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La Santé De La Population De La Capitale-Nationale

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La Santé De La Population De La Capitale-Nationale La santé de la population de la Capitale-Nationale François Desbiens Directeur de santé publique 26 mai 2018 Plan de la présentation • Population de la Capitale-Nationale • État de santé • Inégalités sociales de santé Population de la Capitale-Nationale 4 Le territoire – région 03 Baie-Ste-Catherine Charlevoix 2 territoires de CLSC Québec-Nord 4 territoires de CLSC Portneuf 1 territoire de CLSC Québec-Sud Saint-Casimir 6 territoires de CLSC Correspondance RLS, CLSC, quartiers, municipalités et MRC Quartiers, municipalités, MRC RLS CLSC de la Capitale-Nationale Portneuf Portneuf MRC Portneuf Laurentien Cap-Rouge, Aéroport Sainte-Foy, Sillery, Cité-Universitaire, Plateau, Saint-Louis, Sainte-Foy–Sillery Ancienne-Lorette, Saint-Augustin-de-Desmaures Vieux-Québec−Colline Parlementaire, Saint-Jean-Baptiste, Québec- Québec Haute-Ville Montcalm, Saint-Sacrement Sud Québec Basse-Ville Cap-Blanc, Saint-Roch, Saint-Sauveur Limoilou–Vanier Vieux-Limoilou, Maizerets, Lairet et Vanier Duberger–Les Saules–Lebourgneuf Duberger, Les Saules, Neufchâtel-Est, Lebourgneuf Loretteville, Val-Bélair, Saint-Émile, Châtels, Saint-Gabriel-de- Loretteville–Val-Bélair Valcartier, Lac-Saint-Joseph, Fossambault-sur-le-Lac, Sainte- Catherine de la Jacques-Cartier, Shannon, Wendake Québec- Charlesbourg Charlesbourg, Lac-Saint-Charles, Jésuites, Notre-Dame-des- Nord Laurentides, Lac-Beauport, Lac-Delage, Stoneham-et-Tewkesberry Beauport Beauport, Chute-Montmorency, Sainte-Brigitte-de-Laval Orléans MRC Île-d'Orléans, MRC Côte-de-Beaupré Charlevoix-Ouest MRC Charlevoix Charlevoix Charlevoix-Est MRC Charlevoix-Est La population de la Capitale-Nationale 748 061 824 272 668 948 2006 2017 2036 La croissance de la population 0-17 ans 18-64 ans 65 ans + Total 2016 124 200 470 000 148 300 742 500 2016 143 000 450 000 200 000 793 000 2036 138 000 458 000 228 000 824 000 N.B. Les nombres sont arrondis • Hausse de près de 82 000 personnes entre 2016 et 2036 • Diminution du bassin traditionnel de main-d’œuvre • Hausse très importante du nombre d’aînés Structure de la population 70 67 67 67 66 63 60 18-64 ans 57 55 56 Vieillissement accéléré 65 ans et + 27 28 25 23 21 20 19 18 0-17 ans 17 18 18 17 17 17 17 14 15 13 0 1996 2001 2006 2011 2016 2021 2026 2031 2036 Naissances et décès 7 190 7 318 Naissances 5 834 Décès 3 880 Dans quelques années, il y aura plus de décès que de naissances 1982 1999 2016 Résumé • Population de 748 000 en 2017 • Répartie sur 4 territoires de RLS • Vieillissement se poursuit • Population en croissance État de santé Espérance de vie : 82,5 ans 84,5 Écart : 4,3 80,1 80,2 72,3 L’écart se rétrécit entre les Écart : 7,8 hommes et les femmes 1985-1989 1990-1994 1995-1999 2000-2004 2005-2009 2010-2014 Cancer : 1re cause de mortalité 1/3 des décès dans la région de la Capitale-Nationale Nouveaux cas de cancer (taux brut) = croissance de la population et vieillissement Cancer du sein et ceux reliés à l’appareil respiratoire = efforts de prévention Préoccupations à l’égard