Presentation to Folkehelsealliansen Nordlund Health Issues in British Columbia. Mary Collins, Director BC Healthy Living Alliance May

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1 Presentation to Folkehelsealliansen Nordlund Health Issues in British Columbia Mary Collins, Director BC Healthy Living Alliance May

2 BC Healthy Living Alliance Mission is: To improve the health of all British Columbians through leadership and collaboration to address the risk factors and health inequities that contribute significantly to chronic disease

3 Map of British Columbia From south to north, BC stretches 2,100 km From east to west, as much as 1,050 km Its deeply indented, island dotted coastline extends 7,000 km Population 4.4 million Concentrated in the south, rest of province sparsely populated

4 Map of British Columbia Many communities in coastal, northern and interior of BC are hard to reach Victoria to Alberta border is 1,113 km and 15 hours to drive Vancouver to Watson Lake, Yukon is 2,100 km or 26 hours drive Some areas of the North and Central Coast are accessible only by ferry

5 Health System in BC Canada Health Act provides that all citizens receive medically necessary services provided by physicians and in hospital free of charge provinces must comply to receive federal transfer payments but health care is a provincial responsibility and jealously guarded by the provinces and territories BC has a premium system approx $50 per month ( covers only a very small part of the cost) Province can add other insured services e.g. prescription drugs over a certain amount

6 Health System in BC 5 Regional health authorities with their own boards deliver acute care, residential care, some primary care, mental health, as well as public health services receive funds from province One provincial health services authority provides province wide services e.g. cancer, children s hospital Physicians are primarily independent, work solo or in groups and paid by fee for service Public health expenditures are 3% of total provincial government health spending recommend 6%

7 BC Health Expenditures 2011/12 (est)$1 C = $1.05 US = 5.6 NK Total expenditures $ 15.7 billion ( approx $ 3500 per capita) includes: Regional Services $ 10.5 billion ( 5 regional health authorities and one provincial services authority) Medical Service Plan ( physicians) $ 3.8 billion Pharmacare $ 1.1 billion

8 Overview of the draft policy paper: Provincial Budget across BC Ministries, (proj.)

9 Health Adjusted Life Expectancy at Birth BC 2001 In 2001, HALE at birth was 71.2 years for females and 68.9 years for males in B.C. In Canada the HALE was slightly lower at 70.8 years for females and 68.3for males. For males the estimated difference between British Columbia and Canada is statistically significant at the five per cent level.

10 HALE by income Health Adjusted Life Expectancy for females in B.C. was 73.4 years for those in the upper third of the income distribution, 70.7 years for those in the middle third and 69.3 for those in the bottom third. The values are slightly lower for males at 70.7 years, 69.0 years and 66.9 years for the high, middle and low thirds of the income distribution.

11 Burden of Disease in BC Causes of Premature Mortality & Years Lived in Poor Health The current health burden BC 1998 Cancer 21% Cardiovascular Disease 18% Injuries 12% Mental Disorders 11% Neurological & Sensory Disorders 9% All Others 22% Chronic Respiratory Disease 7% 3

12 Leading Causes of Death in BC 2005 Malignant neoplasms 29% $1.2 billion Cardiovascular disease 23% $944 million Cerebrovascaular diseases 7% $ 242 Million COMBINED 57% Other 27% influenza 4%, CPD 4%, unintentional injuries 4%, diabetes mellitus 3% Other causes 15%

13 Burden of Disease in BC Key Risk Factors Contributing to the Burden of Illness 14% 12% 10% 12% 10% Estimated 10% Estimated 10% % of Total DALY 8% 6% 4% 2% 5% 2% 0% Tobacco Alcohol Obesity Physical inactivity Occupation Illicit drugs Key Risk Factor 4

14 Healthy Living in BC 44.5 percent of British Columbians (18+) were classified as overweight or obese; 43.4 percent of British Columbians consumed vegetables and fruit at least five times per day; 57.7 percent of British Columbians aged 12 + were classified as active or moderately active during their leisure time; and 14.7 percent of British Columbians were classified as current smokers. This translates to over half a million people. ( figures)

15 Overweight and Obesity in BC Rates of overweight have exploded in BC over the past 25 years, with the most recent data from 2007/8 identifying 44.5% of the population as overweight or obese. Lowest in Canada but still alarming. Highest in age group (52.3%) and over 65 (48.8%) Even more alarming is the increase in overweight and obesity in children. The number of children who are either overweight or obese between the ages of 6 11 and has more than doubled in the last 25 years. Measuring our Success Progress Report II ActNowBC 2010

16 Physical Activity in BC residents In British Columbia, an estimated 36.8 per cent of males and 29.3 per cent of females report being physically active. This compares to 30.3 per cent of Canadian males and 23.2 per cent of Canadian females. An estimated 35.3 per cent of British Columbia males and 41.3 per cent of British Columbia females report being physically inactive. This compares to 42.9 per cent of Canadian males and 49.6 per cent of Canadian females.

17 Tobacco use in teenagers BC In B.C. an estimated 9.0 per cent of male teens and 10.9 per cent of female teens report current smoking habits. This is substantially lower than the 14.4 per cent of Canadian male teenagers and 15.2 per cent of Canadian female teenagers who report being current smokers.

