Community Health Survey: final report
Executive summary
This section presents an overview and summary of results from the Annapolis Valley District
Health Authority’s (AVDHA’s) 2009 Community Health Survey. The study, including data
collection, analysis and reporting, was conducted by
.
Community health issues
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AVDHA residents were asked about health issues facing their community today. While the
question was intended to probe for health determinants, respondents largely focused on the
health services system. The most common responses are shortage of doctors (26%), cancer
(8%), general health care or hospital wait times (8%) and the aging population (5%).
•
Many similar responses were obtained when residents were asked what they thought could
be done to improve their community’s health situation. Top responses include hiring more
doctors (29%); increasing the amount of health education (10%); increasing government
funding for health care (6%); and hiring more nurses (6%).
Physical environment
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Nearly three fifths (58%) of AVDHA residents drive a motor vehicle to school or work, making
it the most heavily utilized form of transportation. Over one quarter (26%) of all residents do
not go to school or work, and residents of the Annapolis CHB are most likely (at 32%) to not
go to work or school.
•
Over four fifths (81%) of AVDHA residents report not using any pesticides or fertilizers on
their lawn or garden in the last 12 months, while only one sixth of residents say they did use
fertilizers, pesticides or both in the same period. Usage of lawn or garden chemicals is more
common among Central Kings CHB residents (21%) and less common among Annapolis
Valley CHB residents (10%).
Social support networks
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The majority of AVDHA residents (70%) indicate they would have someone to help them
either all the time or most of the time if they were confined to bed, while one in ten do not
have anyone on whom they can depend in such an event.
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An even higher proportion of AVDHA residents (87%) report that someone is available to take
them to the doctor either all or most of the time if necessary. Only four percent of residents
report that they do not have this type of support.
•
Nearly four fifths of AVDHA residents (78%) can depend on someone to help them prepare
meals all or most of the time if they are unable to do so, while approximately one in ten
residents (9%) lack reliable support in such a scenario.
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Almost three quarters of AVDHA residents (73%) have someone on whom they can rely all or
most of the time to help them with routine chores when sick. Again, one in ten (10%) can not
depend on this form of support.
•
In all of the above categories, those who report fair or poor health (logically, those most likely
to require help) are the most likely to lack support.
Income and food security
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Nearly two thirds of AVDHA residents (64%) who disclosed personal income information
report receiving $40,000 or less per annum, while a further one fourth (25%) fall in the
$40,001 and $70,000 income category. Approximately one in ten respondents (9%) report
yearly individual earnings in excess of $70,000.
•
More than half of respondents (56%) indicate their total household income differs from their
individual earnings.
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Slightly more than two fifths (41%) of AVDHA residents who gave their household income
receive $40,000 or less annually. Three in ten respondents (30%) report yearly household
earnings between $40,000 and $70,000, and just over one quarter (26%) say they receive
more than $70,000 per annum as a household.
•
Generally speaking, reported health and life satisfaction improve with higher incomes.
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More than two fifths of AVDHA residents (43%) report full time employment, while one
quarter (24%) are retired and one eighth (13%) are employed part-time.
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Approximately three in ten residents of the Annapolis CHB are retired – by far the highest
proportion in this employment category of all the CHBs.
•
Not surprisingly, those residents who are employed full time report better health and higher
satisfaction with life, on average, than residents who are unemployed, not currently seeking
work or unable to work.
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One half of AVDHA residents 20 years of age and older (50%) have some form of postsecondary diploma, certificate or degree from either a college or university. More specifically,
approximately one in ten have a Bachelor’s degree (11%) and slightly fewer (8%) have a
graduate or professional degree. On the other end of the educational spectrum, close to two
fifths (37%) of respondents at least 20 years of age have high school matriculation or less.
•
The number of residents who have not graduated from high school has declined from nearly
one in three in 2005 (28%) to fewer than one in five (16%) currently. Residents of the
Annapolis CHB are slightly more likely (at 24% versus the average of 18%) than residents of
other CHBs to lack a high school diploma.
•
In general, reported health and satisfaction with life tend to improve along with education
levels, as does income. Additionally, those residents with no college or university education
are more likely to be unemployed than those with more education.
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Four fifths of AVDHA residents (80%) indicate they consistently have the kinds of food they
want, and a further one fifth of residents (18%) regularly have enough to eat, though not
always what they want. Only 2% state that they sometimes or often lack sufficient food.
•
Approximately one in ten AVDHA residents (11%) say the food they bought did not last and
they lacked money to buy more sometimes or often during the past year, while a further one
in eight (13%) worried this would happen at some point over the past 12 months. One in six
respondents (16%) report they sometimes or often could not afford to eat balanced meals in
the past year.
