DETERMINANTS OF HEALTH

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1

2 DETERMINANTS OF HEALTH Diseases Risk factors Determinants Heart Cancer Lung Stroke Arthritis Depression Tobacco Alcohol Diet Physical Fitness Social Fitness Economic status Education Worklife Environment Social support Genetics Gender Child life Culture Lifestyles and coping Health Services

3

4 THINKING BIG Values Impact Changes Emotions Numbers Differences

5 BIG VALUES What does this community value the most? What do you value the most? If they are not the same, how do you align values?

6 WEIGHING THE BENEFITS Individual Experience Population Experience

7 40 Percentage of Children less than 6 years Living in Low- Income, 2011 Census

8 60.0 Prevalence of Low-income based on LIM (after tax) for Population under 6 living in Private Households Canada BC West Coast Regional Districts South Port Central Port North Port

9 % HIGH INCOME FAMILIES Lower proportions of both low income family units and high income family units make the West Coast relatively unique in having reduced economic inequity BC Canada Regional Districts North Port South Port West Coast Central Port

10 VALUE - EQUITY Figure 3 Vancouver Island Life Expectancy of First Nations and non-first Nations Source: BC Vital Statistics Agency, data as of April 17, 2012 (First Nations individuals identified through linkage to the First Nations Client File

11 BIG NUMBERS What just feels like it is too little or too much? What causes the most number of problematic events?

12 EARLY DEVELOPMENT INDEX A relatively good news story but still 30% of children starting school are not prepared.

13 Children in Care Island Health, Gulf Islands 66 Lake Cowichan 63 Saanich 71 Courtenay 69 Qualicum 61 Greater Victoria Island Health 72 CRVI What this chart means is that there are four times as many children in care in the Alberni area compared with the BC average seems high. 68 Nanaimo 62 Sooke 67 Ladysmith 65 Cowichan 70 Alberni 85 VI North Percentage Variation from BC Rate Children in Care 2012 Children in Care 2011 Children in Care 2010

14 BIG DIFFERENCES What stands out when compared with others?

15 % SINGLE (NEVER MARRIED) Regional Districts North Port South Port Central Port British Columbia Canada West Coast

16 % SPENDING OVER 30% OF THEIR INCOME ON HOUSING North Port South Port Canada Regional Districts British Columbia Central Port West Coast

17 Life Expectancy of Alberni Residents Compared to Cowichan, Courtenay, Island Health and BC to Alberni Cowichan Courtenay BC Total Vancouver Island

18 88 Life Expectancy of Island Health Residents Compared to Island Health and BC Female Male BC Female BC Male Island Health Female Island Health Male LHA 85 - VI North LHA 70 - Alberni LHA 72 - Campbell River LHA 67 - Ladysmith LHA 66 - Lake Cowichan LHA 68 - Nanaimo LHA 65 - Cowichan LHA 71 - Courtenay LHA 62 - Sooke LHA 61 - Greater Victoria LHA 69 - Qualicum LHA 64 - Gulf Islands LHA 63 - Saanich Did anyone catch that while life expectancy overall is lower, that Alberni males have the lowest life expectancy on the Island?

19 BC STATS SOCIO-ECONOMIC INDEX Socio-Economic Index BC Stats LHA 63 - Saanich LHA 64 - Gulf Islands LHA 62 - Sooke LHA 71 - Courtenay LHA 69 - Qualicum LHA 61 - Greater Victoria LHA 67 - Ladysmith LHA 65 - Cowichan LHA 72 - Campbell River LHA 68 - Nanaimo LHA 66 - Lake Cowichan LHA 85 - VI North LHA 70 - Alberni

20 LABOUR FORCE PARTICIPATION West Coast Canada British Columbia Regional Districts South Port Central Port North Port

21 BIG CHANGES Monitoring data over time. o o o Downward trending (or something bad getting more common). Upward trending (or something getting better). No changes (may be good or bad).

22 % OF MARRIED OR LIVING COMMON-LAW FAMILIES OVER THREE CENSUS British Columbia West Coast Census 2001 Census 2006 Census 2011

23 FAMILY STRUCTURE LHA 70 Male One-parent Families Lone-parent Families Female Lone-parent Families Common-law Singles Senior Living Alone Widowed Separated or Divorced Adults Living Alone Married Percentage Variation from Island Health Rate 2011 Census 2006 Census

24 % SPENDING >30% OF INCOME ON ACCOMMODATION OVER TIME British Columbia West Coast Census 2001 Census 2006 Census 2011

25 BIG IMPACT Attributable risk fraction Preventable fraction What can you do that will make a difference locally? Internally directed actions Externally directed activity

26 HIGH SCHOOL SIX YEAR GRADUATION RATE / / / / /14 Alberni - SD Nanaimo-Ladysmith - SD BC

27 EDI VULNERABILITY BY LHA 60 Vulnerability on One or More Scales, w4 w5 10 0

28 BIG EMOTIONS Feeling good facilitates doing more and better. Early wins Celebrations of success

29 % ABORIGINAL Canada British Columbia North Port South Port Regional Districts Central Port West Coast

30 DATA DRIVEN ACTION Information is a catalyst for change. Data empowers people. Data enables decision makers to improve the quality of their decisions. Data may dissuade poorer decisions.

31 KEY DATA SOURCES Census and National Household Survey LHA profiles ( ) McCreary adolescent health survey HELP BC Statistics

32 SUMMARY Many dimensions - slicing and dicing is driven by values. Process of getting there just as important as outcome. Different people have different perceptions - guided by their personal values transparency and equity Own the podium Big wins come with Big effort Big effort follows from Big Commitment

33 PAUL HASSELBACK MD MSC FRCPC

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