Health Profile 2011 - Fraser Health
Health Profile 2011 - Fraser Health
Health Profile 2011 - Fraser Health
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<strong>Health</strong> <strong>Profile</strong> <strong>2011</strong><br />
A look at the health of <strong>Fraser</strong> <strong>Health</strong> residents<br />
Prepared by:<br />
<strong>Health</strong> & Business Analytics, Population <strong>Health</strong> Analysis Team<br />
&<br />
The Office of the Medical <strong>Health</strong> Officer<br />
December <strong>2011</strong>
ii<br />
[This page was left blank intentionally]
Reproduction permitted if not for commercial redistribution.<br />
“The <strong>Fraser</strong> <strong>Health</strong> Authority” (FH) authorizes the use and reproduction of this<br />
publication for purposes other than commercial redistribution. In consideration of this<br />
authorization, the user agrees that for any modified reproduction of this publication all<br />
FRASER HEALTH copyright notices shall be removed, however, FRASER HEALTH shall<br />
be acknowledged as the author of the source publication. Reproduction or storage of<br />
this publication in any form by any means for the purpose of commercial redistribution<br />
is strictly prohibited.<br />
The contents of this report may be reproduced in entirety or in part, as long as the<br />
intended use is not for commercial purposes and that full acknowledgement is given to<br />
the report author <strong>Health</strong> & Business Analytics, <strong>Fraser</strong> <strong>Health</strong> Authority and, where<br />
necessary, the original data source provider.<br />
How to cite this document:<br />
<strong>Health</strong> & Business Analytics, <strong>Fraser</strong> <strong>Health</strong> Authority. <strong>Health</strong> <strong>Profile</strong> <strong>2011</strong>: A Snapshot of<br />
the <strong>Health</strong> of <strong>Fraser</strong> <strong>Health</strong> residents. Surrey, BC: <strong>Fraser</strong> <strong>Health</strong>, <strong>2011</strong>.<br />
How to cite figure or table copied from this report (example):<br />
BC Stats Socioeconomic <strong>Profile</strong>s. As reported in <strong>Health</strong> & Business Analytics, <strong>Fraser</strong><br />
<strong>Health</strong> Authority. <strong>Health</strong> <strong>Profile</strong> <strong>2011</strong>: A Snapshot of the <strong>Health</strong> of <strong>Fraser</strong> <strong>Health</strong><br />
residents. Surrey, BC: <strong>Fraser</strong> <strong>Health</strong>, <strong>2011</strong>.<br />
iii
<strong>Health</strong>y Child Development<br />
Dashboard: <strong>Fraser</strong> <strong>Health</strong> Compared to BC<br />
Current Rate BC Average Comparison Trend Page<br />
Low birth-weight rate per 1,000 live births 58.6 55.8 ↑ 62<br />
Exclusive breastfeeding in past 5 years 64.9% 60.6% √ n/a 64<br />
Early Development Index % children vulnerable Hope * 43% 31% V 70<br />
Physical Environment<br />
Motor vehicle use vehicles per person 0.48 0.46 ≈ ↑ 74<br />
Exposure to second-hand smoke<br />
in vehicles and/or public places<br />
<strong>Health</strong>y Living<br />
FN* 18.9% 16.7% V 78<br />
Tobacco use Ages 12+ FE* 16.6% 16.7% ≈ ↓ 82<br />
Fruit and vegetable consumption FE* 41.3% 43.8% ≈ V 88<br />
Leisure-time physical activity FS* 51.4% 59.3% ↓ 90<br />
Overweight and Obesity FE* 52.0% 44.7% V 92<br />
Disease Prevention<br />
Influenza immunization in hospital HCWs 30.5% 39.8% ↓ 102<br />
Diabetics - Two or more A1C tests/year 49% 50% ≈ ↑ 108<br />
General <strong>Health</strong> Status<br />
Teen birth rate per 1,000 teen females 7.8 10.2 √ ↓ 118<br />
Self-rated health FE* 52.7% 59.6% ↓ 120<br />
Self-rated mental health FE* 71.0% 71.0% ≈ V 122<br />
Morbidity<br />
Rate of new HIV cases (diagnosed in BC)<br />
per 100,000<br />
4.5 6.7 √ ↓ 136<br />
Diabetes mellitus prevalence 6.2% 5.3% ↑ 142<br />
Cardiovascular disease prevalence 3.2% 3.0% ≈ – 146<br />
Mortality<br />
Infant mortality per 1,000 3.4 3.9 ≈ ↓ 162<br />
Cancer mortality per 10,000 14.8 14.9 ≈ ↓ 174<br />
Cardiovascular disease mortality per 10,000 11.1 10.4 ≈ ↓ 175<br />
Cerebrovascular disease mortality per 10,000 3.4 3.5 ≈ ↓ 176<br />
Respiratory disease mortality per 10,000 5.6 5.2 ≈ – 177<br />
Infectious disease mortality per 10,000 1.0 1.0 ≈ ↑ 178<br />
Favourable to BC average √ Data trend in positive direction ↑ ↓<br />
Similar to BC average ≈ Data trend in negative direction ↑ ↓<br />
Unfavourable to BC average Data is stable –<br />
Data trend is variable<br />
V<br />
* Where <strong>Fraser</strong> <strong>Health</strong> level data was not available for the current rate, data is reported for the worst HSDA or LHA; for HSDAs, FN<br />
= <strong>Fraser</strong> North, FS = <strong>Fraser</strong> South, FE = <strong>Fraser</strong> East.<br />
iv
TABLE OF CONTENTS<br />
Table of Contents<br />
Dashboard: <strong>Fraser</strong> <strong>Health</strong> Compared to BC .....................................................................................iv<br />
Table of Contents ......................................................................................................................... 5<br />
POPULATION DEMOGRAPHICS............................................................................................... 7<br />
Population Estimates and Projections.............................................................................................. 8<br />
Population Distribution............................................................................................................ 9<br />
Current and Projected Population by Age and Sex................................................................... 10<br />
Predicted Population Growth ................................................................................................. 12<br />
Child and Youth Population ................................................................................................... 14<br />
Senior Population ................................................................................................................. 17<br />
Dependency Ratio ................................................................................................................ 20<br />
Aboriginal Identity................................................................................................................ 24<br />
Immigrant Population ........................................................................................................... 26<br />
