The Golden Age Boom a Porcupine Health Unit Report on Seniors

The Golden Age Boom A Porcupine Health Unit Report on Seniors

Fall 2007

The Golden Age Boom A Porcupine Health Unit Report on Seniors

Foyez Haque, MBBS, MHSc Public Health Epidemiologist

published by: The Porcupine Health Unit Timmins, Ontario December 2007 A PHU Report on Seniors The Golden Age Boom – ii Preface The Porcupine Health Unit has been providing public health programs and services in the communities of Northeastern Ontario for more than sixty years. From its inception, the goal of the Porcupine Health Unit has been to improve the health of the population of these communities. The Porcupine Health Unit recently undertook an initiative to collate and publish data on those people in our communities who are 65 years or older. Work on this publication began in 2006 when the Community Check-up: Porcupine Health Unit Status Report was published. That report describes the core indicators set by the Mandatory Health Programs and Services Guidelines of the Ministry of Health and Long-Term Care. By illustrating the indicators, this report helps health planners to take necessary steps to achieve their program goals. The various indicators in this report on area seniors provide snapshots of how the Porcupine Health Unit is doing with respect to seniors’ programs. They include demographics, influenza vaccination, emergency room visits, home care data, health risk behaviours (physical activity, leisure activity, smoking, and alcohol consumption), nutrition data (obesity, vegetables and fruit consumption), hip fractures, general health (activities of daily living, high blood pressure, vision, dental visits, cancer data, hospitalizations) and mortality data. With each indicator in this report, a graph or a table has been attached. To allow the readers to evaluate the progress, comparisons were made to data from the Province of Ontario and Canada (where applicable). This report uses the most up-to-date data available at the time of writing to describe the health conditions of seniors in the Porcupine Health Unit catchment area. Data that were used to

A PHU Report on Seniors The Golden Age Boom – iii publish this report came from the provincial and national data sources, i.e., Sta- tistics Canada: Census 2006, the Provincial Health Planning Database (PHP- DB), the Health Planning Service Database (HELPS), 3.1 Canadian Commun- ity Health Survey (CCHS), and Cancer Care Ontario data (SEER Stat 5.3.1). All data were analyzed using SPSS 15.0 (SPSS Inc., Illinois, USA) and STATA 9.1 (STATA Corp., Texas, USA) and is presented according to source guidelines, including weighted values and collapsed response categories, where required. When rates were compared among different years, the population esti- mates were extracted from PHPDB database and also from the 2006 Census. During the CCHS data analyses, when the number of observations for a variable (on which an estimate was based) was less than 30, the weighted estimate was not published in this report, regardless of the value of the coefficient of variation.

iv – The Golden Age Boom A PHU Report on Seniors Acknowledgements I would like to take the opportunity to thank those who helped me to publish this report. First of all, I would like to thank the management committee at the Porcupine Health Unit for their continued enthusiasm, encouragement and persistent keenness to have the report published. A special thank goes to Dr. Dennis Hong for his detailed revision and valuable suggestions. Thanks to fellow epidemiologists Lee Sieswerda who helped me extract data from the Canadian Community Health Survey by using STATA (a statistical software) in a relatively short time, and Jane Hohenadel who helped me initially to draft the contents of this publication. Gary Schelling, the Com- munication Specialist of the Porcupine Health Unit deserves a special thanks for his continuous support regarding the naming of the publication and creating the graphs, design and layout of this report. I would also like to thank Bonnie Schultz, Rita Numainville and Jennifer Bonsall for preliminary editing, clerical support and distribution of the publication. Finally, I would like to extend my gratitude to my wife Yasmin Azher, whose support during the good and bad times of every day has made this work possible. Another person deserves special thanks, whose arrival in this world made my life complete: my twenty-month-old son, Auvoy. Foyez Haque Public Heath Epidemiologist

A PHU Report on Seniors The Golden Age Boom – Porcupine

Health Unit Regions in Ontario, 2007.

vi – The Golden Age Boom A PHU Report on Seniors Executive Summary

2 This report highlights the health status of the seniors living in the geographic area served by the Porcupine Health Unit.

2 In 2006, 11,300 seniors lived in the Porcupine Health Unit catchment area. Out of 11,300 seniors, 5,455 seniors lived in Timmins. Of all seniors, 56% were females whereas 44% were male.

2 The highest proportion of seniors’ income (78.1%) was from old age security or guaranteed income supplement (GIS).

2 About sixty-four percent (64.1%) of seniors in the Porcupine Health Unit area received influenza immunization in 2005, which is lower than the provincial average of 79.4%.

2 The leading cause of emergency visits in the Porcupine Health Unit area was respiratory diseases (14.4%).

2 In the health unit area, 2.7% of seniors received home care services by nurses and another 2.7% of seniors received home care services by neighbours or friends.

2 Higher proportions (70.2%) of seniors in the Porcupine Health Unit area were inactive when compared to their provincial counterparts (51.2%).

2 Walking (49.7%), gardening (17.7%), fishing (13.8%) and home exercise (25.9%) were the most popular leisure activities of seniors in the Porcupine Health Unit area.

2 A majority of seniors in the Porcupine Health Unit area (86.3%) and in Ontario (90.2%) were either former smokers or never smoked.

2 A higher proportion of seniors in the Porcupine Health Unit area (14%) were exposed to second-hand smoke than were the seniors of Ontario (7.7%).

2 The proportion of regular drinkers was lower among the seniors of the Porcupine Health Unit area (36.1%) than the provincial average of 50.3%.

A PHU Report on Seniors The Golden Age Boom– vii 2 About sixty-three percent (63.2%) of seniors in the Porcupine Health Unit area were either overweight or obese. Provincially, about fifty-three percent (52.7%) of seniors were either overweight or obese.

2 About seventy-three percent (72.8%) of seniors in the health unit area wear dentures, whereas in the rest of Ontario about fifty-six percent (55.7%) seniors wear dentures.

