Back to Basics, 2013 POPULATION HEALTH : Vital & Health Statistics

1. Back to Basics, 2013POPULATION HEALTH :Vital & Health Statistics Presented by N. Birkett, MD Epidemiology & Community Medicine

2. 78.1: VITAL STATISTICS INFORMATION • What are the key causes of illness or death in Canada? • Common things are common • using epidemiology can help you run a better clinical practice • Hipocrates • How have disease incidence and mortality changed in Canada in the past 20 years? • Little good information on disease incidence except for reportable diseases and cancer (cancer registries)

3. TOPICS • Demography, population dynamics • Mortality • Morbidity • Summary measures of population health • Aboriginal health

4. Population Dynamics, 2007

5. World Health Report, 2012 (data mostly from 2009)

7. Population Pyramids • Canada, 1901-2001 • Ontario 1901-2001 • Newfoundland 1949-2001 • Yukon 1901-2001

8. General (All-Causes) Mortality

9. # deaths in Canada from 1979-2004; men and women.

10. Mortality RATES in Canada from 1979-2004; men and women.

11. Infant Mortality, 1935-2005

13. 13

15. Cause-Specific Mortality

16. Leading causes of death (2009)

17. Circ Disease: 27.6% CANCER: 30.3% † † Pneumonia & influenza grouped with respiratory disease. Would increase infectious % to about 3.4%.

18. CANCER: 29.8% Circ Disease: 29.0% EXTERNAL CAUSES: 4.8%+ { † † † Pneumonia & influenza grouped with respiratory disease. Would increase infectious % to about 3.5%.

19. CANCER: 31.6% Circ Disease: 27.3% EXTERNAL CAUSES: 3.4%+ { † † † Pneumonia & influenza grouped with respiratory disease. Would increase infectious % to about 3.3%.

20. Cardio-vascular Cluster Cancer Cluster Suicide Crime ‘Other’ Cluster

22. Cancer and AgeAge-Specific Mortality Rates for All Cancers by Sex, Canada, 2003 Surveillance Division, CCDPC, Public Health Agency of Canada

23. Cancer and AgeAge-Specific Incidence Rates for All Cancers by Sex, Canada, 2003 Surveillance Division, CCDPC, Public Health Agency of Canada

24. Time trends in MalesIncidence Mortality

25. Time trends in FemalesIncidence Mortality

28. Income Inequalities in Health

29. Income Inequalities SES (socio-economic status) • Lower  worse health • Life expectancy 6.6 years lower in the poorest group. • Complex causal pathway • Nutrition • Race • Habits • Environmental/occupational • Access to/use of health/preventive services • Political isolation • Others

31. 2 3 4 5 1 2 3 4 5 Income adequacy quintiles Remaining Life Expectancy at age 25. Based on 10-year follow-up to 1991 census Women Men

32. Remaining life expectancy at age 25 (conditional on surviving to age 25), 1991-2001

33. Probability of survival to age 75 (conditional on surviving to age 25), 1991-2001

34. Summary Measures of Population Health Combine mortality and a measure of morbidity

35. Impact of Chronic Diseases

36. Summary Measures ofPopulation Health

37. 2001 Life Expectancy andHealth-Adjusted Life Expectancy • HALE always < LE • Females live longer (but gap is narrowing) • Females suffer more morbidity

38. Disability-Adjusted Life-Years Lost

39. Which Chronic Diseases? Cancer CHD Diabetes Respiratory Neuro-psych Musculoskeltal Sensory Cancer CHD Diabetes Respiratory Neuro-Psych Musculoskeletal Sensory

40. Deaths vs Prevalence, Canada

41. Aboriginal Health

42. Population Pyramids

43. Age-specific Fertility Rates

44. Percentage of Live Births by Age Group of Mother

45. Crude Mortality Rate

46. Age-adjusted Mortality Rate

47. Age-specific Mortality Ratio

48. Life Expectancy at Birth in Years, by Sex

49. Leading Causes of Death (age-standardized)

50. Potential Years of Life Lost (PYLL) First Nations Canada