VANCOUVER ISLAND NORTH Local Health Area Profile

Vancouver Island North (VI 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, VI North encompasses 21,157 square kilometres and includes the communities of Port Hardy, Port Alice, Port McNeill, Alert Bay, Kingcome and Zeballos. VI North borders two other LHAs: Vancouver Island West and Greater Campbell River. VI 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 VI 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, or if you have questions or notice a discrepancy, please contact: Maritia Gully ([email protected]). 1 of 22 Population and Demographics

As of 2017, the Vancouver Island North LHA represented 1.4% (11,325 people) of Island Health’s total population of 793,180. According to the 2016 Census, 31.2% of people living in Vancouver Island North identified themselves as Aboriginal compared to 7.6% across Island Health and 5.9% in BC. Additionally, 4.3% of people living in the Vancouver Island North area identified themselves as a visible minority, compared to 9.6% across Island Health and 30.3% in BC.

On average, the population of the Vancouver Island North LHA is older than that of BC but younger than Island Health overall, with an average age of 41.8 years. The 75+ age group makes up around 5.5% of the population which is lower than Island Health (10%) and BC (8%). Currently the largest population group is between the ages 45 and 64 years.

The Vancouver Island North LHA population is expected to increase by 6.72% to 12,141 over the next 10 years; this is lower than the growth expected for Island Health (8.7%) and BC (10.8%). The greatest growth is expected in the 75+ age group which is expected to more than triple (from 628 to 2,237) over the next 20 years. The 65-74 year age group is expected to increase over the short term and then decline while the 45-64 age group is expected to decline steadily. The 0-19 year age group is expected to remain stable while the 20-44 year age group is expected in increase steadily. See the Population and Demographics summary on page 10 for more information.

Average Age (2017) Estimated Total Population - Vancouver Island North

BC Island Health Vancouver Island North 4K

41.7 44.6 41.8 3K n o i t a l u

p 2K o P

Population Pyramid - 2017 - Vancouver Island North 1K

90+ 85 - 89 0K 80 - 84 75 - 79 Estimated Population Change - Vancouver Island North 70 - 74 65 - 69 7

60 - 64 1 0 2 55 - 59 m

50 - 54 o 200% r f 45 - 49 n

40 - 44 o i t

35 - 39 a l

30 - 34 u 100% p

25 - 29 o P

n

20 - 24 i

15 - 19 ff i D

10 - 14 0%

05 - 09 % 01 - 04 7 9 1 3 5 7 9 1 3 5 7 9 1

<1 1 1 2 2 2 2 2 3 3 3 3 3 4 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2 2 2 2 2 400 200 0 0 200 400

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 the Vancouver Island North LHA was $57,685 in 2016, lower than the BC median household income of $69,979 and Island Health’s $65,735. 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. Unemployment rates in Vancouver Island North are higher in comparison to Island Health and BC (see page 11).

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

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

BC 25.4 25.1 25 Island Health Vancouver Island North n o i

t 20.0

a 19.6 l 20 19.2

u 18.4

p 17.7

o 16.7 P

d 14.9 14.9 e 14.7 t 15 c e l

e 11.7 S

f o

t 10 n e c r e P 5

0

Education High School Completion Rate within 6 years of Grade 8 Enrollment High school completion rates in the Vancouver Island North LHA are lower than the rates for Island Health. Also, according to the 2016 80 Census, and a smaller proportion of the Vancouver Island North 70 adult population have completed post-secondary education. s t

n 60 e d u t 50 S

f o

t 40 Population Aged 25 to 64 with Post-Secondary Certificate, Diploma n e c or Degree (%) r 30 e P 2016 20 BC Island Health BC Island Health Vancouver Island North 10 Vancouver Island North 7 8 9 0 1 2 3 4 5 6 0 0 0 1 1 1 1 1 1 1

63.9 63.7 48.7 0 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2 2 ------5 6 7 8 9 0 1 2 3 4 0 0 0 0 0 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

3 of 22 Determinants of Health

Selected Household Indicators

Dwellings Needing Housing Affordability Housing Affordability Major Repairs (%) Owners (% spending Renters (% spending Housing >30% of Income) >30% of Income) 50 One way to measure affordability of housing is to look at BC 45.0 43.3 how much of a household’s income is spent on shelter. The Island Health proportion in Vancouver Island North is lower than in BC 40 Vancouver Island North 36.3 and Island Health for home owners and for renters; both n o i t

groups having a smaller percentage of the population a l

u 30 spending more than 30% of their incomes on housing. p o P

There is a lower percentage of crowded family households f o 20.7 in Vancouver Island North compared to BC but higher than t n

Island Health (see page 11). The percentage of households e 20 17.2 c

r 15.5 in need of major repairs (e.g., defective electrical wiring) e

P 12.7 is higher than the Island Health and BC rates. 10 6.3 6.2

0 Early Childhood Development and 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 Median household Median lone-parent Lone-parent equitable way so that all children and youth can grow and total income ($) family income ($) Families (%) thrive is critical to the health of the population. This includes supporting mothers during the pre- and 70.0K 70K 65.7K post-natal period, supporting families during early BC 26 development years, and supporting children and youth to 60K 57.7K grow, learn, and transition into adulthood. 50.9K 50K 48.4K s r

Vancouver Island North has the same percentage of a l 41.9K l lone-parent families in comparison to BC and higher than o Island

D 40K 22 Island Health. However, lone-parent families in Vancouver 5 Health 1 0

Island North also have a lower median household income 2 30K than lone-parent families in Island Health and BC. 20K Vancouver Early Childhood Development Instrument (EDI) Island 26 Percent of Preschool Children Vulnerable on 10K North EDI: Vulnerable on >1 Domains 0K

40

35 n

e The Early Development Instrument (EDI) is used to measure r

d 30 l i vulnerability in kindergarten children across five domains (social, h C 25 physical, emotional, language, and communication). Increases in the n e

t EDI rate are a negative indicator of child health and decreases are a r

a 20

g positive indicator. For Island Health overall, vulnerability has r e

d 15 increased between 2007/2009 and 2014/2016; however, Vancouver n i

K Island North had higher levels of vulnerability as compared to Island

% 10 BC Health and BC and has shown an increase over time in the rate of Island Health 5 vulnerability. Vancouver Island North 0 2004-2007 2007-2009 2009-2011 2011-2013 2013-2016 4 of 22 Determinants of Health

Mothers’ smoking during pregnancy has been shown to have negative effects for both mother and the baby. Rates of smoking during pregnancy have been decreasing over the past 8 years; however, across Island Health overall, rates have been much higher than for BC. In the Vancouver Island North LHA, a much higher percentage of mothers smoked during pregnancy.