HEALTH DETERMINANTS ....................................................................................................... 29<br />
Social & Economic Environment ................................................................................................... 30<br />
Home Language................................................................................................................... 30<br />
Education ............................................................................................................................ 32<br />
Lone-Parent Families ............................................................................................................ 38<br />
Individual and Family Income................................................................................................ 40<br />
Low Income Population ........................................................................................................ 44<br />
Income Assistance ............................................................................................................... 48<br />
Unemployment Rate & EI Beneficiaries .................................................................................. 50<br />
Food Security....................................................................................................................... 52<br />
Homelessness...................................................................................................................... 56<br />
Serious Crime Rates ............................................................................................................. 60<br />
<strong>Health</strong>y Child Development.......................................................................................................... 62<br />
Low Birth-Weight Rate.......................................................................................................... 62<br />
Breastfeeding ...................................................................................................................... 64<br />
Children in Government Care ................................................................................................ 68<br />
Early Childhood Development................................................................................................ 70<br />
Grades 4 and 7 Foundation Skills Assessment ......................................................................... 72<br />
Physical Environment .................................................................................................................. 74<br />
Motor Vehicle Use ................................................................................................................ 74<br />
Exposure to Second-hand Smoke........................................................................................... 78<br />
<strong>Health</strong>y Living ............................................................................................................................ 82<br />
Tobacco Use........................................................................................................................ 82<br />
Fruit and Vegetable Consumption .......................................................................................... 88<br />
Self-Reported Leisure Time Physical Activity ........................................................................... 90<br />
Overweight and Obesity: Self-Reported Body Mass Index ........................................................ 92<br />
Vitamin D Inadequacy .......................................................................................................... 96<br />
Disease Prevention ..................................................................................................................... 98<br />
Primary Prevention .................................................................................................................. 98<br />
School Immunization Coverage ............................................................................................. 98<br />
Influenza Immunization Coverage........................................................................................ 102<br />
Secondary Prevention .............................................................................................................106<br />
Screening Mammography Program (SMP)............................................................................. 106<br />
Tertiary Prevention.................................................................................................................108<br />
Diabetes Mellitus (DM) Management.................................................................................... 108<br />
5
HEALTH STATUS .....................................................................................................................111<br />
General <strong>Health</strong> Status .............................................................................................................112<br />
Life Expectancy at Birth ...................................................................................................... 112<br />
Live Birth Rates & Related Indicators ................................................................................... 114<br />
Teen Birth Rate.................................................................................................................. 118<br />
Self-Rated <strong>Health</strong> ............................................................................................................... 120<br />
Self-Rated Mental <strong>Health</strong> .................................................................................................... 122<br />
MORBIDITY ..............................................................................................................................124<br />
Leading Causes of Hospitalization ........................................................................................ 124<br />
Cancer Incidence – Child & Adult......................................................................................... 130<br />
Human Immunodeficiency Virus (HIV) ................................................................................. 136<br />
Chronic Disease ................................................................................................................. 140<br />
Primary <strong>Health</strong> Care (PHC) Patient Registry – Case Definitions............................................ 140<br />
