NORTHERN HEALTH REGION
2014 COMMUNITY HEALTH ASSESSMENT
Dedication
“Catherine Hynes’ passion and dedication to making sure that Northern Communities were accurately represented through data and real life descriptions were overwhelming for those of us working in the communities and with the community health assessment process. She would be pleased with the work that is ongoing to tell the story through the data”. Chief Executive Officer 84 Church Street Flin Flon, MB R8A 1L8 Telephone: (204) 687-3011 Fax: (204) 687-6405 Email: [email protected]
A Message to the Citizens of the Northern Health Region from Helga Bryant, Chief Executive Officer
The Northern Health Region’s 2014 Community Health Assessment (CHA) is the product of an intensive year of work by our Community Health Assessment Working Group, staff, physicians, community partners, and residents.
This is the first Community Health Assessment for our newly amalgamated Region. Over the past three years, a true picture of the Northern Health Region has emerged and we are excited about the direction we are heading. While we still have many health challenges facing our Region, there are some very good news stories submitted by our team showing the great strides we have made toward the priorities set out in our latest Strategic Plan.
I would like to thank everyone who took part in the Community Health Assessment process. Whether you were on our working group or participated in one of our many community consultation activities, your commitment to health in our Region is greatly appreciated.
We are looking forward to the many initiatives planned in the coming years and our continued development as a Region. We have a dedicated team of health care providers and community partners who continue to work together towards our Vision of “Health People; Healthy North” as we continue to deliver on the promise of our Mission. We are dedicated to providing quality, accessible and compassionate health services. Meegwetch, Ekosi, Ekosani, Masi cho!
Sincerely,
Helga Bryant RN, BScN, MScA Chief Executive Officer
Chapter 1 Introduction
1.0 Introduction ...... 1-2
Chapter 2 Data Sources & How To Read This Report
2.1. Process and Methods ...... 2-3
References ...... 2-14
Chapter 3 Our Region
List of Figures ...... 3-3 List of Tables ...... 3-3 3.1. Regional Profile ...... 3-4 3.2. Northern Health Region ...... 3-14 3.3. Demographics ...... 3-16 3.4. Census Indicators ...... 3-31 References ...... 3-40
Chapter 4 Determinants of Health
List of Figures ...... 4-5 List of Tables ...... 4-8 4.1. Key Findings ...... 4-10 4.2. Socioeconomic Factors ...... 4-12 4.3. Environment...... 4-31 4.4. Personal Resources ...... 4-36 4.5. Personal Health Practices and Lifestyle ...... 4-43 4.6. Child & Maternal Health ...... 4-85 4.7. Child & Youth Health ...... 4-104 References ...... 4-155
Chapter 5 Health Status
List of Figures ...... 5-5 List of Tables ...... 5-8 5.1. Key Findings ...... 5-10
TOC 1
5.2. Life Expectancy ...... 5-13 5.3. Self-Rated Health ...... 5-16 5.4. Infant and Child Health ...... 5-23 5.5. Selected Chronic Disease Incidence & Treatment Prevalence ...... 5-40 5.6. Mental Health ...... 5-72 5.7. Injury...... 5-79 5.8. Cancer ...... 5-88 5.9. Communicable Disease ...... 5-96 5.10. Mortality ...... 5-105 References ...... 5-141
Chapter 6 Health System Performance and Quality
List of Figures ...... 6-4 List of Tables ...... 6-5 6.1. Key Findings ...... 6-6 6.2. Accessibility ...... 6-8 6.3. Continuity of Service ...... 6-39 6.4. Safety ...... 6-47 6.5. Effectiveness ...... 6-51 References ...... 6-63
Chapter 7 Health System Performance and Quality
List of Figures ...... 7-3 List of Tables ...... 7-4 7.1. Key Findings ...... 7-6 7.2. Physician Utilization ...... 7-7 7.3. Hospital Utilization ...... 7-10 7.4. High Profile Procedures ...... 7-19 7.5. Dialysis Services ...... 7-35 7.6. Home Care ...... 7-37 7.7. Personal Care Home ...... 7-38
2014 COMMUUNITY HEALTH ASSESSMENT TOC 2
Appendices
Appendix A Indicators By Region and Manitoba
Appendix B Indicators By District and Zone
Appendix C Community Consultation Tools
Appendix D Focus Group Key Themes
Appendix E Staff Survey Tool
Appendix F Community Survey Tool and Results
TOC 3
EXECUTIVE SUMMARY
1.0 Introduction
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Assessing the health of a community is a critical component of improving health. By determining the factors that make us healthy, why we get ill, how we use the health care system, we can get a better sense of how to improve population health. A more focused and comprehensive document such as this allows us to delve more deeply into the health of different sectors of the region whether it is geographical, by district, chronic disease patients or cancer survivors. It allows us the opportunity to examine what it means to be healthy using the definition used by the World Health Organization constitution signed in 1946 when it referred to health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”i While the definition is nearly 70 years old, it continues to resonate as it includes the notion that health is an ongoing process which is not simply the responsibility of the health care system but more a personal and societal responsibility. The CHA is part of a larger ongoing, strategic and planning process that sets out to develop priorities, and facilitate an action plan in order to improve the health of the community and, ultimately, the quality of life of the population. Through review of our data and consultation with our staff and community members, this Community Health Assessment will form the basis for this region’s planning and decision-making process. Given how important this document is, this CHA will need to achieve a clear picture of both the health beliefs of residents, how these beliefs affect health and which determinants of health are the most significant predictors of health outcomes in the region in the future. The information presented in this CHA will be used to inform a wide array of stakeholders and processes including: RHA strategic planning process RHA communities and stakeholders Manitoba Health’s strategic planning and performance deliverable processes To inform residents about the region To inform evidence-based decision making While a CHA is important to how government and the region operates, it also an important public information resource for the many organizations and agencies that impact on our health, wellness and community development. It plays a key role in helping us engage with the public in our shared efforts to improve everyone’s health in the Northern Health Region. In Manitoba, the requirement that all Regional Health Authorities (RHAs) undertake a Community Health Assessment is mandated in the Regional Health Authorities Act This report is the fourth comprehensive CHA that Manitoba RHAs have completed: the first was published in 1997, the second in 2004 and the fourth in 2010. The Manitoba Community Health Assessment Network (CHAN) was established in 1999 to provide a forum for discussing the process of health assessment as well as the underlying factors of community health. This group has representatives from all RHAs, Manitoba health, the Manitoba Centre for Health Policy and CancerCare Manitoba. CHAN has played a vital role in developing and refining the CHA process and methods, encouraging RHA participation, and pointing to future priority areas for study Manitoba. CHAN has played a vital role in developing the CHA process and methods, encouraging RHA participation, and attracting funding. 1-2 Northern Health Region CHA Working Group: Chair: Joy Tetlock, VP Planning & Innovation Members: Rusty Beardy, VP Aboriginal Health Services & Chief Allied Health Officer Dr. Randy Gesell, Medical Officer of Health Tanis Campbell, Director Community Engagement Don Gamache, Manager Behaviourial Health Community Development & Support Services Leanne Pickering, Executive Assistant Planning & Innovation Written by: Cynthia Carr, EPI Research Inc, with assistance from Jamie Simard, Innovation Analyst & Corporate Support Thank you to all staff that assisted in providing input. i World Health Organization, http://www.who.int/about/definition/en/print.html 2014 COMMUUNITY HEALTH ASSESSMENT 1-3 CHAPTER TWO Data Sources & How To Read This Report Chapter 2 Data Sources & How To Read This Report Chapter 2 Data Sources & How To Read This Report ...... 2-2 2.1. Process and Methods...... 2-3 2.1.1. Data Collection ...... 2-3 2.1.2. Primary Data Sources ...... 2-3 2.1.3. Community Consultation & Surveys ...... 2-6 2.1.4. How To Read This Report ...... 2-9 References ...... 2-14 2-2 2.1. Process and Methods 2.1.1. Data Collection Two methods of data collection were used to gather information about the region. The first, "hard data," (administrative and survey data) was obtained through a variety of data sources (see 2.1.2 Primary Data Sources); the second was through a series of consultations and surveys with staff and community members. 2.1.2. Primary Data Sources There are many data sources used in this document and all of these sources are referenced throughout. However, there are several sources that are used for the majority of statistics in this report. The primary data sources used in this document are: Statistics Canada, Canadian Community Health Survey (2003-2012) Statistics Canada, 2011 Census Manitoba Health, Health Information Management Manitoba Health, Communicable Disease Control Manitoba Centre for Health Policy, Manitoba RHA Indicators Atlas 2013 Healthy Child Manitoba, Families First Screening Data CancerCare Manitoba, Community Health Assessment, 2013/14. Manitoba Health, Epidemiology & Surveillance Unit. Injuries Report: Northern Regional Health Authority, 2000-2012. Partners in Planning for Healthy Living, 2012/13 Youth Health Survey Statistics Canada, Canadian Community Health Survey The Canadian Community Health Survey (CCHS) is a cross-sectional survey that collects information related to health status, health care utilization and health determinants for the Canadian population, providing information on a health region level. It relies upon a large sample of respondents and is designed to provide reliable estimates at the health region level. Since 2007, data for the Canadian Community Health Survey (CCHS) are collected yearly instead of every two years. The CCHS is an important source of determinant data and self-reported health data; however, the survey is a Non First Nations Community, household survey only (for residents age 12 and older). This means that persons living in an institutional setting (including personal care homes) or in First Nations Communities are not included in this survey. The survey data is then “weighted” (by age group and gender) in an attempt to accurately represent the regional experience. In order to effectively compare health regions with similar socio-economic characteristics, health regions have been grouped into ‘peer groups’. Statistics Canada used a statistical method to achieve maximum 2014 COMMUUNITY HEALTH ASSESSMENT 2-3 statistical differentiation between health regions. Twenty-four variables were chosen to cover as many of the social and economic determinants of health as possible, using data collected at the health region level mostly from the Census of Canada. Concepts covered include: basic demographics (i.e., population change and demographic structure), living conditions (i.e., socio-economic characteristics, housing, and income inequality), and working conditions (i.e., labour market conditions) The Northern Health Region is classified by Statistics Canada as “Peer Group F”. This Peer Group consists of five regions that account for 0.4 per cent of the Canadian population. These regions are characterized as: Northern and remote regions Very high Aboriginal population Very low employment rates Low proportion of immigrants The regions making up Peer Group F are: Athabasca Health Authority (4713-F), Saskatchewan Keewatin Yatthé Regional Health Authority (4712-F), Saskatchewan Mamawetan Churchill River Regional Health Authority (4711-F), Saskatchewan Mamawetan/Keewatin/Athabasca Regional Health Authorities (4714-F), Saskatchewan Northern Regional Health Authority (4604-F), Manitoba Nunavut (6201-F), Nunavut Région des Terres-Cries-de-la-Baie-James Quebec Région du Nunavik, Quebec For more information, please visit: http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226 2-4 http://www.statcan.gc.ca/pub/82-402-x/2013003/maps/ca-eng.pdf 2014 COMMUUNITY HEALTH ASSESSMENT 2-5 Statistics Canada, 2011 Census The 2011 Census data are used to report on the majority of indicators related to demographic and socioeconomic factors in our region. The majority of data from the Census are from the year 2011. However, there are some economic variables (such as annual median income) where the data being reported is actually from the year 2010 (that is, in 2011, people were asked about their income in the preceding full year). For more information about the Census, please visit Statistics Canada website at: www.statcan.ca. Specific community profiles can be obtained at: http://www12.statcan.gc.ca/census-recensement/2011/dp-pd/prof/index.cfm?Lang=E Manitoba Health, Health Information Management The Health Information Management branch at Manitoba Health provided an extensive amount of population, birth and mortality data for this report. For more information about Manitoba Health and information that is available, please visit: http://www.gov.mb.ca/health/. Manitoba Health, Communicable Disease Control Although communicable disease data were provided as part of the standard Community Profile, Communicable Disease Control also provided some Ad Hoc reports for our region with more specific time trend and gender information. For more information about Manitoba Health, Communicable Disease Control and information that is available, please visit: http://www.gov.mb.ca/health/publichealth/cdc/. Manitoba Centre for Health Policy (MCHP), The 2013 RHA Indicators Atlas Regions have been provided an extensive amount of statistical information through the Manitoba Centre for Health Policy (MCHP), Need to Know Project which has now lead to the second comprehensive data published in 2013 (the first in 2008). The MCHP provides data primarily based on service utilization. As with the data from Manitoba Health, these data are dependent on quality reporting by service providers. For example, if salaried physicians do not "shadow bill" to Manitoba Health, our data about the health service utilization patterns of our residents will not be accurate. MCHP data are rarely provided by age group or gender (unless looking at targeted issues such as immunization among seniors), so there is usually just one measure provided for the whole region. Data are always standardized to take into account age differences among regions. Standardization does allow for more accurate comparisons between regions, however, it masks the true situation (crude rates) in the region and is more difficult to use for program planning. For more information about the Manitoba Centre for Health Policy and wealth of published research available, please visit: 2-6 http://umanitoba.ca/faculties/health_sciences/medicine/units/community_health_sciences/departmental_un its/mchp/research.html 2.1.3. Consultation & Surveys Community consultations were lead by Don Gamache and Tanis Campbell and took place between May- October 2014. Community consultations took place mostly in Thompson but also in several other communities throughout the regiona. Consultations in Thompson occurred with the following groups: Keewatin Tribal Council Northern Health Region Board of Directors Northern Health Region Senior Management Team Northern Doorway Project Hub Membership for Youth Leadership Healthy Moose Lake Opsquia Health Authority Staff Bayline Communities RHA Staff Key Informant interviews also took place with representatives from the following organizations Manitoba Hydro Manitoba Métis Federation Addictions Foundation Manitoba RCMP Mamaweetin Region Health Authority Cross Lake First Nation Thompson Friendship Centre Creighton Community Services Grand Rapids First Nation Moose Lake First Nation Sandy Bay Nursing Station Lynn Lake Friendship Centre Surveys were conducted with Northern Health Region staff, northern community residents and youth between grades 7 and 12. In order to supplement the administrative and other survey data collected for the 2014 Community Health Assessment, a short survey was developed for community residents living in the Northern Health Region. This survey focused on the client experiences of adults 18 years and older have had with regional health services. Advertisement in local newspapers, posters in health facilities and a smart tag was used to 2014 COMMUUNITY HEALTH ASSESSMENT 2-7 encourage residents to fill out the survey on line. Recognizing that not everyone has access on line, facility staff were also asked to distribute paper copies of the survey to patients. In total, there were 531 responses, 515 valid for analysis. A similar survey to the community survey was developed for Northern Health Region staff. This survey focused on what they thought resident experiences were like in the health care system along with their assessment of the Northern Health Region generally. Staff completed 564 surveys, 558 of which were valid for analysis. Of that total, 375 of the surveys were completed online and 189 by paper with responses sent in by July 4, 2014. The northern results from the Partners in Planning, 2012/2013 Manitoba Youth Health Survey (YHS) provides an important basis of information reported in the child health section in chapter 4. The 2012/2013 version of the YHS was completed by grades 7 to 12 students across all RHAs. Northern Health region student from 37 schools took part (see complete listing below). The survey looked at physical activity, healthy eating, body mass index, tobacco use, alcohol and drug use, school and community connectedness, hopelessness and mental wellbeing, as well as sun/UF safety, bullying, injury prevention and healthy sexuality. The report included the following schools: Frontier School Division Schools Cormorant Lake School Cranberry Portage Elementary Frontier Collegiate Institute Grand Rapids School Joseph H. Kerr School Frontier Mosakahiken School Brochet School West Lynn Heights School Leaf Rapids Education Centre Gilliam School Thicket Portage School Mel Johnson School D.R Hamilton School:: Ministic School Disbrowe School Stevenson Island School Helen Betty Osbourne Ininiw Education Resource Center First Nation Band Schools: Oscar Lathlin College Garden Hill First Nations High School Nisichawayasihk Neyo Ohtinwak Collegiate School Red Sucker Lake School Abraham Beardy Memorial (Shamattawa) Mikisew School Flin Flon School Division: Hapnot Collegiate Many Faces Education Centre École McIsaac School Ruth Betts School 2-8 Kelsey School Division: Margaret Barbour Collegiate Mary Duncan School Scott Bateman Middle School Mystery Lake School Division: Burntwood Elementary Deerwood School Juniper School R.D. Parker School Riverside School Wapanohk Community School Westwood Elementary All community consultation materials developed for the Northern Health Region Community Health Assessment are provided in Appendix C. 2.1.4. How To Read This Report This report around 80 core indicators as well as non-core indicators that are priority areas for the region. The report is broken down in the following chapters: Chapter 1 – Key Findings Chapter 2 - Introduction, Methodology and Data Sources Chapter 3 - Regional Profile Chapter 4 - Determinants of Health Chapter 5 - Health Status Chapter 6 - Health System Characteristics Chapter 7 - Health System Performance and Quality Chapters 3 to 7 are organized by each indicator separately, and include information about the importance of the indicator, highlights of the data, as well as graphs and tables to show comparisons to other regions and trends over time. Where available, we have also included district level data for our region. ICD-10 Classification In order to assist with interpretation of the information provided, Table 2.1 provides a brief description of the ICD-10i disease classifications that will be reported through the physician billing, hospitalization and mortality data. 2014 COMMUUNITY HEALTH ASSESSMENT 2-9 Table 2.1. Description of International Classification of Disease (ICD-version 10) and Cause of Death Classifications. Classification Brief Description These are diseases that are generally recognized as communicable or I Certain Infectious and transmissible. This includes tuberculosis, bacterial diseases, Parasitic Disease hepatitis and sexually transmitted infections. A group of diseases in which cells grow unusually and uncontrolled. II Neoplasms (Cancer) Common forms of cancer include lung cancer, breast cancer, prostate cancer, colorectal cancer and skin cancer. III Diseases of the blood and Diseases that are caused by not having enough blood cells. Iron blood-forming organs and deficiency anemia is a common disease in this category (person does certain disorders involving not have enough iron in the diet). the immune mechanism Diseases as a result of not eating properly, by glands that do not work IV Endocrine, nutritional properly or substances in the body which are toxic. Some conditions and metabolic diseases under this category include diabetes, malnutrition, obesity, and thyroid disease. Disorders that affect people’s mood or thinking over time. Some V Mental and behavioural common disorders include depression, disorders caused by drugs or disorders alcohol, and schizophrenia. Also included are mental retardation and childhood and adolescent behavioural and emotional disorders. Those diseases which affect the ability to sense, feel and use VI Diseases of the nervous reflexes. Some common nervous system diseases include Multiple system Sclerosis, Alzheimer’s disease and Parkinson’s Disease. VII Diseases of the eye and Diseases of the Eye and Ear are those that affect a person’s ability to adnexa; see and hear. The most common eye diseases include blindness, nearsightedness, farsightedness, and astigmatism. A number of ear conditions can affect hearing or balance. Ear infections are the most VII Diseases of the ear and common among children, tinnitus (roaring in one’s ears) and mastoid process Meniere's disease (inner ear disease affecting balance). Diseases that affect the movement of blood in heart and blood IX Diseases of the vessels. These diseases can cause problems for the lungs, the brain, circulatory system kidneys or other parts of the body. The most common circulatory diseases are heart diseases and stroke. Diseases which affect breathing. Examples of respiratory diseases X Diseases of the respiratory include the common cold, asthma, lung cancer, pneumonia, system tuberculosis, Chronic Obstructive Pulmonary Disease (COPD) and cystic fibrosis. Conditions that affect the digestive tract in the body. Diseases XI Diseases of the digestive included are appendicitis, Crohn’s disease, colitis, ulcers, disorders system of the gallbladder and liver disease. 2-10 Diseases which affect the layers of skin. Acne, blisters and rashes XII Diseases of the skin and are common conditions in this category. Many of these diseases may subcutaneous tissue be related to quality and availability of clean water as well as personal hygiene practices. XIII Diseases of the This classification includes muscles disorders, arthritis, and musculoskeletal system and osteopathies (disorders of bone density). connective tissue Diseases affecting the reproductive system of men and women. XIV Diseases of the Some common examples include kidney and gall bladder stones, genitourinary system urinary tract infections, kidney failure, and prostate cancer. Conditions related to, or aggravated by, the pregnancy, childbirth or by the puerperium (the six week period following childbirth). These XV Pregnancy, childbirth can be due to maternal causes or obstetric causes. Some examples and the puerperium include pregnancy with abortive outcome, complications of labour and delivery and hypertension in pregnancy. These are conditions that originated perinatal period (the time period XVI Certain conditions from about 20 weeks gestation until about 4 weeks after birth) even originating in the perinatal though death or illness occurs later. This includes birth trauma, period disorders related to length of gestation and fetal growth and infections that occurred during the perinatal period. XVII Congenital Birth defects that develop before birth. Example include infants are malformations, deformations born with heart defects, cleft lip or palate, Down syndrome, spina and chromosomal bifida, and limb defects. abnormalities The conditions and signs or symptoms included consist of: cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated; signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined; XVIII Symptoms, signs and provisional diagnoses in a patient who failed to return for further abnormal clinical and investigation or care; laboratory findings, not cases referred elsewhere for investigation or treatment before the elsewhere classified diagnosis was made; cases in which a more precise diagnosis was not available for any other reason; certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right XIX Injury, poisoning and This classification involves the specific injury type and site. For certain other consequences example injuries to the head, the neck etc with details. Burns and of external causes frostbite are also included in the category. 