ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH
How healthy are we? 2004
Time for the annual check-up Contents
Prevention works 1
The annual check-up 3
Smoking kills 12
One step at a time 18
We are what we eat 22
A closing word 28
Keeping you informed 29
Legal Redwater Highway 2 Bon Accord Gibbons Morinville Hwy 15
Fort Hutterite Sturgeon County Saskatchewan Colony Josephburg
Strathcona St. Albert MacKay County Wildwood Elk Island National Nojack Entwistle Spruce Grove Highway 16 Park Evansburg Highway 16 Fallis Sherwood Ardrossan Wabamun Park Stony Plain Antler Lake Yellowhead County Parkland County Half Moon Lake North Edmonton 21 Collingwood Cove Cooking Lake South Tomahawk Cooking Hastings Lake Keephills Lake
Highway Highway 14 No iver rth Saskatchewan R Beaumont Genesee Devon Nisku
St. Francis New Highway 2 Telfordville Highway 39 Leduc Sarepta Calmar Rolly View Hutterite Colony Thorsby Buford
Sunnybrook Kavanagh Warburg Leduc County
Mission Beach Sundance Beach
Golden Days
The Capital Health region in Alberta is one of Canada’s Population for the Capital Health region, 2003 largest integrated academic health regions, providing Age Group Females Males Total complete health services to residents in the cities of Edmonton, Fort Saskatchewan, Leduc, Spruce Grove and < 1 5,619 5,810 11,429 St. Albert, and the counties of Leduc, Parkland, 1 - 4 22,502 23,637 46,139 Strathcona and Sturgeon (and communities within their geographical areas), as well as the Town of Devon and 5 - 9 30,154 32,018 62,172 communities in the eastern part of Yellowhead County. 10 - 14 33,956 35,340 69,296 15 - 19 34,803 36,399 71,202 20 - 44 189,378 188,531 377,909 45 - 64 118,655 119,507 238,162 65 - 74 30,743 28,141 58,884 75+ 28,929 17,864 46,793 TOTAL 494,739 487,247 981,986 Turn on the television, listen to the radio, Prevention read the newspaper, pick up a magazine, or search the web ... chances are good that you will quickly come across a story about how to works stay healthy. It may involve a new discovery about the health benefit of certain foods. It might be an ad for exercise equipment. Or it may involve long-term research on the causes of particular illnesses or the impact of education, income, employment, housing and the environment on health. Whatever the specifics, the word is getting out. Prevention works – and it works best in an environment and culture that supports healthy living. Many of the leading diseases in our community – like heart disease, many types of cancer, and diabetes – can be prevented. In most cases, what we used to call “accidents” are not really accidents at all. They can be prevented. If we make significant progress in preventing illness and injury, the health system could save millions of dollars a year. And more importantly, it will save lives and improve the quality of life for countless people. The questions remain. Are we creating communities that support health? Are people listening? Are people taking steps to protect their own health? These questions are at the heart of this year’s report on How healthy are we? The report begins, as in the past, with an overview of some leading indicators of the overall health of people in the Capital Health region. Overall, people in the region continue to enjoy good health, but there are areas of concern. How healthy are we? 2004 How healthy are
1 The report also zeros in on three critical issues – smoking, healthy eating, and physical activity. We’ve all heard the messages – don’t smoke, eat more fruit and vegetables, and get active. It turns out that these three actions are probably the best ones people can take to stay healthy. Nevertheless, our rates of smoking and exposure to secondhand smoke are too high. Not enough of us load up our diet with fruit and vegetables. And too few of us make regular physical activity a vital part of our daily routine. Good health is important to people. Most people understand that it’s not good enough to simply expect the health system to fix us up when we’re sick or injured. We need to continue to make changes so that the healthy choices are the easy choices for people. By highlighting the message that prevention works, we hope more people will not only hear the message but take it to heart ... and take action to protect their own health. How healthy are we? 2004 How healthy are
2 The annual
