ATLANTIC HEALTH DATABASE PART C DEATH & DISEASE ATLANTIC HEALTH DATABASE ii Part C ─ Death & Disease NOTE This volume is a companion to Appendix C, and contains brief text descriptions, definitions, data sources, and charts to accompany the Tables in the appendix. Of particular interest are gender differences in the results, so data in the various indicator sets are presented for both males and females. This volume highlights which Atlantic region health districts have higher or lower rates of particular illnesses or causes of death according to Statistics Canada’s raw statistics. However, in many cases, sample sizes at the health district level were small, and the text does not account for the high variability that may result from wide confidence intervals. Statements comparing death and disease rates at the health district level should therefore be interpreted with caution. For most mortality and morbidity indicators, confidence intervals are provided in the accompanying appendix.1 Please see Part A for descriptions of the 21 Atlantic region health districts, which, in the case of Nova Scotia and Prince Edward Island, do not necessarily correspond with actual health region administrative boundaries. Please note that at the time this volume was compiled, the latest available Statistics Canada mortality and morbidity data at the health district level were for 1996. As this volume went to press, 1997 mortality and 1998 morbidity data became available. Subject to interest by users, GPI Atlantic intends to have this database updated on a regular basis. 1 For example, in Section 3.1.2.2 of this volume, on ischaemic heart disease death rates, the following paragraph appears: “As with all comparative data at the health district level, these results should be interpreted with caution due to small sample sizes and correspondingly wide confidence intervals. For example, for females, seven other Atlantic health districts have a confidence interval with a low-end result that is below the high-end estimate for Bathurst (79.7). This means that it is statistically possible, with a 95% confidence interval, for any one of those eight health districts to have the lowest female ischaemic heart disease death rate in the region. For this reason, readers of these text volumes are referred to the confidence intervals provided in the accompanying appendices (in this case Appendix C, Table 123).” Such caveats are not written into each section, but they could apply to many of the other comparative data as well. ATLANTIC HEALTH DATABASE iii Part C ─ Death & Disease TABLE OF CONTENTS 3.1 Death Rates...................................................................................................................... 3 3.1.1 Total mortality – age-standardized death rates ................................................................ 5 3.1.2 Circulatory disease deaths................................................................................................8 3.1.2.1 All circulatory disease deaths ......................................................................... 11 3.1.2.2 Ischaemic heart disease deaths........................................................................ 14 3.1.2.3 Cerebrovascular disease deaths....................................................................... 18 3.1.2.4 All other circulatory disease deaths ................................................................ 20 3.1.3 Unintentional injury deaths............................................................................................ 22 3.1.5 AIDS deaths................................................................................................................... 26 3.1.6 Cancer deaths (malignant neoplasms) ........................................................................... 29 3.1.6.1 All cancers ...................................................................................................... 31 3.1.6.2 Lung cancer..................................................................................................... 35 3.1.6.3 Colorectal cancer ............................................................................................ 40 3.1.6.4 Prostate cancer ................................................................................................ 43 3.1.6.5 Female breast cancer....................................................................................... 45 3.1.7 Respiratory disease deaths ............................................................................................. 48 3.1.7.1 All respiratory disease deaths ......................................................................... 50 3.1.7.2 Pneumonia and influenza................................................................................ 54 3.1.7.3 Bronchitis, emphysema and asthma deaths .................................................... 57 3.1.7.4 All other respiratory disease deaths ................................................................ 59 3.1.8 Deaths due to medically treatable diseases.................................................................... 62 3.1.8.1 Deaths due to medically treatable diseases: cervical cancer........................... 62 3.1.8.2 Deaths due to medically treatable diseases: bacterial infections .................... 63 3.1.8.3 Deaths due to medically treatable diseases: pneumonia and unspecified bronchitis .................................................................................................................... 64 3.1.8.4 Deaths due to medically treatable diseases: hypertensive disease.................. 65 3.1.9 Thirty day acute myocardial infarction (AMI) in-hospital mortality rate...................... 66 3.1.10 Thirty day stroke in-hospital mortality rate ................................................................. 67 Summary – Death Rates.......................................................................................................... 68 3.2 Disease Prevalence ................................................................................................... 69 3.2.1 Musculoskeletal Disorders: Arthritis/rheumatism ......................................................... 69 3.2.2 Diabetes ......................................................................................................................... 74 3.2.3 Asthma ........................................................................................................................... 81 3.2.5 High blood pressure .......................................................................................................87 3.2.6 Cancer incidence............................................................................................................ 93 3.2.6.1 All cancers ...................................................................................................... 94 3.2.6.2 Lung cancer................................................................................................... 101 3.2.6.3 Colorectal cancer .......................................................................................... 108 3.2.6.4 Prostate cancer .............................................................................................. 114 3.2.6.5 Female breast cancer..................................................................................... 119 3.2.7 HIV .............................................................................................................................. 123 Summary – Disease Prevalence............................................................................................ 124 ATLANTIC HEALTH DATABASE iv Part C ─ Death & Disease LIST OF TABLES Table C1. Female breast cancer, incidence and mortality, Canada, 1995-2002, rate per 100,000 women ...................................................................................................................... 46 Table C2. Pneumonia and influenza deaths (ICD-9 480-487), age-standardized rate per 100,000 population, by sex, Canada and Atlantic Provinces, 1996 ....................................... 55 Table C3. Asthma, by sex, household population aged 4 and over, Canada and Atlantic provinces, 1994/95 – 1998/99, (%) .......................................................................... 83 Table C4. Cancer incidence rate, by sex, age-standardized rate per 100,000 population, Canada and provinces, annual, 1997 ..................................................................................... 95 Table C5. Lung cancer incidence, by sex, age-standardized rate per 100,000 population, Canada and provinces, annual, 1997 ................................................................................... 101 Table C6. Colorectal cancer incidence, by sex, age-standardized rate per 100,000 population, Canada and provinces, annual, 1997 ...................................................................... 108 Table C7. Prostate cancer incidence, by sex, age-standardized rate per 100,000 population, Canada and provinces, annual, 1993-2002............................................................. 116 Table C8. Breast cancer incidence, by sex, age-standardized rate per 100,000 population, Canada and provinces, annual, 1992-2002.......................................................................... 120 LIST OF FIGURES Figure 195. Age-standardized total mortality rate per 100,000 population, by sex, Canada and Atlantic Provinces, 1996 (rate)................................................................................... 6 Figure 196.