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首页> 外文期刊>Journal of Rural Health >Birth Outcomes and Infant Mortality by the Degree of Rural Isolation Among First Nations and Non-First Nations in Manitoba, Canada
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Birth Outcomes and Infant Mortality by the Degree of Rural Isolation Among First Nations and Non-First Nations in Manitoba, Canada

机译：加拿大曼尼托巴省原住民和非原住民之间农村隔离程度的出生结果和婴儿死亡率

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Context: It is unknown whether rural isolation may affect birth outcomes and infant mortality differentially for Indigenous versus non-Indigenous populations. We assessed birth outcomes and infant mortality by the degree of rural isolation among First Nations (North American Indians) and non-First Nations populations in Manitoba, Canada, a setting with universal health insurance. Methods: A geocoding-based birth cohort study of 25,143 First Nations and 125,729 non-First Nations live births to Manitoban residents, 1991-2000. Degree of rural isolation was defined by an indicator of urban influence (no, weak, moderate/strong) based on the percentage of the workforce commuting to urban areas. Findings: Preterm birth and low birth weight rates were somewhat lower in all rural areas regardless of the degree of isolation as compared to urban areas for both First Nations and non-First Nations. Infant mortality rates were not significantly different across areas for First Nations (10.7, 9.9, 7.9, and 9.7 per 1,000 in rural areas with no, weak, moderate/strong urban influence, and urban areas, respectively), but rates were significantly lower in less isolated areas for non-First Nations (7.4, 6.0, 5.6, and 4.6 per 1,000, respectively). Adjusted odds ratios showed similar patterns. Conclusions: Living in less isolated areas was associated with lower infant mortality only among non-First Nations. First Nations infants do not seem to have similarly benefited from the better health care facilities in urban centers, suggesting a need to improve urban First Nations' infant care in meeting the challenges of increasing urban migration.
机译：背景：未知的是，农村隔离对土著人口和非土著人口是否会分别影响出生结局和婴儿死亡率。我们通过拥有全民健康保险的加拿大曼尼托巴省的原住民（北美印第安人）与非原住民之间的农村隔离程度评估了出生结局和婴儿死亡率。方法：1991年至2000年，基于地理编码的出生队列研究对25,143个原住民和125,729个非原住民向马尼托班居民进行活产。农村隔离程度由城市影响力指标（无，弱，中/强）确定，该指标基于通勤到城市地区的劳动力比例。调查结果：与原住民和非原住民相比，与城市地区相比，在所有农村地区，不论其隔离程度如何，早产和低出生体重率均较低。在第一民族地区，婴儿死亡率没有显着差异（在没有，弱，中等/强城市影响力的农村地区和城市地区，农村地区的婴儿死亡率分别为每千人中分别为10.7、9.9、7.9和9.7），但非原住民的偏远地区更少（分别为每千人7.4、6.0、5.6和4.6）。调整后的优势比显示出相似的模式。结论：仅在非原住民中，生活在偏远地区与降低婴儿死亡率有关。原住民婴儿似乎并没有从城市中心更好的医疗设施中受益，这表明有必要改善城市原住民的婴儿保健，以应对日益严重的城市移民的挑战。

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