Timiskaming Health Status Profile · The vision of the Timiskaming Health Unit (THU) is total...

Timiskaming

Health Status

Profile January 2013

Acknowledgements

The Timiskaming Health Unit would like to acknowledge the collaborative effort of the following people in development of this document:

Dawn Olsen Health Data Analyst

Celine Butler Epidemiologist

Kim Peters Public Health Promoter

Eryn Pleson Public Health Promoter

Amanda Mongeon Program Evaluator

Timiskaming Health Status Profile

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Table of Contents Acknowledgements ....................................................................................................................................... 1

Table of Contents .......................................................................................................................................... 2

List of Figures ................................................................................................................................................ 3

Introduction .................................................................................................................................................. 4

About this Report .......................................................................................................................................... 4

General Health .............................................................................................................................................. 5

Perceived health ....................................................................................................................................... 5

Perceived mental health ........................................................................................................................... 5

Chronic conditions .................................................................................................................................... 6

Life expectancy ............................................................................................................................................. 7

Impact of unhealthy habits on life expectancy ........................................................................................ 9

Disparities in life expectancy .................................................................................................................. 10

Death ........................................................................................................................................................... 12

Age-standardized mortality rate ............................................................................................................ 12

Dying young ............................................................................................................................................ 13

Leading causes of death ......................................................................................................................... 14

Leading causes of death among males and females .......................................................................... 15

Leading causes of death by age ......................................................................................................... 16

Going to the hospital .................................................................................................................................. 17

Leading causes of emergency room visits .............................................................................................. 17

Leading causes of emergency room visits among males and females............................................... 19

Leading causes of emergency room visits by age .............................................................................. 20

Leading causes of hospitalization ........................................................................................................... 21

Leading causes of hospitalization among males and females ........................................................... 23

Leading causes of hospitalization by age ........................................................................................... 24

Summary ..................................................................................................................................................... 25

Endnotes ..................................................................................................................................................... 26


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List of Figures

Figure 1: Self-rated health, people aged 12 years and older, Timiskaming and Ontario 2009/2010 ........ 5

Figure 2: Self-reported mental health, people aged 12 years and older, Timiskaming and Ontario, 2009/2010 .................................................................................................................................. 6

Figure 3: Life expectancy at birth, Timiskaming and Ontario, 2007/2009 ............................................... 7

Figure 4: Life expectancy at birth, Timiskaming and Ontario, 2000/2002 to 2007/2009 ......................... 8

Figure 5: Life expectancy gained if behavioural risks are removed, Timiskaming residents aged 20 years and older, 2007 ................................................................................................................. 9

Figure 6: Life expectancy at birth, by sex, neighbourhood quintiles, Canada, 2005-2007 ..................... 11

Figure 7: Leading causes of potential years of life lost, Timiskaming, 2003-2007 ................................ 13

Figure 8: Ten leading causes of death, Timiskaming, both sexes and all ages, 2003-2007 (combined) 14

Figure 9: Most common causes of death by age group, Timiskaming, 2003-2007 (combined) ............. 16

Figure 10: Ten leading causes of emergency room visits, Timiskaming, both sexes and all ages (combined), 2010..................................................................................................................... 18

Figure 11: Ten leading causes of emergency room visits, Timiskaming, by sex, 2010 ........................... 19

Figure 12: Ten leading causes of hospitalization, Timiskaming, both sexes and all ages, 2009/2010 (combined) .............................................................................................................................. 22


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Introduction The vision of the Timiskaming Health Unit (THU) is total

wellness of our community. In pursuit of this, the THU

regularly collects, analyzes, and interprets data related to the

health of the Timiskaming population to identify local issues

of public health importance and to monitor changes in

population health status over time.

The Timiskaming Health Status Profile provides a snapshot

of the health of the population served by the THU. Indicators

related to general health status are presented, including life

expectancy, leading causes of death, leading causes of

hospitalization and emergency room visits, as well as

prevalence of selected chronic diseases.

To learn about the population of Timiskaming in terms of

demographics such as age, sex, and socioeconomic status,

refer to the companion document Timiskaming

Demographic Profile document available at

http://www.timiskaminghu.com under “Reports”

About this Report To simplify this document, any reference to “Timiskaming”

refers specifically to the THU catchment area and includes

the District of Timiskaming, the townships of Bisley, Clifford,

Ben Nevis and Pontiac in the Cochrane district, and the

Municipality of Temagami.

Boards of Health in Ontario are

guided by the Ontario Public

Health Standards (OPHS) which

are published by the Ministry of

Health and Long-Term Care

(MOHLTC). The OPHS establish

requirements for programs and

services delivered by Ontario’s

public health units. The OPHS

mandate that Boards of Health

shall engage in ongoing

population health assessment

and surveillance using a range of

provincial and local indicators,

including demographics and

current health status, and

developing and maintaining

population health profiles.

