VANCOUVER ISLAND NORTH - 434 Local Health Area Profile

Vancouver Island North (V.I. North) Local Health Area (LHA) is one of 14 LHAs in Island Health and is located in Island Health’s North Island Health Service Delivery Area (HSDA). Situated at the northern tip of the North Island HSDA, V.I. North encompasses 21,157 square kilometres and includes the communities of Port Hardy, Port Alice, Port McNeill, Alert Bay, Kingcome, and Zeballos. V.I. North borders two other LHAs: Vancouver Island West and Greater Campbell River. V.I. North is situated along Highway 19, approximately a three hour drive from Campbell River. Many of its communities are more accessible by boat or plane than by road. BC Transit runs seven bus lines in the V.I. North area, primarily between Port Hardy and Port McNeill. HandyDART services are also offered in Port Hardy and Port McNeill. There are BC Ferries services from Port Hardy to Bella Coola, Prince Rupert, and Haida Gwaii, as well as between Port McNeill, Sointula and Alert Bay.

July 2018

An accompanying Interpretation Guide has been created to assist with the interpretation of indicators.

The Interpretation Guide should be read with the profiles.

These profiles are not intended to be used for detailed planning or analysis. As they are updated on an annual basis, there may be more current data available. If you are intending to use these profiles for health planning purposes, if you have detailed questions, or notice a discrepancy, please contact Maritia Gully ([email protected]). 1 of 22 Population and Demographics

As of 2019, the Vancouver Island North LHA represents 1.4% (11,869 people) of Island Health’s total population of 843,376. According to the 2016 Census, 31.2% of people living in Vancouver Island North identified themselves as Indigenous, compared to 7.6% across Island Health and 5.9% in BC. Additionally, 4.3% of people living in Vancouver Island North identified themselves as a visible minority, compared to 9.6% across Island Health and 30.3% in BC.

The population of Vancouver Island North is older than that of BC, but younger than Island Health overall, with an average age of 42.1 years. The 75+ age group makes up 4.13% of the population, which is lower than Island Health (10.1%) and BC (7.86%) proportions. Currently the largest population group is between ages 20 and 44.

The Vancouver Island North population is expected to increase by 6.28% to 12,614 by the year 2028; this is lower than the growth expected for Island Health (8.63%) and BC (11.4%). The greatest growth is expected in the 75+ age group, which is expected to more than quadruple (from 490 to 2,090) over the next 20 years. The 65-74 year age group is expected to increase over the short term, but similar to the 20-44 age group, will only have a small increase over 20 years. The 0-19 and 45-64 year age groups is expected to remain relatively stable, while decreasing slightly. See the Population and Demographics summary on page 11 for more information.

Average Age (2018) Estimated Total Population - V.I. North

BC Island Health V.I. North 4K n o

i 3K 41.8 44.7 42.1 t a l

u 2K p o P 1K Population Pyramid - 2019 - V.I. North 0K 90+ 9 1 3 5 7 9 1 3 5 7 9

85 - 89 1 2 2 2 2 2 3 3 3 3 3 80 - 84 0 0 0 0 0 0 0 0 0 0 0 75 - 79 2 2 2 2 2 2 2 2 2 2 2 70 - 74 65 - 69 Estimated Population Change - V.I. North 60 - 64 55 - 59 50 - 54 45 - 49 300% 40 - 44 35 - 39 30 - 34 200% 25 - 29 20 - 24 100% 15 - 19 10 - 14 05 - 09 0% 01 - 04

<1 9 1 3 5 7 9 1 3 5 7 9 1 2 2 2 2 2 3 3 3 3 3 0 0 0 0 0 0 0 0 0 0 0

400 200 0 0 200 400 2 2 2 2 2 2 2 2 2 2 2

Male Population Female Population 0-19 20-44 45-64 65-74 75+ 2 of 22 Determinants of Health

Access to adequate income, affordable housing, healthy food, education, healthy environments, and recreational opportunities influence our health and wellbeing. People who are less well-off generally have poorer health and shorter life expectancies than those who are well-off. By working upstream to improve the conditions in which all people live, work and play, we can decrease these gaps and improve the health and wellbeing of our population.

Income and Employment

The median household income for Vancouver Island North was $57,685 in 2016, lower than the BC median household income of $69,979 and Island Health’s $65,735 (median income in this report is a before-tax measure unless specified otherwise). The proportion of persons who are members of a low income household is higher across all age groups, compared to Island Health and BC overall. The unemployment rate in Vancouver Island North is higher in comparison to Island Health and BC (see also page 12).

Percent of Population with Low Income in 2015 based on after-tax low-income measure (2016 Census)

Low Income Children Low Income Children and Low Income Adults (18 to 64) Low Income Seniors (65+) (<6 years) Youth (<18) n o

i 25.4 25.1 t

a 25 l u

p 20.0 o 19.6 19.2

P 20 18.4 17.7

d 16.7 e

t 14.9 14.7 14.9 c 15 e l 11.7 e S

f 10 o

t n e

c 5 r e

P 0

Education High School Completion Rate within 6 years of Grade 8 Enrollment (2 yr aggregate) High school completion rates in Vancouver Island North are lower than the rates for Island Health. Also, according to 80 the 2016 Census, a smaller proportion of the Vancouver 83.8 s 70 t

Island North adult population have completed n 76.7 e 60 post-secondary education. d 69.5 u t

S 50

f o

t 40 n

Population Aged 25 to 64 with Post-Secondary e

c 30 r

Certificate, Diploma or Degree (%) e

P 20 2016 10 BC Island Health V.I. North 0 1 2 3 4 5 6 7 8 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2 63.9 63.7 48.7 ------8 9 0 1 2 3 4 5 6 0 0 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2

V.I. North Island Health BC 3 of 22 Determinants of Health

Housing Selected Household Indicators Dwellings Needing Housing Affordability Housing Affordability One way to measure affordability of housing is to Major Repairs (%) Owners (% spending Renters (% spending look at how much of a household’s income is spent >30% of Income) >30% of Income) 50 on shelter. The percentage of population spending 45.0 43.3 more than 30% of income in Vancouver Island

North is lower than BC and Island Health levels, n 40 o 36.3 i for both home owners and renters. There is a t a l lower percentage of crowded family households in u p 30 o

Vancouver Island North compared to BC, but P

f o

higher compared to Island Health (see page 12). 20.7 t

The percentage of households in need of major n 20 17.2 e 15.5 c repairs (e.g. defective electrical wiring) is higher r 12.7 e than the Island Health and BC rates. P 10 6.3 6.2

Early Childhood Development and 0 Determinants of Child and Youth Health Median Household and Lone-Parent Income, and Percentage of Lone-Parent Families (2016 Census) Creating supportive and healthy environments in an equitable way so that all children and youth Median household Median lone-parent Lone-parent can grow and thrive is critical to the health of the total income ($) family income ($) Families (%) population. This includes supporting mothers 70.0K 70K 65.7K during the pre- and post-natal period, supporting 26 families during early development years, 60K 57.7K supporting children and youth to grow, learn, and 50.9K 48.4K transition into adulthood. 50K 41.9K 40K 22 Vancouver Island North has the same percentage of lone-parent families in comparison to BC and 30K higher than Island Health. Lone-parent families in Vancouver Island North also have a lower median 20K 26 household income than lone-parent families in 10K Island Health and BC. 0K