Rates of children and youth in care have decreased over the past 4 years; however, across Island Health overall, rates have been much higher than for BC. Vancouver Island North has a much higher rate of children and youth in care than does BC and Island Health and this rate has been increasing in recent years. See the Determinants of Health summary on page 12 for more information.

Percent of Pregnant Women who Reported Smoking at Any Time During Children and Youth in Care per 1,000 Children and Youth Current Pregnancy (5 year aggregate) Y

17.9 17.9 40 34.2

h 35 t u o

15 Y 28.8 30 d n a 11.8 n 25 e r t 10.5 d n l i e c 10 h

r 20

8.5 C

e 0 P

7.3 0 14.6 0 , 15 12.5 1

r e

p 9.0 5 BC 10 BC

e 7.6 t

Island Health a Island Health R 5 Vancouver Island North Vancouver Island North 0 0 2009-2013 2010-2014 2011-2015 2012-2016 2014 2015 2016 2017

Healthy Behaviours and Built Environment

Alcohol Consumption (litres of absolute alcohol sold per person, 1L=58 standard drinks) Preference for healthy behaviours such as healthy eating, exercise, 15.9 reduction of smoking and alcohol consumption, and social 16 14.2 connections contribute to a healthier life. Many of the healthy 14 behaviour indicators are available through the Canadian Community Health Survey (CCHS) but the data is not available at the LHA level. 12 11.5 10.6 Among LHA-level available data, substance use in Vancouver Island North, particularly alcohol consumption per capita, is higher than s 10 9.0 9.4 e

r the Island Health and BC average. The rates of alcohol and t i L 8 tobacco-related hospitalizations are also higher while the rate of llicit drug-related hospitalizations is lower than in the rest of Island 6 Health or BC. 4 BC

2 Island Health Vancouver Island North 0 Employed Population Aged 15 and Over Walking, Biking or Busing to 6 7 8 9 0 1 2 3 4 5 6

0 0 0 0 1 1 1 1 1 1 1 Work (%) 0 0 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2 2 2 BC Island Health Vancouver Island North

Among those who are employed, a lower percentage of the population in the Vancouver Island North LHA reports using active modes of transportation (walking, cycling, public transit) to get to 22.4 19.6 17.5 work. See the Determinants of Health summary on pages 11 and 12 for more information.

5 of 22 Health Status

The health status of the population includes measures such as life expectancy, infant mortality, prevalence of chronic disease, mortality and premature mortality.

Birth Statistics Birth Statistics Per 1,000 Live Births The overall birth rate for Vancouver Island North is higher than 3.0 Island Health; however, there are proportionately fewer births to Infant Mortality* 3.8 older mothers (35 years and over) and more to younger mothers 6.9 (under 20 years). While the rate of low birth weight babies is 10.8 lower than Island Health's and BC's, the rate of pre-term births Stillbirths 8.7 (those born at less than 37 weeks) is higher. 8.5 19.9 Mothers under 20 28.7 years 87.6 Birth Statistics 58.0 53.0 Live Births per 1,000 Population Low Birth Weight 48.1 (1992-1996 to 2011-2015) 76.4 16 15.8 Pre-term Births 79.3 89.3 14 325.6 12.6 Cesarean Sections 285.4 230.2 12 11.1 10.7 246.6 Mothers 35 years 218.6 10 9.6 and over e

t 132.3

a 8.4 R

h

t 8 BC r i

B Island Health 6 Vancouver Island North

*It is important to note that caution should be exercised when dealing 4 with a small number of cases as an increase or decrease may indicate BC random variation rather than a significant change in rates. 2 Island Health

0 Vancouver Island North

6 8 0 2 4 6 8 0 2 4 5 Mortality (Age Standardized Rate per 10,000) 9 9 0 0 0 0 0 1 1 1 1 9 9 0 0 0 0 0 0 0 0 0 1 1 2 2 2 2 2 2 2 2 2 ------0

2 4 6 8 0 2 4 6 8 0 1 115.3 0 9 9 9 9 0 0 0 0 0 1 1 0 9 9 9 9 0 0 0 0 0 0 0 , 110 1 1 1 1 2 2 2 2 2 2 2 0 1

r

e 100 p

e t

a 90 R 82.5 d e

Mortality Statistics z

i 80 d

r 71.5 a

Mortality rates have decreased steadily over the last 5 years. The d 70 67.0 n

a BC age-standardized all-cause mortality rate for the Vancouver t S

Island North LHA is much higher than the Island Health and BC e 60 Island Health g rates; however, this rate has been declining over the past 8 years. A 50 Vancouver Island North

See the Health Status summary on page 14 for cause-specific 2 3 4 5 6 1 1 1 1 1 0 0 0 0 0

mortality rates. 2 2 2 2 2 - - - - - 8 9 0 1 2 0 0 1 1 1 0 0 0 0 0 2 2 2 2 2

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 person would have Female Life lived if he or she had not died prematurely).The PYLL in the 80 Vancouver Island North LHA are higher or similar to the BC and Expectancy BC Island Health rates due to most causes. A complete list of 70 potential years of life lost by cause can be found on page 15. Island Health Vancouver Island North Life expectancy has been increasing over the last few decades; Male Life 80 however, the Vancouver Island North population tends to have a Expectancy shorter life expectancy than both Island Health and BC. 70 Chronic Disease Life 80 Chronic disease prevalence rates tend to be higher for Vancouver Expectancy Island North in comparison to Island Health and BC rates, with the 70 exception of Alzheimer's disease and other dementia which is lower, and depression and mood and anxiety disorders, which 1997- 2002- 2006- 2010- 2011- have higher rates than BC but lower than Island Health. See the 2001 2006 2010 2014 2015 * Complete life expectancy data may not be available Health Status summary on page 13 for more information. for all LHAs due to poor data quality