2014 COMMUUNITY HEALTH ASSESSMENT 2-11 This is the cause of the injury. For example, the external cause of a XX External causes of "head injury" may be motor vehicle accident. This classification morbidity and mortality would note the nature of the external cause (such as car accident) that lead to injury. This classification is used for reasons other than disease or injury: When a person donates an organ or tissue, receives vaccination XXI Factors influencing or discusses a problem which is in itself not a disease or injury. health status and contact When some circumstance or problem is present which influences with health services the person's health status but is not in itself a current illness or injury. They can be recorded as an additional factor to be considered when the person does receive care for an illness or injury How to use and interpret "rates" and "statistical significance" In order to protect confidentiality, when there are less than 5 cases, deaths or other health related events, the actual number will not be presented. You will see a * in the data table. This means that data are suppressed due to small numbers. Unless otherwise noted, most rates presented in this document are "crude rates". This means that the rates represent the true number of events (such as births, deaths, hospitalizations etc) in your district. These rates can be used for your own planning but should not be used to compare to other communities or areas that have very different population distributions (for example a community, such as Winnipeg, that has a much larger proportion of older residents than your community). These rates also should not be used to make comparisons over time if there have been significant changes in your population (such as large growth, or large numbers who have left the community). Many hospitalization and physician visit indicators in this document are calculated using the entire population as the denominator. In other documents you might see rates described as, for example, "treatment prevalence for diabetes among adults age 20 and older", or "hospitalization rates for stroke among adults age 50 and older". These rates will be higher than what is presented in this document, because they use a smaller population (those just in the age group they are reviewing) to calculate rates. In some cases, such as with cancer data and some mortality data, the rates have been "age- standardized" by the source providing the data. This means that the rates have been calculated in a way that takes into account the different population distributions of the locations being compared. For example, if a regional rate is "standardized", you would interpret the rate as: "If the population distribution of our area was the same as for Manitoba overall, what would the expected number of cases or deaths be in our area?" The expected number of cases or deaths are then used to calculate rates. This means that the rate is NOT a true rate from your district but it means that the rate can be used to compare to other areas that have been standardized in the same way. This way you can see how you rank compared to other communities and if there have truly been significant changes over time. Overall, standardized rates are best to use when you want to compare yourself to populations that are different or when looking at changes over time (in case your population has changed over time). Crude 2-12 rates (the actual rate of cases or deaths in your population) are best to use for your own planning in your district but you should be careful in using these rates to compare other communities that may be very different from your own. Health measurements cannot be made with perfect certainty. Many different things affect the accuracy of measurements and how close to the true value we actually get. Because of this, it is best to give the measurements with a range (rather than just a single number) that allows for some wiggle room. Then we can be very certain (95% sure) that the true value of the measurement lies somewhere within that range. 95% Confidence intervals (the range of the true value) have been calculated for many indicators in this report. You will see the confidence intervals either in brackets in the data tables, under the actual rate, or in graphs beside horizontal yellow lines. In the following table the numbers (562,726) are the 95% confidence intervals for the rate of 644 cases per 1,000 residents. This means that the calculated rate of a disease or other event is 644 cases per 1,000 and we are 95% confident that the range for the true value ranges between 562 and 726 per 1,000. When events are very rare and/or district numbers are very small, the confidence intervals can become very wide which tells us we need to be careful interpreting the data. If the confidence interval for your district does not overlap, the confidence interval for the comparison areas (such as region), we are 95% confident that the difference we see in the measured rates is "statistically significant" and likely not just a result of chance. In the table below, the region rate of 365.1 per 1,000 has confidence intervals ranging from 355.2 to 375. These intervals are much narrower than the district because the numbers are larger so need a narrower range to be "confident" the rates are accurate. Because the highest regional number of 375 is still lower than the lowest community number of 562, we can say that the difference in rates is statistically significant. Community Region Number Rate per 1,000 Number Rate per 1,000 Example: community rate is 644 365.1 237 5,213 statistically higher than regional rate (562, 726) (355.2, 375) Example: community rate is 134.3 239.3 45 3,000 statistically lower than regional rate (92.1, 195.8) (212.3, 269.7) Example: community rate is not 107.3 101.2 38 1,345 statistically different than regional rate (73.2, 141.4) (95.8, 106.6) 2014 COMMUUNITY HEALTH ASSESSMENT 2-13 References i This disease classification system is endorsed by the World Health Organization and is used for all physician and hospital billing. Further information on all classifications in the current version, ICD-10, and all specific diseases, conditions and symptoms included within each classification can be found at: http://www.who.int/classifications/icd/en/ 2-14 CHAPTER THREE Our Region Chapter 3Our Region &KDSWHU2XU5HJLRQ /LVWRI)LJXUHV /LVWRI7DEOHV 5HJLRQDO3URILOH *HRJUDSK\DQG3HRSOH &KDQJHV:LWK0HUJHU =RQH'HVFULSWLRQV &RPPXQLW\'HVFULSWLRQV 1RUWKHUQ+HDOWK5HJLRQ 3URJUDPVDQG6HUYLFHV 'HPRJUDSKLFV 3RSXODWLRQ'HQVLW\ 3RSXODWLRQE\$JH*URXS 'HSHQGHQF\5DWLR &KDQJHVLQ3RSXODWLRQ2YHU7LPH 3RSXODWLRQ3URMHFWLRQV $ERULJLQDO3RSXODWLRQ &HQVXV,QGLFDWRUV 0DULWDO6WDWXV )DPLO\6WUXFWXUH /RQH3DUHQW)DPLOLHV /DQJXDJH ,QWHUQDO([WHUQDO0LJUDWLRQ 0RELOLW\6WDWXV 5HIHUHQFHV List of Figures )LJXUH1RUWKHUQ+HDOWK5HJLRQ0DS )LJXUH1RUWKHUQ+HDOWK5HJLRQ2UJDQL]DWLRQDO&KDUW )LJXUH3RSXODWLRQ3\UDPLG1RUWKHUQ+HDOWK5HJLRQ )LJXUH3RSXODWLRQ3\UDPLG0DQLWRED )LJXUH3RSXODWLRQ3\UDPLG1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED )LJXUH3HUFHQWDJHRI3RSXODWLRQE\$JH&DWHJRU\1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED )LJXUH'HSHQGHQF\5DWLRE\5+$ )LJXUH3RSXODWLRQ)LJXUHVE\$JH&DWHJRU\1RUWKHUQ+HDOWK5HJLRQDQG )LJXUH 3HUFHQWDJH&KDQJHLQ3RSXODWLRQE\$JH&DWHJRU\LQ1RUWKHUQ+HDOWK5HJLRQ )LJXUH3RSXODWLRQ3URMHFWLRQV LQWKRXVDQGV )RU1RUWKHUQ+HDOWK5HJLRQ )LJXUH3RSXODWLRQ&KDQJHIRU1RUWKHUQ+HDOWK5HJLRQDQG0DQLWREDE\$JH*URXSIURPWR )LJXUH1RUWKHUQ5+$$ERULJLQDO3RSXODWLRQ )LJXUH1RUWKHUQ+HDOWK5HJLRQ)LUVW1DWLRQV2Q5HVHUYH3RSXODWLRQ3\UDPLG )LJXUH1RUWKHUQ+HDOWK5HJLRQDQG1RUWKHUQ)LUVW1DWLRQV2Q5HVHUYH3RSXODWLRQ3\UDPLG )LJXUH/RQH3DUHQW)DPLOLHVE\5+$ )LJXUH1RQ2IILFLDO/DQJXDJH6SRNHQ$W+RPH )LJXUH2WKHU/DQJXDJHV0RWKHU7RQJXH )LJXUH5DWHRI2QHDQG)LYH &200881,7<+($/7+$66(660(17 3.1. 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Population Density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opulation by Age Group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emales Males 65Ͳ69 55Ͳ59 45Ͳ49 35Ͳ39 25Ͳ29 15Ͳ19 5Ͳ9 Under1 6% 5% 4% 3% 2% 1% 0% 1% 2% 3% 4% 5% 6% %ofpopulation 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV-XQH3RSXODWLRQ5HSRUW )LJXUH3RSXODWLRQ3\UDPLG0DQLWRED 75+ Females Males 65Ͳ69 55Ͳ59 45Ͳ49 35Ͳ39 25Ͳ29 15Ͳ19 5Ͳ9 Under1 5% 4% 3% 2% 1% 0% 1% 2% 3% 4% 5% %ofpopulation 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV-XQH3RSXODWLRQ5HSRUW )LJXUH3RSXODWLRQ3\UDPLG1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 75+ MBMales 65Ͳ69 MBFemales NorthernMales 55Ͳ59 NorthernFemales 45Ͳ49 35Ͳ39 25Ͳ29 15Ͳ19 5Ͳ9 Under1 6% 5% 4% 3% 2% 1% 0% 1% 2% 3% 4% 5% 6% %ofpopulation 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV-XQH3RSXODWLRQ5HSRUW &200881,7<+($/7+$66(660(17 )LJXUH3HUFHQWDJHRI3RSXODWLRQE\$JH&DWHJRU\1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED Northern Manitoba 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV-XQH3RSXODWLRQ5HSRUW 3.3.3. 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Socioeconomic Factors 4.2.1. Income Inequality '(),1,7,21 6RFLRHFRQRPLFIDFWRUVVXFKDVLQFRPHDUHLPSRUWDQWEHFDXVHRIWKHIROORZLQJHYLGHQFHSURYLGHGE\&KLHI 3URYLQFLDO3XEOLF+HDOWK2IILFHU¶VReport on the Health Status of Manitobans 2010i ,Q0DQLWRED¶VUXUDODUHDVWKHGLIIHUHQFHLQOLIHH[SHFWDQF\IRUPHQEHWZHHQWKHKLJKHVWDQGORZHVWLQFRPH DUHDVLVVHYHQ\HDUV)RUZRPHQWKHGLIIHUHQFHLVILYH\HDUV,QXUEDQDUHDVWKHGLIIHUHQFHLQOLIHH[SHFWDQF\ IRUPHQEHWZHHQWKHKLJKHVWDQGORZHVWLQFRPHDUHDVLVDQGIRUZRPHQWKHGLIIHUHQFHLVILYH\HDUV ,QIDQWPRUWDOLW\UDWHVDUHKLJKHUDPRQJ0DQLWREDQVOLYLQJLQORZHULQFRPHQHLJKERXUKRRGVDQGLQQRUWKHUQDQG $ERULJLQDOSRSXODWLRQV 5DWHVRILQMXU\DPRQJ0DQLWREDFKLOGUHQDUHDVVRFLDWHGZLWKVRFLRHFRQRPLFVWDWXV UDWHVDUHKLJKHULQWKH ORZHVWLQFRPHQHLJKERXUKRRGVDQGDPRQJ$ERULJLQDOFKLOGUHQ 6XLFLGHDWWHPSWVDUHPRUHFRPPRQDPRQJSHRSOHLQORZLQFRPHDUHDV$PRQJ0DQLWREDQVOLYLQJLQDUHDVZLWK WKHORZHVWDYHUDJHKRXVHKROGLQFRPHUDWHVDPRQJPDOHVZHUHIRXQGWREHWZLFHDVKLJKDQGIHPDOHVIRXUWLPHV DVKLJKFRPSDUHGWRWKRVHOLYLQJLQDUHDVZLWKWKHKLJKHVWDYHUDJHKRXVHKROGLQFRPH :K\,V7KLV,QGLFDWRU,PSRUWDQW" $VWKHHYLGHQFHDERYHVXJJHVWVZLGHUDQJHVLQLQFRPHKDYHEHHQVKRZQWRQHJDWLYHO\DIIHFWKHDOWKVWDWXVRI FRPPXQLWLHV%\FRQWUDVWWKRVHFRPPXQLWLHVZKRVHUHVLGHQWVHDUQXQLIRUPO\KLJKHULQFRPHVHQMR\EHWWHUKHDOWK VWDWXV6RFLRHFRQRPLFLQGLFDWRUVKDYHWKHJUHDWHVWLPSDFWRQKHDOWKVWDWXVDQGFDQVLJQLILFDQWO\LQIOXHQFHKRZ 5HJLRQDO+HDOWK$XWKRULWLHVGHOLYHUKHDOWKSURJUDPVDQGVHUYLFHV 6RPHLQGLFDWRUVRILQFRPHLQHTXDOLW\WKDWZHKDYHUHYLHZHGLQFOXGHWKHQXPEHUVRIFKLOGUHQDQGIDPLOLHVOLYLQJ XQGHUZKDW6WDWLVWLFV&DQDGDGHILQHVDVWKHORZLQFRPHFXWRII /,&2 /,&2LVWKHLQFRPHOHYHODWZKLFKIDPLOLHV RUSHUVRQVVSHQGSHUFHQWPRUHWKDQDYHUDJHRIWKHLUEHIRUHWD[LQFRPHRQIRRGVKHOWHUDQGFORWKLQJ/,&2LVQRW DQDEVROXWHQXPEHU UDWKHULWLVFDOFXODWHGLQUHODWLRQWRWKHDYHUDJHLQFRPHDQGVSHQGLQJLQWKHFRPPXQLW\RUDUHD WKDWWKHSHUVRQOLYHV7KHUHIRUHWKH/,&2LQDQH[SHQVLYHUHPRWHFRPPXQLW\FRXOGEHKLJKHULQWHUPVRIDEVROXWH GROODUVWKDQLWLVLQDPRUHDIIRUGDEOHVRXWKHUQFRPPXQLW\ What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQSHUFHQWRILWVUHVLGHQWVOLYHGEHORZWKH/,&2LQZKLFKZDV MXVWEHORZWKH0DQLWREDDYHUDJHRISHUFHQW 7KHIRUPHU1RUPDQ5HJLRQKDGD/,&2UDWHRISHUFHQWLQ What did we learn in 2014? ,Q VHH)LJXUH WKHUHJLRQDOUDWHLVLQWKHPLGGOHRIWKHSURYLQFHDWMXVWRYHUSHUFHQWRI UHVLGHQWVZKLFKLVORZHUWKDQWKHSURYLQFLDOUDWHRISHUFHQW )LJXUHSUHVHQWV/,&2UDWHVIRUFKLOGUHQXQGHUDJHVSHFLILFDOO\$JDLQWKHUHJLRQDOUDWHDW SHUFHQWLVPXFKORZHUWKDQWKHSURYLQFLDODYHUDJHRI SHUFHQW )LJXUH/RZ,QFRPH&XW2II$OO3HUVRQV 20% 19.0% 18% 16% 14.8% 14% 11.8% 12.0% 12% 10% 9.5% 7.9% 8% 6% 4% 2% 0% InterlakeͲEastern Southern Northern PrairieMountain Canada Winnipeg Manitoba 6RXUFH 6WDWLVWLFV&DQDGD&DQDGD&HQVXV )LJXUH/RZ,QFRPH&XW2II&KLOGUHQ8QGHU$JH 30% 25% 24.2% 20% 16.1% 14.4% 15% 14.2% 12.0% 11.0% 10% 5% 0% InterlakeͲEastern Southern Northern PrairieMountain Canada Winnipeg Manitoba 6RXUFH 6WDWLVWLFV&DQDGD&DQDGD&HQVXV &200881,7<+($/7+$66(660(17 4.2.2. Median Individual and Household Income '(),1,7,21 0HGLDQLQGLYLGXDOLQFRPHLVFDOFXODWHGXVLQJWKHWRWDOLQFRPH SUHWD[SRVWWUDQVIHU IRUSHUVRQVDJHGDQGRYHU ZKRUHSRUWHGLQFRPHLQWKH&HQVXVRI&DQDGD0HGLDQKRXVHKROGLQFRPHLVFDOFXODWHGIRUDOOKRXVHKROGXQLWVLQWKH &HQVXVRI&DQDGDZKHWKHURUQRWWKH\UHSRUWHGLQFRPH :K\,V7KLV,QGLFDWRU,PSRUWDQW" 0HGLDQLQGLYLGXDODQGKRXVHKROGLQFRPHLVDQLPSRUWDQWPHDVXUHRIWKHLQFRPHLQHTXDOLW\WKDWH[LVWVLQ FRPPXQLWLHV³0HGLDQ´LVWKHSRLQWH[DFWO\EHWZHHQWKHORZHVWDQGKLJKHVWLQFRPHV7KLVLVWKHLQFRPHWKDW VHSDUDWHVWKHERWWRPKDOIRIWKHSRSXODWLRQIURPWKHWRSKDOI7KLVLVDQHIIHFWLYHPHDVXUHEHFDXVHFRPPXQLWLHVZLWK VPDOOHUGLIIHUHQFHVEHWZHHQWKHWRSDQGERWWRPHQGVJHQHUDOO\H[SHULHQFHEHWWHUKHDOWKVWDWXVWKDQWKRVHZLWKPRUH GLVSDUDWHLQFRPHV What did we learn in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hat did we learn in 2014? ,Q VHH7DEOH WKHPHGLDQLQGLYLGXDOLQFRPHIRUWKH1RUWKHUQ+HDOWKUHJLRQZDV DQGLVKLJKHUDPRQJPDOHV WKDQIHPDOHV 7KHUHJLRQKDGWKHORZHVWPHGLDQ LQGLYLGXDOLQFRPHDPRQJ0DQLWRED5+$V 7DEOH VKRZV WKDW WKH UHJLRQDO PHGLDQ KRXVHKROG LQFRPH RI ZKLFK LV EHORZ WKH 0DQLWREDPHGLDQRI DQGPXFKORZHUWKDQWKH&DQDGLDQPHGLDQRI :LWKLQWKH1RUWKHUQUHJLRQSHUFHQWRILQFRPHFDPHIURPHPSOR\PHQW DPRQJPDOHV DQGDPRQJIHPDOHV 7KLVLVVOLJKWO\KLJKHUWKDQWKHSURYLQFLDOUDWHRISHUFHQWSHU FHQWRILQFRPHIRUUHJLRQDOUHVLGHQWVFDPHIURP³*RYHUQPHQW7UDQVIHU´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ncome In Single Parent Families '(),1,7,21 7KLVLQGLFDWRUPHDVXUHVWKHPHGLDQLQFRPHRIVLQJOHSDUHQWIDPLOLHVVSHFLILFDOO\ :K\,V7KLV,QGLFDWRU,PSRUWDQW" 6LQJOHSDUHQWKRXVHKROGVRIWHQKDYHORZHULQFRPHVWKDQWZRSDUHQWKRXVHKROGV7KH\DUHDWPRUHULVNDQG YXOQHUDEOHWRQHJDWLYHVRFLDORXWFRPHVVXFKDVSRRUHUKHDOWKVWDWXVDQGODFNRIDIIRUGDEOHKRXVLQJ7KLVLQGLFDWRU FDQKLJKOLJKWWKRVHPRUHDWULVNKRXVHKROGV What did we learn in 2009? 7KHPHGLDQLQFRPHIRUDVLQJOHSDUHQWIDPLO\LQWKHIRUPHU%XUQWZRRG5HJLRQZDVLQ ORZHUWKDQWKH0DQLWREDPHGLDQRI7KH%XUQWZRRG5HJLRQKDGWKHORZHVWPHGLDQLQFRPHLQ DVLQJOHSDUHQWIDPLO\DPRQJDOO5+$VLQ0DQLWRED 7KHIRUPHU1RU0DQUHJLRQKDGDPHGLDQLQFRPHRIIRUVLQJOHSDUHQWIDPLOLHVKRXVHKROGVLQ What did we learn in 2014? ,Q VHH7DEOH WKHPHGLDQVLQJOHSDUHQWIDPLO\LQFRPHLQWKH1RUWKHUQ+HDOWK5HJLRQURVH WR VWLOOZHOOEHORZWKH0DQLWREDDYHUDJHRI ,WLVDOVRYHU\LPSRUWDQWWRQRWHWKHODUJHGLIIHUHQFHLQFRPHEHWZHHQVLQJOHSDUHQWIDPLOLHVDQGFRXSOH IDPLOLHV 7DEOH0HGLDQ)DPLO\,QFRPH$OO)DPLOLHV 1RUWKHUQ+HDOWK5HJLRQ 0DQLWRED 0HGLDQIDPLO\LQFRPHDOOIDPLOLHV 0HGLDQIDPLO\LQFRPHRIFRXSOHVZLWKFKLOGUHQ 0HGLDQIDPLO\LQFRPHRIVLQJOHSDUHQWIDPLOLHV 4.2.4. Unemployment Rates '(),1,7,21 7KHODERUIRUFHDJHGDQGRYHUZKRGLGQRWKDYHDMREGXULQJWKHUHIHUHQFHZHHN :K\,V7KLV,QGLFDWRU,PSRUWDQW" 7KLVZDVLGHQWLILHGDVDPDMRUFRQFHUQLQ IRU0DQLWRED¶V1RUWKHUQUHJLRQ8QHPSOR\PHQWFDQQHJDWLYHO\ DIIHFWVRFLDOLQFOXVLRQOHDGLQJWRSRRUHUKHDOWKRXWFRPHV What did we learn in 2009? 7KHIRUPHU%XUQWZRRGUHJLRQUHSRUWHGWKHKLJKHVWXQHPSOR\PHQWUDWHVLQWKHSURYLQFHDWSHU FHQWWULSOHWKHDYHUDJH7KLVZDVWUXHDPRQJPHQZRPHQDQGPDOHDQGIHPDOH\RXWK7KHUHZHUH VLJQLILFDQWGLIIHUHQFHVEHWZHHQFRPPXQLWLHVLQWKHUHJLRQ 7KHIRUPHU1250$1UHSRUWHGUDWHVWKDWZHUHDSSUR[LPDWHO\GRXEOHWKHSURYLQFLDODYHUDJH +RZHYHUIHPDOHXQHPSOR\PHQWUDWHVZHUHEHORZDYHUDJH What did we learn in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ales Females 16.0% 14.0% 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% Southern Winnipeg PrairieMountainInterlakeͲEastern Northern Manitoba 6RXUFH 6WDWLVWLFV&DQDGD1DWLRQDO+RXVHKROG6XUYH\ 4.2.5. Labour Force-Participation Rates '(),1,7,21 7KHSHUFHQWDJHRIWKHSRSXODWLRQDJHG\HDUVDQGRYHUZKRZHUHLQWKHODERXUIRUFHLQWKHZHHNSULRUWRWKH &HQVXVRI&DQDGD :K\,V7KLV,QGLFDWRU,PSRUWDQW" /DERXUIRUFHSDUWLFLSDWLRQLQGLFDWHVFRQWULEXWLRQWRVRFLHW\DQGVRFLDOEHORQJLQJ7KRVHZKRDUHHPSOR\HGJHQHUDOO\ H[SHULHQFHIHZHUKHDOWKGLIILFXOWLHVDQGDOODURXQGEHWWHUKHDOWKWKDQWKRVHZKRDUHQRW8QHPSOR\PHQWFDQEH VRFLDOO\LVRODWLQJDQGFDQDIIHFWKHDOWKDQGZHOOEHLQJQHJDWLYHO\ What did we learn in 2009? 7KHSDUWLFLSDWLRQUDWHLQWKHIRUPHU%XUQWZRRGUHJLRQZDVZHOOEHORZWKHSURYLQFLDODYHUDJH LQYHUVXV 0DOHV ZHUHFRQVLVWHQWO\SDUWLFLSDWLQJPRUHWKDQIHPDOHV 1RQ$ERULJLQDOVZHUHSDUWLFLSDWLQJDWVLJQLILFDQWO\JUHDWHUUDWHVWKDQ$ERULJLQDOV RI $ERULJLQDOUHVLGHQWVUHSRUWHGODERXUIRUFHSDUWLFLSDWLRQ 1250$1UHSRUWHGSDUWLFLSDWLRQUDWHVWKDWZHUHYHU\VLPLODUWRWKHSURYLQFLDODYHUDJHVDWSHU FHQW7KHUHZDVDJHQGHUJDSLQWKLVUHJLRQDVZHOOZLWKSHUFHQWSDUWLFLSDWLRQDPRQJIHPDOHV What did we learn in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ousing Affordability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µVXSSO\DQGGHPDQG¶LVVXHV What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRGUHJLRQWKHUDWHRISHRSOHZKRVSHQWRUPRUHRQUHQWZDVVLJQLILFDQWO\ ORZHU WKDQ WKH SURYLQFLDO DYHUDJH LQ ZLWK D SURYLQFLDO UDWH RI 2I WKRVH ZKR RZQHGWKHLUKRPHVRQO\SHUFHQWVSHQWPRUHWKDQWKHORZHVWUDWHLQWKHSURYLQFH ,QWKHIRUPHU1250$1UHJLRQSHUFHQWRIUHQWHUVLQVSHQWSHUFHQWRUPRUHRIWKHLU WRWDOKRXVHKROGLQFRPHRQVKHOWHUFRVWV)RUKRPHRZQHUV SHUFHQWVSHQWPRUHWKDQSHUFHQWRQ WKHLUVKHOWHUFRVWV What did we learn in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ccupation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hat did we learn in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hat did we learn in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Exposure To Second Hand Smoke Among Youth '(),1,7,21 7KLVLQGLFDWRUPHDVXUHWKHSURSRUWLRQRI\RXWKIURPJUDGHVWRH[SRVHGWRYDU\LQJOHYHOVRIHQYLURQPHQWDO WREDFFRVPRNHDWKRPH :K\,V7KLV,QGLFDWRU,PSRUWDQW" :KLOHVHFRQGKDQGVPRNHKDUPVHYHU\RQHLWLVHVSHFLDOO\KDUPIXOWRFKLOGUHQ6HFRQGKDQGVPRNHFDQFDXVHHDU LQIHFWLRQVEUHDWKLQJSUREOHPVRWKHUGLVHDVHVLQFKLOGUHQ What did we learn in 2009? 5HVLGHQWVRIWKHIRUPHU%XUQWZRRGUHJLRQZKRGLGQRWVPRNHKDGDUDWHRI SHUFHQW VLJQLILFDQWO\KLJKHUWKDQWKHSURYLQFLDODYHUDJHRI SHUFHQW2YHUKDOIRIFKLOGUHQZHUHEHLQJ H[SRVHG ,QWKHIRUPHU1250$1UHJLRQPDOHVUHSRUWHGDUDWHRI SHUFHQWDQGIHPDOHVUHSRUWHGDUDWHRI SHUFHQW What did we learn in 2014? $V)LJXUHVKRZVWKHDPRXQWRIH[SRVXUHWRVHFRQGKDQGVPRNHULVHVZLWKHDFKJUDGH2IWKH VWXGHQWVUHVSRQGLQJWRWKHVXUYH\ SHUFHQWRIJUDGHVWXGHQWVUHSRUWHGEHLQJH[SRVHGWRVHFRQG VPRNHHLWKHUDOPRVWHYHU\GD\RUGDLO\ %\JUDGHWKDWILJXUHULVHVWRSHUFHQWDVPRUHVWXGHQWVWDNHXSWKHVPRNLQJKDELW )LJXUH DQG)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH([SRVXUHWR6HFRQG+DQG6PRNH$PRQJ Never Lessthanonceamonth Aboutonceamonth Aboutonceaweek Almosteveryday Everyday 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ NeverExposed Exposed 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 4.4. Personal Resources 4.4.1. 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Readiness To Learn At School Entry '(),1,7,21 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIFKLOGUHQ QRWUHDG\ IRUVFKRRODQG YHU\UHDG\IRUVFKRRO¶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¶VHDUO\OHDUQLQJDQGLQFRPHOHYHOV What did we learn in 2009? 7KHIRUPHU%XUQWZRRGUHJLRQUHSRUWHGKLJKHUUDWHVRIµQRWUHDG\¶FKLOGUHQWKDQWKHSURYLQFLDO DYHUDJHDQGORZHUUDWHVRIµYHU\UHDG\¶FKLOGUHQWKDQWKHSURYLQFLDODYHUDJH 7KHIRUPHU1250$1UHJLRQZDVDOVRDERYHWKHSURYLQFLDOµQRWUHDG\¶UDWHVEXWQRWHGVLJQLILFDQW LPSURYHPHQW What did we learn in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hysicalHealthand SocialCompetence EmotionalMaturity Languageand CommunicationSkills WellͲBeing Cognitive andGeneral Development Knowledge 6RXUFH +HDOWK\&KLOG0DQLWRED(DUO\'HYHORSPHQW,QVWUXPHQW'DWD6SHFLDOGDWDUXQ )LJXUH3HUFHQWDJHRI9HU\5HDG\)RU$UHDRI'HYHORSPHQWWR 2006 2007 2009 2011 70% 60% 50% 40% 30% 20% 10% 0% PhysicalHealth Social Emotional Languageand Communication OneorMore TwoorMore andWellͲBeing Competence Maturity Cognitive Skillsand Areasof Areasof Development General Development Development Knowledge 6RXUFH +HDOWK\&KLOG0DQLWRED(DUO\'HYHORSPHQW,QVWUXPHQW'DWD6SHFLDOGDWDUXQ )LJXUH3HUFHQWDJHRI1RW9HU\5HDG\)RU$UHDRI'HYHORSPHQWWR 2006 2007 2009 2011 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% PhysicalHealth Social Emotional Languageand Communication OneorMore TwoorMore andWellͲBeing Competence Maturity Cognitive SkillsandGeneral Areasof Areasof Development Knowledge Development Development 6RXUFH +HDOWK\&KLOG0DQLWRED(DUO\'HYHORSPHQW,QVWUXPHQW'DWD6SHFLDOGDWDUXQ &200881,7<+($/7+$66(660(17 4.5. Personal Health Practices and Lifestyle 4.5.1. Active Living '(),1,7,21 $QLQGH[ZDVFUHDWHGWRFDOFXODWHWRWDOHQHUJ\H[SHQGLWXUHOHYHOVIRUUHVSRQGHQWVDJHGWREDVHGRQSK\VLFDO DFWLYLW\XQGHUWDNHQGXULQJERWKZRUNWLPHDQGOHLVXUHWLPHDFWLYLWLHVLQWKHSUHYLRXVWKUHHPRQWKV7KHSURSRUWLRQ RIUHVSRQGHQWVWKDWZHUHDFWLYHPRGHUDWHO\DFWLYHRULQDFWLYHLVVKRZQ :K\,V7KLV,QGLFDWRU,PSRUWDQW" 3K\VLFDODFWLYLW\LVDFULWLFDOHOHPHQWLQGHYHORSLQJKHDOWK\OLIHVW\OHKDELWV,ISHRSOHDUHEHFRPLQJPRUHSK\VLFDOO\ DFWLYHWKDWPD\EHDSRVLWLYHLQGLFDWRUWKDWWKHUHJLRQ¶VDWWHPSWWRSURPRWHKHDOWKLHUOLIHVW\OHVLVHIIHFWLYHDV DZDUHQHVVLQFUHDVHVDQGVSUHDGV ,QFRPPXQLW\FRQVXOWDWLRQVWKHUHZDVJUHDWHPSKDVLVSODFHGRQPRYLQJWRZDUGKHDOWKLHUOLIHVW\OHFKRLFHVEXWZLWK DUHFRJQLWLRQRIKRZGLIILFXOWLWFDQEHWRDFKLHYH$VRQHSDUWLFLSDQWQRWHG“When trying to engage the hard to reach parts of the community, communicating to them in a way that will keep them interested and want to become involved in their health is very much a huge challenge.”$ZDUHQHVVLVDQRWKHULPSRUWDQW FKDOOHQJHDVDQRWKHUSDUWLFLSDQWQRWHGWKDW“it is surprising how people think that no connection with how they are living impacts on their body such as drug and alcohol use.” What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRGUHJLRQUHVLGHQWVKDGVOLJKWO\KLJKHUOHYHOVRISK\VLFDODFWLYLW\ LQ WKDQWKH0DQLWREDDYHUDJH +RZHYHUWKHOHYHORISK\VLFDOO\LQDFWLYHSHRSOHZDVDOVR KLJKHUWKDQWKHSURYLQFLDODYHUDJH ZLWKDSURYLQFLDODYHUDJHRILQ 7KHIRUPHU1250$1UHJLRQUHSRUWHGKLJKHUOHYHOVRIDFWLYLW\WKDQWKH0DQLWREDDYHUDJH What did we learn in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ctive Moderate Inactive Southern(*) PrairieMountain Northern Winnipeg InterlakeͲEastern Manitoba 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV )LJXUH3K\VLFDO$FWLYLW\5DWHE\=RQHWR Active Moderate Inactive NelsonHouse/NCN(s) IslandLake(s) GR/Mis,ML/Mos,Eas/Che(s) SayD(TL),Bro/BL,NoL(Lac)(s) CrossLake/PimiCN(s) NorwayHouse/NHCN(s) Thompson,MysteryLake ThePas/OCN,Kelsey BayLine Flin,Snow,Cran,Sher Gillam,FoxLakeCN(s) LL/MC,LR,OͲP(SIL),PN(GVL)(s) NorthernIslandLakeZone(s) NorthernNonͲDirectServiceZone(s) NorthernDirectServiceZone Northern 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV &200881,7<+($/7+$66(660(17 )LJXUH/HYHORI3K\VLFDO$FWLYLW\)LUVW1DWLRQV3HRSOHLQ)LUVW1DWLRQV&RPPXQLWLHV$JHG Males Females 40 35 30 Adults 25 Nation 20 First of 15 10 Percent 5 0 RarelyActive AtLeast30Minutesof ModerateActivities35Ͳ ModerateActivitiesat PhysicalActivityatLeast 59Minutes/Day Least60Minutes/Day OnceaWeek LevelofActivity 6RXUFH +HDOWK&DQDGD$6WDWLVWLFDO3URILOHRQWKH+HDOWKRI)LUVW1DWLRQVLQ&DQDGD 'HWHUPLQDQWVRI+HDOWKWR 4.5.2. Mode of Transportation To Work '(),1,7,21 7KLVLQGLFDWRUEUHDNVGRZQZD\VSHRSOHWUDYHOOHGWRZRUNEDVHGRQUHVSRQVHVWRWKHFHQVXV :K\,V7KLV,QGLFDWRU,PSRUWDQW" $VSDUWRIHIIRUWVWRSURPRWHKHDOWKLHUOLYLQJJUHDWHUDZDUHQHVVKDVEHHQUDLVHGDERXWWKHZD\VSHRSOHWUDYHOWR ZRUNZLWKHIIRUWVEHLQJPDGHWRHQFRXUDJHELNLQJZDONLQJDQGSXEOLFWUDQVLWDVSDUWRIDKHDOWKLHUOLIHVW\OHZKLFK DOVREULQJVHQYLURQPHQWDOEHQHILWV What did we learn in 2009? ,QWKHIRUPHU1250$1UHJLRQSHUFHQWRIUHVSRQGHQWVUHSRUWHGGULYLQJWRZRUN ZHUH SDVVHQJHUVLQDYHKLFOH ZLWKSHUFHQWLQGLFDWLQJWKDWWKH\HLWKHUELNHGRUZDONHGWRZRUN 7KHIRUPHU%XUQWZRRGUHJLRQUHSRUWHGVLPLODUUHVXOWVZLWKSHUFHQWGULYLQJWRZRUNDQGDQRWKHU SHUFHQWZDONLQJRUELNLQJWRZRUN What did we learn in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ealthy Eating '(),1,7,21 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIWKHSRSXODWLRQDJHGDQGRYHUZKRUHSRUWHGWKDWWKH\FRQVXPHGRQ DYHUDJHRUPRUHVHUYLQJVRIIUXLWDQGYHJHWDEOHVSHUGD\ :K\,V7KLV,QGLFDWRU,PSRUWDQW" +HDOWK\HDWLQJLVFULWLFDOWRKHDOWK\GHYHORSPHQWDWDOOVWDJHVRIOLIH+HDOWK\HDWLQJDOVRFRQWULEXWHVWRORZHULQJWKH ULVNRIPDQ\FKURQLFGLVHDVHVLQFOXGLQJFDQFHUGLDEHWHVDQGKHDUWGLVHDVH What did we learn in 2009? 7KRXJKWKHUDWHLQWKHIRUPHU%XUQWZRRGUHJLRQRI SHUFHQWLQZDVEHORZWKHSURYLQFLDO DYHUDJHRISHUFHQWWKHUHZDVDQLPSURYHPHQWLQIUXLWDQGYHJHWDEOHFRQVXPSWLRQUDWHWR SHUFHQWLQ 7KHIRUPHU1250$1UHJLRQUHSRUWHGDORZHUUDWHWKDQWKH0DQLWREDDYHUDJHDWSHUFHQWLQ What did we learn in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¶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inearManitoba(Manitobaaverageaverage) Southern Northern PrairieMountain InterlakeͲEastern Winnipeg 29% 30% 31% 32% 33% 34% 35% 36% 37% 38% 39% PerCentofage12+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV )LJXUH+HDOWK\(DWLQJ5DWHE\=RQHWR NorthernLinear(Northernaverage average) IslandLake(s) SayD(TL),Bro/BL,NoL(Lac)(s) LL/MC,LR,OͲP(SIL),PN(GVL)(s) Gillam,FoxLakeCN(s) Thompson,MysteryLake NorwayHouse/NHCN NorthernIslandLakeZone(s) NorthernDirectServiceZone 0% 10% 20% 30% 40% 50% 60% PerCentofage12+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV &200881,7<+($/7+$66(660(17 4.5.3.1. Food Insecurity '(),1,7,21 7KLVLQGLFDWRUPHDVXUHVWKHOHYHORIIRRGLQVHFXULW\RILQGLYLGXDOVEDVHGRQUHVSRQVHVWRWKH&DQDGLDQ&RPPXQLW\ +HDOWK6XUYH\LQZKLFKTXHVWLRQVDUHDVNHGDERXWSHRSOH¶VDELOLW\WRDIIRUGDQGWRDFFHVVQXWULWLRXVIRRGVLQWKHLU FRPPXQLW\ :K\,V7KLV,QGLFDWRU,PSRUWDQW" )RRGLQVHFXULW\KDVEHHQUHFRJQL]HGE\PDQ\DVDFULWLFDOVRFLDOGHWHUPLQDQWRIKHDOWKSDUWLFXODUO\IRUWKRVHOLYLQJ LQUXUDODQGUHPRWHFRPPXQLWLHV$QXPEHURIVWXGLHVKDYHVKRZQWKDWLQFUHDVHGIRRGLQVHFXULW\OHDGVWRDSRRUHU GLHWZKLFKFDQQHJDWLYHO\LPSDFWKHDOWKVWDWXVLY What did we learn in 2009? 7KLVLQGLFDWRULVQHZIRU What did we learn in 2014? %DVHGRQ&RPPXQLW\+HDOWK6XUYH\UHVXOWVSHUFHQWRI1RUWKHUQ+HDOWK5HJLRQUHVLGHQWVKDYH PRGHUDWHRUVHYHUHOHYHOVRIVHYHUHIRRGLQVHFXULW\EDVHGRQWKHLUVXUYH\UHVSRQVHVLQ7KLV LVZHOODERYHWKH0DQLWREDDYHUDJHRISHUFHQW VHH)LJXUH )LJXUH )RRG,QVHFXULW\5DWHVE\5+$ ȋȌManitobaaverage NorthernRHA* PrairieMountain RHA InterlakeͲEastern RHA WinnipegRHA SouthernRHA 0% 2% 4% 6% 8% 10% 12% 6RXUFH 6WDWLVWLFV&DQDGD&DQDGLDQ&RPPXQLW\+HDOWK6XUYH\7DEOH 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\KLJKHUWKDQ0DQLWREDUDWHDWS 4.5.4. Body Mass Index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hat did we learn in 2009? ,QWKHIRUPHU%XUQWZRRGUHJLRQWKHSURSRUWLRQRIUHVLGHQWVZKRZHUHRYHUZHLJKWRUREHVHZDVZHOO RYHUWKHSURYLQFLDO LQ DQGQDWLRQDODYHUDJHV LQ DQGLQFUHDVLQJUDSLGO\ JRLQJIURPLQWRLQ ,QWKHIRUPHU1250$1UHJLRQWKHSURSRUWLRQRIUHVLGHQWVZKRZHUHRYHUZHLJKWZDVVOLJKWO\XQGHU WKHSURYLQFLDODYHUDJH+RZHYHUWKHSURSRUWLRQRIUHVLGHQWVZKRZHUHREHVHZDVVLJQLILFDQWO\RYHU WKHSURYLQFLDOUDWH What did we learn in 2014? 7KH1RUWKHUQ+HDOWKUHJLRQH[SHULHQFHGDQLPSURYHPHQWLQ%0,ZLWKDVOLJKWUHGXFWLRQLQWKH QXPEHURIUHVLGHQWVZKRZHUHRYHUZHLJKWRUREHVHZKLFKZDVSHUFHQWEHWZHHQDQG VHH)LJXUH ,WZDVVWLOOZHOODERYHDQGVWDWLVWLFDOO\GLIIHUHQWIURPWKH0DQLWRED DYHUDJHRISHUFHQW $V)LJXUHVKRZVWKHSURSRUWLRQRIRYHUZHLJKWDQGREHVHUHVLGHQWVLQWKH1RUWKHUQUHJLRQ UDQJHGIURP SHUFHQWLQ*LOODP)R[/DNH&UHH1DWLRQWR SHUFHQWLQWKH)OLQ)ORQ6QRZ/DNH GLVWULFW &200881,7<+($/7+$66(660(17 )LJXUH%RG\0DVV,QGH[5DWHE\5+$WR Underweight/Normal Overweight Obese Northern(*) InterlakeͲEastern(*) PrairieMountain Southern Winnipeg Manitoba 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV )LJXUH%RG\0DVV,QGH[5DWHE\'LVWULFWDQG=RQHWR Underweight/Normal Overweight Obese NelsonHouse/NCN(s) IslandLake(s) NorwayHouse/NHCN(s) GR/Mis,ML/Mos,Eas/Che(s) SayD(TL),Bro/BL,NoL(Lac)(s) CrossLake/PimiCN(s) BayLine(s) LL/MC,LR,OͲP(SIL),PN(GVL)(*) Gillam,FoxLakeCN(*) ThePas/OCN,Kelsey(*) Thompson,MysteryLake(*) Flin,Snow,Cran,Sher NorthernIslandLakeZone(s) NorthernNonͲDirectServiceZone(s) NorthernDirectServiceZone(*) Northern(*) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV 4.5.5. Alcohol Use '(),1,7,21 7KLVLQGLFDWRUPHDVXUHVWKHSHUFHQWDJH RIWKHSRSXODWLRQDJHGDQGRYHUZKRDUHFXUUHQWGULQNHUVDQGZKR UHSRUWHGGULQNLQJRUPRUHGULQNVRQDWOHDVWRQHRFFDVLRQLQWKHSDVWPRQWKV :K\,V7KLV,QGLFDWRU,PSRUWDQW" ([FHVVLYHXVHRIDOFRKROLVUHODWHGWRFKURQLFGLVHDVHVVXFKDVDOFRKROGHSHQGHQFHFDQFHUDQGFLUUKRVLVRIWKHOLYHU DVZHOODVKHDOWKSUREOHPVVXFKDVLQMXULHV,WLVRQHRIWKHNH\LQGLFDWRUVWRPRQLWRUWUHQGVLQDOFRKROUHODWHGKHDOWK FRQGLWLRQV What did we learn in 2009? 7KHSURSRUWLRQRIUHVLGHQWVRIWKHIRUPHU%XUQWZRRGUHJLRQZKRUHSRUWHGKHDY\GULQNLQJZDV SHUFHQWLQKLJKHUWKDQWKHSURYLQFLDODYHUDJH LQ DQGLQFUHDVLQJ XSIURP LQ 7KHIRUPHU1250$1UHJLRQDOVRUHSRUWHGUDWHVKLJKHUWKDQWKHSURYLQFLDODYHUDJH What did we learn in 2014? 7KHELQJHGULQNLQJUDWHLQWKH1RUWKHUQ+HDOWK5HJLRQZDVSHUFHQWEHWZHHQWR WKHKLJKHVWLQ0DQLWREDDQGZHOODERYH DQGVWDWLVWLFDOO\GLIIHUHQW WKHSURYLQFLDODYHUDJHRISHU FHQW VHH)LJXUH 2IWKRVHFRPPXQLWLHVWKDWKDGGDWDWKHELQJHGULQNLQJUDWHZDVSDUWLFXODUO\KLJKLQ%D\/LQH FRPPXQLWLHVDW SHUFHQWGXULQJWKLVWLPHSHULRG7KH3DV7KRPSVRQ)OLQ)ORQDQG*LOODPDUHDV DOOKDGELQJHGULQNLQJUDWHVVWDWLVWLFDOO\KLJKHUWKDQWKHSURYLQFLDODYHUDJHEHWZHHQSHUFHQW VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH%LQJH'ULQNLQJ5DWHE\5+$WR LinearManitoba(Manitobaaverageaverage) Southern Winnipeg InterlakeͲEastern PrairieMountain Northern(*) 0% 5% 10% 15% 20% 25% 30% 35% PerCentofage12+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV )LJXUH%LQJH'ULQNLQJ5DWHE\=RQHWR NorthernLinear(Northernaverage average) NelsonHouse/NCN(s) IslandLake(s) NorwayHouse/NHCN(s) GR/Mis,ML/Mos,Eas/Che(s) SayD(TL),Bro/BL,NoL(Lac)(s) CrossLake/PimiCN(s) LL/MC,LR,OͲP(SIL),PN(GVL) ThePas/OCN,Kelsey(*) Thompson,MysteryLake(*) Flin,Snow,Cran,Sher(*) Gillam,FoxLakeCN BayLine NorthernIslandLakeZone(*) NorthernNonͲDirectService… NorthernDirectServiceZone(*) 0% 10% 20% 30% 40% 50% 60% 70% PerCentofage12+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV )LJXUH+HDY\'ULQNLQJRQD:HHNO\%DVLV)LUVW1DWLRQV3HRSOHLQ)LUVW1DWLRQV&RPPXQLWLHV DQG7RWDO &DQDGLDQ3RSXODWLRQ $JHG FirstNationsPeopleinFirstNationsCommunities TotalCanadianPopulation 16 14 12 10 8 6 4 2 0 Males Females Bothsexes Sex 6RXUFH +HDOWK&DQDGD$6WDWLVWLFDO3URILOHRQWKH+HDOWKRI)LUVW1DWLRQVLQ&DQDGD 'HWHUPLQDQWVRI+HDOWKWR 127( +HDY\GULQNLQJLVGHILQHGKHUHDVKDYLQJPRUHGULQNVRQRQHRFFDVLRQDWOHDVWRQFHDZHHN 7RWDO&DQDGLDQSRSXODWLRQOLYLQJRXWVLGH)LUVW1DWLRQVFRPPXQLWLHV 7KHGHQRPLQDWRULQFOXGHVWKRVHZKRGLGDQGGLGQRWFRQVXPHDOFRKROLQWKHSDVW\HDU&&+6GDWDKDYHEHHQDJH VWDQGDUGL]HWRWKH5+6DJHVWUXFWXUH &200881,7<+($/7+$66(660(17 4.5.6. Smoking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hat did we learn in 2009? 