Fisher’s Linear Discriminant Function Analysis and its Potential Utility as a Tool for the Assessment of Health-and-Wellness Programs in Indigenous Communities

Eric N. Liberda, Aleksandra M. Zuk, Ian D. Martin and Leonard J. S. Tsuji
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Eric N. Liberda: School of Occupational and Public Health, Ryerson University, Toronto, ON M5B 2K3, Canada
Aleksandra M. Zuk: Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada
Ian D. Martin: Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada
Leonard J. S. Tsuji: Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada

IJERPH, 2020, vol. 17, issue 21, 1-18

Abstract: Diabetes mellitus is a growing public health problem affecting persons in both developed and developing nations. The prevalence of type 2 diabetes mellitus (T2DM) is reported to be several times higher among Indigenous populations compared to their non-Indigenous counterparts. Discriminant function analysis (DFA) is a potential tool that can be used to quantitatively evaluate the effectiveness of Indigenous health-and-wellness programs (e.g., on-the-land programs, T2DM interventions), by creating a type of pre-and-post-program scoring system. As the communities of the Eeyou Istchee territory, subarctic Quebec, Canada, have varying degrees of isolation, we derived a DFA tool for point-of-contact evaluations to aid in monitoring and assessment of health-and-wellness programs in rural and remote locations. We developed several DFA models to discriminate between those with and without T2DM status using age, fasting blood glucose, body mass index, waist girth, systolic and diastolic blood pressure, high-density lipoprotein, triglycerides, and total cholesterol in participants from the Eeyou Istchee. The models showed a ~97% specificity (i.e., true positives for non-T2DM) in classification. This study highlights how varying risk factor models can be used to discriminate those without T2DM with high specificity among James Bay Cree communities in Canada.

Keywords: fisher’s linear discriminant function analysis; type 2 diabetes mellitus; indigenous peoples; health-and-wellness program evaluation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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