2 The rate of colon cancer incidence has declined 17.5% over the period of 1988 to 2002 in the health unit area compared to a decline of about eleven percent (10.8%) in Ontario.

2 Trachea, bronchus and lung cancer incidence declined thirty-three percent (33.1%) from 1988 to 2002 whereas this decline was only 2.4% in Ontario.

2 Prostate cancer incidence has increased in both the Porcupine Health Unit area (40.7%) and in Ontario (42.5%) from 1988 to 2002. This increase might be the result of the advent of new diagnostic techniques.

2 The rate of colon cancer mortality in the Porcupine Health Unit area has fluctuated year to year.

2 The mortality rate from trachea, bronchus and lung cancer increased in the health unit area from 1988 to 2002 (28.7%) whereas the rate remained almost the same in Ontario over the same period of time.

2 The rate of breast cancer mortality has decreased in both Ontario (14.5%) and in the Porcupine Health Unit catchment area (45.4%) since 1988.

2 The rate of prostate cancer mortality in the health unit area increased 59.3% from 1988 to 2002, whereas the rate decreased by 16% in Ontario over the same time.

2 Cardiovascular diseases were the leading cause of hospitalization in the Porcupine Health Unit area (28.7%) followed by respiratory (14.6%) and gastrointestinal (10.3%) diseases.

2 Cardiovascular diseases were also the leading cause of mortality in the Porcupine Health Unit area (38.7%).

viii – The Golden Age Boom A PHU Report on Seniors Contents

Preface iii Acknowledgements v Executive Summary vii

one Basic Demographics Table 1 Seniors’ distribution throughout the Porcupine Health Unit area, 2006. 1 Fig. 1. Household size among seniors in the Porcupine Health Unit area, 2005. 2 Fig. 2. Highest level of education of seniors in the Porcupine Health Unit area and 3 Ontario, 2005. Fig. 2. Highest level of education of seniors in the Porcupine Health Unit area and 4 Ontario, 2005. Fig. 4. Household food situation of seniors in the Porcupine Health Unit area and 5 Ontario, 2005. Fig. 5. Household food security state of seniors in the Porcupine Health Unit area and 6 Ontario, 2005.

two Influenza vaccination Fig. 6. Proportion of seniors in the Porcupine Health Unit area and Ontario who 7 received influenza immunization in 2005. Fig. 7. Seniors in the Porcupine Health Unit area and Ontario, who received the 8 influenza immunization 2003-2004. Fig. 8. Reasons that seniors in the Porcupine Health Unit area and Ontario did not get 9 immunization against influenza, 2005.

three Emergency room visits Fig. 9. Leading causes of emergency room visits by seniors in the Porcupine Health Unit 11 area and Ontario, 2001–05.

four Home care Fig. 10. Percentage of seniors who received home care services covered by government in 13 the Porcupine Health Unit area and Ontario, 2005. Fig. 11. Percentage of seniors who received home care services, not covered by government 14 in the Porcupine Health Unit area and Ontario, 2005. Fig. 12. Barriers to accessing home care service by seniors in the Porcupine Health Unit 15 area, 2005.

A PHU Report on Seniors The Golden Age Boom– ix five Health risk behaviour Physical activity Fig. 13. Activity levels of seniors in the Porcupine Health Unit area and Ontario, 2005. 17 Fig. 14. Level of physical activity by seniors (in a usual day) in the Porcupine Health Unit 18 area and Ontario, 2005. Leisure activity Fig. 15. Leisure activities in the last 3 months in the Porcupine Health Unit area and 19 Ontario, 2005.

Smoking Fig. 16. Type of smoker among seniors in the Porcupine Health Unit area and Ontario, 20 2005. Fig. 17. Exposure to second-hand smoke at home in the Porcupine Health Unit area and 21 Ontario, 2005. Fig. 18. Type of drinker among seniors in the Porcupine Health Unit area and Ontario, 22 2005. Fig. 19. Frequency of drinking 5 or more drinks on one occasion in the last 12 months by 23 seniors in the Porcupine Health Unit area and Ontario, 2005.

six Nutrition Fig. 20. Weight categories of seniors in the Porcupine Health Unit area and Ontario, 25 2005. Fig. 21. Daily consumption of vegetables and fruit by seniors in the Porcupine Health 26 Unit area and Ontario, 2005. Fig. 22. Daily consumption of vegetables and fruit by seniors in the Porcupine Health 27 Unit area by gender, 2005.

seven Hip Fractures Fig. 23. Hip fracture hospitalizations in the Porcupine Health Unit area and Ontario, 29 2005.

eight General Health Hypertension Fig. 24. Proportion of seniors who have high blood pressure in the Porcupine Health 31 Unit area and Ontario, 2005. Fig. 25. Proportion of seniors taking high blood pressure medication in the Porcupine 32 Health Unit area and Ontario, 2005. Activities of daily living Fig. 26. Participation and activity limitation for seniors in the Porcupine Health Unit, 33 Ontario, and Canada, 2005.

– The Golden Age Boom A PHU Report on Seniors Vision Fig. 27. Proportion of seniors with cataracts in the Porcupine Health Unit area and 34 Ontario, 2005. Fig. 28. Seniors who visited an eye doctor in the last 12-month period in the Porcupine 35 Health Unit area and Ontario, 2005.