7KHIRUPHU1250$1UHJLRQUHSRUWHGDVPRNLQJUDWHRISHUFHQWVLJQLILFDQWO\KLJKHUWKDQWKH SURYLQFLDODYHUDJHRISHUFHQW 7KHIRUPHU%XUQWZRRGUHJLRQKDGWKHKLJKHVWVPRNLQJUDWHVLQWKHSURYLQFHDWSHUFHQWDQG LQFUHDVLQJ What did we learn in 2014? 7KH1RUWKHUQUHJLRQKDGWKHKLJKHVWVPRNLQJUDWHEHWZHHQWRDWSHUFHQWZHOO DERYHWKH0DQLWREDDYHUDJHRI SHUFHQWGXULQJWKHVDPHWLPHSHULRG VHH)LJXUH ,QWKH1RUWKHUQ&RPPXQLW\6XUYH\FRQGXFWHGLQWKH6XPPHUDQG)DOOSHUFHQWRI UHVSRQGHQWVLQGLFDWHGWKDWWKH\VPRNHG GDLO\DQGRFFDVLRQDOO\ %D\/LQH&RPPXQLWLHVUHFRUGHGWKHKLJKHVWVPRNLQJUDWHLQWKH1RUWKHUQ5HJLRQDW SHUFHQW ZKLOH*LOODP)R[/DNHKDGWKHORZHVWDWSHUFHQW7KH3DV)OLQ)ORQ7KRPSVRQDQG%D\/LQH DUHDVDOOKDGVPRNLQJUDWHVVWDWLVWLFDOO\DERYHWKHSURYLQFLDODYHUDJH VHH)LJXUH WHAT ARE WE DOING? 3LNZLWRQHLVFKRROKRVWVDFRPPXQLW\IHDVWDQGHGXFDWLRQHYHQWDURXQGTXLWWLQJVPRNLQJHYHU\\HDU GXULQJ1DWLRQDO1RQ6PRNLQJZHHN 7KH1RUWKHUQ+HDOWK5HJLRQKDVSDUWQHUHGZLWKWKHSURYLQFLDOLQLWLDWLYH6WXGHQWV:RUNLQJ$JDLQVW 7REDFFR 6:$7 WRFUHDWHWHDPVLQYDULRXVQRUWKHUQVFKRROVLQFOXGLQJ5'3DUNHU&ROOHJLDWHLQ 7KRPSVRQ&URVV/DNH7KH6:$7WHDPVGRSHHUHGXFDWLRQZLWK\RXQJHUVWXGHQWVWRSUHYHQW HOHPHQWDU\VWXGHQWVIURPVWDUWLQJWRVPRNH 2XUUHJLRQKDVEHHQYHU\DFWLYHSURPRWLQJWKH3URYLQFLDO0%4XLWV&DPSDLJQ DTXLWVPRNLQJ FRQWHVWIRUDOOUHVLGHQWV:HKDYHKDGZLQQHUVIURPWKHQRUWKRQRFFDVLRQV7KHQXPEHUV SDUWLFLSDWLQJIURPWKHQRUWKDQGLQWHUHVWLQWKHFRQWHVWFRQWLQXHVWRULVH 7KHUHJLRQLVZRUNLQJRQDSROLF\WRVWDQGDUGL]HVXSSRUWIRUSDWLHQWVZKRVPRNHZKHQYLVLWLQJWKHLU KHDOWKFDUHSURYLGHUDVDQRXWSDWLHQW 7KHULVNIDFWRUFRDFKLQ7KRPSVRQDQGWKHVPRNLQJUHGXFWLRQFRRUGLQDWRULQ)OLQ)ORQVHHSDWLHQWV GLUHFWO\IRUFHVVDWLRQFRXQVHOOLQJ 7KH+HDOWK\7RJHWKHU1RZSURJUDPZLWKRYHURXWO\LQJFRPPXQLWLHVVXSSRUWVWREDFFRUHGXFWLRQ DFWLYLWLHVE\FRPPXQLWLHVWKURXJKIXQGLQJDZDUHQHVVDQGHGXFDWLRQ &200881,7<+($/7+$66(660(17 )LJXUH6PRNLQJ5DWHE\5+$WR CurrentSmoker FormerSmoker NonͲSmoker Winnipeg Southern PrairieMountain InterlakeͲEastern Northern(*) Manitoba 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV )LJXUH6PRNLQJ5DWHE\=RQHWR CurrentSmoker FormerSmoker NonͲSmoker NelsonHouse/NCN(s) IslandLake(s) NorwayHouse/NHCN(s) GR/Mis,ML/Mos,Eas/Che(*) SayD(TL),Bro/BL,NoL(Lac)(s) CrossLake/PimiCN(s) Gillam,FoxLakeCN ThePas/OCN,Kelsey(*) Flin,Snow,Cran,Sher(*) LL/MC,LR,OͲP(SIL),PN(GVL) Thompson,MysteryLake(*) BayLine(*) NorthernIslandLakeZone(s) NorthernNonͲDirectServiceZone(s) NorthernDirectServiceZone(*) Northern 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV )LJXUH6PRNLQJ6WDWXV)LUVW1DWLRQV3HRSOHLQ)LUVW1DWLRQV&RPPXQLWLHV DQG7RWDO&DQDGLDQ 3RSXODWLRQ $JHG FirstNationsPeopleinFirstNationsCommunities TotalCanadianPopulation 100 80 60 Population of 40 Percent 20 0 NonSmoker DailySmoker OccasionalSmoker SmokingStatus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Childhood Immunization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²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hat did we learn in 2014? 7KHUHZHUHPL[HGUHVXOWVLQYDFFLQHFRYHUDJHLQWKH1RUWKHUQ+HDOWK5HJLRQEHWZHHQDQG $JHVDQGVDZLQFUHDVHVLQYDFFLQHFRYHUDJHZKLOHDJHH[SHULHQFHGDGHFOLQH7KH1RUWKHUQ +HDOWK5HJLRQZDVDERYHWKHSURYLQFLDOFRYHUDJHUDWHIRUDJHVDQGE\ VHH7DEOH &RYHUDJHRISROLRDQGPHDVOHVKDGQRWDEOHLQFUHDVHVLQFRYHUDJHUDWHVZKLOHFRYHUDJHIRU+%9DWDJH H[SHULHQFHGDGHFOLQHLQWKH1RUWKHUQ+HDOWK5HJLRQE\ VHH7DEOH 7DEOH9DFFLQH&RYHUDJH5DWHVE\$JHIRU1RUWKHUQ&RPSDUHGWR0DQLWRED $JH 1RUWKHUQ 0DQLWRED $JH 1RUWKHUQ 0DQLWRED $JH 1RUWKHUQ 0DQLWRED $JH 1RUWKHUQ 0DQLWRED $JH 1RUWKHUQ 0DQLWRED 6RXUFH 0DQLWRED,PPXQL]DWLRQ0RQLWRULQJ6\VWHP$QQXDO5HSRUW 7DEOH,QGLYLGXDO$QWLJHQV)RU1RUWKHUQE\$JH*URXS $JH*URXS $QWLJHQ $JH 7HWDQXV $JH 3ROLR 3HUWXVVLV $JH 0HDVOHV $JH +%9 $JH 'LSWKHULD 6RXUFH 0DQLWRED,PPXQL]DWLRQ0RQLWRULQJ6\VWHP$QQXDO5HSRUW 4.5.7.1.1. Complete Immunization Rates for Age 1 '(),1,7,21 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIFKLOGUHQZKRKDGFRPSOHWHLPPXQL]DWLRQVFKHGXOHVIRU'D3WS+L% 'LSKWKHULD$FHOOXODU3HUWXVVLV7HWDQXV3ROLR+DHPRSKLOXVLQIOXHQ]D%LPPXQL]DWLRQUDWHVDVRIWKHLUILUVW ELUWKGD\ What did we learn in 2009? 7KHIRUPHU%XUQWZRRGUHJLRQKDGWKHORZHVWFRPSOHWHLPPXQL]DWLRQUDWHVLQWKHSURYLQFH SHU FKLOGUHQLQZLWKDSURYLQFLDOUDWHRI ,WDOVRKDGWKHVHFRQGORZHVWUDWHVIRU)LUVW 1DWLRQVLPPXQL]DWLRQV LQZLWKDSURYLQFLDOUDWHRI 7KHIRUPHU1250$1UHJLRQKDGDORZHUUDWHWKDQWKHSURYLQFLDODYHUDJHEXWLWZDVLQFUHDVLQJ What did we learn in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inearManitoba(Manitoba)average Southern Northern InterlakeͲEastern Winnipeg PrairieMountain Health 65% 70% 75% 80% 85% PerCent 6RXUFH 0DQLWRED,PPXQL]DWLRQ0RQLWRULQJ6\VWHP$QQXDO5HSRUW 127( 1RUWKHUQDQG6RXWKHUQKDYHVWDWLVWLFDOO\ORZHUWKDQDYHUDJHUDWH 4.5.7.1.2. Complete Immunization Rates for Age 2 '(),1,7,21 7KLVLQGLFDWRUPHDVXUHVWKHFUXGHSURSRUWLRQRIFKLOGUHQZKRKDGFRPSOHWHLPPXQL]DWLRQVFKHGXOHVIRU'D3WS+L% 'LSKWKHULD$FHOOXODU3HUWXVVLV7HWDQXV3ROLR+DHPRSKLOXVLQIOXHQ]D%LPPXQL]DWLRQUDWHVDVRIWKHLUVHFRQG ELUWKGD\V What did we learn in 2009? 7KHIRUPHU%XUQWZRRGUHJLRQUHSRUWHGWKHORZHVWFRPSOHWHLPPXQL]DWLRQUDWHV FKLOGUHQLQ IRUWKLVDJHJURXSLQWKHSURYLQFH WKHDYHUDJHZDVLQ ,WZDVIRXUWKORZHVWDPRQJ $ERULJLQDOFKLOGUHQ ZLWKDSURYLQFLDODYHUDJHRI $PRQJQRQ$ERULJLQDOFKLOGUHQLW ZDVKLJKHUWKDQWKHSURYLQFLDODYHUDJH KLJKHUWKDQWKHSURYLQFLDODYHUDJHRILQ 7KHIRUPHU1250$1UHJLRQKDGDORZHUUDWHWKDQWKHSURYLQFLDODYHUDJHDQGLWZDVGHFUHDVLQJ What did we learn in 2014? $VZLWKRQH\HDUROGLQIDQWFRYHUDJHWKHUHZDVDQLPSURYHPHQWLQFRYHUDJHUDWHVLQWKH1RUWKHUQ UHJLRQ IURP LQWRLQ ,QLWZDVSHUFHQWZKLFKZDVDERYHWKH 0DQLWREDDYHUDJHRISHUFHQW VHH)LJXUH WHAT DO WE KNOW? :KHQ0,06JHQHUDWHGUHSRUWRI0LVVLQJ,PPXQL]DWLRQLVUHFHLYHGLWLVUHYLHZHGDQGSKRQHFDOOVDUHPDGH RIIHULQJDQDSSRLQWPHQWIRULPPXQL]DWLRQ+DYLQJDQ(05LQWKH1+5KDVVWUHDPOLQHGWKHSURFHVVDQG DOORZHGDSSRLQWPHQWVWREHVFKHGXOHGPRUHHIILFLHQWO\ &200881,7<+($/7+$66(660(17 )LJXUH &RPSOHWH,PPXQL]DWLRQ5DWHVIRU$OO,QIDQWV$JHG LinearManitoba(Manitoba)average Southern Winnipeg InterlakeͲEastern Northern PrairieMountain 0% 10% 20% 30% 40% 50% 60% 70% PerCent 6RXUFH 0DQLWRED,PPXQL]DWLRQ0RQLWRULQJ6\VWHP$QQXDO5HSRUW 127( 6RXWKHUQKDVVWDWLVWLFDOO\ORZHUWKDQDYHUDJHUDWH1RUWKHUQDQG3UDLULH0RXQWDLQKDYHVWDWLVWLFDOO\KLJKHUWKDQDYHUDJHUDWH 4.5.7.1.3. Complete Immunization Rates for Age 7 '(),1,7,21 7KLVLVWKHFUXGHSURSRUWLRQRIFKLOGUHQZKRKDGFRPSOHWHLPPXQL]DWLRQVFKHGXOHVIRU'D3WS+L%'LSKWKHULD $FHOOXODU3HUWXVVLV7HWDQXV3ROLR+DHPRSKLOXVLQIOXHQ]D%LPPXQL]DWLRQUDWHVDVRIWKHLUVHYHQWKELUWKGD\V What did we learn in 2009? 7KHIRUPHU%XUQWZRRGUHJLRQKDGWKHORZHVWFRPSOHWHLPPXQL]DWLRQUDWHVLQWKHSURYLQFHIRUWKLVDJH JURXS ZLWKDQDYHUDJHRILQ ,PPXQL]DWLRQUDWHVIRUERWK)LUVW1DWLRQV ZLWKDQDYHUDJHRI DQGQRQ)LUVW1DWLRQVFKLOGUHQ ZLWKDQDYHUDJHRI ZHUHEHORZWKHSURYLQFLDODYHUDJHV 7KHIRUPHU1250$1UHJLRQKDGDVLJQLILFDQWO\KLJKHUUDWH WKDQWKHSURYLQFLDODYHUDJH DQGUHSRUWHGLQFUHDVHVRYHUWLPH What did we learn in 2014? :KLOHWKH1RUWKHUQUHJLRQLPPXQL]DWLRQFRYHUDJHUDWHDWDJH ZDVDERYHWKH0DQLWRED DYHUDJHRISHUFHQWLQLWZDVDVKDUSGHFOLQHIURP DQG DV )LJXUHVKRZV7KLVGHFOLQHZDVPLUURUHGDWWKHSURYLQFLDOOHYHO WHAT ARE WE DOING? 3UHVFKRROLPPXQL]DWLRQFRQWLQXHVWREHRIIHUHGLQDOO5+$FRPPXQLWLHV'XULQJWKHYLVLWDQ\ LPPXQL]DWLRQVQHHGHGZLOOEHDGPLQLVWHUHGLQDQHIIRUWWRSURYLGHLPPXQL]DWLRQDWHYHU\RSSRUWXQLW\ ,PPXQL]DWLRQUHFRUGVIRUVWXGHQWVHQUROOHGLQ*UDGHDUHUHYLHZHGDQQXDOO\DQGDQ\VWXGHQWZKRLV PLVVLQJDQDQWLJHQLVVHWDOHWWHUDQGRIIHUHGWKHDQWLJHQDWD6FKRRO%DVHG&OLQLF &200881,7<+($/7+$66(660(17 )LJXUH&RPSOHWH,PPXQL]DWLRQ5DWHVIRU$OO,QIDQWV$JHG LinearManitoba(Manitoba)average Winnipeg InterlakeͲEastern Southern Northern PrairieMountain 45% 50% 55% 60% 65% PerCent 6RXUFH 0DQLWRED,PPXQL]DWLRQ0RQLWRULQJ6\VWHP$QQXDO5HSRUW 127( :LQQLSHJKDVVWDWLVWLFDOO\ORZHUWKDQDYHUDJHUDWH3UDLULH0RXQWDLQKDVVWDWLVWLFDOO\KLJKHUWKDQDYHUDJHUDWH 4.5.7.1.4. Complete Immunization Rates for Age 11 '(),1,7,21 7KLVLQGLFDWRUPHDVXUHVWKHFUXGHSURSRUWLRQRIFKLOGUHQZKRKDGFRPSOHWHLPPXQL]DWLRQVFKHGXOHVIRU'D3WS+L% 'LSKWKHULD$FHOOXODU3HUWXVVLV7HWDQXV3ROLR+DHPRSKLOXVLQIOXHQ]D%LPPXQL]DWLRQUDWHVDVRIWKHLUHOHYHQWK ELUWKGD\V What did we learn in 2009? 7KHIRUPHU%XUQWZRRGUHJLRQKDGWKHORZHVWLPPXQL]DWLRQUDWHVLQWKHSURYLQFHDWSHU FKLOGUHQ WKHDYHUDJHZDVLQ 7KHLPPXQL]DWLRQUDWHIRU)LUVW1DWLRQVFKLOGUHQZDV DERYHWKHSURYLQFLDODYHUDJH ZLWKDQDYHUDJHRI LQ 7KHIRUPHU1250$1UHJLRQKDGDUDWHRISHUFHQWDERYHWKHSURYLQFLDODYHUDJH What did we learn in 2014? 7KHLPPXQL]DWLRQUDWHIRUFKLOGUHQDJHG\HDUVROGZDVSHUFHQWLQEHORZWKH0DQLWRED DYHUDJHRISHUFHQW,PPXQL]DWLRQUDWHVIRU\HDUROGVUHPDLQHGIDLUO\VWHDG\IURPWR VHH)LJXUH :+$7$5(:('2,1*" :HRIIHUWKH+%DQG+39YDFFLQHVDVVFKRROEDVHGLPPXQL]DWLRQSURJUDP$Q\HOLJLEOHYDFFLQHVDUHDOVR RIIHUHGGXULQJWKHVFKRROEDVHGFOLQLF7UDQVIHUVDQGDEVHQWHHLVPFRQWLQXHVWREHWKHPRVWVLJQLILFDQW IDFWRULQIOXHQFLQJVHULHVFRPSOHWLRQLQWKHVFKRROEDVHGSURJUDP &200881,7<+($/7+$66(660(17 )LJXUH&RPSOHWH,PPXQL]DWLRQ5DWHVIRU$OO,QIDQWV$JHG LinearManitoba(Manitoba)average Winnipeg Northern InterlakeͲEastern Southern PrairieMountain 0% 10% 20% 30% 40% 50% 60% 70% PerCent 6RXUFH 0DQLWRED,PPXQL]DWLRQ0RQLWRULQJ6\VWHP$QQXDO5HSRUW 127( :LQQLSHJKDVVWDWLVWLFDOO\ORZHUWKDQDYHUDJHUDWH3UDLULH0RXQWDLQ,QWHUODNH(DVWHUQDQG6RXWKHUQKDYHVWDWLVWLFDOO\KLJKHUWKDQDYHUDJH UDWH 4.5.7.1.5. Complete Immunization Rates for Age 17 '(),1,7,21 7KLVLQGLFDWRUPHDVXUHVWKHFUXGHSURSRUWLRQRIFKLOGUHQZKRKDGFRPSOHWHLPPXQL]DWLRQVFKHGXOHVIRU'D3WS+L% 'LSKWKHULD$FHOOXODU3HUWXVVLV7HWDQXV3ROLR+DHPRSKLOXVLQIOXHQ]D%LPPXQL]DWLRQUDWHVDVRIWKHLUVHYHQWHHQWK ELUWKGD\V What did we learn in 2009? 7KHIRUPHU%XUQWZRRGUHJLRQUHSRUWHGWKHORZHVWUDWHLQWKHSURYLQFH ZLWKDQDYHUDJHRI LQ 7KHUDWHVIRU$ERULJLQDO DQGQRQ$ERULJLQDO \RXWKZHUHERWKEHORZWKH SURYLQFLDODYHUDJHV DQGUHVSHFWLYHO\LQ 7KHIRUPHU1250$1UHJLRQUHSRUWHGDKLJKHUUDWHWKDQWKHSURYLQFLDODYHUDJH%RWK$ERULJLQDODQG QRQ$ERULJLQDOFKLOGUHQZHUHDERYHWKHSURYLQFLDODYHUDJH What did we learn in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inearManitoba(Manitoba)average Northern Winnipeg InterlakeͲEastern Southern PrairieMountain 0% 10% 20% 30% 40% 50% 60% 70% PerCent 6RXUFH 0DQLWRED,PPXQL]DWLRQ0RQLWRULQJ6\VWHP$QQXDO5HSRUW 127( :LQQLSHJDQG1RUWKHUQKDYHVWDWLVWLFDOO\ORZHUWKDQDYHUDJHUDWH3UDLULH0RXQWDLQDQG6RXWKHUQKDYHVWDWLVWLFDOO\KLJKHUWKDQDYHUDJH UDWH 4.5.7.2. Immunization Among Seniors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nfluenza Immunization Among Seniors '(),1,7,21 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIVHQLRUV DJHGDQGRYHU WKDWKDYHFRPSOHWHLPPXQL]DWLRQVIRU LQIOXHQ]D :K\,V7KLV,QGLFDWRU,PSRUWDQW" ,PPXQL]LQJVHQLRUVLVSDUWLFXODUO\LPSRUWDQWIRULQIOXHQ]DDQGSQHXPRFRFFDOGLVHDVHWRSUHYHQWPRUWDOLW\DQG PRUELGLW\:KLOHVHQLRUYDFFLQDWLRQUDWHVIRULQIOXHQ]DKDYHEHHQULVLQJJUDGXDOO\&DQDGDVWLOOIDOOVZHOOEHORZWKH QDWLRQDOWDUJHWRISHUFHQWFRYHUDJHIRUDGXOWVRYHU,QWKHFRYHUDJHUDWHLQ&DQDGDIRUWKRVHRYHU ZDVSHUFHQW What did we learn in 2009? 7KHIRUPHU%XUQWZRRGUHJLRQUHSRUWHGWKHORZHVWUDWHLQ0DQLWRED VLJQLILFDQWO\ORZHUWKDQ WKHSURYLQFLDODYHUDJH %RWK)LUVW1DWLRQV DQGQRQ)LUVW1DWLRQV VHQLRUVZHUH EHORZWKHLUUHVSHFWLYHDYHUDJHV 7KHIRUPHU1250$1UHJLRQZDVVOLJKWO\EHORZWKHSURYLQFLDODYHUDJHDW SHUFHQW)LUVW 1DWLRQVVHQLRUVKDGDQDERYHDYHUDJHLPPXQL]DWLRQUDWHQRQ)LUVW1DWLRQVVHQLRUVGLGQRW What did we learn in 2014? ,QWKH1RUWKHUQUHJLRQLQIOXHQ]DLPPXQL]DWLRQUDWHGHFOLQHGWR SHUFHQWDJDLQEHORZ WKH0DQLWREDDYHUDJH7KHGLIIHUHQFHLQLPPXQL]DWLRQUDWHVEHWZHHQWKHUHJLRQDQGWKHSURYLQFHLV FRQVLGHUHGVWDWLVWLFDOO\VLJQLILFDQW VHH)LJXUH $V)LJXUHVKRZVZKLOHLPPXQL]DWLRQUDWHVGHFOLQHGLQWKH1RUWKHUQ+HDOWK5HJLRQSDUWLFXODUO\ WKH1RUWKHUQ'LUHFW6HUYLFH]RQHWKH1RUWKHUQ,VODQG/DNH]RQHKDGDVWDWLVWLFDOO\VLJQLILFDQW LQFUHDVHIURPSHUFHQWLQWRSHUFHQWLQ )LJXUH,QIOXHQ]D,PPXQL]DWLRQIRU6HQLRUVE\5+$DQG 2006/07 2011/12 ManitobaLinear(Manitobaaverageaverage2006/072006/07) ManitobaLinear(Manitobaaverage2011/12average2011/12) Northern(1,2) Southern(1,2,t) PrairieMountain(t) InterlakeͲEastern(t) Winnipeg(t) 0% 10% 20% 30% 40% 50% 60% 70% PerCent ofresidentsage65+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV )LJXUH,QIOXHQ]D,PPXQL]DWLRQIRU6HQLRUVE\=RQHDQG 2006/07 2011/12 LinearNorthern(Northernaverageaverage2006/072006/07) LinearNorthern(Northernaverageaverage2011/122011/12) NorwayHouse/NHCN(1,t) IslandLake(1,t) SayD(TL),Bro/BL,NoL(Lac)(2) GR/Mis,ML/Mos,Eas/Che Puk/MatColCN(s) LL/MC,LR,OͲP(SIL),PN(GVL) ThePas/OCN,Kelsey(t) Gillam,FoxLakeCN NorthernIslandLakeZone(1,t) NorthernDirectServiceZone(t) ͲΨ ʹͲΨ ͶͲΨ ͲΨ ͺͲΨ ͳͲͲΨ PerCent ofresidentsage65+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV &200881,7<+($/7+$66(660(17 4.5.7.2.2. Pneumococcal Immunization Among Seniors '(),1,7,21 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIVHQLRUV DJHGDQGRYHU WKDWKDYHFRPSOHWHLPPXQL]DWLRQVIRU SQHXPRQLD What did we learn in 2009? 7KHSQHXPRFRFFDOLPPXQL]DWLRQUDWHDPRQJDOOVHQLRUVLQWKHIRUPHU%XUQWZRRGUHJLRQZDV SHU UHVLGHQWVDJHGDQGROGHUZKLFKZDVVLJQLILFDQWO\ORZHUWKDQ0DQLWREDDW LQ,WZDV WKHORZHVWUDWHUHFRUGHGDPRQJ0DQLWRED5+$V 7KHIRUPHU1250$1UHJLRQKDGDQLPPXQL]DWLRQUDWHRIIRUZKLFKZDVVOLJKWO\DERYH WKHSURYLQFLDODYHUDJH What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQSQHXPRFRFFDOLPPXQL]DWLRQUDWHLQFUHDVHGVOLJKWO\IURPSHUFHQWLQ WRSHUFHQWLQ VHH)LJXUH $PRQJ1RUWKHUQ+HDOWK5HJLRQ]RQHVLWZDVWKH1RUWKHUQ,VODQG/DNH]RQHZKLFKKDGWKHPRVW SURQRXQFHGLQFUHDVHLQSQHXPRFRFFDOLPPXQL]DWLRQIURPSHUFHQWFRYHUDJHLQWR SHUFHQWLQ VHH)LJXUH )LJXUH3QHXPRFRFFDO,PPXQL]DWLRQIRU6HQLRUVE\5+$DQG 2006/07 2011/12 LinearManitoba(Manitobaaverageaverage2006/072006/07) LinearManitoba(Manitobaaverageaverage2011/122011/12) Southern(1,2) Northern PrairieMountain InterlakeͲEastern(t) Winnipeg 54% 56% 58% 60% 62% 64% 66% 68% 70% 72% PerCent ofresidentsage65+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV )LJXUH3QHXPRFRFFDO,PPXQL]DWLRQIRU6HQLRUVE\=RQHDQG 2006/07 2011/12 LinearNorthern(Northernaverageaverage2006/072006/07) LinearNorthern(Northernaverageaverage2011/122011/12) Puk/MatColCN(1,2) IslandLake(1,t) NelsonHouse/NCN(1) CrossLake/PimiCN LL/MC,LR,OͲP(SIL),PN(GVL) Thompson,MysteryLake BayLine Gillam,FoxLakeCN NorthernIslandLakeZone(1,t) NorthernDirectServiceZone ͲΨ ʹͲΨ ͶͲΨ ͲΨ ͺͲΨ ͳͲͲΨ PerCent ofresidentsage65+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV &200881,7<+($/7+$66(660(17 4.5.8. Cancer Screening 4.5.8.1. Cervical Cancer Screening '(),1,7,21 7KLVLQGLFDWRUPHDVXUHWKHUDWHSHUZRPHQLQ0DQLWREDDJHWR ZLWKRQHRUPRUH3$3VPHDUVLQD\HDU WLPHSHULRGE\5+$RIUHVLGHQFH :K\,V7KLV,QGLFDWRU,PSRUWDQW" ,QZRPHQLQ&DQDGDZLOOEHGLDJQRVHGZLWKFHUYLFDOFDQFHUDQGZLOOGLHIURPLW5HJXODU3$3 VPHDUVFDQGHWHFWRUSUHYHQWWKHHDUO\FHOOFKDQJHVWKDWFDQOHDGWRFHUYLFDOFDQFHUY,WLVH[SHFWHGWKDWWKH LQWURGXFWLRQRIWKH+39 +XPDQ3DSLOORPDYLUXV YDFFLQHLQVFKRROVZLOOOHDGWRGUDPDWLFDOO\UHGXFHGUDWHVRI FHUYLFDOFDQFHUGLDJQRVHV What did we learn in 2009? &HUYLFDOFDQFHUVFUHHQLQJVVKRZHGDVLJQLILFDQWGHFOLQHLQWKHIRUPHU%XUQWZRRGUHJLRQZKLFKKDG WKHORZHVWUDWHLQ0DQLWRED1RDJHJURXSUHDFKHGSHUFHQWVFUHHQLQJ 7KHIRUPHU1250$1UHJLRQKDGWKHWKLUGORZHVWUDWHLQWKHSURYLQFHDQGWKHUDWHZDVGHFUHDVLQJ UDSLGO\ What did we learn in 2014? $V)LJXUHVKRZVWKHFHUYLFDOFDQFHUVFUHHQLQJUDWHLQWKH1RUWKHUQ+HDOWK5HJLRQEHWZHHQ ZDV SHUFHQWVWDWLVWLFDOO\EHORZWKH0DQLWREDDYHUDJHRISHUFHQW )LJXUH&HUYLFDO&DQFHU6FUHHQLQJE\5+$ LinearManitoba(Manitoba)average Northern* PrairieMountain Winnipeg* Southern* InterlakeͲEastern* 56% 58% 60% 62% 64% 66% 68% 70% 72% PerCentofwomenaged20–69 6RXUFH &HUYL[&KHFN5HJLVWU\$SULO ±0DUFK 127(˖ 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S DŽ )LJXUH:RPHQ(YHU+DYLQJD3DS7HVW)LUVW1DWLRQV:RPHQLQ)LUVW1DWLRQV&RPPXQLWLHV DQG$OO :RPHQLQ&DQDGD E\$JH*URXS FirstNationsWomeninFirstNationsCommunities Canada 100 90 80 70 60 Population 50 of 40 30 Percent 20 10 0 18Ͳ29 30Ͳ39 40Ͳ49 50Ͳ59 60+ AllAges(18+) AgeGroup 6RXUFH +HDOWK&DQDGD$6WDWLVWLFDO3URILOHRQWKH+HDOWKRI)LUVW1DWLRQVLQ&DQDGD 'HWHUPLQDQWVRI+HDOWKWR 127( 7RWDOSRSXODWLRQOLYLQJRXWVLGH)LUVW1DWLRQVFRPPXQLWLHV &200881,7<+($/7+$66(660(17 4.5.8.2. 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Pregnancy Rate :K\,V7KLV,QGLFDWRU,PSRUWDQW" 3UHJQDQF\FDQEHDFRQVLGHUDEOHSXEOLFKHDOWKLVVXHLQPDQ\FRXQWULHVSDUWLFXODUO\IRUWHHQV3UHJQDQF\IRUROGHU PRWKHUVFDQFDXVHKHDOWKFRPSOLFDWLRQVGXHWRSUHH[LVWLQJFRQGLWLRQVVXFKDVGLDEHWHVWK\URLGGLVHDVHKLJKRUORZ EORRGSUHVVXUHRUILEURLGVZKLFKFDQDIIHFW\RXUSUHJQDQF\DQGELUWK3UHJQDQF\FRPSOLFDWLRQVFDQDOVRUHVXOWIRU ROGHUPRPVVXFKDVKLJKEORRGSUHVVXUHDQGEOHHGLQJLQWKHWKLUGWULPHVWHU What did we learn in 2014? $V)LJXUHLQGLFDWHVSUHJQDQF\UDWHVZHUHJHQHUDOO\KLJKHULQ)LUVW1DWLRQV&RPPXQLWLHVWKDQLQ 1RQ)LUVW1DWLRQV&RPPXQLWLHVLQWKH1RUWKHUQ+HDOWK5HJLRQ)LUVW1DWLRQV&RPPXQLW\SUHJQDQF\ UDWHVZHUHSDUWLFXODUO\KLJKLQWKH SHUSRSXODWLRQ DQG )LJXUH3UHJQDQF\5DWHLQ1RUWKHUQ+HDOWK5HJLRQ FirstNationsonReserve MunicipalitiesIncludingOffReserveFirstNations 300 250 200 1,000 per 150 Rate 100 50 0 10Ͳ14 15Ͳ19 20Ͳ24 25Ͳ29 30Ͳ34 35Ͳ39 40Ͳ44 45Ͳ49 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW &200881,7<+($/7+$66(660(17 4.6.2. Breastfeeding Initiation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hat did we learn in 2009? %UHDVWIHHGLQJLQLWLDWLRQUDWHVLQ%XUQWZRRGGHFUHDVHGVLJQLILFDQWO\IURPSHUFHQWWRSHUFHQW EHWZHHQ DQGZKLFKLVVLJQLILFDQWO\ORZHUWKDQWKH0DQLWRED DYHUDJHRISHUFHQWLQ 7KHIRUPHU1250$1UHJLRQH[SHULHQFHGDQLQFUHDVHLQEUHDVWIHHGLQJLQLWLDWLRQIURP SHUFHQW LQ WR SHUFHQWLQWKRXJKLWVWLOOUHPDLQHGVWDWLVWLFDOO\EHORZ WKHSURYLQFLDODYHUDJH What did we learn in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anitobaLinear(Manitoba)average Northern InterlakeͲEastern PrairieMountain Winnipeg* Southern 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% PerCentofInͲHospitalLiveBirths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anitoba Northern 90% 80% Live 70% 60% Hospital Ͳ 50% In of 40% Cent 30% Per 20% 10% 0% 2010/11 2011/12 2012/13 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW'LVFKDUJH$EVWUDFW'DWDEDVH 4.6.3. Inadequate Prenatal Care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hat did we learn in 2014? 7KHSURSRUWLRQRIQHZPRWKHUVZKRKDGLQDGHTXDWHSUHQDWDOFDUHZDVSHUFHQWLQWKH1RUWKHUQ +HDOWK5HJLRQIURP ZHOODERYHWKHSURYLQFLDODYHUDJHRISHUFHQW VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH5DWHVRI,QDGHTXDWH3UHQDWDO&DUHE\5+$ ManitobaLinear(Manitoba)average Winnipeg* Southern* PrairieMountain* InterlakeͲEastern* Northern* 0% 5% 10% 15% 20% 25% 30% 35% 40% PerCent 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\3HULQDWDO6HUYLFHVDQG2XWFRPHVLQ0DQLWRED 127(˖ 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S DŽ 4.6.4. Families First Program '(),1,7,21 7KH)DPLOLHV)LUVW3URJUDPSURYLGHVSUHYDOHQFHUDWHVRIULVNIDFWRUVIRUSRRUFKLOGRXWFRPHVEDVHGRQULVNIDFWRU SHUFHQWDJHV RIWKHUHJLRQDOSRVWSDUWXPSRSXODWLRQVFUHHQHGIRUHQUROOPHQWLQWKH)DPLOLHV)LUVW3URJUDP :K\,V7KLV,QGLFDWRU,PSRUWDQW" 7KLVDVVHVVPHQWWRROLVXVHGE\SXEOLFKHDOWKQXUVHVWKURXJKD)DPLOLHV)LUVWVFUHHQLQJIRUP,WLVXVHGWRLGHQWLI\ IDPLOLHVZKRPD\QHHGIXUWKHUVXSSRUWDQGDVVLVWDQFHWRHQVXUHFKLOGUHQDUHUDLVHGLQDKHDOWK\HQYLURQPHQW,WFDQ EHDQLQGLFDWRURIKRZZHOODGMXVWHGIDPLOLHVDUHLQDUHJLRQWRKDYHFKLOGUHQ What did we learn in 2009? 7KHSURSRUWLRQRIIDPLOLHVZLWKWKUHHRUPRUHULVNIDFWRUVLQWKHIRUPHU%XUQWZRRGUHJLRQIURP WRZDV SHUFHQWZHOODERYHWKH0DQLWREDDYHUDJHRISHUFHQW ,QWKHIRUPHU1250$1UHJLRQ SHUFHQWRIIDPLOLHVKDGWKUHHRUPRUHULVNIDFWRUV What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQKDVVLQFHDUHFHQWGHFOLQHLQWKHQXPEHURIIDPLOLHVZLWKWKUHHRUPRUH ULVNIDFWRUVIURPSHUFHQWLQWR SHUFHQWLQ VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH7KUHHRU0RUH5LVN)DFWRUVRQ6FUHHQ Northern Manitoba 35% 30% 25% 20% 15% 10% 5% 0% 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 6RXUFH +HDOWK\&KLOG0DQLWRED)DPLOLHV)LUVW6FUHHQLQJ'DWD6SHFLDO'DWD5XQ )LJXUH7KUHHRU0RUH5LVN)DFWRUVRQ6FUHHQE\5HJLRQ LinearManitoba(Manitobaaverageaverage) InterlakeͲEastern* Winnipeg Northern* PrairieMountain* Southern* 0% 10% 20% 30% 40% 50% PerCent 6RXUFH +HDOWK\&KLOG0DQLWRED)DPLOLHV)LUVW6FUHHQLQJ'DWD6SHFLDO'DWD5XQ 127(˖ 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S DŽ 4.6.4.1. Alcohol and Drug Use During Pregnancy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hat did we learn in 2009? 7KHFRPELQHGIRXU\HDUDYHUDJHRIDOFRKROXVHGXULQJSUHJQDQF\LQWKHIRUPHU%XUQWZRRG5HJLRQ ZDVSHUFHQWDERYHWKH0DQLWREDDYHUDJHRISHUFHQW7KHUDWHRIGUXJXVHGXULQJ SUHJQDQF\LQFUHDVHGIURP SHUFHQWWRSHUFHQWEHWZHHQDQG 7KHFRPELQHGIRXU\HDUDYHUDJHRIDOFRKROXVHGXULQJSUHJQDQF\LQWKHIRUPHU1250$15HJLRQ ZDVSHUFHQW5DWHVIRUGUXJXVHZHUHQRWDYDLODEOH What did we learn in 2014? $V)LJXUH VKRZVPDWHUQDODOFRKROXVHUDWHVKDYHIOXFWXDWHGLQWKH1RUWKHUQ+HDOWK5HJLRQ GHFOLQLQJIURPSHUFHQWWRSHUFHQWEHWZHHQDQG WKHQULVLQJWRSHUFHQWLQ &200881,7<+($/7+$66(660(17 )LJXUH 0DWHUQDO$OFRKRO8VH Northern Manitoba 25% 20% 15% 10% 5% 0% 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 6RXUFH +HDOWK\&KLOG0DQLWRED)DPLOLHV)LUVW6FUHHQLQJ'DWD6SHFLDO'DWD5XQ )LJXUH0DWHUQDO$OFRKRO8VHE\5HJLRQ LinearManitoba(Manitobaaverageaverage) InterlakeͲEastern* Winnipeg PrairieMountain* Northern* Southern* 0% 5% 10% 15% 20% 25% PerCent 6RXUFH +HDOWK\&KLOG0DQLWRED)DPLOLHV)LUVW6FUHHQLQJ'DWD6SHFLDO'DWD5XQ 127(˖ 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S DŽ 4.6.4.2. Smoking During Pregnancy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hat did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQWKHSURSRUWLRQRIZRPHQZKRVPRNHGGXULQJSUHJQDQF\ZDV SHUFHQWEHWZHHQDQG ,QWKHIRUPHU1250$15HJLRQWKHSURSRUWLRQEHWZHHQDQGZDVSHUFHQW What did we learn in 2014? 0DWHUQDOVPRNLQJUDWHVLQWKH1RUWKHUQ+HDOWK5HJLRQKDYHUHPDLQHGLQWKHSHUFHQWUDQJHIURP WR7KHUHKDVEHHQDUHFHQWGHFOLQHLQUDWHVIURPSHUFHQWLQWRSHUFHQWLQ VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH0DWHUQDO6PRNLQJ Northern Manitoba 30% 25% 20% 15% 10% 5% 0% 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 6RXUFH +HDOWK\&KLOG0DQLWRED)DPLOLHV)LUVW6FUHHQLQJ'DWD6SHFLDO'DWD5XQ )LJXUH0DWHUQDO6PRNLQJE\5HJLRQ LinearManitoba(Manitobaaverageaverage) InterlakeͲEastern* Winnipeg Northern PrairieMountain Southern* 0% 10% 20% 30% 40% 50% PerCent 6RXUFH +HDOWK\&KLOG0DQLWRED)DPLOLHV)LUVW6FUHHQLQJ'DWD6SHFLDO'DWD5XQ 127(˖ 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S DŽ 4.6.4.3. Anxiety & Depression in Mothers of Newborns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hat did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQLQWKHSHULRGWKHSHUFHQWDJHRIPRWKHUVH[SHULHQFLQJ GHSUHVVLRQZDVSHUFHQWVOLJKWO\KLJKHUWKDQWKH0DQLWREDDYHUDJHRISHUFHQW ,QWKHIRUPHU1250$15HJLRQLQWKHSHULRGWKHSHUFHQWDJHRIPRWKHUVH[SHULHQFLQJ GHSUHVVLRQZDVSHUFHQW What did we learn in 2014? 0DWHUQDO'HSUHVVLRQUDWHVLQWKH1RUWKHUQ+HDOWK5HJLRQH[SHULHQFHGDVWHDG\ULVHEHWZHHQ RIPRWKHUVH[SHULHQFLQJGHSUHVVLRQ DQG EHIRUHGHFOLQLQJDJDLQLQZKHUH LWUHDFKHGSHUFHQW VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH0DWHUQDO'HSUHVVLRQDQGRU$Q[LHW\ Northern Manitoba 25% 20% 15% 10% 5% 0% 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 6RXUFH +HDOWK\&KLOG0DQLWRED)DPLOLHV)LUVW6FUHHQLQJ'DWD6SHFLDO'DWD5XQ )LJXUH0DWHUQDO'HSUHVVLRQDQGRU$Q[LHW\E\5HJLRQ LinearManitoba(Manitobaaverageaverage) InterlakeͲEastern* Southern Winnipeg Northern* PrairieMountain* 0% 5% 10% 15% 20% 25% PerCent 6RXUFH +HDOWK\&KLOG0DQLWRED)DPLOLHV)LUVW6FUHHQLQJ'DWD6SHFLDO'DWD5XQ 127(˖ 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S DŽ 4.6.4.4. Mother With Less Than A Grade 12 Education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hat did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQH[SHULHQFHGDGHFUHDVHLQPRWKHUVRIQHZERUQVZLWKOHVVWKDQDJUDGH HGXFDWLRQIURPSHUFHQWWRSHUFHQWEHWZHHQDQG 7KHIRUPHU1250$15HJLRQUHSRUWHGDFRPELQHGIRXU\HDUUDWHRISHUFHQWLQ What did we learn in 2014? ,QWKH1RUWKHUQ+HDOWK5HJLRQWKHSURSRUWLRQRIPRWKHUVZLWKOHVVWKDQKLJKVFKRROHGXFDWLRQ GHFOLQHGVOLJKWO\IURPSHDNLQJDW SHUFHQWLQWR SHUFHQWLQ VHH )LJXUH &200881,7<+($/7+$66(660(17 )LJXUH0RWKHU+DV/HVV7KDQ+LJK6FKRRO(GXFDWLRQ Northern Manitoba 25% 20% 15% 10% 5% 0% 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 6RXUFH +HDOWK\&KLOG0DQLWRED)DPLOLHV)LUVW6FUHHQLQJ'DWD6SHFLDO'DWD5XQ )LJXUH0RWKHU+DV/HVV7KDQ+LJK6FKRRO(GXFDWLRQE\5HJLRQ LinearManitoba(Manitobaaverageaverage) Winnipeg* Northern PrairieMountain InterlakeͲEastern* Southern* 0% 10% 20% 30% 40% 50% PerCent 6RXUFH +HDOWK\&KLOG0DQLWRED)DPLOLHV)LUVW6FUHHQLQJ'DWD6SHFLDO'DWD5XQ 127(˖ 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S DŽ 4.6.4.5. Social Assistance / Financial Difficulties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hat did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQIDPLOLHVZLWKQHZERUQVZKRUHFHLYHVRFLDODVVLVWDQFHLQFUHDVHG IURPSHUFHQWWRSHUFHQWEHWZHHQDQG7KLVLVPXFKKLJKHUWKDQWKHSURYLQFLDO DYHUDJHRISHUFHQWLQ 7KHIRUPHU1250$15HJLRQUHSRUWHGDUDWHRISHUFHQWLQ What did we learn in 2014? 7KHSURSRUWLRQRIIDPLOLHVUHFHLYLQJVRFLDODVVLVWDQFHGLGH[SHULHQFHDVWHDG\GHFOLQHLQWKH1RUWKHUQ +HDOWK5HJLRQIURPDKLJKRI SHUFHQWLQWRSHUFHQWLQ VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH)LQDQFLDO'LIILFXOWLHV Northern Manitoba 25% 20% 15% 10% 5% 0% 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 6RXUFH +HDOWK\&KLOG0DQLWRED)DPLOLHV)LUVW6FUHHQLQJ'DWD6SHFLDO'DWD5XQ )LJXUH)LQDQFLDO'LIILFXOWLHVE\5HJLRQ LinearManitoba(Manitobaaverageaverage) InterlakeͲEastern* PrairieMountain Northern Winnipeg* Southern* 0% 5% 10% 15% 20% 25% 30% 35% PerCent 6RXUFH +HDOWK\&KLOG0DQLWRED)DPLOLHV)LUVW6FUHHQLQJ'DWD6SHFLDO'DWD5XQ 127(˖ 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S DŽ 4.7. Child & Youth Health :+$7$5(:('2,1*" 7KH &200881,7<+($/7+$66(660(17 4.7.1. 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Sex Practices Among Youth DEFINITION 7KLVLQGLFDWRUPHDVXUHVUHVSRQVHVWRTXHVWLRQVUHODWHGWRVH[XDODFWLYLW\E\\RXWKVSHFLILFDOO\WKHLUFRPIRUWOHYHOLQ GLVFXVVLQJELUWKFRQWUROZLWKWKHLUSDUWQHU Why Is This Indicator Important? 6H[XDOO\DFWLYH\RXWKDQG\RXQJDGXOWVPD\HQJDJHLQEHKDYLRXUVWKDWFRXOGSXWWKHPDWULVNIRUQHJDWLYHKHDOWK RXWFRPHVVXFKDV6H[XDOO\7UDQVPLWWHG,QIHFWLRQV 67,V DQGWKHKHDOWKFRPSOLFDWLRQVWKDWPD\DULVHIURPLWRUWKH ULVNRIDQXQSODQQHGSUHJQDQF\,I\RXWKDUHDEOHWRWDONRSHQO\DQGIUHHO\DERXWELUWKFRQWURODQG67,VLWZLOO OLNHO\OHDGWROHVVULVN\VH[XDODFWLYLW\DQGWKHFRPSOLFDWLRQVWKDWDULVHIURPLW What did we learn in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havenothadsex Never Rarely Often Always Notasked 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ Ihavenothadsex Never Rarely Often Always 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ )LJXUH+RZRIWHQGR\RXIHHOFRPIRUWDEOHWDONLQJWRWKHSHUVRQ V \RXDUHKDYLQJVH[ZLWKDERXW67,VE\JUDGH Ihavenothadsex Never Rarely Often Always Notasked 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ Ihavenothadsex Never Rarely Often Always 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ &200881,7<+($/7+$66(660(17 )LJXUH,QWKHSDVW\HDUGLG\RXKDYHXQSODQQHGVH[DIWHUXVLQJDOFRKRORUGUXJVE\JUDGH Notasked No,Ididnothaveunplannedsexafterusingalcoholordrugs Yes,Ihadunplannedsexafterusingalcoholordrugs Ididnothavesexinthepastyear Ihavenothadsex 100% 80% 60% 40% 20% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 80% 60% 40% 20% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 4.7.1.2. Preferred Information Sources DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHUHVSRQVHVRI\RXWKWRZKHUHWKH\VHHNLQIRUPDWLRQDERXWVH[XDOKHDOWK Why Is This Indicator Important? 7KHVRXUFHRIVH[XDOKHDOWKLQIRUPDWLRQLVLPSRUWDQWWRPRQLWRUDVPDQ\VRXUFHVGRQRWKDYHWKHH[SHUWLVHRU NQRZOHGJHQHHGHGWRFUHGLEO\SURYLGH\RXWKZLWKQHFHVVDU\LQIRUPDWLRQ7KLVPD\UHVXOWLQULVNLHUVH[XDOSUDFWLFHV DPRQJ\RXWK What did we learn in 2014? 