Every year, we do an annual check-up on the health of people living in the Capital Health check-up region. We check the vital signs, check for health problems, look at how people use the health system, and check the choices people make that affect their health and the health of others in our community. This annual check-up helps detect early signs of health problems. It points out trends and shows changes in people’s health. And it helps identify areas where action can be taken to prevent illness and injury and improve the overall health of people in the Capital Health region. A word about the data… The most recent data The vital signs continue to be available that are comparable for the good, but there are some Capital and Calgary troubling signs. Health regions, Alberta, and Canada are used in Overall, people in the Capital Health region this report. Where trend data are available, they continue to enjoy good health. are included in the tables. On the positive side, most people in the Data from the 1996-97 National Population region can expect to live long and healthy Health Survey (NPHS) lives. Men can expect to live to 76.2 years were aggregated using and women outlive them by about 4.8 years. 1996 regional health boundaries. We have also seen a decline in the rate of Data from the 2000-01 men and women dying from heart disease. Canadian Community Health Surveys (CCHS) However, heart disease and cancer continue were aggregated using to be the leading causes of death in the pre-2003 regional health boundaries. region. Breast cancer, prostate cancer, lung For the 2003 CCHS, June cancer, and colorectal cancer are the four top 2003 regional health cancers in Alberta and were responsible for boundaries were used. Data sources for the over 50% of new cancers and cancer deaths tables are noted under in 2001.i There has been an increase in the the tables. rate of women dying from lung cancer while Dashed lines in tables the death rates from other cancers, indicate that data were i not available. particularly breast cancer, have gone down. How healthy are we? 2004 How healthy are
i Alberta Cancer Board. Cancer in Alberta: a regional picture, 2004. 3 Check the vital signs
Capital Calgary Health indicators Year Health1 Health1 Alberta1 Canada Low birth weight 1998 6.4 6.9 6.2 5.72 (% live births <2500 g) 2000 6.3 6.6 6.1 – 2002 6.4 7.3 6.5 – Preterm births 1998 8.2 7.7 7.5 7.23 (% live births <37 weeks) 2000 9.4 8.7 8.5 7.63 2002 9.1 9.1 8.6 – Teen birth rate 1998 22.9 18.8 25.4 21.23 (live births per 1,000 females aged 15-19 years) 2000 19.6 17.6 22.4 18.93 2002 16.4 14.2 19.5 – Teen pregnancy rate 1998 53.24 51.84 53.04 41.75 (pregnancies per 1,000 females aged 15-19 years) 2000 45.34 45.74 46.34 38.25 2002 – ––– Infant mortality rate 97-99 5.46 4.36 5.16 5.37 (per 1,000 live births) 99-01 6.6 5.2 5.9 5.37 00-02 6.26 5.76 6.56 5.27 Life expectancy at birth in years 1998 (M) 74.98 76.78 76.28 76.09 1998 (F) 80.78 81.98 81.98 81.59 2000 (M) 75.68 77.28 77.18 76.79 2000 (F) 81.28 81.98 82.08 81.99 2002 (M) 76.28 78.08 77.48 77.29 2002 (F) 81.08 81.98 82.08 82.19 Death rate for heart disease 1998 158.1 145.1 156.9 – (per 100,000) 2000 136.9 146.1 144.4 – 2002 129.1 133.5 137.3 – Death rate for cerebrovascular disease (stroke) 1998 40.5 36.2 39.9 47.110 (per 100,000) 2000 36.9 37.7 40.3 – 2002 39.5 36.3 40.6 – Suicide rate 1998 15.3 12.0 13.8 12.410 (per 100,000) 2000 13.1 12.9 13.1 – 2002 12.9 13.1 13.3 – Death rate for cancer 1998 149.7 144.9 149.8 184.110 (per 100,000) 2000 147.0 154.8 152.0 – 2002 149.9 140.7 147.9 – Death rate for unintentional injury 1998 24.0 21.8 31.5 27.010 (per 100,000) 2000 26.0 22.2 28.6 – 2002 23.1 19.8 27.7 –
1 Vital Statistics, Alberta Registry (birth and death data 1998, 2000, 2002). December 2003 health region boundaries used. Mortality rates for selected causes are age/sex standardized to the 1996 Alberta population. 2 Statistics Canada. CANSIM Table 102-4005. Low birth weight (less than 2,500 grams), by sex, Canada, provinces and territories, annual. 3 Health Canada. Canadian Perinatal Health Report, 2003. Ottawa: Minister of Public Works and Government Services Canada, 2003. 4 Alberta Health and Wellness. Alberta Reproductive Health: Pregnancies and Births (2002). Pre-2003 health region boundaries used. 5 Statistics Canada. CANSIM Table 106-9001. Teen pregnancy, by pregnancy outcomes, women aged 15 to 19, Canada, provinces and territories, annual. Years 1998 and 2000. 6 Alberta Health and Wellness (Health Surveillance). Table B-2 Infant mortality (2003 health region boundaries used). www.health.gov.ab.ca/regions/require/b2.htm. 7 Statistics Canada. CANSIM Table 102-0030. Infant mortality, by sex and birthweight, Canada, provinces and territories, annual (180 series). Years 1998, 2000, 2001. 8 Alberta Health and Wellness (Health Surveillance) Table B-1. Life expectancy at birth by health region of residence (2003 health region boundaries used). www.health.gov.ab.ca/regions/require/b1.htm. 9 Statistics Canada. CANSIM Table 102-0511. Life expectancy – abridged life table, at birth and at age 65, by sex, Canada, provinces and territories, annual. Years 1998, 2000, 2002 10 Canadian Institute for Health Information and Statistics Canada. Health Indicators, Volume 2003, No. 2 (November), Catalogue #82-221-XIE. Mortality data are for 1997 and are age/sex standardized to the 1991 Canadian Population. How healthy are we? 2004 How healthy are