Dental visits Fig. 29. Frequency of dentist visits among seniors in the Porcupine Health Unit area and 36 Ontario, 2005. Fig. 30. Denture wearers in the Porcupine Health Unit area and Ontario, 2005. 37 37 Fig. 31. Type of dental insurance providers used by seniors in the Porcupine Health Unit 38 area and Ontario, 2005.

nine Cancer Fig. 32. Incidence of colon cancer among seniors in the Porcupine Health Unit area and 39 Ontario, 1988–2002. Fig. 33. Incidence of trachea, bronchus, and lung cancer among seniors in the Porcupine 40 Health Unit area and Ontario, 1988–2002. Fig. 34. Incidence of prostate cancer among seniors in the Porcupine Health Unit area 41 and Ontario, 1988–2002. Fig. 35. Incidence of breast cancer among seniors in the Porcupine Health Unit area and 42 Ontario, 1988–2002. Fig. 36. Colon cancer mortality among seniors in the Porcupine Health Unit area and 43 Ontario, 1988–2002. Fig. 37. Trachea, bronchus and lung cancer mortality among seniors in the Porcupine 44 Health Unit area and Ontario, 1988–2002. Fig. 38. Breast cancer mortality among seniors in the Porcupine Health Unit area and 45 Ontario, 1988–2002. Fig. 39. Prostate cancer mortality among seniors in the Porcupine Health Unit area and 46 Ontario, 1988–2002.

ten Hospitalization Fig. 40. Leading causes of hospitalizations of seniors in the Porcupine Health Unit area 47 and Ontario, 1996–2005.

eleven Mortality Fig. 41. Cause-specific deaths of seniors in the Porcupine Health Unit area and Ontario, 1994–2003.

A PHU Report on Seniors The Golden Age Boom– xi There was no respect for youth when I was young, and now that I am old there is no respect for age. I missed it coming and going. w J.B. Priestly

xii – The Golden Age Boom A PHU Report on Seniors 1. Basic Demographics

Table 1. Seniors’ distribution throughout the Porcupine Health Unit area, 2006.*

Census Subdivision & Type Total population Male Female Cochrane T 785 345 435 Cochrane Office Area Total 785 345 435 Constance Lake 92 R 60 20 30 Hearst 745 335 410 Mattice-Val Cote TP 105 50 50 Hearst Office Area Total 910 405 490 Hornepayne TP 105 55 50 Iroquois Falls Office Area Total 920 400 515 Fauquier-Strickland TP 140 55 60 Kapuskasing 1,470 635 845 Moonbeam 240 125 110 Opasatika 50 30 30 Val Rita-Harty TP 105 55 50 Kapuskasing Office Area Total 2,005 900 1,095 Black River-Matheson TP 460 205 240 Matheson Office Area Total 460 205 240 Marten Falls 65 R 10 5 5 Peawanuck 25 5 10 James Bay Area Total 35 10 15 Moosonee Office Area Total 70 20 30 Smooth Rock Falls Office Area Total 285 115 160 Timmins 5,455 2,320 3,135 Timmins Office Area Total 5,455 2,320 3,135 Cochrane UNO North Part 340 190 145 Cochrane UNO SE Part — — — Cochrane UNO SW Part — — — Cochrane UNO Total 340 190 145 Health Unit Total 11,335 4,955 6,295

Source: 2006 Census, Statistics Canada (* – totals may not add up, due to census data collection processes)

A PHU Report on Seniors The Golden Age Boom– Fig. 1. Household size among seniors in the Porcupine Health Unit area, 2005.

3 per household 8.6%

1 per household 30.6%

2 per household 57.5%

Source: 3.1 Canadian Community Health Survey, 2005

W About two-thirds of the senior population (57.5%) in the Porcupine Health Unit area lived with another person in the household.

W About one-third of the senior population in the same area lived by themselves.

W A small proportion of the senior population (8.6%) in the health unit area lived with two other individuals in the same household.

– The Golden Age Boom A PHU Report on Seniors Fig. 2. Highest level of education of seniors in the Porcupine Health Unit area and Ontario, 2005.

50 47.3 Ontario PHU

40 39.0

31.6 30

22.8 21.1 percentage 20

11.3 10

0 grade school secondary to college university

Source: 3.1 Canadian Community Health Survey, 2005

W Eleven percent (11.3%) of seniors in the Porcupine Health Unit area were university-educated (lower than the provincial average of 22.8%).

W One-third of seniors have achieved only grade school with a further one- third (39%) achieving high school or college.

W In the Province of Ontario, about sixty-eight percent (68.4%) of seniors were educated to either the grade school or secondary to college level.

A PHU Report on Seniors The Golden Age Boom– Fig. 3. Source of household income of seniors in the Porcupine Health Unit area and Ontario, 2005. 100 Ontario PHU 83.0 84.0 80 78.1 73.4

63.0 62.7 60 percentage

40 36.5

21.9 20.9 20 15.2

9.3 7.2 4.7 6.3 5.5 2.9 0

WSIB

CPP/QPP pensions OAS/GIS

other income

wages & salaries self-employment

dividends & interest Source: 3.1 Canadian Community Health Survey, 2005

W The highest proportion of seniors’ (78.1%) income in the Porcupine Health Unit area was from old age security (OAS) or guaranteed income supplement (GIS).

W Canadian Pension Plan (CPP) (73.4%) and pensions (62.7%) were the other sources of income of local seniors.

W A few seniors (4.7%) in the Porcupine Health Unit catchment area received income from the Workplace Safety and Insurance Board (WSIB).

– The Golden Age Boom A PHU Report on Seniors Fig. 4. Household food situation of seniors in the Porcupine Health Unit area and Ontario, 2005.

100 Ontario 91.4 PHU 84.2 80

60 percentage

20 7.4 4.9 0.4 0.5 0 always had enough enough, but not always sometimes & o en did of the kinds of food kinds of food wanted not have enough to eat wanted to eat

Source: 3.1 Canadian Community Health Survey, 2005

W About eighty-four percent of seniors (84.2%) in the Porcupine Health Unit area had enough of the kinds of food they wanted to eat, which is lower than their provincial counterparts (91.4%).

W About seven percent (7.4%) of the area seniors had enough food, but not always the kinds of food they wanted to eat, which is higher than the provincial average (4.9%).

A PHU Report on Seniors The Golden Age Boom– Fig. 5. Household food security state of seniors in the Porcupine Health Unit area and Ontario, 2005.