a) Diabetes Mellitus (DM) ................................................................................................ 142<br />
b) Asthma ...................................................................................................................... 144<br />
c) Cardiovascular Disease and Congestive Heart Failure ..................................................... 146<br />
d) Depression/Anxiety ..................................................................................................... 150<br />
e) Hypertension.............................................................................................................. 152<br />
f) Stroke (Acute Cerebrovascular Syndrome) ..................................................................... 154<br />
g) Chronic Obstructive Pulmonary Disease (COPD) ............................................................ 156<br />
h) Osteoarthritis (OA)...................................................................................................... 158<br />
i) Dementia .................................................................................................................... 160<br />
MORTALITY ..............................................................................................................................162<br />
Infant Mortality .................................................................................................................. 162<br />
All Causes of Death – ASMR ................................................................................................ 168<br />
Potential Years of Life Lost – PYLL ....................................................................................... 170<br />
Age-Standardized Mortality Rate, by Natural Cause ............................................................... 172<br />
Age-Standardized Mortality Rate, by External Cause.............................................................. 180<br />
6
POPULATION DEMOGRAPHICS<br />
Population Demographics<br />
Information on population characteristics such as sex, age structure, and growth rate is<br />
important for planning community services. Population growth and aging are projected to have<br />
a significant effect on the usage and costs of services.<br />
7
POPULATION DEMOGRAPHICS<br />
Population Estimates and Projections<br />
Definition<br />
Population estimates and projections are<br />
developed annually by BC Stats using a<br />
methodology called P.E.O.P.L.E. (Population<br />
Extrapolation for Organizational<br />
Planning with Less Error). Data reported<br />
are from P.E.O.P.L.E 36. Data sets<br />
consist of population estimates (1986-<br />
2010) which incorporate information<br />
from 1986, 1991, 1996, 2001 and 2006<br />
Censuses of Canada, and population<br />
projections, which contain estimates<br />
from 1986 to 2010 and projections for<br />
<strong>2011</strong> to 2036. All figures are as of July<br />
1 st of the year stated; i.e., data periods<br />
(e.g. 1999/2000) are census year (July<br />
1 to June 30). For more information, see<br />
Methodology and Analysis on the BC<br />
Stats website.<br />
Population growth is the sum of the<br />
natural rate of increase (births minus<br />
deaths) plus net migration (which is the<br />
difference between movements into the<br />
region and those out of the region). Net<br />
migration is a key factor driving growth<br />
in <strong>Fraser</strong> <strong>Health</strong>.<br />
Population percent increase =<br />
End of period population - start of period population (100)<br />
Start of period population<br />
The dependency ratio represents the<br />
number of people in “dependent” age<br />
groups per 100 people in the “independent”<br />
age group. The “dependent”<br />
age groups are those generally<br />
presumed to be too young (aged ≤17)<br />
or too old (aged 65+) to work; the<br />
“independent” group are those of typical<br />
working age, 18 to 64 years.<br />
Limitations<br />
Data are produced annually. Discrepancies<br />
may exist with data presented in<br />
released or future reports due to ongoing<br />
amending and updating of data.<br />
Population projection models are<br />
sophisticated estimates based on<br />
previous census data; they are therefore<br />
only an indication of population growth.<br />
Projections do not take into account<br />
unexpected changes in population (e.g.,<br />
natural disasters, economic downfall).<br />
Data may also not fully reflect current<br />
population dispersion. Internal migration<br />
could affect the proportion of<br />
people living in each LHA while external<br />
migration could affect the total<br />
population in the health authority.<br />
8
POPULATION DEMOGRAPHICS<br />
POPULATION ESTIMATES & PROJECTIONS<br />
Population Distribution<br />
BC Population Distribution by <strong>Health</strong> Authority, <strong>2011</strong><br />
VCHA<br />
1,151,320<br />
25%<br />
BC Total = 4,584,102<br />
FHA<br />
1,635,340<br />
36%<br />
VIHA<br />
765,849<br />
17%<br />
IHA<br />
741,619<br />
16%<br />
NHA<br />
289,974<br />
6%<br />
<strong>Fraser</strong> <strong>Health</strong> Population Distribution by LHA, <strong>2011</strong><br />
FH Total = 1,635,340<br />
Mission<br />
43,439<br />
3%<br />
Abbotsford<br />
140,934<br />
9%<br />
Chilliwack<br />
87,905<br />
5%<br />
Hope<br />
8,298<br />
1%<br />
Agassiz/<br />
Harrison<br />
9,165<br />
1%<br />
Burnaby<br />
230,749<br />
14%<br />
Coquitlam<br />
224,619<br />
14%<br />
South Surrey/<br />
White Rock<br />
87,752<br />
5%<br />
Maple Ridge<br />
96,294<br />
6%<br />
New Westminster<br />
67,817<br />
4%<br />
Surrey<br />
403,249<br />
24%<br />
Langley<br />
134,008<br />
8%<br />
Delta<br />
101,111<br />
6%<br />
Source: BC Stats, Service BC, BC Ministry of Labour and Citizens' Services, P.E.O.P.L.E. 36 Projections.<br />
9
90+<br />
85-89<br />
80-84<br />
75-79<br />
70-74<br />
65-69<br />
60-64<br />
55-59<br />
50-54<br />
45-49<br />
40-44<br />
35-39<br />
30-34<br />
25-29<br />
20-24<br />
15-19<br />
10-14<br />
5-9<br />
1-4<br />
POPULATION DEMOGRAPHICS<br />
POPULATION ESTIMATES & PROJECTIONS<br />
<strong>Fraser</strong> <strong>Health</strong> Population Age Distribution, <strong>2011</strong><br />
500,000<br />
50%<br />
400,000<br />
40%<br />
Population<br />
300,000<br />
200,000<br />
30%<br />
20%<br />
Percent<br />
100,000<br />
10%<br />
0<br />
≤14 15-24 25-44 45-64 65+<br />
Count 271,777 223,149 460,157 449,513 230,744<br />
% of Total Pop 16.6% 13.6% 28.1% 27.5% 14.1%<br />
0%<br />
Projected Change in <strong>Fraser</strong> <strong>Health</strong> Population, <strong>2011</strong> to 2031<br />
