Health Disparities in Chickenpox or Shingles in Alberta?

By Russell, M. L.; Schopflocher, D. P. et al. | Canadian Journal of Public Health, January/February 2008 | Go to article overview

Health Disparities in Chickenpox or Shingles in Alberta?


Russell, M. L., Schopflocher, D. P., Svenson, L. W., Canadian Journal of Public Health


ABSTRACT

Objective: Exploring for evidence of socio-economic health disparities in chickenpox and shingles in Alberta, Canada.

Methods: Chickenpox and shingles cases were identified from administrative data from Alberta's universal health care insurance system for 1994-2002. Incident cases were those with the earliest dated utilization of a health service (chickenpox: ICD9-CM 052/ICD10-CA B01; shingles: ICD9-CM 053/ICD10-CA B02). Crude and age-specific rates were estimated for each year by an indicator of socio-demographic status based upon the nature of the payer and eligibility for health care premium subsidy (SES-proxy) for the provincial health care insurance system.

Results: Among young children there is a gradient of disparity in chickenpox rates prior to the year in which publicly funded vaccination programs were implemented. After this point, disparities decline but less so for First Nations children than for others. There was no evidence of disparity by SES-proxy for shingles.

Conclusion: Publicly funded vaccination programs may effectively contribute to reduction in disease disparities for vaccine-preventable diseases. Further study is required to ascertain why disparities continue for First Nations children.

Key words: Herpes zoster; chickenpox; Canada; population surveillance; social class; income; Indians, North American

Canadians of lower socio-economic status (SES) and Aboriginal identity are known to incur health disparities.1,2 These include elevated rates of some vaccine-preventable diseases (e.g., pertussis, rubella) among Aboriginal peoples.3

Varicella vaccine was licensed in Canada in 1998, and Alberta initiated a publicly funded vaccination program in April, 2001. Starting in 2001, Health Canada - First Nations & Inuit Health Branch Alberta Region implemented a funded varicella vaccination program within their routine immunization program which paralleled the provincial program (personal communication, Ruth Richardson, Regional CDC Nurse Manager Health Canada FNIHB, Alberta Region, August 8, 2006). We explore for evidence of disparities in the occurrence of varicella (chickenpox) and varicella zoster (shingles) in Alberta, using administrative data from Alberta's universal, publicly funded health care insurance system for the period 1994 2002. There are few data addressing disparities (especially for Aboriginal peoples) related to these diseases.

METHODS

Over 99% of Alberta's 3 million residents are covered by the provincial health care insurance plan. Information on each insured person is maintained in a provincial registration file which includes demographic information as well as a unique lifetime personal health number (PHN) which can be used to link the registration file to a variety of health data sources. Alberta collects a health care insurance premium on a quarterly basis; therefore the accuracy of the registry is maintained during inter-censal periods.4 Health Canada is responsible for the payment of these premiums for First Nations treaty-status Aboriginals. Therefore, this status is tracked by Alberta Health and Wellness and an indicator of treaty status can be created. 5 The premiums for all individuals on social services are paid by the government, which permits social service status to be tracked and an indicator formed by Alberta Health and Wellness. For all other Albertans, the registry includes whether or not the person is eligible for health care premium subsidy based upon taxable family income from the previous calendar year. All of this information was used to create a single socio-economic status indicator variable (SES-proxy) with 4 mutually exclusive categories (Table I) that are useful for persons aged less than 65 years (the government of Alberta waives the premium for persons aged 65 or older). We used the PHN for deterministic linkage between the registry, the electronic fee-for-service data system and the Hospital Morbidity Inpatient Database to identify incident cases of chickenpox and shingles. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Health Disparities in Chickenpox or Shingles in Alberta?
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.