2YHUDOOWKH,QWHUQHW DIULHQG SDUHQWFDUHJLYHU VFKRRO DQGGRFWRU ZHUHWKHWRSVRXUFHVRILQIRUPDWLRQDERXWVH[XDOKHDOWK VHH)LJXUH 7KHPDLQVRXUFHVRILQIRUPDWLRQGRFKDQJHZLWKHDFKJUDGH,QJUDGHWKHSULPDU\VRXUFHIRUVH[XDO KHDOWKLQIRUPDWLRQZDVDSDUHQWRUFDUHJLYHU %\JUDGHWKHLQWHUQHW IROORZHGE\ IULHQGV DUHWKHPRVWLPSRUWDQWVRXUFHVRILQIRUPDWLRQIRUMXVWRYHUKDOIWKHVWXGHQWV VHH 7DEOH &200881,7<+($/7+$66(660(17 )LJXUH:KDWDUH\RXUSUHIHUUHG6RXUFHVRI,QIRUPDWLRQDERXW6H[XDOLW\3XEHUW\%LUWK&RQWURODQG67,VE\*UDGH Doctor Publichealthnurse/Women'sHealthClinic/Nursepractitioner School(teacher,nurseorcounsellor,presenter) Telephonehelpline TeenClinic CommunityResourceCentre Otherfamilymember Sibling(s) Parent/caregiver Media(TV,movies,magazines,books,pamphlets) Friend(s) Internet Overall Grade12 Grade11 Grade10 Grade9 Grade8 Grade7 0% 5% 10% 15% 20% 25% 30% 35% 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 7DEOH:KDW$UH *UDGH *UDGH *UDGH *UDGH *UDGH *UDGH 2YHUDOO ,QWHUQHW )ULHQG V 0HGLD 79PRYLHV PDJD]LQHVERRNV SDPSKOHWV 3DUHQWFDUHJLYHU 6LEOLQJ V 2WKHUIDPLO\PHPEHU &RPPXQLW\5HVRXUFH &HQWUH 7HHQ&OLQLF 7HOHSKRQHKHOSOLQH 6FKRRO WHDFKHUQXUVH RUFRXQVHOORU SUHVHQWHU 3XEOLFKHDOWK QXUVH:RPHQ V+HDOWK &OLQLF1XUVH SUDFWLWLRQHU 'RFWRU 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ &200881,7<+($/7+$66(660(17 4.7.1.3. 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Youth Smoking DEFINITION 7KLVLQGLFDWRUPHDVXUHVVPRNLQJIUHTXHQF\RI\RXWK6WXGHQWVZKRUHSRUWHGVPRNLQJDWOHDVWFLJDUHWWHVLQWKHLU OLIHDQGUHSRUWHGVPRNLQJ HYHU\GD\ RU DOPRVWHYHU\GD\ ZHUHFRQVLGHUHG 'DLO\VPRNHUV 2FFDVLRQDOVPRNHUV ZHUHGHILQHGDVVWXGHQWVZKRUHSRUWHGVPRNLQJDWOHDVWFLJDUHWWHVLQWKHLUOLIHDQGRUUHSRUWHGVPRNLQJ VRPH GD\V Why Is This Indicator Important? 6PRNLQJLVWKHOHDGLQJSUHYHQWDEOHFDXVHRIGHDWKLQ&DQDGDNLOOLQJDSSUR[LPDWHO\&DQDGLDQVHYHU\\HDU 7KH\RXQJHUVRPHRQHLVZKHQWKH\TXLWVPRNLQJWKHOHVVOLNHO\WKH\DUHWRGHYHORSUHVSLUDWRU\GLVHDVHVHVSHFLDOO\ OXQJFDQFHU6PRNLQJLVUHVSRQVLEOHIRUDQXPEHURIGLVHDVHVLQFOXGLQJKHDUWGLVHDVHVWURNHDQGPDQ\OXQJ GLVHDVHV7KH\RXQJHUSHRSOHVWDUWVPRNLQJWKHOHVVOLNHO\WKH\DUHWRTXLWDQGWKHPRUHOLNHO\WKH\DUHWREHFRPH DGGLFWHGWRQLFRWLQH7KH\DUHPRUHOLNHO\WREHVPRNHUVDVDGXOWVYLLL What did we learn in 2009? 7KHIRUPHU%XUQWZRRGUHJLRQKDGWKHKLJKHVWUDWHLQWKHSURYLQFHDWSHUFHQWSHUFHQWRI JLUOVDQGSHUFHQWRIER\VEHWZHHQJUDGHVVL[WRWZHOYHVPRNH ,QWKHIRUPHU1250$1UHJLRQSHUFHQWRIER\VDQG SHUFHQWRIJLUOVLQJUDGHVVL[WRWZHOYH VPRNH What did we learn in 2014? 2YHUDOOWKH\RXWKVPRNLQJUDWHZDVSHUFHQWLQLQWKH1RUWKHUQ+HDOWK5HJLRQ6PRNLQJ UDWHVLQFUHDVHGZLWKHDFKJUDGH,QJUDGH SHUFHQWRIVWXGHQWVVPRNHGRFFDVLRQDOO\RUGDLO\%\ JUDGHSHUFHQWRIVWXGHQWVZHUHVPRNLQJ VHH)LJXUH $V)LJXUHVKRZVWKHUHZHUHKLJKHUVPRNLQJUDWHVIRUJLUOVWKDQER\VSDUWLFXODUO\IRURFFDVLRQDO VPRNLQJZLWK SHUFHQWRIJLUOVPRNLQJYHUVXVSHUFHQWRIER\V &200881,7<+($/7+$66(660(17 WHAT ARE WE DOING? 7KH1RUWKHUQ+HDOWK5HJLRQKDVSDUWQHUHGZLWKWKHSURYLQFLDOLQLWLDWLYH6WXGHQWV:RUNLQJ$JDLQVW 7REDFFRWRFUHDWH6:$7WHDPV 6WXGHQWV:RUNLQJ$JDLQVW7REDFFR LQYDULRXVQRUWKHUQVFKRROV LQFOXGLQJ5'3DUNHU&ROOHJLDWHLQ7KRPSVRQ&URVV/DNH7KH6:$7WHDPVGRSHHUHGXFDWLRQ ZLWK\RXQJHUVWXGHQWVWRSUHYHQWHOHPHQWDU\VWXGHQWVIURPVWDUWLQJWRVPRNH )RFXVLVDOVRRQ/XQJV$UH)RU/LIH7UDLQLQJIRUWHDFKHUVSULRUWR6:$7SUHYHQWLRQPHVVDJLQJDQG DFWLYLWLHVIRUWHDFKHUVWRGLUHFWJUDGHVWXGHQWVZKLFKDUHFULWLFDODJHVIRUIRUPLQJLGHDVDERXW VPRNLQJ 7REDFFRWDFNOHWHDPVDUHSHHUPHQWRULQJSURJUDPVZLWKDIRFXVRQVFKRRODQGFRPPXQLW\EDVHG DFWLYLWLHVWKDWKHOSWREULQJDZDUHQHVVWRWKHLVVXHVRIWREDFFRSURGXFWV6FKRROVWKDWKDYH SDUWLFLSDWHGLQWKLVSURJUDPDUH5XWK%HWWV&RPPXQLW\6FKRROLQ)OLQ)ORQ0DU\'XQFDQ6FKRROLQ 7KH3DV&RUPRUDQW/DNH6FKRROLQ&RUPRUDQWDQG)URQWLHU&ROOHJLDWH,QVWLWXWHLQ&UDQEHUU\ 3RUWDJH5HFHQWLPSOHPHQWHGDFWLYLWLHVLQFOXGHZULWLQJWKHLURZQSXEOLFVHUYLFHDQQRXQFHPHQWVDQG UHFLWLQJWKHPRQWKHUDGLR%OXH/LJKW3URMHFWZKLFKHQFRXUDJHVVPRNHIUHHKRPHVFUHDWLQJ VWRU\ERDUGVDQGSURGXFLQJYLGHRVIRUWKHLURZQDQWLWREDFFRFRPPHUFLDOVDQGFOHDQLQJXSEXWWVRQ VFKRROJURXQGVDQGFRPPXQLW\7KLVEURXJKWJUHDWHUDZDUHQHVVWRWKHDPRXQWRIFLJDUHWWHVVPRNHG RQDQGDURXQGWKHVFKRRODVZHOODVWKHHQYLURQPHQWDOLVVXHRIFLJDUHWWHEXWWVOLWWHULQJRXU SOD\JURXQGVDQGFRPPXQLW\ 7KHWREDFFRUHGXFWLRQSURMHFWIRFXVHVRQUHGXFLQJWKHLQLWLDWLRQRIWREDFFRDQGVPRNHOHVVWREDFFR SURGXFWVDVZHOODVDUHGXFWLRQLQWKHXVHRIWKHVHSURGXFWV7KLVLVDFFRPSOLVKHGWKURXJKFUHDWLQJD VXSSRUWLYHHQYLURQPHQWDQGGHYHORSLQJVNLOOVRIWKH\RXWKSDUWLFLSDWLQJLQWREDFFRWDFNOHWHDPVLQ DGGLWLRQWRLQFUHDVLQJWKHFDSDFLW\ZLWKLQWKHFRPPXQLW\WRDGGUHVVWREDFFRLVVXHVE\VWUHQJWKHQLQJ WKHLUVNLOOVLQKHDOWKEHKDYLRXUFKDQJH7KHVHDFWLYLWLHVUDQJHIURPDGGUHVVLQJORFDOSROLFLHVUHODWHG WRWREDFFRXVHFRPPXQLW\DZDUHQHVVSURJUDPVVXFKDV³WKHEOXHOLJKWSURMHFW´DQGUHGXFLQJWKH EDUULHUVWRWREDFFRFHVVDWLRQ )LJXUH DailySmoker Occasional NonͲsmoker 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ DailySmoker Occasional NonͲsmoker 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% female male Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ &200881,7<+($/7+$66(660(17 4.7.2.1. Means of Obtaining Cigarettes DEFINITION 7KLVLQGLFDWRUPHDVXUHVUHVSRQVHVE\\RXWKRQKRZWKH\DFFHVVFLJDUHWWHV Why Is This Indicator Important? ,WLVLPSRUWDQWLQNQRZKRZ\RXWKDUHDFFHVVLQJFLJDUHWWHVDVLWZLOOLPSDFWWKHHIIHFWLYHQHVVRIDQ\QRQVPRNLQJ FDPSDLJQLIWKHUHLVDZLGHDFFHSWDQFHDQGDFFHVVWRFLJDUHWWHVIURPIULHQGVDQGIDPLO\,WPD\DOVRSRLQWWR XQGHUDJHFKLOGUHQDFFHVVLQJFLJDUHWWHVLOOHJDOO\DWUHWDLOHUV What did we learn in 2014? 6WXGHQWVREWDLQHGFLJDUHWWHVPRVWO\IURPWKHLUIULHQGVZKRHLWKHUJLYHLWWRWKHP RUVHOOWKHP ,QDGGLWLRQSHUFHQWUHSRUWHGEX\LQJWKHLURZQFLJDUHWWHVHYHQWKRXJKLWZRXOGEHDJDLQVW WKHODZWRGRVRIRUFKLOGUHQXQGHU VHH)LJXUH )LJXUH+RZ6WXGHQWV2EWDLQHG&LJDUHWWHV Itakethemfromafriendorsomeoneelse Itakethemfrommymother,fatherorsiblings Afriendorsomeoneelsegivesthemtome Myparentorcaregivegivesthemtome Mybrotherorsistergivesthemtome Iasksomeonetobuythemforme Ibuythemfromafriendorsomeoneelse Ibuythemmyselfatthestore 0% 2% 4% 6% 8% 10% 12% 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 4.7.2.2. 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Binge Drinking In Past 30-Days DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIWLPHV\RXWKKDYHKDGDELQJHGULQNLQJVHVVLRQRIGULQNVRUPRUHDWRQH WLPH Why Is This Indicator Important? )UHTXHQWELQJHGULQNLQJZLOORIWHQOHDGWRULVN\EHKDYLRXUE\\RXWKVRLWLVLPSRUWDQWWRLGHQWLI\KRZPDQ\WLPHV DOFRKROLVFRQVXPHGGXULQJDELQJHGULQNLQJVHVVLRQ What did we learn in 2014? $VPDOOPDMRULW\ RI1RUWKHUQ+HDOWK5HJLRQVWXGHQWVKDGQHYHUKDGDELQJHGULQNLQJVHVVLRQ RIGULQNVRUPRUH2QFHDJDLQZLWKRWKHUGUXJDQGDOFRKROLQGLFDWRUVELQJHGULQNLQJUDWHVULVHZLWK HDFK\HDULQKLJKVFKRRO,QJUDGH SHUFHQWRIVWXGHQWVKDGHQJDJHGLQELQJHGULQNLQJ%\ JUDGHSHUFHQWKDGGRQHVR VHH)LJXUH )LJXUH'XULQJ7KH3DVW0RQWK GD\V 2Q+RZ0DQ\'D\V'LG 80% 60% 40% 20% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ &200881,7<+($/7+$66(660(17 )LJXUH 'XULQJ7KH3DVW0RQWK GD\V 2Q+RZ0DQ\'D\V'LG EverBingeDrink NeverBingeDrink 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ (YHU%LQJH'ULQN 1HYHU%LQJH'ULQN *UDGH *UDGH *UDGH *UDGH *UDGH *UDGH 2YHUDOO 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 4.7.3.3. 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Youth Diet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³NLGVLQWKH.LWFKHQ´JURXSHYHU\VXPPHUWRWHDFK\RXWKKRZWRFRRNKHDOWK\ IRRGV &200881,7<+($/7+$66(660(17 4.7.4.1. Frequency of Fruit & Vegetable Consumption DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRI\RXWKUHSRUWLQJWKHQXPEHURIVHUYLQJVRIIUXLWVDQGYHJHWDEOHVWKH\ FRQVXPH Why Is This Indicator Important? )UXLWDQGYHJHWDEOHFRQVXPSWLRQLVDNH\FRUQHUVWRQHWRKHDOWK\HDWLQJSDUWLFXODUO\IRU\RXWK7KHCanada Food GuideUHFRPPHQGVWKDW\RXWKDJHG\HDUVKDYHDWOHDVW IHPDOHV RU PDOHV VHUYLQJVRIIUXLWDQG YHJHWDEOHVGDLO\ What did we learn in 2009? $FFRUGLQJWRWKHUHFHQW6FKRRO )LJXUH'DLO\)UXLWVDQG9HJHWDEOH&RQVXPSWLRQ 45% 40% 35% 30% 25% 20% respondents of 15% % 10% 5% 0% 2timesorless 3Ͳ6times 7ormoretimes 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 2timesorless 3Ͳ6times 7ormoretimes 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Females Males Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ &200881,7<+($/7+$66(660(17 4.7.4.2. Less Healthy Food Consumption (include salty snacks, drinks, fast food) DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRI\RXWKUHSRUWLQJWKHQXPEHURIWLPHVWKH\HDWOHVVKHDOWK\IRRGVXFKDV VDOW\VQDFNVVRIWGULQNVRUIDVWIRRG Why Is This Indicator Important? +HDOWKLHUHDWLQJKDELWVIRU\RXWKKDYHEHHQDVVRFLDWHGZLWKLPSURYHGVWXGHQWSHUIRUPDQFHLQVFKRROZKLOH FRQVXPSWLRQRIOHVVKHDOWK\IRRGVKDVEHHQDVVRFLDWHGZLWKSRRUHUDFKLHYHPHQWLQERWKODQJXDJHDQGPDWKFODVVHV ,I\RXWKDUHQRWHDWLQJDKHDOWK\GLHWWKH\ZLOOODFNWKHQHFHVVDU\QXWULHQWVQHHGHGWRPD[LPL]HWKHLUOHDUQLQJ SRWHQWLDO[ What did we learn in 2014? ,QWKH1RUWKHUQ+HDOWK5HJLRQSHUFHQWRI\RXWKUHSRUWHGKDYLQJIDVWIRRGWZRWLPHVDZHHNRU OHVVDQGSHUFHQWKDGVDOW\RUVXJDU\VQDFNVWZLFHRUOHVVDZHHN$FRQVLGHUDEOHQXPEHURI \RXWKUHSRUWHGKDYLQJVDOW\DQGVXJDU\VQDFNVWLPHVDZHHNDWSHUFHQW VHH)LJXUH )LJXUH'DLO\&RQVXPSWLRQRI6DOW\RU6XJDU\6QDFNVDQG)DVW)RRG Saltyorsugarysnacks FastFood 100% 90% 80% 70% 60% 50% respondents 40% of % 30% 20% 10% 0% 2timesorless 3Ͳ6times 7ormoretimes 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 4.7.5. Healthy Weight &KLOGKRRGREHVLW\LVEHFRPLQJDVLJQLILFDQWSXEOLFKHDOWKFRQFHUQLQ&DQDGD%HLQJRYHUZHLJKWRUREHVHFDUULHV LQFUHDVHGULVNIRUDZLGHUDQJHRIVHULRXVGLVHDVHVDQGFRQGLWLRQVLQFOXGLQJK\SHUWHQVLRQKHDUWGLVHDVHGLDEHWHV VWURNHRVWHRDUWKULWLVDQGVRPHFDQFHUV 4.7.5.1. Perception of Weight DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHUHVSRQVHVRI\RXWKZKRDVVHVVZKHWKHUWKH\DUHRYHUZHLJKW Why Is This Indicator Important? 0HDVXULQJ\RXWKSHUFHSWLRQRIWKHLUZHLJKWLVLPSRUWDQWWRPRQLWRUIRUSRWHQWLDOHDWLQJGLVRUGHUVDPRQJ\RXWK *LYHQWKHLPSRUWDQFHSODFHGRQSK\VLFDODSSHDUDQFHJLUOVLQSDUWLFXODUIHHOVRFLHWDOSUHVVXUHWRVWULYHWRDFKLHYHWKH LGHDOERG\LPDJHRUEHFRPHGLVVDWLVILHGZLWKWKHLUDSSHDUDQFH7KHUHLVDOVRSUHVVXUHRQER\VZKLFKFDQDOVROHDG WRHDWLQJGLVRUGHUVVWHURLGXVHDQGH[FHVVLYHH[HUFLVH[L What did we learn in 2014? 5HVXOWVZHUHIDLUO\FRQVLVWHQWDFURVVJUDGHVZLWKSHUFHQWRYHUDOOIHHOLQJWKH\ZHUHDWWKHULJKW ZHLJKWDQGSHUFHQWWKLQNLQJWKH\ZHUHRYHUZHLJKW VHH)LJXUH 7KHUHLVDFRQWUDVWLQSHUFHLYHGERG\ZHLJKWE\JHQGHU)RUIHPDOHV SHUFHQWRIUHVSRQGHQWV WKRXJKWWKH\ZHUHRYHUZHLJKWZKLOHRQO\SHUFHQWRIPDOHVWKRXJKWWKH\ZHUH VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH6HOI3HUFHLYHG%RG\:HLJKWE\*UDGH Underweight Abouttherightweight Overweight 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Grade7Ͳ8Grade9Ͳ10 Grade11Ͳ12 Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ Underweight Abouttherightweight Overweight 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Female Male Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 4.7.5.2. Actual Weight by Gender & Grade DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHUHVSRQVHVRI\RXWKZKRUHSRUWWKHLUZHLJKWDQGKHLJKW Why Is This Indicator Important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hat did we learn in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nderweight Healthyweight Overweight Obese 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ Underweight Healthyweight Overweight Obese 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Female Male Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 4.7.6. Physical Activity DEFINITION 7KLVLQGLFDWRUPHDVXUHVUHVSRQVHVWRTXHVWLRQVDERXWWKHOHYHORISK\VLFDODFWLYLW\E\\RXWK Why Is This Indicator Important? /RZHUSK\VLFDODFWLYLW\OHYHOVDPRQJ\RXWKDUHPRUHOLNHO\WROHDGWRLQFUHDVHGERG\ZHLJKWDQGDQLQFUHDVHGULVNRI GHYHORSLQJREHVLW\UHODWHGGLVHDVHDQGDGYHUVHKHDOWKRXWFRPHV What did we learn in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¶VLQYROYHPHQW$OPRVWSHUFHQW GLGVRRQHRUPRUHWLPHVDZHHN7KLV ZDVSDUWLFXODUO\SRSXODUZLWKPDOHVZLWKSHUFHQWSDUWLFLSDWLRQLQXQRUJDQL]HGSK\VLFDODFWLYLW\ RXWVLGHVFKRRO VHH)LJXUH $V)LJXUH UHYHDOVSK\VLFDODFWLYLW\WHQGVWREHGRQHZLWKIULHQGV-XVWXQGHUSHUFHQW RI\RXWKLQGLFDWHGWKDWWKHLUSK\VLFDODFWLYLWLHVZHUHGRQHZLWKRUPRUHIULHQGV :+$7$5(:('2,1*" ,QFRRSHUDWLRQZLWKWKH6FKRRO'LVWULFWRI0\VWHU\/DNHWKH1RUWKHUQ+HDOWK5HJLRQKDVDVVLVWHGLQ FUHDWLQJWKH³$FWLYHDQG6DIH5RXWHVWR6FKRRO´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nactive ModeratelyActive Active 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ Afterschool Lunch Recess/Spare Beforeschool 0% 10% 20% 30% 40% 50% 60% 70% 80% 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ )LJXUH ,Q7KH3DVW0RQWK GD\V +RZ2IWHQ'LG Never Lessthanonceaweek 1Ͳ3timesperweek 4ormoretimesperweek 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Female Male overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ Never Lessthanonceaweek 1Ͳ3timesperweek 4ormoretimesperweek 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Female Male overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ &200881,7<+($/7+$66(660(17 )LJXUH ,Q7KH3DVW0RQWK GD\V +RZ2IWHQ+DYH Never Lessthanonceaweek 1Ͳ3timesperweek 4ormoretimesperweek 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Female Male overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ Female Male Overall 70% 60% 50% 40% 30% 20% 10% 0% Organizedbyschool Organizedoutsideschoolwitha Organizedoutsideschool coachorinstructor withoutacoachorinstructor 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ )LJXUH 3K\VLFDO$FWLYLW\:LWK)ULHQGV 30% 25% 20% 15% 10% 5% 0% Nofriend 1friend 2friends 3friends 4friends 5friends 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ &200881,7<+($/7+$66(660(17 4.7.7. Youth Mental Well-Being 0RQLWRULQJPHQWDOKHDOWKZHOOEHLQJLVSDUWLFXODUO\LPSRUWDQWDVPHQWDOLOOQHVVHVRIWHQHPHUJHLQ\RXWK(DUO\ PHQWDOKHDOWKDVVHVVPHQWGLDJQRVLVDQGWUHDWPHQWRIFKLOGUHQDQG\RXWKPD\DYRLGORQJWHUPPHQWDOKHDOWK GLVDELOLWLHVZKLFKFDQOHDGWRXQHPSOR\PHQWLQYROYHPHQWZLWKWKHODZDQGKRPHOHVVQHVV 4.7.7.1. Social Environment & Bullying DEFINITION 7KLVLQGLFDWRUPHDVXUHVUHVSRQVHVWRTXHVWLRQVRQ\RXWKVDIHW\DQGLQVWDQFHVRIEXOO\LQJ Why Is This Indicator Important? 7KHVRFLDOHQYLURQPHQWWKDW\RXWKUHVLGHZLWKLQKDVDVLJQLILFDQWLPSDFWRQVFKRROSHUIRUPDQFHDVZHOODVRQ SK\VLFDODQGPHQWDOKHDOWK6SHFLILFDOO\EXOO\LQJFDQEHDVLJQLILFDQWSUREOHPLQWKHVFKRROHQYLURQPHQWDV\RXWK ZKRDUHEXOOLHGDUHPRUHOLNHO\WRIHHOEDGDERXWWKHPVHOYHVDQGEHGHSUHVVHG7KH\PD\ORVHLQWHUHVWLQJRLQJWR VFKRRODQGFDQHYHQHQJDJHLQHPSOR\GUDVWLFPHDVXUHVVXFKDVFDUU\LQJZHDSRQVXVHYLROHQFHWRH[DFWUHYHQJHRU WU\WRKDUPWKHPVHOYHV.LGVZKREXOO\RWKHUVDUHPRUHOLNHO\WRGURSRXWRIVFKRROKDYHGUXJDQGDOFRKRO SUREOHPVDQGEUHDNWKHODZ[LL What did we learn in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verall Mental Health Indicator DEFINITION 7KLVLQGLFDWRUPHDVXUHVUHVSRQVHVRI\RXWKWRKRZWKH\DVVHVVWKHLURYHUDOOPHQWDOKHDOWK Why Is This Indicator Important? $QRYHUDOOVHOIDVVHVVPHQWRIPHQWDOKHDOWKLVLPSRUWDQWWRPRQLWRUDPRQJ\RXWKWRJDXJHWKHH[WHQWWRZKLFK\RXWK PHQWDOKHDOWKVHUYLFHVRXJKWWREHPDGHDYDLODEOHIRU\RXWKLQVFKRROVWRPDNHWLPHO\LQWHUYHQWLRQV What did we learn in 2014? 2YHUDOOMXVWXQGHUKDOI RI\RXWKZHUHFRQVLGHUHGWREHIORXULVKLQJIURPDPHQWDOKHDOWK SHUVSHFWLYH)HPDOHVWHQGHGWRVFRUHSRRUHUWKDQPDOHVZLWKPRUHIHPDOHV WKDQPDOHV UHSRUWHGWREHODQJXLVKLQJ VHH)LJXUH )LJXUH 0HQWDO+HDOWK&RQWLQXXPE\*HQGHU Languishing Moderate Flourishing 60% 50% 40% 30% 20% 10% 0% Female Male Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ &200881,7<+($/7+$66(660(17 4.7.8. Sun Safety & Youth 4.7.8.1. Use of Artificial Tanning Equipment DEFINITION 7KLVLQGLFDWRUPHDVXUHVUHVSRQVHVWRWDQQLQJEHGXVHE\\RXWK Why Is This Indicator Important? 7KHXVHRIWDQQLQJEHGVLVDFRQFHUQDVDWDQIURPWKHOLJKWVLQDWDQQLQJVDORQZLOOGDPDJHWKHVNLQDQGFDXVHRWKHU DGYHUVHKHDOWKHIIHFWVLQFOXGLQJDQLQFUHDVHGULVNRIVNLQFDQFHUSDUWLFXODUO\IRU\RXQJSHRSOH7KHUHLVQRVDIHZD\ WRJHWDWDQDQGERWK+HDOWK&DQDGDDQGWKH&DQDGLDQ&DQFHU6RFLHW\UHFRPPHQGQRWXVLQJWKHP[LLL What did we learn in 2014? $V)LJXUH VKRZVWDQQLQJHTXLSPHQWXVHLVTXLWHORZDPRQJ\RXWKLQWKH1RUWKHUQ+HDOWK 5HJLRQ)HPDOHLVKLJKHUZLWK SHUFHQWLQGLFDWLQJWKDWWKH\KDYHXVHGWDQQLQJHTXLSPHQWZKLOH RQO\SHUFHQWRIPDOHVKDYH )LJXUH 8VH2I,QGRRU7DQQLQJ(TXLSPHQWE\*HQGHU Yes No 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Female Male Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 4.7.8.2. Use of Sunscreen DEFINITION 7KLVLQGLFDWRUPHDVXUHV\RXWKUHVSRQVHVWRZKHWKHUWKH\XVHVXQVFUHHQDQGKRZIUHTXHQWO\ Why Is This Indicator Important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hat did we learn in 2014? 2YHUDOOXVHRIVXQVFUHHQLVORZZLWKRQO\SHUFHQWRI\RXWKLQGLFDWLQJWKDWWKH\XVHLWRIWHQRU DOZD\V8VHLVKLJKHUDPRQJIHPDOHVSHUFHQWVD\LQJWKH\XVHLWRIWHQRUDOZD\VYHUVXVSHU FHQWIRUPDOHVZKRGR VHH)LJXUH )LJXUH 8VH2I6XQ893URWHFWLRQE\*HQGHU Never/Rarely Often Always 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Female Male Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ &200881,7<+($/7+$66(660(17 )LJXUH 3HUFHQWDJHRI5HVSRQGHQWVE\*UDGHDQG*HQGHU Female Male 30% 25% 20% 15% 10% respondents of % 5% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 25% 20% 15% 10% respondents 5% of % 0% 12or 13 14 15 16 17 18orolder younger 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ )LJXUH3HUFHQWDJHRI5HVSRQGHQWV3URYLGHGE\*UDGH 30% 25% 20% 15% respondents 10% of % 5% 0% Grade7Grade8Grade9Grade10 Grade11 Grade12 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 50% respondents 49% of % 48% female male 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ &200881,7<+($/7+$66(660(17 )LJXUH3HUFHQWDJHRI5HVSRQGHQWVE\6FKRRO 16% 15% 14% 13% 12% 11% 10% 9% 8% 7% 6% respondents of 5% % 4% 3% 2% 1% 0% 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ Allofmylife 94% 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ )LJXUH3HUFHSWLRQRI+HDOWKE\*HQGHU Excellent/VeryGood Good/Fair Poor 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Female Male Overall 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 2timesorless 3Ͳ6times 7ormoretimes Coffee/lattes/icedcoffee Energydrinks Sportsdrinks Dietpop/soda Pop/soda Milk Water 100%fruitjuice 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ &200881,7<+($/7+$66(660(17 )LJXUH6WXGHQW6PRNLQJ6WDWXVE\*UDGH Currentsmoker NonͲsmoker 100% 90% 80% 70% 60% 50% respondents 40% of % 30% 20% 10% 0% Grade9Grade10 Grade11 Grade12 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 90% 80% 70% 60% 50% respondents 40% of % 30% 20% 10% 0% Female Male 6RXUFH 3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ References L&KLHI3URYLQFLDO3XEOLF+HDOWK2IILFHU¶V5HSRUWRQWKH+HDOWK6WDWXVRI0DQLWREDQV3ULRULWLHVIRU3UHYHQWLRQ (YHU\RQH(YHU\3ODFH(YHU\'D\1RYHPEHU LL,ELG LLLKWWS ZZZOXQJFDSURWHFWSURWHJH]WREDFFRWDEDJLVPHVHFRQGVHFRQGDLUHKXUWVQXLWBHSKS LY2IILFHRI1XWULWLRQ3ROLF\DQG3URPRWLRQ+HDOWK3URGXFWVDQG)RRG%UDQFKIncome-Related Household Food Security in Canada2WWDZD Y&DQDGLDQ&DQFHU6RFLHW\µV6WHHULQJ&RPPLWWHHCanadian Cancer Statistics, 20147RURQWR &DQDGLDQ&DQFHU 6RFLHW\ YL3XEOLF+HDOWK$JHQF\RI&DQDGDThe Chief Public Health Officer's Report on the State of Public Health in Canada, YLL2QWDULR0LQLVWU\RI+HDOWKDQG/RQJ7HUP&DUHInitial Report on Public Health$XJXVW YLLL7HUHVD-DQ] 6WDWLVWLFV&DQDGD Current Smoking Trends L[&DQDGLDQ&HQWUHRQ6XEVWDQFH$EXVH Substance Abuse in Canada: Youth in Focus2WWDZD21 &DQDGLDQ&HQWUHRQ6XEVWDQFH$EXVH [$OEHUWD+HDOWK6HUYLFHVHealthy Eating and School Performance: An Evidence Summary, 2012. [L3XEOLF+HDOWK$JHQF\RI&DQDGDThe Chief Public Health Officer's Report on the State of Public Health in Canada, 2011. 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Life Expectancy DEFINITION 7KHQXPEHURI\HDUVDSHUVRQZRXOGEHH[SHFWHGWROLYHVWDUWLQJIURPELUWK IRUOLIHH[SHFWDQF\DWELUWK RQWKH EDVLVRIWKHPRUWDOLW\VWDWLVWLFVIRUDJLYHQREVHUYDWLRQSHULRGW\SLFDOO\DFDOHQGDU\HDU5HSRUWE\DJHDQGVH[ Why Is This Indicator Important? /LIHH[SHFWDQF\LVRQHRIWKHPRVWZLGHO\XVHGLQGLFDWRUVRIWKHKHDOWKRIDSRSXODWLRQDQGWKHRYHUDOOHIIHFWLYHQHVV RILWVKHDOWKFDUHV\VWHP,WLVLPSRUWDQWWRQRWHWKDWWKLVPHDVXUHVTXDQWLW\QRWTXDOLW\RIOLIH What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQKDGWKHORZHVWOLIHH[SHFWDQF\IRUERWKPHQ \HDUV DQGZRPHQ \HDUV DPRQJDOOUHJLRQVLQ0DQLWRED7KHUHZDVDOVRDGHFOLQHLQOLIHH[SHFWDQF\EHWZHHQ DQGZKLFKZDVRQO\VHHQLQDIHZUHJLRQV 7KHIRUPHU1250$15HJLRQUHSRUWHGDOLIHH[SHFWDQF\EHORZWKHSURYLQFLDODYHUDJH0DOHV H[SHULHQFHGDQLQFUHDVHLQOLIHH[SHFWDQF\ IURP \HDUVLQ WR\HDUVLQ ZKLOHIHPDOHVH[SHULHQFHGDGHFUHDVH IURP \HDUVLQ WR\HDUVLQ What did we learn in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Ͳ2006 2007Ͳ2011 LinearManitoba(Manitobaaverageaverage2002Ͳ20022006Ͳ2006) LinearManitoba(Manitobaaverageaverage2007Ͳ20112007Ͳ2011) Northern(1,2) InterlakeͲEastern PrairieMountain(t) Winnipeg(1,2,t) Southern(1,2,t) ͺ Ͳ ʹ Ͷ ͺ ͺͲ LifeExpectancy 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH0DOH/LIH([SHFWDQF\DW%LUWKE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2002Ͳ2006 2007Ͳ2011 LinearNorthern(Northernaverageaverage2002Ͳ20022006Ͳ2006) LinearNorthern(Northernaverageaverage2007Ͳ20072011Ͳ2011) NelsonHouse/NCN(1,2) Sham,YorkFN,Tat(SPL)(1,2) Bu(OH),MS(GR),GLN/GLFN(1,2) Puk/MatColCN(2) LL/MC,LR,OͲP(SIL),PN(GVL)(1) ThePas/OCN,Kelsey(2) Thompson,MysteryLake Gillam,FoxLakeCN NorthernIslandLakeZone(1,2) NorthernDirectServiceZone(1,2) 0 20406080100 Life Expectancy 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH)HPDOH/LIH([SHFWDQF\DWELUWKDQG 2002Ͳ2006 2007Ͳ2011 LinearManitoba(Manitobaaverageaverage2002Ͳ20022006Ͳ2006) LinearManitoba(Manitobaaverageaverage20072007Ͳ 2011Ͳ2011) Northern(1,2) InterlakeͲEastern PrairieMountain(1) Winnipeg(2,t) Southern(1,2,t) 72 74 76 78 80 82 84 86 LifeExpectancy 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH/LIH([SHFWDQF\DW%LUWKIRU)HPDOHE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2002Ͳ2006 2007Ͳ2011 LinearNorthern(Northernaverageaverage2002Ͳ20022006Ͳ2006) LinearNorthern(Northernaverageaverage2007Ͳ20072011Ͳ2011) NelsonHouse/NCN(1,2) NorwayHouse/NHCN(1,2) GR/Mis,ML/Mos,Eas/Che(1,2) Gillam,FoxLakeCN(1) BayLine Bu(OH),MS(GR),GLN/GLFN Puk/MatColCN SayD(TL),Bro/BL,NoL(Lac) NorthernIslandLakeZone(1,2) NorthernDirectServiceZone(1,2) 0 20406080100 LifeExpectancy 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD &200881,7<+($/7+$66(660(17 5.3. Self-Rated Health 5.3.1. Self-Rated Physical Health DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSHUFHQWDJH RIWKHSRSXODWLRQDJHDQGRYHUZKRUHSRUWWKDWWKHLUKHDOWKLV H[FHOOHQWYHU\JRRGJRRGRUIDLUSRRU Why Is This Indicator Important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hat did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQVDZDGRZQZDUGWUHQGLQWKRVHZKRUHSRUWHGH[FHOOHQWYHU\JRRGRU JRRGSK\VLFDOKHDOWK IURPSHUFHQWLQWRSHUFHQWLQ ,QWKHVDPHWLPHWKH SURYLQFLDOUDWHDOVRGHFOLQHGIURP SHUFHQWWRSHUFHQW ,Q SHUFHQWRIIRUPHU1250$15HJLRQUHVLGHQWVUHSRUWHGSRVLWLYHKHDOWKVWDWXV7KLV ZDVORZHUWKDQWKHSURYLQFLDODYHUDJHRISHUFHQW What did we learn in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xcellent VeryGood Good Fair/Poor Northern InterlakeͲEastern PrairieMountain Southern Winnipeg Manitoba 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV )LJXUH6HOI3HUFHLYHG+HDOWKE\1RUWKHUQ'LVWULFWDQG=RQH Excellent VeryGood Good Fair/Poor NelsonHouse/NCN(s) IslandLake(s) NorwayHouse/NHCN(s) GR/Mis,ML/Mos,Eas/Che(s) SayD(TL),Bro/BL,NoL(Lac)(s) CrossLake/PimiCN(s) LL/MC,LR,OͲP(SIL),PN(GVL)(s) BayLine(s) Gillam,FoxLakeCN(s) Flin,Snow,Cran,Sher ThePas/OCN,Kelsey Thompson,MysteryLake NorthernIslandLakeZone(s) NorthernNonͲDirectServiceZone(s) NorthernDirectServiceZone Northern 0% 20% 40% 60% 80% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV &200881,7<+($/7+$66(660(17 5.3.2. Self-Rated Health among Youth DEFINITION 7KHSHUFHQWDJHRIVWXGHQWVZKRUHSRUWLQWKH What did we learn in 2014? $FFRUGLQJWRWKH )LJXUH Excellent/VeryGood Good/Fair Poor 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Female Male Overall 6RXUFH &DQFHU&DUH0DQLWRED3DUWQHUVLQ3ODQQLQJIRU+HDOWK\/LYLQJ 5.3.3. General Mental Health Scale DEFINITION 7KHJHQHUDOPHQWDOKHDOWKVFDOHLVDGHULYHGPHDVXUHIURPWKH6)TXHVWLRQQDLUHDGGUHVVLQJRYHUDOOPHQWDOKHDOWK RQDVFDOHRIWR KLJKHULVEHWWHU Why Is This Indicator Important? 7KLVLVDQLPSRUWDQWLQGLFDWRUDVLWFDQSURYLGHPRUHFRQVLVWHQWLQIRUPDWLRQDERXWDUHJLRQ¶VKHDOWKVWDWXVWKDQPRUH WUDGLWLRQDOKHDOWKVWDWXVLQGLFDWRUVOLNHLQFRPHRUHGXFDWLRQDWWDLQPHQWLQVRPHLQVWDQFHV,WLVLPSRUWDQWWRQRWH WKDWWKLVLQGLFDWRUFRPHVIURPWKH&DQDGLDQ&RPPXQLW\+HDOWK6XUYH\ZKLFKGRHVQRWLQFOXGH)LUVW1DWLRQV FRPPXQLWLHV What did we learn in 2009? )RUPHU%XUQWZRRG5HJLRQUHVLGHQWVKDGDQDYHUDJHVFRUHRIVOLJKWO\DERYHWKHSURYLQFLDO DYHUDJH+RZHYHUPXFKRIWKHGDWDZDVVXSSUHVVHGGXHWRORZSRSXODWLRQDQGGRHVQRWLQFOXGH)LUVW 1DWLRQVFRPPXQLWLHV 5HVLGHQWVRIWKHIRUPHU1250$15HJLRQKDGWKHKLJKHVWDYHUDJHVFRUHDW7KHUHZDVD QRWDEOHGLIIHUHQFHEHWZHHQPDOHVDQGIHPDOHVLQWKLVUHJLRQZLWKPDOHVUHSRUWLQJEHWWHUPHQWDO KHDOWKE\DFRQVLGHUDEOHPDUJLQZLWKPXFKORZHUUDWHVRISRRUPHQWDOKHDOWKDPRQJPDOHV WKDQIHPDOHV What did we learn in 2014? ,QWKHJHQHUDOPHQWDOKHDOWKVFDOHRI SHUFHQWRI1RUWKHUQ+HDOWK5HJLRQUHVLGHQWV VFRUHGµKLJK¶RQWKHPHQWDOKHDOWKVFDOHZKLFKLVDERYHWKHSURYLQFLDODYHUDJHRI SHUFHQW VHH )LJXUH $V)LJXUH VKRZVDPRQJWKH1RUWKHUQ+HDOWK5HJLRQFRPPXQLWLHVPXFKRIWKHGDWDZDV VXSSUHVVHGGXHWRORZQXPEHUV,QWKH*LOODP)R[/DNH&1DUHD SHUFHQWVFRUHGORZRQWKH PHQWDOKHDOWKVFDOHZKLFKZDVFRQVLGHUDEO\RYHUWKHUHJLRQDODYHUDJHRISHUFHQW WHAT DO WE KNOW? 7KH1RUWKHUQ&RPPXQLW\6XUYH\LQWKH6XPPHU)DOOIRXQGWKDWSHUFHQWRIUHVSRQGHQWVUDWHG WKHLUPHQWDOKHDOWKDVHLWKHUJRRGYHU\JRRGRUH[FHOOHQW &200881,7<+($/7+$66(660(17 )LJXUH*HQHUDO0HQWDO+HDOWK6FDOHE\5+$ High(92Ͳ100) Medium(80Ͳ91) Low(0Ͳ79) Winnipeg InterlakeͲEastern Southern PrairieMountain Northern Manitoba 0% 20% 40% 60% 80% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV )LJXUH *HQHUDO0HQWDO+HDOWK6FDOHE\1RUWKHUQ'LVWULFWDQG=RQH High(92Ͳ100) Medium(80Ͳ91) Low(0Ͳ79) NelsonHouse/NCN(s) IslandLake(s) NorwayHouse/NHCN(s) SayD(TL),Bro/BL,NoL(Lac)(s) CrossLake/PimiCN(s) LL/MC,LR,OͲP(SIL),PN(GVL)(s) Flin,Snow,Cran,Sher Thompson,MysteryLake Gillam,FoxLakeCN ThePas/OCN,Kelsey BayLine(s) GR/Mis,ML/Mos,Eas/Che(s) NorthernIslandLakeZone(s) NorthernNonͲDirectServiceZone(s) NorthernDirectServiceZone Northern 0% 20% 40% 60% 80% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV 5.3.4. Physical Functioning Scale DEFINITION 7KLVLQGLFDWRUUHIHUVWRWKHSURSRUWLRQRIWKHSRSXODWLRQDJHDQGRYHUZLWKDVFRUHRISHUFHQWRQWKH3K\VLFDO )XQFWLRQLQJ6FDOHRIWKH6)LQ Why Is This Indicator Important? 7KLVLVDKHDOWKXWLOLW\LQGH[WKDWXVHVHLJKWGLPHQVLRQVRIIXQFWLRQLQJ YLVLRQKHDULQJVSHHFKPRELOLW\GH[WHULW\ IHHOLQJVFRJQLWLRQDQGSDLQ WRFUHDWHDGHVFULSWLRQRIDQLQGLYLGXDO¶VRYHUDOOKHDOWKVWDWXV ,WLVLPSRUWDQWWRQRWHWKDWWKLVLQGLFDWRUFRPHVIURPWKH&DQDGLDQ&RPPXQLW\+HDOWK6XUYH\ZKLFKGRHVQRW LQFOXGH)LUVW1DWLRQVFRPPXQLWLHV What did we learn in 2009? $SSUR[LPDWHO\RQHKDOI RIIRUPHU%XUQWZRRG5HJLRQUHVLGHQWVQRWOLYLQJLQ)LUVW1DWLRQV FRPPXQLWLHVKDGSHUIHFWVFRUHV7KLVZDVORZHUWKDQWKHSURYLQFLDODYHUDJHRISHUFHQW 5DWHVLQWKHIRUPHU1250$15HJLRQZHUHEHWWHUDW SHUFHQWZKLFKZDVKLJKHUWKDQWKH SURYLQFLDODYHUDJH What did we learn in 2014? 