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Emerging Infectious Diseases Journal


Volume 8: No. 1, January 2011

A Conversation with Michael Tjepkema, Senior Research Analyst at Statistics Canada


Fran Kritz: Iím Fran Kritz, senior editor at Home Front Communications in Washington, DC. Weíre speaking today with Michael Tjepkema, senior research analyst at Statistics Canada. Dr. Tjepkema has written a very interesting article for the December 2010 issue of Chronic Diseases in Canada. For this issue, there is a joint publishing initiative between Preventing Chronic Disease, a publication of the Centers for Disease Control and Prevention in Atlanta, and Chronic Diseases in Canada. Dr. Tjepkemaís article looks at mortality rates among Aboriginal adults living in urban areas in Canada. Dr. Tjepkema, welcome.


Dr. Michael Tjepkema: Hello, Fran.


Kritz: Thanks so much for speaking with us today. Let me ask you a little bit about your study. First of all, what was the time frame of it?


Tjepkema: The time frame is, we examined a cohort of Aboriginal adults based on our 1991 census that were aged 25 and older and we tracked their mortality from June of that year up until December 31, 2001.


Kritz: And the time frame, even though itís about, the data ended about 10 years ago, itís important that we look at it now. Why is that?


Tjepkema: Itís very important because this study fills an important data gap because we do not know the mortality outcomes for Aboriginal people living in urban Canada, so the fact that we were able to provide estimates fills an important information gap and even though that the data does only go until 2001, many of these mortality rates, many of our findings would still be relevant to today.


Kritz: Now your study found a higher rate of premature death among urban Aboriginal adults than among urban non-Aboriginal adults. What did you find, what accounted for that?


Tjepkema: There are many reasons why the Aboriginal adults would have a higher mortality rate. We did examine socioeconomic characteristics such as income, educational attainment, lone parent status, whether someone worked or not, and all these variables together we found accounted for about almost two-thirds of the excess mortality among Aboriginal men and about one-third for Aboriginal women. So this study stresses the importance of the social determinants of health.


Kritz: There seem to be some similarities between some causes of premature death among this group and similar groups in the United States. Factors such as suicide, certain types of cancer, cardiovascular disease. Have you looked at doing a comparison study between the 2 nations?


Tjepkema: I havenít done a comparison study between the two nations, but itís true that a lot of these causes of death that you mentioned cardiovascular disease and cancer, specifically lung cancer, and injuries both unintentional and intentional, do drive a lot of this disparity in mortality between the Aboriginal and non-Aboriginal people.


Kritz: The full issue of Chronic Diseases in Canada looked at various health issues and determinants among Aboriginal adults and seems to culminate in the fact that there is this rate of premature death. How do you think they might use this data going forward?


Tjepkema: Well, we do hope that our study results are used by program areas both within government departments and among Aboriginal organizations. But, because of my position within my organization, we donít actually advocate policy change, but we do provide information such as this that can be used to create and target programs to help reduce some of this disparity and premature mortality.


Kritz: One of the things that I thought, was a look at how the statistics were used. And so what I saw in your article was, looking at, tell me if I got this correct, looking at age 25, how many years left of life was projected. Did I understand that correctly?


Tjepkema: That is correct, we did examine remaining years of life at age 25 and this is, you know, kind of a basic fundamental indicator of the health of a population. And our results do clearly show that Aboriginal men living in urban Canada were expected to live 4.7 years shorter than other non-Aboriginal men, and the gap was even larger when we examined the results for women, Aboriginal women were 6.3 years shorter.


Kritz: Finally, Dr. Tjepkema, are you doing any research in this area right now?


Tjepkema: Yes we are. We are using the same database and examining disparities looking at cardiovascular disease mortality and getting to the more specifics, and I focus on the North American Indian population, which is one of our 3 Aboriginal groups in Canada. Also, I have some stuff coming out on the potential years of life lost before the age of 75, which kind of ties into the premature mortality that we found among, in this paper. So there is some research that is ongoing and in terms of the future, we do plan to examine differences among cancer incidence among Aboriginal and non-Aboriginal people.


Kritz: Dr. Michael Tjepkema, senior research analyst in the health analysis division at Statistics Canada, this is really very striking research and weíll look forward to following up with you, to see where your study of this population takes you in the next few years. Thank you so much for speaking with us.


Tjepkema: Youíre welcome.


Kritz: In Washington, DC, Iím Fran Kritz for Home Front Communications.



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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.


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