(MOHLTC, 2008, p. 12; 15)

This report provides information

on the general health status of

the population served by the

Timiskaming Health Unit. It can

be used to better understand

our individual and collective

health, to make plans about how

we can improve health, and to

measure progress towards the

achievement of better health.

http://www.timiskaminghu.com/


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General Health The health of individuals and populations is determined by many factors; thus, to understand the overall

health of the community, there are a number of measures that can be used. Sources of information

include mortality (the number and causes of death), frequency and causes of emergency room visits and

hospitalizations as measures of health conditions. Not all illnesses and conditions lead people to seek

medical care. For that reason, another way of measuring the health of a community is to examine how

people rate their own health. Self-rated health measures an individual's perception of his or her overall

health. Studies have found that self-rated health is an important predictor of illness, disability and

mortality, particular when ratings are poor.1,2,3,4,5,6

Perceived health

Figure 1: Self-rated health, people aged 12 years and older, Timiskaming and Ontario 2009/2010

Source: Statistics Canada, CCHS, 2009/2010

In 2009/2010, about half (53.5%) of Timiskaming

residents reported their health to be “excellent

or very good”, which was not statistically

different from Ontario’s percentage (Figure 1).

Among Timiskaming males, 54.1% rated their

health as “excellent or very good”, which was

similar to Timiskaming females (52.9%). These

percentages were not statistically different from

Ontario males and females.

Perceived mental health The World Health Organization defines mental health as "a state of well-being in which the individual

realizes his or her own abilities, can cope with the normal stresses of life, can work productively and

fruitfully, and is able to make a contribution to his or her community".7 Thus, mental health not only

refers to the absence of mental illness but also to mental wellness. People with good mental health tend

to experience lower rates of physical health problems than those with moderate or poor mental health

or mental illness.8 Conversely, poor mental health, including conditions such as anxiety and depression,

can lead to decreased productivity at work, greater use of alcohol and drugs to cope and can contribute

to the risk of chronic diseases.9,10

0102030405060708090

100

Overall Males Females

53.5 54.1 52.961.0 61.4 60.6

Perc

enta

ge o

f pop

ulat

ion

aged

12

yea

rs &

old

er

Timiskaming Ontario


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Figure 2: Self-reported mental health, people aged 12 years and older, Timiskaming and Ontario, 2009/2010

Source: Statistics Canada, CCHS, 2009/10

In 2009/2010, a lower percentage of

Timiskaming residents reported their mental

health as “excellent or very good” compared

to the rest of Ontario: 63.9% in Timiskaming

compared to 74.3% for Ontario. A lower

percentage of Timiskaming males (59.2%)

rated their mental health as “excellent or very

good” compared to males in Ontario (75.3%).

There were no statistical differences between

Timiskaming males and females.

Chronic conditions Chronic diseases may significantly impair everyday physical and mental functions and reduce one’s

ability to perform activities of daily living. In 2007, the MOHLTC reported that, worldwide, chronic

diseases had overtaken infectious diseases as the leading cause of death and disability11 and this

remains true today.

As part of the Canadian Community Health Survey (CCHS), respondents were asked if they had been

diagnosed with certain health conditions by a health professional that were expected to last, or had

lasted for at least six months, at the time of the survey. The prevalence of these chronic conditions is

outlined below.

In 2009/2010, 27.0% of Timiskaming residents (aged 12 years and older) reported being diagnosed with high blood pressure. This was statistically higher than the province (17.4%).

Hypertension is the medical term used to describe a condition when blood pressure is consistently

elevated.12 There are many risk factors that are associated with hypertension, including a diet high in

sodium (salt), being obese, having diabetes, smoking, older age and having a family history of

hypertension.

0102030405060708090

100


63.9*59.2*

68.674.3 75.3 73.3

Perc

enta

ge o

f pop

ulat

ion

aged

12

yea

rs &

old

erTimiskaming Ontario

*Statistically lower than Ontario


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Table 1: Prevalence of selected chronic conditions, self-reported by persons aged 12 years and older, Timiskaming and Ontario, 2009/2010

Timiskaming

% Ontario

% High blood pressure 27.0* 17.4

Back problems 24.8 19.4

Arthritis 22.7 17.0

Asthma 9.4E 8.3

Diabetes 6.8E 6.8

*Statistically higher than Ontario E: small sample size; interpret with caution Source: Statistics Canada, CCHS, 2009/10

Life expectancy In Timiskaming, newborn residents are expected to celebrate

79 birthdays. Specifically, for the three year period between

2007 and 2009, the life expectancy at birth was 79.1 years for

the general population of Timiskaming. 13 This was

statistically lower than the life expectancy for Ontario, which

was 81.5 years.