Chronic Disease Age Standardized Prevalence in 2017 Per 1,000 Individuals

BC Island Health Vancouver Island North

Alzheimer's Disease and Other 20.7 21.9 19.2 Dementia

Chronic Kidney Disease 22.5 21.7 26.2

Heart Failure 19.9 18.1 32.6

Ischemic Heart Disease 71.5 62.2 82.2

Chronic Obstructive Pulmonary 62.0 62.4 103.8 Disease

Diabetes 80.9 70.1 93.4

Osteoarthritis 86.7 92.7 109.4

Asthma 122.3 129.2 166.5

Hypertension 226.4 214.0 257.1

Depression 245.5 275.4 264.3

Mood & Anxiety Disorders 300.1 338.4 324.9

7 of 22 Health Service Use

Population Attached to Physician at the Practice Level (%) Access to health services also determines health service utilization. Access to primary care services plays an 85 important role in the use of emergency department and 81.8 inpatient services. The population attached to physicians at 80.3 79.5 the practice level is calculated by the Ministry of Health and 80 78.6 d indicates the percentage of population who have a regular e h 76.5 c 75.7 physician or regular physician practice. A larger percentage a t t 75 A of the Vancouver Island North LHA population has a t physician at the practice level, reflecting an increase in n e c r

recent years. e

P 70

There is a higher rate of home care clients over 75 and a BC lower rate of home support clients for Vancouver Island 65 North compared to Island Health. The Vancouver Island Island Health Vancouver Island North North rates of home care visits and home support hours for 60

this age group are lower than Island Health's rate. See the 8 9 0 1 2 3 4 5 6 7 0 0 1 1 1 1 1 1 1 1

Health Service Use summary on page 16 for more 0 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2 2 information on these topics.

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

2.48K 198.4 188.7 185.6 194.9 2.37K 175.4 176.3 181.9 181.0 2.20K 2.09K 2.11K Home Care 1.85K Clients - 75+

Home Care 1.42K 1.23K Visits - 75+ 107.7 105.0 99.2 96.2 101.5 101.5 Home 82.8 81.4 Support Clients - 75+

Island Health Vancouver Island North Island Health Vancouver Island North

Home Support Hours Rate per 1,000 Population

30K 31.5K

25K 23.6K 27.3K

20K Home Support 18.1K Hours - 75+ 15K

10K

5K Island Health 0K Vancouver Island North 4 5 6 7 1 1 1 1 0 0 0 0 2 2 2 2 8 of 22 Health Service Use

Acute Care Inpatient Cases (Age Standardized Rate per 10,000) The age standardized hospitalization rate (inpatient admissions) for the Vancouver Island North LHA population is higher than the Island Health and BC rates, both overall and for the population aged 75 and over. 100 Inpatient Hospital admission rates for Ambulatory Care Sensitive Case Rate Conditions (ASCS) - conditions that can be treated in the 50 community if services are available and would not necessarily require hospitalization – are lower in Vancouver 0 Island North and have decreased in the last fiscal year.

400 Emergency/urgent care visit rates are higher in Vancouver Inpatient Island North than Island Health, but the rate of higher Case Rate - urgency visits is lower. Health service usage is based on 75+ 200 where the user resides rather than where the service is BC provided. See the Health Service Use summary on page 16 Island Health for more information on these topics. 0 Vancouver Island North 3 4 5 6 7 1 1 1 1 1 0 0 0 0 0 2 2 2 2 2

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

1000 8 899 885 7 ED/Urgent s

Care 500 n o

i 6

Utilization s s i

m 5.4 d 5 A

t

0 n e 4.6 i

t 4 a p

60 n I 62 t

57 n 3 e c

ED Visits - r

40 e CTAS 1, 2 P 2 or 3 (%) Island Health Island Health 20 BC 1 BC 0 Vancouver Island North 0 Vancouver Island North 3 4 5 6 7 3 4 5 6 7 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 2 2 2 2 2

9 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.

Population and Demographics Summary

Vancouver Sub-group Time Island Indicator Description BC Island Description Period Health North 2017- Population 10 Year Population Growth (%) 10.8 8.7 6.7 2027 and Population Population aged 0-19 (%) 2017 19.9 18.0 22.7 Projection Population aged 20-44 (%) 2017 33.6 29.8 26.9

Population aged 45-64 (%) 2017 28.1 28.7 32.8

Population aged 65-74 (%) 2017 10.5 13.6 12.1

Population aged 75 and over (%) 2017 7.8 9.9 5.5

Percent growth of the 0-19 age group population in 2017 9.1 7.5 12.6 next 10 years Percent growth of the 20-44 age group population in 2017 9.1 7.5 12.6 next 10 years Percent growth of the 45-64 age group population in 2017 0.5 -6.4 -23.1 next 10 years Percent growth of the 65-74 age group population in 2017 30.9 17.8 40.2 next 10 years Percent growth of the 75+ age group population in 2017 54.5 60.3 119.7 next 10 years

Average Age 2017 41.7 44.6 41.8

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

Visible minority population (%) 2016 30.3 9.6 4.3

Population in private households with Aboriginal 2016 5.9 7.6 31.2 Identity (%)

Marital Status Population aged 15 and over who are married (%) 2016 48.7 46.8 41.2

Population aged 15 and over who are common-law 2016 9.4 11.5 18.0 (%) Population aged 15 and over who are single, never 2016 27.2 24.5 24.9 married (%)

Population aged 15 and over who are widowed (%) 2016 5.4 6.2 5.2

Population aged 15 and over who are separated or 2016 9.3 11.1 10.7 divorced (%)

Migration and Immigrant population (%) 2016 28.3 15.8 9.0 Immigrants Population migrating to area in the last 5 years (%) 2016 20.9 20.6 18.1

0.0 0.5 1.0 1.5 2.0 This shows the relative magnitude of the LHA value compared to the Island Health value for that indicator.