100 94.1 Ontario 90.7 PHU

60 percentage

1.4 0.5 0.4 0 0.1 0 0 food secure food insecure food insecure with food insecure with without hunger moderate hunger severe hunger

Source: 3.1 Canadian Community Health Survey, 2005

W About ninety-one percent (90.7%) of the health unit area seniors had the ability to access nutritious food. This was lower than the provincial average of 94.1%.

W A small proportion (about 0.5%) of seniors in the area reported food insecurity without hunger. None of the seniors reported food insecurity with hunger.

– The Golden Age Boom A PHU Report on Seniors 2. Influenza vaccination

Fig. 6. Proportion of seniors in the Porcupine Health Unit area and Ontario who received influenza immunization in 2005.

79.4 80 Ontario PHU 70 64.1 60

percentage 40 29.1 30

20 13.7 10

0 had u shot never had u shot

Source: 3.1 Canadian Community Health Survey, 2005

W About sixty-four percent (64.1%) of seniors in the Porcupine Health Unit area received influenza immunization in 2005, which is lower than the provincial average of 79.4%.

W A substantial proportion of seniors (29.1%) in the area had never received influenza immunization, which is higher than the provincial rate (13.7%).

A PHU Report on Seniors The Golden Age Boom – Fig. 7. Seniors in the Porcupine Health Unit area and Ontario, who received the influenza immunization 2003-2004.

80 Ontario 72.6 PHU 70

60 57.7

percentage 40

10 6.8 6.4

0 2003 2004

Source: 3.1 Canadian Community Health Survey, 2005

W About fifty-eight percent (57.7%) of Porcupine Health Unit area seniors reported that they received immunization against influenza in 2004. This is lower than the provincial rate of 72.6%.

W Statistics on seniors in the Porcupine Health Unit area who received influenza immunization in 2003 were almost the same as the provincial statistics.

– The Golden Age Boom A PHU Report on Seniors Fig. 8. Reasons that seniors in the Porcupine Health Unit area and Ontario did not get immunization against influenza, 2005.

40 Ontario 35.5 35.5 PHU 35

25 22.8 20.5 20.5 percentage 20

15 11.4 10 6.0 5 3.0 2.7 2.1 1.6 1.8 0.8 1.2 0

cost fear

previous reaction language problem

haven’t got around to it resp didn’t think necessary doctor didn’t think necessary Source: 3.1 Canadian Community Health Survey, 2005

W The Canadian Community Health Survey has identified seven reasons seniors did not receive influenza immunization.

W Language problems (35.5%) and cost (35.5%) were two main reasons stated by seniors in the Porcupine Health Unit area for not having immunization against influenza.

W Respondents answered they “did not think it was necessary”, “previous experience of adverse reaction”, “did not get around to it”, “fear” and “doc-

tor did not think it was necessary” as other reasons for not receiving influenza immunization.

A PHU Report on Seniors The Golden Age Boom– The hardest years are those between ten and seventy. w Helen Hayes

0 – The Golden Age Boom A PHU Report on Seniors 3. Emergency room visits

Fig. 9. Leading causes of emergency room visits by seniors in the Porcupine Health Unit area and Ontario, 2001–05.

20 percentage

0 neuro not musculo cardio genito injury & gastro respiratory skin ENT logical & specified skeletel vascular urinary poisoning intestinal psych. W Ontario 16.3 15.6 11.7 14.1 9.4 10.4 7.8 4.2 1.7 2.8 W PHU 31.2 14.4 10.5 9.5 7.5 6.2 5.7 3.7 2.7 2.7

Source: Provincial Health Planning Database (PHPDB), extracted March 12, 2007. Health Data and Decision Support Unit, Ministry of Health and Long-Term Care, Ontario.

W In the Porcupine Health Unit area, the leading known cause of emergency visits among seniors was respiratory disease (14.4%).

W The lowest reported causes for emergency visits by seniors were neurological and psychiatric (2.7%), as well as diseases of the ears, nose and throat (2.7%).

A PHU Report on Seniors The Golden Age Boom – 11 Just remember: when you’re over the hill, you pick up speed. w Charles M. Schulz

– The Golden Age Boom A PHU Report on Seniors 4. Home care

Fig. 10. Percentage of seniors who received home care services covered by government in the Porcupine Health Unit area and Ontario, 2005.

15 Ontario PHU

9 percentage

0 health medical nursing care personal care house work meals shopping respite care services equipment W Ontario 4.1 1.3 0.9 4.0 3.2 1.2 0.3 0.3 W PHU 12.6 0 0 3.7 4.5 0 0.4 0

Source: 3.1 Canadian Community Health Survey, 2005

W A leading proportion of seniors (12.6%) in the Porcupine Health Unit area utilized nursing care services.

W House work (3.7%) and meals (4.5%) were two other home care services that seniors in the health unit area commonly used.

A PHU Report on Seniors The Golden Age Boom – 13 Fig. 11. Percentage of seniors who received home care services, not covered by government in the Porcupine Health Unit area and Ontario, 2005. 5 4.6 Ontario PHU

3 2.7 2.7 percentage

2 1.8 1.5

1 0.9 0.6 0.5 0.6 0.4 0.3 0 0

other nurses family

volunteer homemaker

neighbourhood/friend Source: 3.1 Canadian Community Health Survey, 2005

W In the Porcupine Health Unit area as well as in Ontario, home care services were also provided by both individuals and non-governmental organizations.

W In the health unit area, home care services were also provided by nurses (2.7%), and neighbours or friends (2.7%).

W Homemakers (0.4%) and families (0.5%) also provided home care services to local seniors.

14 – The Golden Age Boom A PHU Report on Seniors Fig. 12. Barriers to accessing home care service by seniors in the Porcupine Health Unit area, 2005.

8.4 8

6 5.4 percentage

2 1.5 1.4 1.2

0 cost too busy didn’t know doctor think still waiting/ where to go not neccessary home care

Source: 3.1 Canadian Community Health Survey, 2005

W 8.4% of area seniors reported that they were too busy to access home care services.

