Population Health Profile
December 2015
Demographic Profile
The North West LHIN region represents a unique
geography. Key characteristics of the North West LHIN
geography and population:
•
largest land mass across Ontario health regions,
approximately 47% of the entire province.
•
largest proportion of Aboriginal people of all
Ontario LHINs - 21.5% of North West LHIN
population.
•
smallest total population of all Ontario LHINs with
Red Lake
approximately 231,000 people – about 2.0% of the
Kenora
provincial population.
Greenstone
Sioux Lookout
Dryden
Manitouwadge
Nipigon
Marathon
Terrace Bay
Atikokan
Rainy River
Thunder Bay
Emo Fort Frances
The following table reflects population characteristics
including total population size, proportion of population
Northern IDN
District of Kenora IDN
older than 65, proportion of the population who identify
District of Thunder Bay IDN
City of Thunder Bay IDN
as Aboriginal, and proportion of the population who are
District of Rainy River IDN
Francophone, at the LHIN and sub-LHIN level (Integrated
District Networks):
Figure 1: (Above) Integrated District Networks (IDNs)
Table 1. Population Profile – 2011 Census Characteristics
IDN
Total Population
% Age 65+
% Aboriginal Identity*
% Francophone
Northern
21,815
5.5
81.3
0.5
District of Kenora
43,130
15.6
25.5
2.9
District of Rainy River
20,370
17.2
22.3
1.8
City of Thunder Bay
127,975
17.1
9.9
2.7
District of Thunder Bay
17,830
13.9
32.4
13.0
North West LHIN
231,120
15.5
21.5
3.4
Ontario
13,677,687
15.6
2.4
4.4
1) Statistics Canada. 2011 Census. 2) Statistics Canada. 2011 National Household Survey. The non-response rate for the Aboriginal Identity question in the NHS was approximately
30% for North West LHIN residents with significant variation between communities. 3) This definition is based on the Inclusive Definition of Francophone, as defined by the Ontario
Office of Francophone Affairs (2009).
Figure 2: Population Pyramid
90+
Female
Male
85-89
2025
2025
The following population pyramid for the North
West LHIN illustrates the ageing of the population
between 2015 and 2025. The population projections
were derived from the Ministry of Finance data,
based on the 2011 census. We expect that by 2025,
approximately 24.1% of our population will be
seniors, compared to the 2015 projection of 17.3%.
80-84
75-79
70-74
65-69
Age Groups
60-64
Health Status and Health Behaviours
55-59
50-54
45-49
Compared to the province, 2014 Canadian
40-44
Community Health Survey data tells us that residents
35-39
in the North West LHIN have:
30-34
25-29
20-24
•
A lower life expectancy at birth
15-19
•
Poorer perceived general health
•
Higher proportion of heavy drinkers
•
Higher rates of obesity
•
Higher rates of daily smokers
•
A lower proportion of individuals with a regular
10-14
05-09
01-04
00-<01
-10,000
-5,000
0
5,000
doctor
10,000
•
Number of People
A stronger sense of community belonging
Table 2: Health Status and Health Behaviours
NW LHIN
ONTARIO
Perceived mental health as excellent or very good
62.8%
70.4%
Participation or activity limitation, sometimes or often
42.5%
31.9%
Sense of community belonging, somewhat strong or very strong
75.4%
68.1%
Overweight or obese (adults age 18+)
62.0%
52.6%
Smoking, daily or occasional
23.4%
17.4%
Heavy drinking
23.7%
16.2%
Leisure-time physical activity, active or moderately active
55.5%
52.7%
Has a regular medical doctor
86.0%
92.5%
Self-Reported Health Status (Age 12+)
1
Self-Reported Health Behaviours (Age 12+)2
Sources:
1. Derived from analysis of the 2014 Canadian Community Health Survey – Ontario Share File
2. Gathered from Canadian Institutes for Health Information yourhealthsystem.ca
2
Health Outcomes
Birth Outcomes
Using hospital administrative data, we compared
North West LHIN birth data to the province and found
that:
•
There were a significantly higher proportion of
pre-term births
•
There were a significantly higher proportion of
babies with Neonatal Abstinence Syndrome
•
The rate of babies small for gestational age was
significantly lower
Table 3: Health Status and Health Behaviours
Indicator
NW LHIN
ONTARIO
Pre-term (<37 weeks) - % of live births
9.4%**
8.0%
Small for gestational age rate
7.1%**
9.2%
Primary Caesarean Section Rate (<35 years)
15.6%
14.8%
Rate of Neonatal Abstinence
Syndrome (any diagnosis of NAS age 0-28 days) in 2014 2, 3, 4
3.8%**
0.45%
Sources:
1.