Figure 3: Life expectancy at birth, Timiskaming and Ontario, 2007/2009

The life expectancy of

Timiskaming males at birth

was 76.1 years and was

statistically lower than

Timiskaming females (81.8

years). Ontario males had a

significantly lower life

expectancy than Ontario

females as well. The life

expectancy for males in

Ontario was 79.2 years and

83.6 years for females.

Source: Statistics Canada, Table 102-4307, 2007/2009

65

70

75

80

85

90


79.1*

76.1*E

81.8*E 81.5

79.2

83.6

Age

(yea

rs)

Timiskaming Ontario

*Statistically lower than Ontario E: use with caution

Life expectancy is the average number of

years a newborn baby is expected to live

if current death trends continue. For

people already living, life expectancy is

dependent on their age, and will vary.


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As shown in Figure 4, from 2000/2002 to 2007/2009 life expectancy in Ontario has been increasing.

There were no statistical differences in life expectancy over time for Timiskaming. Life expectancy in

Timiskaming has been statistically lower than Ontario.

Figure 4: Life expectancy at birth, Timiskaming and Ontario, 2000/2002 to 2007/2009

Source: Statistics Canada, Table 102-4307, 2000/2002 to 2007/2009


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Impact of unhealthy habits on life expectancy Within Canada, British Columbia has the highest life expectancy at birth for both males and females. In

comparison to Ontario, British Columbia has the smallest percentage of residents who smoke, have poor

fruit and vegetable consumption or are physically inactive. 14 A 2012 study examined the impact of

unhealthy habits on life expectancy of Ontarians.15 It suggests that 77% of Ontarians would need to

reduce their unhealthy behaviours to meet British Columbia’s targets for physical activity, diet and

smoking. If those healthy living targets were achieved, Ontarians on average would increase life

expectancy by 3.0 years. Smoking, physical inactivity and poor diet were the three leading behavioural

causes of death in Ontario. What does this mean for Timiskaming residents?

Figure 5 shows the impact of eliminating five unhealthy behaviours on life expectancy for Timiskaming

residents aged 20 years and older. If someone chose not to smoke, they could expect to gain 4.3 years in

life expectancy. Physical activity and a healthy diet could add 5.4 years to a person’s life expectancy.

Removing all five risk factors would add 9.4 years to a person’s life expectancy.

Figure 5: Life expectancy gained if behavioural risks are removed, Timiskaming residents aged 20 years and older, 2007

Source: ICES and Public Health Ontario, 2012


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Disparities in life expectancy Canada ranks ninth in the world for life expectancy at birth.15 Canada’s life expectancy may be

contrasted with countries like Kenya, where life expectancy for females is 59 years and for males is 57

years, or Pakistan, where life expectancy for females is 67 years and for males is 65 years.16

While Canada’s life expectancy ranks near the top in the world, certain populations within Canada do

not fare as well. 17 As discussed in the previous section on unhealthy life habits, life expectancy tends to

be lower in regions where the rates of smoking, heavy drinking and obesity are relatively high. In these

regions, there are also higher levels of long-term unemployment, fewer high school and university

graduates, a relatively larger Aboriginal population and are in rural or remote locations.17

Data has also shown (refer to Figure 3) that life expectancy is lower for males than it is for females. This

gap between the sexes is most noticeable in lower-income groups.17 For the years 2005 to 2007,

Statistics Canada divided the Canadian population into five equal groups (quintiles) according to their

neighbourhood incomei and then calculated life expectancy for each group. Figure 6 shows that the life

expectancy for the lowest income quintile is 75.6 years for males and 81.7 for females. The life

expectancy for the highest income quintile is 80.3 years for males and 84.0 for females. There is an

upward trend whereby life expectancy increases as income increases. This trend is more evident for

males than females.

iRefers to the average before-tax income by household member in each census dissemination area.


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Figure 6: Life expectancy at birth, by sex, neighbourhood quintiles, Canada, 2005-2007

Source: Statistics Canada. (2011). Vital Statistics. Special tabulation18


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Death

Age-standardized mortality rate An age-standardized mortality rate allows us to compare the death rate of Timiskaming residents, with

the death rates for Ontario residents, by removing the effects of differences in age. For example, the risk

of dying is greater with increasing age so a population with a higher percentage of older adults will have

a higher overall crude death rate for most chronic conditions. Similarly, injuries are more common

among young people so areas with more youth may have higher crude mortality rates for injury-related

deaths.19 Nearly one fifth (18.6%) of the population in Timiskaming is 65 years or older compared with

13.7% of Ontario’s population that are older adults.20 An age-standardized mortality rate helps account

for these differences in age.