4 Socio-economic indicators1
Capital Calgary Families and households Health Health Alberta Canada Lone parent families (%) 16.1 14.4 14.4 15.7 Lone female parent (% of lone parent families) 81.1 80.6 79.8 81.3 Seniors (65 years of age and older) living alone (%) 28.0 25.5 27.7 26.7 % children at home who are 25 years of age and older 8.1 7.8 6.8 9.5 % Aboriginal population 4.4 2.8 5.3 3.3
Income and education Low income families (%) 12.3 10.2 10.5 12.8 Median family income – all Census families $60,760 $64,737 $60,142 $55,016 Median family income – lone parent families $33,094 $36,309 $32,763 $30,791 Housing affordability (proportion spending 30% or more of household income on shelter) 21.8 22.1 20.6 23.5 High school completion and/or some post secondary education (% of 20-34 year olds) 32.5 32.3 32.2 30.9 Less than high school completion (% of 20-34 year olds) 16.3 14.2 18.2 15.6 Unemployment rate (%)2 4.1 5.0 4.6 7.3
1 Statistics Canada. 2001 Census. (2003 health region boundaries) 2 Statistics Canada, Labour Force Characteristics, Unemployment Rates, June 2004 for Canada, provinces, and the Census Metropolitan Areas of Edmonton and Calgary.
Another concern is with newborn babies. with 9.1% of babies in 2002 being born Too many babies are born too soon or before 37 weeks. preterm (before 37 weeks gestation) and/or they are born too small for their gestational Health problems continue age – both factors that can result in babies The percentage of people who rate their who are low birth weight. This puts them at health as excellent or good has remained risk for health problems not only when they about the same. The proportions in are born but also later in their lives. Calgary and Alberta have been similar Although the causes are complex and not for 1996/97, 2000/01, and 2003 but for fully understood, we know about some risk Canada, the percentage has decreased. factors. Smoking, alcohol, and drug use Almost one quarter of people in the during pregnancy, the age of the mother, region indicate they experience quite a multiple births, inadequate prenatal care, lot of stress in their lives. and certain medical conditions (e.g. high The risk of people experiencing blood pressure) during pregnancy all depression has decreased from increase the risk of having a baby that is 2000/01 rates. Within Capital Health, low birth weight. In 2002, Capital Health’s 7% of people 12 years or older were rate of low birth weight babies was 6.4%. at risk for a major depressive episode That’s lower than the rate in Calgary but in 1996/97 and this increased higher than the provincial target of 5.5%. considerably in 2000/01 to almost The preterm birth rate in Capital Health has 10%. In 2003, the rate was down to steadily increased over the last 15 years 6%. How healthy are we? 2004 How healthy are
5 Health problems1,2,3
Capital Calgary Year Health Health Alberta Canada High blood pressure (%) 96/97 8.0 8.1 8.0 10.0 00/01 11.2 8.7 10.5 12.6 2003 13.8 11.0 12.2 14.4 Diabetes (%) 96/97 2.7 2.2 2.4 3.2 00/01 3.3 3.1 3.4 4.1 2003 3.9 2.5 3.6 4.6 Asthma (%) 96/97 6.4 8.0 7.1 7.2 00/01 10.2 8.2 8.9 8.4 2003 8.7 9.9 9.1 8.4 Arthritis or rheumatism (%) 96/97 13.7 11.0 13.1 13.8 00/01 17.0 12.9 15.9 15.2 2003 17.4 13.7 16.3 16.8 Had an injury that limits normal activity (%) 96/97 15.7 12.4 13.9 10.9 00/01 17.8 18.0 17.4 13.3 2003 15.3 15.2 15.4 13.1 Self-rated health (% who rated health as 96/97 62.0 67.5 64.3 67.0 excellent or very good) 00/01 59.8 63.2 61.5 61.4 2003 63.7 67.9 63.9 58.4 “Quite a lot” of life stress – 96/97 – ––– 18 years of age and older (%) 00/01 27.7 26.5 26.0 26.1 2003 23.5 23.3 23.3 24.4 “Probable” risk of major depressive episode (%) 96/97 6.9 5.7 5.6 5.1 00/01 9.9 9.3 9.2 7.1 2003 6.1 6.7 6.4 –
1 Statistics Canada (1998). National Population Health Survey (NPHS), 1996/97, Public Use Microdata Files (PUMF). 2 Statistics Canada (2002). Canadian Community Health Survey (CCHS), 2000/01, (Pre-2003 health region boundaries). 3 Statistics Canada (2004). Canadian Community Health Survey (CCHS), 2003, (June 2003 health region boundaries). Note: Data are for the population 12 years of age or older, unless otherwise noted.