Early Development Instrument (EDI) The Early Development Instrument (EDI) is used to Percent of Preschool Children Vulnerable in measure vulnerability in "waves" of kindergarten children EDI: Vulnerable on ≥1 Domains across five domains (social, physical, emotional, language, and communication). Increases in the EDI rate are a 40 negative indicator of child health and decreases are a 40.0

t positive indicator. For Island Health overall, vulnerability n 35 e 32.2 had increased between 2007/2009 and 2011/2013, but c r

e 30.0 decreased in the most recent wave. Vancouver Island P 30 31.1 29.9 North has had higher levels of vulnerability compared to 26.0 Island Health and BC, and has shown an increase over time 2004- 2007- 2009- 2011- 2013- in the rate of vulnerability. 2007 2009 2011 2013 2016 V.I. North Island Health BC 4 of 22 Determinants of Health

Mothers’ smoking during pregnancy has demonstrated negative effects for both mother and baby. Rates of smoking during pregnancy have been decreasing over the past eight years; across Island Health overall rates have been higher than for BC. In Vancouver Island North, a much higher percentage of mothers reported smoking during pregnancy and this has increased in 2014-2018.

Rates of children and youth in care have decreased over the past five years across Island Health overall; however, rates have been much higher than BC. Vancouver Island North has a much higher rate of children and youth in care than BC and Island Health, and this rate has been increasing in recent years. See the Determinants of Health summary on page 13 for more information.

Percent of Pregnant Women who Reported Children and Youth in Care Smoking at Any Time During Current Pregnancy per 1,000 Children and YouthY (5 yr aggregate) 8 1 - 35 36.3 0

18 19.3 e 28.8

18.5 g 30 a

t 0 n 25 0 e 14 0 c , r 11.3 1 e

20

10.0 r P

10 e 14.6 8.1 p 15 11.4 e

6.4 t 9.0 6 a 10 6.9 R - - - - - 4 5 6 7 8 0 1 2 3 4 1 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0

2 2 2 2 2 2014 2015 2016 2017 2018 2 2 2 2 2 Healthy Behaviours and Built Environment

Alcohol Consumption (litres of absolute alcohol sold per person, 1L=58 Preference for healthy behaviours such as healthy eating, exercise, reduction of smoking and alcohol standard drinks) consumption, and social connections contribute to a 15 14.5 14.8 healthier life. Many of the healthy behaviour indicators are available through the Canadian 14 Community Health Survey (CCHS), but the data is 13 not available at the LHA level. Among LHA-level s e

r 12 11.6 available data, substance use in Vancouver Island t i

L North, particularly alcohol consumption per capita, 11 10.6 is higher than the Island Health and BC level. 10 9.4 9.0 9 Employed Population Aged 15 and Over 6 7 8 9 0 1 2 3 4 5 6 7 0 0 0 0 1 1 1 1 1 1 1 1

0 0 0 0 0 0 0 0 0 0 0 0 Walking, Biking or Busing to Work (%) 2 2 2 2 2 2 2 2 2 2 2 2 BC Island Health V.I. North Among those who are employed, a slightly lower percentage of the population in Vancouver Island North reports using active modes of transportation (walking, 22.4 19.6 17.5 cycling, and public transit) to get to work compared to Island Health and BC. See the Determinants of Health summary on pages 12. V.I. North Island Health BC 5 of 22 Health Status

The health status of the population is measured with several indicators such as life expectancy, infant mortality, prevalence of chronic disease, mortality, and premature mortality.

Birth Statistics Birth Statistics Per 1,000 Live Births (2013-2017) The overall birth rate for Vancouver Island North is similar to Island Health; however, there are 3.5 Infant 4.0 proportionately fewer births to older mothers (35 years Mortality* and over) and a greater number younger mothers (under 7.4 20 years). The rate of low birth weight babies and 11.4 pre-term babies (those born at less than 37 weeks) is Stillbirths 10.0 higher than Island Health and BC. The infant mortality 10.9 rate in this LHA is nearly twice the rate of Island Health 17.8 Mothers under and BC. 26.2 20 years 77.9 Birth Statistics 57.8 Low Birth 53.8 Live Births per 1,000 Population Weight (1989-1993 to 2013-2017) 59.8 77.1 18 17.6 Pre-term Births 82.7 94.2 16 331.3 Cesarean 291.8 Sections

e 197.5 t 14 13.3 a

R 252.9

h Mothers 35

t 12.1 227.9 r i 12 years and over B 163.0

9.5 *It is important to note that caution should be exercised 10 9.4 when dealing with a small number of cases as an increase or decrease may indicate random variation rather than a 8.3 significant change in rates. 8 3 7 1 5 9 3 7 9 9 0 0 0 1 1

9 9 0 0 0 0 0 Mortality (Age Standardized Rate per 10,000) 1 1 2 2 2 2 2 ------9 3 7 1 5 9 3 8 9 9 0 0 0 1 9 9 9 0 0 0 0

1 1 1 2 2 2 2 115.3 100

Mortality Statistics 79.2 80 71.5 Mortality rates have decreased steadily over the last 66.8 decade. The age-standardized all-cause mortality rate 70.2 for Vancouver Island North was much higher than the 60 64.5 Island Health and BC rates, but this rate has rapidly ------2 3 4 5 6 7

declined over the past decade. See the Health Status 8 9 0 1 2 3 1 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 0 summary on page 15 for cause-specific mortality rates. 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2 2 2 2

V.I. North Island Health BC 6 of 22 Health Status

Life Expectancy Potential years of life lost (PYLL), is a measure of premature mortality (an estimate of the average years a 82 person would have lived if they had not died before the 82.3 81.9 established life expectancy of 75 years).The PYLL in Life 80 Vancouver Island North are higher or similar to the BC Expectancy 78.1 and Island Health rates due to most causes. A complete 78 list of potential years of life lost by cause can be found 76 on page 16. 84 Life expectancy has been increasing over the last few 84.3 82 83.8 decades in the Vancouver Island North population, but Female Life 80.0 Expectancy life expectancy tends to be shorter than both Island 80 Health and BC. 78 Chronic Disease 81 79 80.3 Chronic disease prevalence rates tend to be higher for 79.9 Male Life Vancouver Island North in comparison to Island Health 77 76.5 Expectancy and BC rates, with the exception of Alzheimer's disease 75 and other dementia, which is lower. See the Health Status summary on page 14 for more information. 73 ------1 6 0 4 5 6 7 7 2 6 0 1 2 3 0 0 1 1 1 1 1 9 0 0 1 1 1 1 0 0 0 0 0 0 0 9 0 0 0 0 0 0 2 2 2 2 2 2 2 1 2 2 2 2 2 2

