A retrospective look for a brighter future for First Nations’ heart health

October 2018

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First Nations people are believed to experience high rates of ischemic heart disease (IHD), a leading cause of death in Canada, and an important topic of discussion among cardiovascular and allied healthcare professionals attending this year’s Canadian Cardiovascular Congress (CCC) in Toronto.

Dr. Annette Schultz, a registered nurse, researcher and Associate Professor with the College of Nursing Rady Faculty of Health Sciences, University of Manitoba, believes First Nations people continue to be disproportionately represented in health care, as evidenced by higher rates of acute myocardial infarctions, IHD hospitalizations and mortality. Schultz, who is also a principal investigator with St. Boniface Hospital Research Centre, addressed how increased access to angiograms may lead to improved outcomes for Indigenous populations.

I think looking at our healthcare systems and asking ourselves how we can change is equally important a question as looking at what’s going on in an individual.

- Annette Schultz, PhD

At CCC, Schultz presented findings of a population-based retrospective study, titled Differences in Five Year Outcomes and Follow-up Care Post Index Coronary Angiography Among First Nation People and All Other Manitobans. The study’s primary objective was to compare clinical outcomes and physician follow-up between First Nation and non-First Nation patients following index angiography in Manitoba.

Schultz and her team analyzed health administrative data from the Manitoba Population Research Data Repository for all adults in Manitoba who underwent index coronary angiography between 2000 and 2009. Nearly 26,000 cases were studied. The result of the analysis revealed that First Nation people were more likely to die or be re-hospitalized within five years for all causes including heart disease. Similarly, First Nations people were less likely to visit a specialist within a reasonable time after a coronary angiogram. 

“This is important because now we have a very clear picture of what’s going on with an entire provincial system,” said Schultz. ”We need to look at the system and how the system is now failing First Nations [people] when it comes to heart disease. We need to be asking ourselves what we can be doing different to either make it a place that opens the doors for [First Nations people] to come so we can be doing interventions earlier.”

She added “I think looking at our healthcare systems and asking ourselves how we can change is equally important a question as looking at what’s going on in an individual.”

Her CCC poster presentation (pdf) is available online.

Schultz’s et al’s study Health Outcome and Follow-up Care Differences Between First Nation and Non-First Nation Coronary Angiogram Patients is published by the Canadian Journal of Cardiology.