2QWKH 3K\VLFDO)XQFWLRQLQJVFDOHSHUFHQWRI1RUWKHUQ+HDOWK5HJLRQUHVLGHQWVKDG SHUIHFWSK\VLFDOIXQFWLRQLQJZKLFKLVHTXDOWRWKDWRIWKHSURYLQFLDODYHUDJH VHH)LJXUH $PRQJWKH1RUWKHUQ+HDOWK5HJLRQ]RQHVWKH1RUWKHUQ'LUHFW6HUYLFH]RQHKDGWKHKLJKHVWSHUIHFW SK\VLFDOIXQFWLRQLQJUDWHRISHUFHQW VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH3K\VLFDO)XQFWLRQLQJ6FDOHE\5+$ PerfectPhysicalFunctioning LessthanPerfectPhysicalFunctioning InterlakeͲEastern Winnipeg Northern PrairieMountain Southern Manitoba 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV )LJXUH3K\VLFDO)XQFWLRQLQJE\1RUWKHUQ'LVWULFWDQG=RQH PerfectPhysicalFunctioning LessthanPerfectPhysicalFunctioning NelsonHouse/NCN(s) IslandLake(s) NorwayHouse/NHCN(s) SayD(TL),Bro/BL,NoL(Lac)(s) CrossLake/PimiCN(s) BayLine Gillam,FoxLakeCN ThePas/OCN,Kelsey Thompson,MysteryLake LL/MC,LR,OͲP(SIL),PN(GVL) Flin,Snow,Cran,Sher GR/Mis,ML/Mos,Eas/Che(s) NorthernIslandLakeZone(s) NorthernNonͲDirectServiceZone NorthernDirectServiceZone Northern 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV 5.4. Infant and Child Health ,QIDQW DQG FKLOGKHDOWK DUH LPSRUWDQW SULRULWLHV DV D QXPEHURI VLJQLILFDQW LQHTXDOLWLHV FDQGHYHORSULJKW DW ELUWK ZKLFKFDQFRQWLQXHWRDIIHFWWKHLUKHDOWKVWDWXVZHOOLQWRDGXOWKRRG6RPHJURXSVRIFKLOGUHQDUHPRUHOLNHO\WREH LQMXUHGDQGRUH[SHULHQFHSK\VLFDODQGPHQWDOKHDOWKFKDOOHQJHV:LWKHIIHFWLYHLQWHUYHQWLRQVPDQ\DGYHUVHKHDOWK RXWFRPHVIRUFKLOGUHQFDQEHSUHYHQWHG,WGRHVUHTXLUHDFWLRQRQDQXPEHUIURQWVEH\RQGWKHKHDOWKFDUHV\VWHP JLYHQWKDWKHDOWKVWDWXVRI\RXQJSHRSOHLQ&DQDGDLVLQIOXHQFHGE\DZLGHUDQJHRIVRFLDOFXOWXUDOSK\VLFDODQG HFRQRPLFIDFWRUV &KLOGDQGLQIDQWKHDOWKZDVLGHQWLILHGDVDNH\KHDOWKFKDOOHQJHLQDQXPEHURI1RUWKHUQFRPPXQLWLHVGXULQJIRFXV JURXSGLVFXVVLRQVLQ3DUWLFLSDQWVQRWHGWKHKLJKELUWKUDWHVLQWKHLUFRPPXQLW\DORQJZLWKDQXPEHURIFKLOG KHDOWKFRQGLWLRQVWKH\ZHUHHQFRXQWHULQJVXFKDV$'+'DXWLVPUHVSLUDWRU\LOOQHVVDQG)$6'$VRQHSDUWLFLSDQW QRWHG“These things [child health conditions] are burdening our health care and education system and we have no supports to do anything.” &200881,7<+($/7+$66(660(17 5.4.1. Birth Rate DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHQXPEHURIELUWKVLQDQDUHDDVDUDWHRIZRPHQ Why Is This Indicator Important? %LUWKUDWHLQIRUPDWLRQFDQSURYLGHLPSRUWDQWLQIRUPDWLRQDERXWWKHDJHVWUXFWXUHRIDUHJLRQDV\RXQJHUZRPHQWHQG WRKDYHPRUHELUWKVWKDQROGHURQHV,WFDQDOVRSURYLGHLPSRUWDQWSODQQLQJLQIRUPDWLRQDERXWWKHUHVRXUFHVQHHGHG WRDGGUHVVPDWHUQDODQGFKLOGKHDOWKQHHGVJRLQJIRUZDUG What did we learn in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ȋȌManitobaaverage Winnipeg InterlakeͲEastern PrairieMountain Southern Northern 0 5 10 15 20 25 Rateper1,000 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW 127( 1RUWKHUQDQG6RXWKHUQKDYHVWDWLVWLFDOO\KLJKHUWKDQDYHUDJHUDWH,QWHUODNH(DVWHUQDQG:LQQLSHJKDYHVWDWLVWLFDOO\ORZHUWKDQDYHUDJH UDWH )LJXUH%LUWK5DWHE\1RUWKHUQ'LVWULFWDQG=RQH ȋȌNorthern average ThePas/OCN/Kelsey* BayLine* Lynn/MCFN/Leaf/OͲPFN(SIL)/PNFN(Granville)* SayisiDene/Tadoule/Barren… FlinFlon/SnowLake/Cranberry/Sherridon* Thompson/MysteryLake* Gillam/FoxLakeCN GR/MisipawistikCN/ML/MosakahikenCN/Eas/Chema ShamattawaFN/YorkFactoryFN/Tataskweyak… NorwayHouse/NorwayHouseCN* Bunibonibee/OxfordHouse/MantoSipi/God'sRiver/G* CrossLake/PimicikamakCN* IslandLake* NelsonHouse/NisichawayasihkCreeNation* Pukatawagan/MathiasColombCN* 0 1020304050 Rateper1,000 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW 127( µ ¶LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP1RUWKHUQDYHUDJH &200881,7<+($/7+$66(660(17 )LJXUH%LUWK5DWHE\ Northern Manitoba 30 25 20 15 1,000 per 10 Rate 5 0 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW 5.4.2. Teen Birth Rate DEFINITION 7KHWHHQELUWKUDWHLQGLFDWRUPHDVXUHVWKHQXPEHURIELUWKVIURPWHHQDJHPRWKHUVDJHG \HDUVSHU IHPDOHVLQWKLVDJHJURXS Why Is This Indicator Important? 9HU\VLPLODUWRWHHQSUHJQDQF\UDWHWHHQELUWKUDWHVDUHDFRQFHUQEHFDXVHRIWKHLQFUHDVHGULVNVRIEDELHVERUQWR WHHQPRWKHUVLQFOXGLQJORZELUWKUDWHGHDWKGXULQJLQIDQF\DQGSUHWHUPELUWK7KHUHDUHDOVRVWURQJHFRQRPLF FRQVHTXHQFHVVLQFHWHHQDJHPRWKHUVDUHPRUHOLNHO\WRGURSRXWRIVFKRRODQGVXIIHUIURPIHZHUHFRQRPLF RSSRUWXQLWLHV7HHQDJHPRWKHUVEHWZHHQWKHDJHVRIDUHDOVRPRUHOLNHO\WREHVLQJOHSDUHQWVUHVXOWLQJLQQR KRXVHKROGLQFRPHWRSURYLGHVXSSRUW What did we learn in 2009? :KLOHWKHWHHQELUWKUDWHLQWKHIRUPHU%XUQWZRRGUHJLRQGHFUHDVHGIURP LQ WRSHUZRPHQLQWKHUDWHUHPDLQHGVLJQLILFDQWO\KLJKHUWKDQWKH 0DQLWREDDYHUDJHRILQ 7KHIRUPHU1250$1UHJLRQH[SHULHQFHGDQLQFUHDVHLQWHHQELUWKUDWHVIURPWR SHU SRSXODWLRQEHWZHHQWKHWZRWLPHSHULRGV What did we learn in 2014? 7KHWHHQELUWKUDWHLQWKH1RUWKHUQ+HDOWK5HJLRQLQZDVSHUSRSXODWLRQPRUH WKDQWKUHHWLPHVWKH0DQLWREDDYHUDJHRI VHH)LJXUH $V)LJXUHLOOXVWUDWHV,VODQG/DNHKDGWKHKLJKHVWWHHQELUWKUDWHDPRQJ1RUWKHUQ+HDOWK5HJLRQ GLVWULFWVLQZLWKDUDWHWKDWLVVWDWLVWLFDOO\KLJKHUWKDQWKH1RUWKHUQDYHUDJH%RWKWKH%D\OLQH FRPPXQLWLHVDQG7KRPSVRQKDGUDWHVVWDWLVWLFDOO\EHORZWKHUHJLRQDODYHUDJH 7KH1RUWKHUQ+HDOWK5HJLRQH[SHULHQFHGDGHFOLQHLQWHHQELUWKUDWHVIURPSHUWHHQVLQ WRSHULQ VHH)LJXUH 7DEOHSUHVHQWVGLIIHUHQFHVLQWHHQELUWKUDWHVZLWKLQWKHUHJLRQ$OWKRXJKWKHUHJLRQDOUDWH UHPDLQVPXFKKLJKHUWKDQWKHSURYLQFLDOUDWHWKLVWDEOHVKRZVWKHGLIIHUHQFHVEHWZHHQRXUGLUHFW VHUYLFHFRPPXQLWLHVDQG)LUVW1DWLRQVFRPPXQLWLHVZKHUHZHGRQRWSURYLGHGLUHFWVHUYLFHV:KLOH WKHWHHQELUWKUDWHLVORZHULQRXUGLUHFWVHUYLFHFRPPXQLWLHVWKHUDWHLVDFWXDOO\LQFUHDVLQJRYHUWLPH ZKLOHWKHRSSRVLWHLVWUXHIRURXU)LUVW1DWLRQFRPPXQLWLHV &200881,7<+($/7+$66(660(17 )LJXUH7HHQ%LUWK5DWHE\5+$ LinearManitoba(Manitoba)average Winnipeg* Southern InterlakeͲEastern PrairieMountain Northern 0 1020304050 Ratesper1,000femalesage15to19 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW6SHFLDO'DWD5XQ 127( µ ¶LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH )LJXUH7HHQ%LUWK5DWHE\1RUWKHUQ'LVWULFW ȋȌNorthern average BayLine* ThePas/OCN/Kelsey* Lynn/MCFN/Leaf/OͲPFN(SIL)/PNFN… Gillam/FoxLakeCN Thompson/MysteryLake* FlinFlon/SnowLake/Cranberry/Sherridon* SayisiDene/Tadoule/Barren… Pukatawagan/MathiasColombCN CrossLake/PimicikamakCN ShamattawaFN/YorkFactoryFN/Tataskweyak… Bunibonibee/OxfordHouse/MantoSipi/God's… NorwayHouse/NorwayHouseCN GR/MisipawistikCN/ML/Mosakahiken… NelsonHouse/NisichawayasihkCreeNation IslandLake* 0 50 100 150 200 Rateper1,000 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW6SHFLDO'DWD5XQ 127( µ ¶LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP1RUWKHUQDYHUDJH 7DEOH7HHQ%LUWKVE\ AreaofResidence Count Rate Count Rate Count Rate Northern 347 51.1 309 46.3 282 43.1 NorthernDirectServiceZone 83 27.6 83 26.9 98 32.2 NorthernNonͲDirectServiceZone 185 62.0 165 58.6 130 47.5 NorthernIslandLakeZone 79 99.6 61 78.4 54 71.2 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW6SHFLDO'DWD5XQ )LJXUH7HHQ%LUWK5DWHE\ Manitoba Northern 60 50 19 to 15 40 age 30 females 20 1,000 10 per Rates 0 2010/11 2011/12 2012/13 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW6SHFLDO'DWD5XQ &200881,7<+($/7+$66(660(17 5.4.3. Preterm Birth Rate DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHQXPEHURIOLYHLQIDQWVERUQSULRUWRZHHNVJHVWDWLRQH[SUHVVHGDVDSHUFHQWDJHRIDOO OLYHELUWKV ZHHNVJHVWDWLRQLVFRQVLGHUHG IXOOWHUP Why Is This Indicator Important? 3UHWHUPELUWKVDUHWKHOHDGLQJFDXVHRI&DQDGLDQLQIDQWPRUWDOLW\DFFRXQWLQJIRUSHUFHQWRIGHDWKVLQWKH SHULQDWDOSHULRG WKHWLPHULJKWEHIRUHDQGDIWHUELUWK 7KH\DUHUHVSRQVLEOHIRUDZLGHYDULHW\RIKHDOWKLVVXHVLQWKHORQJDQGVKRUWWHUPLQFOXGLQJVORZHUEUDLQ GHYHORSPHQWPHQWDOKHDOWKLOOQHVVHVDQGUHVSLUDWRU\FRQGLWLRQV7KHVHFDQH[LVWLQWRDGXOWKRRGDQGFRQWULEXWHWR LQFUHDVHGKHDOWKFDUHFRVWV What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQLGHQWLILHGWKLVDVDNH\DUHDWRIRFXVLQFKLOGKHDOWKDVUDWHVRISUHWHUP ELUWKV ZHUHDPRQJWKHKLJKHVWLQ0DQLWREDDQGZHUHLQFUHDVLQJRYHUWLPH IURPLQ WRLQ 7KHIRUPHU1250$15HJLRQUHSRUWHGUDWHVORZHU WKDQWKHSURYLQFLDODYHUDJH WKRXJKLQFUHDVHVZHUHEHLQJVHHQRYHUWLPH What did we learn in 2014? ,QWKH1RUWKHUQ+HDOWK5HJLRQUHFRUGHGDSUHWHUPELUWKUDWHRI SHUFHQWDERYHWKH SURYLQFLDODYHUDJHRISHUFHQW,WZDVWKHKLJKHVWUDWHDPRQJ0DQLWRED5+$V VHH)LJXUH EXWZDVQRWVWDWLVWLFDOO\KLJKHUWKDQWKHSURYLQFLDODYHUDJH )LJXUH3UHWHUP%LUWK5DWHE\5+$ ȋȌManitobaaverage Southern* InterlakeͲEastern Winnipeg PrairieMountain Northern 0% 2% 4% 6% 8% 10% PerCent 6RXUFH 5HSRUW&%&DQDGLDQ,QVWLWXWHIRU+HDOWK,QIRUPDWLRQ 127( µ ¶LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH 5.4.4. Low Birth Weight Rate DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSHUFHQWDJHRIOLYHLQIDQWVERUQZHLJKLQJOHVVWKDQJUDPVWRWKHQXPEHURIELUWKV ELUWKZHLJKWNQRZQDQGJUHDWHUWKDQJUDPV Why Is This Indicator Important? 7KLVLVDQLPSRUWDQWLQGLFDWRURILQIDQWKHDOWKGHYHORSPHQWDQGVXUYLYDODVORZELUWKZHLJKWLQIDQWVDUHPRUHOLNHO\ WRVXIIHUIURPGLVDELOLW\RUGLVHDVHLQFOXGLQJYLVXDOSUREOHPVUHVSLUDWRU\SUREOHPVOHDUQLQJGLVDELOLWLHVDQG FHUHEUDOSDOV\ What did we learn in 2009? 7KHUDWHRIORZELUWKZHLJKW /%: LQIDQWVLQWKHIRUPHU1250$15HJLRQ ZDVVLPLODUWR WKHSURYLQFLDODYHUDJH ZKHQYLHZHGRYHU\HDUV $OWKRXJKDFWXDOQXPEHUVRIORZELUWKZHLJKWLQIDQWVDUHUHODWLYHO\VPDOOWKH/%:UDWHLQWKHIRUPHU %XUQWZRRG5HJLRQZDVDPRQJWKHKLJKHVWLQWKHSURYLQFHDQGKDVEHHQFRQVLVWHQWO\KLJKHUWKDQWKH SURYLQFLDODYHUDJH RYHU\HDUV WKRXJKLWZDVVWDWLVWLFDOO\LQVLJQLILFDQW What did we learn in 2014? 7KHSURSRUWLRQRIORZELUWKZHLJKWLQIDQWVLQWKH1RUWKHUQ+HDOWK5HJLRQZDVSHUFHQWLQ WKHKLJKHVWDPRQJ0DQLWRED5+$VDERYHWKHSURYLQFLDODYHUDJHRISHUFHQW VHH )LJXUH +RZHYHUWKLVGLIIHUHQFHLVQRWVWDWLVWLFDOO\VLJQLILFDQW $V)LJXUHVKRZVWKHORZELUWKZHLJKWUDWHURVHVOLJKWO\LQWKH1RUWKHUQ+HDOWK5HJLRQIURP SHUOLYHLQIDQWVLQWRLQ7KH0DQLWREDDYHUDJHZDV 7KHORZELUWKZHLJKWUDWHIOXFWXDWHG\HDUO\EHWZHHQDQGLQWKH1RUWKHUQ+HDOWK 5HJLRQIURPSHUFHQWLQWRSHUFHQWLQ VHH)LJXUH $PRQJ1RUWKHUQ+HDOWK5HJLRQ]RQHVORZELUWKZHLJKWUDWHVKDGVWDWLVWLFDOO\VLJQLILFDQWLQFUHDVHVLQ ,VODQG/DNHDQG)OLQ)ORQ6QRZ/DNHIURPWR6KDPDWWDZD H[SHULHQFHGDVWDWLVWLFDOO\VLJQLILFDQWGHFUHDVHRYHUWKRVHWZRWLPHSHULRGV1HOVRQ+RXVH)1KDG WKHKLJKHVWUDWHLQWKH1RUWKHUQ+HDOWK5HJLRQDW SHUOLYHLQIDQWV VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH /RZ%LUWK:HLJKW5DWHE\5+$ LinearManitoba(Manitobaaverageaverage) Southern InterlakeͲEastern PrairieMountain Winnipeg Northern 0% 1% 2% 3% 4% 5% 6% 7% PerCentoflivebirths 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW 127( 6RXWKHUQKDVVWDWLVWLFDOO\ORZHUWKDQDYHUDJHUDWH )LJXUH$QQXDO/RZ%LUWK:HLJKW5DWHVE\5+$DQG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 LinearManitoba(Manitoba averageaverage 2002/032002/03Ͳ 2006/07Ͳ2006/07) LinearManitoba(Manitobaaverageaverage2007/082007/08Ͳ 2011/12Ͳ2011/12) Southern(1,2) PrairieMountain(1,2) InterlakeͲEastern Northern Winnipeg(1,2) 01234567 Rateper100liveinfants 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH$QQXDO/RZ%LUWK:HLJKW5DWHVE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 LinearNorthern(Northernaverageaverage2002/032002/03Ͳ 2006/07Ͳ2006/07) LinearNorthern(Northernaverageaverage2007/082007/08Ͳ 2011/12Ͳ2011/12) Sham,YorkFN,Tat(SPL)(t) NorwayHouse/NHCN Bu(OH),MS(GR),GLN/GLFN(t) GR/Mis,ML/Mos,Eas/Che Flin,Snow,Cran,Sher(t) ThePas/OCN,Kelsey CrossLake/PimiCN Thompson,MysteryLake IslandLake(t) Puk/MatColCN LL/MC,LR,OͲP(SIL),PN(GVL) NelsonHouse/NCN(1,2) SayD(TL),Bro/BL,NoL(Lac)(s) BayLine(s) Gillam,FoxLakeCN(s) NorthernNonͲDirectServiceZone NorthernDirectServiceZone NorthernIslandLakeZone(t) 0246810 Rateper100liveinfants 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV &200881,7<+($/7+$66(660(17 )LJXUH/RZ%LUWK:HLJKW5DWHE\1RUWKHUQ'LVWULFWDQG=RQH NorthernȋȌaverage ShamattawaFN/YorkFactoryFN/Tataskweyak… BayLine Gillam/FoxLakeCN Pukatawagan/MathiasColombCN NorwayHouse/NorwayHouseCN SayisiDene/Tadoule/Barren… ThePas/OCN/Kelsey FlinFlon/SnowLake/Cranberry/Sherridon Thompson/MysteryLake GR/MisipawistikCN/ML/Mosakahiken… Bunibonibee/OxfordHouse/MantoSipi/God's… CrossLake/PimicikamakCN Lynn/MCFN/Leaf/OͲPFN(SIL)/PNFN(Granville) NelsonHouse/NisichawayasihkCreeNation IslandLake 0% 2% 4% 6% 8% 10% 12% PerCentoflivebirths 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW 127( µ ¶LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP1RUWKHUQDYHUDJH )LJXUH/RZ%LUWK:HLJKW5DWHE\ Northern Manitoba 7% 6% 5% births 4% live of 3% Cent 2% Per 1% 0% 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW 5.4.5. High Birth Weight Rate DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIOLYHLQIDQWVERUQZKRDUHRYHUJUDPVLQZHLJKWDWELUWK Why Is This Indicator Important? +%:LQIDQWVDUHPRUHOLNHO\WRGHYHORS7\SH'LDEHWHVDQGDUHDWDJUHDWHUULVNRILQIDQWPRUWDOLW\WKDQQRUPDO ZHLJKWLQIDQWV,WLVDOVRWLHGWRPXFKKLJKHUUDWHVRIJHVWDWLRQDOGLDEHWHVL What did we learn in 2009? 5DWHVRI+%:LQIDQWVLQWKHIRUPHU%XUQWZRRG5HJLRQGHFOLQHGVOLJKWO\IURPSHUFHQWLQ WR SHUFHQWLQ+RZHYHUWKHUDWHUHPDLQHGDERYHWKHSURYLQFLDODYHUDJHRI DSSUR[LPDWHO\SHUFHQW 6LPLODUO\LQWKHIRUPHU1250$15HJLRQDOWKRXJKWKHUHZDVDGHFOLQHLQ+%:LQIDQWVIURP SHUFHQWWRSHUFHQWWKHUDWHDOVRUHPDLQHGDERYHWKH0DQLWREDDYHUDJH What did we learn in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inearManitoba(Manitobaaverageaverage) Winnipeg PrairieMountain Southern Northern InterlakeͲEastern 0% 5% 10% 15% 20% PerCentoflivebirths 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW 127( :LQQLSHJKDVVWDWLVWLFDOO\ORZHUWKDQDYHUDJHUDWH,QWHUODNH(DVWHUQDQG1RUWKHUQKDYHVWDWLVWLFDOO\KLJKHUWKDQDYHUDJHUDWH )LJXUH+LJK%LUWK:HLJKWE\1RUWKHUQ'LVWULFWDQG=RQH ȋȌNorthernaverage Lynn/MCFN/Leaf/OͲPFN… SayisiDene/Tadoule/Barren… CrossLake/PimicikamakCN* NelsonHouse/Nisichawayasihk… Thompson/MysteryLake ShamattawaFN/YorkFactory… IslandLake ThePas/OCN/Kelsey Bunibonibee/Oxford… FlinFlon/Snow… Pukatawagan/MathiasColomb… GR/Misipawistik… NorwayHouse/NorwayHouse… BayLine Gillam/FoxLakeCN 0% 5% 10% 15% 20% 25% 30% PerCentoflivebirths 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW 127( µ ¶LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP1RUWKHUQDYHUDJH )LJXUH+LJK%LUWK:HLJKWE\ Northern Manitoba 25% 20% 15% births live 10% of Cent 5% Per 0% 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW &200881,7<+($/7+$66(660(17 5.4.6. Large for Gestational Age (LGA) DEFINITION 7KLVLQGLFDWRULVFDOFXODWHGE\LQFOXGLQJLQIDQWVODUJHIRUSUHWHUPODUJHIRUWHUPDQGODUJHIRUSRVWWHUPELUWKVLQWKH QXPHUDWRUDQGWRWDOOLYHERUQGHOLYHULHVLQWKHGHQRPLQDWRU7RSURYLGHDQLQGLFDWLRQRIWKHVL]HRIWKHVHEDELHVLQ WKHDYHUDJHELUWKZHLJKWIRU0DQLWREDQHZERUQVZDVSRXQGVDQGIRU/*$ZDV SRXQGV Why Is This Indicator Important? 7KLVLQGLFDWRULVEDVHGRQWKHHVWLPDWHGJHVWDWLRQDODJHRIDEDE\$QLQIDQWZKRLV/*$KDVDKLJKHUULVNIRULQMXU\ GXULQJELUWKDQGORZEORRGVXJDUSRVWELUWK/*$LQIDQWVDUHDOVRWLHGWRSURORQJHGSUHJQDQFLHVDQGJHVWDWLRQDO GLDEHWHVLL What did we learn in 2014? 7KHSURSRUWLRQRI/*$LQIDQWVZDVSHUFHQWLQWKH1RUWKHUQ+HDOWK5HJLRQLQZHOO DERYHWKH0DQLWREDDYHUDJHRISHUFHQW VHH)LJXUH 7KLVGLIIHUHQFHLVVWDWLVWLFDOO\ VLJQLILFDQW )LJXUH/DUJH)RU*HVWDWLRQDO$JHE\5+$ ȋȌManitobaaverage Winnipeg Southern PrairieMountain InterlakeͲEastern Northern 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20% PerCent 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW 127( :LQQLSHJKDVVWDWLVWLFDOO\ORZHUWKDQDYHUDJHUDWH,QWHUODNH(DVWHUQDQG1RUWKHUQKDYHVWDWLVWLFDOO\KLJKHUWKDQDYHUDJHUDWH 5.4.7. Small for Gestational Age (SGA) DEFINITION 5DWHVIRU6PDOOIRU*HVWDWLRQDO$JH 6*$ DUHFDOFXODWHGE\WDNLQJDOOOLYH±ERUQVPDOOIRUSUHWHUPVPDOOIRUWHUP DQGVPDOOIRUSRVWWHUPELUWKVDQGGLYLGLQJE\WKHWRWDOQXPEHURIOLYH±ERUQGHOLYHULHV7RSURYLGHDQLQGLFDWLRQRI WKHVL]HRIWKHVHEDELHVLQWKHDYHUDJHELUWKZHLJKWIRU0DQLWREDQHZERUQVZDVSRXQGVDQG IRU6*$ZDVSRXQGV Why Is This Indicator Important? $QLQIDQWZKRLV6*$LVPRUHOLNHO\WRIDFHERWKVKRUWWHUPDQGORQJWHUPKHDOWKLVVXHVLQFOXGLQJGLDEHWHV K\SHUWHQVLRQDQGFDUGLRYDVFXODUGLVHDVH,WLVUHODWHGWRPDWHUQDOVPRNLQJSRRUQXWULWLRQGXULQJSUHJQDQF\ SODFHQWDOLQVXIILFLHQF\DQGRWKHUFRQGLWLRQVLLL What did we learn in 2014? 7KHSURSRUWLRQRI6*$LQIDQWVLQWKH1RUWKHUQ+HDOWK5HJLRQZDVSHUFHQWLQEHORZWKH 0DQLWREDDYHUDJHRISHUFHQW VHH)LJXUH KRZHYHUWKLVGLIIHUHQFHLVQRWVWDWLVWLFDOO\ GLIIHUHQW )LJXUH6PDOOIRU*HVWDWLRQDO$JHE\5+$ ȋȌManitobaaverage InterlakeͲEastern PrairieMountain Southern Northern Winnipeg 0% 2% 4% 6% 8% 10% 12% PerCent 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV+HDOWK,QIRUPDWLRQ0DQDJHPHQW 127( :LQQLSHJKDVVWDWLVWLFDOO\KLJKHUWKDQDYHUDJHUDWH,QWHUODNH(DVWHUQDQG3UDLULH0RXQWDLQKDYHVWDWLVWLFDOO\ORZHUWKDQDYHUDJHUDWH &200881,7<+($/7+$66(660(17 5.5. Selected Chronic Disease Incidence & Treatment Prevalence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anadian Medical Association Journal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“Goodpubliceducationaboutpreventing chronicdiseasecanbedesignedforfamiliestolearntogether,maybethroughthe schools.” 6RPHSDUWLFLSDQWVGLGVXJJHVWWKDWWKHUHLVDFRQVLGHUDEOHEDUULHUWRFKURQLFGLVHDVHSUHYHQWLRQDVRQHSDUWLFLSDQW QRWHGWKDW“Thosethatarehighestriskforchronicdiseaseoftenneedtohavetheirbasic needsmetbeforetheyaregoingtobeabletoaddresshealthneeds.Basicneedssuch asrunningwater,properhousing,andhealthyfoodoptionsthatareaffordable.”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³6WDUWWR ([HUFLVHZLWK3K\VLR´ SURJUDPDLPHGSULPDULO\WRZDUGVFDUGLDFSDWLHQWVWRDOORZWKHPWRH[HUFLVH LQDVDIHDQGVXSHUYLVHGHQYLURQPHQWDIWHUH[SHULHQFLQJDFDUGLDFHYHQW &200881,7<+($/7+$66(660(17 5.5.1. Acute Myocardial Infarction DEFINITION 7KHDQQXDOUDWHRIKRVSLWDOL]DWLRQ RUPRUHGD\V RUGHDWKGXHWR$0,SHUUHVLGHQWVDJHRUROGHURYHUD ILYH\HDUSHULRG Why Is This Indicator Important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hat did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQUHSRUWHGDVLJQLILFDQWGHFOLQHLQKRVSLWDOL]DWLRQVGXHWR$0, IURP SHULQ WRLQ EXWVWLOOVLJQLILFDQWO\DERYHWKHSURYLQFLDO DYHUDJH SHULQ 7KHIRUPHU1250$15HJLRQUHSRUWHG$0,UDWHV SHULQ VLJQLILFDQWO\ DERYHWKHSURYLQFLDODYHUDJHEXWWKH\ZHUHGHFUHDVLQJVWHDGLO\ IURP SHULQ What did we learn in 2014? 7KH$0,UDWHLQWKH1RUWKHUQ+HDOWK5HJLRQGHFOLQHGIURPSHUSRSXODWLRQLQWR LQ7KHQRUWKHUQUDWHZDVVWDWLVWLFDOO\KLJKHUWKDQWKH0DQLWREDDYHUDJHIRUERWKWLPH SHULRGV VHH)LJXUH $PRQJ1RUWKHUQ+HDOWK5HJLRQ]RQHVWKH1RUWKHUQ,VODQG/DNH]RQHKDGWKHKLJKHVW$0,UDWHV VWDWLVWLFDOO\DERYHWKHUHJLRQDODYHUDJH7KH*UDQG5DSLGVGLVWULFWKDGWKHKLJKHVW$0,UDWHDWLQ VHH)LJXUH )LJXUH $0,5DWHVE\5+$DQG 2002Ͳ2006 2007Ͳ2011 ManitobaLinear(Manitobaaverageaverage2002Ͳ20062002Ͳ2006) ManitobaLinear(Manitobaaverageaverage2007Ͳ20112007Ͳ2011) Winnipeg(t) Southern PrairieMountain(t) InterlakeͲ Eastern(2,t) Northern(1,2) 0123456 Rateper1,000 residentsageͶͲΪ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH$0,5DWHVE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2002Ͳ2006 2007Ͳ2011 LinearNorthern(Northernaveragaveragee2002Ͳ20062002Ͳ2006) NorthernLinear(Northernaverageaverage2007Ͳ20112007Ͳ2011) LL/MC,LR,OͲP(SIL),PN(GVL) Flin,Snow,Cran,Sher Thompson,MysteryLake CrossLake/PimiCN Bu(OH),MS(GR),GLN/GLFN ThePas/OCN,Kelsey(1) Gillam,FoxLakeCN(s) Puk/MatColCN(s) BayLine NelsonHouse/NCN NorwayHouse/NHCN(1,2) IslandLake(2) Sham,YorkFN,Tat(SPL)(2) GR/Mis,ML/Mos,Eas/Che(1,2) SayD(TL),Bro/BL,NoL(Lac)(s) NorthernDirectServiceZone NorthernNonͲDirectServiceZone(1,2) NorthernIslandLakeZone(2) 024681012 Rateper1,000 residentsage40+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD &200881,7<+($/7+$66(660(17 5.5.2. Arthritis Prevalence DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSHUFHQWDJHRIUHVLGHQWVDJHG RUROGHUGLDJQRVHGZLWKDUWKULWLV RVWHRRUUKHXPDWRLG XVLQJDFRPELQDWLRQRIGDWDLQSK\VLFLDQYLVLWVKRVSLWDOL]DWLRQVDQGSUHVFULSWLRQGUXJV Why Is This Indicator Important? $FFRUGLQJWRWKH3XEOLF+HDOWK$JHQF\RI&DQDGDSHUFHQWRI&DQDGLDQVRYHUWKHDJHRIILIWHHQDUHOLYLQJZLWK DUWKULWLVWKHPDMRULW\RIZKRPDUHZRPHQYLL3K\VLFDOLQDFWLYLW\DQGREHVLW\FDQSOD\DODUJHUROHLQWKHRQVHWDQG VHYHULW\RIDUWKULWLV What did we learn in 2009? $OWKRXJKUHJLRQDOUHVLGHQWVKDYHIDLUO\KLJKUDWHVRIULVNIDFWRUVUHVLGHQWVRIWKHIRUPHU%XUQWZRRG 5HJLRQUHSRUWHGWKHORZHVWDUWKULWLVUDWH LQ LQWKHSURYLQFH RILQ ,QWKHIRUPHU1250$15HJLRQUDWHV LQ GHFOLQLQJVOLJKWO\WR LQ ZHUHKLJKHUWKDQWKHSURYLQFLDODYHUDJH RILQPRVWUHFHQWWLPH SHULRG ZKLFKH[SHULHQFHGDVLPLODUVOLJKWGHFOLQH What did we learn in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Ͳ2006/07 2010/11Ͳ2011/12 LinearManitoba(Manitobaaveragaveragee2005/062005/06Ͳ2006/Ͳ072006/07) LinearManitoba(Manitobaaverageaverage2010/112010/11Ͳ2011/12Ͳ2011/12) Southern(1,2,t) Winnipeg InterlakeͲEastern(2,t) PrairieMountain(2,t) Northern(1,2) 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% PerCent ofresidentsage19+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH$UWKULWLV3UHYDOHQFHE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2005/06Ͳ2006/07 2010/11Ͳ2011/12 LinearNorthern(Northernaverageaverage2005/062005/06Ͳ2006/07Ͳ2006/07) LinearNorthern(Northernaverageaverage2010/112010/11Ͳ2011/12Ͳ2011/12) NelsonHouse/NCN(1,2) Sham,YorkFN,Tat(SPL)(2) ThePas/OCN,Kelsey(1,t) BayLine(1,t) IslandLake(1,t) Puk/MatColCN SayD(TL),Bro/BL,NoL(Lac) Flin,Snow,Cran,Sher(1) Bu(OH),MS(GR),GLN/GLFN CrossLake/PimiCN(2,t) GR/Mis,ML/Mos,Eas/Che(2,t) Thompson,MysteryLake(1,2) NorwayHouse/NHCN(2,t) LL/MC,LR,OͲP(SIL),PN(GVL)(1,2) Gillam,FoxLakeCN(1,2,t) NorthernIslandLakeZone(1,t) NorthernNonͲDirectService… NorthernDirectServiceZone(1,2,t) 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% PerCent ofresidentsage19+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD &200881,7<+($/7+$66(660(17 5.5.3. 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Diabetes Prevalence (19+) DEFINITION 7KHQXPEHURILQGLYLGXDOVDJHG DQGRYHUZKRKDYHEHHQGLDJQRVHGE\DKHDOWKSURIHVVLRQDODVKDYLQJGLDEHWHV 'DWDGHULYHGIURPDSRSXODWLRQEDVHGGDWDEDVHRILQGLYLGXDOVGLDJQRVHGZLWKGLDEHWHVH[SUHVVHGDVDUDWHSHU SRSXODWLRQ Why Is This Indicator Important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“You need to have food for your kids. 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Hypertension Prevalence DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSHUFHQWDJHRISHUVRQVDJHGRUROGHUZKRKDGDWOHDVWRQHSK\VLFLDQYLVLWIRU K\SHUWHQVLRQLQDWKUHH\HDUSHULRG Why Is This Indicator Important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hat did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQWKHK\SHUWHQVLRQUDWH LQIURPLQ ZDVDERYHWKHSURYLQFLDODYHUDJH LQ DQGHYHU\GLVWULFWH[FHSWWZRVDZD VLJQLILFDQWLQFUHDVHLQK\SHUWHQVLRQWUHDWPHQWUDWHV ,QWKHIRUPHU1250$15HJLRQK\SHUWHQVLRQZDVDERYHWKHSURYLQFLDODYHUDJHDQGLQFUHDVLQJ IURPLQWRLQ What did we learn in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inearManitoba(Manitobaaverageaverage2006/072006/07) LinearManitoba(Manitobaaverageaverage2011/122011/12) Southern(1,2) Winnipeg(1,2,t) Prairie Mountain(1,2,t) InterlakeͲ Eastern(1,2,t) Northern(1,2,t) 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% PerCent ofresidentsage19+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH+\SHUWHQVLRQ3UHYDOHQFHE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2006/07 2011/12 LinearNorthern(Northernaverageaverage2006/072006/07) LinearNorthern(Northernaverageaverage2011/122011/12) Flin,Snow,Cran,Sher SayD(TL),Bro/BL,NoL(Lac) Puk/MatColCN ThePas/OCN,Kelsey(2,t) Thompson,MysteryLake(1,2) NelsonHouse/NCN(1,2) GR/Mis,ML/Mos,Eas/Che(1,2) LL/MC,LR,OͲP(SIL),PN(GVL)(1,2) BayLine(1,2) Bu(OH),MS(GR),GLN/GLFN(1,2) Sham,YorkFN,Tat(SPL)(1,2) NorwayHouse/NHCN(1,2) Gillam,FoxLakeCN(1,2,t) CrossLake/PimiCN(1,2) IslandLake(1,2,t) NorthernDirectServiceZone(1,2,t) NorthernNonͲDirectServiceZone(1,2) NorthernIslandLakeZone(1,2,t) 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% PerCent ofresidentsage19+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD 5.5.9. Ischemic Heart Disease (IHD) Incidence DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHDYHUDJHQXPEHURIQHZFDVHVRILVFKHPLFKHDUWGLVHDVH ,+' IRUUHVLGHQWVDJHG DQG ROGHUH[SUHVVHGDVDUDWHSHUSHUVRQ±\HDUVDVGHILQHGE\HLWKHU$QHZFDVHRI,+'LVGHILQHGDVD KRVSLWDOL]DWLRQWZRSK\VLFLDQYLVLWVRUDSK\VLFLDQYLVLWZLWKDWOHDVWWZRSUHVFULSWLRQVIRU,+'PHGLFDWLRQV Why Is This Indicator Important? ,VFKHPLFKHDUWGLVHDVHLVWKHPRVWKRVSLWDOL]HGFDUGLDFUHODWHGFRQGLWLRQLQ&DQDGDVRLWLVSDUWLFXODUO\LPSRUWDQWWKDW ZHPRQLWRULQFLGHQFHUDWHVLQRUGHUWRSUHYHQWFRVWO\KRVSLWDOL]DWLRQIROORZXSVWRWUHDWWKLVFDUGLDFFRQGLWLRQ[L What did we learn in 2014? 7KHLQFLGHQFHUDWHIRULVFKHPLFKHDUWGLVHDVHDOVRGHFOLQHGLQWKH1RUWKHUQ+HDOWK5HJLRQIURP SHUSHUVRQ\HDUVLQWRLQ VHH)LJXUH $V)LJXUHVKRZVPRVWGLVWULFWVLQWKH1RUWKHUQ+HDOWK5HJLRQH[SHULHQFHGLQFLGHQFHUDWH GHFOLQHVWKRXJKWKHDUHDVZLWKWKHKLJKHVWLQFLGHQWUDWHVKDGLQFUHDVHVRYHUWKHWZRWLPHSHULRGV 1RUZD\+RXVHDQG&URVV/DNHERWKKDGVWDWLVWLFDOO\VLJQLILFDQWLQFUHDVHV &200881,7<+($/7+$66(660(17 )LJXUH,VFKHPLF+HDUW'LVHDVH,QFLGHQFHE\5+$DQG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 LinearManitoba(Manitobaaverageaverage2002/032002/03Ͳ2006/07Ͳ2006/07) LinearManitoba(Manitobaaverageaverage2007/082007/08Ͳ2011/12Ͳ2011/12) Southern(1,2,t) InterlakeͲ Eastern(1,t) Winnipeg(t) PrairieMountain(2) Northern(1,2) 0 0.2 0.4 0.6 0.8 1 Rateper100personͲyearsofresidentsage19+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH,VFKHPLF+HDUW'LVHDVH,QFLGHQFHE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 LinearNorthern(Northernaverageaverage2002/032002/03Ͳ2006/07Ͳ2006/07) LinearNorthern(Northernaverageaverage2007/082007/08Ͳ2011/12Ͳ2011/12) BayLine(t) Flin,Snow,Cran,Sher(1,2) Thompson,MysteryLake LL/MC,LR,OͲP(SIL),PN(GVL) ThePas/OCN,Kelsey SayD(TL),Bro/BL,NoL(Lac)(1,t) Gillam,FoxLakeCN Bu(OH),MS(GR),GLN/GLFN(1,t) Sham,YorkFN,Tat(SPL)(1) GR/Mis,ML/Mos,Eas/Che(1) Puk/MatColCN NelsonHouse/NCN(2) IslandLake(1,2) NorwayHouse/NHCN(1,2,t) CrossLake/PimiCN(1,2) NorthernDirectServiceZone(t) NorthernNonͲDirectService… NorthernIslandLakeZone(1,2) 00.511.522.5 Rateper100personͲyearsofresidentsage19+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD 5.5.10. Ischemic Heart Disease (IHD) Prevalence DEFINITION 7KHWUHDWPHQWSUHYDOHQFHUDWHRI,+' UHVWULFWLRQWRIORZWRFRURQDU\DUWHULHV LQUHVLGHQWVDJHRUROGHULVGHILQHG E\DFRPELQDWLRQRIGDWDLQSK\VLFLDQYLVLWVKRVSLWDOL]DWLRQVDQGSUHVFULSWLRQGUXJVRYHUD\HDUSHULRG Why Is This Indicator Important? +HDUWGLVHDVHLVWKHFRVWOLHVWGLVHDVHIRURXUKHDOWKFDUHV\VWHPDQGLWSXWVWKHPRVWVWUDLQRQRXUKHDOWKFDUHV\VWHP ,WLVRXUQDWLRQ¶VOHDGLQJFDXVHRIGHDWK,WZDVLGHQWLILHGDVDPDMRUFRQFHUQLQSUHYLRXVUHSRUWV(GXFDWLRQDO UHVRXUFHVWRKHOSPDQDJHKHDUWGLVHDVHZHUHDOVRQRWHGDVDPDMRUFRQFHUQ0DMRUULVNIDFWRUVLQFOXGHVPRNLQJODFN RISK\VLFDODFWLYLW\DQGXQKHDOWK\HDWLQJVWUHVVGLDEHWHVK\SHUWHQVLRQDQGKLJKFKROHVWHURO[LL$VSHUVRQVZLWK,+' EHWWHUPDQDJHWKHLUGLVHDVHDQGWKH\OLYHORQJHUWKLVPD\DOVROHDGWRDQLQFUHDVHLQWKHQXPEHURISHUVRQVOLYLQJ ZLWK,+' What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQKDGDVWDWLVWLFDOO\LQVLJQLILFDQWLQFUHDVH LQ WR LQ DQGUHPDLQHGVLJQLILFDQWO\KLJKHUWKDQWKHSURYLQFLDODYHUDJH LQ 7KHIRUPHU1250$15HJLRQGHFUHDVHGE\DVWDWLVWLFDOO\VLJQLILFDQWUDWH IURP LQWR LQ What did we learn in 2014? 3UHYDOHQFHIRULVFKHPLFKHDUWGLVHDVHGHFOLQHGLQWKH1RUWKHUQ+HDOWK5HJLRQIURPSHUFHQWLQ WR SHUFHQWLQDVWDWLVWLFDOO\VLJQLILFDQWGHFOLQH,WVWLOO UHPDLQHGDERYHWKHSURYLQFLDODYHUDJHRI SHUFHQW VHH)LJXUH $V)LJXUHLOOXVWUDWHVPRVW1RUWKHUQ+HDOWK5HJLRQGLVWULFWVH[SHULHQFHGGHFOLQHVLQSUHYDOHQFH ZLWKWKH'LUHFW6HUYLFH=RQHKDYLQJDVWDWLVWLFDOO\VLJQLILFDQWGHFOLQHEHWZHHQWKHWZRWLPHSHULRGV 7KHRWKHUWZR]RQHVUHPDLQHGVWDWLVWLFDOO\DERYHWKHUHJLRQDODYHUDJH &200881,7<+($/7+$66(660(17 )LJXUH,VFKHPLF+HDUW'LVHDVH3UHYDOHQFHE\5+$$QG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 LinearManitoba(Manitobaaverageaverage2002/032002/03Ͳ2006/07Ͳ2006/07) LinearManitoba(Manitobaaverageaverage2007/082007/08Ͳ2011/12Ͳ2011/12) Southern(1,2,t) InterlakeͲEastern(1,2,t) Winnipeg(t) PrairieMountain(2) Northern(1,2,t) 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% PerCent ofresidentsage19+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH,VFKHPLF+HDUW'LVHDVHE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 LinearNorthern(Northernaverageaverage2002/032002/03Ͳ2006/07Ͳ2006/07) LinearNorthern(Northernaverageaverage2007/082007/08Ͳ2011/12Ͳ2011/12) Flin,Snow,Cran,Sher(2,t) BayLine(1,t) Thompson,MysteryLake(t) LL/MC,LR,OͲP(SIL),PN(GVL) ThePas/OCN,Kelsey(t) SayD(TL),Bro/BL,NoL(Lac) Puk/MatColCN NelsonHouse/NCN Bu(OH),MS(GR),GLN/GLFN(1,2) GR/Mis,ML/Mos,Eas/Che(1,2) Sham,YorkFN,Tat(SPL)(1,2) Gillam,FoxLakeCN(1,2) IslandLake(1,2) NorwayHouse/NHCN(1,2,t) CrossLake/PimiCN(1,2,t) NorthernDirectServiceZone(t) NorthernNonͲDirectServiceZone(1,2) NorthernIslandLakeZone(1,2) 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% PerCent ofresidentsage19+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD 5.5.11. Osteoporosis Treatment Prevalence (19+) DEFINITION 7KLVLQGLFDWRUUHIHUVWRWKHSHUFHQWDJHRIUHVLGHQWVDJHGRUROGHUGLDJQRVHGZLWKRVWHRSRURVLV Why Is This Indicator Important? $SSUR[LPDWHO\WHQSHUFHQWRI&DQDGLDQVRYHUIRUW\KDYHEHHQGLDJQRVHGZLWKRVWHRSRURVLV,WLVIRXUWLPHVPRUH OLNHO\WRGHYHORSLQZRPHQ,WKDVDQHQRUPRXVLPSDFWRQTXDOLW\RIOLIHFDXVLQJIUDFWXUHVGHIRUPLW\DQG GLVDELOLW\,WDOVRUHVXOWVLQGHFUHDVHGPRELOLW\DQGLQGHSHQGHQFH7KHUDWHVRIWUHDWPHQWDUHVHHQE\PDQ\DVDQ LQGLFDWRURIWKHVXFFHVVRISUHYHQWLRQHIIRUWVE\SULPDU\FDUHSK\VLFLDQVDQGVSHFLDOLVWV[LLL What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQUHSRUWHGLQFUHDVHGRVWHRSRURVLVWUHDWPHQWUDWHVE\IRXUSHUFHQW IURP LQ WRLQ DQGZDVDERYHWKH0DQLWREDDYHUDJH LQ ,QWKHIRUPHU1250$15HJLRQUDWHV LQ ZHUHDERYHWKHSURYLQFLDO DYHUDJHDQGLQFUHDVLQJ What did we learn in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Ͳ2006/07 2009/10Ͳ2011/12 LinearManitoba(Manitobaaverageaverage2004/052004/05Ͳ2006/07Ͳ2006/07) LinearManitoba(Manitobaaverageaverage2009/102009/10Ͳ2011/12Ͳ2011/12) Southern(1,2,t) InterlakeͲEastern(2,t) Winnipeg(t) PrairieMountain(2,t) Northern(t) 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% PerCent ofresidentsage50+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH2VWHRSRURVLV3UHYDOHQFHE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2004/05Ͳ2006/07 2009/10Ͳ2011/12 LinearNorthern(Northernaverageaverage2004/052004/05Ͳ2006/07Ͳ2006/07) LinearNorthern(Northernaverageaverage2009/102009/10Ͳ2011/12Ͳ2011/12) Puk/MatColCN Flin,Snow,Cran,Sher(t) BayLine NelsonHouse/NCN ThePas/OCN,Kelsey(t) Thompson,MysteryLake(t) NorwayHouse/NHCN Sham,YorkFN,Tat(SPL) Bu(OH),MS(GR),GLN/GLFN LL/MC,LR,OͲP(SIL),PN(GVL) IslandLake GR/Mis,ML/Mos,Eas/Che Gillam,FoxLakeCN SayD(TL),Bro/BL,NoL(Lac) CrossLake/PimiCN(2,t) NorthernDirectServiceZone(t) NorthernIslandLakeZone NorthernNonͲDirectServiceZone(2) 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% PerCent ofresidentsage50+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD 5.5.12. Respiratory Disease Prevalence DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRISHUVRQVKDYLQJDWOHDVWRQHSK\VLFLDQYLVLWRUKRVSLWDOL]DWLRQIRUD UHVSLUDWRU\GLVHDVHZLWKLQDWZR\HDUSHULRG Why Is This Indicator Important? 