Exploring the relationship between ethnicity and hypertension in Canada

Background: Previous work examining differences in hypertension across ethnic groups employ race as the principal variable. While differences in hypertension have been identified across racial groups, there is great variation between ethnic groups amongst racial groupings that could mask differences in hypertension and cardiovascular disease (CVD) risk. In light of Canada's ethnic diversity, research aimed at identifying specific groups that are at a health disadvantage is essential for understanding the health of the overall population. In addition, this research would be beneficial for creating programs and policies aimed at reducing or eliminating these disparities. Since CVD is the leading cause of mortality in Canada and hypertension is one of the most significant and modifiable risk factors for CVD, it is important to move past crude classifications based on race and examine ethnic group differences. The purpose of this study is to examine the relationship between ethnicity and hypertension in Canada, while employing more narrow classifications for ethnicity than previous studies. In addition, because ethnicity has been shown to be representative of an individual's social experience, this study also aims to investigate whether this relationship can be explained by one or all of the following variable: socioeconomic status, physical activity, body mass index, smoking status, daily alcohol consumption or acculturation. Methods. This study used the 2004 Canadian Community Health Survey, cycle 2.1 to compare 29 different ethnic groups in Canada on whether they had high blood pressure that had been diagnosed by a health professional. Associations were examined using logistic regression. Subsequent logistic regression analyses included socioeconomic status, physical activity, body mass index, smoking status, daily alcohol consumption and acculturation to test for the effect of each of these variables on the relationship between ethnicity and hypertension. Results. Ukrainians, Chinese, Portuguese, South Asians, Aboriginals, Blacks, Filipinos and South East Asians were found to have significantly higher odds of having high blood pressure than Canadians (OR's = 1.50, 1.56, 2.72, 1.38, 1.36, 1.66, 2.21 & 2.24 respectively, p<.001). In addition, the only significant mediating effects were between SES and Aboriginals as well as obesity and Aboriginals. None of the other independent variables accounted for >10% of the risk experienced by the ethnic groups that were significantly associated with hypertension. Interpretation: The odds of having high blood pressure in Canada varies considerably across ethnic groups within racial groups indicating previous research is not specific enough to inform policy and program development. Because this study was not able to explain this relationship using the sociodemographic and lifestyle factors mentioned above, future research should be done to determine what places certain ethnic groups at a greater risk in order to tailor interventions aimed at reducing high blood pressure that are suited to the specific needs of each cultural group.

Stolen past: Shattered futures, aboriginal justice in Canada

It is acknowledged that Canada's criminal justice system has some major flaws, particularly with respect to its application to various ethnic subgroups. Aboriginal Canadians are one subgroup particularly sensitive to the problems in the system as is reflected by their disproportionately high rates of criminality and incarceration. Over the past 50 years many programs have been developed and recommendations have been made to alleviate the tensions Aboriginals find within the system. However, the situation today is essentially the same. Aboriginals are still overrepresented within the system and solutions that have been brought forward have had little success in stemming their flow into the system. Blame for Aboriginal mistreatment in the system has been placed at all levels from line police officers to high-level officials and politicians and attempts to resolve problems continue as an on going process. However, many of the recommendations and reforms have revolved around culture conflict. Although this thesis recognizes the importance of culture conflict in the overrepresentation of Aboriginals within the Canadian criminal justice system, it has also recognized that culture conflict alone is not responsible for all the flaws within the system as it pertains to Aboriginals. This thesis is of the opinion that in order for reforms to the criminal justice system to be successful, the context in which the system is operating must also be considered. Variables such as geographic isolation, economic disparity and social/political stability are viewed as operating in conjunction with culture, ultimately influencing Aboriginal treatment within the system. The conclusions drawn from this study confirm that when these factors operate together, the overrepresentation of Aboriginals within the Canadian criminal justice system is inevitable. Thus all three variables, culture conflict (social/political stability being part), geographic isolation and economic disparity must be address within the system if any significant changes in the crime rates or incarceration rates of Aboriginals is to be expected. In addition, primary research indicated the influence of cooperation as a factor in moderating the effects of criminality; not just cooperation among Aboriginals and non-Aboriginals, but also cooperation among differing Aboriginal communities. It was argued that when all these issues are addressed, Aboriginal peoples in Canada will have the strength to repair their shattered futures.