W 5.4% of area seniors indicated that they were still waiting for home care services to be provided to them.

A PHU Report on Seniors The Golden Age Boom– 15 My grandmother started walking five miles a day when she was sixty. She is ninety-seven now and we don’t know where the hell she is. w Ellen DeGeneres

– The Golden Age Boom A PHU Report on Seniors 5. Health risk behaviour Physical activity

Fig. 13. Activity levels of seniors in the Porcupine Health Unit area and Ontario, 2005.

80 70.2 70 Ontario PHU 60 51.2 50

percentage 40

30 23.8 20 18.0 13.7 8.9 10

0 physically active moderately active inactive

Source: 3.1 Canadian Community Health Survey, 2005

W Only 8.9% of seniors in the Porcupine Health Unit area were physically active, compared to 18% in the rest of Ontario.

A PHU Report on Seniors The Golden Age Boom – 17 Fig. 14. Level of physical activity by seniors (in a usual day) in the Porcupine Health Unit area and Ontario, 2005.

50 46.1 Ontario 44.8 PHU

30 29.3

percentage 23.0 21.6 20 18.1

1.3 0 0 usually sit stand or walk carry light load carry heavy load

Source: 3.1 Canadian Community Health Survey, 2005

W About twenty-nine percent (29.3%) of seniors in the Porcupine Health Unit area spent their time sitting down during a usual day, compared to twenty-three percent of seniors province-wide.

W About forty-five percent (44.8%) of seniors in the health unit area liked to spend their time standing or walking which is almost par with the Province of Ontario rate (46.1%).

W About eighteen percent of seniors (18.1%) indicated that they carried

light loads regularly, compared to twenty-two percent (21.6%) of seniors in Ontario.

18 – The Golden Age Boom A PHU Report on Seniors Leisure activity

Fig. 15. Leisure activities in the last 3 months in the Porcupine Health Unit area and Ontario, 2005.

80 Ontario PHU 70 63.0 60 49.7 50 41.3

percentage 40

29.5 30 25.9

20 17.7 13.8 11.3 8.4 10 5.9 3.6 3.6 0 walking gardening swimming shing social home dance exercise

Source: 3.1 Canadian Community Health Survey, 2005

W Walking was the most popular activity of seniors in the Porcupine Health Unit area (49.7%), as well as for seniors province-wide (63%).

W Fewer seniors in the Porcupine Health Unit area participated in leisure activities than seniors in the rest of Ontario, with the notable exception of fishing.

A PHU Report on Seniors The Golden Age Boom– 19 Smoking

Fig. 16. Type of smoker among seniors in the Porcupine Health Unit area and Ontario, 2005.

60 Ontario 52.4 52.2 PHU 50

40 37.8 34.1

percentage 30

11.1 10 7.7

1.6 1.2 0 daily occasional former never

Source: 3.1 Canadian Community Health Survey, 2005

W About eleven percent of seniors (11.1%) in the Porcupine Health Unit area were daily smokers, compared to about eight percent (7.7%) of seniors in the Province of Ontario.

W Most of the seniors in the health unit area were either former smokers (52.2%) or never smoked (34.1%).

20 – The Golden Age Boom A PHU Report on Seniors Fig. 17. Exposure to second-hand smoke at home in the Porcupine Health Unit area and Ontario, 2005.

Ontario 100 PHU 88.5 81.1 80

60 percentage

20 14.0 7.7

0 exposed at home not exposed

Source: 3.1 Canadian Community Health Survey, 2005

W A higher proportion of seniors in the Porcupine Health Unit area were exposed to second-hand smoke (14%) than their provincial counterparts (7.7%).

A PHU Report on Seniors The Golden Age Boom– 21 Alcohol drinking

Fig. 18. Type of drinker among seniors in the Porcupine Health Unit area and Ontario, 2005.

60 Ontario 50.3 PHU 50

40 36.1

percentage 30 27.6 24.5 21.0 20 17.4

10 9.3 3.8 0 regular occasional former never

Source: 3.1 Canadian Community Health Survey, 2005

W The proportion of regular drinkers among seniors in the Porcupine Health Unit area (36.1%) was lower than seniors province-wide (50.3%).

W The proportion of seniors in the Porcupine Health Unit area who identified themselves as an occasional or former drinker (24.5% and 27.6%) was higher than the provincial average (17.4% and 21%).

22 – The Golden Age Boom A PHU Report on Seniors Fig. 19. Frequency of drinking 5 or more drinks on one occasion in the last 12 months by seniors in the Porcupine Health Unit area and Ontario, 2005.

60 58.6 Ontario 49.7 PHU 50

percentage 30

10 8.0 5.0 3.9 2.9 0 never less than once a month more than once a month

Source: 3.1 Canadian Community Health Survey, 2005

W Binge drinking is usually described as drinking five or more drinks in one occasion and is linked to alcohol-related health problems.

W The frequency of “never drinking 5 or more drinks in one occasion” was higher in the Province of Ontario (58.6%) than in the Porcupine Health Unit area (49.7%).

A PHU Report on Seniors The Golden Age Boom– 23 My grandmother was a very tough woman. She buried three husbands and two of them were just napping. w Rita Rudner

– The Golden Age Boom A PHU Report on Seniors 6. Nutrition

Fig. 20. Weight categories of seniors in the Porcupine Health Unit area and Ontario, 2005. 50 Ontario 42.7 PHU 40 38.1 36.8 35.8

30 27.4 percentage

20 14.6

0 acceptable weight overweight obese BMI 18.5-24.9 BMI 25.0-29.9 BMI >30

Source: 3.1 Canadian Community Health Survey, 2005

W The combined rate of overweight and obesity was higher among seniors in Porcupine Health Unit area (63.2%) than seniors in the Province of Ontario (52.7%).

W The Body Mass Index (BMI) may underestimate or overestimate risks in adults over 65 years of age.