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. Determinants of Health Summary Vancouver Sub-group Time Island Indicator Description BC Island Description Period Health North Population aged 25 to 64 with post-secondary certificate, Education 2016 63.9 63.7 48.7 diploma or degree (%) Grade 12 completion among students entering Grade 12 2014- 80.0 73.8 71.8 for the first time (%) (2yr Agg) 2016 Students completing high school within six years of 2014- 83.2 76.6 68.8 enrollment in Grade 8 (%) (2yr Agg) 2016

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

Health Alcohol consumption (litres of absolute alcohol sold per 2016 9.4 11.5 15.9 Behaviours person, 1L=58 standard drinks) Lone-parent family households (% of census families with Household 2016 25.5 22.0 25.6 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 renter or 2016 6.3 6.2 15.5 owner (%)

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

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 and females Income 2016 12,817.0 12,100.0 14,421.0 aged 15 and over Inequality Low income based on after-tax low income measure (%) 2016 15.5 14.8 18.9

Low income based on after-tax low-income measure, ages 2016 18.4 19.2 25.1 less than 18 years (%) Low income based on after-tax low-income measure, ages 2016 17.7 19.6 25.4 less than 6 years (%) Low income based on after-tax low-income measure, ages 2016 14.9 14.7 16.7 18 to 64 years (%) Low income based on after-tax low-income measure, ages 2016 14.9 11.7 20.0 65 years and over (%) Households (owned) spending more than 30% of income on 2016 20.7 17.2 12.7 housing (%) Households (rented) spending more than 30% of income on 2016 43.3 45.0 36.3 housing (%)

Income Population on Income Assistance (%) 2012 1.9 1.8 3.2 Supports Population aged 15 and over on Employment Insurance (%) 2012 1.5 1.4 2.9

Alcohol-related hospitalizations (age-standardized rate Morbidity 2014 512.5 647.6 733.5 per 100,000) Illicit drug-related hospitalizations (age-standardized rate 2014 132.4 125.8 115.1 per 100,000) Tobacco-related hospitalizations (age-standardized rate 2014 529.5 542.5 591.5 per 100,000) Employed Population Aged 15 and Over Walking, Biking or 2016 22.4 19.6 17.5 Transportation Busing to Work (%) 0.0 0.5 1.0 1.5 2.0 This shows the relative magnitude of the LHA value compared to the Island Health value for that indicator. 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.

Determinants of Health Summary (Continued)

Vancouver Sub-group Time Island Indicator Description BC Island Description Period Health North Child Mental Diseases & Disorders Hospitalizations Child Health 2017 1.6 1.9 2.5 (age-standardized rate per 1,000 aged 0-14) Youth Mental Dis. & Disorders Hospitalizations 2017 11.3 11.9 0.0 (age-standardized rate per 1,000 aged 15-24) Child/Youth Mental Dis. & Disorders Hosp. 2017 6.0 5.8 6.0 (age-standardized rate per 1,000 aged 0-24) Child hospitalizations - Injury/Poisoning (rate per 2015-2017 4.5 5.4 5.2 1,000 aged 0 to 14) - (2yr Agg) Child hospitalizations - Respiratory Dis. (rate per 2015-2017 7.9 9.1 12.1 1,000 aged 0 to 14) - (2yr Agg) Child hospitalizations - Dental Surgery (rate per 2015-2017 7.1 9.5 19.6 1,000 aged 0 to 14) -(2yr Agg) Pregnant women who reported smoking at any 2012-2016 7.3 10.5 17.9 time during current pregnancy (%) (5yr Agg)

Crime Serious Violent Crime (rate per 1,000 population) 2012 3.1 2.2 2.7

Serious Crime (rate per 1,000 population) 2012 10.1 7.7 9.5

Number of Serious Crimes per Police Officer 2012 7.0 5.7 4.7

This scale is theM roetloatr iVve hmicalge nTihtuedfte ( oraf tteh ep eLrH 1A, 0v0a0lu peo cpoumlaptaiorend) to th2e0 I1sl2and Health 3v.a6lue for tha2t.1 indicator 1.5 Non-Cannabis Drug Offences (rate per 1,000 2012 170.3 154.8 182.8 population) EDI: Kindergarten children rated as vulnerable for Early 2013-2016 14.8 16.2 23.0 physical development (%) Development EDI: Kindergarten children rated as vulnerable for 2013-2016 15.7 14.7 15.0 social development (%) EDI: Kindergarten children rated as vulnerable for 2013-2016 16.1 16.6 25.0 emotional development (%) EDI: Kindergarten children rated as vulnerable for 2013-2016 9.4 9.0 8.0 language development (%) EDI: Kindergarten children rated as vulnerable for 2013-2016 14.2 11.9 7.0 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, excluding communication (%) Children and Youth in Care (rate per 1,000 children Protecting 2017 7.6 12.5 34.2 aged 0-18) children and Children and Youth in Need of Protection (rate per youth 2016 27.7 39.2 88.1 1,000 children aged 0-18)

0.0 0.5 1.0 1.5 2.0 This shows the relative magnitude of the LHA value compared to the Island Health value for that indicator.

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.

Health Status Summary

Vancouver Sub-group Time Island Indicator Description BC Island Description Period Health North

Births Live Birth Rate (rate per 1,000 population) 2012-2016 9.5 8.3 10.0

Stillbirths (rate per 1,000 births) 2012-2016 10.8 8.7

Infant Mortality - deaths of infants under 1 year of 2012-2016 3.0 3.8 age (rate per 1,000 live births) Low Weight Births - less than 2,500 grams (rate per 2012-2016 58.0 53.0 48.1 1,000 live births)

Cesarean Sections (rate per 1,000 live births) 2012-2016 325.6 285.4 230.2

Pre-term Births - gestational age less than 37 2012-2016 76.4 79.3 89.3 weeks (rate per 1,000 live births) Mothers under 20 - live births to mothers under 20 2012-2016 19.9 28.7 87.6 years of age (rate per 1,000 live births) Mothers 35 and over - live births to mothers aged 2012-2016 246.6 218.6 132.3 35 and over (rate per 1,000 live births)