50%<br />
by Age Groups<br />
40%<br />
Percent Change<br />
30%<br />
20%<br />
10%<br />
0%<br />
-10%<br />
≤14 15-24 25-44 45-64 65+<br />
<strong>2011</strong>-2021 16.8% -3.5% 24.7% 17.5% 46.2%<br />
2021-2031 12.7% 14.4% 9.0% 15.3% 40.1%<br />
Source: BC Stats, Service BC, BC Ministry of Labour and Citizens' Services, P.E.O.P.L.E. 36 Projections.<br />
11
Predicted Population Growth<br />
Population Growth Projections, by <strong>Health</strong> Authority<br />
2,500,000<br />
FHA IHA VCHA VIHA NHA<br />
2,000,000<br />
Population<br />
1,500,000<br />
1,000,000<br />
500,000<br />
0<br />
2001 2006 <strong>2011</strong> 2016 2021 2026 2031<br />
100%<br />
Predicted Distribution of BC Population by <strong>Health</strong> Authority, 2001-2031<br />
% of BC Population<br />
75%<br />
50%<br />
25%<br />
0%<br />
2001 2006 <strong>2011</strong> 2016 2021 2026 2031<br />
NHA 7% 7% 6% 6% 6% 6% 5%<br />
VIHA 17% 17% 17% 17% 16% 16% 16%<br />
VCHA 25% 25% 25% 25% 24% 24% 24%<br />
IHA 17% 16% 16% 16% 16% 15% 15%<br />
FHA 34% 35% 36% 37% 38% 39% 39%<br />
Vital Events & Net Migration Estimates in <strong>Fraser</strong> <strong>Health</strong><br />
40,000<br />
Births Deaths Net Migration<br />
30,000<br />
Population<br />
20,000<br />
10,000<br />
0<br />
2001 2006 <strong>2011</strong> 2016 2021 2026 2031<br />
Source: BC Stats, Service BC, BC Ministry of Labour and Citizens' Services, P.E.O.P.L.E. 36 Projections.<br />
12
POPULATION DEMOGRAPHICS<br />
POPULATION ESTIMATES & PROJECTIONS<br />
Projected Change in Population,<br />
<strong>2011</strong> to 2031<br />
Local <strong>Health</strong> Area<br />
Change<br />
in # of People %<br />
Burnaby 86,577 37.5%<br />
New Westminster 25,975 38.3%<br />
Coquitlam 113,436 50.5%<br />
Maple Ridge 37,117 38.5%<br />
Delta 12,392 12.3%<br />
Langley 86,133 64.3%<br />
Surrey 181,844 45.1%<br />
South Surrey/White Rock 25,523 29.1%<br />
Abbotsford 57,362 40.7%<br />
Mission 17,656 40.6%<br />
Chilliwack 30,194 34.3%<br />
Hope 167 2.0%<br />
Agassiz/Harrison 1,442 15.7%<br />
<strong>Fraser</strong> <strong>Health</strong> 675,818 41.3%<br />
<strong>Fraser</strong> <strong>Health</strong> Population Growth by Age Groups, <strong>2011</strong> to 2031<br />
Age <strong>2011</strong> 2016 2021 2026 2031<br />
≤14 271,777 290,528 317,406 340,374 357,685<br />
15-24 223,149 214,163 215,421 228,970 246,510<br />
25-44 460,157 515,034 573,803 609,890 625,565<br />
45-64 449,513 495,974 528,072 562,036 608,819<br />
65+ 230,744 279,685 337,252 403,828 472,579<br />
85+ 31,163 38,808 44,621 52,378 63,910<br />
All ages 1,635,340 1,795,384 1,971,954 2,145,098 2,311,158<br />
Percent Population Change, <strong>2011</strong> to 2031<br />
Age <strong>2011</strong>-2016 2016-2021 2021-2026 2026-2031<br />
≤14 6.9% 9.3% 7.2% 5.1%<br />
15-24 -4.0% 0.6% 6.3% 7.7%<br />
25-44 11.9% 11.4% 6.3% 2.6%<br />
45-64 10.3% 6.5% 6.4% 8.3%<br />
65+ 21.2% 20.6% 19.7% 17.0%<br />
85+ 24.5% 15.0% 17.4% 22.0%<br />
All ages 9.8% 9.8% 8.8% 7.7%<br />
Source: BC Stats, Service BC, BC Ministry of Labour and Citizens' Services, P.E.O.P.L.E. 36 Projections.<br />
13
Child and Youth Population<br />
Provincial Distribution of Children & Youth (Age ≤16), <strong>2011</strong><br />
BC Total = 792,545<br />
VIHA<br />
118,979<br />
15%<br />
NHA<br />
61,961<br />
8%<br />
VCHA<br />
176,611<br />
22%<br />
IHA<br />
122,286<br />
15%<br />
FHA<br />
312,708<br />
40%<br />
25%<br />
Proportion of Children & Youth (Age ≤16)<br />
in <strong>Health</strong> Authority Population, <strong>2011</strong><br />
20%<br />
Percent of Population<br />
15%<br />
10%<br />
5%<br />
0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Percent 19.1% 16.5% 15.3% 15.5% 21.4% 17.3%<br />
Count 312,708 122,286 176,611 118,979 61,961 792,545<br />
Source: BC Stats, Ministry of Labour and Citizens’ Services, P.E.O.P.L.E. 36 projections.<br />
14
POPULATION DEMOGRAPHICS<br />
CHILD & YOUTH<br />
Projected Child & Youth Population (Age ≤16)<br />
25%<br />
20%<br />
Percent of Total Population<br />
15%<br />
10%<br />
5%<br />
0%<br />
<strong>2011</strong> 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021<br />
FH 19.1% 18.9% 18.7% 18.5% 18.4% 18.4% 18.3% 18.3% 18.3% 18.2% 18.2%<br />
BC 17.3% 17.1% 16.9% 16.8% 16.8% 16.7% 16.7% 16.7% 16.7% 16.7% 16.7%<br />
# in FH 312,708 313,925 316,401 320,030 324,666 329,678 335,197 341,059 347,084 352,814 358,806<br />
350,000<br />
Number of Children & Youth in <strong>Fraser</strong> <strong>Health</strong>,<br />
by Sex and Age Group, <strong>2011</strong><br />
300,000<br />
250,000<br />
200,000<br />
150,000<br />
100,000<br />
50,000<br />
0<br />
Proportion of Children & Youth (Age ≤16) in LHA Populations, <strong>2011</strong><br />
Surrey<br />
Chilliwack<br />
Abbotsford<br />
Maple Ridge<br />
Mission<br />
Langley<br />
Agassiz/Harrison<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Coquitlam<br />
Delta<br />
BC<br />
Hope<br />
Burnaby<br />
South Surrey/White Rock<br />
New Westminster<br />
21.6%, (87,028)<br />
21.1%, (18,528)<br />
20.9%, (29,390)<br />
20.8%, (20,068)<br />
20.3%, (8,810)<br />
19.2%, (25,703)<br />
19.2%, (1,757)<br />
19.1%, (312,708)<br />
18.3%, (41,090)<br />
18.2%, (18,357)<br />
17.3%, (792,545)<br />
17.2%, (1,431)<br />
16.0%, (36,909)<br />
15.7%, (13,785)<br />
14.5%, (9,852)<br />
0% 10% 20% 30% 40% 50%<br />
Note: Values in parentheses represent the observed number of deaths in each area.<br />
Source: BC Stats, Ministry of Labour and Citizens’ Services, P.E.O.P.L.E. 36 projections.<br />
16
POPULATION DEMOGRAPHICS<br />
SENIOR POPULATION<br />
VIHA<br />
142,482<br />
20%<br />
Senior Population<br />
Provincial Distribution of Seniors (Age 65+), <strong>2011</strong><br />
BC Total = 699,363<br />
NHA<br />
33,340<br />
5%<br />
VCHA<br />
151,987<br />
22%<br />
FHA<br />
230,744<br />
33%<br />
IHA<br />
140,810<br />
20%<br />
25%<br />
Proportion of Seniors (Age 65+)<br />
in <strong>Health</strong> Authority Population, <strong>2011</strong><br />
20%<br />
Percent of Population<br />
15%<br />
10%<br />
5%<br />
0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Percent 14.1% 19.0% 13.2% 18.6% 11.5% 15.3%<br />
Count 230,744 140,810 151,987 142,482 33,340 699,363<br />
Source: BC Stats, Ministry of Labour and Citizens’ Services, P.E.O.P.L.E. 36 projections.<br />
17
Projected Senior Population (Age 65+)<br />
25%<br />
20%<br />
Percent of Population<br />
15%<br />
10%<br />
5%<br />
0%<br />
<strong>2011</strong> 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021<br />