Chronic Disease Age Standardized Prevalence in 2018 Per 1,000 Individuals

BC Island Health V.I. North

Heart Failure 19.4 17.7 32.2

Alzheimer's Disease and Other Dementia 20.3 21.3 19.2

Chronic Kidney Disease 23.2 22.2 24.4

Chronic Obstructive Pulmonary Disease 51.1 52.5 95.5

Episodic Asthma 49.9 52.9 65.2

Ischemic Heart Disease 69.4 60.5 80.1

Diabetes 80.3 69.5 94.0

Osteoarthritis 84.9 91.1 105.8

Asthma 123.1 130.7 167.1

Hypertension 224.7 212.1 250.0

V.I. North Island Health BC 7 of 22 Grouping Description Health StatusHealth Status

Mental Health and Substance Use Chronic Disease Age Standardized Prevalence Per 1,000 Individuals Over recent years, many of the LHAs across Island Health have been 278.3 working to address the ongoing opioid public health emergency and to 270 273.6 discuss how to improve mental health and wellbeing. In light of this Depression ongoing health emergency, this page highlights several measures that 260 250 are directly or indirectly related to the crisis at hand. 246.0 85 85.8 Mental Health Conditions Episodic 80 81.1 Depression Prevalence of conditions related to mental health in Vancouver Island 75 North vary when compared to BC and Island Health rates. The most 72.2 notable conditions are schizophrenia and delusional disorders, where 340 342.7 Vancouver Island North prevalence is lower than BC and Island Health Mood & Anxiety 336.1 overall. Vancouver Island North prevalence in all of the other mental Disorders 320 health conditions sit between BC (lower) and Island Health (higher) values. 300 301.9 122.1 120 Substance Use Episodic Mood & Anxiety Disorders 110 109.5 Vancouver Island North alcohol and tobacco-related deaths remain 100 101.6 higher than BC and Island Health, although tobacco-related death rates 11.6 have dropped over the last few years. Rates of illicit drug toxicity 11.5 Schizophrenia & deaths are much lower than Island Health and BC. The indicators Delusional directly below have combined deaths that are partially or entirely 11.0 11.0 Disorders attributed to the substance being measured; for more details visit 10.5 10.6 http://aodtool.cfar.uvic.ca/aod/about.php. Also, see hospitalization rates on page 15.

Substance-Related Deaths Illicit Drug Toxicity Deaths (Age Standardized Rate per 100,000) (Crude Rate per 100,000)

30 30.3 200 191.7 221.7 28.4 Alcohol-related 150 Deaths 20.4 93.6 Illicit Drug 20 94.6 100 82.6 Toxicity Deaths 19.9 83.0

250 10 8.5 8.5 Tobacco-related 231.4 200 2016 2017 2018 Deaths 163.5 155.7 132.9 For the most up to date data on Illicit Drug Toxicity Deaths, 150 159.2 127.7 visit: https://www2.gov.bc.ca/gov/content/life- events/death/coroners-service/statistical-reports 2008 2010 2012 2014 2016 V.I. North Island Health BC 8 of 22 Health Service Use

Population Attached to Physician at the Practice Access to primary care services plays an important role Level (%) in the use of emergency department and inpatient 81.8 services. The population attached to physicians at the 80.3 practice level is calculated by the Ministry of Health and 80 79.5 indicates the percentage of population who have a 78.6 regular physician or regular physician practice. A slightly larger percentage of the Vancouver Island North 76.5 d

e 75.7 population has a physician at the practice level, h c a reflecting an large increase in the most recent year. t 75 t A

t n

There is a slightly lower rate of home care and home e c support clients over 75 years of age for Vancouver Island r e North compared to Island Health. Vancouver Island P 70 North rates of home care visits and home support hours for this age group are lower than Island Health's rate. See the Health Service Use summary on page 17 for more information on these topics. 65 8 9 0 1 2 3 4 5 6 7 0 0 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2 2

Home Care Visits Home Care and Home Support Clients Rate per 1,000 Population Rate per 1,000 Population

2014 2015 2016 2017 2014 2015 2016 2017 2018 4 9 7 1 9 6 0 . 4 3 ...... 2.48K Home . . 8 2 4 8 7 1 5 1 5 6 2.37K . 9 9 8 8 8 8 8 7 7 2.20K Care 2 1 1

2.11K 1 1

2.09K 1 1 1 1 1 3

Home 1.85K Clients - 1 Care 1.42K 75+ 1.23K 7 0 5 5 . . Visits - Home . . 2 2 7 4 5 1 1 6 . . 8 4 . . . . 0 0 0 0 9 6 75+ 4 Support 7 2 1 1 1 1 1 9 9 9 8 Clients - 8 8 75+

Home Support Hours Rate per 1,000 Population

40K 31.5K 38.6K 30K Home 28.0K Support 20K 23.6K Hours - 75+ 10K 4 5 6 7 8 1 1 1 1 1 0 0 0 0 0 2 2 2 2 2

V.I. North Island Health BC 9 of 22 Health Service Use

Acute Care Inpatient Cases (Age Standardized Rate per 1,000)

The age standardized hospitalization rate (inpatient 140 admissions) for the Vancouver Island North 138.5 population is higher than the Island Health and BC 122.0 rates, both overall and for the population aged 75 120 and over. Inpatient Case Rate The hospital admission rate for Ambulatory Care 100 Sensitive Conditions (ACSC) – conditions that can be treated in the community if services are available 81.5 81.9 78.1 and would not necessarily require hospitalization – 80 80.8 is slightly higher in Vancouver Island North compared to Island Health, after an increase in the 500 most recent year. 466.9

Emergency/urgent care visit rates are higher in Inpatient 400 Vancouver Island North than Island Health, but the Case Rate - rate of higher urgency visits is lower. Health service 75+ 340.2 usage is based on where the user resides rather 317.6 than where the service is provided. See the Health 291.9 Service Use summary on page 17 and 18 for more 300 information on these topics. 291.6 285.0 3 4 5 6 7 8 1 1 1 1 1 1 0 0 0 0 0 0 2 2 2 2 2 2

Unscheduled Emergency and Urgent Care Centre Ambulatory Care Sensitive Conditions Visits Rate per 1,000 Population and Percent of (% of Admissions) Higher Urgency A (Canadian Triage and Acuity Scale (CTAS) 1, 2 or 3) 8 s

1000 n 7 o

953 i

899 s

ED/Urgent 800 s i 6

Care m

d 5.2

600 A Utilization 5 5.4 t 5.0 n

389 e 400 467 i 4.6

t 4 a p

68 n 67 I 3

ED Visits - 65 t n

e 2 CTAS 1, 2 c r or 3 (%) 60 62 e 57 P 1 3 4 5 6 7 8 3 4 5 6 7 8 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2 2 2 2

V.I. North Island Health BC 10 of 22 The chart below shows how various indicators for this LHA compare with the rest of Island Health. This LHA's result for each indicator is shown with a large circle. Green identifies results better than Island Health; red identifies results worse than Island Health. These results do not necessarily reflect statistical significance. Island Health's value is shown by the black dotted line, which is always at the centre of the chart. Light gray shading encompassing small grey circles indicates the range of the other LHA values and the dark gray shading shows ±10% from the Island Health value. This is meant to show the relative magnitude of the LHA compared to Island Health, and in some cases extends beyond the chart display. Population and Demographics Summary Sub-group Time Island V.I. Indicator Description BC Description Period Health North