Canadian Institute for Health Information (CIHI). Childbirth Indicators by Place of Residence. 2014
2.
IntelliHEALTH ONTARIO portal. Inpatient Discharges Main Table. Extracted January 27, 2016.
3.
IntelliHEALTH ONTARIO portal. Population Projection Summary LHIN table. Extracted January 27, 2016.
4.
Number of discharges with MRDx=P961 for infants aged 0-28 days, per 1000 infants aged 0-28 days [projected (2014)], by calendar year
Estimates of total infant population used as proxy of number of live births.
** Statistically different from province
3
Chronic Conditions
Using Canadian Community Health Survey self-reported data in combination with hospital administration data,
the following table presents a glimpse into the chronic diseases affecting North West LHIN residents. Though
this data is not comprehensive, it is helpful for planning and implementing effective, integrated care. We found
that when compared to Ontario, North West LHIN residents have greater rates of hospitalization for arthritis,
chronic obstructive pulmonary disease, congestive heart failure, diabetes, and stroke.
Table 4: Prevalence of Chronic Conditions in 2014
Indicator
NW LHIN
ONTARIO
Arthritis
24.1%
18.1%
Diabetes
8.3%
7.5%
High blood pressure
21.9%
18.7%
Chronic obstructive pulmonary disease (COPD)
6.0%
3.7%
Self-reported diagnoses1
Age-standardized hospitalization rates2,3 (Admission to acute care hospitals, per 100,000)
Arthritis
860.4**
284.7
Diabetes
39.2**
19.0
COPD
319.0**
171.1
Congestive Heart Failure
212.0**
149.8
Ischaemic Heart Disease
251.0
209.2
Heart Attack
281
195
Stroke
147**
116
Sources:
1.Canadian Community Health Survey, 2014, Ontario Share File. Calculated February 15, 2016.
2.intelliHEALTH ONTARIO portal, Discharge Abstract Database, Inpatient Summary Data Table (2014). Accessed February 24,
2016. Age-standardized rates calculated with counts from intelliHEALTH, divided by census population, directly adjusted to the
2011 Census population. All ages included.
3.Canadian Institute for Health Information. www.yourhealthsystem.ca . Accessed February 17, 2016.
** Statistically different from provincial rate
4
North West LHIN residents often experience higher rates of ambulatory visits, which may reflect an increased
burden of urgent health conditions. Increased use of ambulatory care is also likely related to low accessibility or
availability of alternative options.
Table 5. Emergency Visits and Hospitalizations
Emergency Visits, 2014-2015
NW LHIN
ONTARIO
Rate of Unscheduled Emergency Visits1
902.5
446.2
39.8
22.7
Rate of Emergency Visits for Conditions that could be
treated in primary care settings2
Hospitalization Rates (age-standardized per 100,0000), fiscal year 2014/2015
Hospitalizations for Ambulatory Care Sensitive Conditions3
461
262
Injury Hospitalizations4
761
512
Self-injury hospitalizations3
191
64
Sources:
1. intelliHEALTH ONTARIO portal, National Ambulatory Care Reporting Standards, Ambulatory All Visit Summary Table (2014).
Accessed February 24, 2016. Number of unscheduled emergency visits divided by total population, multiplied by 1000.
2. intelliHEALTH ONTARIO portal, National Ambulatory Care Reporting Standards, Ambulatory All Visit Summary Table (2014).
Accessed February 24, 2016. Calculation based on: http://www.health.gov.on.ca/en/pro/programs/ris/docs/emergency_visits_
that_could_be_treated_in_alternative_primary_care_setting_en.pdf
3. Canadian Institute for Health Information. www.yourhealthsystem.ca . Accessed February 17, 2016.
4. intelliHEALTH ONTARIO portal. Discharge Abstract Database, Inpatient Discharge ALL Table. Accessed April 25, 2016.
Early Detection of Cancer and Cancer Incidence
Cancer screening programs involve testing healthy populations of certain age groups for signs of the disease
so that the progression of the cancer can be treated. Some cancer screening programs are related to reduced
incidence and mortality of the disease. Cancer Care Ontario and other agencies have developed specific guidelines
to help individuals and health care providers participate in appropriate cancer screening. After adjusting for the
ages of potential screeners, we found that lower rates of North West LHIN residents were participating in breast
cancer screening (i.e. mammogram), cervical cancer screening (i.e. Pap test), and colorectal cancer screening
(i.e., fecal occult blood test, colonoscopy, or flexible sigmoidoscopy).