Life Female Life Expectancy 2011-2015 84.6 84.1 80.9 Expectancy Male Life Expectancy 2011-2015 80.6 80.2 77.2

Life Expectancy 2011-2015 82.6 82.2 78.6

Alzheimer's Disease and Other Dementia - Morbidity 2017 20.7 21.9 19.2 Prevalence (age-standardized rate per 1,000) Asthma - Prevalence (age-standardized rate per 2017 122.3 129.2 166.5 1,000) Chronic Kidney Disease - Prevalence 2017 22.5 21.7 26.2 (age-standardized rate per 1,000) Chronic Obstructive Pulmonary Disease - 2017 62.0 62.4 103.8 Prevalence (age-standardized rate per 1,000) Mood and Anxiety Disorders - Prevalence 2017 300.1 338.4 324.9 (age-standardized rate per 1,000) Depression - Prevalence (age-standardized rate per 2017 245.5 275.4 264.3 1,000) Diabetes - Prevalence (age-standardized rate per 2017 80.9 70.1 93.4 1,000) Heart Failure - Prevalence (age-standardized rate 2017 19.9 18.1 32.6 per 1,000) Hypertension - Prevalence (age-standardized rate 2017 226.4 214.0 257.1 per 1,000) Ischemic Heart Disease - Prevalence 2017 71.5 62.2 82.2 (age-standardized rate per 1,000) Osteoarthritis - Prevalence (age-standardized rate 2017 86.7 92.7 109.4 per 1,000)

0.0 0.5 1.0 1.5 2.0

This shows the relative magnitude of the LHA value compared to the Island Health value for that indicator.

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.

Health Status Summary (Continued)

Vancouver Sub-group Time Island Indicator Description BC Island Description Period Health North Alcohol-related deaths (age-standardized rate per Deaths 2014 26.5 36.4 53.4 100,000) Illicit drug-related deaths (age-standardized rate 2014 8.3 8.6 16.3 per 100,000) Tobacco-related deaths (age-standardized rate per 2014 84.6 114.6 53.5 100,000) Mortality due to unintentional injuries 2012-2016 3.1 3.4 5.5 (age-standardized rate per 10,000)

Mortality (age-standardized rate per 10,000) 2012-2016 64.8 67.0 82.5

Health Matrix* Health Matrix: Healthy (%) 2016 24.1 24.7

Health Matrix: Minor Conditions (%) 2016 11.3 10.7

Health Matrix: Moderate or Major Conditions (%) 2016 2.6 2.0

Health Matrix: Low Chronic Conditions (%) 2016 27.0 27.5

Health Matrix: Medium Chronic Conditions (%) 2016 10.0 9.4

Health Matrix: Severe Mental Health & Substance 2016 1.9 2.4 Use (%)

Health Matrix: Maternity & Healthy Newborns (%) 2016 2.0 2.3

Health Matrix: Frail in Community (%) 2016 0.5 0.4

Health Matrix: High Chronic w/o Frailty (%) 2016 4.5 5.1

Health Matrix: High Chronic w/ Frailty (%) 2016 0.7 0.6

Health Matrix: Cancer (%) 2016 1.6 1.1

Health Matrix: Frail in Residential Care(%) 2016 1.0 0.3

Health Matrix: End of Life (%) 2016 0.8 0.6

Health Matrix: Non-Users (%) 2016 12.0 13.1

0.0 0.5 1.0 1.5 2.0 This shows the relative magnitude of the LHA value compared to the Island Health value for that indicator.

*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/conducting-health-research/data-access/health_system_matrix_61_definitions.pdf

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.

Potential Years of Life Lost (PYLL)

Vancouver Sub-group Time Island Indicator Description BC Island Description Period Health North All Cause Potential Years of Life Lost rate (age Potential 2012-2016 43.1 47.0 77.5 standardized per 1,000) Years of Life Cerebrovascular diseases - Potential Years of Life Lost 2012-2016 0.9 0.9 0.7 Lost rate (age standardized per 1,000) Chronic lower respiratory diseases - Potential 2012-2016 0.8 0.8 2.1 Years of Life Lost rate (age standardized per 1,000) Diabetes - Potential Years of Life Lost rate (age 2012-2016 1.2 1.1 2.6 standardized per 1,000) Arteries, arterioles and capillaries - Potential Years 2012-2016 0.3 0.4 0.2 of Life Lost rate (age standardized per 1,000) Accidental Falls - Potential Years of Life Lost rate 2012-2016 0.4 0.5 0.7 (age standardized per 1,000) Influenza and pneumonia - Potential Years of Life 2012-2016 0.5 0.6 1.0 Lost rate (age standardized per 1,000) Suicide - Potential Years of Life Lost rate (age 2012-2016 3.2 3.8 8.5 standardized per 1,000) Ischemic heart diseases - Potential Years of Life 2012-2016 2.5 2.5 4.4 Lost rate (age standardized per 1,000) Endocrine, nutritional and metabolic diseases - 2012-2016 1.7 1.6 3.9 PYLL rate (age standardized per 1,000) Circulatory system - Potential Years of Life Lost 2012-2016 5.3 5.8 7.7 rate (age standardized per 1,000) Lung/tracheal Cancer - Potential Years of Life Lost 2012-2016 2.7 3.0 3.3 rate (age standardized per 1,000) Malignant neoplasms - Potential Years of Life Lost 2012-2016 13.3 14.5 17.6 rate (age standardized per 1,000) Motor vehicle accidents - Potential Years of Life 2012-2016 1.7 1.7 2.3 Lost rate (age standardized per 1,000) Diseases of the respiratory system - Potential 2012-2016 1.6 1.8 4.8 Years of Life Lost rate (age standardized per 1,000) Diseases of the digestive system - Potential Years 2012-2016 2.1 2.7 7.4 of Life Lost rate (age standardized per 1,000)

0.0 0.5 1.0 1.5 2.0

This shows the relative magnitude of the LHA value compared to the Island Health value for that indicator.

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.