Population and 10-Year Population Growth (%) 2019-2028 11.4 8.6 6.3 Population Projection Population aged 0-19 (%) 2019 19.4 17.7 20.4

Population aged 20-44 (%) 2019 33.9 29.8 32.9

Population aged 45-64 (%) 2019 27.9 28.2 31.7

Population aged 65-74 (%) 2019 11.0 14.2 10.9

Population aged 75 and over (%) 2019 7.9 10.1 4.1

Percent growth of the 0-19 age group 2019 3.5 2.0 -7.2 population in next 10 years Percent growth of the 20-44 age group 2019 10.1 7.2 8.6 population in next 10 years Percent growth of the 45-64 age group 2019 -0.1 -5.7 -17.0 population in next 10 years Percent growth of the 65-74 age group 2019 27.1 13.0 43.8 population in next 10 years Percent growth of the 75+ age group 2019 55.5 58.2 133.3 population in next 10 years

Average Age (years) 2018 41.8 44.7 42.1

Age and Median Age of Population (Years) 2016 43.0 47.7 44.2 Demographics Population where language spoken most 2016 15.6 3.7 1.6 often at home is not English or French (%) Visible minority population (%) 2016 30.3 9.6 4.3

Population in private households with 2016 5.9 7.6 31.2 Aboriginal Identity (%) Population aged 15 and over who are Marital Status 2016 48.7 46.8 41.2 married (%) Population aged 15 and over who are 2016 9.4 11.5 18.0 common-law (%) Population aged 15 and over who are single, 2016 27.2 24.5 24.9 never married (%) Population aged 15 and over who are 2016 5.4 6.2 5.2 widowed (%) Population aged 15 and over who are 2016 9.3 11.1 10.7 separated or divorced (%) Migration and Immigrant population (%) 2016 28.3 15.8 9.0

Immigrants Population migrating to area in the last 5 2016 20.9 20.6 18.1 years (%) 0.0 0.5 1.0 1.5 2.0 11 of 22 The chart below shows how various indicators for this LHA compare with the rest of Island Health. This LHA's result for each indicator is shown with a large circle. Green identifies results better than Island Health; red identifies results worse than Island Health. These results do not necessarily reflect statistical significance. Island Health's value is shown by the black dotted line, which is always at the centre of the chart. Light gray shading encompassing small grey circles indicates the range of the other LHA values and the dark gray shading shows ±10% from the Island Health value. This is meant to show the relative magnitude of the LHA compared to Island Health, and in some cases extends beyond the chart display. Determinants of Health Summary

Sub-group Time Island Indicator Description BC V.I. North Description Period Health

Population aged 25 to 64 with post-secondary Education 2016 63.9 63.7 48.7 certificate, diploma or degree (%)

Grade 12 completion among students entering 2015- 80.2 73.5 72.8 Grade 12 for the first time (%) (2yr Agg) 2017

Students completing high school within six years 2016- 83.8 76.7 69.5 of enrollment in Grade 8 (%) (2yr Agg) 2018

Population aged 15 and over who are unemployed Employment 2016 6.7 6.8 10.5 (%)

Health Alcohol consumption (litres of absolute alcohol 2017 9.4 11.6 14.8 Behaviours sold per person, 1L=58 standard drinks)

Lone-parent family households (% of census Household 2016 25.5 22.0 25.6 families with children)

Private households with multiple families (%) 2016 3.0 1.5 1.2

Private households with 5 or more persons (%) 2016 8.3 5.3 6.5

Dwellings rated as needing major repairs by 2016 6.3 6.2 15.5 renter or owner (%)

Private households that are owner-occupied (%) 2016 68.0 69.1 68.4

Morbidity Alcohol-related hosp. (age stnd. rate per 100,000) 2016 397.0 440.6 795.8

Cannabis-related hosp. (age stnd rate per 2016 27.8 31.4 56.9 100,000)

Opioid-related hosp. (age stnd rate per 100,000) 2016 45.8 49.9 149.8

Tobacco-related hosp. (age stnd rate per 100,000) 2016 491.5 443.4 583.5

Employed Population Aged 15 and Over Walking, Transportation 2016 22.4 19.6 17.5 Biking or Busing to Work (%)

0.0 0.5 1.0 1.5 2.0

12 of 22 The chart below shows how various indicators for this LHA compare with the rest of Island Health. This LHA's result for each indicator is shown with a large circle. Green identifies results better than Island Health; red identifies results worse than Island Health. These results do not necessarily reflect statistical significance. Island Health's value is shown by the black dotted line, which is always at the centre of the chart. Light gray shading encompassing small grey circles indicates the range of the other LHA values and the dark gray shading shows ±10% from the Island Health value. This is meant to show the relative magnitude of the LHA compared to Island Health, and in some cases extends beyond the chart display. Determinants of Health Summary (Continued)

Sub-group Time Island Indicator Description BC V.I. North Description Period Health Child Mental Diseases & Disorders Hosp. (rate Child Health 2018 1.9 2.2 0.0 per 1,000 aged 0-14) Youth Mental Diseases & Disorders Hosp. (rate 2018 12.0 12.1 3.8 per 1,000 aged 15-24) Child/Youth Mental Diseases & Disorders Hosp. 2018 6.4 6.6 1.7 (rate per 1,000 aged 0 to 24) Child hospitalizations - Injury/Poisoning (rate per 2016-2018 4.4 5.5 4.4 1,000 aged 0 to 14) - (2yr Agg) Child hospitalizations - Respiratory Dis. (rate per 2016-2018 8.0 9.2 12.9 1,000 aged 0 to 14) - (2yr Agg) Child hospitalizations - Dental Surgery (rate per 2016-2018 7.0 9.8 17.8 1,000 aged 0 to 14) -(2yr Agg) Pregnant women who reported smoking at any 2014-2018 6.4 10.0 19.3 time during current pregnancy (%) (5yr Agg) EDI: Kindergarten children rated as vulnerable Early 2013-2016 14.8 16.2 23.0 for physical development (%) Development EDI: Kindergarten children rated as vulnerable 2013-2016 15.7 14.7 15.0 for social development (%) EDI: Kindergarten children rated as vulnerable 2013-2016 16.1 16.6 25.0 for emotional development (%) EDI: Kindergarten children rated as vulnerable 2013-2016 9.4 9.0 8.0 for language development (%) EDI: Kindergarten children rated as vulnerable 2013-2016 14.2 11.9 7.0 for communication development (%) EDI: Kindergarten children rated as vulnerable on 2013-2016 32.2 31.1 40.0 one or more domains (%) EDI: Kindergarten children rated as vulnerable on 2013-2016 28.6 28.5 39.0 one or more domains, excl. communication (%)

