@article{ref1,
title="Fracture risk among First Nations people: a retrospective matched cohort study",
journal="CMAJ : Canadian Medical Association journal",
year="2004",
author="Leslie, William D. and Derksen, S and Metge, Colleen J. and Lix, Lisa M. and Salamon, Elizabeth A. and Wood Steiman, P and Roos, Leslie L.",
volume="171",
number="8",
pages="869-873",
abstract="BACKGROUND: Canadian First Nations people have unique cultural, socioeconomic and health-related factors that may affect fracture rates. We sought to determine the overall and site-specific fracture rates of First Nations people compared with non-First Nations people. METHODS: We studied fracture rates among First Nations people aged 20 years and older (n = 32 692) using the Manitoba administrative health database (1987-1999). We used federal and provincial sources to identify ethnicity, and we randomly matched each First Nations person with 3 people of the same sex and year of birth who did not meet this definition of First Nations ethnicity (n = 98 076). We used a provincial database of hospital separations and physician billing claims to calculate standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for each fracture type based on a 5-year age strata. RESULTS: First Nations people had significantly higher rates of any fracture (age- and sex-adjusted SIR 2.23, 95% CI 2.18-2.29). Hip fractures (SIR 1.88, 95% CI 1.61-2.14), wrist fractures (SIR 3.01, 95% CI 2.63-3.42) and spine fractures (SIR 1.93, 95% CI 1.79-2.20) occurred predominantly in older people and women. In contrast, craniofacial fractures (SIR 5.07, 95% CI 4.74-5.42) were predominant in men and younger adults. INTERPRETATION: First Nations people are a previously unidentified group at high risk for fracture.<p /> <p>Language: en</p>",
language="en",
issn="0820-3946",
doi="10.1503/cmaj.1031624",
url="http://dx.doi.org/10.1503/cmaj.1031624"
}