District of Sub-region Population Profile 2016

Overview

This profile is one in a series of five profiles for each of the sub-regions (Integrated District Networks – IDN) in the North West LHIN. The North West LHIN has five sub-regions that represent local planning areas for health services. These sub- regions correspond to Integrated District Networks implemented through the Health Services Blueprint, which focus on providing equitable access to health care services for the residents within the district, improving health outcomes for the population and arranging for people to receive the level of care they need closer to home.

This profile describes the population demographics, health, and health system utilization for the District of Kenora sub-region.

The data presented in these profiles reflects the most up-to-date District of Kenora data – 2015-2016 unless otherwise indicated – compiled from (43,100) survey or census data and health administrative databases.

Map of the North West LHIN District of Kenora sub-region.

Community (census sub-divisions) within each Local Health Hub (LHH)

Dryden LHH: Dryden, , Machin, , Wabigoon Lake Ojibway Nation Kenora LHH: Kenora, Kenora Unorganized, Sioux Narrows-Nestor Falls, Naotkamegwanning First Nation (), Anishinabe of Wauzhushk Onigum (Rat Portage), Ochiichagwe’Babigo’ining First Nation (The Dalles), Northwest Angle No. 33 First Nation (/33B), Northwest Angle No. 37 First Nation (), Iskatewizaagegan #39 Independent First Nation (Shoal Lake 39A/34B2), Shoal Lake No. 40 First Nation, Grassy Narrows First Nation (English River 21), Washagamis Bay (Obashkaandagaang), Independent Nations (Whitedog) Red Lake LHH: Red Lake, ,

North West Local Health Integration Network Executive Summary

The District of Kenora sub-region contains three Local Health The North West LHIN funding allocation by health care sector for Hubs, including: Dryden, Kenora and Red Lake. the District of Kenora sub-region is as follows:

Population 56.8% Hospitals ÆÆ The population of the District of Kenora sub-region is the second most populated district in the North West LHIN, with 15.3% Long-Term Care Homes a total population of 45, 835 ÆÆ The population of the District of Kenora sub-region accounts 2.3% Community Health Centres

for 19.4% of the North West LHIN’s total population Community Mental Health and 13.5% ÆÆ Over half of the sub-region population lives in rural areas Addiction Services

(53.5%) 4.4% Community Support Services ÆÆ Approximately one-fifth of the population of District of Kenora sub-region identify as First Nation 7.7% Community Care Access Centre ÆÆ The District of Kenora sub-region has an approximate total 0% 100% area of 54,108 square kilometers

Total number of health service provider (HSP) programs or operations: 43 Health System Total number of HSP organizations: 35 The District of Kenora sub-region has 35 unique health service Total allocation of funding: $92,990,044 providers offering 43 LHIN-funded programs. Source: North West LHIN. Sector Share and Total Expenses Analysis by IDN, 2011. Data extracted from Canadian Management Information System.

Population Characteristics

Table 1: Population Characteristics District of Kenora North West LHIN

Total Population (2015) 45,835 235,666 13,792,052 % Change since 2011 5.1 2.2 7.2 % Female 49 50 51 % Male 51 50 49 % Children and youth, ages 0-19 years 23 23 22 % Working age, ages 20-64 years 60 60 62 % Seniors, aged 65+ years 17 17 16 % Seniors, ages 75+ 7 7 7 % of people age 65+ living alone 28.7 29.9 24.4 % Population who report French as their mother tongue 2.9 3.3 4.4 Second language spoken most frequently at home Ojibway French French % Population who identify as Aboriginal 26.7 21.4 2.3 % population 19.9 18.0 1.5 % Metis population 6.4 3.1 0.6 % Inuk or multiple Aboriginal identities 0.1 0 0 % Population who are immigrants 5.3 7.5 28.6 % Total visible minority population 1.3 2.2 25.9

Sources: Population Estimates: 2015 LHIN sub-region population estimates. Health Analytics Branch, MOHLTC, 2017. Census Profile - Age, Sex, Marital Status, Families, Households, Dwellings and Language for , Provinces, Territories, Census Divisions, Census Subdivisions and Dissemination Areas, 2011 Census. 2011 Census Statistics Canada 98-314-XCB2011007 2011 NHS Semi-custom Profile for Canada, Provinces, Territories, Census Divisions, Census Subdivisions and Dissemination Areas , National Household Survey, 2011 (all GNRs). 2011 National Household Survey - Statistics Canada. NHS Special Collection: Profile for the NHS Special Collection for 13 Indian reserves and Indian settlements in , 2011. Available at https://www12.statcan.gc.ca/nhs-enm/2011/ref/no13reserves/index.cfm?LANG=E.

