Métis people living in Ontario have a higher prevalence of asthma and COPD than the rest of the Ontario population: ICES study

Prevalence of asthma and COPD are 30 per cent and 70 per cent higher, respectively, in Métis people compared to the general Ontario population, according to a study by researchers at the Institute for Clinical Evaluative Sciences (ICES) and the Métis Nation of Ontario (MNO).

The study, published today in the journal PLOS ONE, is the first large-scale, population study to quantify asthma and COPD in the Ontario Métis population in terms of health services use.

“In most cases, we found lower rates of primary and specialist ambulatory care visits for these diseases among the Métis, suggesting they are not able to access these services as well as other Ontarians. This could be contributing to the higher rates of emergency department visits and hospitalizations also observed for asthma and COPD among Métis individuals,” said Dr. Andrea Gershon, the study’s lead author, ICES scientist and respirologist and scientist at Sunnybrook Health Sciences Centre.

In the 2011 Canadian National Household Survey, 451,795 people self-identified as Métis, accounting for 32 per cent of the overall Aboriginal population in Canada.

“The results of this study are disturbing and highlight some of the key health challenges facing the Métis people of Ontario,” said Gary Lipinski, President of the Métis Nation of Ontario. “They also provide important direction for much needed policy and programming interventions to reduce the unacceptably high rates of asthma and COPD among our Métis citizens.”

The study linked the Métis Nation of Ontario Citizenship Registry to provincial health administrative databases to measure and compare burden of asthma and COPD between the Métis and non-Métis populations of Ontario between 2009 and 2012. The study found:

• Prevalence of asthma and COPD were 30 per cent and 70 per cent higher, respectively, in the Métis compared to the general Ontario population.
• General physician and specialist ambulatory care visits were significantly lower in Métis with asthma. Specialist visits for COPD were also lower.
• Emergency department visits and hospitalizations were generally higher for Métis compared to non-Métis with either disease.
• All-cause mortality in Metis with COPD was 1.3 times higher compared to non-Metis with COPD.

“A number of factors are likely contributing to the higher prevalence of asthma and COPD observed among the Ontario Métis. The prevalence of smoking, a known risk factor for COPD and a trigger for asthma, is 33 per cent for the Métis population nationally, nearly twice that of the Canadian general population. In addition, socio-economic conditions, such as poor housing with poor air quality and enhanced exposure to allergens and molds, may also be contributors in regions where many Métis reside,” adds Gershon.

The study, “Asthma and chronic obstructive pulmonary disease (COPD) prevalence and health services use in Ontario Métis: a population-based cohort study” was published today in PLOS ONE.

Authors: Andrea S. Gershon, Saba Khan, Julie Klein-Geltink, Drew Wilton, Teresa To, Eric J Crighton, Lisa Pigeau, Jo MacQuarrie, Yvon Allard, Storm J. Russell and David A. Henry.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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