A PHU Report on Seniors The Golden Age Boom – 25 Fig. 21. Daily consumption of vegetables and fruit by seniors in the Porcupine Health Unit area and Ontario, 2005.

Ontario 50 PHU 44.9 43.4 43.1 41.2 40

30 percentage

0 less than 5 servings 5−10 servings

Source: 3.1 Canadian Community Health Survey, 2005

W A lower proportion of seniors of the Porcupine Health Unit area (41.2%) consumed the recommended 5–10 servings of vegetables and fruit (according to Canada’s Food Guide to Healthy Eating, 1992) than their provincial counterparts (43.1%).

W The current Canada Food Guide (Eating Well with Canada’s Food Guide, 2007) recommends at least seven servings of vegetables and fruit for seniors. In that case, many more seniors of the Porcupine Health Unit area did not meet the required amount.

26 – The Golden Age Boom A PHU Report on Seniors Fig. 22. Daily consumption of vegetables and fruit by seniors in the Porcupine Health Unit area by gender, 2005.

Male 48.8 50 47.0 Female 41.7 40 34.2

30 percentage

0 less than 5 servings 5−10 servings

Source: 3.1 Canadian Community Health Survey, 2005

W A higher proportion of females (47%) consumed the previously recommended 5 to 10 servings of vegetables and fruit than their male counterparts (34.2%) in the Porcupine Health Unit area.

W As might be expected, a lower proportion of females (41.7%) in the area consumed less than 5 servings of vegetables and fruit than their male counterparts (48.8%).

A PHU Report on Seniors The Golden Age Boom– 27 Old age is like a plane flying through a storm. Once you are aboard, there is nothing you can do. w Golda Meir

– The Golden Age Boom A PHU Report on Seniors 7. Hip Fractures Fig. 23. Hip fracture hospitalizations in the Porcupine Health Unit area and Ontario, 2005.

800 Canada Ontario 700 PHU

600

500

400 rate/100,000

300

200

100

0 2001 2002 2003 2004 2005

W Canada 554 544 545 525 502 W Ontario 573 567 570 553 521 W PHU 426 † 692 723 622

Source: CIHI Health Indicator Reports, Canadian Institute for Health Information, 2005 († - data not available)

W The rate of hip fracture hospitalizations was higher in the Porcupine Health Unit area than in Ontario and Canada over the period of 2003 to 2005.

W Over the period of 2001 to 2005, the highest number of hip fracture hospitalizations in the Porcupine Health Unit area was reported in 2004 (723/100,000 population).

A PHU Report on Seniors The Golden Age Boom – 29 Retirement at sixty-five is ridiculous. When I was sixty-five, I still had pimples. w George Burns

0 – The Golden Age Boom A PHU Report on Seniors 8.0 General Health Hypertension Fig. 24. Proportion of seniors who have high blood pressure in the Porcupine Health Unit area and Ontario, 2005.

Ontario 60 PHU 54.6 49.6 50.4 50 45.2

percentage 30

0 have high blood pressure do not have high blood pressure

Source: 3.1 Canadian Community Health Survey, 2005

W About fifty percent of the area seniors (49.6%) reported having high blood pressure, which was higher than their provincial counterparts (45.2%).

W This is self-reported data and therefore may be an overestimation of the diagnosis of high blood pressure. Some seniors may report high blood pressure without true diagnosis.

A PHU Report on Seniors The Golden Age Boom – 31 Fig. 25. Proportion of seniors taking high blood pressure medication in the Porcupine Health Unit area and Ontario, 2005.

60 55.0 Ontario 50 47.7 PHU

percentage 30

10 5.7 5.3

0 taking medication not taking medication

Source: 3.1 Canadian Community Health Survey, 2005

W Fifty-five percent of the area seniors reported taking blood pressure medication, compared to about forty-eight percent (47.7%) of seniors province-wide.

32 – The Golden Age Boom A PHU Report on Seniors Activities of daily living

Fig. 26. Participation and activity limitation for seniors in the Porcupine Health Unit, Ontario, and Canada, 2005.

60 52.8 53.1 Canada 50 49.7 49.8 46.3 46.2 Ontario PHU 40

percentage 30

0 participation & no participation & activity limitation activity limitation

Source: 3.1 Canadian Community Health Survey, 2005

W A lower proportion of seniors in the health unit area (49.7%) reported that they had activity limitation. In the Province of Ontario 53.1% of seniors and in Canada 52.8% of seniors reported that they had activity limitation.

W A higher percentage of seniors in the health unit area with activity limitations reported that they were regularly active, as compared to both Ontario and Canada seniors.

A PHU Report on Seniors The Golden Age Boom– 33 Vision

Fig. 27. Proportion of seniors with cataracts in the Porcupine Health Unit area and Ontario, 2005.

80 78.7 76.3 Ontario 70 PHU

percentage 40

30 23.5 21.3 20

0 cataracts no cataracts

Source: 3.1 Canadian Community Health Survey, 2005

W About twenty-one percent (21.3%) of the Porcupine Health Unit area seniors reported having cataracts, compared to 23.5% of seniors in the entire province.

34 – The Golden Age Boom A PHU Report on Seniors Fig. 28. Seniors who visited an eye doctor in the last 12-month period in the Porcupine Health Unit area and Ontario, 2005.

60.0 60 Ontario 51.7 PHU 50

percentage 30

10 5.4 1.1 0 visited not visited (in last 12 months)

Source: 3.1 Canadian Community Health Survey, 2005

W Only fifty-two percent (51.7%) of seniors in the Porcupine Health Unit area reported visiting an eye doctor in the last year, compared to sixty percent (60%) province-wide.

W A small proportion of seniors (5.4%) in the health unit area reported they had not visited an eye doctor in the last 12 months. This was higher than the provincial average (1.1%).

A PHU Report on Seniors The Golden Age Boom– 35 Dental visits

Fig. 29. Frequency of dentist visits among seniors in the Porcupine Health Unit area and Ontario, 2005.