2YHUPLOOLRQ&DQDGLDQVOLYHZLWKDVHULRXVUHVSLUDWRU\GLVHDVHDQGWKDWQXPEHULVRQO\LQFUHDVLQJZLWKRXUDJLQJ SRSXODWLRQ6PRNLQJLVWKHODUJHVWULVNIDFWRUDQGHDVLO\WKHPRVWSUHYHQWDEOH3ROOXWLRQDQGVHFRQGKDQGVPRNH DUHDOVRPDMRUULVNIDFWRUVDVLVDLUTXDOLW\LQWKHZRUNSODFHDQGDWKRPH[LY What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQUHSRUWHGDVLJQLILFDQWGHFUHDVHIURPWRSHUFHQWEHWZHHQ DQG,WUHPDLQHGVLJQLILFDQWO\EHORZWKHSURYLQFLDOUDWH 7KHIRUPHU1250$15HJLRQZDVDOVREHORZWKHSURYLQFLDODYHUDJHDQGVDZDVWDWLVWLFDOO\ VLJQLILFDQWGHFUHDVHIURPSHUFHQWLQWR SHUFHQWLQ What did we learn in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anitobaLinear(Manitobaaverageaverage2006/072006/07) ManitobaLinear(Manitobaaverageaverage2011/122011/12) Northern(1,2,t) Southern(1,2,t) Winnipeg(1,t) InterlakeͲEastern(t) Prairie Mountain(1,2,t) 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% PerCent 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH7RWDO5HVSLUDWRU\0RUELGLW\E\1RUWKHUQ'LVWULFWDQG=RQHDQG 2006/07 2011/12 NorthernLinear(Northernaverageaverage2006/072006/07) NorthernLinear(Northernaverage2011/12average2011/12) Puk/MatColCN(1,2,t) IslandLake(1,2,t) Sham,YorkFN,Tat(SPL)(1,2) NelsonHouse/NCN(1,2,t) GR/Mis,ML/Mos,Eas/Che(1,2) NorwayHouse/NHCN(1,2) CrossLake/PimiCN(1,2) Bu(OH),MS(GR),GLN/GLFN(1,2) SayD(TL),Bro/BL,NoL(Lac)(1,2,t) BayLine(1,2) ThePas/OCN,Kelsey(2,t) LL/MC,LR,OͲP(SIL),PN(GVL)(t) Flin,Snow,Cran,Sher(1,2) Thompson,MysteryLake(1,2,t) Gillam,FoxLakeCN NorthernIslandLakeZone(1,2,t) NorthernNonͲDirectServiceZone(1,2,t) NorthernDirectServiceZone(1,2,t) 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% PerCent 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD 5.5.13. Stroke Incidence Rate DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHDQQXDOUDWHRIKRVSLWDOL]DWLRQRUGHDWKGXHWRVWURNHLQDILYH\HDUSHULRGSHU UHVLGHQWVDJHRUROGHU Why Is This Indicator Important? 6WURNHLVRQHRIWKHELJJHVWFDXVHVRIGHDWKDQGGLVDELOLW\LQ&DQDGDUHVSRQVLEOHIRUDSSUR[LPDWHO\GHDWKV HYHU\\HDU7KHUHDUHPDQ\ULVNIDFWRUVERWKXQFRQWUROODEOHOLNHHWKQLFLW\DQGJHQGHUDQGFRQWUROODEOHOLNHKLJK EORRGSUHVVXUHDQGVPRNLQJ[Y What did we learn in 2009? 0HDQLQJIXOUHGXFWLRQVLQUDWHVRFFXUUHGLQPRVWRIWKHGLVWULFWVRIWKHIRUPHU%XUQWZRRG5HJLRQ IURP SHULQ WRSHULQ WKRXJKWKHUHJLRQ UHPDLQHGVLJQLILFDQWO\DERYHWKHSURYLQFLDODYHUDJH SHUGXULQJ ,QWKHIRUPHU1250$15HJLRQWKHUDWHZHQWIURP SHULQ WRSHU LQVKRZLQJDVWDWLVWLFDOO\VLJQLILFDQWGHFUHDVHRYHUWLPH What did we learn in 2014? 7KHUHZHUHGHFOLQHVLQVWURNHUDWHVLQWKH1RUWKHUQ+HDOWK5HJLRQIURPSHUSRSXODWLRQLQ WRLQ,WVWLOOUHPDLQHGVWDWLVWLFDOO\DERYHWKHSURYLQFLDODYHUDJHRI VHH )LJXUH $V)LJXUHVKRZVWKHUHLVDZLGHUDQJHLQVWURNHUDWHVDFURVV1RUWKHUQ+HDOWK5HJLRQ FRPPXQLWLHV7KH'LUHFW6HUYLFH]RQHKDVWKHORZHVWVWURNHUDWHVZKLOHWKH1RUWKHUQ,VODQG/DNH ]RQHKDGWKHKLJKHVWZLWKDUDWHRILQVWDWLVWLFDOO\KLJKHUWKDQWKHUHJLRQDODYHUDJH &200881,7<+($/7+$66(660(17 )LJXUH6WURNH5DWHVE\5+$DQG 2002Ͳ2006 2007Ͳ2011 LinearManitoba(Manitobaaverageaverage2002Ͳ20062002Ͳ2006) ManitobaLinear(Manitobaaverage2007averageͲ20112007Ͳ2011) Southern(2,t) PrairieMountain(t) Winnipeg(1) InterlakeͲEastern(1,t) Northern(1,2) 0123456 Rateper1,000 residentsage40+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH6WURNH5DWHVE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2002Ͳ2006 2007Ͳ2011 LinearNorthern(Northernaverageaverage2002Ͳ20022006Ͳ2006) LinearNorthern(Northernaverageaverage2007Ͳ20072011Ͳ2011) Flin,Snow,Cran,Sher ThePas/OCN,Kelsey Thompson,MysteryLake Bu(OH),MS(GR),GLN/GLFN(1,t) LL/MC,LR,OͲP(SIL),PN(GVL) Puk/MatColCN(s) NelsonHouse/NCN BayLine Sham,YorkFN,Tat(SPL)(1,2) NorwayHouse/NHCN(1,2) CrossLake/PimiCN(1,2) IslandLake(1,2) Gillam,FoxLakeCN(1,2) GR/Mis,ML/Mos,Eas/Che(1,s) SayD(TL),Bro/BL,NoL(Lac)(s) NorthernDirectServiceZone NorthernNonͲDirectService… NorthernIslandLakeZone(1,2) 0 2 4 6 8 10 12 14 16 Rateper1,000 residentsage40+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV 5.6. Mental Health 7KHFKDOOHQJHVLQPDQDJLQJPHQWDOKHDOWKFRQGLWLRQVLQWKH1RUWKHUQ+HDOWK5HJLRQFRPPXQLWLHVZHUHDPDMRU WKHPHRIGLVFXVVLRQIRUIRFXVJURXSVLQ7KHSUHYDLOLQJVHQWLPHQWDPRQJSDUWLFLSDQWVZDVWKDWZKLOHPHQWDO KHDOWKZRUNHUVLQFRPPXQLWLHVDUHGHGLFDWHGDQGGRLQJZKDWWKH\FDQWRKHOSORFDOUHVLGHQWVWKHUHZHUHQRWHQRXJK UHVRXUFHVWRGHDOZLWKRQJRLQJPHQWDOKHDOWKFRQGLWLRQV:KLOHSDUWLFLSDQWVDJUHHGWKHUHZDVPXFKJUHDWHU DZDUHQHVVRIPHQWDOKHDOWKLVVXHVDQGFRQGLWLRQVFRPPXQLWLHVDUHRQO\DEOHWRGHDOZLWKFULVHVEXWQRWPDQDJHWKH FRQGLWLRQ$VRQHSDUWLFLSDQWQRWHG“Mental health workers only deal with mental illness and not mental health issues. That needs to change to have time for them to see other people with other mental health issues.”7KHUHZDVDJHQHUDOFRQVHQVXVWKDWWKHPRVWSUHVVLQJPHQWDOKHDOWKQHHGVLQ FRPPXQLWLHVDUHDFFHVVWRPHQWDOKHDOWKSURIHVVLRQDOVVXFKDVSV\FKRORJLVWVDQGDGGUHVVLQJORQJZDLWLQJOLVWVIRU PHQWDOKHDOWKVHUYLFHV 7KDWVDLGWKHUHVWLOOUHPDLQVDVWLJPDZLWKVHHLQJDPHQWDOKHDOWKSURIHVVLRQDO$VRQHFRPPXQLW\FRQVXOWDWLRQ SDUWLFLSDQWUHPDUNHG“Having the community feel comfortable in coming to see the mental health professionals and accessing the service is the challenge.”7KHUHZDVDOVRDIUXVWUDWLRQDERXWWKH WLPHOLQHVVRIPHQWDOKHDOWKVHUYLFHVLQDFULVLV$VRQHSDUWLFLSDQWUHFRXQWHG“Suicides that occurred last year in our community happened during the evenings and weekends. This is outside the time frame that professionals are working from health or educational. Supports are not available when crisis happen during evenings and weekends.”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revalence of Dementia (55+) DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIUHVLGHQWVDJHG\HDUVDQGROGHUZLWKGHPHQWLD Why Is This Indicator Important? 'HPHQWLDLVWKHPRVWFRPPRQFDXVHRIGLVDELOLW\DPRQJWKHHOGHUO\ZLWKDSSUR[LPDWHO\&DQDGLDQVHQLRUV VXIIHULQJIURPLW,WLVDOVRULVLQJDORQJZLWKWKHULVLQJQXPEHURIVHQLRUVDVDUHWKHDVVRFLDWHGFRVWV7KHUHDUHD QXPEHURIZD\VWRUHGXFHRQH¶VGHPHQWLDULVNIDFWRUVLQFOXGLQJDKHDOWK\GLHWDQGH[HUFLVH[YL What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQUHSRUWHGGHFUHDVHGGHPHQWLDUDWHV IURPLQ WR LQ WKDWZHUHDOVRORZHUWKDQWKHSURYLQFLDODYHUDJH LQ ,QWKHIRUPHU1250$15HJLRQUDWHVZHUHORZHUWKDQWKHSURYLQFLDODYHUDJHDQGUHPDLQHG UHODWLYHO\VWDEOH IURP LQ WR LQ What did we learn in 2014? 7KHSURSRUWLRQRIUHVLGHQWVGLDJQRVHGZLWKGHPHQWLDLQWKH1RUWKHUQ+HDOWK5HJLRQGHFOLQHGIURP SHUFHQWLQWRSHUFHQWLQ7KH1RUWKHUQ+HDOWK5HJLRQ UHPDLQHGVWDWLVWLFDOO\EHORZWKH0DQLWREDDYHUDJHRISHUFHQW VHH)LJXUH $V)LJXUHLOOXVWUDWHVGHPHQWLDUDWHVZHUHIDLUO\FRQVLVWHQWDFURVV1RUWKHUQ+HDOWK5HJLRQ FRPPXQLWLHVDQG]RQHV7KH/\QQ/DNH/HDI5DSLGVDUHDKDGWKHKLJKHVWUDWHVDWSHUFHQWLQ )LJXUH'HPHQWLD3UHYDOHQFHE\5+$DQG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 LinearManitoba(Manitobaaverageaverage2002/032002/03Ͳ2006/07Ͳ2006/07) LinearManitoba(Manitobaaverageaverage2007/082007/08Ͳ2011/12Ͳ2011/12) Northern(1,2) InterlakeͲ Eastern(1,2) Prairie Mountain(1,2) Winnipeg Southern(1) 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% PerCent ofresidentsage55+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH'HPHQWLD3UHYDOHQFHE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 LinearNorthern(Northernaverageaverage2002/032002/03Ͳ2006/07Ͳ2006/07) LinearNorthern(Northernaverageaverage2007/082007/08Ͳ2011/12Ͳ2011/12) NelsonHouse/NCN Flin,Snow,Cran,Sher(2) GR/Mis,ML/Mos,Eas/Che Thompson,MysteryLake NorwayHouse/NHCN IslandLake BayLine ThePas/OCN,Kelsey Gillam,FoxLakeCN Sham,YorkFN,Tat(SPL) Bu(OH),MS(GR),GLN/GLFN CrossLake/PimiCN LL/MC,LR,OͲP(SIL),PN(GVL) Puk/MatColCN(s) SayD(TL),Bro/BL,NoL(Lac)(s) NorthernIslandLakeZone NorthernDirectServiceZone(2) NorthernNonͲDirectServiceZone 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% PerCent ofresidentsage55+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV &200881,7<+($/7+$66(660(17 5.6.2. Prevalence of Mood and Anxiety Disorders (10+) DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIUHVLGHQWVDJHRUROGHUGLDJQRVHGZLWKDQDQ[LHW\RUPRRGGLVRUGHU Why Is This Indicator Important? $Q[LHW\GLVRUGHUVDUHDPRQJWKHPRVWFRPPRQRIDOOPHQWDOKHDOWKGLVRUGHUVLQ&DQDGDZLWKXSWRSHUFHQWRI SHRSOHDIIHFWHGE\LW,QGLYLGXDOVPD\FKRRVHQRWWRVHHNWUHDWPHQWIRUWKHLUDQ[LHW\EHFDXVHWKH\FRQVLGHUWKH V\PSWRPVPLOGRUQRUPDORUWKHV\PSWRPVWKHPVHOYHVPD\LQWHUIHUHZLWKVHHNLQJKHOSIURPWKHKHDOWKFDUHV\VWHP $Q[LHW\GLVRUGHUVFDQEHHIIHFWLYHO\WUHDWHGLQWKHFRPPXQLW\VHWWLQJWKURXJKSV\FKRWKHUDS\RUPHGLFDWLRQ What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQWKHSURSRUWLRQRIUHVLGHQWVZLWKDPRRGRUDQ[LHW\GLVRUGHUZDV SHUFHQWLQEHORZWKH0DQLWREDDYHUDJHRISHUFHQW 7KHIRUPHU1RUPDQ5HJLRQKDGDSUHYDOHQFHUDWHRISHUFHQWIRUPRRGDQGDQ[LHW\GLVRUGHUVLQ What did we learn in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Ͳ2006/07 2007/08Ͳ2011/12 ManitobaLinear(Manitobaaverageaverage2002/032002/03Ͳ2006/07Ͳ2006/07) ManitobaLinear(Manitobaaverageaverage2007/082007/08Ͳ2011/12Ͳ2011/12) Northern(1,2) Southern(1,2,t) InterlakeͲEastern(1,2) Winnipeg PrairieMountain(t) 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% PerCent ofresidentsage10+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH0RRGDQG$Q[LHW\'LVRUGHUV3UHYDOHQFHE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 LinearNorthern(Northernaverageaverage2002/032002/03Ͳ2006/07Ͳ2006/07) LinearNorthern(Northernaverageaverage2007/082007/08Ͳ2011/12Ͳ2011/12) Puk/MatColCN(1,2,t) SayD(TL),Bro/BL,NoL(Lac)(1,2) GR/Mis,ML/Mos,Eas/Che(1,2) Sham,YorkFN,Tat(SPL)(1,2) CrossLake/PimiCN(1,2) NelsonHouse/NCN(1,2) NorwayHouse/NHCN(1,2) IslandLake(1,2,t) Bu(OH),MS(GR),GLN/GLFN(1,2) ThePas/OCN,Kelsey(2,t) Flin,Snow,Cran,Sher(1,2) Thompson,MysteryLakeͲ1 LL/MC,LR,OͲP(SIL),PN(GVL) BayLine Gillam,FoxLakeCN NorthernNonͲDirectServiceZone(1,2) NorthernIslandLakeZone(1,2,t) NorthernDirectServiceZone(1,2,t) 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% PerCent ofresidentsage10+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD &200881,7<+($/7+$66(660(17 5.6.3. Prevalence of Substance Abuse (10+) DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSHUFHQWDJHRIUHVLGHQWVDJHG\HDUVDQGROGHUZLWKVXEVWDQFHDEXVH Why Is This Indicator Important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“They go through the treatment and they are then left to go right back into the situations that they left. It is a cycle.”$QRWKHUSDUWLFLSDQW HFKRHGWKLVVD\LQJ“If they are getting the treatment outside their own communities – this leads to no supports. They’re being set up for failure. If they have the supports in the community they would have a better success.” 6XEVWDQFHDEXVHZDVDOVRFRQVLGHUHGDQLPSRUWDQWKHDOWKLVVXHLQWKHLUFRPPXQLW\E\UHVSRQGHQWVWRWKH1RUWKHUQ &RPPXQLW\6XUYH\'UXJVDQGVXEVWDQFHDEXVHZDVUDQNHGWKHPRVWLPSRUWDQWKHDOWKLVVXHFLWHGE\ SHUFHQWRI VXUYH\SDUWLFLSDQWV What did we learn in 2009? ,QWKHIRUPHU1250$15HJLRQUDWHVUHPDLQHGVLJQLILFDQWO\KLJKHUWKDQWKHSURYLQFLDOUDWH LQ WKRXJKWKHUHZDVDVWDWLVWLFDOO\VLJQLILFDQWGHFUHDVH IURPLQ WRLQ 7KHIRUPHU%XUQWZRRG5HJLRQUHSRUWHGVWDELOLW\LQVXEVWDQFHDEXVHUDWHV LQERWK DQG EXWUHPDLQHGVLJQLILFDQWO\DERYHWKH0DQLWREDDYHUDJH What did we learn in 2014? 7KHSURSRUWLRQRI1RUWKHUQ+HDOWK5HJLRQUHVLGHQFHGLDJQRVHGZLWKVXEVWDQFHDEXVHGHFOLQHGIURP SHUFHQWLQWR SHUFHQWLQDVWDWLVWLFDOO\VLJQLILFDQW GHFOLQH,WVWLOOUHPDLQHGVWDWLVWLFDOO\DERYHWKH0DQLWREDDYHUDJHRISHUFHQW VHH)LJXUH $V)LJXUHVKRZVGHFOLQHVLQ1RUWKHUQ+HDOWK5HJLRQFRPPXQLWLHVDQG]RQHVZHUHVHHQ WKURXJKRXWWKHUHJLRQZLWKWKHPRVWVLJQLILFDQWGHFOLQHVRFFXUULQJLQWKH1RUWKHUQ,VODQG/DNHDQG 1RUWKHUQ1RQ'LUHFW6HUYLFH]RQHV )LJXUH 6XEVWDQFH$EXVH3UHYDOHQFHDQG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 LinearManitoba(Manitobaaverageaverage2002/032002/03Ͳ2006/07Ͳ2006/07) ManitobaLinear(Manitobaaverageaverage2007/082007/08Ͳ2011/12Ͳ2011/12) Southern(1,2) Winnipeg InterlakeͲEastern(1,t) PrairieMountain Northern(1,2,t) 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% PerCent ofresidentsage10+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH6XEVWDQFH$EXVH3UHYDOHQFHE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 NorthernLinear(Northernaverageaverage2002/032002/03Ͳ2006/07Ͳ2006/07) NorthernLinear(Northernaverageaverage2007/082007/08Ͳ2011/12Ͳ2011/12) Flin,Snow,Cran,Sher IslandLake(1,t) ThePas/OCN,Kelsey(1,2) GR/Mis,ML/Mos,Eas/Che(1,2) BayLine(1,2) Thompson,MysteryLake(1,2) NorwayHouse/NHCN(1,2) Puk/MatColCN(1,2,t) Bu(OH),MS(GR),GLN/GLFN(1,2,t) Gillam,FoxLakeCN(1,2) CrossLake/PimiCN(1,2) NelsonHouse/NCN(1,2,t) SayD(TL),Bro/BL,NoL(Lac)(1,2) Sham,YorkFN,Tat(SPL)(1,2) LL/MC,LR,OͲP(SIL),PN(GVL)(1,2) NorthernIslandLakeZone(1,2,t) NorthernDirectServiceZone(1,2) NorthernNonͲDirectServiceZone(1,2,t) 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% PerCent ofresidentsage10+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD &200881,7<+($/7+$66(660(17 5.7. Injury ,QMXULHVDUHWKHOHDGLQJFDXVHRIGHDWKDQGKRVSLWDOL]DWLRQDPRQJ\RXQJHUDGXOWVLQ0DQLWRED,QMXU\GHDWKVDUHPRUH FRPPRQDPRQJPHQWKDQZRPHQ,QMXULHVIDOOLQWRWZRPDLQFDWHJRULHVRILQWHQWLRQDOLQMXULHV VHOIGLUHFWHGVXFKDV VXLFLGHRUVHOIKDUPRUGLUHFWHGDWRWKHUVVXFKDVIDPLO\YLROHQFHFKLOGDEXVHDVVDXOWRUPXUGHU 8QLQWHQWLRQDO LQMXULHVDUHXQLQWHQGHGRFFXUUHQFHVVXFKDVPRWRUYHKLFOHFROOLVLRQVIDOOVILUHVDQGSRLVRQLQJV 5.7.1. Injury Hospitalization Rates DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIDOOKRVSLWDOL]DWLRQVUHODWHGWRLQMXULHV Why Is This Indicator Important? /RZHUKRVSLWDOL]DWLRQUDWHVPD\EHLQDQLQGLFDWRURIKRZHIIHFWLYHDUHJLRQLVLQLWVLQMXU\SUHYHQWLRQHIIRUWV 5.7.1.1. Intentional Injury Hospitalizations by Year DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHUDWHRIKRVSLWDOL]DWLRQVGXHWRLQWHQWLRQDOLQMXU\SHUSRSXODWLRQ Why Is This Indicator Important? ,QWHQWLRQDOLQMXULHVDUHHLWKHUVHOIGLUHFWHGDFWLRQVVXFKDVVXLFLGHRUVHOIKDUPRULWLVGLUHFWHGDWRWKHUV IDPLO\ YLROHQFHFKLOGDEXVHDVVDXOWPXUGHU 7KLVPHDVXUHPHQWLVDZD\WRJDXJHKRZHIIHFWLYHWKHUHJLRQLVLQ SUHYHQWLRQHIIRUWVSDUWLFXODUO\UHODWHGWRVXLFLGHDQGIDPLO\YLROHQFH What did we learn in 2014? ,QWHQWLRQDOLQMXU\KRVSLWDOL]DWLRQUDWHVUHPDLQHGIDLUO\IODWLQWKHUDQJHRIKRVSLWDOL]DWLRQVSHU SRSXODWLRQIURP7KHUDWHURVHIURP SHU WR SHU 6LQFHWKHUHKDVEHHQDGHFOLQHLQUDWHVWRSHULQ VHH)LJXUH +RVSLWDOL]DWLRQUDWHVE\JHQGHUUHYHDOWKDWIHPDOHUDWHVKDYHZLWKVRPHIOXFWXDWLRQ\HDUWR\HDU GHFOLQHGIURPWR VHH)LJXUH 5DWHVZHQWIURPSHUSRSXODWLRQLQWR SHULQZKLFKZDVWKHORZHVWUDWHIRUIHPDOHVVHHQGXULQJWKHWLPHSHULRGVWXGLHG 5DWHVIRUPDOHVZHUHRQWKHULVHIURPWRSHDNLQJDWSHUSRSXODWLRQLQ EHIRUHGHFOLQLQJWRSHULQ VHH)LJXUH )LJXUH,QWHQWLRQDO,QMXU\+RVSLWDOL]DWLRQV5DWHIRUWKH1RUWKHUQ+HDOWK5HJLRQ 600 500 400 1,000 300 per 200 Rate 100 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV3XEOLF+HDOWKDQG3ULPDU\+HDOWK&DUH'LYLVLRQHSL5(32571RUWKHUQ+HDOWK 5HJLRQ &200881,7<+($/7+$66(660(17 )LJXUH,QWHQWLRQDO,QMXU\+RVSLWDOL]DWLRQV5DWHIRU)HPDOHVLQ1RUWKHUQ+HDOWK5HJLRQ 500 450 400 350 300 1,000 250 per 200 Rate 150 100 50 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV3XEOLF+HDOWKDQG3ULPDU\+HDOWK&DUH'LYLVLRQHSL5(32571RUWKHUQ+HDOWK 5HJLRQ )LJXUH,QWHQWLRQDO,QMXU\+RVSLWDOL]DWLRQVIRU0DOH5HVLGHQWVLQ1RUWKHUQ+HDOWK5HJLRQ 700 600 500 400 300 ͳǡͲͲͲ 200 100 0 ʹͲͲͲ ʹͲͲͳ ʹͲͲʹ ʹͲͲ͵ ʹͲͲͶ ʹͲͲͷ ʹͲͲ ʹͲͲ ʹͲͲͺ ʹͲͲͻ ʹͲͳͲ ʹͲͳͳ ʹͲͳʹ 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV3XEOLF+HDOWKDQG3ULPDU\+HDOWK&DUH'LYLVLRQHSL5(32571RUWKHUQ+HDOWK 5HJLRQ 5.7.1.2. Injury Related Hospitalization Rates and Counts DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHUDWHRIKRVSLWDOL]DWLRQVGXHWRLQMXULHVERWKLQWHQWLRQDODQGXQLQWHQWLRQDOSHU UHVLGHQWV Why Is This Indicator Important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hat did we learn in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njury Hospitalization by Age for Intentional & Unintentional Injuries DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHUDWHRILQWHQWLRQDODQGXQLQWHQWLRQDOLQMXULHVSHUSRSXODWLRQE\DJHFDWHJRU\ Why Is This Indicator Important? ,WLVLPSRUWDQWWRGHWHUPLQHZKLFKDJHFDWHJRULHVDUHVXIIHULQJIURPERWKLQWHQWLRQDODQGXQLQWHQWLRQDOLQMXULHVLQ RUGHUWRKRQHDQ\LQMXU\SUHYHQWLRQHIIRUWVWRWKHULJKWDXGLHQFH What did we learn in 2014? ,QORRNLQJDWXQLQWHQWLRQDOLQMXU\KRVSLWDOL]DWLRQVE\DJHJURXSIURPWRXQLQWHQWLRQDO LQMXULHVVWD\VUHODWLYHO\IODWXQWLODJH ZKHQLWULVHVPRUHVWHHSO\EHIRUHOHYHOOLQJRIIDJDLQDW DJHV$PXFKVWHHSHULQFUHDVHRFFXUVZLWKWKHDJHJURXSZLWKFRQVLGHUDEOHLQFUHDVHV ZLWKROGHUVHQLRUV VHH)LJXUH $V)LJXUHVKRZVWKHLQWHQWLRQDOLQMXU\KRVSLWDOL]DWLRQUDWHLVYHU\ORZLQWKH\RXQJHUDJH FDWHJRULHVZLWKFRQVLGHUDEOHLQFUHDVHVVHHQLQWKH DQGDJHJURXSV7KHUDWHWKHQGHFOLQHV ZLWKHYHU\DJHJURXSWRQHDU]HURE\DJH %UHDNLQJWKHUDWHVGRZQE\JHQGHU VHH)LJXUHDQG)LJXUH IHPDOHUDWHVIRULQWHQWLRQDO LQMXULHVWHQGWREHORZHUDQGSHDNVRRQHULQWKH DJHFDWHJRU\8QLQWHQWLRQDOLQMXULHVUDWHVWHQG WREHORZHUDWHDUOLHUDJHFDWHJRULHVEXWVRRQEHFRPHFRQVLGHUDEO\KLJKHUWKDQPDOHUDWHVE\WKH DJHFDWHJRU\ 0DOHUDWHVIRUERWKLQWHQWLRQDODQGXQLQWHQWLRQDOLQMXULHVDUHFRQVLGHUDEO\KLJKHUWKDQIHPDOHUDWHVXS WRWKHDJHFDWHJRU\ZKHQIHPDOHXQLQWHQWLRQDOLQMXULHVVWDUWWRRYHUWDNHPDOHUDWHV )LJXUH,QMXU\+RVSLWDOL]DWLRQV5DWHIRU$OO1RUWKHUQ+HDOWK5HJLRQE\$JH&DWHJRU\ UnintentionalInjuryHospitalizations IntentionalInjuryHospitalizations 9000 8000 7000 6000 100,000 5000 per 4000 Rate 3000 2000 1000 0 <1 1Ͳ45Ͳ910Ͳ14 15Ͳ19 20Ͳ24 25Ͳ34 35Ͳ44 45Ͳ54 55Ͳ64 65Ͳ74 75Ͳ84 85+ 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV3XEOLF+HDOWKDQG3ULPDU\+HDOWK&DUH'LYLVLRQHSL5(32571RUWKHUQ+HDOWK 5HJLRQ )LJXUH,QMXU\+RVSLWDOL]DWLRQV5DWHIRU)HPDOHVE\$JH&DWHJRU\LQ1RUWKHUQ+HDOWK5HJLRQ UnintentionalInjuryHospitalizations IntentionalInjuryHospitalizations 9000 8000 7000 6000 100,000 5000 per 4000 Rate 3000 2000 1000 0 <1 1Ͳ45Ͳ910Ͳ14 15Ͳ19 20Ͳ24 25Ͳ34 35Ͳ44 45Ͳ54 55Ͳ64 65Ͳ74 75Ͳ84 85+ 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV3XEOLF+HDOWKDQG3ULPDU\+HDOWK&DUH'LYLVLRQHSL5(32571RUWKHUQ+HDOWK 5HJLRQ &200881,7<+($/7+$66(660(17 )LJXUH,QMXU\+RVSLWDOL]DWLRQV5DWHIRU0DOHVLQ1RUWKHUQ+HDOWK5HJLRQ UnintentionalInjuryHospitalizations IntentionalInjuryHospitalizations 7000 6000 5000 100,000 4000 per Rate 3000 2000 1000 0 <1 1Ͳ45Ͳ910Ͳ14 15Ͳ19 20Ͳ24 25Ͳ34 35Ͳ44 45Ͳ54 55Ͳ64 65Ͳ74 75Ͳ84 85+ 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV3XEOLF+HDOWKDQG3ULPDU\+HDOWK&DUH'LYLVLRQHSL5(32571RUWKHUQ+HDOWK 5HJLRQ 5.7.2. Injury Causes of Hospitalization DEFINITION 7KLVLQGLFDWRULOOXVWUDWHVWKHQXPEHUVRIFDVHVDQGUDWHVIRUWKHOHDGLQJFDXVHVRILQMXU\KRVSLWDOL]DWLRQ Why Is This Indicator Important? )LQGLQJRXWZKLFKLQMXULHVDUHUHVLGHQWVDUHVXVWDLQLQJFDQSURYLGHLPSRUWDQWFOXHVDERXWZKHWKHUSHRSOHDUH HQJDJLQJLQULVN\EHKDYLRXUDQGZKHWKHUQHZVWUDWHJLHVDUHQHHGHGWRUHGXFHWKHQXPEHURISUHYHQWDEOHLQMXULHV What did we learn in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per Rate 3000 2000 1000 0 <1 1Ͳ45Ͳ910Ͳ14 15Ͳ19 20Ͳ24 25Ͳ34 35Ͳ44 45Ͳ54 55Ͳ64 65Ͳ74 75Ͳ84 85+ 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV3XEOLF+HDOWKDQG3ULPDU\+HDOWK&DUH'LYLVLRQHSL5(32571RUWKHUQ+HDOWK 5HJLRQ 5.8. 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Overall Cancer Incidence DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHDJHVWDQGDUGL]HGUDWHDQGFUXGHUDWHRIDOOFDQFHUVSHUSRSXODWLRQ Why Is This Indicator Important? &DQFHUZDVLGHQWLILHGDVDPDMRUFRQFHUQLQERWKIRUPHUUHJLRQV7KLVFDQWHOOXVDERXWWKHHIIHFWLYHQHVVRI VFUHHQLQJSURJUDPVPDMRUULVNIDFWRUVDQGFDQFHUWUHDWPHQWDFFHVV,WDOVRWHOOVXVKRZZHOORXUV\VWHPZRUNVWR SUHYHQWPDMRUULVNIDFWRUVDQGFDQFHUIURPKDSSHQLQJ What did we learn in 2009? 7KHIRUPHU1250$1UHJLRQH[SHULHQFHGDQRYHUDOOGHFUHDVHLQFDQFHULQFLGHQFHIRUERWKPHQ IURPSHULQWRLQ DQGZRPHQ IURPSHULQ WRLQ +RZHYHULWDOVRVDZVWDWLVWLFDOO\VLJQLILFDQWLQFUHDVHVLQFHUYLFDO FDQFHUOXQJFDQFHUDQGPHODQRPD 7KHIRUPHU%XUQWZRRGUHJLRQH[SHULHQFHGDQLQFUHDVHLQFDQFHULQFLGHQFHLQERWKPHQ IURPWR SHUEHWZHHQDQG DQGZRPHQ WRSHUGXULQJWKH VDPHSHULRGV )HPDOHVUHPDLQHGEHORZWKHSURYLQFLDODYHUDJH LQ ZKLOHPDOHVKDG WKHKLJKHVWUDWHLQWKHSURYLQFH WKHDYHUDJHZDVLQ What did we learn in 2014? 7KHRYHUDOOFDQFHULQFLGHQFHUDWHIRUWKH1RUWKHUQ+HDOWK5HJLRQZDVSHUSRSXODWLRQ EDVHGRQSDWLHQWVVHHQDQG7KLVLQFLGHQFHUDWHLVRYHUWKH0DQLWREDDYHUDJH RI VHH)LJXUH )LJXUH2YHUDOO&DQFHU,QFLGHQFHE\5+$ ȋȌManitobaaverage Southern* InterlakeͲEastern Winnipeg PrairieMountain Northern 0 100 200 300 400 500 600 Rate per100,000 6RXUFH &$1&(5&$5(0$1,72%$ 127( 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S 5.8.2. Breast Cancer Incidence DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHUDWHRIEUHDVWFDQFHUGLDJQRVHVSHUZRPHQ Why Is This Indicator Important? ,WLVHVWLPDWHGWKDWZRPHQIURP0DQLWREDZLOOEHGLDJQRVHGZLWKEUHDVWFDQFHUWKLV\HDUZLWK G\LQJIURP WKHGLVHDVH%UHDVWFDQFHUKDVWKHKLJKHVWLQFLGHQFHUDWHIRUDOOFDQFHUVDPRQJ0DQLWREDZRPHQDQGWKHVHFRQG KLJKHVWPRUWDOLW\UDWH[L[ What did we learn in 2009? 7KHIHPDOHEUHDVWFDQFHULQFLGHQFHUDWHDPRQJ%XUQWZRRGUHVLGHQWVLQFUHDVHGIURPWR SHU EHWZHHQDQG7KLVLVORZHUWKDQWKH0DQLWREDDYHUDJHRILQ DQGUDQNVWKHORZHVWLQWKHSURYLQFH 7KHEUHDVWFDQFHULQFLGHQFHUDWHGHFOLQHGIURPWRFDVHVSHUUHVLGHQWVLQWKHIRUPHU 1250$1UHJLRQRYHUWKHWZRWLPHSHULRGV What did we learn in 2014? 7KHEUHDVWFDQFHULQFLGHQFHUDWHLQWKH1RUWKHUQ+HDOWKUHJLRQZDV SHUSRSXODWLRQ EHORZWKH0DQLWREDDYHUDJHRI VHH)LJXUH )LJXUH %UHDVW&DQFHU,QFLGHQFHE\5+$ ȋȌManitobaaverage Northern Southern PrairieMountain InterlakeͲEastern Winnipeg 0 20 40 60 80 100 120 140 Rate per100,000women 6RXUFH &$1&(5&$5(0$1,72%$ 127( 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S &200881,7<+($/7+$66(660(17 5.8.3. Prostate Cancer Incidence DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHUDWHRISURVWDWHFDQFHUGLDJQRVHVSHUPHQ Why Is This Indicator Important? ,WLVHVWLPDWHGWKDW0DQLWREDPHQZLOOEHGLDJQRVHGZLWKSURVWDWHFDQFHULQZLWKPHQLQWKHSURYLQFH G\LQJIURPWKHGLVHDVH3URVWDWHFDQFHUKDVWKHKLJKHVWLQFLGHQFHUDWHDPRQJDOOFDQFHUVLQ0DQLWREDDQGWKHUG KLJKHVWPRUWDOLW\UDWH[[ What did we learn in 2009? 7KHSURVWDWHFDQFHULQFLGHQFHUDWHLQWKHIRUPHU%XUQWZRRGUHJLRQLQFUHDVHGIURPWRQHZ FDVHVSHUEHWZHHQDQGEHORZWKH0DQLWREDDYHUDJHRIFDVHV 7KHIRUPHU1250$1UHJLRQKDGDSURVWDWHFDQFHULQFLGHQFHUDWHRIFDVHVSHULQ GHFOLQLQJWRFDVHVLQZKLFKZDVEHORZWKH0DQLWREDDYHUDJH What did we learn in 2014? 7KHSURVWDWHFDQFHULQFLGHQFHUDWHZDVSHUSRSXODWLRQLQWKH1RUWKHUQ+HDOWK5HJLRQ ZKLFKZDVEHORZWKHSURYLQFLDODYHUDJHRI VHH)LJXUH )LJXUH3URVWDWH&DQFHU,QFLGHQFHE\5+$ LinearManitoba(Manitoba) average Northern PrairieMountain Southern Winnipeg InterlakeͲEastern 0 20 40 60 80 100 120 140 Rate per100,000men 6RXUFH &$1&(5&$5(0$1,72%$ 127( 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S 5.8.4. Lung Cancer Incidence DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHUDWHRIOXQJFDQFHUGLDJQRVHVSHUSRSXODWLRQ Why Is This Indicator Important? ,WLVHVWLPDWHGWKDW0DQLWREDQVZLOOEHGLDJQRVHGZLWKOXQJFDQFHULQZLWKLQWKHSURYLQFHG\LQJIURP WKHGLVHDVH/XQJFDQFHUKDVWKHKLJKHVWPRUWDOLW\UDWHLQ0DQLWRED[[L What did we learn in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hat did we learn in 2014? 7KHOXQJFDQFHULQFLGHQFHUDWHLQWKH1RUWKHUQ+HDOWK5HJLRQZDVSHUUHVLGHQWVZHOO DERYHWKHSURYLQFLDODYHUDJHRI7KHGLIIHUHQFHLQUDWHVLVFRQVLGHUHGVWDWLVWLFDOO\VLJQLILFDQW VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH/XQJ&DQFHU,QFLGHQFHE\5+$ LinearManitoba(Manitoba)average Southern InterlakeͲEastern Winnipeg PrairieMountain Northern* 0 20 40 60 80 100 120 140 Rate per100,000 6RXUFH &$1&(5&$5(0$1,72%$ 127( 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S 5.8.5. Colorectal Cancer Incidence DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHUDWHRIFRORUHFWDOFDQFHUGLDJQRVHVSHUSRSXODWLRQ Why Is This Indicator Important? ,WLVHVWLPDWHGWKDW 0DQLWREDQVZLOOEHGLDJQRVHGZLWKFRORUHFWDOFDQFHULQZLWKLQWKHSURYLQFHG\LQJ IURPWKHGLVHDVH&RORUHFWDOFDQFHUKDVWKHUGKLJKHVWPRUWDOLW\UDWHDQGWKHQGKLJKHVWFDQFHULQFLGHQFHUDWHLQ 0DQLWRED[[LL What did we learn in 2009? 7KHFRORUHFWDOFDQFHULQFLGHQFHUDWHIRUIHPDOHVLQIRUPHU%XUQWZRRGUHJLRQLQFUHDVHGIURPWR SHUEHWZHHQDQG7KLVPRVWUHFHQWUDWHLVKLJKHUWKDQ0DQLWREDDW LQDQGQRZUDQNVDPRQJWKHKLJKHVWRIDOO5+$VLQWKHSURYLQFH 7KH PDOH FRORUHFWDO FDQFHU LQFLGHQFHUDWH LQ %XUQWZRRG LQFUHDVHGIURP WR SHU EHWZHHQDQGDQGLVKLJKHUWKDQWKH0DQLWREDDYHUDJHRILQ ,Q WKH IRUPHU 1250$1 UHJLRQ WKH FRORUHFWDO FDQFHU LQFLGHQFH UDWH GHFOLQHG IRU ERWK PDOHV DQG IHPDOHV)RUPDOHVLWZHQWIURPWRFDVHVSHUSRSXODWLRQEHWZHHQWKHWZRWLPHSHULRGV 7KHIHPDOHUDWHGHFOLQHGIURPWRFDVHVSHUSRSXODWLRQ What did we learn in 2014? 7KHFRORUHFWDOFDQFHULQFLGHQFHUDWHIRUWKH1RUWKHUQ+HDOWK5HJLRQZDVSHUSRSXODWLRQ ZKLFKZDVDERYHWKHSURYLQFLDODYHUDJHRI VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH&RORUHFWDO&DQFHU,QFLGHQFHE\5+$ LinearManitoba(Manitoba)average Southern Winnipeg InterlakeͲEastern PrairieMountain Northern 0 102030405060708090 Rate per100,000 6RXUFH &$1&(5&$5(0$1,72%$ 127( 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S 5.9. Communicable Disease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Chlamydia DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHQXPEHURIFDVHVRIWKHQRWLILDEOHVH[XDOO\WUDQVPLWWHGLQIHFWLRQ 67, &KODP\GLD WUDFKRPDWLVSHUSRSXODWLRQSHU\HDU Why Is This Indicator Important? &KODP\GLDLVWKHPRVWFRPPRQVH[XDOO\WUDQVPLWWHGEDFWHULDOLQIHFWLRQLQ&DQDGD&KODP\GLDFDQOHDGWR3HOYLF ,QIODPPDWRU\'LVHDVH 3,' LQPDQ\ZRPHQLIOHIWXQWUHDWHG What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQWKH&KODP\GLDUDWHIRUZRPHQ SHUUHVLGHQWVLQ ZDVDOPRVWILYHWLPHVKLJKHUWKDQWKH0DQLWREDDYHUDJH LQ DQGPRUHWKDQIRXU WLPHVKLJKHUIRUPHQ SHULQZLWKDQDYHUDJHRI 2QUHVHUYHUHVLGHQWV ZHUHPRUHOLNHO\WREHGLDJQRVHG SHULQWRLQ WKRXJKUDWHVRI GLDJQRVHVZHUHULVLQJDPRQJRIIUHVHUYHUHVLGHQWVDWDKLJKHUUDWH SHULQWR LQ ,QWKHIRUPHU1250$15HJLRQZRPHQKDGWKHKLJKHVWUDWHVLQWKHSURYLQFHDWIURP 1250$1PDOHVKDGDUDWHRIWKHWKLUGKLJKHVWLQWKHSURYLQFHGXULQJWKH VDPHSHULRG What did we learn in 2014? $V)LJXUHLOOXVWUDWHVWKHFKODP\GLDUDWHIRUWKH1RUWKHUQ+HDOWK5HJLRQKDVJHQHUDOO\LQFUHDVHG RYHUWKHWLPHSHULRGZLWKUDWHVVWDUWLQJDW SHUFOLPELQJWRLQ 2QWKHRWKHUKDQGWKH0DQLWREDDYHUDJHFOLPEHGPRGHVWO\IURPZKLOHUHPDLQLQJ UHODWLYHO\IODWWKHUHDIWHULQWKHUDQJHRIFDVHVSHUSRSXODWLRQ 7KH1RUWKHUQ+HDOWK5HJLRQFKODP\GLDUDWHZDVRYHUIRXUWLPHVKLJKHUWKDQWKDWRIRWKHU5+$VLQ 0DQLWREDLQ VHH)LJXUH )LJXUH&KODP\GLD5DWHIRU1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED Northern Manitoba 2500 2000 1500 1000 500 0 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 6RXUFH 0RQWKO\&RPPXQLFDEOH'LVHDVH5HSRUWV0DQLWRED0RQWKO\6XUYHLOODQFH8QLW5HSRUWV )LJXUH&KODP\GLD5DWHE\5+$ ȋȌManitobaaverage Southern Winnipeg PrairieMountain InterlakeͲEastern Northern 0 500 1000 1500 2000 2500 Rate per100,000 6RXUFH 0RQWKO\&RPPXQLFDEOH'LVHDVH5HSRUWV0DQLWRED0RQWKO\6XUYHLOODQFH8QLW5HSRUWV 127( 1RUWKHUQKDVVWDWLVWLFDOO\KLJKHUWKDQDYHUDJH,QWHUODNH(DVWHUQ3UDLULH0RXQWDLQ:LQQLSHJDQG6RXWKHUQKDYHVWDWLVWLFDOO\ORZHUWKDQ DYHUDJH &200881,7<+($/7+$66(660(17 5.9.1.2. Gonorrhea DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHQXPEHURIFDVHVRIWKHQRWLILDEOHVH[XDOO\WUDQVPLWWHGLQIHFWLRQ 67, *RQRUUKHDSHU SRSXODWLRQSHU\HDU Why Is This Indicator Important? $IWHUDORQJGHFOLQH*RQRUUKHDLVEDFNRQWKHULVHLQ&DQDGDZLWKLQIHFWLRQVRYHUWKHODVWWHQ\HDUVLQFUHDVLQJRYHU ILIW\WKUHHSHUFHQW7KLVLVGXHERWKWRLQFRQVLVWHQWXVHRIVDIHUVH[PHWKRGVDQGEHWWHUVFUHHQLQJPHWKRGV,WKDVD GLVSURSRUWLRQDWHHIIHFWRQ\RXQJSHRSOHHVSHFLDOO\\RXQJPHQXQGHUWKHDJHRIWZHQW\IRXU[[LLL What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQ*RQRUUKHDLQIHFWLRQUDWHVZHUHKLJKHUDPRQJWKRVHOLYLQJRQ UHVHUYH LQ WKRXJKRIIUHVHUYHFDVHVZHUHULVLQJDWDKLJKHUUDWH)LUVW1DWLRQVUHVLGHQWV ZHUHEHLQJGLDJQRVHGZLWKDVLJQLILFDQWSURSRUWLRQRIWKHFDVHVDWHLJKW\IRXUSHUFHQW7KHUDWHRI LQIHFWLRQZDVDOVRPXFKKLJKHUWKDQWKH0DQLWREDDYHUDJH)HPDOHVKDGDUDWHRIFDVHVSHU UHVLGHQWVDQGSHUIRUPDOHV ,QWKHIRUPHU1250$15HJLRQZRPHQKDGWKHVHFRQGKLJKHVWUDWHVLQWKHSURYLQFHDW $W1250$1PDOHVKDGWKHIRXUWKKLJKHVWLQWKHSURYLQFH What did we learn in 2014? 