Income Median lone-parent family income ($) 2016 50,894.0 48,366.0 41,886.0

Median household total income ($) 2016 69,979.0 65,735.0 57,685.0 Difference in median income comparing males Income 2016 12,817.0 12,100.0 14,421.0 and females aged 15 and over Inequality Low income based on after-tax low income 2016 15.5 14.8 18.9 measure (%) Low income based on after-tax low-income 2016 18.4 19.2 25.1 measure, ages less than 18 years (%) Low income based on after-tax low-income 2016 17.7 19.6 25.4 measure, ages less than 6 years (%) Low income based on after-tax low-income 2016 14.9 14.7 16.7 measure, ages 18 to 64 years (%) Low income based on after-tax low-income 2016 14.9 11.7 20.0 measure, ages 65 years and over (%) Households (owned) spending more than 30% of 2016 20.7 17.2 12.7 income on housing (%) Households (rented) spending more than 30% of 2016 43.3 45.0 36.3 income on housing (%) Children and Youth in Care (rate per 1,000 Protecting 2018 6.9 11.4 36.3 children aged 0-18) Child and Children and Youth in Need of Protection (rate 2017 29.5 41.3 104.6 Youth per 1,000 children aged 0-18) 0.0 0.5 1.0 1.5 2.0 13 of 22 The chart below shows how various indicators for this LHA compare with the rest of Island Health. This LHA's result for each indicator is shown with a large circle. Green identifies results better than Island Health; red identifies results worse than Island Health. These results do not necessarily reflect statistical significance. Island Health's value is shown by the black dotted line, which is always at the centre of the chart. Light gray shading encompassing small grey circles indicates the range of the other LHA values and the dark gray shading shows ±10% from the Island Health value. This is meant to show the relative magnitude of the LHA compared to Island Health, and in some cases extends beyond the chart display. Health Status Summary Sub-group Time Island V.I. Indicator Description BC Description Period Health North

Births Live Birth Rate (rate per 1,000 population) 2013-2017 9.4 8.3 9.5

Stillbirths (rate per 1,000 births) 2013-2017 11.4 10.0 10.9

Infant Mortality - deaths of infants under 1 year of 2013-2017 3.5 4.0 7.4 age (rate per 1,000 live births) Low Weight Births - less than 2,500 grams (rate per 2013-2017 57.8 53.8 59.8 1,000 live births)

Cesarean Sections (rate per 1,000 live births) 2013-2017 331.3 291.8 197.5

Pre-term Births - gestational age less than 37 2013-2017 77.1 82.7 94.2 weeks (rate per 1,000 live births) Mothers under 20 - live births to mothers under 20 2013-2017 17.8 26.2 77.9 years of age (rate per 1,000 live births) Mothers 35 and over - live births to mothers aged 2013-2017 252.9 227.9 163.0 35 and over (rate per 1,000 live births) Alzheimer's Disease and Other Dementia - Morbidity 2018 20.3 21.3 19.2 Prevalence (age-standardized rate per 1,000) Asthma - Prevalence (age-standardized rate per 2018 123.1 130.7 167.1 1,000) Chronic Kidney Disease - Prevalence 2018 23.2 22.2 24.4 (age-standardized rate per 1,000) Chronic Obstructive Pulmonary Disease - 2018 51.1 52.5 95.5 Prevalence (age-standardized rate per 1,000) Mood and Anxiety Disorders - Prevalence 2018 301.9 342.7 336.1 (age-standardized rate per 1,000) Depression - Prevalence (age-standardized rate per 2018 246.0 278.3 273.6 1,000) Diabetes - Prevalence (age-standardized rate per 2018 80.3 69.5 94.0 1,000) Heart Failure - Prevalence (age-standardized rate 2018 19.4 17.7 32.2 per 1,000) Hypertension - Prevalence (age-standardized rate 2018 224.7 212.1 250.0 per 1,000) Ischemic Heart Disease - Prevalence 2018 69.4 60.5 80.1 (age-standardized rate per 1,000) Osteoarthritis - Prevalence (age-standardized rate 2018 84.9 91.1 105.8 per 1,000) Episodic Asthma - Prevalence (age-standardized 2018 49.9 52.9 65.2 rate per 1,000) Episodic Depression - Prevalence 2018 72.2 85.8 81.1 (age-standardized rate per 1,000) Episodic Mood & Anxiety Disorders - Prevalence 2018 101.6 122.1 109.5 (age-standardized rate per 1,000) Schizophrenia & Delusional Disorders - Prevalence 2018 11.0 11.6 10.6 (age-standardized rate per 1,000) 0.0 0.5 1.0 1.5 2.0 14 of 22 The chart below shows how various indicators for this LHA compare with the rest of Island Health. This LHA's result for each indicator is shown with a large circle. Green identifies results better than Island Health; red identifies results worse than Island Health. These results do not necessarily reflect statistical significance. Island Health's value is shown by the black dotted line, which is always at the centre of the chart. Light gray shading encompassing small grey circles indicates the range of the other LHA values and the dark gray shading shows ±10% from the Island Health value. This is meant to show the relative magnitude of the LHA compared to Island Health, and in some cases extends beyond the chart display. Health Status Summary (Continued) Sub-group Time Island V.I. Indicator Description BC Description Period Health North

Deaths Mortality (age stnd. rate per 10,000) 2013-2017 64.5 66.8 79.2

Mort.- unintentional injury (age stnd. rate per 10,000) 2013-2017 3.2 3.4 5.1

Alcohol-related deaths (age stnd rate per 100,000) 2016 83.0 94.6 221.7

Illicit Drug Toxicity Deaths (crude rate per 100,000) 2018 30.3 28.4 8.5

Tobacco-related deaths (age stnd rate per 100,000) 2016 127.7 132.9 155.7

Life Life Expectancy 2013-2017 82.3 81.9 78.1 Expectancy Female Life Expectancy 2013-2017 84.3 83.8 80.0

Male Life Expectancy 2013-2017 80.3 79.9 76.5

Morbidity Alcohol-related hosp. (age stnd. rate per 100,000) 2016 397.0 440.6 795.8

Cannabis-related hosp. (age stnd rate per 100,000) 2016 27.8 31.4 56.9

Opioid-related hosp. (age stnd rate per 100,000) 2016 45.8 49.9 149.8

Tobacco-related hosp. (age stnd rate per 100,000) 2016 491.5 443.4 583.5

Health Health Matrix: Non-Users (%) 2017 12.1 12.3 Matrix* Health Matrix: Healthy (%) 2017 33.6 32.5