Health Service Use Summary

Vancouver Sub-group Time Island Indicator Description BC Island Description Period Health North

Complex Home Care Visits (rate per 1,000 population) 2017 438.3 270.3 Continuing Care Home Care Visits (rate per 1,000 population aged 2017 2,477.7 1,228.8 75 and over)

Residential Care Beds (rate per 1,000 population 2017 70.0 49.0 aged 75 and over)

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

Home Care Clients (rate per 1,000 population aged 2017 185.6 194.9 75 and over)

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

Home Support Clients (rate per 1,000 population 2017 101.5 81.4 aged 75 and over)

Home Support Hours (rate per 1,000 population) 2017 4,069.3 1,510.1

Home Support Hours (rate per 1,000 population 2017 27,306.1 18,120.8 aged 75 and over)

Unscheduled Emergency Department or Urgent Emergency 2017 446.6 885.3 Care Centre visits (rate per 1,000 population)

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

Unscheduled Emergency Department or Urgent 2017 783.1 1,135.4 Care Centre visits for 75+ (rate per 1,000 75+ pop)

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

Acute Care Day Cases (age-standardized rate per Hospital Day 2017 88.1 87.3 83.2 1,000 population) Care Acute Care Day Cases (age-standardized rate per 2017 209.7 227.0 159.0 1,000 population aged 75 and over)

Population Attached to Physician at the Practice Primary Care 2017 76.5 78.6 80.3 Level (%)

0.0 0.5 1.0 1.5 2.0

This shows the relative magnitude of the LHA value compared to the Island Health value for that indicator.

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.

Health Service Use Summary (Continued)

Vancouver Sub-group Time Island Indicator Description BC Island Description Period Health North Acute Care Inpatient Cases (age-standardized rate Hospital 2017 78.9 81.8 130.4 per 1,000 population) Inpatient Care Acute Care Inpatient Cases (age-standardized rate 2017 301.2 292.9 413.5 per 1,000 population aged 75 and over) Alternative Level of Care Cases (age-standardized 2017 3.7 1.9 1.6 rate per 1,000 population) Alternative Level of Care Cases (age-standardized 2017 35.2 19.3 23.6 rate per 1,000 population aged 75 and over) Alternative Level of Care Days (age-standardized 2017 78.2 75.2 76.8 rate per 1,000 population) Alternative Level of Care Days (age-standardized 2017 761.1 793.8 987.5 rate per 1,000 population aged 75 and over)

Ambulatory Care Sensitive conditions (%) 2017 4.9 4.6

Ambulatory Care Sensitive conditions among 2017 10.7 10.6 population aged 75+ (%) Medical Acute Care Utilization (case rate per 1,000 2017 39.1 38.7 38.9 population) Surgical Acute Care Utilization (case rate per 1,000 2017 20.7 24.3 22.1 population) Maternity Acute Care Utilization (case rate per 2017 10.5 10.2 11.6 1,000 population) Psychiatry (Dementia excluded) Acute Care 2017 7.4 7.2 5.9 Utilization (case rate per 1,000 population) MRI Utilization - Island Health facilities only (rate 2016 32.1 17.8 per 1,000 population)

0.0 0.5 1.0 1.5 2.0

This shows the relative magnitude of the LHA value compared to the Island Health value for that indicator.

17 of 22 Data Sources

Population and Demographics

Population and Population Projection Population and Population Projection: Average Age (People): BC Statistics - Calendar year ending 2017 │ Percent growth of the 0-19 age group population in next 10 years: BC Statistics - People Version 2017 │ Percent growth of the 20-44 age group population in next 10 years: BC Statistics - People Version 2017 │ Percent growth of the 45-64 age group population in next 10 years: BC Statistics - People Version 2017 │ Percent growth of the 65-74 age group population in next 10 years: BC Statistics - People Version 2017 │ Percent growth of the 75+ age group population in next 10 years: BC Statistics - People Version 2017 │ Population aged 0-19 (%): BC Statistics - People Version 2017 │ Population aged 20-44 (%): BC Statistics - People Version 2017 │ Population aged 45-64 (%): BC Statistics - People Version 2017 │ Population aged 65-74(%): BC Statistics - People Version 2017 │ Population aged 75 and over (%): BC Statistics - People Version 2017 │ Total population growth between 2016 and 2026: BC Statistics - People Version 2017

Age and Demographics Median Age of Population: Census, Calendar year 2016 │Population in private households with Aboriginal Identity (%): National Household Survey, Calendar year 2016 │Population where language spoken most often at home is not English or French (%): Census, Calendar year 2016 │ Visible minority population (%): National Household Survey, Calendar year 2016

Marital Status Population aged 15 and over who are common-law (%): Census, Calendar year 2016 │Population aged 15 and over who are married (%): Census, Calendar year 2016 │ Population aged 15 and over who are separated or divorced (%): Census, Calendar year 2016 │ Population aged 15 and over who are single, never married (%): Census, Calendar year 2016 │ Population aged 15 and over who are widowed (%): Census, Calendar year 2016

Migration and Immigrants Immigrant population (%): National Household Survey, Calendar year 2016 │Population migrating to area in the last 5 years (%): National Household Survey, Calendar year 2016

Determinants of Health

Education Grade 12 completion among students entering Grade 12 for the first time (%) (2yr Agg): Ministry of Education, 2014-2016 │ Population aged 25 to 64 with post-secondary certificate, diploma or degree (%): National Household Survey, Calendar year ending 2016 │ Students completing high school within six years of enrollment in Grade 8 (%) (2yr Agg): Ministry of Education, 2014-2016

Employment Population aged 15 and over who are unemployed (%): National Household Survey, Calendar year 2016

Health Behaviours Alcohol consumption (litres of absolute alcohol sold per person, 1L=58 standard drinks): AOD, Calendar Year 2016

Household Dwellings rated as needing major repairs by renter or owner (%): National Household Survey, Calendar year ending 2016 │ Lone-parent family households (% of census families with children):Census, Calendar year ending 2016 │ Private households that are owner-occupied (%): National Household Survey, Calendar year ending 2016 │ Private households with 5 or more persons (%): Census, Calendar year ending 2016 │ Private households with multiple families (%): Census, Calendar year ending 2016

Income Median household total income ($): National Household Survey, Calendar year 2016 │ Median lone-parent family income ($): National Household Survey, Calendar year 2016