7KHUDWHIRUJRQRUUKHDLQWKH1RUWKHUQ+HDOWK5HJLRQZDVFRQVLGHUDEO\KLJKHUWKDQWKH0DQLWREDUDWH IURP7KHUHJLRQDOUDWHURVHVXEVWDQWLDOO\EHWZHHQDQGIURPSHU LQWR LQ%H\RQGWKHUDWHGHFOLQHGDQGIOXFWXDWHGLQWKHFDVHVSHU UDQJH7KH0DQLWREDJHQHUDOO\KRYHUHGLQWKHFDVHVSHUDUHD VHH)LJXUH $VZLWK&KODP\GLDWKH1RUWKHUQ+HDOWK5HJLRQUDWHIRUJRQRUUKHDZDVVL[WLPHKLJKHUWKDQWKH 0DQLWREDDYHUDJHIRU VHH)LJXUH )LJXUH*RQRUUKHD5DWHIRU1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED Northern Manitoba 800 700 600 500 400 300 200 100 0 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 6RXUFH 0RQWKO\&RPPXQLFDEOH'LVHDVH5HSRUWV0DQLWRED0RQWKO\6XUYHLOODQFH8QLW5HSRUWV )LJXUH*RQRUUKHD5DWHE\5+$ ȋȌManitobaaverage Southern PrairieMountain InterlakeͲEastern Winnipeg Northern 0 100 200 300 400 500 600 700 Rate per100,000 6RXUFH 0RQWKO\&RPPXQLFDEOH'LVHDVH5HSRUWV0DQLWRED0RQWKO\6XUYHLOODQFH8QLW5HSRUWV 127( 1RUWKHUQKDVVWDWLVWLFDOO\KLJKHUWKDQDYHUDJH,QWHUODNH(DVWHUQ3UDLULH0RXQWDLQ:LQQLSHJDQG6RXWKHUQKDYHVWDWLVWLFDOO\ORZHUWKDQ DYHUDJH &200881,7<+($/7+$66(660(17 5.9.1.3. HIV DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHUDWHRIQHZODERUDWRU\FRQILUPHGLQIHFWLRQVZLWK+,9SHUSHUSRSXODWLRQSHU \HDU Why Is This Indicator Important? +,9 +XPDQ,PPXQRGHILFLHQF\9LUXV LVWKHYLUXVWKDWOHDGVWR$,'6$OWKRXJKSHUVRQVZLWK+,9FDQRIWHQOHDG ORQJSURGXFWLYHOLYHVZLWKSURSHUPDQDJHPHQW+,9FDQQRWEHFXUHGDQGWKHUHLVQRYDFFLQHWRSUHYHQWLW,WLV ZLGHO\SUHYHQWDEOHWKURXJKVDIHUVH[PHWKRGV$FFRUGLQJWRWKH3XEOLF+HDOWK$JHQF\RI&DQDGDLQIHFWLRQUDWHVDUH ULVLQJDVLVWKHQXPEHURI&DQDGLDQVOLYLQJZLWK+,9,WDOVRDIIHFWV$ERULJLQDO&DQDGLDQVGLVSURSRUWLRQDWHO\ HVSHFLDOO\$ERULJLQDOZRPHQZKRDUHLQIHFWHGDWDPXFKKLJKHUUDWHWKDQQRQ$ERULJLQDOZRPHQ[[LY What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQZRPHQKDGWKHVHFRQGKLJKHVWUDWHLQ0DQLWREDDQGPHQKDGWKH WKLUGKLJKHVWLQWKHSURYLQFHDOWKRXJKVWLOOTXLWHXQFRPPRQZLWKORZQXPEHUV7KHUHZHUHRQO\ FDVHVGLDJQRVHGLQ%XUQWZRRGEHWZHHQ DQGLQPDOHVDQG LQIHPDOHV ,QWKHIRUPHU1250$15HJLRQ+,9UDWHVZHUHYHU\ORZDQGGHFUHDVLQJIRUERWKVH[HV H[DFW QXPEHUVXQDYDLODEOH What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQ+,9UDWHGLGH[SHULHQFHDQLQFUHDVHIURPWRULVLQJIURP SHUWRLQFORVHWRWKH0DQLWREDDYHUDJHRI VHH)LJXUH 7KH+,9UDWHIRUWKH1RUWKHUQ+HDOWK5HJLRQZDVSHUSRSXODWLRQZKLFKZDVEHORZWKH 0DQLWREDDYHUDJHRI VHH)LJXUH )LJXUH+,95DWHIRU1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED Northern Manitoba 12 10 8 6 100,000 per 4 Rate 2 0 2010 2011 2012 6RXUFH 0RQWKO\&RPPXQLFDEOH'LVHDVH5HSRUWV0DQLWRED0RQWKO\6XUYHLOODQFH8QLW5HSRUWV )LJXUH+,95DWHE\5+$ ȋȌManitobaaverage InterlakeͲEastern PrairieMountain Southern Northern Winnipeg 012345678 Rate per100,000 6RXUFH 0RQWKO\&RPPXQLFDEOH'LVHDVH5HSRUWV0DQLWRED0RQWKO\6XUYHLOODQFH8QLW5HSRUWV 127( ,QWHUODNH(DVWHUQDQG3UDLULH0RXQWDLQKDYHVWDWLVWLFDOO\ORZHUWKDQDYHUDJH &200881,7<+($/7+$66(660(17 5.9.2. 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Mortality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hat did we learn in 2009? 7RWDOPRUWDOLW\UDWHVLQ%XUQWZRRGLQFUHDVHGIURPWRSHUSRSXODWLRQEHWZHHQ DQG7KLVZDVVLJQLILFDQWO\KLJKHUWKDQWKH0DQLWREDDYHUDJHRILQ 7KHIRUPHU1250$1UHJLRQH[SHULHQFHGDVOLJKWLQFUHDVHLQUDWHVIURPWREHWZHHQWKH WZRWLPHSHULRGV What did we learn in 2014? 7KHUHZDVRQO\DYHU\VOLJKWLQFUHDVHLQPRUWDOLW\UDWHVLQWKH1RUWKHUQ+HDOWK5HJLRQIURPSHU SRSXODWLRQLQWRLQDERYHWKHSURYLQFLDODYHUDJHRI 5.10.2. Leading 10 Causes of Mortality DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSHUFHQWDJHRIGHDWKVUHSUHVHQWHGE\WKHWHQPRVWSUHYDOHQWFDXVHV Why Is This Indicator Important? 7KLVLQGLFDWHVWKHSUHYDOHQFHRIFDXVHVRIPRUWDOLW\DQGPDNHVLWHDVLHUWRGHWHFWUHJLRQDOWUHQGVDQGZKHWKHURUQRW WKH\IROORZEURDGHUWUHQGV,WDOVRWHOOVXVDERXWWKHSUHYHQWDELOLW\RIWKHVHFDXVHVDQGKRZWREHVWDGGUHVVWKHP What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQODUJHO\IROORZHGSURYLQFLDOWUHQGVLQWHUPVRIFDXVHVRIPRUWDOLW\ &LUFXODWRU\GLVHDVHV LQIHPDOHVDQGLQPDOHVLQ DQGFDQFHU LQIHPDOHV DQGLQPDOHVLQ KDGORZHUUDWHVWKDQDYHUDJH LQIHPDOHVDQGLQ WKHVDPHSHULRGUHVSHFWLYHO\,QPDOHVLWZDVDQG (QGRFULQHDQGQXWULWLRQDO GLVRUGHUVZHUHULVLQJ LQIHPDOHVLWURVHIURPLQ WRLQ,QPDOHVLW URVHIURPLQ WRLQ +RZHYHUWKHQXPEHURILQMXU\UHODWHGGHDWKVZDV QRWDEO\KLJKHUWKDQWKHSURYLQFLDODYHUDJH What did we learn in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Injury Mortality Rates DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHQXPEHURIGHDWKVGXHWRLQMXU\SHUUHVLGHQWVSHU\HDUEDVHGRQ9LWDO6WDWLVWLFV GHDWKFRGHV Why Is This Indicator Important? 7KLVWHOOVXVKRZVHULRXVRIDQLVVXHWKLVLVLQDUHJLRQDQGDOORZVXVWRSURSHUO\DOORFDWHUHVRXUFHVLQRUGHUWR UHGXFHLW What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQUHSRUWHGWKHKLJKHVWUDWHVLQWKHSURYLQFH ZDVWKHSURYLQFLDO DYHUDJHLQ DPRQJPDOHVWKRXJKWKH\ZHUHGHFUHDVLQJ IURPLQ WRLQ )HPDOHVZHUHDOVRUDQNHGWKHKLJKHVWLQWKHSURYLQFH LQ WKRXJKWKH\ZHUH GHFUHDVLQJDVZHOO LQ WRLQ ,QWKHIRUPHU1250$15HJLRQLWUHPDLQHGWKHWKLUGOHDGLQJFDXVHRIGHDWK What did we learn in 2014? 7KHDJHVWDQGDUGL]HGUDWHIRUDOOLQMXULHVZDVIURPLQWKH1RUWKHUQ5+$7KHUDWHV ZHUHFRQVLGHUDEO\KLJKHUIRUPDOHVERWKIRUXQLQWHQWLRQDODQGLQWHQWLRQDOLQMXULHVFRPSDUHGWR IHPDOHV 7DEOH1RUWKHUQ+HDOWK5HJLRQ,QMXU\GHDWKV&RXQWVDQG$JHVWDQGDUGL]HG5DWHV ,QMXULHV RI&DVHV )HPDOH RI&DVHV 0DOH RI&DVHV 2YHUDOO 8QLQWHQWLRQDO ,QWHQWLRQDO $OO,QMXULHV 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV3XEOLF+HDOWKDQG3ULPDU\+HDOWK&DUH'LYLVLRQHSL5(32571RUWKHUQ+HDOWK 5HJLRQ 5.10.3.1. Suicide Rates DEFINITION 7KHDQQXDOUDWHRIGHDWKVGXHWRVXLFLGHSHUUHVLGHQWVDJHGDQGROGHU7KHGDWDDUHE\FDOHQGDU\HDUUDWKHU WKDQILVFDO\HDU6XLFLGHLVWKHDFWRILQWHQWLRQDOO\NLOOLQJRQHVHOIWKURXJKVHOILQIOLFWHGLQMXU\ HJFXWWLQJRU SRLVRQLQJ Why Is This Indicator Important? 6XLFLGHLVDFRPSOH[SKHQRPHQRQZLWKPDQ\ULVNIDFWRUV$SSUR[LPDWHO\ SHUFHQWRIVXLFLGDOSHRSOHKDYHD SV\FKLDWULFGLVRUGHUPRVWFRPPRQO\GHSUHVVLRQRUSV\FKRVLV$ERULJLQDO\RXWKDUHILYHWRVHYHQWLPHVPRUHOLNHO\ WRFRPPLWVXLFLGHWKDQQRQ$ERULJLQDO\RXWKDFFRUGLQJWR+HDOWK&DQDGD[[Y What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQUHSRUWHGWKHKLJKHVWVXLFLGHUDWHVLQ0DQLWREDDWVXLFLGHVLQ ZKLFKZDVDQLQFUHDVHIURPSHULQ ,QWKHIRUPHU1250$15HJLRQWKHUHZDVDVOLJKWLQFUHDVHLQUDWHVIURPSHULQ WRLQZKLFKZDVFORVHWRWKH0DQLWREDDYHUDJHRILQ What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQH[SHULHQFHGDVWDWLVWLFDOO\VLJQLILFDQWLQFUHDVHLQVXLFLGHUDWHVIURP SHUSRSXODWLRQLQWRLQ7KH0DQLWREDDYHUDJHZDV VHH)LJXUH $PRQJ1RUWKHUQ+HDOWK5HJLRQ]RQHVWKHKLJKHVWVXLFLGHUDWHVZHUHVHHQLQWKH1RUWKHUQ,VODQG /DNH]RQH LQ DQGWKH1RUWKHUQ1RQ'LUHFW6HUYLFH]RQH LQ ZKLFK KDGDVWDWLVWLFDOO\VLJQLILFDQWLQFUHDVHEHWZHHQWKHWZRWLPHSHULRGV VHH)LJXUH WHAT ARE WE DOING? 7KH+23(1RUWK6XLFLGH3UHYHQWLRQ&RPPLWWHH¶VJRDOLVWRHQKDQFHSURWHFWLYHIDFWRUVIRULQGLYLGXDOV IDPLOLHVDQGFRPPXQLWLHVZLWKLQWKHUHJLRQZKLOHUHGXFLQJVXLFLGHUDWHVDQGSURPRWLQJOLIHWKURXJKD P\ULDGRILQLWLDWLYHVDQGDFWLYLWLHV$OOWKHDFWLYLWLHVRI+23(1RUWKDUHFHQWHUHGRQOLIHSURPRWLRQ 6RPHUHFHQWLQLWLDWLYHLQFOXGH +HDOWKSURPRWLRQ UDLVLQJDZDUHQHVVZKLOHUHGXFLQJVWLJPD *DWHNHHSHUWUDLQLQJVXFKDV6DIH7DON0HQWDO+HDOWK)LUVW$LGDQG$6,676FKRRO%DVHG 7UDLQLQJDQG,QLWLDWLYHVLQFOXGLQJ &200881,7<+($/7+$66(660(17 )LJXUH$YHUDJH$QQXDO6XLFLGH5DWHVE\5+$DQG 2002Ͳ2006 2007Ͳ2011 LinearManitoba(Manitobaaverageaverage2002Ͳ20022006Ͳ2006) LinearManitoba(Manitobaaverageaverage2007Ͳ20072011Ͳ2011) Southern(1,2) Winnipeg PrairieMountain InterlakeͲEastern Northern(1,2,t) 012345 Rateper10,000residents age10+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH$YHUDJH$QQXDO6XLFLGH5DWHVE\1RUWKHUQ+HDOWK5HJLRQ=RQHDQG 2002Ͳ2006 2007Ͳ2011 LinearNorthern(Northernaverageaverage2002Ͳ20022006Ͳ2006) LinearNorthern(Northernaverageaverage2007Ͳ20072011Ͳ2011) NorthernDirectServiceZone NorthernNonͲDirectService Zone(1,2,t) NorthernIslandLakeZone(1,2) 0246810 Rateper10,000residents age10+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD 5.10.3.2. 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Cancer Mortality DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHQXPEHURIGHDWKVGXHWRFDQFHURYHUDJLYHQWLPHSHULRGH[SUHVVHGDVDUDWHSHU SRSXODWLRQ Why Is This Indicator Important? 7KLVWHOOVXVDERXWZKHUHZHVKRXOGWDUJHWRXUFDQFHUSUHYHQWLRQVWUDWHJLHVDQGZKDWRXUJUHDWHUULVNIDFWRUVPLJKW EH What did we learn in 2009? 6WDWVZHUHRQO\DYDLODEOHIRUWKH1RUWKHUQ5HJLRQDVDZKROHLQFOXGLQJERWKIRUPHUUHJLRQV7KHWRS FDQFHUVFDXVLQJLQPHQZHUHOXQJ FRORUHFWDO SURVWDWH SDQFUHDV DQGEODGGHU 2WKHUFDQFHUVFRPSULVHG SHUFHQW,QZRPHQWKH\ZHUHOXQJ FRORUHFWDO EUHDVW SDQFUHDV DQGRYDU\ 2WKHUFDQFHUGHDWKVZHUH SHUFHQW 7KHIRUPHU1250$1UHJLRQKDGDQRYHUDOOFDQFHUPRUWDOLW\UDWHLQRISHU ZKLOHWKHIRUPHU%XUQWZRRGUHJLRQKDGDUDWHRIWKHKLJKHVWPRUWDOLW\UDWHVDPRQJ 5+$V7KH1250$1UDWHZDVFRQVLGHUHGVWDWLVWLFDOO\GLIIHUHQWIURPWKH0DQLWREDDYHUDJHRI What did we learn in 2014? 7KHRYHUDOOFDQFHUPRUWDOLW\UDWHLQLQWKH1RUWKHUQ+HDOWK5HJLRQZDVSHU SRSXODWLRQWKHKLJKHVWUDWHDPRQJ5+$VDQGVWDWLVWLFDOO\GLIIHUHQWIURPWKH0DQLWREDDYHUDJHRI VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH2YHUDOO&DQFHU0RUWDOLW\E\5+$ LinearManitoba(Manitoba)average Southern* PrairieMountain Winnipeg InterlakeͲEastern* Northern* 0 50 100 150 200 250 300 Rate per100,000 6RXUFH &$1&(5&$5(0$1,72%$ 127( 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S 5.10.4.1. Lung Cancer Mortality DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHQXPEHURIGHDWKVGXHWROXQJFDQFHURYHUDJLYHQWLPHSHULRGH[SUHVVHGDVDUDWHSHU SRSXODWLRQ What did we learn in 2009? 7KHIRUPHU1250$1UHJLRQKDGDOXQJFDQFHUPRUWDOLW\UDWHLQRISHU ZKLOHWKHIRUPHU%XUQWZRRGUHJLRQKDGDUDWHRI 7KHVHUHJLRQDOUDWHVZHUHDERYHWKH0DQLWRED DYHUDJHRIWKRXJKWKHGLIIHUHQFHVZHUHQRWFRQVLGHUHGVWDWLVWLFDOO\VLJQLILFDQW What did we learn in 2014? 7KHOXQJFDQFHUPRUWDOLW\UDWHLQLQWKH1RUWKHUQ+HDOWK5HJLRQDSSHDUHGWRULVHWR SHUSRSXODWLRQWKHKLJKHVWUDWHDPRQJ5+$VWKRXJKQRWVWDWLVWLFDOO\GLIIHUHQWIURPWKH 0DQLWREDDYHUDJHRI VHH)LJXUH )LJXUH/XQJ&DQFHU0RUWDOLW\E\5+$ LinearManitoba(Manitoba)average Southern Winnipeg PrairieMountain InterlakeͲEastern Northern 0 1020304050607080 Rate per100,000 6RXUFH &$1&(5&$5(0$1,72%$ 127( 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S &200881,7<+($/7+$66(660(17 5.10.4.2. Colorectal Cancer Mortality DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHQXPEHURIGHDWKVGXHWRFRORUHFWDOFDQFHURYHUDJLYHQWLPHSHULRGH[SUHVVHGDVDUDWH SHUSRSXODWLRQ What did we learn in 2009? 7KHIRUPHU1250$1UHJLRQKDGDFRORUHFWDOFDQFHUPRUWDOLW\UDWHLQRISHU ZKLOHWKHIRUPHU%XUQWZRRGUHJLRQKDGDUDWHRI7KH1250$1UDWHZDVWKHKLJKHVW DPRQJ5+$VWKRXJKWKHGLIIHUHQFHZLWKWKH0DQLWREDDYHUDJHRIZDVQRWFRQVLGHUHGVWDWLVWLFDOO\ VLJQLILFDQW What did we learn in 2014? 7KHFRORUHFWDOFDQFHUPRUWDOLW\UDWHLQLQWKH1RUWKHUQ+HDOWK5HJLRQDSSHDUHGWRULVHWR SHUSRSXODWLRQWKHKLJKHVWUDWHDPRQJ5+$VDQGVWDWLVWLFDOO\GLIIHUHQWIURPWKH 0DQLWREDDYHUDJHRI VHH)LJXUH )LJXUH&RORUHFWDO&DQFHU0RUWDOLW\E\5+$ LinearManitoba(Manitoba)average Southern Winnipeg PrairieMountain InterlakeͲEastern Northern* 0 1020304050 Rate per100,000 6RXUFH &$1&(5&$5(0$1,72%$ 127( 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S 5.10.4.3. Breast Cancer Mortality DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHQXPEHURIGHDWKVGXHWREUHDVWFDQFHURYHUDJLYHQWLPHSHULRGH[SUHVVHGDVDUDWHSHU SRSXODWLRQ What did we learn in 2009? 7KHIRUPHU1250$1UHJLRQKDGDEUHDVWFDQFHUPRUWDOLW\UDWHLQRISHU ZKLOHWKHIRUPHU%XUQWZRRGUHJLRQKDGDUDWHRI7KH1250$1UDWHZDVWKHKLJKHVWDPRQJ 5+$VWKRXJKWKHGLIIHUHQFHZLWKWKH0DQLWREDDYHUDJHRI ZDVQRWFRQVLGHUHGVWDWLVWLFDOO\ VLJQLILFDQW What did we learn in 2014? 7KHEUHDVWFDQFHUPRUWDOLW\UDWHLQLQWKH1RUWKHUQ+HDOWK5HJLRQDSSHDUHGWRGURSWR SHUSRSXODWLRQWKHORZHVWUDWHDPRQJ5+$VWKRXJKQRWVWDWLVWLFDOO\GLIIHUHQWIURPWKH 0DQLWREDDYHUDJHRI VHH)LJXUH )LJXUH%UHDVW&DQFHU0RUWDOLW\E\5+$ LinearManitoba(Manitoba)average Northern PrairieMountain Southern Winnipeg InterlakeͲEastern 0 5 10 15 20 25 30 35 40 Rate per100,000women 6RXUFH &$1&(5&$5(0$1,72%$ 127( 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S &200881,7<+($/7+$66(660(17 5.10.4.4. Prostate Cancer Mortality DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHQXPEHURIGHDWKVGXHWRSURVWDWHFDQFHURYHUDJLYHQWLPHSHULRGH[SUHVVHGDVDUDWHSHU SRSXODWLRQ What did we learn in 2009? 7KHIRUPHU1250$1DQG%XUQWZRRGUHJLRQVKDGKLJKSURVWDWHFDQFHUPRUWDOLW\UDWHVRI DQG SHUSRSXODWLRQUHVSHFWLYHO\ZHOODERYHWKH0DQLWREDDYHUDJHRILQ7KH GLIIHUHQFHVLQUDWHVZHUHFRQVLGHUHGVWDWLVWLFDOO\VLJQLILFDQWIRUERWKUHJLRQV What did we learn in 2014? 7KHSURVWDWHFDQFHUPRUWDOLW\UDWHLQLQWKH1RUWKHUQ+HDOWK5HJLRQDSSHDUHGWRGURSWR SHUSRSXODWLRQWKHKLJKHVWUDWHDPRQJ5+$VWKRXJKQRWVWDWLVWLFDOO\GLIIHUHQWIURPWKH 0DQLWREDDYHUDJHRI VHH)LJXUH )LJXUH3URVWDWH&DQFHU0RUWDOLW\5DWH LinearManitoba(Manitoba)average Southern Winnipeg PrairieMountain InterlakeͲEastern Northern 0 102030405060 Rate per100,000men 6RXUFH &$1&(5&$5(0$1,72%$ 127( 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S 5.10.5. Leading 10 Causes of Premature Mortality DEFINITION 7KLVLQGLFDWRUUHIHUVWRWKHDQQXDOSURSRUWLRQ RISUHPDWXUHGHDWKVIRUWKHPRVWSUHYDOHQW,&' DQG,&' FRGHJURXSLQJVIRUFDXVHRIGHDWKIRUDJJUHJDWHDUHDV Why Is This Indicator Important? ,WLVLPSRUWDQWWKDWUHJLRQVDUHDZDUHRIZKLFKGLVHDVHVDQGFRQGLWLRQVDUHFDXVLQJSUHPDWXUHGHDWKLQRUGHUWRWDUJHW WUHDWPHQWPDQDJHPHQWDQGSUHYHQWLRQSURJUDPVIRUWKRVHFRQGLWLRQVLQRUGHUWKDWUHVLGHQWVOLYHORQJHUDQGDWD KLJKHUTXDOLW\RIOLIH What did we learn in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Premature Mortality Rates DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHDQQXDOQXPEHURIGHDWKVRFFXUULQJEHIRUHWKHDJHRISHUSRSXODWLRQIRU LQGLYLGXDOVZKLFKLVDGMXVWHGWRDUHIHUHQFH RUVWDQGDUG SRSXODWLRQRILQGLYLGXDOVXQGHU\HDUVRIDJH Why Is This Indicator Important? 3UHPDWXUH0RUWDOLW\5DWH 305 LVFRQVLGHUHGE\PDQ\KHDOWKUHVHDUFKHUVWREHWKHVLQJOHEHVWLQGLFDWRURID SRSXODWLRQ¶VKHDOWKVWDWXV+LJKHU305VLQGLFDWHSRRUHURYHUDOOKHDOWKDQGJUHDWHUQHHGIRUKHDOWKVHUYLFHV What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQKDGDVOLJKWLQFUHDVHLQ305IURPGHDWKVSHULQ WRSHUUHVLGHQWVLQZKLFKZDVWKHKLJKHVWUDWHUHFRUGHGDPRQJ0DQLWRED5+$V IRUWKDWWLPHSHULRG 7KHIRUPHU1250$15HJLRQKDGWKHVHFRQGKLJKHVWUDWHVEXWWKHUHZDVDVOLJKWGHFUHDVHIURP GHDWKSHUUHVLGHQWVLQ WRLQ What did we learn in 2014? 7KH3UHPDWXUH0RUWDOLW\5DWHVWD\HGYLUWXDOO\XQFKDQJHGLQWKH1RUWKHUQ+HDOWK5HJLRQPRYLQJIURP SHUSRSXODWLRQLQWRLQ,WZDVVWDWLVWLFDOO\DERYHWKH0DQLWRED DYHUDJHRI VHH)LJXUH &RQVLVWHQWZLWKRWKHUILQGLQJVLQWKLVFKDSWHU305UDWHVZHUHKLJKHULQWKH1RUWKHUQ,VODQG/DNH VWDWLVWLFDOO\DERYHWKH0DQLWREDDYHUDJH DQGWKH1RQ'LUHFW6HUYLFH]RQHV VHH)LJXUH )LJXUH 3055DWHVE\5+$DQG 2002Ͳ2006 2007Ͳ2011 LinearManitoba(Manitobaaverageaverage2002Ͳ20022006Ͳ2006) LinearManitoba(Manitobaaverageaverage2007Ͳ 20112007Ͳ2011) Southern(1,2,t) Winnipeg(1,2,t) PrairieMountain(t) InterlakeͲEastern Northern(1,2) 0.0 1.0 2.0 3.0 4.0 5.0 6.0 Rateper1,000residents aged0Ͳ74 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH 3055DWHVE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2002Ͳ2006 2007Ͳ2011 LinearNorthern(Northernaverageaverage2002Ͳ20022006Ͳ2006) LinearNorthern(Northernaverageaverage2007Ͳ20072011Ͳ2011) Gillam,FoxLakeCN Flin,Snow,Cran,Sher Thompson,MysteryLake(2) ThePas/OCN,Kelsey(1,2) BayLine SayD(TL),Bro/BL,NoL(Lac)(1,2) LL/MC,LR,OͲP(SIL),PN(GVL)(1,2) Puk/MatColCN(1,2) CrossLake/PimiCN(1,2) GR/Mis,ML/Mos,Eas/Che(1,2) Bu(OH),MS(GR),GLN/GLFN(1,2) NorwayHouse/NHCN(1,2) IslandLake(1,2) Sham,YorkFN,Tat(SPL)(1,2) NelsonHouse/NCN(1,2) NorthernDirectServiceZone(1,2) NorthernNonͲDirectServiceZone(1,2) NorthernIslandLakeZone(1,2) 024681012 Rateper1,000residents aged0Ͳ74 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD &200881,7<+($/7+$66(660(17 5.10.7. 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Infant Mortality DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIOLYHELUWKVZHLJKLQJJUDPVRUPRUHWKDWGLHZLWKLQWRGD\VRI ELUWKUHSRUWHGDVDUDWHSHUOLYHELUWKVIRUDJLYHQSHULRGRIWLPH7KLVPHDVXUHH[FOXGHVVWLOOELUWKVDQGLQIDQWV OHVVWKDQJUDPVRUZHHNVRIJHVWDWLRQ Why Is This Indicator Important? ,QIDQWPRUWDOLW\LVDYHU\LPSRUWDQWLQGLFDWRUDVLWLQIRUPVXVDERXWKHDOWKVWDWXVTXDOLW\DQGDFFHVVWRSUHQDWDOFDUH DQGPRUWDOLW\,WDOVRWHOOVXVDERXWWKHDWWHQWLRQSDLGWRPDWHUQDODQGFKLOGUHQ¶VKHDOWKDQGWKHHIIHFWLYHQHVVRI SUHYHQWDWLYHFDUHDVZHOODVWKHDFFHVVLELOLW\RIKHDOWKFDUHDQGWKHVWDWXVRIZRPHQ What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQLQIDQWPRUWDOLW\GHFUHDVHGIURPGHDWKVSHULQ WR LQUHPDLQLQJDERYHWKH0DQLWREDDYHUDJHRI ,QWKHIRUPHU1250$15HJLRQWKHUHZDVDFRQVLGHUDEOHLQFUHDVHLQLQIDQWPRUWDOLW\UDWHVIURP SHULQ WRSHULQ What did we learn in 2014? )URPWRWKH1RUWKHUQ+HDOWK5HJLRQKDGDQLQIDQWPRUWDOLW\UDWHRIGHDWKV SHUELUWKVWKHKLJKHVWDPRQJ0DQLWRED5+$V,WZDVFRQVLGHUHGVWDWLVWLFDOO\GLIIHUHQWIURPWKH 0DQLWREDDYHUDJHRIGHDWKVSHULQIDQWV VHH)LJXUH )LJXUH ,QIDQW0RUWDOLW\E\5+$ ȋȌManitoba average PrairieMountain Winnipeg SouthernHealthͲ SantéSud InterlakeͲEastern Northern* 024681012 Rate per 1,000 infants 6RXUFH 0DQLWRED+HDOWK+HDOWK\/LYLQJDQG6HQLRUV5+$3URILOH 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJH 5.10.9. Child Mortality DEFINITION &KLOGPRUWDOLW\UDWHVDUHFDOFXODWHGDVWKHWRWDOQXPEHURIGHDWKVDJHGWR \HDUVGLYLGHGE\WKHWRWDOSRSXODWLRQ RIWKHVDPHDJHLQWKDWWLPHSHULRG,WLVUHSRUWHGDVUDWHRIGHDWKVSHUFKLOGUHQDJHGWR \HDUVIRUD JLYHQSHULRGRIWLPH Why Is This Indicator Important? ,QMXU\LVWKHOHDGLQJFDXVHRIFKLOGPRUWDOLW\LQ&DQDGDZLWKFDQFHUFRPLQJVHFRQG7KLVZDVLGHQWLILHGDVDNH\ DUHDRIFRQFHUQIRUWKHIRUPHU%XUQWZRRGUHJLRQ What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQFKLOGPRUWDOLW\UDWHVUHPDLQHGVWDEOHZLWKDVOLJKWGHFUHDVHIURP GHDWKVSHUSRSXODWLRQLQ WRLQZKLFKZDVVWLOOVLJQLILFDQWO\ DERYHWKHSURYLQFLDODYHUDJHRI What did we learn in 2014? )URPWRWKH1RUWKHUQ+HDOWK5HJLRQKDGDFKLOGPRUWDOLW\UDWHRI GHDWKV SHUSRSXODWLRQZKLFKLVDOPRVWWKUHHWLPHVWKH0DQLWREDUDWHRIGHDWKVSHU SRSXODWLRQ7KH1RUWKHUQUDWHLVFRQVLGHUHGWREHVWDWLVWLFDOO\DERYHWKH0DQLWREDDYHUDJH VHH )LJXUH )LJXUH&KLOG0RUWDOLW\E\5+$ ȋȌManitobaaverage Winnipeg* Southern InterlakeͲEastern PrairieMountain Northern* 0 102030405060708090100 Rate per100,000childrenage1Ͳ19 6RXUFH 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Accessibility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irths by Location of Birth DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIELUWKVWKDWRFFXUZLWKLQWKH5HJLRQWKHPRWKHULVUHVLGLQJDVZHOODV PHDVXULQJELUWKVWKDWRFFXURXWVLGHRIWKH5HJLRQ Why Is This Indicator Important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hat did we learn in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egular Medical Doctor DEFINITION 7KLVLVWKHSHUFHQWDJHRIDUHDUHVLGHQWVZKRKDGDWOHDVWRQHDPEXODWRU\YLVLWWRDSK\VLFLDQ LQFOXGLQJ*3)3VDQG VSHFLDOLVWV LQDJLYHQ5HJLRQLQDRQH\HDUSHULRG Why Is This Indicator Important? $FFHVVWRDUHJXODUIDPLO\SK\VLFLDQLVFULWLFDOWRDQ\KHDOWKFDUHVWUDWHJ\WKDWZDQWVWRPDQDJHDQGWUHDWSDWLHQWVLQ DQRXWSDWLHQWVHWWLQJ,IUHVLGHQWVDUHXQDEOHWRDFFHVVDUHJXODUIDPLO\SK\VLFLDQWKH\DUHPRUHOLNHO\WRDFFHVV KRVSLWDO(5VIRUWKHLUKHDOWKFDUHQHHGVZKLFKZLOOEHPRUHFRVWO\WRWKHV\VWHP'XULQJIRFXVJURXSVHVVLRQVLQ 1RUWKHUQFRPPXQLWLHVLQUHJXODUDFFHVVWRSK\VLFLDQVZDVYLHZHGDVDEDUULHUWRKHDOWKFDUHDFFHVV SDUWLFXODUO\LQVPDOOHUFRPPXQLWLHV What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQWKHSURSRUWLRQRIUHVLGHQWVDFFHVVLQJDPHGLFDOGRFWRUZDV SHUFHQWLQVLJQLILFDQWO\ORZHUWKDQWKHSURYLQFLDODYHUDJHRISHUFHQW7KLV UHVXOWPD\EHVRPHZKDWPLVOHDGLQJDVWKHIRUPHU%XUQWZRRG5HJLRQHVWDEOLVKHGSUDFWLFH PHWKRGVZKLFKDUHGLIIHUHQWIURPWKHW\SLFDOVDPHGRFWRUIRUWKHSDWLHQWV\VWHPWKDWZHVHH HOVHZKHUH 7KHDYHUDJHLQWKHIRUPHU1250$15HJLRQZDVSHUFHQWLQGRZQIURP SHUFHQWLQ What did we learn in 2014? )URPWRSHUFHQWRIUHVLGHQWVLQWKH1RUWKHUQ+HDOWK5HJLRQKDGDFFHVV WRDUHJXODUGRFWRUZHOOEHORZWKH0DQLWREDDYHUDJHRISHUFHQWGXULQJWKHVDPHWLPH SHULRG VHH)LJXUH $PRQJ1RUWKHUQGLVWULFWVDQG]RQHVWKH/\QQ/DNHDQGWKH3DVGLVWULFWVKDGDFFHVVOHYHOVRI RYHUSHUFHQWZKLOHWKH,VODQG/DNHDQG6D\LVL'HQHGLVWULFWVKDGRQO\SHUFHQWDFFHVV VHH)LJXUH )LJXUH5HVLGHQWV+DYLQJD5HJXODU0HGLFDO'RFWRUE\5+$ ȋȌManitobaaverage Northern InterlakeͲEastern PrairieMountain Southern Winnipeg 0% 20% 40% 60% 80% 100% PerCentofage12+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV )LJXUH5HVLGHQWV+DYLQJD5HJXODU0HGLFDO'RFWRUE\1RUWKHUQ'LVWULFWDQG=RQH ManitobaȋʹȌaverage NelsonHouse/NCN(s) NorwayHouse/NHCN(s) CrossLake/PimiCN(s) IslandLake SayD(TL),Bro/BL,NoL(Lac) Thompson,MysteryLake BayLine Gillam,FoxLakeCN GR/Mis,ML/Mos,Eas/Che Flin,Snow,Cran,Sher ThePas/OCN,Kelsey LL/MC,LR,OͲP(SIL),PN(GVL) NorthernIslandLakeZone NorthernNonͲDirectService… NorthernDirectServiceZone 0% 20% 40% 60% 80% 100% PerCentofage12+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV &200881,7<+($/7+$66(660(17 6.2.3. Ambulatory Visit Rate DEFINITION 7KLVLQGLFDWRUUHIHUVWRWKHDYHUDJHDQQXDOQXPEHURIDPEXODWRU\YLVLWVWRDOOSK\VLFLDQVSHUUHVLGHQWRQDQ RXWSDWLHQWRUDSSRLQWPHQWEDVLV Why Is This Indicator Important? 7KHDPEXODWRU\YLVLWUDWHFDQVKRZXVDORQJZLWKDQXPEHURIRWKHULQGLFDWRUVH[DPLQHGLQWKLVFKDSWHUKRZZHOO FKURQLFFDUHSDWLHQWVDUHEHLQJPDQDJHGRXWVLGHRIKRVSLWDOVHWWLQJVZKLFKLVWKHSUHIHUUHGPRGHORIKHDOWKFDUH GHOLYHU\DVLWHQVXUHVPRUHUHJXODURQJRLQJPDQDJHPHQWRIFKURQLFFRQGLWLRQVDQGDYRLGVPRUHFRVWO\KRVSLWDOFDUH What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQUHSRUWHGWKHORZHVWUDWHLQWKHSURYLQFHLQDWYLVLWV SHUUHVLGHQWGRZQIURPLQ7KH0DQLWREDDYHUDJHZDVLQ 7KHIRUPHU1250$15HJLRQKDGDVOLJKWGHFUHDVHIURPLQWR LQ What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQH[SHULHQFHGDGHFOLQHLQLWVDPEXODWRU\YLVLWUDWHIURPYLVLWVSHU UHVLGHQWLQWRLQ7KHFKDQJHZDVVWDWLVWLFDOO\VLJQLILFDQWDQGGLIIHUHQWIURP WKH0DQLWREDDYHUDJHRI VHH)LJXUH :KLOHWKH1RUWKHUQ'LUHFW6HUYLFH=RQHH[SHULHQFHGDGHFOLQHLQYLVLWUDWHVEHWZHHQWKHWZRWLPH SHULRGVWKHUHZHUHLQFUHDVHVLQERWKWKH1RUWKHUQ,VODQG=RQH YLVLWVYHUVXV DQGWKH 1RUWKHUQ1RQ'LUHFW6HUYLFH=RQH YLVLWVYHUVXV VHH)LJXUH )LJXUH$PEXODWRU\9LVLW5DWHE\5+$DQG 2006/07 2011/12 ManitobaLinear(Manitobaaverage2006/07average2006/07) ManitobaLinear(Manitobaaverage2011/12average2011/12) Northern(1,2,t) Southern(1,2) InterlakeͲEastern PrairieMountain Winnipeg(t) 0123456 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH$PEXODWRU\9LVLW5DWHVE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2006/07 2011/12 NorthernLinear(Northernaverage2006/07average2006/07) NorthernLinear(Northernaverage2011/12average2011/12) Puk/MatColCN(1,2) CrossLake/PimiCN(1,t) NelsonHouse/NCN(1,2,t) Sham,YorkFN,Tat(SPL)(1,2,t) NorwayHouse/NHCN(1,2) GR/Mis,ML/Mos,Eas/Che(1,2) SayD(TL),Bro/BL,NoL(Lac)(1,2) IslandLake(1,2) BayLine(1,2) Bu(OH),MS(GR),GLN/GLFN(1,2) Thompson,MysteryLake(1,2) Gillam,FoxLakeCN LL/MC,LR,OͲP(SIL),PN(GVL)(t) ThePas/OCN,Kelsey(2,t) Flin,Snow,Cran,Sher(t) NorthernNonͲDirectServiceZone(1,2,t) NorthernIslandLakeZone(1,2) NorthernDirectServiceZone(2,t) 0123456 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD &200881,7<+($/7+$66(660(17 6.2.3.1. Ambulatory Visit Rate by Age and Gender DEFINITION 7KHDYHUDJHQXPEHURIYLVLWVWRSK\VLFLDQVE\UHVLGHQWDJHDQGVH[LQDJLYHQ\HDU Why Is This Indicator Important? $JHDQGJHQGHULQIRUPDWLRQSURYLGHVPRUHGHWDLOHGLQIRUPDWLRQDERXWZKLFKJURXSVRISHRSOHDUHDFFHVVLQJWKH SULPDU\FDUHV\VWHPDOORZLQJWKH5HJLRQWRNQRZZKLFKJURXSVQHHGWREHHQFRXUDJHGPRUHWRPDNHDPEXODWRU\ YLVLWV What did we learn in 2014? )LJXUHLOOXVWUDWHVDPEXODWRU\YLVLWUDWHVE\DJHJURXSDQGJHQGHULQWZRGLIIHUHQWWLPHSHULRGV ,QERWKSHULRGVWKHUHLVDVLPLODUSDWWHUQRILQFUHDVLQJYLVLWVZLWKLQFUHDVLQJSDWLHQWDJH )RUWKHPRVWSDUWYLVLWUDWHVLQERWKWLPHSHULRGVDUHKLJKHUDPRQJIHPDOHVWKDQPDOHVLQHYHU\DJH JURXS7KHH[FHSWLRQLVWKDWLQWKHYHU\HOGHUO\DJHJURXSVWKHUHDUHVLPLODUSDWLHQWYLVLWVDQG SHUKDSVPRUHDPRQJPDOHVLQWKHPRUHUHFHQWDQGROGHUDJHJURXS )LJXUH$PEXODWRU\9LVLW5DWHVE\$JHDQG6H[DQG Female2006/07 Female2011/12 Male2006/07 Male2011/12 14 12 10 8 6 4 2 0 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 6.2.4. Ambulatory Consultation Rate DEFINITION 7KLVLVWKHDJHDGMXVWHGDYHUDJHQXPEHURIDPEXODWRU\FRQVXOWDWLRQV ILUVWUHIHUUDOV SHUUHVLGHQWWRDOOSK\VLFLDQVLQ DILVFDO\HDU&RQVXOWDWLRQVDUHDVXEVHWRIDPEXODWRU\YLVLWV WKH\RFFXUZKHQRQHSK\VLFLDQUHIHUVDSDWLHQWWR DQRWKHUSK\VLFLDQ Why Is This Indicator Important? 7KHVHW\SHVRIDSSRLQWPHQWVDUHSULPDULO\ZLWKVSHFLDOLVWV7KLVFDQWHOOXVDERXWWKHDFFHVVLELOLW\RIVSHFLDOLVWVLQD JLYHQDUHD,WLVHVSHFLDOO\LPSRUWDQWLQ1RUWKHUQDQGUXUDODUHDV WRHQVXUHWKDWVSHFLDOLVWYLVLWVDUHWLPHO\DQG DYDLODEOH What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQVSHFLDOLVWUDWHVUHPDLQHGYLUWXDOO\XQFKDQJHGDWYLVLWV SHUUHVLGHQWLQDQG7KLVZDVHTXDOWRWKHSURYLQFLDODYHUDJHLQ 7KHIRUPHU1250$15HJLRQUHSRUWHGDVOLJKWLQFUHDVHIURPYLVLWVWREHWZHHQWKH WZRWLPHSHULRGVZKLFKZDVVWDWLVWLFDOO\EHORZWKHSURYLQFLDODYHUDJH What did we learn in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inear(Manitobaaverage2006/07) Linear(Manitobaaverage2011/12) Manitobaaverage2006/07 Manitobaaverage2011/12 PrairieMountain(1,2,t) Southern(1,2,t) Northern(1,2) InterlakeͲEastern Manitoba Winnipeg(1,2) 0 0.05 0.1 0.15 0.2 0.25 0.3 0.35 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH$PEXODWRU\&RQVXOW9LVLW5DWHVE\5+$DQG 2006/07 2011/12 LinearNorthern(Northernaverageaverage2006/072006/07) LinearNorthern(Northernaverageaverage2011/122011/12) Sham,YorkFN,Tat(SPL)(1,t) Flin,Snow,Cran,Sher(1,t) NelsonHouse/NCN(1,2) BayLine(1,2) GR/Mis,ML/Mos,Eas/Che(1,2) Puk/MatColCN Thompson,MysteryLake ThePas/OCN,Kelsey(2) LL/MC,LR,OͲP(SIL),PN(GVL)(2,t) Gillam,FoxLakeCN Bu(OH),MS(GR),GLN/GLFN IslandLake CrossLake/PimiCN SayD(TL),Bro/BL,NoL(Lac)(t) NorwayHouse/NHCN(1,2) NorthernDirectServiceZone NorthernNonͲDirectServiceZone NorthernIslandLakeZone 0 0.1 0.2 0.3 0.4 0.5 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD 6.2.5. Visit Location within District DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIUHVLGHQWVZKRYLVLWWKHLUIDPLO\SK\VLFLDQLQWKHLU5HJLRQ Why Is This Indicator Important? 7KLV LQGLFDWRU SURYLGHV LQIRUPDWLRQ RQ ZKHWKHU UHVLGHQWV LQ D 5HJLRQ DUH YLVLWLQJ WKHLU IDPLO\ SK\VLFLDQV RU VSHFLDOLVWVLQWKHLURZQ5HJLRQRUJRLQJRXWVLGHWKH5HJLRQIRUSULPDU\FDUH7KLVLVDQLPSRUWDQWLQGLFDWRURIKRZ DFFHVVLEOHSK\VLFLDQVDUHLQWKH5HJLRQDQGZKHWKHUWKHUHDUHDGHTXDWHUHVRXUFHV7UDYHOOLQJIRUFDUHFUHDWHVSDWLHQW VWUHVVDQGGLVORFDWLRQZKLFKFDQKLQGHUSDWLHQWZLOOLQJQHVVWRVHHNFDUHEHIRUHLOOQHVVHVEHFRPHZRUVHDVZHOODV WKHLUDELOLW\WRPDQDJHFKURQLFGLVHDVHVZLWKRQJRLQJSK\VLFLDQVXSSRUW What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQWKHUDWHRIUHVLGHQWVZKRYLVLWHGDJHQHUDOSUDFWLWLRQHU *3 ZLWKLQWKH5HJLRQGHFUHDVHGIURPSHUFHQWWRSHUFHQWEHWZHHQDQG ZKLFKLVPXFKORZHUWKDQWKH0DQLWREDDYHUDJHRISHUFHQWLQ 7KHIRUPHU1250$15HJLRQUHSRUWHGDQLQFUHDVHIURP SHUFHQWLQWR SHUFHQWLQ What did we learn in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nDistrict ElsewhereinRHA ToOtherRHA ToWinnipeg Northern InterlakeͲEastern PrairieMountain Winnipeg Southern Manitoba 0.00% 20.00% 40.00% 60.00% 80.00% 100.00% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV )LJXUH /RFDWLRQRI9LVLWVWR6SHFLDOLVWE\5+$ InDistrict ElsewhereinRHA ToOtherRHA ToWinnipeg Northern InterlakeͲEastern PrairieMountain Winnipeg Southern Manitoba 0.00% 20.00% 40.00% 60.00% 80.00% 100.00% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 6.2.6. Inflow and Outflow of RHA Patients DEFINITION 7KHLQDQGRXWIORZRIWKH5+$UHVLGHQWVPHDVXUHVWKHUHODWLRQVKLSEHWZHHQKRVSLWDOVHUYLFHVSURYLGHGLQDUHJLRQ DQGWKHXWLOL]DWLRQRIWKRVHVHUYLFHVE\ORFDOUHVLGHQWV,QLWDOVRPHDVXUHVWKHSURSRUWLRQRIUHJLRQDOUHVLGHQWV WKDW DUH KRVSLWDOL]HG LQ WKHLU 5+$ DQG RXWVLGH WKHLU UHJLRQ DV ZHOO DV WKH SURSRUWLRQ RI KRVSLWDO GD\V VSHQW LQ UHJLRQDOKRVSLWDOV Why Is This Indicator Important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hat did we learn in 2009? 