Health Matrix: Adult (18+) Major Cond. (%) 2017 3.4 3.3

Health Matrix: Child and Youth (<18) Major Cond.(%) 2017 0.8 1.2

Health Matrix: Low Chronic Conditions (%) 2017 27.1 28.1

Health Matrix: Medium Chronic Conditions (%) 2017 10.0 9.3

Health Matrix: Severe Mental Health & Substance Use.. 2017 2.0 2.6

Health Matrix: Maternity & Healthy Newborns (%) 2017 1.8 2.1

Health Matrix: Frail in Community (%) 2017 0.5 0.3

Health Matrix: High Chronic w/o Frailty (%) 2017 4.6 5.5

Health Matrix: High Chronic w/ Frailty (%) 2017 0.7 0.5

Health Matrix: Cancer (%) 2017 1.7 1.3

Health Matrix: Frail in Residential Care(%) 2017 1.0 0.3

Health Matrix: End of Life (%) 2017 0.7 0.6

0.0 0.5 1.0 1.5 2.0 *The Health Matrix is a way of categorizing the population into different groups based on their health service utilization patterns. These categories are mutually exclusive and add up to 100% - in other words, everyone is placed into one of the categories, going from low or no utilization to high utilization at end of life; people who may meet the criteria for more than one category would be placed into the higher utilization category – for example, someone with medium complex chronic conditions who was also living in residential care would be counted in the Frail, Living in Residential Care category. For more information on the Health Matrix, see https://www2.gov.bc.ca/assets/gov/health/forms/5511datadictionary.pdf 15 of 22 The chart below shows how various indicators for this LHA compare with the rest of Island Health. This LHA's result for each indicator is shown with a large circle. Green identifies results better than Island Health; red identifies results worse than Island Health. These results do not necessarily reflect statistical significance. Island Health's value is shown by the black dotted line, which is always at the centre of the chart. Light gray shading encompassing small grey circles indicates the range of the other LHA values and the dark gray shading shows ±10% from the Island Health value. This is meant to show the relative magnitude of the LHA compared to Island Health, and in some cases extends beyond the chart display. Potential Years of Life Lost (PYLL) from life expectancy of 75 years Sub-group Time Island V.I. Indicator Description BC Description Period Health North

Potential All Cause PYLL rate (age stnd. per 1,000) 2013-2017 44.0 47.9 82.3 Years of Cerebrovascular diseases - PYLL rate (age stnd. Life Lost 2013-2017 0.9 1.0 1.5 per 1,000)

Chronic lower respiratory diseases - PYLL rate 2013-2017 0.8 0.9 2.3 (age stnd. per 1,000)

Diabetes - PYLL rate (age stnd. per 1,000) 2013-2017 1.3 1.1 2.7

Arteries, arterioles and capillaries - PYLL rate 2013-2017 0.3 0.3 0.1 (age stnd. per 1,000)

Accidental Falls - PYLL rate (age stnd. per 2013-2017 0.4 0.4 0.7 1,000)

Influenza and pneumonia - PYLL rate (age stnd. 2013-2017 0.5 0.5 1.0 per 1,000)

Suicide - PYLL rate (age stnd. per 1,000) 2013-2017 3.2 3.9 6.3

Ischemic heart diseases - PYLL rate (age stnd. 2013-2017 2.5 2.4 3.9 per 1,000)

Endocrine, nutritional and metabolic diseases - 2013-2017 1.7 1.6 4.1 PYLL rate (age stnd. per 1,000)

Circulatory system - PYLL rate (age stnd. per 2013-2017 5.2 5.7 8.5 1,000)

Lung/tracheal Cancer - PYLL rate (age stnd. per 2013-2017 2.6 2.8 2.9 1,000)

Malignant neoplasms - PYLL rate (age stnd. per 2013-2017 13.0 14.1 16.5 1,000)

Motor vehicle accidents - PYLL rate (age stnd. 2013-2017 1.6 1.5 2.3 per 1,000)

Diseases of the respiratory system - PYLL rate 2013-2017 1.6 1.7 4.0 (age stnd. per 1,000)

Diseases of the digestive system - PYLL rate 2013-2017 2.2 2.8 9.8 (age stnd. per 1,000)

0.0 0.5 1.0 1.5 2.0

16 of 22 The chart below shows how various indicators for this LHA compare with the rest of Island Health. This LHA's result for each indicator is shown with a large circle. Green identifies results better than Island Health; red identifies results worse than Island Health. These results do not necessarily reflect statistical significance. Island Health's value is shown by the black dotted line, which is always at the centre of the chart. Light gray shading encompassing small grey circles indicates the range of the other LHA values and the dark gray shading shows ±10% from the Island Health value. This is meant to show the relative magnitude of the LHA compared to Island Health, and in some cases extends beyond the chart display.

Health Service Use Summary Sub-group Time Island V.I. Indicator Description BC Description Period Health North

Complex Home Care Visits (rate per 1,000 population) 2018 475.6 290.1 Continuing Home Care Visits (rate per 1,000 population Care 2017 2,477.7 1,228.8 aged 75+)

Long-Term Care Beds (rate per 1,000 2018 69.0 49.0 population aged 75+)

Home Care Clients (rate per 1,000 2017 30.8 37.4 population)

Home Care Clients (rate per 1,000 2018 187.1 132.2 population aged 75+)

Home Support Clients (rate per 1,000 2017 13.5 7.9 population)

Home Support Clients (rate per 1,000 2018 94.4 87.6 population aged 75+)

Home Support Hours (rate per 1,000 2018 3,823.2 1,542.7 population)

Home Support Hours (rate per 1,000 2018 38,580.8 27,995.2 population aged 75+)

Unscheduled Emergency Dept. or Urgent Emergency 2018 466.9 952.7 Care Centre visits (rate per 1,000 pop.)

Emergency Visits with CTAS of 1, 2 or 3 (%) 2017 67.8 61.9

Unscheduled Emergency Dept. or Urgent 2018 785.3 1,117.8 Care Centre visits (rate per 1,000 75+ pop.)

Emergency Visits with CTAS of 1, 2 or 3 (%) 2017 78.3 75.3 for 75+ population

Acute Care Day Cases (age stnd. rate per Hospital 2018 86.8 83.5 76.7 1,000 population) Day Care Acute Care Day Cases (age stnd. rate per 2018 223.2 197.8 163.9 1,000 population aged 75+)

Primary Population Attached to Physician at Practice 2017 76.5 78.6 80.3 Care Level (%) 0.0 0.5 1.0 1.5 2.0

17 of 22 The chart below shows how various indicators for this LHA compare with the rest of Island Health. This LHA's result for each indicator is shown with a large circle. Green identifies results better than Island Health; red identifies results worse than Island Health. These results do not necessarily reflect statistical significance. Island Health's value is shown by the black dotted line, which is always at the centre of the chart. Light gray shading encompassing small grey circles indicates the range of the other LHA values and the dark gray shading shows ±10% from the Island Health value. This is meant to show the relative magnitude of the LHA compared to Island Health, and in some cases extends beyond the chart display. Health Service Use Summary (Continued)

Sub-group Time Island V.I. Indicator Description BC Description Period Health North

Acute Care Day Cases (age stnd. rate per 1,000 Hospital 2018 86.8 83.5 76.7 population) Day Care Acute Care Day Cases (age stnd. rate per 1,000 2018 223.2 197.8 163.9 population aged 75+) Acute Care Inpatient Cases (age stnd. rate per Hospital 2018 78.1 81.5 122.0 1,000 population) Inpatient Acute Care Inpatient Cases (age stnd. rate per Care 2018 291.9 285.0 340.2 1,000 population aged 75+) Alternative Level of Care Cases (age stnd. rate 2018 3.7 1.8 3.5 per 1,000 population) Alternative Level of Care Cases (age stnd. rate 2018 33.8 18.8 45.8 per 1,000 population 75+) Alternative Level of Care Days (age stnd. rate 2018 70.7 70.7 79.8 per 1,000 population) Alternative Level of Care Days (age stnd. rate 2018 661.7 738.2 843.0 per 1,000 population 75+)