des cancers du système digestif (côlon, estomac, pancréas, foie, etc.) : augmentation de la consommation d’alcool Mortalité par cancer = recherche, traitements améliorés, détection précoce et efforts en prévention Diabète prévalence de diagnostic 100 • Situation qui progresse avec l’âge • 22 % des 65 ans et + ont un diagnostic de diabète Tauxp.100 22 65 ans + 15 8 5 45-64 ans 1,3 0 0,9 20-44 ans 2000-2001 2015-2016 Hypertension artérielle prévalence de diagnostic • Situation qui progresse avec l’âge • 63 % des 65 ans et + ont un diagnostic 100 d’hypertension artérielle 63 65 ans + 49 24 19 45-64 ans 3 3 0 20-44 ans 2000-2001 2015-2016 Maladies coronariennes prévalence de diagnostic • Situation qui progresse avec l’âge • 32 % des 65 ans et + ont un diagnostic 100 de maladies coronariennes 32 27 65 ans + 6 7 40-64 ans 0 2000-2001 2015-2016 Sédentarité 50 19 % 50 18 ans + 30 23 19 18 *16 ** 0 0 2007-2008 2013-2014 18-24 ans 25-44 ans 45-64 ans 65 ans + • Situation qui progresse avec l’âge • 30 % des 65 ans et + sont sédentaires Obésité Scénario 25 16 % 18 ans + d’augmentation linéaire Projections 21 18 Scénario de 16 ralentissement 6 Près de 3 x plus 0 1987 1998 2003 2007 2009 2011 2013 2015 2017 2019 2021 2023 Boissons sucrées Une fois par jour ou plus 100 19 % 100 15 ans + 24 25 19 16 19 18 13 0 0 Hommes Femmes Total 15-24 ans 25-44 ans 45-64 ans 65 ans et + • 19 % de la population de la Capitale-Nationale consomme au moins une sorte de boisson sucrée une fois par jour ou plus • Près de 1 personne sur 5 de 65 ans et + • Plus fréquent chez les hommes • Plus fréquent chez les 15-24 ans Tabagisme 16 % 38 12 ans + 16 1987 2013-2014 2013-2014 1987 Constante diminution Consommation excessive d’alcool 100 100 21 % 12 ans + 48 33 21 20 14 ** *8 0 0 2000-2001 2013-2014 12-17 ans 18-24 ans 25-44 ans 45-64 ans 65 ans et + • Consommation excessive est plus fréquente chez les hommes, mais la hausse est plus marquée chez les femmes • La consommation excessive est moins fréquente chez les 65 ans et +, mais c’est le groupe d’âge avec la hausse la plus marquée Cannabis 100 16 % 15 ans + 2008 2014-2015 (ns) 45 (ns) (ns) 34 35 (+) ** (ns) 23 (ns) 14 (ns) 8 (ns) *4 ** *1,6 0 15 à 17 ans 18 à 24 ans 25 à 44 ans 45 à 64 ans 65 ans et plus • La hausse observée : chez les consommateurs «moins d’une fois par mois» • La fréquence quotidienne a diminué Santé mentale Variation Indicateurs % + fréquent chez les : temporelle 2016 • Femmes Troubles mentaux 13 % - 1 an et + et an 1 2015 • 65 ans et + Alzheimer et autres tr. 2016 • Femmes 2 % - 2015 neurocognitifs majeurs et + ans 40 • 85 ans et + Tr. du déficit de l'attention avec 2016 • Garçons 5 % - à 24 ans ans 24 à 1 ou sans hyperactivité (TDA/H) 2015 • 10-14 ans Suicide 107 2014 • Hommes - (moyenne par année) décès 2010 • 40-49 ans Prévention des maladies infectieuses Indicateurs Données Couverture vaccinale complète de 10% et 2016 et Enfants 2 ans Entre 2011 Infection nosocomiale de 40% et 2016 et (Clostridium difficile) 2011 Entre Sous le seuil 2015 Couverture vaccinale générale (MEV) - recommandé 2014 De 2 à 3 fois Chlamydia, gonorrhée et syphilis et 2014 et plus de cas 2000 Entre Santé des tout-petits Variation Indicateurs