60 55.9 53.1 Ontario 50 PHU

40 33.2

percentage 30 29.1

10 4.0 3.5 0 more than once less than once emergency visit

Source: 3.1 Canadian Community Health Survey, 2005

W About twenty-nine percent (29.1%) of the seniors in the Porcupine Health Unit area reported visiting a dentist more than once, compared to about fifty-three percent (53.1%) in the entire province.

W About fifty-six percent (55.9%) of the seniors in the health unit area reported visiting the emergency department for a tooth disorder, compared to about thirty-three percent (33.2%) of seniors province-wide.

36 – The Golden Age Boom A PHU Report on Seniors Fig. 30. Denture wearers in the Porcupine Health Unit area and Ontario, 2005.

80 Ontario 72.8 PHU 70

60 55.7

percentage 40 37.1

30 20.8 20

0 wears dentures does not wear dentures

Source: 3.1 Canadian Community Health Survey, 2005

W About three-quarters of seniors in the Porcupine Health Unit area (72.8%) reported wearing dentures or having artificial teeth, whereas about half of the seniors in the Province of Ontario (55.7%) reported wearing dentures.

A PHU Report on Seniors The Golden Age Boom– 37 Fig. 31. Type of dental insurance providers used by seniors in the Porcupine Health Unit area and Ontario, 2005.

25 21.9 Ontario PHU 20

percentage 11.3 10 7.2 7.1 5.8 5.4 5

0 government-sponsored employer-sponsored private

Source: 3.1 Canadian Community Health Survey, 2005

W In both Ontario (21.9%) and the Porcupine Health Unit area (11.3%), the dental insurance provider most utilized by seniors was employer- sponsored insurance agencies.

W Government and private insurance agencies were also indicated as providers of dental insurance to seniors in both the health unit area and in Ontario as a whole.

38 – The Golden Age Boom A PHU Report on Seniors 9. Cancer Fig. 32. Incidence of colon cancer among seniors in the Porcupine Health Unit area and Ontario, 1988–2002.

350

300

250

200 rate/100,000 150

100

0 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

W Ontario 241.9 235.8 230.6 232.5 221.4 218.8 228.9 215.9 218.6 210.1 225.3 225.6 222.2 216.5 215.8 W PHU 238.2 328.2 209.8 255.1 262.1 217.6 239.6 221.4 214.7 221.0 243.9 185.4 234.9 154.8 196.5

Source: Cancer Care Ontario, SEER*Stat data, 2004

W In the Porcupine Health Unit area, the rate of colon cancer decreased about eighteen percent between 1988 and 2002. Over the same period, the Province of Ontario as a whole experienced about an eleven percent drop.

W The highest incidence of colon cancer in the health unit area was reported in 1989 (328.2/100,000).

A PHU Report on Seniors The Golden Age Boom – 39 Fig. 33. Incidence of trachea, bronchus, and lung cancer among seniors in the Porcupine Health Unit area and Ontario, 1988–2002.

600

500

400

300 rate/100,000

200

100

0 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

W Ontario 312.8 306.9 310.8 318.3 317.8 319.7 313.6 314.6 324.5 310.2 320.5 315.4 315.3 319.1 305.3 W PHU 526.4 404.4 468.2 545.8 487.5 368.8 569.9 447.0 409.5 321.3 428.9 423.2 461.7 507.8 352.1

Source: Cancer Care Ontario, SEER*Stat data, 2004

W The incidence rate of cancer of the trachea, bronchus and lung in the Porcupine Health Unit area has been higher than the provincial average since 1988.

W The cancer incidence in the health unit area rate decreased thirty-three percent (33.1%) in 2002 from that of 1988.

W The highest incidence of cancer of the trachea, bronchus and lung in the health unit area was reported in 1994 (569.9/100,000 population).

40 – The Golden Age Boom A PHU Report on Seniors Fig. 34. Incidence of prostate cancer among seniors in the Porcupine Health Unit area and Ontario, 1988–2002.

600

500

400

rate/100,000 300

200

100

0 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

W Ontario 248.6 258.3 293.4 334.2 373.7 381.6 356.1 319.2 331.3 357.4 345.6 338.3 358.7 378.8 354.5 W PHU 208.8 256.0 360.8 421.5 400.9 283.6 345.9 293.6 263.7 355.9 239.9 307.5 560.3 295.0 293.7

Source: Cancer Care Ontario, SEER*Stat data, 2004

W The prostate cancer incidence rate has increased in both Ontario (42.5%) and in the Porcupine Health Unit area (40.7%) over the years from 1988 to 2002. This increased incidence may be the result of im- proved diagnostic techniques.

W The highest incidence of prostate cancer in the health unit area was reported in the year 2000 (560.3/100,000 population).

A PHU Report on Seniors The Golden Age Boom– 41 Fig. 35. Incidence of breast cancer among seniors in the Porcupine Health Unit area and Ontario, 1988–2002.

250

200

150 rate/100,000

100

0 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

W Ontario 204.6 210.4 207.0 217.5 224.4 211.8 210.9 202.6 203.5 207.3 205.4 208.9 200.3 194.8 200.7 W PHU 155.8 175.1 159.3 120.5 118.7 213.0 232.1 103.0 151.1 241.8 155.3 201.5 192.8 235.9 249.5

Source: Cancer Care Ontario, SEER*Stat data, 2004

W Breast cancer incidence rates have increased in the Porcupine Health Unit area since 1988. The rate remained practically the same in the Province of Ontario over the same period of time.

W In some years, especially from 1989 to 1992, the breast cancer incidence rates decreased in the health unit area, but since 1995 these rates have started to climb again.

W The highest rate of breast cancer incidence in the health unit area was

reported in 2002 (249.5/100,000 population).

42 – The Golden Age Boom A PHU Report on Seniors Fig. 36. Colon cancer mortality among seniors in the Porcupine Health Unit area and Ontario, 1988–2002.