2 Table 2: Socio-economic Indicators District of Kenora North West LHIN Ontario % Population age 25-64 who have graduated from high school 81.3 82.5 88.9 % Population age 25-64 with completed post-secondary 55.6 58.0 64.8 education % In the labour force (Participation rate) 64.0 61.8 52.6 % Employed 90.2 90.5 91.7 % Population living below low-income measure (LIM-AT) 10.4 12.9 13.8 % Children living in low income households/LIM (age<18) 13.0 17.9 16.3 % Housing affordability-spending 30% or more on rent 14.4 14.6 22.1 or payments % of dwellings in need of major repairs 14.8 12.1 5.9

Sources: 2011 NHS Semi-custom Profile for Canada, Provinces, Territories, Census Divisions, Census Subdivisions and Dissemination Areas , National Household Survey, 2011 (all GNRs). 2011 National Household Survey - Statistics Canada. NHS Special Collection: Profile for the NHS Special Collection for 13 Indian reserves and Indian settlements in Northern Ontario, 2011. Available at https://www12.statcan.gc.ca/nhs-enm/2011/ref/no13re- serves/index.cfm?LANG=E.

Health System Characteristics

Table 3: Description of Acute Care Services by Local Health Hub District of Indicator Red Lake LHH Kenora LHH Dryden LHH North West LHIN Kenora LHH Red Lake Margaret Dryden Regional Acute Care Hospital Cochenour Hospital District Hospital Hospital # Acute beds 14 55 31 100 601 # Complex continuing care 4 10 10 24 299 beds # Elderly capital assistance 0 0 0 0 118 beds # Inpatient mental health 0 19 0 19 122 beds # Inpatient rehab beds 0 0 0 0 50

Table 4: Description of Health Service Providers by Local Health Hub and Sector District of Indicator Red Lake LHH Kenora LHH Dryden LHH North West LHIN Kenora Organizations specializing 6 12 6 14 29 in mental health Organizations specializing 1 3 1 5 20 in addictions Community support and 5 9 11 18 60 assertive outreach services Home and Community 1 1 1 1 1 Care Services # Long-term care homes 1 - 32 2 - 212 1 - 97 4 - 341 14 - 1601 (LTCH) - number of beds Acquired brain injury services 1 1 1 1 1 Assisted living - ABI and 0 2 0 2 3 physical disability (PD) Seniors supportive housing, 0 3 - 64 2 - 37 5 - 101 11 - 504 buildings - beds

3 Public Health

Table 5: Public Health and Population Health Indicators by Health Unit and LHIN, 2015-2016 Thunder Bay District Northwestern District North West LHIN Ontario Health Unit 1 Health Unit 2 Population 154,082 81,584 235,666 13,792,052 PROPORTION WITH CHILDHOOD VACCINATIONS Childhood Vaccinations: 98 98 - 87.9 Measles, mumps, rubella (MMR) 7 years Childhood Vaccinations 98 96 - 93.7 (MMR) 17 years Meningococcal 84 89 - 81.5 Pertussis (17 years) 77 99 - 69.9 HPV 45 61 - 80.2 Teenage pregnancy rates 2014, per 1,000 females of reproductive age 40.4 45.8 - 17.5 (2014) Avoidable deaths per 100,000 338 (2011) 268 (2011) 309 (2010-2012) 196 (2010-2012) (crude rate) Life expectancy (at birth) (2007-2009) 79.3 77.4 78.6 81.5 ED visits for injuries, children 0-19 22,434 18,820 20,980 13,252.4 years (2015), rate per 100,000 City of District District District of Northern Thunder of Rainy of North West LHIN Ontario Thunder Bay District Bay River Kenora ED visits for injuries, children 0-19 years (2015), rate per 100,000 25,961 8,363 10,965 23,206 19,987 20,980 13,252.4 (by sub-region) Sources: Thunder Bay District Health Unit report, extracted using PEAR in July, 2016. Data extracted January 18, 2017. Northwestern Health Unit report, prepared in December 2016. Data extracted January 18, 2017. Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization coverage report for school pupils: 2012-13 school year. Toronto, ON: Queen’s Printer for Ontario; 2014. Public Health Ontario Snapshots: Thunder Bay Health Unit and Northwestern Health Unit: Emergency department visits for all injuries – age-specific rate (0-19 years) 2015. Toronto, ON: Ontario Agency for Health Protection and Promotion; 2017 March 8 (cited 2017 March 8). Intellihealth National Ambulatory Care Reporting System, Ambulatory All Visit Problem Dx and External Cause Table, extracted January 30, 2017. Note: The ED visits for injuries in children for the North West LHIN was calculated as a summation of the cases in the two Health Units – it was not calculated uniquely. Additionally, the Northern sub-region is divided between the two health units, and therefore some of the sums may not add up appropriately.