Données temporelle Nouveau-nés avec de jeunes mamans 2014 5,8 - p. 1 000 (15-19 ans) 2010 Vivre avec un seul parent 11 % 2011 - Nouveau-nés faible poids 6 % 2014 2010 - Nouveau-nés prématurés 7 % 2014 2010 Enfants de la maternelle vulnérables dans nd 23 % 2012 au moins un domaine de développement Résumé Gains : • Augmentation de l’espérance de vie • Diminution de la mortalité par cancers et par suicide • Diminution de la sédentarité et du tabagisme • Prévention des infections dans les milieux de soins, la vaccination chez les enfants • Santé des nourrissons Résumé Préoccupations : • Hausse des maladies chroniques (diabète, hypertension artérielle et maladies coronariennes) • Hausse de l’obésité, de la consommation excessive d’alcool et de la consommation de cannabis • Hausse importante des ITSS • Enfants vulnérables – domaine de développement Inégalités sociales de santé Inégalités sociales de santé Définition Ce sont des écarts, pourtant évitables, entre hommes et femmes, entre groupes socioéconomiques et entre territoires, qui ont un impact sur de nombreux aspects de la santé des populations. INÉGALITÉ = INIQUITÉ Inégalités selon le territoire - – Sillery Vanier – Ville Ville - - – Les Saules Saules Les Bélair Bélair – - Foy Foy - Orléans Portneuf Lebourneuf Beauport Val Basse Charlevoix Laurentien Laurentien Haute Charlesbourg Lorretteville Sainte Limoilou Maladies chroniques vs PQ Duberger Diabète (65 ans +) = — — — — = — — — = Hypertension artérielle (20 ans +) — — — — = Maladies coronariennes (65 ans +) = = = Habitudes de vie vs PQ Fumeurs de cigarettes (15 ans +) = — = — = = = — = = Consommation de drogues (15 ans +) = = = = — = = = = Consommation de breuvages sucrés (18 ans +) = — = — — = = = = = Inégalité dès la naissance Espérance de vie à la naissance, 2010-2014 Haute-Ville 84,7 Sainte-Foy-Sillery 84,3 Charlesbourg 84,2 Laurentien 83,8 Loretteville-Val-Bélair 83,6 Capitale-Nationale 82,5 8 ans d’écart entre Duberger-Les Saules-Lebourneuf 82,4 Haute-Ville et Portneuf 82,1 Basse-Ville Orléans 82,0 Ensemble du Québec 81,9 Beauport 81,5 Charlevoix-Ouest 80,9 Charlevoix-Est 80,7 Limoilou-Vanier 79,7 Basse-Ville 76,5 50 31 Inégalités selon la scolarité et le revenu Scolarité Études Sans DES Postsecondaires Obésité 21 % 14 % Sédentarité 40 % 13 % Alcool (consommation excessive) 16 % 26 % Revenu Faible revenu Autres Fumeurs de cigarettes 26 % 15 % Résumé Équité en santé • Présence de disparités selon le territoire, la scolarité ou le revenu • Écarts de santé parfois importants PRINCIPAUX CONSTATS Au niveau régional : – La population est en croissance et le vieillissement se poursuit – Des conditions socioéconomiques plus avantageuses que le reste du Québec – Des gains sur le plan de la santé, mais aussi des préoccupations importantes ACTIONS EN SANTÉ PUBLIQUE En collaboration avec divers partenaires : – Promotion de saines habitudes de vie – Promotion des environnements favorables à la pratique d’activités – Mise en place de centres d’abandon tabagique – Prévention du suicide – Prévention des maladies infectieuses – Programme SIPPE – Révision de l’offre de service en ITSS Des questions? 36.
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