For the period between 2007 and 2009, Timiskaming’s all-cause mortality rate was higher than Ontario. • The age-standardized mortality rate in Timiskaming was 626.3 deaths per 100,000 population, which

was statistically higher than Ontario’s mortality rate of 514.4 deaths per 100,000 population (2007-2009).21

For the period between 2007 and 2009 in Timiskaming, females had a lower death rate than males. • The age-standardized mortality rate for Timiskaming females was 503.9 per 100,000 population,

which was statistically lower than Timiskaming males’ mortality rate of 764.5 per 100,000 population (2007-2009).21


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Dying young For the period 2003 to 2007 in Timiskaming, ischemic heart

disease was the leading cause of potential years of life lost

(Figure 7). Lung cancer, motor vehicle collisions, suicide

and cerebrovascular diseases were the next most common

causes of potential years of life lost.

Figure 7: Leading causes of potential years of life lost, Timiskaming, 2003-2007

Source: intelliHEALTH Ontario (2003-2007). Ontario Ministry of Health and Long-Term Care. Extracted May 2, 2012

Potential years of life lost (PYLL) is an measure of premature mortality. It represents the number of years not lived by an individual from birth to age 75. This indicator places more

weight on causes of early death than causes of death at older ages. PYLL varies by sex, socioeconomic status

and geographic area.


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Leading causes of deathii For the five years from 2003 to 2007, there were 1,945 deaths among residents of Timiskaming, which is

an average of 389 deaths per year. The number one cause of death during that time period was

ischaemic heart disease, which was listed as the primary cause of death for 17.3% of all deaths in

Timiskaming. Other leading causes of death were cancer of the lung and bronchus, chronic lower

respiratory diseases (includes chronic obstructive pulmonary disease (COPD)), cerebrovascular diseases

(includes stroke), and diabetes. Figure 8 presents overall leading causes of death for Timiskaming for the

five-year period 2003 to 2007.

Figure 8: Ten leading causes of death, Timiskaming, both sexes and all ages, 2003-2007 (combined)

Source: Ontario Mortality Data. (2003-2007). Ontario Ministry of Health and Long-Term Care, intelliHEALTH ONTARIO. Extracted May 2, 2012

ii The leading causes of death were grouped based on the work of Roberto Becker with modifications as approved by the Leading Cause Group subcommittee of the Core Indicators Working Group, Association of Public Health Epidemiologists in Ontario. Reference: Becker R, Silvi J, Ma Fat D, L'Hours J, Laurenti R. A method for deriving leading causes of death. WHO Bulletin April 2006; 84(4): 297-303, Appendices A-D. Available online at: http://www.who.int/bulletin/volumes/84/4/297.pdf

http://www.who.int/bulletin/volumes/84/4/297.pdf


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Leading causes of death among males and females

In Timiskaming, the leading cause of death for both males and females was ischaemic heart disease for

the five-year period 2003 to 2007. The second leading cause of death in both males and females for the

same time period was cancer of the lung and bronchus, responsible for 10.5% of all deaths for males and

9.2% for females.

Chronic lower respiratory diseases, which include chronic obstructive pulmonary disease (COPD), were

the third leading cause of death for males, contributing to 7.2% of all deaths, but were the fifth leading

cause of death among females (4.1% of all deaths among females).

For females, cerebrovascular disease was the third leading cause of death (6.1%). Cerebrovascular

diseases includes stroke.

The table below presents overall leading causes of death for Timiskaming males and females for the

five-year period 2003 to 2007.

Table 2: Ten leading causes of death for Timiskaming males and females, 2003-2007 (combined) Timiskaming Males Total deaths: 1,025

Timiskaming Females Total deaths: 920

Primary Cause

% of deaths

Primary Cause

% of deaths

Ischaemic heart disease 18.3 Ischaemic heart disease 16.1 Cancer of lung or bronchus 10.5 Cancer of lung or bronchus 9.2

Chronic lower respiratory diseases 7.2 Cerebrovascular diseases 6.1 Cancer of colon, rectum & anus 4.3 Diabetes 5.0

Cerebrovascular diseases 4.2 Chronic lower respiratory diseases 4.1 Lymph & blood related cancers (includes

leukemia, Hodgkin’s, Non-Hodgkin’s) 3.5 Dementia & Alzheimer Disease

3.8

Diabetes 3.4 Breast cancer 3.2 Diseases of urinary system 2.7 Cancer of colon, rectum & anus 2.9

Prostate cancer 2.4 Influenza & pneumonia 2.5 Suicide 2.1 Diseases of urinary system 2.4



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Leading causes of death by age

Very few deaths occur among children under the age of 19 years. On average, there were 4.2 deaths per

year in the 0 to 19 year age group in Timiskaming for the five year period between 2003 and 2007.