Ambulatory Care Sensitive conditions (%) 2018 5.0 5.2

Ambulatory Care Sensitive conditions among 2018 10.2 10.7 population aged 75+ (%) Medical Acute Care Utilization (case rate per 2018 38.6 38.6 67.6 1,000 population) Surgical Acute Care Utilization (case rate per 2018 20.6 24.0 24.7 1,000 population) Maternity Acute Care Utilization (case rate per 2018 10.2 9.9 15.9 1,000 population) Psychiatry (Dementia excluded) Acute Care 2018 7.6 7.6 11.8 Utilization (case rate per 1,000 population) MRI Utilization - Island Health facilities only 2016 32.1 17.8 (rate per 1,000 population) 0.0 0.5 1.0 1.5 2.0

18 of 22 Data Sources

Population and Demographics

Population and Population Projection Average Age: BC Statistics, 2018 | Population Pyramid: BC Statistics - P.E.O.P.L.E. 2019 | Estimated Total Population - 2039: BC Statistics - P.E.O.P.L.E. 2019 | Estimated Population Change - 2039: BC Statistics - P.E.O.P.L.E. 2019 │10 Year Population Growth (%): BC Statistics - P.E.O.P.L.E. 2019 | Population aged 0-19 (%) - BC Statistics - P.E.O.P.L.E. 2019 | Population aged 20-44 (%) - BC Statistics - P.E.O.P.L.E. 2019 | Population aged 45-64 (%) - BC Statistics - P.E.O.P.L.E. 2019 | Population aged 65-74(%) - BC Statistics - P.E.O.P.L.E. 2019 | Population aged 75 and over (%) - BC Statistics - P.E.O.P.L.E. 2019 | Percent growth of the 0-19 age group population in next 10 years - BC Statistics - P.E.O.P.L.E. 2019 | Percent growth of the 20-44 age group population in next 10 years - BC Statistics - P.E.O.P.L.E. 2019 | Percent growth of the 45-64 age group population in next 10 years - BC Statistics - P.E.O.P.L.E. 2019 | Percent growth of the 65-74 age group population in next 10 years - BC Statistics - P.E.O.P.L.E. 2019 | Percent growth of the 75+ age group population in next 10 years - BC Statistics - P.E.O.P.L.E. 2019

Age Demographics & Marital Status Median Age of Population - Census, 2016 | Population where language spoken most often at home is not English or French (%) - Census, 2016 | Visible minority population (%) - Census, 2016 | Population in private households with Aboriginal Identity (%) - Census, 2016 | Population aged 15 and over who are married (%) - Census, 2016 | Population aged 15 and over who are common-law (%) - Census, 2016 | Population aged 15 and over who are single, never married (%) - Census, 2016 | Population aged 15 and over who are widowed (%) - Census, 2016 | Population aged 15 and over who are separated or divorced (%) - Census, 2016

Migration and Immigrants Immigrant population (%): Census, 2016 │Population migrating to area in the last 5 years (%): Census, 2016

Determinants of Health

Education & Employment Population aged 25 to 64 with post-secondary certificate, diploma or degree (%) - Census, 2016 | Grade 12 completion among students entering Grade 12 for the first time (%) (2yr Agg) - Ministry of Education, 2017 | Students completing high school within six years of enrollment in Grade 8 (%) (2yr Agg) - Ministry of Education, 2018 | Population aged 15 and over who are unemployed (%): Census, 2016

Health Behaviours Alcohol consumption (litres of absolute alcohol sold per person, 1L=58 standard drinks)- AOD: CISUR, 2017

Household Dwellings rated as needing major repairs by renter or owner (%) - Census, 2016 │ Lone-parent family households (% of census families with children) - Census, 2016 │ Private households that are owner-occupied (%) - Census, 2016 │ Private households with 5 or more persons (%) - Census, 2016 │ Private households with multiple families (%) - Census, 2016 | Households (owned) spending more than 30% of income on housing (%) - Census, 2016 | Households (rented) spending more than 30% of income on housing (%) - Census, 2016

Income & Income Inequality Median household total income ($) - Census, 2016 │ Median lone-parent family income ($) - Census, 2016 | Difference in median income comparing males and females aged 15 and over - Census, 2016 │ Households (owned) spending more than 30% of income on housing (%) - Census, 2016 │ Households (rented) spending more than 30% of income on housing (%) - Census, 2016 │ Low income based on after-tax low income measure (%) - Census, 2016 │ Low income based on after-tax low-income measure, ages 18 to 64 years (%) - Census, 2016 │ Low income based on after-tax low-income measure, ages 65 years and over (%) - Census, 2016 │ Low income based on after-tax low-income measure, ages less than 6 years (%) - Census, 2016 │ Low income based on after-tax low-income measure, ages less than 18 years (%) - Census, 2016

19 of 22 Data Sources

Determinants of Health

Morbidity Alcohol-related hospitalizations (age-standardized rate per 100,000) - CISUR, 2016 | Cannabis-related hospitalizations (age-standardized rate per 100,000) - CISUR, 2016 | Opioid-related hospitalizations (age-standardized rate per 100,000) - CISUR, 2016 | Tobacco-related hospitalizations (age-standardized rate per 100,000) - CISUR, 2016

Transportation Employed population aged 15 and over walking, biking or busing to work (%) - Census, 2016

Child Health Child hospitalizations - Dental Surgery (rate per 1,000 aged 0 to 14) -(2yr Agg): Ministry of Health Health Ideas, 2016-2018 │ Child Hospitalizations - Injury/Poisoning (rate per 1,000 aged 0 to 14) - (2yr Agg): Ministry of Health Health Ideas, 2016-2018 │ Child hospitalizations - Respiratory Dis. (rate per 1,000 aged 0 to 14) - (2yr Agg): Ministry of Health Health Ideas, 2016-2018 │ Child Mental Diseases & Disorders Hospitalizations (Indirect Age Standardized rate per 1,000 aged 0-14): Ministry of Health Health Ideas, 2018 │ Child/Youth Mental Diseases & Disorders Hospitalizations (Indirect Age Standardized rate per 1,000 aged 15-24): Ministry of Health Health Ideas, 2018

Early Development EDI: Kindergarten children rated as vulnerable for social development (%) - Early Development Instrument, 2016 │ EDI: Kindergarten children rated as vulnerable for communication development (%) - Early Development Instrument, 2016 │ EDI: Kindergarten children rated as vulnerable for emotional development (%) - Early Development Instrument, 2016 │ EDI: Kindergarten children rated as vulnerable for language development (%) - Early Development Instrument, 2016 │ EDI: Kindergarten children rated as vulnerable for physical development (%) - Early Development Instrument, 2016 │ EDI: Kindergarten children rated as vulnerable on one or more domains (%) - Early Development Instrument, 2016 │ EDI: Kindergarten children rated as vulnerable on one or more domains, excluding communication (%) - Early Development Instrument, 2016

Protecting Children and Youth Children and Youth in Care (rate per 1,000 children aged 0 to 18) - Ministry of Children and Family Development, 2018 │ Children and Youth in Need of Protection (rate per 1,000 children aged 0 to 18) - Ministry of Children and Family Development, 2017

