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Cedar Project: Predictors of mortality among young Indigenous people who use drugs in Canada
The Cedar Project is a cohort of 605 young Indigenous people who use illicit drugs in British Columbia, Canada. Since 2003, 35 deaths were identified and confirmed. Crude mortality rate was calculated using person-time methods. Indirect standardized mortality ratios were calculated using the age-specific mortality rate of Canadians in 2008. Censoring occurred on March 31, 2013. Predictors of mortality were identified using Cox regression with a cutoff of p<0.1 for inclusion multivariate models.
Participants accumulated 5184 person-years of follow-up resulting in a crude mortality rate of 675 per 100,000 person-years. Participants were 12.7 times (95%CI=5.1,31.5) more likely to die than Canadians the same age. Causes of deaths include: overdose (n=11), substance abuse (n=5), suicide (n=5), HIV-related (n=3), homicide (n=2), other (n=6), and under investigation or unknown (n=3). Being female, ever being paid for sex, ever injecting, ever incarcerated, ever receiving methadone, ever overdosing, age at first drug smoking, HIV infection, HCV infection and recent injection predicted mortality in unadjusted Cox models. In adjusted analyses, ever having injected remained significantly associated with time to death.
Indigenous young people who use drugs are dying at a rate nearly 13 times Canadians their age. Injection drug use appears to be an important contributor to their early mortality. The vulnerability of these young people is extreme and must be addressed.
Learning Areas:
Administration, management, leadershipAdvocacy for health and health education
Diversity and culture
Program planning
Public health administration or related administration
Public health or related public policy
Learning Objectives:
Identify disparities in mortality rates between young Indigenous people who use drugs and Canadians the same age.
Keyword(s): Native Americans, Mortality
Qualified on the content I am responsible for because: Kate Jongbloed is a PhD student at the University of British Columbia’s School of Population and Public Health. Her research takes place within The Cedar Project, an ongoing three-city cohort study addressing HIV and HCV-related vulnerabilities of young Aboriginal people who use illicit drugs in Prince George, Vancouver and Chase, BC. She is supported by a CIHR Doctoral Award and a UBC Four Year Fellowship award.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.