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Back to Basics, 2011 POPULATION HEALTH : Vital & Health Statistics

Back to Basics, 2011 POPULATION HEALTH : Vital & Health Statistics. Presented by Robert Spasoff, MD Epidemiology & Community Medicine. 78.1: VITAL STATISTICS INFORMATION.

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Back to Basics, 2011 POPULATION HEALTH : Vital & Health Statistics

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  1. Back to Basics, 2011POPULATION HEALTH :Vital & Health Statistics Presented by Robert Spasoff, MD Epidemiology & Community Medicine

  2. 78.1: VITAL STATISTICS INFORMATION • What are the key causes of illness or death in Canada? Common things are common – using epidemiology can help you run a better clinical practice • How have disease incidence and mortality changed in Canada in the past 20 years? • Little good information on disease incidence except for reportable diseases and cancer (cancer registries)

  3. TOPICS • Demography, population dynamics • Mortality, and inequalities therein • Morbidity • Summary measures of population health • Aboriginal health

  4. Population Dynamics, 2007

  5. World Health Report, 2006 (data mostly from 2004)

  6. Canadian Historical Population Pyramids • http://www12.statcan.ca/english/census01/products/analytic/companion/age/cda01pymd.cfm

  7. Standardization • An older method of adjusting for confounding (usually used for differences in age between two populations) • Refers observed events to a standard population, producing hypothetical values • Direct: yields age-standardized rate (ASMR) • Indirect: yields standardized mortality ratio (SMR)

  8. Mortality dataThree ways to summarize them • Mortality rates (crude, specific, standardized) • PYLL: subtracts age at death from some “acceptable” age of death. Emphasizes causes that kill at younger ages. • Life expectancy: average age at death if current mortality rates continue. Derived from life table.

  9. General (All-Causes) Mortality

  10. Annual NUMBER of Deaths,by Sex, Canada, 1979-2004 10

  11. Age-Standardized Mortality RATES,Canada, 1979-2004

  12. Infant Mortality, 1935-2005

  13. Loses a lot of detail here

  14. 14

  15. Income Inequalities in Health

  16. 2 3 4 5 1 2 3 4 5 Income adequacy quintiles Remaining Life Expectancy at age 25. Based on 10-year follow-up to 1991 census

  17. Remaining life expectancy at age 25 (conditional on surviving to age 25), 1991-2001

  18. Probability of survival to age 75 (conditional on surviving to age 25), 1991-2001

  19. Cause-Specific Mortality

  20. Leading causes of death • Cardiovascular disease: 37% • Heart disease: 20% • Other circulatory disease: 10% • Stroke 7% • Cancer: 28% • Lung cancer: 9% (M); 6% (W) • Breast cancer: 4% (W) • Prostate cancer: 4% (M) • Respiratory Disease: 10% • Injuries: 6% • Diabetes: 3% • Alzheimer’s: 1%

  21. Impact of different causes of death in Canada 2001: • Mortality rates and PYLL • Source: Statistics Canada

  22. CANCER: 30.3% Circ Disease: 27.6% †† † † Pneumonia & influenza grouped with respiratory disease. Would increase infectious % to about 3.4%.

  23. CANCER: 29.8% Circ Disease: 29.0% EXTERNAL CAUSES: 4.8%+ { † † † Pneumonia & influenza grouped with respiratory disease. Would increase infectious % to about 3.5%.

  24. CANCER: 31.6% Circ Disease: 27.3% EXTERNAL CAUSES: 3.4%+ { † † † Pneumonia & influenza grouped with respiratory disease. Would increase infectious % to about 3.3%.

  25. Deaths due to Cardiovascular Disease and Cancer, Canada, 1979-2004: Sex ratio (M/F)

  26. Loses a lot of detail here

  27. Overall trends in mortality from Cancer 1976-2005: rates and numbers

  28. Overall trends in mortality 1976-2005: rates and numbers

  29. Cancer and AgeAge-Specific Incidence Rates for All Cancers by Sex, Canada, 2003 Surveillance Division, CCDPC, Public Health Agency of Canada

  30. Cancer and AgeAge-Specific Mortality Rates for All Cancers by Sex, Canada, 2003 Surveillance Division, CCDPC, Public Health Agency of Canada

  31. Time trends in MalesIncidence Mortality

  32. Time trends in FemalesIncidence Mortality

  33. Summary Measures of Population Health

  34. Summary measuresof population health • Combine mortality and morbidity statistics, in order to provide a more comprehensive population health indicator, e.g., QALY • Years lived are weighted according to quality of life, disability, etc. • Two types: • Health expectancies point up from zero • Health gaps point down from ideal (Japan)

  35. Summary Measures ofPopulation Health

  36. 2001 Life Expectancy andHealth-Adjusted Life Expectancy • HALE always < LE • Females live longer (but gap is narrowing) • Females suffer more morbidity

  37. Disability-Adjusted Life-Years Lost, by Disease Group

  38. Which Chronic Diseases?

  39. Impact of Chronic Diseases

  40. Deaths vs Prevalence, Canada

  41. LE vs HALE, Canada

  42. Aboriginal Health

  43. Population Pyramids

  44. Canadian population pyramids A. First Nations and overall population compared B. Animated display, showing changing Canadian population 1901 - 2001 Link to Statistics Canada

  45. Age-specific Fertility Rates

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