18 of 22 Data Sources

Determinants of Health

Income Inequality

Difference in median income comparing males and females aged 15 and over: National Household Survey, Calendar year ending 2016 │ Households (owned) spending more than 30% of income on housing (%):National Household Survey, Calendar year ending 2016 │ Households (rented) spending more than 30% of income on housing (%):National Household Survey, Calendar year ending 2016 │ Low income based on after-tax low income measure (%):National Household Survey, Calendar year ending 2016 │ Low income based on after-tax low-income measure, ages 18 to 64 years (%):National Household Survey, Calendar year ending 2016 │ Low income based on after-tax low-income measure, ages 65 years and over (%):National Household Survey, Calendar year ending 2016 │ Low income based on after-tax low-income measure, ages less than 6 years (%):National Household Survey, Calendar year ending 2016 │ Low income based on after-tax low-income measure, ages less than 18 years (%):National Household Survey, Calendar year ending 2016

Income Supports Population aged 15 and over on Employment Insurance (%): BC Statistics, 4 quarter average as of Sept 2012 2012 │ Population on Income Assistance (%): BC Statistics, September 2012

Morbidity Alcohol-related hospitalizations (age-standardized rate per 100,000): CISUR, Fiscal year ending 2014 │ Illicit drug-related hospitalizations (age-standardized rate per 100,000): CISUR, Fiscal year ending 2014 │ Tobacco-related hospitalizations (age-standardized rate per 100,000): CISUR, Fiscal year ending 2014

Transportation Employed population aged 15 and over walking, biking or busing to work (%): National Household Survey, Calendar year ending 2016

Child Health Child hospitalizations - Dental Surgery (rate per 1,000 aged 0 to 14) -(2yr Agg): Ministry of Health Health Ideas, Period ending 2015-2017 │ Child Hospitalizations - Injury/Poisoning (rate per 1,000 aged 0 to 14) - (2yr Agg): Ministry of Health Health Ideas, Period ending 2015-2017 │ Child hospitalizations - Respiratory Dis. (rate per 1,000 aged 0 to 14) - (2yr Agg): Ministry of Health Health Ideas, Period ending 2015-2017 │ Child Mental Diseases & Disorders Hospitalizations (Indirect Age Standardized rate per 1,000 aged 0-14): Ministry of Health Health Ideas, Fiscal year ending 2017 │ Child/Youth Mental Diseases & Disorders Hospitalizations (Indirect Age Standardized rate per 1,000 aged 15-24): Ministry of Health Health Ideas, Fiscal year ending 2017

Crime Motor Vehicle Theft (rate per 1,000 population): BC Statistics, Avg 2009-2011 2012 │ Non-Cannabis Drug Offences (rate per 1,000 population): BC Statistics, Avg 2009-2011 2012 │ Number of Serious Crimes per Police Officer: BC Statistics, Avg 2009-2011 2012 │ Serious Crime (rate per 1,000 population): BC Statistics, Avg 2009-2011 2012 │ Serious Violent Crime (rate per 1,000 population): BC Statistics, Avg 2009-2011 2012

Early Development EDI: Kindergarten children rated as vulnerable for social development (%): Early Development Instrument, Wave ending 2016 │ EDI: Kindergarten children rated as vulnerable for communication development (%): Early Development Instrument, Wave ending 2016 │ EDI: Kindergarten children rated as vulnerable for emotional development (%): Early Development Instrument, Wave ending 2016 │ EDI: Kindergarten children rated as vulnerable for language development (%): Early Development Instrument, Wave ending 2016 │ EDI: Kindergarten children rated as vulnerable for physical development (%): Early Development Instrument, Wave ending 2016 │ EDI: Kindergarten children rated as vulnerable on one or more domains (%): Early Development Instrument, Wave ending 2016 │ EDI: Kindergarten children rated as vulnerable on one or more domains, excluding communication (%): Early Development Instrument, Wave ending 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, Fiscal year ending 2016 │ Children and Youth in Need of Protection (rate per 1,000 children aged 0 to 18): Ministry of Children and Family Development, End of August 2014 19 of 22 Data Sources

Health Status

Births Cesarean Sections (rate per 1,000 live births):Vital Statistics, 5 year aggregate 2012-2016 │ Infant Mortality - deaths of infants under 1 year of age (rate per 1,000 live births):Vital Statistics, 5 year aggregate 2012-2016 │ Live Birth Rate (rate per 1,000 population):Vital Statistics, 5 year aggregate 2012-2016 │ Low Weight Births - less than 2,500 grams (rate per 1,000 live births):Vital Statistics, 5 year aggregate 2012-2016 │ Mothers 35 and over - live births to mothers aged 35 and over (rate per 1,000 live births):Vital Statistics, 5 year aggregate 2012-2016 │ Mothers under 20 - live births to mothers under 20 years of age (rate per 1,000 live births):Vital Statistics, 5 year aggregate 2012-2016 │ Pre-term Births - gestational age less than 37 weeks (rate per 1,000 live births): Vital Statistics, 5 year aggregate 2012-2016 │ Stillbirths (rate per 1,000 births): Vital Statistics, 5 year aggregate 2012-2016

Life Expectancy Female Life Expectancy: BC Statistics, Calendar Year Range 2011-2015 │ Life Expectancy: BC Statistics, Calendar Year Range 2011-2015 │ Male Life Expectancy: BC Statistics, Calendar Year Range 2011-2015