FH 14.1% 14.5% 14.8% 15.0% 15.3% 15.6% 15.8% 16.1% 16.4% 16.8% 17.1%<br />
BC 15.3% 15.7% 16.2% 16.6% 17.0% 17.4% 17.8% 18.2% 18.6% 19.0% 19.4%<br />
# in FH 230,744 240,432 250,145 259,777 269,821 279,685 289,952 300,665 312,251 324,791 337,252<br />
250,000<br />
Number of Seniors in <strong>Fraser</strong> <strong>Health</strong>,<br />
by Sex and Age Group, <strong>2011</strong><br />
200,000<br />
150,000<br />
100,000<br />
50,000<br />
0<br />
65-74 75-84 85+ 65+ Total<br />
Females 65,006 41,068 20,377 126,451<br />
Males 60,631 32,876 10,786 104,293<br />
Both 125,637 73,944 31,163 230,744<br />
Source: BC Stats, Ministry of Labour and Citizens’ Services, P.E.O.P.L.E. 36 projections.<br />
18
POPULATION DEMOGRAPHICS<br />
SENIOR POPULATION<br />
Proportion of Seniors (Age 65+) in LHA Populations, <strong>2011</strong><br />
South Surrey/White Rock<br />
Hope<br />
Agassiz/Harrison<br />
Delta<br />
Chilliwack<br />
Langley<br />
BC<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Abbotsford<br />
Burnaby<br />
Surrey<br />
New Westminster<br />
Maple Ridge<br />
Mission<br />
Coquitlam<br />
26.4%, (23,127)<br />
21.5%, (1,781)<br />
19.2%, (1,758)<br />
18.3%, (18,478)<br />
16.6%, (14,578)<br />
16.4%, (21,938)<br />
15.3%, (699,363)<br />
14.1%, (230,744)<br />
13.4%, (18,950)<br />
13.0%, (30,015)<br />
12.8%, (51,472)<br />
12.5%, (8,450)<br />
11.8%, (11,337)<br />
11.4%, (4,969)<br />
10.6%, (23,891)<br />
0% 10% 20% 30% 40% 50%<br />
Note: Values in parentheses represent the observed number of deaths in each area<br />
Source: BC Stats, Ministry of Labour and Citizens’ Services, P.E.O.P.L.E. 36 projections.<br />
19
Dependency Ratio<br />
The dependency ratio represents the number of people in “dependent” age groups per<br />
100 people in the “independent” age group. The “dependent” age groups are those<br />
generally presumed to be too young (aged ≤17) or too old (aged 65+) to work; the<br />
“independent” group are those of typical working age, 18–64. Based solely on age<br />
structure, the dependency ratio does not account for those people in the “dependent”<br />
age groups who do work or for those in the “independent” age group who do not work.<br />
With the elimination of mandatory retirement at age 65 in BC as of January 1, 2008,<br />
increasing numbers of older adults are expected to remain in the workforce.<br />
<strong>Fraser</strong> <strong>Health</strong> Dependency Ratios* by Age Group<br />
50%<br />
40%<br />
Dependency Ratio<br />
30%<br />
20%<br />
10%<br />
0%<br />
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 <strong>2011</strong><br />
Child (≤17) 37.0% 36.1% 35.6% 35.2% 34.6% 34.3% 33.5% 32.7% 32.2% 31.6% 31.1%<br />
Senior (65+) 17.9% 18.0% 18.1% 18.3% 18.4% 18.7% 18.8% 18.9% 20.1% 21.3% 21.5%<br />
* Ratio of children aged ≤17 years to adults aged 18-64 years; Ratio of older adults aged 65-years and older to<br />
adults aged 18-64 years.<br />
Source: BC Stats, Ministry of Labour and Citizens’ Services, P.E.O.P.L.E. 36 projections (prepared by<br />
<strong>Health</strong> & Business Analytics)<br />
20
POPULATION DEMOGRAPHICS<br />
DEPENDENCY RATIO<br />
Projected Child & Youth Population (Age ≤17)<br />
25%<br />
20%<br />
Percent of Population<br />
15%<br />
10%<br />
5%<br />
0%<br />
<strong>2011</strong> 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021<br />
FH 20.4% 20.1% 19.9% 19.7% 19.6% 19.5% 19.4% 19.4% 19.3% 19.3% 19.3%<br />
BC 18.5% 18.3% 18.1% 17.9% 17.8% 17.8% 17.7% 17.7% 17.7% 17.7% 17.7%<br />
# in FH 333,513 334,875 337,085 340,331 344,637 349,901 355,250 361,166 367,413 373,703 379,663<br />
25%<br />
Projected Proportions of Seniors (Age 65+)<br />
20%<br />
Percent of Population<br />
15%<br />
10%<br />
5%<br />
0%<br />
<strong>2011</strong> 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021<br />
FH 14.1% 14.5% 14.8% 15.0% 15.3% 15.6% 15.8% 16.1% 16.4% 16.8% 17.1%<br />
BC 15.3% 15.7% 16.2% 16.6% 17.0% 17.4% 17.8% 18.2% 18.6% 19.0% 19.4%<br />
# in FH 230,744 240,432 250,145 259,777 269,821 279,685 289,952 300,665 312,251 324,791 337,252<br />
Source: BC Stats, Ministry of Labour and Citizens’ Services, P.E.O.P.L.E. 36 projections.<br />
21
Child (Age ≤17) Dependency Ratio* in LHA Populations, <strong>2011</strong><br />
Chilliwack<br />
Surrey<br />
Abbotsford<br />
Maple Ridge<br />
Agassiz/Harrison<br />
Mission<br />
Langley<br />
Delta<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Hope<br />
South Surrey/White Rock<br />
Coquitlam<br />
BC<br />
Burnaby<br />
New Westminster<br />
36.7%, (19,697)<br />
35.6%, (92,295)<br />
34.4%, (31,203)<br />
33.8%, (21,459)<br />
33.5%, (1,860)<br />
32.4%, (9,418)<br />
32.4%, (27,403)<br />
31.4%, (19,766)<br />
31.1%, (333,513)<br />
30.5%, (1,525)<br />
29.6%, (14,767)<br />
28.2%, (44,124)<br />
27.9%, (847,307)<br />
24.5%, (39,456)<br />
21.6%, (10,540)<br />
* Ratio of children aged ≤17 years to adults aged 18-64 years.<br />
0% 10% 20% 30% 40% 50%<br />
Seniors (Age 65+) Dependency Ratio in LHA Populations, <strong>2011</strong><br />
South Surrey/White Rock<br />
Hope<br />
Agassiz/Harrison<br />
Delta<br />
Chilliwack<br />
Langley<br />
BC<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Abbotsford<br />
Surrey<br />
Burnaby<br />
Maple Ridge<br />
New Westminster<br />
Mission<br />
Coquitlam<br />
15.3%, (23,891)<br />
27.2%, (14,578)<br />
25.9%, (21,938)<br />
23.0%, (699,363)<br />
21.5%, (230,744)<br />
20.9%, (18,950)<br />
19.8%, (51,472)<br />
18.6%, (30,015)<br />
17.9%, (11,337)<br />
17.3%, (8,450)<br />
17.1%, (4,969)<br />
29.4%, (18,478)<br />
35.7%, (1,781)<br />
31.7%, (1,758)<br />
46.4%, (23,127)<br />
0% 10% 20% 30% 40% 50%<br />
** Ratio of older adults aged 65 years and older to adults aged 18-64 years.<br />
Source: BC Stats, Ministry of Labour and Citizens’ Services, P.E.O.P.L.E. 36 projections (prepared by <strong>Health</strong> &<br />
Business Analytics)<br />
22
POPULATION DEMOGRAPHICS<br />
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23
Aboriginal Identity<br />
What are we looking at?<br />
Based on the 2006 Canadian Census,<br />
Aboriginal identity reports the number of<br />
people who identified themselves to be<br />
a registered Indian or a Band member,<br />
or they claimed Aboriginal ancestry, or<br />
reported identifying with an Aboriginal<br />
group – North American Indian (also<br />
known as First Nations), Inuit, or Métis.<br />
Defined as an Indian under the Indian<br />
Act, a registered Indian is someone<br />
assigned a number registered by the<br />
Department of Indian Affairs; most are<br />
