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Week 9 Article 1.docx

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University of Toronto Scarborough

Week 9 Article 1 The association of housing density, isolation, and tuberculosis in Canadian First Nations Communities -Early 20 century; death rate from T.B. in first nations in Canada was 700/100 000  Due to malnutrition, confinement on crowded reservations with poor sanitation, & lack of immunity to the TB bacillus -In 1999, rate was 10 times that of the overall Canadian rate in 1997 -Association has been recognized between overcrowded housing and T.B. incidence, paediatric TB, & TB mortality -T.B. incidence higher in communities which are isolated from health services -All forms of T.B. were included; pulmonary & extrapulmonary -Housing density expressed as the average number or persons per room (ppr) in a community, and household income is expressed in Canadian dollars -Results:  Average housing density higher in first nations (F.N.) (0.7 ppr), than in non-aboriginal Canadian population (0.4 ppr)  T.B. incidence rises as ppr increases  F.N. TB rates highest in Saskatchewan, then Alberta and Manitoba  The 3 provinces have highest average levels of housing density  Income levels lowest in maritime provinces  Manitoba has highest proportion of communities that are considered isolated (55.6%)  Ppr and income levels were higher in isolated communities  Analyses also showed that ppr and average household income not significantly related, though community population and ppr were related -Tb incidence is higher in communities located in isolated areas, and in communities with a higher average housing density -An increase in community income is associated with decreased risk of T.B.  Income levels are higher in isolated communities (where TB incidence is higher), this is because there employees have higher wages since the cost of living is elevated. -Some communities with overcrowded housing may experience a higher prevalence of latent TB infection, and risk factors for progression from TB infection to disease  Risk factors: substance abuse, and under nutrition (more prevalent in communities with socioeconomic disadvantages). Socioeconomic variables include unemployment & homelessness -Overall, data
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