Morbidity Alzhiemer's Disease and Other Dementia - Prevalence (age-standardized rate per 1,000):MoH - Chronic Disease Registries, Fiscal year ending 2017 │ Asthma - Prevalence (age-standardized rate per 1,000):MoH - Chronic Disease Registries, Fiscal year ending 2017 │ Chronic Kidney Disease - Prevalence (age-standardized rate per 1,000):MoH - Chronic Disease Registries, Fiscal year ending 2017 │ Chronic Obstructive Pulmonary Disease - Prevalence (age-standardized rate per 1,000):MoH - Chronic Disease Registries, Fiscal year ending 2017 │ Depression - Prevalence (age-standardized rate per 1,000):MoH - Chronic Disease Registries, Fiscal year ending 2017 │ Diabetes - Prevalence (age-standardized rate per 1,000):MoH - Chronic Disease Registries, Fiscal year ending 2017 │ Heart Failure - Prevalence (age-standardized rate per 1,000):MoH - Chronic Disease Registries, Fiscal year ending 2017 │ Rate per 1,000):MoH - Chronic Disease Registries, Fiscal year ending 2017 │ Ischemic Heart Disease - Prevalence (age-standardized rate per 1,000):MoH - Chronic Disease Registries, Fiscal year ending 2017 │ Mood and Anxiety Disorders - Prevalence (age-standardized rate per 1,000):MoH - Chronic Disease Registries, Fiscal year ending 2017 │Osteoarthritis - Prevalence (age-standardized rate per 1,000):MoH - Chronic Disease Registries, Fiscal year ending 2017 │ Health Service Utilization

Deaths Alcohol-related deaths (age-standardized rate per 100,000):CISUR, Fiscal year ending 2014 │ Illicit drug-related deaths (age-standardized rate per 100,000):CISUR, Fiscal year ending 2014 │ Mortality (age-standardized rate per 10,000):Vital Statistics, Calendar year ending 2012-2016 │ Mortality due to unintentional injuries (age-standardized rate per 10,000):Vital Statistics, Calendar year ending 2012-2016 │ Tobacco-related deaths (age-standardized rate per 100,000):CISUR, Fiscal year ending 2013 │ Tobacco-related deaths (age-standardized rate per 100,000):CISUR, Fiscal year ending 2014

Health Matrix Health Matrix: Cancer (%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: End of Life (%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: Frail in Community (%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: Frail in Residential Care(%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: Healthy (%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: High Chronic w/ Frailty (%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: High Chronic w/o Frailty (%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: Low Chronic Conditions (%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: Maternity & Healthy Newborns (%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: Medium Chronic Conditions (%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: Minor Conditions (%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: Moderate or Major Conditions (%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: Non-Users (%):Blue Matrix and People, Fiscal year ending 2016 │ Health Matrix: Severe Mental Health & Substance Use (%):Blue Matrix and People, Fiscal year ending 2016

20 of 22 Data Sources

Health Status

Potential Life Years Lost Accidental Falls - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ All Cause Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Arteries, arterioles and capillaries - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Cerebrovascular diseases - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Chronic lower respiratory diseases - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Circulatory system - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Diabetes - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Diseases of the digestive system - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Diseases of the respiratory system - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Endocrine, nutritional and metabolic diseases - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Influenza and pneumonia - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Ischemic heart diseases - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Lung/tracheal Cancer - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Malignant neoplasms - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Motor vehicle accidents - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016 │ Suicide - Potential Life Years Lost rate (age standardized per 1,000):Vital Statistics, Calendar year ending 2012-2016

Complex Continuing Care Home Care Clients (rate per 1,000 population aged 75 and over):Island Health - Ideas, Fiscal year ending 2017 │ Home Care Clients (rate per 1,000 population):Island Health - Ideas, Fiscal year ending 2017 │ Home Care Visits (rate per 1,000 population aged 75 and over):Island Health - Ideas, Fiscal year ending 2017 │ Home Care Visits (rate per 1,000 population):Island Health - Ideas, Fiscal year ending 2017 │ Home Support Clients (rate per 1,000 population aged 75 and over):Island Health - Ideas, Fiscal year ending 2017 │ Home Support Clients (rate per 1,000 population):Island Health - Ideas, Fiscal year ending 2017 │ Home Support Hours (rate per 1,000 population aged 75 and over):Island Health - Ideas, Fiscal year ending 2017 │ Home Support Hours (rate per 1,000 population):Island Health - Ideas, Fiscal year ending 2017 │ Residential Care Beds (rate per 1,000 population aged 75 and over):Island Health - Ideas, Fiscal year ending 2017

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

Hospital Day Care Acute Care Day Cases (age-standardized rate per 1,000 population aged 75 and over):Ministry of Health Health Ideas, Fiscal year ending 2017 │ Acute Care Day Cases (age-standardized rate per 1,000 population):Ministry of Health Health Ideas, Fiscal year ending 2017

Primary Care Population attached to physician at the practice level (%):Ministry of Health, Fiscal year ending 2017

21 of 22 Data Sources

Health Status

Hospital Inpatient Care Acute Care Inpatient Cases (age-standardized rate per 1,000 population aged 75 and over):Ministry of Health Health Ideas, Fiscal year ending 2017 │ Acute Care Inpatient Cases (age-standardized rate per 1,000 population):Ministry of Health Health Ideas, Fiscal year ending 2017 │ Alternative Level of Care Cases (age-standardized rate per 1,000 population aged 75 and over):Ministry of Health Health Ideas, Fiscal year ending 2017 │ Alternative Level of Care Cases (age-standardized rate per 1,000 population):Ministry of Health Health Ideas, Fiscal year ending 2017 │ Alternative Level of Care Days (age-standardized rate per 1,000 population aged 75 and over):Ministry of Health Health Ideas, Fiscal year ending 2017 │ Alternative Level of Care Days (age-standardized rate per 1,000 population):Ministry of Health Health Ideas, Fiscal year ending 2017 │ Ambulatory Care Sensitive conditions (%):Island Health - Ideas, Fiscal year ending 2017 │ Ambulatory Care Sensitive conditions among population aged 75+ (%):Island Health - Ideas, Fiscal year ending 2017 │ Maternity Acute Care Utilization (case rate per 1,000 population):Ministry of Health Health Ideas, Fiscal year ending 2017 │ Medical Acute Care Utilization (case rate per 1,000 population):Ministry of Health Health Ideas, Fiscal year ending 2017 │ MRI Utilization - Island Health facilities only (rate per 1,000 population):Island Health, Fiscal year ending 2016 │ Psychiatry (Dementia excluded) Acute Care Utilization (case rate per 1,000 population):Ministry of Health Health Ideas, Fiscal year ending 2017 │ Surgical Acute Care Utilization (case rate per 1,000 population):Ministry of Health Health Ideas, Fiscal year ending 2017

22 of 22