•
Residents who are unemployed or not employed (these are also the categories with the
lowest education and income levels, on average) are the most vulnerable regarding food
security.
Personal health practices and coping skills
Stress sources and coping
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Very few community members say their lives are extremely stressful (only 3%), although the
majority experience some level of stress – one in five (19%) feel their life is quite a bit
stressful while more than two fifths (42%) say their lives are a bit stressful. Just over one
third of residents (27%) report experiencing very low levels of stress.
•
The proportion of residents who report their lives are not at all stressful has declined
somewhat over the past six years, from 17% in 2003 to 9% in 2009.
•
Age seems to correspond with stress: individuals between the ages of 25 and 49 are
significantly more likely than other age categories to report their life is quite a bit or extremely
stressful. There is also a relationship between general health and stress level: residents who
say they are in poor health are much more likely to report that their life is extremely stressful
(48%, as compared to only 17% who are in very good health and 20% who say they are in
excellent health).
•
A clear majority (63%) of AVDHA residents report a very good or excellent ability to handle
unexpected or difficult problems, while only one in ten indicate difficulty in this area (2%
saying fair and 8% saying poor).
•
A similar majority (67%) of residents feel they have a very good or excellent ability to handle
day-to-day demands, and only 6% say their ability is fair or poor.
•
Once again, ability to handle problems and day-to-day demands tends to increase with
income, education level and employment status.
•
Results indicate that residents’ work situation is the most common contributor (cited by 23%
of respondents) to feelings of stress, followed by their financial situation (cited by 15%).
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S a t i s f a c t i o n wi t h l i f e
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Ninety-four percent of residents state they are either satisfied or very satisfied with life in
general. Satisfaction levels with specific areas of life are similarly high, with the following
results (listed is the percentage who report they are either satisfied or very satisfied with that
aspect): job or main activity (88%); financial situation (76%); self (92%); relationships with
family members (95%); and relationships with friends (96%);
•
Levels of dissatisfaction with life in general are higher among residents with poor health
(26%) and those who are unemployed (22%) or not employed (22%). On the other hand,
reported satisfaction with life in general tends to increase with both personal and household
income and education level, with similar trends in all specific satisfaction areas measured.
P h y s i c a l a c t i vi t y
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The share of AVDHA residents who report doing at least 60 minutes of physical activity per
day is 42% (typical week) and 38% (previous week). An additional one quarter report doing
30 to less than 60 minutes per day in the typical week (26%) or previous week (25%). Ten
percent did no physical activity in the previous week and 8% say they do none in a typical
week.
•
Respondents report having performed slightly more moderate physical activity (3.73 hours) in
the past week than hard physical activity (3.47 hours), and men averaged significantly more
hard physical activity (4.51 hours) than women (2.48 hours) in the same period.
•
Not surprisingly, there is a positive correlation between amount of physical activity and
reported health.
•
When asked what improvements can be made in their community to encourage more
physical activity, the most common response was improved or more walking trails (19%),
followed by a fitness centre, gym, weight room or YMCA (15%), a swimming or wading pool
(13%), bicycle paths or dedicated lanes (9%) and more exercise or recreation programs,
generally (9%).
C h a n g e s ma d e t o i mp r o v e h ea l t h
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To improve their health, most respondents indicate that they would begin or increase their
level of physical activity (62% cite this method, up from 45% in 2003). Smoking has
decreased in importance, with only six percent of respondents listing smoking cessation or
reduction as the most important method of improving physical health, down from 18% who
cited this method in 2003. Residents with no high school diploma are the most likely (at 11%)
to mention smoking cessation or reduction as a means to improve their health.
•
Lack of will power / self-discipline was cited by 22% of residents as the most common barrier
to making improvements to health. Sixteen percent indicate that their work schedule stands
in the way of them making improvements, followed by financial constraints and family
responsibilities (7% and 5%, correspondingly).
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F r u i t a n d v eg e t a b l e c o n s u mp t i o n
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Three-fifths (60%) of AVDHA residents eat fruit and vegetables less than five times per day,
while close to two-fifths (37%) eat them five to ten times per day and 2% eat them more than
10 times per day. Consumption in 2009 is very close to that reported in 2003 CCHS study.
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Just over half (53%) of AVDHA residents indicate they drink fruit juice once or more daily,
down slightly from 58% who reported doing so in 2003. Residents aged 16 to 24 have the
highest average annual consumption (479 times per year).
