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Prevalence and associated factors of COPD among Aboriginal peoples in Canada: a cross-sectional study

Dove Medical Press

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Abstract

Background

COPD among Aboriginal peoples in Canada is a major public health concern. This study was conducted in order to determine the prevalence and association between certain risk factors and COPD among the 35-year-old or older Aboriginal peoples in Canada.

Methods

This is a cross-sectional study. It uses data from Statistics Canada’s Aboriginal Peoples Survey (APS), 2012. It consists of 8,117 self-identified Aboriginal peoples, aged 35 years old or older from all Canadian provinces and territories. The study outcomes centered on evaluating the prevalence and associated factors of COPD.

Results

This study found that 6.80% of the participants self-reported having COPD. Results of the logistic regression analysis show that COPD was significantly higher among daily smokers (odds ratio [OR], 2.28; 95% confidence interval [95% CI], 1.65–3.14), aged 55 years or older (OR, 3.04; 95% CI, 2.14–4.30), who earned $5,000–$9,999 per annum (OR, 4.21; 95% CI, 2.39–7.41) and needed health care over the past 12 months and did not receive it (OR, 1.83; 95% CI, 1.27–2.65).

Conclusion

The findings of our study show that COPD is strongly associated with Aboriginal peoples, who are older, smoke, have a low socioeconomic status (SES) and do not have access to health care when needed. Clinicians, health care professionals, medical/public health organizations, researchers and patients will greatly benefit from additional research in this common, serious and often overlooked disease among Aboriginal peoples in Canada.

Most cited references37

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The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General.

(2014)
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Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary.

(2017)
This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD (GOLD) 2017 Report focuses primarily on the revised and novel parts of the document. The most significant changes include: 1) the assessment of COPD has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations; 2) for each of the groups A to D, escalation strategies for pharmacological treatments are proposed; 3) the concept of de-escalation of therapy is introduced in the treatment assessment scheme; 4) nonpharmacologic therapies are comprehensively presented and; 5) the importance of comorbid conditions in managing COPD is reviewed.
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Prevalence and incidence of COPD in smokers and non-smokers: the Rotterdam Study

(2016)
COPD is the third leading cause of death in the world and its global burden is predicted to increase further. Even though the prevalence of COPD is well studied, only few studies examined the incidence of COPD in a prospective and standardized manner. In a prospective population-based cohort study (Rotterdam Study) enrolling subjects aged ≥45, COPD was diagnosed based on a pre-bronchodilator obstructive spirometry (FEV1/FVC < 0.70). In absence of an interpretable spirometry within the Rotterdam Study, cases were defined as having COPD diagnosed by a physician on the basis of clinical presentation and obstructive lung function measured by the general practitioner or respiratory physician. Incidence rates were calculated by dividing the number of incident cases by the total number of person years of subjects at risk. In this cohort of 14,619 participants, 1993 subjects with COPD were identified of whom 689 as prevalent ones and 1304 cases as incident ones. The overall incidence rate (IR) of COPD was 8.9/1000 person-years (PY); 95 % Confidence Interval (CI) 8.4–9.4. The IR was higher in males and in smokers. The proportion of female COPD participants without a history of smoking was 27.2 %, while this proportion was 7.3 % in males. The prevalence of COPD in the Rotterdam Study is 4.7 % and the overall incidence is approximately 9/1000 PY, with a higher incidence in males and in smokers. The proportion of never-smokers among female COPD cases is substantial. Electronic supplementary material The online version of this article (doi:10.1007/s10654-016-0132-z) contains supplementary material, which is available to authorized users.
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Author and article information

Journal
Int J Chron Obstruct Pulmon Dis
Int J Chron Obstruct Pulmon Dis
International Journal of COPD
International Journal of Chronic Obstructive Pulmonary Disease
Dove Medical Press
1176-9106
1178-2005
2017
30 June 2017
: 12
: 1915-1922
Author notes
Correspondence: Yelena Bird, School of Public Health, University of Saskatchewan, 104 Clinic Place, E-Wing, Health Sciences, Room 3322, Saskatoon, SK S7N 2Z4, Canada, Tel +1 306 966 8432, Fax +1 306 966 7920, Email yelena.bird@ 123456usask.ca
Article
copd-12-1915
10.2147/COPD.S138304
5501631
© 2017 Bird et al. This work is published and licensed by Dove Medical Press Limited

The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Categories
Original Research

Respiratory medicine