Asthma in First Nations Adults: Prevalence and Associated Factors
Background: Asthma is a significant cause of morbidity worldwide. Research suggests that Indigenous people experience a higher asthma burden than non-Indigenous Canadians. However, few studies have examined the prevalence of asthma and associated factors in adult First Nations people by phenotype and through a sex/gender lens. The study aimed to determine the prevalence of atopic and non-atopic asthma in First Nations women and men and whether the correlates of asthma varied by atopic status and by sex/gender. Methods: The data source was the First Nations Lung Health Project (FNLHP), a community-based participatory study in two First Nation communities in rural Saskatchewan, Canada. Participants were 648 women and 647 men 18 years of age and older. Data were obtained via interviewer-administered questionnaires and clinical testing. The dependent variable, asthma phenotype, was a categorical variable with three response options (no asthma, atopic asthma, non-atopic asthma) and derived from a combination of self-reported asthma and allergy testing. The independent variables included personal, environmental, and social/economic factors. Multinomial logistic regression was the primary analysis. Results: Atopic and nonatopic asthma prevalence was 11.4% and 5%, respectively. There were no significant sex differences in asthma prevalence; however, the results of the multivariable analysis indicated a significantly higher occurrence of non-atopic asthma in women 40 years of age and older compared to same-age men. Only one variable was associated with atopic asthma: those with depression had 2.9 times higher odds of atopic asthma than those without depression (95%CI: 1.38, 6.20). Statistically significantly associated with an elevated odds of non-atopic asthma were home dampness (OR=1.83, 95%CI: 1.08-3.11), ever alcohol use (OR=2.21, 95%CI: 1.09-4.48) and the presence of a co-morbidity (OR=1.77, 95% CI: 1.17, 2.68). Financial strain was related to an increased odds of nonatopic asthma in women and decreased odds in men. Conclusion: The results from this study suggest the possibility of intriguing differences in the correlates of asthma by phenotype and sex. Future research incorporating a longitudinal design and enhanced measurement is required to advance understanding of the complex interrelationships between sex, asthma phenotype, and various risk factors in First Nations adults.
First Nations, Asthma
Master of Science (M.Sc.)
Community Health and Epidemiology
Community and Population Health Science