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A higher proportion of respondents consume fruit once or more daily (67%), and nearly two
fifths (38%) eat fruit twice or more per day.
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Generally speaking, men and those with lower incomes and education levels are more likely
to consume fruit juice more than once daily, while women and residents with higher incomes
and education levels are more likely to consume fruit once or more per day.
•
Similarities in frequency patterns are evident for consumption of green salad, potatoes
(excluding fried and potato chips) and carrots, with the highest proportion of respondents
eating each two to three times per week (33%, 39% and 41%, respectively), and two percent
or less eating these vegetables more than once daily. Residents with higher income and
education levels tend to consume more green salad, while those on the other end of the
income and educational spectrum tend to consume more potatoes.
•
Consumption of other vegetables is more frequent, with over half (56%) of respondents
indicating they eat other vegetables once or more daily, and nearly one in five (18%)
consuming them two or more times per day. Once again, consumption of other vegetables is
positively related to education level.
Health services
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The majority of AVDHA residents (66%) indicate they visited a doctor’s office when sick or
seeking medical advice in the past year. Only 14% went to a walk-in clinic or community
health centre, and slightly fewer (13%) visited a hospital outpatient clinic or emergency
room).
•
More than one in ten respondents (12%) indicate they went without medical care in the past
year when they needed it. When asked why this occurred, the most common response was
long waiting times (29%), followed by unavailability at the time required (23%). Women are
much more likely than men (28% versus 15%, respectively) to say medical care was
unavailable when they needed it.
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Only two percent of AVDHA residents report experiencing a need for home care in the past
year that went unmet, down slightly from 2003, when five percent of respondents found
themselves in such a situation. The most common explanation, then as now, is that home
services are unavailable in their area (15% cite this reason). This issue seems to be most
acute in the Western Kings and Annapolis CHBs, although it should be noted that the N size
was very low (41) for this question. Other AVDHA residents who went without needed home
care in the past year explain that they didn’t know whom to contact, they didn’t qualify or were
otherwise ineligible, or the cost was prohibitive (8% - 9% for each), among other reasons
given.
•
Of those respondents who say they needed home care in the past year (whether they
received it or not), the type of care most often cited is housework (51%), followed by personal
care (32%), meal preparation or delivery (28%) and caregiver respite (19%).
Health status
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Arthritis and high blood pressure are by far the most common chronic health conditions
experienced by AVDHA residents (at 24% and 20%, respectively). Not surprisingly, the
incidence of both these chronic conditions increases with age and decreases with rising
household income level. Personal and / or household incomes also play a role with asthma,
anxiety and mood disorders, diabetes and heart disease, with likelihood of suffering from
these conditions falling with rising incomes.
•
Nearly one in four (24%) respondents report they have ever been diagnosed with high blood
pressure, up from only one in ten (11%) in 2005 (although awareness and changing
guidelines may play a role in this increase).
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The proportion of AVDHA residents who have ever been diagnosed with cancer has
remained steady since 2005 at seven percent, and respondents with household incomes of
$60,000 or lower are generally more likely to have been diagnosed with cancer than those
with higher household incomes.
•
Slightly more than half (53%) of respondents report very good or excellent general health,
while just one sixth (16%) say their general health is only fair or poor. As one would expect,
reported general health is related to issues such as weight, employment status, education
level and income.
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Respondents rate their mental health more highly than general health, with nearly three out of
four (73%) residents reporting very good or excellent mental health and only six percent
stating that their mental health is fair or poor. In general, the incidence of reported mental
health issues tends to increase with decreasing education levels.
•
One in five AVDHA residents (20%) report feeling a very strong sense of belonging to their
community, and a further 55% say this feeling is somewhat strong. Six percent indicate that
their sense of community belonging is very weak. There is a direct relationship between
reported health and reported sense of belonging.
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Two percent of female AVDHA residents report being pregnant.
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The vast majority (83%) of residents are five feet to less than six feet tall, while 15% are six
feet or taller. Younger residents, men and those with higher incomes are generally more
likely to fall into the latter height category.
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Average reported weight among AVDHA residents is approximately 174 pounds. Just over
one fifth (22%) of respondents fall between 160 and 179 pounds, and 72% weigh between
120 and 199 pounds. Reported health declines among those weighing 200 pounds or more.
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Nearly two in five (38%) respondents have a body mass index (BMI) in the “normal” range,
and a further one in three (35%) are considered “overweight.” One in four residents (26%)
fall into one of three “obese” categories according to their BMI. Once again, reported health
tends to decline with rising BMIs.
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