Long-term-care residents - Concerns identified by population and care trends

Background: Despite an abundance of data and analysis of First Nations morbidity and mortality rates, accurate data have not been available to serve the First Nations community in Eastern Canada. Methods: Data for Eskasoni, the largest Mi'kmaq community, were obtained for 1996 through 1999 and Cape Breton and Nova Scotia were used as regional and provincial reference populations respectively. Age-adjusted relative risks (AARR) were calculated for overall mortality and disease-specific hospital admissions. Results: Eskasoni's mortality AARR was greater than 1.0 in 3 of the 4 years studied, although the data may understate Eskasoni's mortality rates. Eskasoni's total admission AARRs were significantly greater than the two reference populations. Neoplasm admission rates were generally lower, while circulatory disease admission AARRs were significantly higher. A rise in diabetic admission rates was noted with the AARR reaching statistical significance in the final years of the study. Respiratory disease was the leading cause of hospitalization with significantly greater rates of admission than regional or provincial rates. Pneumonia and influenza accounted for more than one half of respiratory admissions. Infectious disease admissions were more prevalent in Eskasoni while rates of liver disease were generally low. Conclusion: Results suggest that members of the largest Mi'kmaq band are at greater risk for a number of disease categories and health promotion should be targeted toward respiratory ailments, circulatory disease and diabetic management. Further analysis, however, remains an important priority.