Asthma Prevalence and Barriers to Access
Asthma is a growing concern in First Nations communities1. Information on asthma in First Nations populations is limited but recent sources suggest that the prevalence of asthma in aboriginal children and youth ranges from 12-14% (on and off reserve)2-4, but lower in the Territories at 5.7%5, possibly due to an underestimate because of poor access to health services6. Rates of airflow obstruction have been found as high as 25% in Northern Alberta7.
Lifestyle, geographic, physical and temporal factors contribute to these statistics and the disproportionately heavy burden of asthma in First Nations populations8. For example, high rates of smoking and obesity in First Nations populations contribute to asthma exacerbations4;5;7. The smoking rate in First Nations is triple the National average; 70% of First Nations youth smoke9 and obesity is on the rise. Moreover, indoor air quality is poor due to mould, overcrowding and smoke in homes5;7and outdoor air quality is impacted by wood smoke and road dust. These conditions put children with asthma at greater risk of asthma exacerbations. These factors are also put children at greater risk of developing asthma and/or allergies.
Further, unequal access to health care, gaps in social support and a host of cultural and social factors, impact the options First Nations peoples have to address asthma concerns. A recent study showed that Aboriginal people access health care less effectively and find it intimidating10. In interviews conducted by Stewart et al.11, First Nations children and families described numerous barriers to accessing health care and social support including transportation, lack of childcare and loss of work time. Children described feeling isolated. Key support needs for children were listed as: to feel normal, just like their peers; informational support on asthma and asthma management; reducing isolation by building a supportive network; improving support-seeking and other coping skills. Parents reported a need for: support for their children, education for themselves, culturally appropriate support, increased community awareness, child care and additional support or respite care for grandparents11.
(1) Garner R, Kohen D. Changes in the prevalence of asthma among Canadian children. Health Rep 2008; 19(2):45-50.
(2) Public Health Agency of Canada. Life and Breath: Respiratory Disease in Canada, 2007. Ottawa: Ministry of Health, 2007.
(3) First Nations Regional Health Survey: RHS Phase 2 (2008/10) Preliminary Results - Adult -Youth - Child. Ottawa, Ontario: First Nations Information Governance Centre, 2011.
(4) Garner R, Carrière G, Sanmartin C et al. The Health of First Nations Living Off-Reserve, Inuit, and Métis Adults in Canada: The Impact of Socio-economic Status on Inequalities in Health. Ottawa: Statistics Canada, 2010.
(5) Gao Z, Rowe BH, Majaesic C et al. Prevalence of asthma and risk factors for asthma-like symptoms in Aboriginal and non-Aboriginal children in the northern territories of Canada. Can Respir J 2008; 15(3):139-145.
(6) Crighton EJ, Wilson K, Senecal S. The relationship between socio-economic and geographic factors and asthma among Canada's Aboriginal populations. Int J Circumpolar Health 2010; 69(2):138-150.
(7) Sin DD, Sharpe HM, Cowie RL et al. Spirometric findings among school-aged First Nations children on a reserve: a pilot study. Can Respir J 2004; 11(1):45-48.
(8) Postl BD, Cook CL, Moffatt M. Aboriginal child health and the social determinants: why are these children so disadvantaged? Healthc Q 2010; 14 Spec No:42-51.
(9) Life and Breath: Respiratory Disease in Canada. Ottawa: Public Health Agency of Canada., 2007.
(10) Moffatt ME, Cook C. How can the health community foster and promote the health of Aboriginal children and youth? Paediatr Child Health 2005; 10(9):549-552.
(11) Stewart M, King M, Letourneau N et al. Inequities: Experienced by Aboriginal Children with Respiratory Problems and Parents. 2011.