Primary Care

Table 6: Self-reported Primary Care Experience Indicators by Sub-region (January 2013 - September 2016) District of Kenora North West LHIN Ontario % Population with a primary care provider 87.9 86.3 94.5 % Population without a primary care provider 55.6 58.0 64.8 % Males unattached - 16.5 7.2

% Females unattached - 11.6 4.1

16-44 years - 18.8 8.3 45-64 years - 14.1 4.5 65+ years - 6.4 2.1 % of population able to get same day/next day appointments 21.4 25.0 44.7 % Who found it “easy” to get after-hours care 13.8 28.5 46.9 (without going to the ED) % Who waited 90 or more days to see a specialist after being 34.4 37.5 30.7 advised to see one % Taking prescription medications 62.9 63.8 53.4

Sources: Health Analytics Branch, Ministry of Health and Long Term Care. Health Care Experience Survey Results, January 2013 – September 2016. Extracted March 6, 2017. 4 North West LHIN Home and Community Care

Table 7: Select Home and Community Care Indicators by LHH, 2015-2016 (unless otherwise indicated) District of North West Indicator Red Lake LHH Kenora LHH Dryden LHH Ontario Kenora LHIN

# of unique clients 221 1,264 749 2,234 14,188 584,296

% of clients with end-of-life service 2.3 1.0 2.4 1.6 3.3 5.6 goal

Personal support worker/home- making services as percent of total 75.1 65.4 64.7 66.5 70.7 67.3 services

Sources: Intellihealth Ontario, Home Care Services Table, accessed March 22, 2016. Cancer Care Ontario, iPort Access. Accessed March 23, 2017.

Ambulatory Care Hospital Data

Table 8: Select Ambulatory Care Indicators by LHH, 2015-2016 (unless otherwise indicated) Red Lake District of North West Indicator Kenora LHH Dryden LHH Ontario LHH Kenora LHIN

Red Lake Margaret Lake of the Dryden Ambulatory Care Unit Cochenour Woods District Regional Memorial Hospital Health Centre Hospital

# of ED Visits 3,289 17,704 15,509 36,502 213,431 6,249,503

% of ED visits that are CTAS IV and V 57.4 41.4 62.0 51.6 40.1 35.6 (low acuity)

% of ED visits that are CTAS I-III (high acuity) 42.4 58.2 37.9 48.1 58.6 65.0

% of ED visits that are best managed 2.1 3.6 15.2 6.1 4.3 1.9 elsewhere (per 1,000 population)

90th percentile ED length of stay* 5.6 6.8 4.8 5.8 6.9 8

ED Wait Time for Physician Initial Assessment NA 3.5 2.6 3.1 2.4 3.0 (Hours, 90th Percentile) *

% of repeat visits (within 30 days) for mental 19.9 14.4 19.4 17.0 16.8 20.1 health condition **

% of repeat visits (within 30 days) for 32.8 35.6 30.5 34.3 46.4 33.0 substance abuse condition

* The sub-region percentile represents an average across the sub-region, weighted by number of ED visits per hospital.

Source: Canadian Institute for Health Information, National Ambulatory Care Reporting System. Accessed March 22, 2017. Note: some of these estimates may not represent exact counts because of suppressed data. These values were calculated from the SAA Performance Indicator Results (November 2016) for FY 2015-2016. Averages were used to estimate quarterly counts for the following hospitals (due to occasional data suppression): North of Superior Healthcare Group – Wilson Memorial General Hospital, Nipigon District Memorial Hospital, Manitouwadge General Hospital, Atikokan General Hospital, Riverside Health Care Facilities – Rainy River, and Red Lake Margaret Cochenour Memorial Hospital. North of Superior Healthcare Group – McCausland Hospital and Riverside Health Care Facilities – Emo are suppressed because of low total number of visits (data confidentiality).

5 Inpatient Hospital Data

Table 9: Select Inpatient Care Indicators by LHH, 2015-2016 (unless otherwise indicated) Red Lake District of North West Indicator Kenora LHH Dryden LHH Ontario LHH Kenora LHIN

Red Lake Margaret Lake of the Dryden Cochenour Woods District Regional Memorial Hospital Health Centre Hospital