Precise causes of death cannot be reported due to small number of cases.

The majority of deaths occurred among residents aged 65 years and older, with an average of 298.6

deaths per year from 2003 to 2007. The most common causes of death in this age group were ischaemic

heart disease, cancer of the lung and bronchus and chronic lower respiratory diseases.

The most common causes of death in the 20 to 44 year age group were neoplasms (cancer), suicide,

motor vehicle collisions and accidental poisoning. The average number of deaths for the 20 to 44 year

age group was 15.4 per year from 2003 to 2007. The average number of deaths for the 45 to 64 year age

group was 71.1 per year in the same time period.

Figure 9: Most common causes of death by age group, Timiskaming, 2003-2007 (combined)


Congenital anomaliesExternal causesAll other causes

0 to 19 years:

1.1%4.0%

18.2%

76.7%

Neoplasms

Suicide

Motor vehicle collisions

All other causes

20 to 44 years:

Ischemic heart disease

Cancer of lung & bronchus

Cerebrovascular disease

Chronic lower respiratory diseasesDiabetes

All other causes

65+ years:

Ischemic heart disease

Cancer of lung & bronchus

Cancer of colon rectum anusDiabetes

All other causes

45 to 64 years:


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Going to the hospital

Leading causes of emergency room visits The leading causes of unscheduled emergency room visits are presented using the International

Statistical Classification of Diseases, tenth revision (ICD-10), which classifies diseases and health

problems recorded on health and vital records.22 Data presented in this section are for 2010 and

represents the number of emergency room (ER) visits and not the number of people visiting the ER. For

example, a person may have more than one visit during the year of data examined. Causes are based on

the one main problem during a given emergency visit.iii

• In 2010, there were 34,244 unscheduled ER visits in Timiskaming.

• The number one cause of visits to the ER in Timiskaming was injuries and poisonings, which

accounted for 6,441 visits, or nearly one-fifth (18.8%) of all ER visits.

o Among ER visits specifically due to injuries and poisonings, 14.7% were injuries to the head

and 5.7% were related to burns. Note that injuries to the head represented 2.8% of all ER

visits in Timiskaming in 2010.

• In 2010, the second leading cause of ER visits in Timiskaming was respiratory conditions, which

accounted for 5,904 visits, or 17.2% of all ER visits.

o Among ER visits specifically due to respiratory conditions, about half (54.8%) were due to

acute upper respiratory infections and a fifth (21.7%) were due to chronic obstructive

pulmonary disease (COPD). Note that acute upper respiratory infections represented 9.4%

of all ER visits in Timiskaming in 2010, and COPD corresponded to 3.7% of all ER visits in

Timiskaming in 2010.

iii Emergency visits due to pregnancy and birth (ICD-10 Chapter 15) were excluded, because these do not represent burden of illness. Factors influencing health status & contact with health services (ICD-10 Chapter 21) and provisional codes for research and temporary assignment (ICD-10 Chapter 23) were excluded as they do not represent diseases or conditions.


Page | 18

Figure 10: Ten leading causes of emergency room visits, Timiskaming, both sexes and all ages (combined), 2010

Source: Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO, 2010. Date extracted: August 29, 2012


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Leading causes of emergency room visits among males and females

In Timiskaming in 2010, the top reasons for ER visits among females was diseases of the respiratory

system, which comprised 18.3% of all ER visits by females, followed by injury and poisonings (15.3%) and

diseases of the genitourinary system (9.1%).

The top reasons for ER visits among Timiskaming males was injury and poisonings, which accounted for

23.0% of ER visits by males in 2010, followed by respiratory conditions (15.9%) and diseases of

musculoskeletal and connective tissue (9.7%).

Figure 11: Ten leading causes of emergency room visits, Timiskaming, by sex, 2010



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Leading causes of emergency room visits by age

In 2010, respiratory diseases were the leading cause of ER visits in Timiskaming among young children

between 0 and 9 years of age, and older adults aged 65 years and over. Injury and poisoning was the

leading cause of ER visits in Timiskaming among the 10 to 19 year age group as well as adults 20 to 64

years of age.