5
Table 6: Cancer Screening Prevalence
Age-adjusted Screening Participation
Women aged 50-74 who completed
at least one mammogram within a
two-year period (2012-2013)
57.9%
59.0%
Women aged 21-69 who completed
at least one Pap test within a threeyear period (2011-2013)
57.7%
61.8%
Individuals overdue for colorectal
cancer screening (fecal occult blood
test, colonoscopy, flexible
sigmoidoscopy) (2013)
46.4%
41.5%
Source:
1. Cancer Quality Council of Ontario. Quality Index. North West LHIN. Retrieved from
http://www.csqi.on.ca/by_lhin/north_west/ on February 29, 2016.
After adjusting for the age distribution in our population, we found that there were significantly higher rates
of colorectal cancer and lung cancer in the North West LHIN region compared to the province. The rate of
breast cancer was comparable to the Ontario rate, and the rate of prostate cancer was significantly lower.
Indicator
North West LHIN
Ontario
Female breast cancer
115.6
111.5
Prostate cancer
84.5
118.8
Colorectal Cancer
60.6
50.4
Lung Cancer
64.7
51.5
Estimated age-standardized
cancer incidence rates per 100,000
population, 2015
Source:
2. Cancer Quality Council of Ontario. Quality Index. North West LHIN. Retrieved from
http://www.csqi.on.ca/by_lhin/north_west/ on February 29, 2016.
6
Mortality
Using 2011 Census data, we found that mortality rates for the North West LHIN are significantly higher
compared to the province, across different indicators.
Table 7. Mortality Rates By Selected Causes
Age-standardized mortality rate/100,000 (2010-2012)1
North West LHIN
Ontario
Premature Mortality (death age <75 years)
409.2
271.7
Potentially Avoidable deaths
309.3
196.2
Avoidable Deaths from Preventable Causes
207.9
125.0
Avoidable Deaths from Treatable Causes
101.4
71.3
All Causes
915
666
All Cancers
238
185
Circulatory Diseases
255
141
Respiratory Diseases
70
41
Unintentional Injuries
50
29
Self-inflicted injuries
19
9
Bloodforming/Endocrine
39
23
Digestive Systems
19
14
Infectious Diseases
13
13
Nervous System
82
62
Leading Cause of Deaths 20112
Age- and sex- adjusted mortality rates (per 100,000)
Source:
2. Cancer Quality Council of Ontario. Quality Index. North West LHIN. Retrieved from
http://www.csqi.on.ca/by_lhin/north_west/ on February 29, 2016.
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Life Expectancy
Life expectancy at birth is the average number of years a newborn baby can be expected to live if current mortality
trends continue. It is an indicator of current health and mortality conditions.
People living in Northwestern Ontario continue to have lower life expectancy than Ontarians overall. Males
continue to have lower life expectancy than females, but the gap is decreasing.
The following table shows the life expectancy for males and females in the North West LHIN and Ontario for
the most recent time period available. The North West LHIN area is further divided into the Thunder Bay District
Health Unit (City of Thunder Bay and District of Thunder Bay IDNs) and Northwestern Health Unit areas (Northern,
Kenora and Rainy River IDNs).
Table 8: Life Expectancy
Indicator
Females
Males
North West LHIN
81.1
76.2
Thunder Bay District Health Unit
82.2
76.5
Northwest Health Unit
79.1
75.8
Ontario
83.6
79.2
Life expectancy at birth (in years 2007-2009)
Source:
1. Statistics Canada. 2013. Health Profile. Statistics Canada Catalogue no. 82-228-XWE. Ottawa. Released December 12, 2013.
Glossary
Age-standardized rates: Age-standardized rates are used to adjust for variations in the population age and sex structure; this allows comparisons
between geographic areas (Northwestern Ontario and Ontario) and over time for the North West LHIN area.
Ambulatory Care Sensitive Conditions (ACSC): Conditions where appropriate ambulatory care prevents or reduces the need for admission to
hospital, per 100,000 population under age 75 years.
Avoidable mortality: Deaths that could potentially have been avoided through preventative practices, public health policies and provision of timely
and effective health care.
Crude rate: Number of events (hospitalizations, deaths, new cancer cases, etc.) / total population of interest. Crude rates should be used with
caution for comparing geographic areas since there is no adjustment for differences in age-sex distribution of areas being compared.
8