7KH,QIORZ2XWIORZUDWLRLQWKHIRUPHU%XUQWZRRG5HJLRQZDVLQZKLFKLVFRQVLVWHQWZLWK H[SHFWDWLRQVIRUDVPDOOHUUHJLRQ 7KHUDWLRLQWKHIRUPHU1250$15HJLRQZDVLQ What did we learn in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nterlakeͲEastern Southern Northern PraireMountain Winnipeg 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 6RXUFH &,+,+HDOWK,QGLFDWRUV,QWHUDFWLYH7RRO ǣȀȀǤ Ǥ ȀȀ ǤǫαΨ͵ȀȀǤ Ǥ ȀȀ ƬαΨ͵ȀȀǤ Ǥ ȀȀ ƬαΨ͵ȀȀǤ Ǥ ȀȀ )LJXUH:KHUH5+$+RVSLWDO3DWLHQWV&DPH)URP)RU+RVSLWDO6HSDUDWLRQV RHAResidents OtherRHAResidents WinnipegResidents NonͲManitobans Northern InterlakeͲEastern PrairieMountain Winnipeg Southern Manitoba 0% 20% 40% 60% 80% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV )LJXUH:KHUH5+$5HVLGHQWV:HQWIRU+RVSLWDO6HSDUDWLRQV HomeRHAHospital OtherRHAHospital WinnipegHospital OutofProvinceHospital Northern InterlakeͲEastern PrairieMountain Winnipeg Southern Manitoba 0% 20% 40% 60% 80% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV &200881,7<+($/7+$66(660(17 6.2.7. Cancer Care 6.2.7.1. Breast Assessment Waits DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHPHGLDQWLPHLWWDNHVIRUILQDOGLDJQRVLVIRUZRPHQZKRKDYHDQDEQRUPDOILQGLQJRQ WKHLUPDPPRJUDP Why Is This Indicator Important? 7LPHO\GLDJQRVLVRIFDQFHUKDVDQLPSRUWDQWSV\FKRORJLFDOLPSDFWRQSDWLHQWVDVZHOODVLPSDFWLQJWUHDWPHQW RXWFRPHV What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQKDGEUHDVWDVVHVVPHQWZDLWWLPHVRIGD\VEDVHGRQ GDWDZKLFKZDVVLJQLILFDQWO\GLIIHUHQWIURPWKH0DQLWREDDYHUDJHRIGD\VEDVHGRQ GDWD 7KHIRUPHU1250$15HJLRQKDGDZDLWWLPHRI GD\VZKLFKZDVDOVRVLJQLILFDQWO\KLJKHU WKDQWKHSURYLQFLDODYHUDJH What did we learn in 2014? 7KHPHGLDQZDLWWLPHIRUEUHDVWDVVHVVPHQWGLDJQRVLVLPSURYHGIRUWKH SHULRGJRLQJWRGD\VIRUWKH1RUWKHUQ+HDOWK5HJLRQWKRXJKLWZDVVWLOODERYHWKH0DQLWRED DYHUDJHRIGD\V VHH)LJXUH )LJXUH%UHDVW:DLWLQ'D\V1RUWKHUQ+HDOWK5HJLRQ 45 40 35 30 25 20 15 10 5 0 NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± 6.2.7.2. Radiation Therapy Waits DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIFDQFHUSDWLHQWVZKRUHFHLYHUDGLDWLRQWKHUDS\ZLWKLQIRXUZHHNVRIEHLQJ UHDG\WREHWUHDWHG Why Is This Indicator Important? 3URYLGLQJWLPHO\FDQFHUFDUHWUHDWPHQWLVLPSRUWDQWLQLPSURYLQJSDWLHQWRXWFRPHVDQGUHGXFLQJWKHSV\FKRORJLFDO VWUHVVWKDWFDQUHVXOWIURPORQJZDLWLQJWLPHVIRUKHDOWKFDUHWUHDWPHQW What did we learn in 2009? ,QSHUFHQWRISDWLHQWVLQWKHIRUPHU%XUQWZRRG5HJLRQUHFHLYHGUDGLDWLRQ WKHUDS\ZLWKLQIRXUZHHNVDVGLG SHUFHQWRIIRUPHU1250$15HJLRQUHVLGHQWV7KLV FRPSDUHVWRWKH0DQLWREDDYHUDJHRI SHUFHQW What did we learn in 2014? ,QYLUWXDOO\DOO 1RUWKHUQ+HDOWK5HJLRQFDQFHUSDWLHQWVZHUHWUHDWHGZLWK UDGLDWLRQWKHUDS\ZLWKLQIRXUZHHNV VHH)LJXUH )LJXUH5DGLDWLRQ7KHUDS\:DLWV1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 100% 99% 98% 97% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± &200881,7<+($/7+$66(660(17 6.2.7.2.1. Lung Cancer What did we learn in 2009? ,QSHUFHQWRISDWLHQWVLQWKHIRUPHU1250$15HJLRQUHFHLYHGUDGLDWLRQ WKHUDS\ZLWKLQIRXUZHHNV'DWDIURPWKHIRUPHU%XUQWZRRG5HJLRQZHUHVXSSUHVVHGGXHWR ORZQXPEHUV What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQKDGDOORILWVOXQJFDQFHUSDWLHQWVVHHQZLWKLQZHHNVIRU UDGLDWLRQWKHUDS\LQZKLFKHTXDOHGWKH0DQLWREDDYHUDJH VHH)LJXUH )LJXUH5DGLDWLRQ7KHUDS\:DLWVIRU/XQJ&DQFHU3DWLHQWV1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 120% 100% 80% 60% 40% 20% 0% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± 6.2.7.2.2. Colorectal Cancer What did we learn in 2009? ,QGDWDZDVVXSSUHVVHGLQWKHIRUPHU%XUQWZRRG5HJLRQVGXHWRORZQXPEHUV 6LPLODUO\WKHIRUPHU1250$15HJLRQGLGQRWUHSRUWDQ\GDWDIRUWKLVLQGLFDWRUGXHWRORZ QXPEHUV What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQGDWDIRUFRORUHFWDOFDQFHUSDWLHQWVZDLWLQJIRUUDGLDWLRQWKHUDS\ ZHUHVXSSUHVVHGGXHWRVPDOOQXPEHUVLQ VHH)LJXUH +RZHYHUWKHSDVW HVWLPDWH ZDVUHYLVHGIRUWKHHQWLUHUHJLRQDQGWKHHVWLPDWHZDVSHUFHQWZKLFKLV LGHQWLFDOWRWKHSURYLQFLDOUDWH )LJXUH5DGLDWLRQ7KHUDS\:DLWVIRU&RORUHFWDO&DQFHU3DWLHQWV1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 120% ͳͲͲǤͲΨ ͳͲͲǤͲΨ 100% 80% 60% 40% 20% 0% NorthernPastEstimate NorthernCurrentEstimate(s) ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± 127( V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV &200881,7<+($/7+$66(660(17 6.2.7.2.3. Female Breast Cancer What did we learn in 2009? ,QDOO1250$15HJLRQEUHDVWFDQFHUSDWLHQWVZHUHVHHQZLWKLQIRXUZHHNVIRU UDGLDWLRQWKHUDS\'DWDIRUWKHIRUPHU%XUQWZRRG5HJLRQZHUHVXSSUHVVHGGXHWRORZ QXPEHUV What did we learn in 2014? $OO1RUWKHUQ+HDOWK5HJLRQEUHDVWFDQFHUSDWLHQWVZHUHWUHDWHGZLWKUDGLDWLRQWKHUDS\ZLWKLQ IRXUZHHNVLQ7KH0DQLWREDDYHUDJHZDV SHUFHQW VHH)LJXUH )LJXUH5DGLDWLRQ7KHUDS\:DLWVIRU%UHDVW&DQFHU1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 120% 100% 80% 60% 40% 20% 0% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± 6.2.7.2.4. Prostate Cancer What did we learn in 2009? ,QGDWDZDVVXSSUHVVHGLQERWKWKHIRUPHU%XUQWZRRGDQG1250$15HJLRQVGXH WRORZQXPEHUV What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQGDWDIRUSURVWDWHFDQFHUSDWLHQWVZDLWLQJIRUUDGLDWLRQWKHUDS\ZDV VXSSUHVVHGGXHWRVPDOOQXPEHUVLQ VHH)LJXUH 7KH0DQLWREDDYHUDJHZDV SHUFHQWRISURVWDWHFDQFHUSDWLHQWVZHUHWUHDWHGZLWKUDGLDWLRQWKHUDS\ZLWKLQIRXUZHHNV )LJXUH5DGLDWLRQ7KHUDS\:DLWV)RU3URVWDWH&DQFHU1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 94% 92% 90% 88% 86% 84% 82% NorthernPastEstimate NorthernCurrentEstimate(s) ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± 127( V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV &200881,7<+($/7+$66(660(17 6.2.7.3. Cancer Surgery DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIFDQFHUSDWLHQWVZKRDUHWUHDWHGZLWKVXUJHU\ Why Is This Indicator Important? 6XUJHU\UDWHVFDQSURYLGHLPSRUWDQWLQIRUPDWLRQERWKDERXWWKHDSSURSULDWHQHVVRIFDQFHUFDUHDVZHOODVWKHSRLQWDW ZKLFKFDQFHUVDUHEHLQJGLDJQRVHG What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQKDGDVXUJHU\UDWHRISHUFHQWVOLJKWO\XQGHU WKHSURYLQFLDODYHUDJHRI SHUFHQW 7KHIRUPHU1250$15HJLRQKDGDUDWHRISHUFHQW1250$1¶VUDWHZDVVWDWLVWLFDOO\ ORZHUWKDQWKH0DQLWREDRYHUDOODYHUDJH What did we learn in 2014? ,QWKH1RUWKHUQ+HDOWK5HJLRQSHUFHQWRIFDQFHUSDWLHQWVZHUHWUHDWHGZLWKVXUJHU\IURP WRZKLFKLVVOLJKWO\EHORZWKH0DQLWREDDYHUDJHRISHUFHQW VHH)LJXUH )LJXUH 3URSRUWLRQRI3DWLHQWV7UHDWHG:LWK6XUJHU\LQ1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED$OO&DQFHUV 55% 54% 53% 52% 51% 50% 49% 48% 47% 46% 45% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± 6.2.7.3.1. Lung Cancer What did we learn in 2009? ,QWKHIRUPHU1250$15HJLRQKDGDVXUJHU\UDWHIRUOXQJFDQFHUSDWLHQWVRI SHUFHQWEHORZWKH0DQLWREDDYHUDJHZDVSHUFHQW'DWDIURPWKHIRUPHU%XUQWZRRG 5HJLRQZHUHVXSSUHVVHGGXHWRVPDOOQXPEHUV What did we learn in 2014? )URPSHUFHQWRIOXQJFDQFHUSDWLHQWVZHUHWUHDWHGZLWKVXUJHU\DQGLQFUHDVH IURPWKHSDVWHVWLPDWHRISHUFHQW7KH0DQLWREDDYHUDJHZDVSHUFHQW VHH)LJXUH )LJXUH3URSRUWLRQRI/XQJ&DQFHU3DWLHQWV7UHDWHG:LWK6XUJHU\ 35% 30% 25% 20% 15% 10% 5% 0% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± &200881,7<+($/7+$66(660(17 6.2.7.3.2. Colorectal Cancer What did we learn in 2009? )URP&DQFHU&DUH0DQLWREDGDWDLQWKHIRUPHU1250$15HJLRQKDGDVXUJHU\UDWH IRUFRORUHFWDOFDQFHUSDWLHQWVRISHUFHQWZKLFKZDVVWDWLVWLFDOO\EHORZWKH0DQLWRED DYHUDJHRISHUFHQW 7KHIRUPHU%XUQWZRRG5HJLRQKDGDUDWHRISHUFHQW What did we learn in 2014? )URPGDWDSHUFHQWRIFRORUHFWDOFDQFHUSDWLHQWVZHUHWUHDWHGZLWKVXUJHU\ ZKLFKLVKLJKHUWKDQWKHSDVWHVWLPDWHRISHUFHQW7KH0DQLWREDDYHUDJHZDVSHU FHQW VHH)LJXUH )LJXUH3URSRUWLRQRI&RORUHFWDO&DQFHU3DWLHQWV7UHDWHG:LWK6XUJHU\1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± 6.2.7.3.3. Female Breast Cancer What did we learn in 2009? )URP&DQFHU&DUH0DQLWREDGDWDLQWKHIRUPHU1250$15HJLRQKDGDVXUJHU\UDWH IRUEUHDVWFDQFHUSDWLHQWVRI SHUFHQWVOLJKWO\EHORZWKH0DQLWREDDYHUDJHZDV SHU FHQW 7KHIRUPHU%XUQWZRRG5HJLRQKDGDUDWHRI SHUFHQW What did we learn in 2014? ,Q SHUFHQWRI1RUWKHUQ+HDOWK5HJLRQ¶VEUHDVWFDQFHUSDWLHQWVZHUHWUHDWHG ZLWKVXUJHU\XSIURPWKHSDVWHVWLPDWHIRUWKHQRUWKRI SHUFHQW,WZDVDOVRRYHUWKH 0DQLWREDDYHUDJHRI SHUFHQW VHH)LJXUH )LJXUH3URSRUWLRQRI%UHDVW&DQFHU3DWLHQWV7UHDWHG:LWK6XUJHU\1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 95% 94% 93% 92% 91% 90% 89% 88% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± &200881,7<+($/7+$66(660(17 6.2.7.3.4. Prostate Cancer What did we learn in 2009? )URP&DQFHU&DUH0DQLWREDGDWDLQWKHIRUPHU1250$15HJLRQKDGDVXUJHU\UDWH RISHUFHQWIRUSURVWDWHFDQFHUSDWLHQWVEHORZWKH0DQLWREDDYHUDJHRI SHUFHQW 7KHIRUPHU%XUQWZRRG5HJLRQKDGDQLGHQWLFDOVXUJHU\UDWHRISHUFHQW What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQKDGDVXUJHU\UDWHRISHUFHQWIRUSURVWDWHFDQFHUSDWLHQWV ZKLFKZDVKLJKHUWKDQWKHSDVWHVWLPDWHRISHUFHQW,WLVDOVRKLJKHUWKDQWKH0DQLWRED DYHUDJHRISHUFHQW VHH)LJXUH )LJXUH3URSRUWLRQRI3URVWDWH&DQFHU3DWLHQWVWUHDWHGZLWK6XUJHU\1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± 6.2.7.4. Radiation Therapy Treatment DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIDOOFDQFHUSDWLHQWVZKRDUHWUHDWHGZLWKUDGLDWLRQWKHUDS\ Why Is This Indicator Important? 5DGLDWLRQWKHUDS\WUHDWPHQWUDWHVFDQSURYLGHLPSRUWDQWLQIRUPDWLRQERWKDERXWWKHDSSURSULDWHQHVVRIFDQFHUFDUHDV ZHOODVRQZKHQFDQFHUVDUHEHLQJGLDJQRVHGLQSDWLHQWVZKLFKFDQEHDQLQGLFDWRURIKRZVXFFHVVIXOFDQFHU SUHYHQWLRQLQLWLDWLYHVDUHLQDJLYHQ5HJLRQ What did we learn in 2009? )URP&DQFHU&DUH0DQLWREDGDWDLQWKHIRUPHU1250$15HJLRQKDGDUDGLDWLRQ WKHUDS\WUHDWPHQWUDWHRISHUFHQWIRUSURVWDWHFDQFHUSDWLHQWV7KH0DQLWREDDYHUDJHZDV SHUFHQW 7KHIRUPHU%XUQWZRRG5HJLRQKDGDUDWHRISHUFHQW What did we learn in 2014? ,QWKHUDGLDWLRQWKHUDS\WUHDWPHQWUDWHIRUWKH1RUWKHUQ+HDOWK5HJLRQZDV SHUFHQWEHORZWKHSDVWHVWLPDWHIRUWKH5HJLRQRI SHUFHQW7KH0DQLWREDDYHUDJHZDV SHUFHQW VHH)LJXUH )LJXUH3URSRUWLRQRI&DQFHU3DWLHQWV5HFHLYLQJ5DGLDWLRQ7KHUDS\1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 33% 32% 32% 31% 31% 30% 30% 29% 29% 28% 28% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± &200881,7<+($/7+$66(660(17 6.2.7.4.1. Lung Cancer What did we learn in 2009? )URP&DQFHU&DUH0DQLWREDGDWDLQWKHIRUPHU1250$15HJLRQKDGDUDGLDWLRQ WKHUDS\WUHDWPHQWUDWHIRUOXQJFDQFHUSDWLHQWVRISHUFHQWVLJQLILFDQWO\EHORZWKH 0DQLWREDDYHUDJHRISHUFHQW 7KHIRUPHU%XUQWZRRG5HJLRQVKDGDUDWHRI SHUFHQW What did we learn in 2014? )URPGDWDWKH1RUWKHUQ+HDOWK5HJLRQKDGDUDGLDWLRQWKHUDS\WUHDWPHQWUDWHRI SHUFHQWIRUOXQJFDQFHUSDWLHQWVEHORZWKHSDVWHVWLPDWHIRUWKH5HJLRQRISHUFHQW ,WLVDOVRXQGHUWKH0DQLWREDDYHUDJHRI SHUFHQW VHH)LJXUH )LJXUH3URSRUWLRQRI/XQJ&DQFHU3DWLHQWV5HFHLYLQJ5DGLDWLRQ7KHUDS\1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 41% 40% 39% 38% 37% 36% 35% 34% 33% 32% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± 6.2.7.4.2. Colorectal Cancer What did we learn in 2009? 7KHIRUPHU1250$15HJLRQKDGWKHLUGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV7KH 0DQLWREDDYHUDJHWUHDWPHQWUDWHZDVSHUFHQW 6LPLODUO\WKHIRUPHU%XUQWZRRG5HJLRQGLGQRWUHSRUWWKLVGDWDGXHWRVPDOOQXPEHUV What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQKDGDUDGLDWLRQWKHUDS\WUHDWPHQWUDWHIRUFRORUHFWDOFDQFHU SDWLHQWVRISHUFHQWLQDGHFUHDVHIURPWKHSDVWHVWLPDWHRISHUFHQWEXW DERYHWKH0DQLWREDDYHUDJHRISHUFHQW VHH)LJXUH )LJXUH3URSRUWLRQRI&RORUHFWDO&DQFHU3DWLHQWV5HFHLYLQJ5DGLDWLRQ7KHUDS\1RUWKHUQ+HDOWK5HJLRQDQG 0DQLWRED 45% 45% 44% 44% 43% 43% 42% 42% 41% 41% 40% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± &200881,7<+($/7+$66(660(17 6.2.7.4.3. Female Breast Cancer What did we learn in 2009? 7KHIRUPHU1250$15HJLRQKDGDUDGLDWLRQWKHUDS\WUHDWPHQWUDWHRISHUFHQWIRU EUHDVWFDQFHUSDWLHQWVLQ7KH0DQLWREDDYHUDJHZDV SHUFHQW 7KHIRUPHU%XUQWZRRG5HJLRQKDGDUDWHRISHUFHQW What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQKDVDWUHDWPHQWUDWHRISHUFHQWIRUEUHDVWFDQFHUSDWLHQWV DERYHWKHSDVWHVWLPDWHIRUWKH1RUWKRISHUFHQW,WZDVDOVRDERYHWKH0DQLWREDDYHUDJH RISHUFHQW VHH)LJXUH )LJXUH3URSRUWLRQRI%UHDVW&DQFHU3DWLHQWV5HFHLYLQJ5DGLDWLRQ7KHUDS\1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 64% 62% 60% 58% 56% 54% 52% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± 6.2.7.4.4. Prostate Cancer What did we learn in 2009? 7KHIRUPHU1250$15HJLRQKDGWKHLUGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV 7KHIRUPHU%XUQWZRRG5HJLRQKDGDUDGLDWLRQWKHUDS\WUHDWPHQWUDWHRISHUFHQWIRU SURVWDWHFDQFHUSDWLHQWVDERYHWKH0DQLWREDDYHUDJHWUHDWPHQWUDWHRISHUFHQW What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQKDGDUDGLDWLRQWKHUDS\WUHDWPHQWUDWHIRUSURVWDWHFDQFHUSDWLHQWV RISHUFHQWZHOOEHORZWKHSDVWHVWLPDWHRI SHUFHQW7KH1RUWKHUQUDWHZDVVOLJKWO\ EHORZWKH0DQLWREDDYHUDJHRISHUFHQW VHH)LJXUH )LJXUH3URSRUWLRQRI3URVWDWH&DQFHU3DWLHQWV5HFHLYLQJ5DGLDWLRQ7KHUDS\1RUWKHUQ+HDOWK5HJLRQDQG0DQLWRED 40% 35% 30% 25% 20% 15% 10% 5% 0% NorthernPastEstimate NorthernCurrentEstimate ManitobaCurrentEstimate 6RXUFH &$1&(5&$5(0$1,72%$&20081,7<+($/7+$66(660(17± &200881,7<+($/7+$66(660(17 6.2.7.5. Cancer End-Of-Life Care DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRISDWLHQWVZKRGLHRIFDQFHUZLWKDQDFXWHFDUHKRVSLWDOVWD\LQWKHODVWWZR ZHHNVRIOLIH Why Is This Indicator Important? %\WUDFNLQJKRVSLWDOXWLOL]DWLRQQHDUHQGRIOLIHKHDOWKSODQQHUVFDQHQVXUHDSSURSULDWHFDUHRSWLRQVDUHPDGH DYDLODEOHWRWKRVHSDWLHQWVDQGWKHLUIDPLOLHVIRUFDQFHUSDWLHQWVGXULQJWKHWHUPLQDOSKDVHRIWKHLUGLVHDVH,WFDQ DOVRJDXJHWKHVXFFHVVRIHIIRUWVWRSURYLGHSDOOLDWLYHFDUHRSWLRQVIRUFDQFHUSDWLHQWVWKDWDYRLGHQGRIOLIH KRVSLWDOL]DWLRQV What did we learn in 2009? ,QWKHIRUPHU1250$15HJLRQSHUFHQWRILWVFDQFHUSDWLHQWVKDGDFXWHFDUHVWD\VLQ WKHODVWWZRZHHNVRIWKHLUOLIH ,QWKHIRUPHU%XUQWZRRG5HJLRQWKHILJXUHZDVSHUFHQW%RWK5HJLRQVZHUHEHORZWKH 0DQLWREDDYHUDJHRISHUFHQW What did we learn in 2014? ,QWKH1RUWKHUQ+HDOWK5HJLRQSHUFHQWRIFDQFHUSDWLHQWVZKRGLHGKDGDQDFXWHFDUH VWD\LQWKHODVWWZRZHHNVRIWKHLUOLIHLQZKLFKZDVVOLJKWO\EHORZWKH0DQLWRED DYHUDJHRISHUFHQW 6.3. Continuity of Service 6.3.1. Continuity of Care DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIUHVLGHQWVZKRKDYHKDGSHUFHQWRIPRUHRUWKHLUDPEXODWRU\YLVLWVZLWK WKHVDPHKHDOWKFDUHSURYLGHU Why Is This Indicator Important? ,ISDWLHQWVDUHDEOHWRVHHWKHVDPHKHDOWKFDUHSURYLGHUWKHTXDOLW\RIFDUHKDVEHHQVKRZQWRLPSURYHDVKHDOWK SURYLGHUVGLVFRYHUWKHLUXQLTXHKHDOWKFDUHQHHGV&RQWLQXLW\RIFDUHZDVRQHRIWKHPRVWVLJQLILFDQWFRQFHUQVIRU 1RUWKHUQUHVLGHQWVH[SUHVVHGGXULQJIRFXVJURXSVHVVLRQVLQ%H\RQGWKHFRQFHUQRIDFFHVVWRGRFWRUVWKH JUHDWHU FRQFHUQ ZDV DURXQG WXUQRYHU RI SK\VLFLDQ UHVRXUFHV $V RQH SDUWLFLSDQW QRWHG ³«>SDWLHQWV DUH@ DOZD\V IHHOLQJOLNHWKH\KDYHWRVWDUWDOORYHUDJDLQZLWKWKHLUPHGLFDOKLVWRU\7KLVJHWVSHRSOHIUXVWUDWHG7KLVDOVROHDGV WRGLIIHUHQWWUHDWPHQWPHWKRGVEHFDXVHRIJHWWLQJGLIIHUHQWGRFWRUV´ What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQWKHUDWHUHPDLQHGVWDEOHDWSHUFHQWEHWZHHQ DQGSHUFHQWLQ7KLVZDVVWLOOVLJQLILFDQWO\ORZHUWKDQWKH SURYLQFLDOUDWHRISHUFHQWLQ 7KHIRUPHU1250$15HJLRQVDZDVOLJKWGHFUHDVHIURPSHUFHQWLQ WRSHUFHQWLQ What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQH[SHULHQFHGDQLQFUHDVHLQUDWHVRIFRQWLQXLW\RIFDUHIURP SHUFHQWRIUHVLGHQWVVHHLQJWKHVDPHSK\VLFLDQPRUHWKDQSHUFHQWRIWKHWLPHLQ WRSHUFHQWLQ'HVSLWHWKHLQFUHDVHWKH5HJLRQUHPDLQHG VWDWLVWLFDOO\EHORZWKH0DQLWREDDYHUDJHRISHUFHQWLQ VHH)LJXUH $PRQJ1RUWKHUQGLVWULFWVERWKWKH1RUWKHUQQRQGLUHFWDQG1RUWKHUQ,VODQG/DNH]RQHVKDG VWDWLVWLFDOO\VLJQLILFDQWLQFUHDVHVLQFRQWLQXLW\RIFDUHEHWZHHQWKHWZRWLPHSHULRGV VHH )LJXUH &200881,7<+($/7+$66(660(17 )LJXUH &RQWLQXLW\RI&DUHE\5+$DQG 2005/06Ͳ2006/07 2010/11Ͳ2011/12 LinearManitoba(Manitobaaverageaverage2005/062005/06Ͳ2006/07Ͳ2006/07) LinearManitoba(Manitobaaverageaverage2010/112010/11Ͳ2011/12Ͳ2011/12) Northern(1,2) Southern(1,2) InterlakeͲEastern PrairieMountain(1,2) Winnipeg 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH&RQWLQXLW\RI&DUHE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2005/06/2006/07 2010/11Ͳ2011/12 LinearNorthern(Northernaverageaverage2005/062005/06Ͳ2006/07Ͳ2006/07) LinearNorthern(Northernaverageaverage2010/112010/11Ͳ2011/12Ͳ2011/12) NelsonHouse/NCN Sham,YorkFN,Tat(SPL)(1,2) IslandLake(1,2,t) Puk/MatColCN NorwayHouse/NHCN(1,2,t) Bu(OH),MS(GR),GLN/GLFN(1,t) GR/Mis,ML/Mos,Eas/Che(2,t) SayD(TL),Bro/BL,NoL(Lac) CrossLake/PimiCN(1,2,t) LL/MC,LR,OͲP(SIL),PN(GVL)(1,2) BayLine(1,2) Gillam,FoxLakeCN(1,2) ThePas/OCN,Kelsey(2,t) Thompson,MysteryLake(1,2,t) Flin,Snow,Cran,Sher NorthernNonͲDirectServiceZone(1,t) NorthernIslandLakeZone(1,2,t) NorthernDirectServiceZone(1,2) 0% 20% 40% 60% 80% 100% 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD 6.3.2. 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Benzodiazepines Prescriptions in Older Adults DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIVHQLRUVDJHDQGROGHUOLYLQJLQWKHFRPPXQLW\ZKRKDYHKDGDWOHDVW WZRSUHVFULSWLRQVRUDJUHDWHUWKDQGD\VXSSO\RIEHQ]RGLD]HSLQHVLQDJLYHQWLPHSHULRG Why Is This Indicator Important? 8VHRIEHQ]RGLD]HSLQHVLVJHQHUDOO\QRWDGYLVHGIRUVHQLRUVVRLWLVSUHIHUDEOHWRVHHORZHUUDWHVRIXVHIRUWKLVGUXJ 7KLVLVDJRRGLQGLFDWRURISUHVFULSWLRQSUDFWLFHVLQD5HJLRQDQGKRZLPSRUWDQWGUXJVDIHW\DQGGUXJSUHVFULSWLRQ PRQLWRULQJLV What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQH[SHULHQFHGDQLQFUHDVHLQ%HQ]RGLD]HSLQHSUHVFULSWLRQVIRU VHQLRUULVLQJIURPSHUFHQWLQWRSHUFHQWLQ7KLV UDWHZDVVWLOOZHOOEHORZDQGVWDWLVWLFDOO\GLIIHUHQWIURPWKH0DQLWREDDYHUDJHRISHUFHQW 7KHIRUPHU1250$15HJLRQDOVRH[SHULHQFHGDQLQFUHDVHEHWZHHQWKHWZRWLPHSHULRGV IURPWR SHUFHQW What did we learn in 2014? ,QWKH1RUWKHUQ+HDOWK5HJLRQEHQ]RGLD]HSLQHSUHVFULSWLRQUDWHVIRUVHQLRUVLQFUHDVHGIURP SHUFHQWLQWRSHUFHQWLQ VHH)LJXUH 7KLV UDWHVWLOOUHPDLQHGVWDWLVWLFDOO\EHORZWKH0DQLWREDDYHUDJHRISHUFHQW 3UHVFULSWLRQUDWHVZLWKLQWKH1RUWKHUQ+HDOWK5HJLRQZHUHKLJKHVWLQWKH1RUWKHUQ'LUHFW 6HUYLFH=RQHDWSHUFHQWLQ VHH)LJXUH )LJXUH3URSRUWLRQRI6HQLRUVZLWK%HQ]RGLD]HSLQH3UHVFULSWLRQVE\5+$DQG 2005/06Ͳ2006/07 2010/11Ͳ2011/12 ManitobaLinear(Manitobaaverage2005/06averageͲ2005/062006/07Ͳ2006/07) ManitobaLinear(Manitobaaverageaverage2010/112010/11Ͳ2011/12Ͳ2011/12) Northern(1,2) InterlakeͲEastern (1,2,t) Winnipeg(1,2) Southern(1,2) PrairieMountain (1,2,t) 0% 5% 10% 15% 20% 25% 30% Percentof75+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH3URSRUWLRQRI6HQLRUVZLWK%HQ]RGLD]HSLQH3UHVFULSWLRQVE\1RUWKHUQ'LVWULFWDQG=RQH DQG 2005/06Ͳ2006/07 2010/11Ͳ2011/12 LinearNorthern(Northernaveraaveragege20052005/06/06Ͳ2006Ͳ2006/07)/07 LinearNorthern(Northernaverageaverage2010/112010/11Ͳ2011/12Ͳ2011/12) NorwayHouse/NHCN(1,2) GR/Mis,ML/Mos,Eas/Che(1,t) Bu(OH),MS(GR),GLN/GLFN(1,t) LL/MC,LR,OͲP(SIL),PN(GVL)(s) Flin,Snow,Cran,Sher(1) BayLine CrossLake/PimiCN ThePas/OCN,Kelsey Thompson,MysteryLake NelsonHouse/NCN(s) Sham,YorkFN,Tat(SPL)(s) IslandLake(2,s) Puk/MatColCN(s) SayD(TL),Bro/BL,NoL(Lac)(2,s) Gillam,FoxLakeCN(s) NorthernIslandLakeZone(2,s) NorthernNonͲDirectServiceZone(1,2) NorthernDirectServiceZone(1,2) 0% 5% 10% 15% 20% 25% Percentof75+ 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD V LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV &200881,7<+($/7+$66(660(17 6.4.2. 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Hospitalization for Ambulatory Care Sensitive Conditions DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHDFXWHFDUHKRVSLWDOL]DWLRQUDWHIRUDPEXODWRU\FDUHFRQGLWLRQVIRUWKHSRSXODWLRQXQGHU DJH\HDUV Why Is This Indicator Important? 0DQ\KRVSLWDOL]DWLRQVIRUDPEXODWRU\FDUHFRQGLWLRQVFDQEHDYRLGHGE\SURYLGLQJRQJRLQJFDUHLQDSULPDU\FDUH VHWWLQJSDUWLFXODUO\IRULOOQHVVHVDQGFKURQLFGLVHDVHVDQGFRQGLWLRQV+LJKHUKRVSLWDOL]DWLRQUDWHVPD\LQGLFDWHWKDW DFFHVVWRDSSURSULDWHSULPDU\FDUHPD\QRWEHDYDLODEOH What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQH[SHULHQFHGDQLQFUHDVHLQWKHKRVSLWDOL]DWLRQUDWHIURPWR SHUUHVLGHQWVEHWZHHQDQG7KLVZDVWKHKLJKHVWUDWHDPRQJ0DQLWRED 5+$V 5DWHVLQWKHIRUPHU1250$15HJLRQGHFUHDVHVIURP WRLQWKHVDPHWLPHSHULRG7KLV ZDVVWLOODERYHWKHSURYLQFLDODYHUDJHRISHUSRSXODWLRQLQ What did we learn in 2014? 7KHKRVSLWDOL]DWLRQUDWHIRUDPEXODWRU\FDUHVHQVLWLYHFRQGLWLRQVGHFOLQHGVLJQLILFDQWO\LQWKH 1RUWKHUQ+HDOWK5HJLRQIURPFDVHVSHUSRSXODWLRQLQWR 'HVSLWHWKH GHFOLQHLWUHPDLQHGVWDWLVWLFDOO\DERYHWKH0DQLWREDDYHUDJHRI VHH)LJXUH (DFK1RUWKHUQ=RQHUHSRUWHGGHFOLQHVLQKRVSLWDOL]DWLRQUDWHVZLWKWKH1RUWKHUQ,VODQG/DNH=RQH H[SHULHQFLQJDVWDWLVWLFDOO\VLJQLILFDQWGHFOLQHEHWZHHQWKHWZRWLPHSHULRGV VHH)LJXUH &200881,7<+($/7+$66(660(17 )LJXUH $PEXODWRU\&DUH6HQVLWLYH&RQGLWLRQVE\5+$DQG 2006/07 2011/12 ManitobaLinear(Manitobaaverage2006average/072006/07) ManitobaLinear(Manitobaaverageaverage2011/122011/12) Winnipeg(1,2,t) Southern(t) InterlakeͲEastern(t) PrairieMountain (1,2,t) Northern(1,2,t) 0 5 10 15 20 25 Rateper1,000aged0Ͳ74 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH$PEXODWRU\&DUH6HQVLWLYH&RQGLWLRQVE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2006/07 2011/12 NorthernLinear(Northernaverage2006/07average2006/07) NorthernLinear(Northernaverage2011/12average2011/12) Flin,Snow,Cran,Sher(t) NorwayHouse/NHCN BayLine(t) Thompson,MysteryLake(1,t) ThePas/OCN,Kelsey(1,2) SayD(TL),Bro/BL,NoL(Lac)(1,t) Puk/MatColCN(1,2) GR/Mis,ML/Mos,Eas/Che(1,2) LL/MC,LR,OͲP(SIL),PN(GVL)(1,2) Gillam,FoxLakeCN(1,2) Sham,YorkFN,Tat(SPL)(1,2) NelsonHouse/NCN(1,2) IslandLake(1,2,t) Bu(OH),MS(GR),GLN/GLFN(1,2,t) CrossLake/PimiCN(1,2,t) NorthernDirectServiceZone(1,2,t) NorthernNonͲDirectServiceZone(1,2,t) NorthernIslandLakeZone(1,2,t) 0 5 10 15 20 25 30 35 40 45 Rateper1,000aged0Ͳ74 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD 6.5.2. Caesarean Section Rate DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSHUFHQWDJHRIDOOELUWKVGHOLYHUHGE\&DHVDUHDQ6HFWLRQ Why Is This Indicator Important? 8QQHFHVVDU\FDHVDUHDQVHFWLRQVDUHDVVRFLDWHGZLWKKLJKHUFRVWVWRWKHKHDOWKFDUHV\VWHPDQGJUHDWHUULVNRI PDWHUQDOPRUELGLW\7KHVHUDWHVFDQVKRZWKHTXDOLW\DQGDGKHUHQFHWRFOLQLFDOSUDFWLFHJXLGHOLQHVDVORZHUUDWHVRI FDHVDULDQVHFWLRQDUHDVVRFLDWHGZLWKEHWWHUFDUHIRUPRWKHUVDQGQHZERUQV What did we learn in 2009? ,QWKHIRUPHU%XUQWZRRG5HJLRQWKHUHZDVDVOLJKWLQFUHDVHIURPSHUFHQWLQ WR SHUFHQWLQ7KLVZDVVLJQLILFDQWO\EHORZWKH0DQLWRED DYHUDJHRI SHUFHQWLQWKHODWWHUWLPHSHULRG 7KHIRUPHU1250$15HJLRQUHSRUWHGDQLQFUHDVHIURPSHUFHQWLQ WR SHUFHQWLQVLJQLILFDQWO\DERYHWKHSURYLQFLDODYHUDJH What did we learn in 2014? ,Q SHUFHQWRIDOOELUWKVLQWKH1RUWKHUQ+HDOWKUHJLRQZDVE\&DHVDULDQ6HFWLRQ ZKLFKZDVORZHUWKDQWKH0DQLWREDDYHUDJHRI SHUFHQW VHH)LJXUH )LJXUH&DHVDULDQ6HFWLRQ5DWHE\5HJLRQ InterlakeͲEastern Southern Northern PraireMountain Winnipeg 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 Source:CIHIHealthIndicatorsInteractiveTool, ǣȀȀǤ Ǥ ȀȀ ǤǫαΨ͵ȀȀǤ Ǥ ȀȀ ƬαΨ͵ȀȀǤ Ǥ ȀȀ ƬαΨ͵ȀȀǤ Ǥ ȀȀ &200881,7<+($/7+$66(660(17 6.5.3. Dental Extractions among Children DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHQXPEHURIVXUJLFDOGHQWDOH[WUDFWLRQVSHUIRUPHGH[SUHVVHGDVDUDWHRIFKLOGUHQ WR\HDUVRIDJH Why Is This Indicator Important? 7KLVLQGLFDWRULVDQLPSRUWDQWJDXJHRIKRZZHOOD5HJLRQGRHVLQSURYLGLQJRQJRLQJDFFHVVWRKLJKTXDOLW\GHQWDO VHUYLFHVIRUFKLOGUHQ,IFKLOGUHQDUHDEOHWRKDYHUHJXODUGHQWDOFKHFNXSVWKLVFDQRIWHQSUHYHQWWKHQHHGWR VXUJLFDOO\H[WUDFWWHHWK7KLVLQGLFDWRUFDQDOVRKLJKOLJKWVRFLRHFRQRPLFLQHTXDOLWLHVDVORZLQFRPHIDPLOLHVFDQQRW DIIRUGWRKDYHUHJXODUYLVLWVWRWKHGHQWLVW What did we learn in 2009? 7KHIRUPHU%XUQWZRRG5HJLRQKDGDGHQWDOH[WUDFWLRQUDWHWKDWLQFUHDVHGIURP H[WUDFWLRQVSHUFKLOGUHQLQWRLQ,WZDV VLJQLILFDQWO\DERYHWKH0DQLWREDDYHUDJHRI, 7KHIRUPHU1250$15HJLRQDOVRH[SHULHQFHGDQLQFUHDVHLQUDWHVIURPWR EHWZHHQWKHWZRWLPHSHULRGVZKLFKZDVDOVRFRQVLGHUHGVWDWLVWLFDOO\RYHUWKH0DQLWRED DYHUDJH What did we learn in 2014? 7KH1RUWKHUQ+HDOWK5HJLRQH[SHULHQFHGDQLQFUHDVHLQWKHH[WUDFWLRQUDWHIURP LQ WRLQVLJQLILFDQWO\RYHUWKH0DQLWREDDYHUDJHRI VHH)LJXUH ,QWKH1RUWKHUQ+HDOWK5HJLRQ]RQHVWKHH[WUDFWLRQUDWHVZHUHIRXQGWRKLJKHVWLQWKH 1RUWKHUQ,VODQG/DNHDQG1RQ'LVWULFW]RQHVZKHUHUDWHVZHUHVWDWLVWLFDOO\RYHUWKH1RUWKHUQ +HDOWK5HJLRQDYHUDJHLQERWKWLPHSHULRGV VHH)LJXUH )LJXUH'HQWDO([WUDFWLRQ6XUJHU\5DWHVE\5+$DQGDQG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 ManitobaLinear(Manitobaaverage2002/03averageͲ2002/032006/07Ͳ2006/07) ManitobaLinear(Manitobaaverageaverage2007/082007/08Ͳ2011/12Ͳ2011/12) Winnipeg(1,2) Southern(1,2,t) PrairieMountain (1,2,t) InterlakeͲEastern (1,2,t) Northern(1,2) 0 1020304050607080 Per1,000 aged0Ͳ5 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD )LJXUH'HQWDO([WUDFWLRQ5DWHVE\1RUWKHUQ'LVWULFWDQG=RQHDQG 2002/03Ͳ2006/07 2007/08Ͳ2011/12 NorthernLinear(Northernaverage2002average/03Ͳ20062002/03/07Ͳ2006/07) NorthernLinear(Northernaverageaverage2007/082007/08Ͳ2011/12Ͳ2011/12) Flin,Snow,Cran,Sher Gillam,FoxLakeCN Thompson,MysteryLake(1,2,t) BayLine(1,2,t) ThePas/OCN,Kelsey(1,2) NelsonHouse/NCN(1,2) NorwayHouse/NHCN(1,2,t) CrossLake/PimiCN(1,2) Sham,YorkFN,Tat(SPL)(1,2) SayD(TL),Bro/BL,NoL(Lac)(1,2) GR/Mis,ML/Mos,Eas/Che(1,2) LL/MC,LR,OͲP(SIL),PN(GVL)(1,2) Bu(OH),MS(GR),GLN/GLFN(1,2) IslandLake(1,2) Puk/MatColCN(1,2,t) NorthernDirectServiceZone(1,2) NorthernNonͲDirectServiceZone(1,2) NorthernIslandLakeZone(1,2) 0 20 40 60 80 100 120 Per1,000 aged0Ͳ5 6RXUFH 0DQLWRED&HQWUHIRU+HDOWK3ROLF\5+$,QGLFDWRUV$WODV 127( LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQILUVWWLPHSHULRG LQGLFDWHVDUHD VUDWHZDVVWDWLVWLFDOO\GLIIHUHQWIURP0DQLWREDDYHUDJHLQVHFRQGWLPHSHULRG W LQGLFDWHVFKDQJHRYHUWLPHZDVVWDWLVWLFDOO\VLJQLILFDQWIRUWKDWDUHD &200881,7<+($/7+$66(660(17 6.5.4. Cancer Late Stage Diagnosis DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIFDQFHUSDWLHQWVZKRZHUHGLDJQRVHGDWVWDJHRIWKHLUFDQFHU Why Is This Indicator Important? 3DWLHQWVZLWKODWHVWDJHFDQFHUGLDJQRVLVKDYHSRRUHUWUHDWPHQWRXWFRPHVDQGDORZHUFKDQFHRIVXUYLYDO7KH REMHFWLYHLVWRUHGXFHWKHQXPEHURIODWHVWDJHFDQFHUGLDJQRVHVE\SURPRWLQJFDQFHUSUHYHQWLRQVWUDWHJLHVDQGWKH XVHRIFDQFHUVFUHHQLQJSURJUDPVWRGHWHFWFDQFHUVHDUO\WRLPSURYHWUHDWPHQWRXWFRPHV&DQFHU&DUH0DQLWREDLV DOVRZRUNLQJWRUHGXFHWKHWLPHLWWDNHVIURPGLDJQRVLVWRWUHDWPHQWDVLWLPSURYHVWKHHIILFLHQF\RIWKHLUKHDOWK GHOLYHU\V\VWHPWKURXJKWKHXVHRISDWLHQWQDYLJDWRUV What did we learn in 2009? ,QWKHSURSRUWLRQRIFDQFHUSDWLHQWVLQWKHIRUPHU1250$15HJLRQZLWKDODWH VWDJHFDQFHUGLDJQRVLVZDV SHUFHQWWKHKLJKHVWDPRQJ0DQLWRED5+$V,WZDV VLJQLILFDQWO\RYHUWKH0DQLWREDDYHUDJHRI SHUFHQW 7KHIRUPHU%XUQWZRRG5HJLRQKDGDUDWHRISHUFHQW What did we learn in 2014? ,QWKHODWHVWDJHGLDJQRVLVUDWHIRUFDQFHULQWKH1RUWKHUQ+HDOWK5HJLRQZDVSHU FHQWVWDWLVWLFDOO\RYHUWKH0DQLWREDDYHUDJHRI SHUFHQW VHH7DEOH /DWHVWDJHGLDJQRVHVUDQJHGIURPSHUFHQWIRUSURVWDWHFDQFHUWRSHUFHQWIRUOXQJ FDQFHULQWKH5HJLRQ 7DEOH&DQFHU/DWH6WDJH'LDJQRVLVE\&DQFHU7\SH 3HUFHQWRI&DQFHU3DWLHQWV'LDJQRVHG$W/DWH6WDJH ,9 $OO&DQFHUV /XQJ &RORUHFWDO %UHDVW IHPDOH V 3URVWDWH µV¶LQGLFDWHVGDWDVXSSUHVVHGGXHWRVPDOOQXPEHUV 6RXUFH &DQFHU&DUH0DQLWRED5HJLRQDO3URILOH 6.5.5. Cancer Survival Rates DEFINITION 7KLVLQGLFDWRUPHDVXUHVWKHSURSRUWLRQRIFDQFHUSDWLHQWVZKRDUHVWLOODOLYHILYH\HDUVDIWHUGLDJQRVLV Why Is This Indicator Important? &DQFHUVXUYLYDOUDWHVDUHDQLPSRUWDQWLQGLFDWRURIWKHEXUGHQRIFDQFHURQWKHKHDOWKFDUHV\VWHPDVZHOODVKRZ HIIHFWLYHWUHDWPHQWDQGDFFHVVWRFDQFHUFDUHV\VWHPLV&DQFHUVXUYLYDOGDWDLVDOVRLPSRUWDQWIRUKHDOWKSODQQHUVWR GHWHUPLQHWKHOHYHORIVHUYLFHVQHHGHGIRUWKHRQJRLQJPDQDJHPHQWRIFDQFHUDVDFKURQLFGLVHDVH What did we learn in 2009? ,QRYHUDOOFDQFHUVXUYLYDOUDWHLQWKHIRUPHU%XUQWZRRG5HJLRQZDVSHUFHQW 7KHIRUPHU1250$1UHJLRQKDGD VXUYLYDOUDWH%RWK5HJLRQVZHUHEHORZWKH 0DQLWREDDYHUDJHRISHUFHQW What did we learn in 2014? &DQFHUVXUYLYDOUDWHVDSSHDUWRKDYHZRUVHQHGLQWKH1RUWKHUQ+HDOWK5HJLRQ,Q WKHFDQFHUVXUYLYDOUDWHRYHUDOOZDVSHUFHQWVLJQLILFDQWO\EHORZWKH0DQLWREDDYHUDJHRI SHUFHQW VHH)LJXUH )LJXUH2YHUDOO&DQFHU6XUYLYDO5DWHVE\5+$ LinearManitoba(Manitoba)average Northern* InterlakeͲEastern Winnipeg PrairieMountain Southern* 0% 10% 20% 30% 40% 50% 60% 70% PerCent 6RXUFH &$1&(5&$5(0$1,72%$ 127( 6LJQLILFDQWO\GLIIHUHQWIURP0DQLWREDUDWH S &200881,7<+($/7+$66(660(17 6.5.5.1. Colorectal Cancer Survival Rates What did we learn in 2009? ,QWKHFRORUHFWDOFDQFHUVXUYLYDOUDWHLQWKHIRUPHU%XUQWZRRG5HJLRQZDV SHUFHQWUHVSHFWLYHO\7KH%XUQWZRRGUDWHZDVWKHKLJKHVWDPRQJ0DQLWRED5+$V7KH 0DQLWREDDYHUDJHZDV SHUFHQW 7KH1250$1VXUYLYDOUDWHZDVSHUFHQW What did we learn in 2014? ,QWKHFRORUHFWDOFDQFHUVXUYLYDOUDWHLQWKH1RUWKHUQ+HDOWK5HJLRQZDVIRXQGWR EHSHUFHQWZHOOEHORZWKH0DQLWREDDYHUDJHRISHUFHQW7KH1RUWKHUQUDWHQHHGV WREHWUHDWHGZLWKFDXWLRQKRZHYHUDVWKHUDWHLVEDVHGRQDORZQXPEHURIFDVHV VHH)LJXUH )LJXUH)LYH