Table 3: Leading causes of ER visits, Timiskaming, by age group, 2010 Age group Number of

emergency visits Leading causes (ICD-10 Chapter)

Under 1 year 586 Diseases of respiratory system (36.5%) Certain infectious & parasitic diseases (13.1%) Diseases of the ear & mastoid process (9.6%)

Injury & poisoning (7.3%) Diseases of skin & subcutaneous tissue (6.7%)

1 to 9 years 3,243 Diseases of respiratory system (31.2%) Injury & poisoning (16.6%)

Diseases of the ear & mastoid process (16.5%) Certain infectious & parasitic diseases (10.9%) Diseases of skin & subcutaneous tissue (6.2%)

10 to 19 years 4,211 Injury & poisoning (30.5%) Diseases of respiratory system (19.4%)

Certain infectious & parasitic diseases (5.8%) Diseases of genitourinary system (5.8%)

Diseases of skin & subcutaneous tissue (5.3%) 20 to 44 years 10,309 Injury & poisoning (20.2%)

Diseases of respiratory system (15.0%) Diseases of musculoskeletal system (9.9%)

Diseases of digestive system (8.2%) Diseases of genitourinary system (7.8%)

45 to 64 years 9,179 Injury & poisoning (17.7%) Diseases of respiratory system (14.6%)

Diseases of musculoskeletal system (13.2%) Diseases of digestive system (7.6%)

Diseases of genitourinary system (6.3%) 65 + years 6,716 Diseases of respiratory system (14.5%)

Injury & poisoning (13.0%) Diseases of musculoskeletal system (10.5%)

Diseases of circulatory system (8.8%) Diseases of digestive system (7.1%)



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Leading causes of hospitalization Hospitalizations are counted at patient discharge and are based on the most responsible diagnosis. The

leading causes of hospitalization are presented using ICD-10.22,iv Data on hospital stays in Timiskaming

are for calendar years 2009/2010.

• For 2009/2010, there were 8,467 hospitalizations in Timiskaming.

• The leading cause of hospitalization was diseases of the circulatory system, responsible for 17.5% of

all hospitalizations in Timiskaming, or 1,478 hospital stays.

o Among hospital stays specifically due to diseases of the circulatory system, 46.9% were

ischaemic heart disease. Note that ischaemic heart disease was responsible for 8.2% of all

hospital stays in Timiskaming in 2009/2010.

• The second leading cause of hospitalization was diseases of the digestive system, which represented

13.6% of all hospital discharges.

o Among hospitalizations specifically due to diseases of the digestive system, 22.8% were due

to gallstones & other diseases of the gallbladder and biliary tract. Note that gallstones &

other diseases of gallbladder and biliary tract represented 3.1% of all hospitalizations in

Timiskaming in 2009/2010.

• The third leading cause of hospitalization was diseases of the respiratory system.

o The most common disease of the respiratory system was COPD, responsible for 42.3% of

hospitalizations due to respiratory disease. COPD corresponded to 3.6% of all hospital stays

in Timiskaming in 2009/2010.

iv Hospital stays due to factors influencing health status & contact with health services (ICD-10 Chapter 21) and provisional codes for research and temporary assignment (ICD-10 Chapter 23) were excluded as they do not represent diseases or conditions.


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Figure 12: Ten leading causes of hospitalization, Timiskaming, both sexes and all ages, 2009/2010 (combined)

Source: Ontario Ministry of Health and Long-Term Care. Discharge Abstract Database. (2009-2010). Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Date extracted: January 9, 2013.


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Leading causes of hospitalization among males and females

Table 4 shows leading causes of hospitalization among Timiskaming males and females in 2009/2010.

The number one cause of hospitalization among males was diseases of the circulatory system, which

accounted for 21.0% of all hospital stays by males. The number one cause of hospitalization among

Timiskaming females was diseases of the circulatory system, which represented 14.6% of all hospital

stays by females.

Table 4: Ten leading causes of hospitalization, Timiskaming, males and females, 2009/2010 Timiskaming males Total visits: 3,831

%

Timiskaming females Total visits: 4,636

%

Diseases of circulatory system 21.0 Diseases of circulatory system 14.6 Diseases of digestive system 13.4 Diseases of digestive system 13.8

Diseases of respiratory system 9.6 Pregnancy & childbirth 11.4 Injuries and poisoning 8.5 Injuries and poisoning 7.5

Neoplasms (Cancer) 8.2 Diseases of respiratory system 7.5 Mental & behavioural disorders** 6.6 Diseases of musculoskeletal system &

connective tissue 7.0

Diseases of musculoskeletal system & connective tissue

6.6 Diseases of genitourinary system 7.0

Diseases of genitourinary system 4.1 Neoplasms (Cancer) 6.4 Endocrine, nutritional & metabolic

diseases 3.5 Mental & behavioural disorders** 5.7

Diseases of nervous system 1.9 Endocrine, nutritional & metabolic diseases

2.6

**Note: The reader is cautioned these data will not be a complete picture of hospitalizations due to mental disorders by Timiskaming residents. Hospitals are mandated to submit data for hospital discharges to CIHI Discharge Abstract Database, from which the data in this section were derived. As of April 1, 2006, patients with mental disorders who occupy designated psychiatric beds in acute care hospitals have been reported through the Ontario Mental Health Reporting System (OHMRS). For that reason, the convention is to exclude hospitalizations due to ICD-10 Chapter 5 Mental Health & Behavioural Disorders for the data presented in this table. There were no facilities in Timiskaming with designated mental health beds. Thus, hospitalizations with most responsible diagnosis “mental & behavioural disorders” were included in this data. Source: Ontario Ministry of Health and Long-Term Care, Discharge Abstract Database, IntelliHEALTH Ontario. 2005-2010. Date extracted: January 9, 2013