members of a Band. There are also First<br />
Nations people who are not registered<br />
Indians. These are often persons or<br />
descendants of persons who lost their<br />
rights to be registered through disenfranchisement<br />
or through marriage to<br />
non-Indians before 1985. There are two<br />
other Aboriginal groups in Canada; the<br />
Inuit, or Aboriginal people of Northern<br />
Canada and the Arctic, and the Métis.<br />
Why do we care?<br />
Aboriginal peoples generally have lower<br />
life expectancy, worse health status,<br />
and poorer health outcomes than other<br />
British Columbians. Much of this<br />
disparity is linked to inequitable socioeconomic<br />
factors and stems from the<br />
experiences of Aboriginal peoples after<br />
colonization. 2<br />
Compared to other BC residents,<br />
Aboriginal people tend to have lower<br />
high school graduation rates, higher<br />
unemployment rates, and lower wages.<br />
Aboriginal peoples are more likely to<br />
experience food insecurity, to be loneparents,<br />
and to have a disproportionate<br />
number of children in government care.<br />
The prevalence of diabetes, heart<br />
disease, arthritis, and other chronic<br />
conditions is higher among Aboriginal<br />
peoples than among non-Aboriginal<br />
peoples. 2<br />
• Roughly, 38,105 residents of <strong>Fraser</strong><br />
<strong>Health</strong> self-identified as Aboriginal on<br />
the 2006 Census, accounting for 2.7%<br />
of the total population. Some 15,640<br />
registered Indians live in the <strong>Fraser</strong><br />
<strong>Health</strong> area.<br />
• The distribution of Aboriginal people<br />
across <strong>Fraser</strong> <strong>Health</strong> LHAs shows an<br />
east-west gradient; eastern LHAs have<br />
larger proportions of Aboriginal people<br />
in their population than western LHAs.<br />
• Surrey LHA has the largest actual<br />
number of Aboriginal people, followed<br />
by Chilliwack LHA, which has the<br />
largest number of registered Indians.<br />
However, Aboriginal people make up<br />
only 2.0% of Surrey compared to<br />
6.6% of Chilliwack.<br />
Limitations<br />
Census population data cannot include<br />
people who do not participate in the<br />
census (i.e., some young people, some<br />
Aboriginal reserve populations, and<br />
often the homeless).<br />
2 British Columbia, Provincial <strong>Health</strong> Officer. (2009).<br />
Pathways to health and healing - 2nd report on the health<br />
and well-being of Aboriginal people in British Columbia.<br />
Provincial <strong>Health</strong> Officer's annual report 2007. Victoria, BC:<br />
Ministry of <strong>Health</strong>y Living and Sport.<br />
24
POPULATION DEMOGRAPHICS<br />
ABORIGINAL POPULATION<br />
Aboriginal Population by LHA, 2006<br />
LHA<br />
Aboriginal Identity Registered Indian* Total<br />
Number Percent Number Percent Population<br />
Burnaby 3,005 1.5% 1,490 0.7% 200,855<br />
New Westminster 1,835 3.2% 735 1.3% 57,850<br />
Coquitlam 3,010 1.5% 895 0.5% 195,745<br />
Maple Ridge 2,480 3.0% 745 0.9% 84,030<br />
Delta 1,900 2.0% 740 0.8% 96,750<br />
Langley 3,460 3.0% 1,100 0.9% 116,900<br />
Surrey 6,830 2.0% 2,190 0.7% 334,430<br />
South Surrey/White Rock 1,185 1.6% 345 0.5% 76,440<br />
Abbotsford 3,805 3.1% 1,090 0.9% 122,800<br />
Mission 2,520 6.5% 960 2.5% 38,560<br />
Chilliwack 5,045 6.6% 2,850 3.7% 76,415<br />
Hope 1,315 16.6% 975 12.3% 7,920<br />
Agassiz/Harrison 1,715 21.6% 1,525 19.2% 7,940<br />
<strong>Fraser</strong> <strong>Health</strong> 38,105 2.7% 15,640 1.1% 1,416,640<br />
BC 196,070 4.8% 110,550 2.7% 4,074,385<br />
* Registered Indians are a subset of those with Aboriginal identity.<br />
Source: Statistics Canada, Census 2006.<br />
Source: Statistics Canada, Census 2006; Map prepared by <strong>Fraser</strong> <strong>Health</strong>, <strong>Health</strong> & Business Analytics.<br />
25
Immigrant Population<br />
What are we looking at?<br />
Immigrant population refers to all those<br />
who were born in another country, but<br />
have been granted the right to live in<br />
Canada permanently by immigration<br />
authorities. Children born in Canada to<br />
immigrant parents are considered nonimmigrants.<br />
Based on the 2006 Census,<br />
recent immigrants are those who came<br />
to Canada between 2001 and 2006.<br />
Using data provided by the Immigration<br />
Services Society of BC, community<br />
settlement patterns are presented for<br />
761 Government-Assisted Refugees who<br />
settled in BC in 2010, including the age<br />
and sex breakdown for these people.<br />
Why do we care?<br />
New immigrants can face many unique<br />
challenges, which can often leave them<br />
at a disadvantage. They may have a<br />
hard time adapting to life in Canada,<br />
have no social support network, and<br />
they can face challenges accessing<br />
health and social services because of<br />
language and cultural barriers. They<br />
may have difficulty finding employment<br />
and are more likely to have lower<br />
incomes than Canadian-born citizens<br />
are. These factors, amongst others,<br />
can take a toll on one’s well-being and<br />
contribute to poor health outcomes.<br />
32.2% in 2006. The majority of <strong>Fraser</strong><br />
<strong>Health</strong> immigrants arrived in Canada<br />
in the last 15 years (data not shown).<br />
• In 2010, more than 80% of government-assisted<br />
refugees in BC settled in<br />
the <strong>Fraser</strong> <strong>Health</strong> area, particularly in<br />
the communities of Surrey and<br />
Burnaby. Recent immigrants and<br />
refugees in particular face the most<br />
challenging disadvantages among all<br />
immigrants.<br />
• Among <strong>Fraser</strong> <strong>Health</strong> LHAs, Burnaby<br />
and Surrey have the largest proportion<br />
of immigrants in their populations<br />
overall, including the largest proportion<br />
of recent immigrants. Consulting<br />
with and engaging different ethnic/<br />
cultural communities informs and<br />
enhances service planning and<br />
program development.<br />
Distribution of Immigrants in British Columbia,<br />
by <strong>Health</strong> Authority, 2006<br />
n = 1,119,215<br />
<strong>Fraser</strong>, 42%<br />
Vancouver Coastal<br />
39%<br />
Northern, 2%<br />
Interior, 7%<br />
Vancouver Island<br />
10%<br />
• Over 40% of all immigrants in BC live<br />
in the <strong>Fraser</strong> <strong>Health</strong> region, comprising<br />
one third of the area’s population; the<br />
