006 and 2016, followed from birth until age 10, death, or 2019. Period prevalence of CCC and FL were calculated as percentages. Age-related adjusted incidence rates (aIR), and adjusted incidence rate ratios (aIRR) with 95% confidence intervals (CI) for maternal/neonatal factors, health care utilization and medication prescriptions were estimated in regression analyses.
Results:
Among 7853 Métis children, the prevalence of CCC was 13.7% (95% CI 13.0, 14.5) and FL was 4.0% (95% CI 3.6, 4.4). The highest aIRs occurred during the first year of life: 95.7 cases/1000 person-years (95% CI 88.6, 102.7) for CCC and 11.6 cases per 1000 person-years (95% CI 8.7, 14.5) for FL. Most common CCC were prematurity/neonatal, neoplasms, and cardiovascular, while most common FL were attention deficit hyperactivity disorder, language disorder, and respiratory congenital malformations. Incidence rates were 30% higher for CCC and 40% higher for FL in urban versus rural areas. Métis children with any CCC or FL had 40% higher health care utilization and received 70% more medication prescriptions than those without these conditions.
Conclusion:
The burden and early onset of chronic and complex conditions among Métis children highlight the need for continued monitoring and evaluation of medical services to ensure responsive and equitable care.