Page | 24

Leading causes of hospitalization by age

Table 5 shows the leading causes of hospitalization in Timiskaming by age group for 2009/2010. The

majority of hospitalizations were by older adults aged 65 years and older, with diseases of the

circulatory system as the leading cause. Diseases of the respiratory system was the top reason for

hospitalization among the 1 to 9 year age group. Pregnancy and childbirth were the leading cause of

hospitalization among the 10 to 19 year and 20 to 44 year age groups.

Table 5: Leading causes of hospitalization, Timiskaming, by age group, 2009/2010

Age group Number of

hospital stays Leading causes (ICD-10 Chapter) Under 1 year 115 Certain conditions originating in perinatal period (51.3%)

Diseases of respiratory system (16.5%) Congenital malformations, deformations & chromosomal

anomalies (10.4%) 1 to 9 years 153 Diseases of respiratory system (35.9%)

Diseases of digestive system (15.0%) Certain infectious & parasitic diseases (7.2%)

Injury & poisoning (5.9%) 10 to 19 years 316 Pregnancy & childbirth (16.5%)

Injury & poisoning (15.2%) Diseases of digestive system (13.9%)

Mental and behavioural disorders (12.7%) 20 to 44 years 1,567 Pregnancy & childbirth (30.5%)

Diseases of digestive system (13.4%) Mental & behavioural disorders (12.0%)

Injury & poisoning (8.1%) 45 to 64 years 2,471 Diseases of circulatory system (19.5%)

Diseases of digestive system (14.9%) Neoplasms (10.0%)

Diseases of musculoskeletal system & connective tissue (9.7%) 65 + years 3,845 Diseases of circulatory system (23.8%)

Diseases of digestive system (12.9%) Diseases of respiratory system (10.2%)

Neoplasms (8.3%) Source: Ontario Ministry of Health and Long-Term Care, Discharge Abstract Database, IntelliHEALTH ONTARIO, 2010. Date extracted: August 29, 2012


Page | 25

Summary This report provides a brief profile of the general health status of the population served by the

Timiskaming Health Unit.

This report is intended for local public health and health care professionals, community organizations

working in other health and social service sectors, government decision-makers, and individuals and

community groups within the general public. The findings in this report can be used to better

understand our individual and collective health, to make plans about how we can improve health, and to

measure progress towards the achievement of better health.


Page | 26

Endnotes

1 Bopp M, Braun J, Gutzwiller F, Faeh D, for the Swiss National Cohort Study Group. (2012). Health risk or resource? Gradual and independent association between self-rated health and mortality persists over 30 Years. PLoS ONE 7(2): e30795. doi:10.1371/journal.pone.0030795

2 Ford, J., Spallek, M. & Dobson, A. (2007). Self-rated health and a healthy lifestyle are the most important predictors of survival in elderly women. Age and Ageing, 37(2): 194-200 first published online December 6, 2007 doi:10.1093/ageing/afm171

3 Pietiläinen O, Laaksonen M, Rahkonen O, Lahelma E. (2011). Self-rated health as a predictor of disability retirement – The contribution of ill-health and working conditions. PLoS ONE, 6(9), e25004. doi:10.1371/journal.pone.0025004

4C A Cott, C.A., Gignac, M.A. & Badley, E.M. (1999). Determinants of self rated health for Canadians with chronic disease and disability. doi:10.1136/jech.53.11.731

5 Idler, EL, Benyamini, Y. (1997). Self-rated health and mortality: a review of twenty-seven community studies. Journal of Health and Social Behaviour. 38: 21–37.

6 Heistaro, S., Jousilahti, P., Lahelma, E., Vartiainen, E., Puska, P. (2001). Self rated health and mortality: a long term prospective study in eastern Finland. J Epidemiol Community Health. ;55:227-232 doi:10.1136/jech.55.4.227

7World Health Organization. (2011). Retrieved from http://www.who.int/features/factfiles/mental_health/en/index.html 8 Keyes, CLM. (2005). Chronic physical conditions and aging: Is mental health a potential protective factor? Ageing International. 30(1):88-104. Retrieved at http://midus.wisc.edu/findings/pdfs/192.pdf

9 Canadian Mental Health Association et al. (2008). Mental health promotion in Ontario: A call to action. Retrieved from http://www.ontario.cmha.ca/policy_positions.asp?cID=25899