200

150

100 rate/100,000

0 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

W Ontario 121.8 118.6 106.6 107.5 102.9 97.1 101.2 104.8 100.6 93.1 97.5 101.6 97.8 98.3 100.0 W PHU 64.0 159.5 127.1 132.5 165.0 66.8 113.2 149.5 163.7 61.3 140.9 111.6 77.2 107.0 132.6

Source: Cancer Care Ontario, SEER*Stat data, 2004

W The rate of colon cancer mortality in the Porcupine Health Unit area has fluctuated from year to year.

W The highest mortality rate from colon cancer in the health unit area was reported in 1992 (165/100,000 population).

W The mortality rate of colon cancer dropped in the Province of Ontario in the period from 1988 to 2002 (17.9%).

A PHU Report on Seniors The Golden Age Boom– 43 Fig. 37. Trachea, bronchus and lung cancer mortality among seniors in the Porcupine Health Unit area and Ontario, 1988–2002.

600

500

400

rate/100,000 300

200

100

0 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

W Ontario 277.4 270.0 269.7 271.9 264.6 279.8 283.7 274.1 275.8 273.2 278.7 287.4 271.2 277.7 271.7 W PHU 326.2 427.8 366.3 337.3 370.6 394.2 347.4 394.0 359.8 347.5 420.1 299.6 385.9 552.0 419.8

Source: Cancer Care Ontario, SEER*Stat data, 2004

W The mortality rate for cancers of the trachea, bronchus and lungs in the Porcupine Health Unit area was consistently higher than that of Ontario.

W The rate of mortality from trachea, bronchus and lung cancer in the Porcupine Health Unit area increased substantially from 1988 to 2002 (28.7%), whereas the rate remained steady in the whole of Ontario.

W The highest rate of mortality due to trachea, bronchus and lung cancer in

the health unit area was reported in 2001 (552/100,000 population).

44 – The Golden Age Boom A PHU Report on Seniors Fig. 38. Breast cancer mortality among seniors in the Porcupine Health Unit area and Ontario, 1988–2002.

150

120

90 rate/100,000

0 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

W Ontario 83.3 88.0 83.3 85.0 84.4 85.1 86.9 85.9 84.2 83.2 72.1 72.5 79.2 72.8 71.2 W PHU 88.8 115.7 55.2 53.0 94.0 76.9 59.5 65.7 84.5 127.4 29.1 28.8 66.4 90.5 48.5

Source: Cancer Care Ontario, SEER*Stat data, 2004

W The rate of breast cancer mortality declined in both Ontario (14.5%) and in the Porcupine Health Unit area (45.4%) from 1988 to 2002.

W The highest rate of breast cancer mortality in the Porcupine Health Unit area was reported in 1997 (127.4 deaths per 100,000).

A PHU Report on Seniors The Golden Age Boom– 45 Fig. 39. Prostate cancer mortality among seniors in the Porcupine Health Unit area and Ontario, 1988–2002.

200

150

rate/100,000 100

0 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

W Ontario 93.1 90.5 90.1 91.7 96.9 98.8 95.8 95.2 91.4 90.1 87.8 84.2 82.3 81.7 78.2 W PHU 53.5 86.4 141.1 77.8 115.9 119.6 106.2 150.7 116.1 89.2 105.5 88.2 109.5 84.7 85.2

Source: Cancer Care Ontario, SEER*Stat data, 2004

W The ater of prostate cancer mortality in the Porcupine Health Unit area increased 59.3% from 1988 to 2002.

W The rate of prostate cancer mortality in the Province of Ontario declined slightly (16%) over the same period of time.

46 – The Golden Age Boom A PHU Report on Seniors 10. Hospitalization

Fig. 40. Leading causes of hospitalizations of seniors in the Porcupine Health Unit area and Ontario, 1996–2005. 35

30.3 30 Ontario 28.7 PHU 25

20 percentage 15 14.6 12.0 12.5 10.6 11.3 10 10.3 8.4 8.6 7.4 6.2 5.5 5.7 5 4.5 4.0 4.6 4.3 1.8 2.0 0

cancer

endocrine respiratory psychiatric non-speci c cardiovascular genitourinary gastrointestinal musculoskeletalneurological &

injury & poisoning Source: Provincial Health Planning Database (PHPDB), extracted April 05, 2007. Health Data and Decision Support Unit, Ministry of Health and Long-Term Care, Ontario.

W Ten leading causes of hospitalization were identified. Cardiovascular diseases were the foremost cause of hospitalizations in the Porcupine Health Unit area (28.7%) and in Ontario (30.3%).

W Respiratory diseases (14.6%), non-specific causes (12%) and gastrointestinal diseases (10.3%) were also leading causes of hospitalizations in the health unit area.

A PHU Report on Seniors The Golden Age Boom – 47 Old age is the most unexpected of all things that happen to a man. w Leon Trotsky

– The Golden Age Boom A PHU Report on Seniors 11. Mortality

Fig. 41. Cause-specific deaths of seniors in the Porcupine Health Unit area and Ontario, 1994–2003. 50

41.1 Ontario 40 38.7 PHU

30 26.3 26.4 percentage

10.7 10 10.0 6.9 6.5 4.0 3.6 3.7 4.2 2.2 3.0 2.7 3.0 1.0 1.0 1.4 1.6 0

cancer infections endocrine respiratory non-speci c genitourinary psychiatric cardiovascular gastrointestinal neurological &

injury & poisoning

Source: Provincial Health Planning Database (PHPDB), extracted April 11, 2007. Health Data and Decision Support Unit, Ministry of Health and Long-Term Care, Ontario.

W In the Porcupine Health Unit area, about thirty-nine percent (38.7%) of seniors’ deaths were attributed to cardiovascular diseases. In Ontario, the rate was 41.1%.

W Cancer (26.4%) and respiratory diseases (10.7%) were also identified as leading causes of seniors’ mortality in the Porcupine Health Unit area.