proportion of BC’s immigrants that live<br />
in <strong>Fraser</strong> <strong>Health</strong> is increasing. As well,<br />
the proportion of the <strong>Fraser</strong> <strong>Health</strong><br />
population who are immigrants has<br />
increased from 26.6% in 1996 to<br />
Source: Immigrant Services Society of BC, 2010<br />
Limitations<br />
The Canadian census excludes residents<br />
living in institutions.<br />
26
POPULATION DEMOGRAPHICS<br />
IMMIGRANT POPULATION<br />
Proportion of Immigrants in <strong>Health</strong> Authority Populations, 2006<br />
50%<br />
40%<br />
% Total Population .<br />
30%<br />
20%<br />
10%<br />
0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Recent immigrants** 5.9% 0.9% 7.5% 1.4% 0.7% 4.4%<br />
Long-term immigrants* 26.3% 11.4% 35.7% 15.2% 8.7% 23.1%<br />
# Recent immigrants 83,795 6,290 76,330 9,465 1,960 177,840<br />
# Long-term immigrants 372,125 76,400 362,800 106,165 23,860 941,365<br />
* Long-term immigrants are those who immigrated before 2001; ** recent immigrants are those<br />
who immigrated between 2001 and 2006.<br />
Proportion of Immigrants in LHA Populations<br />
by Period of Immigration, 2006<br />
Burnaby<br />
Surrey<br />
Coquitlam<br />
<strong>Fraser</strong> <strong>Health</strong><br />
New Westminster<br />
Delta<br />
BC<br />
Abbotsford<br />
South Surrey/White Rock<br />
Maple Ridge<br />
Langley<br />
Mission<br />
Agassiz/Harrison<br />
Chilliwack<br />
Hope<br />
39.9% 10.8%<br />
32.6%<br />
8.2%<br />
28.3%<br />
6.4%<br />
26.3%<br />
5.9%<br />
24.4%<br />
7.3%<br />
24.2%<br />
3.8%<br />
23.1%<br />
4.4%<br />
21.8%<br />
4.3%<br />
21.0%<br />
3.1%<br />
15.6% 2.2%<br />
14.6% 2.6%<br />
13.1% 1.9%<br />
14.5% 0.4%<br />
12.8% 1.0%<br />
12.9% 0.5%<br />
Immigrated before 2001<br />
Immigrated after 2001<br />
Source: Statistics Canada, Census 2006.<br />
0% 20% 40% 60% 80% 100%<br />
% Total Population<br />
27
Maple Ridge<br />
1.6%<br />
Community Settlement Patterns for<br />
Government-Assisted Refugees, 2010<br />
New Westminster<br />
5.1%<br />
n = 761<br />
Coquitlam<br />
18.9%<br />
Port Coquitlam<br />
1.3%<br />
Pitt Meadows<br />
1.2%<br />
Mission<br />
0.5%<br />
Burnaby<br />
23.5%<br />
Langley<br />
0.4%<br />
Delta<br />
0.4%<br />
Unknown<br />
0.4%<br />
Other BC<br />
communities<br />
13.5%<br />
Other provinces<br />
5.3%<br />
Surrey<br />
27.9%<br />
Source: Immigrant Services Society of BC, 2010.<br />
Age & Sex Breakdown for Government-Assisted Refugees,<br />
2010<br />
Age Group<br />
Female Male Total<br />
# % # % # %<br />
< 6 37 10.4% 47 11.6% 84 11.0%<br />
6-12 55 15.4% 79 19.5% 134 17.6%<br />
13-18 50 14.0% 58 14.3% 108 14.2%<br />
19-64 207 58.1% 217 53.6% 424 55.7%<br />
65+ 7 2.0% 4 1.0% 11 1.4%<br />
All Ages 356 46.8% 405 53.2% 761 100.0%<br />
Note: percentages reflect the proportion of females or males in each age group.<br />
Source: Immigrant Services Society of BC, 2010.<br />
28
HEALTH DETERMINANTS<br />
<strong>Health</strong> Determinants<br />
Social & Economic Environment<br />
The social and economic conditions in which people live affect their health. It is well<br />
documented that different socioeconomic groups experience different health outcomes; those in<br />
poorer environments are more likely to experience poorer health outcomes. Support from<br />
friends, families, and communities, higher levels of education and higher income are all<br />
associated with improved health status and life expectancy.<br />
<strong>Health</strong>y Child Development<br />
Children are the most valuable resource in our society and yet they are the most vulnerable<br />
because they are fully dependent on adults and society for their care. They are also the most<br />
responsive to the world in which they live. Positive environments and experiences keep children<br />
healthy, and have life-long health, social, and emotional effects. Supporting healthy child<br />
development can prevent future illness and disease, and in turn may reduce the growing<br />
burden on the health care system.<br />
The Physical Environment<br />
The presence of natural or man-made hazards in our environment can affect our health.<br />
Contaminants in our air, water, food, and soil at certain levels of exposure can cause a variety of<br />
health problems, including cancer, respiratory and gastrointestinal illness, birth defects, and other<br />
illness. How we build the environment around us, workplace and community safety, good<br />
transportation, well-designed neighbourhoods, and safe housing also contribute to good health.<br />
<strong>Health</strong>y Living<br />
Personal health practices can affect our health directly, for example, the foods we eat, and<br />
whether or not we smoke or exercise. Our health behaviours are determined both by the<br />
choices we make and by the choices available to us. A single parent with a long commute to<br />
work, for instance, may not have the time or energy to exercise despite the desire to do so.<br />
Maintaining a healthy body weight for our size contributes to good health.<br />
Disease Prevention<br />
Primary prevention describes measures that stop a disease or condition from occurring.<br />
Examples include better car design to improve collision avoidance and protection of passengers,<br />
in crashes, pollution controls, food safety, and immunization. Secondary prevention refers<br />
to measures that prevent further damage when a disease or condition has already occurred;<br />
for example, screening tests. Tertiary prevention is done in order to minimize the effect of the<br />
disease and prevent complications for a disease that has already occurred and caused damage;<br />
examples include diabetic education or cardiac rehabilitation.<br />
29
SOCIAL & ECONOMIC ENVIRONMENT<br />
Home Language<br />
What are we looking at?<br />
Home language refers to the language<br />
spoken most often at home by the<br />
individual at the time of the 2006<br />
Canadian census.<br />
Why do we care?<br />
This indicator provides information on<br />
language use. Language barriers affect<br />
the ability to communicate effectively<br />
with others who do not speak the same<br />
language. Language barriers can<br />
prevent people from accessing health<br />
care and ineffective translation or<br />
interpretation services can result in<br />
missed diagnoses and poorer treatment<br />
outcomes. Areas where languages other<br />
than English are commonly spoken at<br />
home may have lower levels of English<br />
fluency and/or literacy than other areas.<br />
Limitations<br />
