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Ischemic Heart Disease (IHD) and Related Health Care Utilization in Metis in Manitoba

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Ischemic Heart Disease (IHD) and Related Health Care Utilization in Metis in Manitoba Metis Health Knowledge Authority in Manitoba Ischemic Heart Disease (IHD) and Related Health Care Utilization in Metis in Manitoba Winnipeg, Manitoba, Canada 2012 Manitoba Metis Federation – Health & Wellness Department Authors: Judith G. Bartlett, MD, MSc, CCFP Julianne Sanguins, RN, PhD Sheila Carter Punam Mehta, MSc Nathan Hoeppner, MA Mena Bassily, MD, MSc Publication Information Published by the Manitoba Metis Federation–Health & Wellness Department (MMF–HWD), 2012. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording, or otherwise without the proper written permission of the publisher. How to cite this publication: Bartlett, J. G., Sanguins, J., Carter, S., Mehta, P., Hoeppner, N., & Bassily, M (2012). Ischemic Heart Disease (IHD) and Related Health Care Utilization in Metis in Manitoba . Winnipeg, MB: Manitoba Metis Federation. Additional copies of this report can be downloaded from the MMF–HWD website: http://health.mmf.mb.ca Health & Wellness Department Manitoba Metis Federation Room 201 – 150 Henry Avenue Winnipeg Manitoba R3B 0J7 Telephone: (204) 586-8474 Acknowledgements The Manitoba Metis Federation–Health & Wellness Department wishes to thank the following individuals and organizations for their role in the production of this report: The President and Board of Directors of Manitoba Metis Federation for their ongoing support Funding for this publication was provided by the Public Health Agency of Canada Cette publication a été réalisée grâce au financement de l'Agence de la santé publique du Canada Manitoba Centre for Health Policy for use and analysis of data contained in the Population Health Research Data Repository under project #H2010:420 (HIPC #2010/2011 - 53). Specifically, we would like to thank Dr. Pat Martens, Charles Burchill, Hui Chen, Heather Prior, and Angela Bailly for their assistance with this project Manitoba Health for linkage with Personal Health Insurance Numbers (PHIN) Aggregated Diagnosis Groups™ (ADGs™) codes for risk adjustment in logistic models were created using The John Hopkins Adjusted Clinical Group ® (ACG®) Case-Mix System version 9 External Peer Reviewers for their input Loni Cheng Research Assistant in the MMF–HWD for review and editing All data management, programming, and analyses were performed using SAS® version 9.2 Disclosure The results and conclusions in this report are those of the authors and no official endorsement by the Public Health Agency of Canada, Manitoba Health, or other parties is intended or should be inferred. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada. In our study, data were coded to protect the identification of study participants. All data comes from an administrative database with identifying information of both patients and health care providers removed. In addition, there was no contact with patients or providers during any part of this study. The intent of these analyses was to examine patterns among groups based on Metis ethnicity and on different geographical divisions. For the purposes of this particular study we obtained approvals from the Manitoba Metis Federation to access the Metis Population Database, the Faculty of Medicine’s Research Ethics Board at the University of Manitoba for approval of our research design and activities, and the Manitoba Government’s Health Information Privacy Committee to access the Population Health Research Data Repository. Table of Contents Table of Contents................................................................................................................................ i List of Figures...................................................................................................................................... iv List of Tables........................................................................................................................................ x Executive Summary............................................................................................................................ xi Section 1: Introduction and Methods ........................................................................................... 1 1.1 Background of this Report........................................................................................................... 1 1.1.1 Ischemic Heart Disease Definition............................................................................ 2 1.1.2 Acronyms....................................................................................................................... 3 1.2 Background of the Research Team............................................................................................. 3 1.3 Purpose of this Report and Outline of the Sections ................................................................ 4 1.4 What’s in the Report: The Types of Graphs, Tables, and Analyses ...................................... 5 1.5 How to Read this Report ............................................................................................................. 5 1.5.1 Geographical Boundaries of the MMF Regions, RHAs, and Winnipeg CAs...... 5 1.5.2 Making Sense of the Graphs....................................................................................... 8 1.6 Methods Used in this Report..................................................................................................... 13 1.7 Datasets Used in this Research.................................................................................................. 14 1.8 How was the Cohort Created? .................................................................................................. 15 1.9 Data Production and Analysis ................................................................................................... 15 1.9.1 Generation of Rates ................................................................................................... 15 1.9.2 Crude and Adjusted Rates......................................................................................... 16 1.9.3 Prevalence and Incidence Rates................................................................................16 1.9.4 Logistic Regression Modelling.................................................................................. 17 1.10 Data Interpretation ................................................................................................................... 18 1.11 Limitations.................................................................................................................................. 19 1.12 Summary..................................................................................................................................... 20 _______________________________ MMF Health & Wellness | i Section 2: Overview of the MMF–Health & Wellness Department ................................. 23 2.1 Introduction ................................................................................................................................. 23 2.2 The Metis...................................................................................................................................... 23 2.3 The Manitoba Metis Federation................................................................................................ 23 2.4 Manitoba Metis Federation–Health & Wellness Department .............................................. 26 2.5 Description of a Culturally Coherent Metis ‘Methodology’ or Lens for Wellness ............ 26 2.5.1 Ways of Knowing ....................................................................................................... 26 2.6 Knowledge Translation............................................................................................................... 30 Section 3: Demographics of the Study Population ................................................................ 33 3.1 Age Profile of Manitoba............................................................................................................. 33 3.2 Premature Mortality Rate ........................................................................................................... 38 Section 4: Morbidity Profile ......................................................................................................... 47 4.1 Ischemic Heart Disease ............................................................................................................. 47 Overall Key Findings......................................................................................................................... 49 4.2 Ischemic Heart Disease (IHD) Prevalence ............................................................................. 50 4.3 Hypertension Prevalence ........................................................................................................... 60 4.4 Diabetes Prevalence .................................................................................................................... 66 4.5 Stroke Incidence Rate................................................................................................................. 73 4.6 Congestive Heart Failure Prevalence ....................................................................................... 78 4.7 Prevalence of Depression..........................................................................................................
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