Hospital occupancy rate % (2014-2015) 61.4 73.1 73.2 - - - Hospital Standardized Mortality Ratio (HSMR) 93 145 127 - 96 91 Cost of a standard hospital stay ($) $8,448 $6,235 $5,592 - $5,242 $5,407 (2014-2015) % Low risk pregnancies delivered by Caesarean - 20.5 17.1 - 17.5 15.2 section (2014-2015) % of patients discharged from hospital inpatient beds (acute and post-acute) without 97.7 91.0 97.5 94.1 90.4 94.2 an ALC designation % of Patient Days in Alternate Level of Care 29.3 23.8 18.5 - 20.6 13.8 # of acute care hospital stays 562 2,234 1,355 4,151 28,668 1,167,388 Ambulatory care sensitive conditions 5.1 4.0 6.3 4.7 5.8 3.4 (per 1000, <75 years) Diabetes related amputation unique patient 0.0 46.1 11.1 31.7 26.5 11.2 rate per 100,000* DAY SURGERY Knee replacement completed cases - 35 56 76 575 26,547 (Total, partial, revisions) % Knee replacement surgeries within target - 60 98 83 71 79 time (Total, partial, revisions) Hip replacement completed cases - - 69 69 394 15,596 (Total, partial, revisions) % Hip replacement surgeries within target - - 100 100 83 80 time (Total, partial, revisions) Cataract surgery completed cases - 544 - 544 2,671 130,422 % Cataract surgeries within target - 80 - 80 92 88 DIAGNOSTICS MRI completed cases - - - - 15,911 819,531 % Completed within access target - - - - 40 36 CT Completed cases - 3,915 NR 3,915 24,561 1,412,466 % Completed cases within access target - 92 NR 92 75 73 INPATIENT REHAB % ALC cases for general rehab 0 1 8 2 0 7 % ALC cases for special rehab 0 1 0 1 13 20

Sources: Canadian Institutes for Health Information, Discharge Abstract Database. Data extracted February 27, 2017. Canadian Institute for Health Information, www.yourhealthsystem.cihi.ca, accessed March 2017. Cancer Care Ontario, iPort Access. Accessed October 2, 2017. IntelliHealth Ontario, Inpatient Rehab Database, accessed March 29, 2017.

6 Long-Term Care

Table 10: Select Long-Term Care Indicators by LHH, 2015-2016 (unless otherwise indicated) Red Lake Distric of North West Kenora LHH Dryden LHH Ontario LHH Kenora LHH LHIN Northwood Birchwood Princess Pinecrest Lodge Terrace Court Worsened Pressure Ulcer in Long- 3.8 2.9 1.3 3.2 3.1 3.5 3.0 Term Care *

The number of potentially avoidable visits to the emergency department - - - - 35.8 39.2 32.0 made by residents of LTCH per 100 LTCH residents admitted **

# Admissions to LTC homes 21 79 - 62 162 1,420 56,999

* The sub-region estimate represents an average across the sub-region, weighted by number of LTCH admissions this year. ** Reporting at the facility-level not recommended, and in most cases, would be suppressed due to small cell size: http://www.hqontario.ca/Portals/0/documents/system-performance/ltc-indicator-review-report- november-2015.pdf

Source: Intellihealth Ontario, Long Term Care Database. Accessed March 27, 2017. Canadian Institute for Health Information, National Ambulatory Care Reporting System. Accessed March 27, 2017. Canadian Institute for Health Information, www.yourhealthsystem.cihi.ca, accessed March 2017.

Limitations

The sub-region profile provides an overview of the health system at the LHIN sub-region level, sometimes providing an overview at the local health hub level and/or the entire sub-region. There are some limitations with the data presented here:

• Many of the indicators reported here are used by Canadian Institute for Health Information, the Ministry of Health and Long Term Care, and Health Quality Ontario. However, some of the indicators presented in this profile have not been validated, and therefore may not be the most appropriate illustration of population health need or health system practice. Some of the suggested indicators were not accessible at the time of analysis, or needed to be suppressed because of confidentiality. • Sample size is a major consideration when conducting analyses at a sub-LHIN level or local health hub level. The robustness of the estimates depends on how common an outcome/event is, therefore we may observe a lot of variability in these measures over time. • Some of the sub-region level indicators represent weighted averages of local health hub indicators, and may deviate from estimates that are calculated using the entire sub-region. • The data presented here is the most up-to-date complete data available, though some measures were not available for fiscal year 2015-2016.

Acronyms Used

ALC - Alternate Level of Care HCC – Home and Community Care “-“ – Not Available or suppressed CIHI – Canadian Institute for Health Information IDN – Integrated District Network LHIN - Local Health Integration Network CTAS - Canadian Triage and Acuity Scale LHH – Local Health Hub NR - Not reported ED – Emergency Department LTCH – Long-Term Care Home

7 Contact

For more information or to request a hard copy of the sub-region profiles, please contact the North West LHIN Communications and Engagement Division. North West LHIN documents can be made available in alternate formats to meet accessibility needs.

Contact Information Email: [email protected] Telephone: 807-684-9425 Fax: 807-684-9533 www.northwestlhin.on.ca

Mailing Address North West LHIN (Head Office) 975 Alloy Drive, Suite 201 Thunder Bay, Ontario P7B 5Z8 Canada

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