Health Status

Life Expectancy Female Life Expectancy - BC Statistics, 2017 | Male Life Expectancy - BC Statistics, 2017 | Life Expectancy - BC Statistics, 2017

Deaths Mortality (age-standardized rate per 10,000) - Vital Statistics, 2017 | Mortality due to unintentional injuries (age-standardized rate per 10,000) - Vital Statistics, 2017 | Alcohol-related deaths (age-standardized rate per 100,000) - CISUR, 2016 | Tobacco-related deaths (age-standardized rate per 100,000) - CISUR, 2016 | Illicit Drug Toxicity Deaths (crude rate per 100,000) - BC Coroner's Service, 2018

Health Matrix Health Matrix: Healthy (%) - Blue Matrix and People, 2017 | Health Matrix: Adult (18+) Major Conditions (%) - Blue Matrix and People, 2017 | Health Matrix: Child and Youth (<18) Major Conditions (%) - Blue Matrix and People, 2017 | Health Matrix: Low Chronic Conditions (%) - Blue Matrix and People, 2017 | Health Matrix: Medium Chronic Conditions (%) - Blue Matrix and People, 2017 | Health Matrix: Severe Mental Health & Substance Use (%) - Blue Matrix and People, 2017 | Health Matrix: Maternity & Healthy Newborns (%) - Blue Matrix and People, 2017 | Health Matrix: Frail in Community (%) - Blue Matrix and People, 2017 | Health Matrix: High Chronic w/o Frailty (%) - Blue Matrix and People, 2017 | Health Matrix: High Chronic w/ Frailty (%) - Blue Matrix and People, 2017 | Health Matrix: Cancer (%) - Blue Matrix and People, 2017 | Health Matrix: Frail in Residential Care(%) - Blue Matrix and People, 2017 | Health Matrix: End of Life (%) - Blue Matrix and People, 2017

20 of 22 Data Sources

Health Status

Births Live Birth Rate (rate per 1,000 population) - Vital Statistics, 2017 | Stillbirths (rate per 1,000 births) - Vital Statistics, 2017 | Infant Mortality - deaths of infants under 1 year of age (rate per 1,000 live births) - Vital Statistics, 2017 | Low Weight Births - less than 2,500 grams (rate per 1,000 live births) - Vital Statistics, 2017 | Cesarean Sections (rate per 1,000 live births) - Vital Statistics, 2017 | Pre-term Births - gestational age less than 37 weeks (rate per 1,000 live births) - Vital Statistics, 2017 | Mothers under 20 - live births to mothers under 20 years of age (rate per 1,000 live births) - Vital Statistics, 2017 | Mothers 35 and over - live births to mothers aged 35 and over (rate per 1,000 live births) - Vital Statistics, 2017

Morbidity Alzheimer's Disease and Other Dementia - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Asthma - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Chronic Kidney Disease - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Chronic Obstructive Pulmonary Disease - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Mood and Anxiety Disorders - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Depression - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Diabetes - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Heart Failure - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Hypertension - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Ischemic Heart Disease - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Osteoarthritis - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Episodic Asthma - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Episodic Depression - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Episodic Mood & Anxiety Disorders - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018 | Schizophrenia & Delusional Disorders - Prevalence (age-standardized rate per 1,000) - MoH - Chronic Disease Registries, 2018

Complex Continuing Care Home Care Visits (rate per 1,000 population) - Island Health - Ideas, 2018 | Home Care Visits (rate per 1,000 population aged 75 and over) - Island Health - Ideas, 2017 | Long-Term Care Beds (rate per 1,000 population aged 75 and over) - Island Health - Ideas, 2018 | Home Care Clients (rate per 1,000 population) - Island Health - Ideas, 2017 | Home Care Clients (rate per 1,000 population aged 75 and over) - Island Health - Ideas, 2018 | Home Support Clients (rate per 1,000 population) - Island Health - Ideas, 2017 | Home Support Clients (rate per 1,000 population aged 75 and over) - Island Health - Ideas, 2018 | Home Support Hours (rate per 1,000 population) - Island Health - Ideas, 2018 | Home Support Hours (rate per 1,000 population aged 75 and over) - Island Health - Ideas, 2018

Emergency Unscheduled Emergency Department or Urgent Care Centre visits (rate per 1,000 population) - Island Health - Ideas, 2018 | Emergency Visits with CTAS of 1, 2 or 3 (%) - Island Health - Ideas, 2017 | Unscheduled Emergency Department or Urgent Care Centre visits for 75+ (rate per 1,000 75+ population) - Island Health - Ideas, 2018 | Emergency Visits with CTAS of 1, 2 or 3 (%) for 75+ population - Island Health - Ideas, 2017

Hospital Day Care Acute Care Day Cases (age-standardized rate per 1,000 population) - Ministry of Health Health Ideas, 2018 | Acute Care Day Cases (age-standardized rate per 1,000 population aged 75 and over) - Ministry of Health Health Ideas, 2018

Primary Care Population attached to physician at the practice level (%) - Ministry of Health, 2017

21 of 22 Data Sources

Health Status

Potential Years of Life Lost Accidental Falls - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | All Cause Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Arteries, arterioles and capillaries - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Cerebrovascular diseases - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Chronic lower respiratory diseases - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Circulatory system - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Diabetes - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Diseases of the digestive system - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Diseases of the respiratory system - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Endocrine, nutritional and metabolic diseases - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Influenza and pneumonia - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Ischemic heart diseases - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Lung/tracheal Cancer - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Malignant neoplasms - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Motor vehicle accidents - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017 | Suicide - Potential Years of Life Lost rate (age standardized per 1,000): Vital Statistics, Calendar year ending 2013-2017

Hospital Inpatient Care Acute Care Inpatient Cases (age-standardized rate per 1,000 population) - Ministry of Health Health Ideas, 2018 | Acute Care Inpatient Cases (age-standardized rate per 1,000 population aged 75 and over) - Ministry of Health Health Ideas, 2018 | Alternative Level of Care Cases (age-standardized rate per 1,000 population) - Ministry of Health Health Ideas, 2018 | Alternative Level of Care Cases (age-standardized rate per 1,000 population aged 75 and over) - Ministry of Health Health Ideas, 2018 | Alternative Level of Care Days (age-standardized rate per 1,000 population) - Ministry of Health Health Ideas, 2018 | Alternative Level of Care Days (age-standardized rate per 1,000 population aged 75 and over) - Ministry of Health Health Ideas, 2018 | Ambulatory Care Sensitive conditions (%) - Island Health - Ideas, 2018 | Ambulatory Care Sensitive conditions among population aged 75+ (%) - Island Health - Ideas, 2018 | Medical Acute Care Utilization (case rate per 1,000 population) - Ministry of Health Health Ideas, 2018 | Surgical Acute Care Utilization (case rate per 1,000 population) - Ministry of Health Health Ideas, 2018 | Maternity Acute Care Utilization (case rate per 1,000 population) - Ministry of Health Health Ideas, 2018 | Psychiatry (Dementia excluded) Acute Care Utilization (case rate per 1,000 population) - Ministry of Health Health Ideas, 2018 | MRI Utilization - Island Health facilities only (rate per 1,000 population) - Island Health, 2016

22 of 22