18 Risk Factors for chronic disease in BC Unhealthy eating Poor consumption of veggies & fruit in adults and children Trend towards increasing obesity in children Food insecurity is related to poor access & consumption of veggies & fruit and consumption of unhealthy choices Lack of physical activity High rates of physically inactive (44.1%)

19

20 Risk Factors for chronic disease in BC Smoking Young adults highest prevalence rate in BC More likely than older adults to be social smokers 45% of daily smokers began between the ages of 18 and 29 years

21 Healthy Living: Targets for 2010 CURRENT STATE [Source: BCHLA] 8/10 do not smoke BCHLA TARGETS 9/10 will not smoke ActNow BC TARGETS 8.5/10 will not smoke 4/10 eat at least 5 servings of vegetables & fruit a day 6/10 are physically active 5/10 are a healthy weight 225,000 British Columbians 7/10 will eat over 5 servings of vegetables & fruit a day + 948,000 British Columbians 7/10 will be physically active + 351,000 British Columbians 7/10 will be a healthy weight 5/10 will eat at least 5 servings of vegetables & fruits a day 7/10 will get enough activity for health benefits 7/10 will be at a healthy weight + 349,000 British Columbians

22 British Columbia Population Number of Smokers and Former Smokers If BCHLA Targets Acheived 225, , , ,000 # of Individuals 500, , , , , Year Current Smokers Former Smokers

23 Considering the Social and Economic Determinants of Health Health is not equitably distributed Need to consider other social and economic factors Major focus of BCHLA Work in past three years Getting traction with wide range of groups particularly with respect to children

24 LE 0 for BC Total Population ( ) by Local Health Area Stikine Telegraph Creek Fort Nelson Snow Country Queen Charlotte Nisga'a Upper Skeena Prince Rupert Terrace Prince Rupert Queen Charlotte Kitimat Kitimat Kitimat Smithers Nechako Central Coast Central Coast Burns Lake Peace River North Peace River South Life Expectancy at Birth Central Coast Central Coast Prince George Central Coast Bella Coola Valley Central Coast Quesnel Vancouver Island North Vancouver Island North Cariboo-Chilcotin Vancouver Island West Campbell River Vancouver Island West Campbell River 100 Mile HouseNorth Thompson CourtenayPowell River Lillooet Sunshine Coast Howe Sound Alberni South Cariboo Kamloops Maple Ridge Golden Revelstoke Nanaimo Agassiz-Harrison Salmon Arm Lake Cowichan Merritt Mission Hope Enderby Sooke Vernon Princeton Saanich Chilliwack Arrow Lakes Keremeos Kootenay LakeWindermere Kettle Valley Grand Forks Nelson Kimberley Trail Creston Cranbrook Fernie North Vancouver City Centre Westside North East Midtown Burnaby Richmond Richmond Delta Delta

25 BC Poverty rate by family type Elderly Married Couples (couple means no children) Non-Elderly Married Couples Tw o-parent Families Female Lone-parent families (Based on after-tax income, standardized to 2006 dollars. Data source: Statistics Canada Income Trends in Canada 2006)

26

27 Percentage of food insecure households in BC by income deciles (2005) (1 = lowest household income level; 10 = highest household income level) 25.0% 22.2% 20.0% 15.0% 12.7% 10.0% 7.9% 5.0% 5.4% 3.8% 3.7% 0.8% 0.0% DECILE 1 DECILE 2 DECILE 3 DECILE 4 DECILE 5 DECILE 6 DECILE 7-10 (Data source: Statistics Canada Canadian Community Health Survey Cycle )

28 Heart disease in BC by income Prevalence of heart disease Men Women Age-Standardized Percentage Age-Standardized Percentage Lowest Lower Middle Higher Middle Highest 0 Lowest Lower Middle Higher Middle Highest Household Income Quartiles Household Income Quartiles (Data source: Statistics Canada Canadian Community Health Survey Cycle ; Percentages were standardized to the 2004 Canadian population as the reference with bootstrap weight valued provided by Statistics Canada. Confidence intervals for age-standardized percentages(45-64, 65+) were calculated with the method based on the gamma distribution developed by Fay and Feuer in 1997)

29 Diabetes in BC by income Prevalence of Diabetes Men Women Age-Standardized Percentage Age-Standardized Percentage Lowest Lower Middle Higher Middle Highest 0 Lowest Lower Middle Higher Middle Highest Household Income Quartiles Household Income Quartiles (Data source: Statistics Canada Canadian Community Health Survey Cycle ; Percentages were standardized to the 2004 Canadian population as the reference with bootstrap weight valued provided by Statistics Canada. Confidence intervals for age-standardized percentages(45-64, 65+) were calculated with the method based on the gamma distribution developed by Fay and Feuer in 1997)

30 Smoking in BC by income Prevalence of Smoking Men Women Age-Standardized Percentage Age-Standardized Percentage Lowest Lower Middle Higher Middle Highest 0 Lowest Lower Middle Higher Middle Highest Household Income Quartiles Household Income Quartiles (Data source: Statistics Canada Canadian Community Health Survey Cycle ; Percentages were standardized to the 2004 Canadian population as the reference with bootstrap weight valued provided by Statistics Canada. Confidence intervals for age-standardized percentages(25-44, 45-64, 65+) were calculated with the method based on the gamma distribution developed by Fay and Feuer in 1997)

31 Benefits of addressing health inequities Improves the health of all Reduce costs of lost productivity, improved health of people and communities increases competitiveness productivity and profitability Decrease demand for health services

32

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34 Healthy Living in BC While we are a relatively healthy population in BC there is much work to be done BC Government planning some new initiatives on healthy living expect announcements soon. Increasing information in the media and social media on healthy living But still many challenges to be overcome

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