Injury in First Nations Communities in Ontario

Background: High and variable rates of injury have been reported in Aboriginal communities in Canada. This has not been well studied for specific injury types. We sought to compare the rate and categories of injuries leading to hospital admission among those in First Nations communities relative to those living in small northern and southern communities in Ontario. Methods: Administrative data were used to define the study populations. The incidence of all-cause injury and specific injury categories for residents living in Ontario's Aboriginal communities (N = 28,816) was determined for 2004 using hospital discharge data. Comparisons were made with residents of small communities in northern (N = 211,834) and southern Ontario (N = 650,002). Age- and sex-adjusted rates were calculated. Results: All-cause-injury age- and sex-adjusted rates were 2.5 times higher for those living in First Nations communities compared to those living in northern communities. Relative risks (RR) for specific injury types in First Nations compared with northern communities were: assault (RR = 5.5 in females and 4.8 in males), intentional self-harm (RR = 5.9 in females and 5.2 in males) and accidental poisoning (RR = 4.9 in females and 3.7 in males). Differences were also seen between northern and southern communities: assault (RR = 2.8 in females and 3.5 in males), intentional self-harm (RR = 2.1 in females and 1.4 in males) and accidental poisoning (RR = 2.2 in females and 1.7 in males). Discussion: Injuries severe enough to require a hospital admission were higher in First Nations communities in northern Ontario relative to those in northern and southern Ontario communities. Higher rates of certain injuries were also noted in northern compared with southern communities. This underscores the importance of using a geographic comparison group.