10 Bunker SJ, Colquhoun DM, Esler MD, et al. (2003). Stress and coronary heart disease: psychosocial risk factors. National Heart Foundation of Australia position statement update. Medical Journal of Australia. 178(6), 272-276. Retrieved at https://www.mja.com.au/journal/2003/178/6/stress-and-coronary-heart-disease-psychosocial-risk-factors 11 Ontario Ministry of Health and Long-Term Care. (2007). Preventing and managing chronic disease: Ontario’s Framework. Retrieved from: http://www.health.gov.on.ca/english/providers/program/cdpm/pdf/framework_full.pdf 12 Public Health Agency of Canada. (2011). Hypertension. Retrieved from http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/hypertension-eng.php 13 Statistics Canada. Table 102-4307. (2012 May 30). Life expectancy, at birth, by sex, three-year average. Retrieved from http://www5.statcan.gc.ca/cansim/pick-choisir?id=1024307&searchTypeByValue=1&lang=eng 14 Manuel, D.G., Perez, R., Bennett, C., Rosella, L., Tajiaard, M., Roberts, M., Sanderson, R., Tuna, M., Tanuseputro, P., & Manson, H. (2012). Seven more years: The impact of smoking, alcohol, diet, physical activity and stress on health and life expectancy in Ontario. Toronto: ICES and Public Health Ontario. Retrieved from http://www.oahpp.ca/resources/documents/reports/seven_more_years/PHO-ICES_SevenMoreYears_Report_web.pdf

http://ageing.oxfordjournals.org/search?author1=Jessica+Ford&sortspec=date&submit=Submit

http://jech.bmj.com/search?author1=C+A+Cott&sortspec=date&submit=Submit

http://www.who.int/features/factfiles/mental_health/en/index.html

http://midus.wisc.edu/findings/pdfs/192.pdf

http://www.ontario.cmha.ca/policy_positions.asp?cID=25899

https://www.mja.com.au/journal/2003/178/6/stress-and-coronary-heart-disease-psychosocial-risk-factors

https://www.mja.com.au/journal/2003/178/6/stress-and-coronary-heart-disease-psychosocial-risk-factors

http://www.health.gov.on.ca/english/providers/program/cdpm/pdf/framework_full.pdf

http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/hypertension-eng.php

http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/hypertension-eng.php

http://www5.statcan.gc.ca/cansim/pick-choisir?id=1024307&searchTypeByValue=1&lang=eng

http://www.oahpp.ca/resources/documents/reports/seven_more_years/PHO-ICES_SevenMoreYears_Report_web.pdf

http://www.oahpp.ca/resources/documents/reports/seven_more_years/PHO-ICES_SevenMoreYears_Report_web.pdf


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15 Statistics Canada. (2011). Organisation for Economic Co-operation and Development, OECD Health Data 2010. 16 United Nations, Department of Economic and Social Affairs, Population Division. (2011). World population prospects: The 2010 Revision. Retrieved from http://unstats.un.org/unsd/demographic/products/socind/ 17 Greenberg, L., Normandin, C. (2011). Health at a glance: Disparities in life expectancy at birth. Statistics Canada. Retrieved from http://www.statcan.gc.ca/pub/82-624-x/2011001/article/11427-eng.htm

18Statistics Canada.(2011). Vital Statistics. Special tabulation. Retrieved from http://www.statcan.gc.ca/pub/82-624-x/2011001/article/desc/11427-06-desc-eng.htm

19 Bain, N. (2009). Standardization of rates. Retrieved from http://www.apheo.ca/resources/indicators/Standardization%20report_NamBains_FINALMarch16.pdf

20Statistics Canada (2009). Post-Census population estimates. IntelliHEALTH, Ontario Ministry of Health and Long-Term Care. Date extracted: March 2012.

21 Ontario Mortality Data. (2007-2009). Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Date extracted: Mar 2012. Population Estimates (2005-2007). Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO, Date extracted: January 15, 2013.

22 World Health Organization. International classification of diseases and related health problems. 10th revision; vol 2. Geneva, Switzerland: WHO; 1993. Most recent version available from: http://apps.who.int/classifications/icd10/browse/2010/en

http://unstats.un.org/unsd/demographic/products/socind/

http://www.statcan.gc.ca/pub/82-624-x/2011001/article/11427-eng.htm

http://www.statcan.gc.ca/pub/82-624-x/2011001/article/desc/11427-06-desc-eng.htm

http://www.statcan.gc.ca/pub/82-624-x/2011001/article/desc/11427-06-desc-eng.htm

http://www.apheo.ca/resources/indicators/Standardization%20report_NamBains_FINALMarch16.pdf

http://apps.who.int/classifications/icd10/browse/2010/en

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