Data are expressed as a percentage of<br />
single responses and multiple responses<br />
were excluded.<br />
Data provided on home language does<br />
not reveal anything about language<br />
proficiency or the language spoken at<br />
work, at school, or socially, so it does<br />
not show overall language habits.<br />
By itself, home language does not tell us<br />
anything about English fluency or<br />
literacy, which have important<br />
implications for service development,<br />
communication, and education.<br />
• Punjabi and Chinese are the most<br />
common non-English languages in<br />
<strong>Fraser</strong> <strong>Health</strong>, with Surrey, Burnaby,<br />
and Abbotsford LHAs having larger<br />
proportions of residents who speak<br />
these languages than other LHAs.<br />
Translation and interpretation of<br />
health services and information should<br />
be commonly available in these<br />
languages, particularly in these areas.<br />
• Translation and interpretation services<br />
should be accessible as needed in all<br />
areas of <strong>Fraser</strong> <strong>Health</strong> and for all<br />
common home languages.<br />
30
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Home Language: Most Common Languages Spoken at Home<br />
Other than English, <strong>Fraser</strong> <strong>Health</strong>, 2006<br />
Punjabi<br />
6.5%<br />
Chinese n.o.s.*<br />
Mandarin<br />
Korean<br />
Cantonese<br />
2.0%<br />
1.9%<br />
1.9%<br />
1.8%<br />
Tagalog (Pilipino)<br />
0.7%<br />
Hindi<br />
0.6%<br />
Vietnamese<br />
0.6%<br />
Persian (Farsi)<br />
Spanish<br />
0.6%<br />
0.6%<br />
French = 0.3%<br />
Other = 3.7%<br />
0% 2% 4% 6% 8% 10%<br />
* n.o.s. = not otherwise stated<br />
Percent<br />
Top Three Home Languages in <strong>Fraser</strong> <strong>Health</strong> LHAs,<br />
Percent of Total Single Responses, 2006<br />
Burnaby English (62.3%) Chinese (n.o.s. 1 ) (7.3%) Cantonese (6.9%)<br />
New Westminster English (81.2%) Punjabi (3.2%) Tagalog (1.8%)<br />
Coquitlam English (78.1%) Korean (3.8%) Cantonese (3.4%)<br />
Maple Ridge English (93.6%) Punjabi (0.9%) Korean (0.8%)<br />
Delta English (85.4%) Punjabi (7.0%) Mandarin (1.4%)<br />
Surrey English (66.7%) Punjabi (18.0%) Hindi (2.0%)<br />
S.Surrey/W. Rock English (92.6%) Korean (1.5%) Mandarin (1.3%)<br />
Langley English (93.1%) Korean (1.8%) Mandarin (0.8%)<br />
Abbotsford English (80.4%) Punjabi (13.8%) Korean (1.0%)<br />
Mission English (92.5%) Punjabi (4.2%) Korean (0.6%)<br />
Chilliwack English (96.3%) German (0.8%) Punjabi (0.3%)<br />
Hope English (95.9%) Korean (1.1%) Czech (0.9%)<br />
Agassiz/Harrison English (98.2%) German (0.4%) Dutch (0.3%)<br />
<strong>Fraser</strong> <strong>Health</strong> English (78.7%) Punjabi (6.5%) Chinese (n.o.s 1 ) (2.0%)<br />
Notes: 1 n.o.s. = not otherwise stated<br />
Source: Statistics Canada, Census 2006.<br />
31
Education<br />
What are we looking at?<br />
Six-year Dogwood completion rates<br />
track the proportion of students who<br />
graduate from high school with a<br />
Certificate of Graduation (Dogwood),<br />
within six years of starting Grade 8.<br />
Data are reported at the school district<br />
and provincial levels.<br />
Census data report the highest level of<br />
schooling, based on the highest grade<br />
or year of elementary or secondary<br />
school attended, or the highest level of<br />
post secondary schooling completed<br />
(university or other non-university) for<br />
the population age 25 years and older.<br />
Why do we care?<br />
Schooling is linked to income, with those<br />
with less education being more likely to<br />
have lower incomes. A lack of education<br />
and poverty are both associated with<br />
unhealthy lifestyles and poor well-being.<br />
Lower education levels can also increase<br />
the likelihood of functional illiteracy,<br />
making health promotion and access to<br />
healthcare problematic as illiterate<br />
people cannot read health literature or<br />
instructions.<br />
• Chilliwack school district has the worst<br />
high school completion rates in <strong>Fraser</strong><br />
<strong>Health</strong>, with only 69% of students<br />
graduating from high school within six<br />
years of starting Grade 8.<br />
• In general, high school completion<br />
rates are lower among boys than<br />
among girls; in 2009/10, <strong>Fraser</strong>-<br />
Cascade was the only school district in<br />
<strong>Fraser</strong> <strong>Health</strong> with better rates among<br />
boys.<br />
• Aboriginal students have high school<br />
completion rates far below average. In<br />
Burnaby, roughly one in every three<br />
Aboriginal students graduated within<br />
six years.<br />
• Students with English as a Second<br />
Language (ESL) in Chilliwack have<br />
worse dogwood completion rates than<br />
their peers in other school districts.<br />
• Looking at the highest level of<br />
schooling, one out of every six <strong>Fraser</strong><br />
<strong>Health</strong> residents 25-years and older<br />
has not completed high school.<br />
• There is large variability in proportions<br />
of educated residents across LHAs,<br />
with LHAs in the west having more<br />
educated residents than in the east.<br />
• In <strong>Fraser</strong> <strong>Health</strong>, Coquitlam and South<br />
Surrey/White Rock LHAs have the<br />
smallest proportion of residents whose<br />
highest level of education is below<br />
high school, but the proportions are<br />
still higher than that of West Side LHA<br />
in Vancouver Coastal <strong>Health</strong>.<br />
• West Side LHA in Vancouver Coastal<br />
<strong>Health</strong> has 25% more of its 25+<br />
population with a university degree<br />
than the best LHA in <strong>Fraser</strong> <strong>Health</strong><br />
(Burnaby LHA).<br />
Limitations<br />
Only formal education is captured;<br />
people may be self-taught, acquiring<br />
knowledge and skills through the media,<br />
libraries, and other resources.<br />
Census data is not adjusted for the age<br />
structure of the LHA population. Areas<br />
with older populations may have a<br />
higher percentage of people without<br />
formal education.<br />
32
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Six-Year High School Dogwood Completion Rates<br />
by School District, 2009/10<br />
Coquitlam<br />
Delta<br />
Abbotsford<br />
Langley<br />
Surrey<br />
Burnaby<br />
Mission<br />
BC<br />
Maple Ridge-Pitt Meadows<br />
New Westminster<br />
<strong>Fraser</strong>-Cascade<br />
Chilliwack<br />
70.0%<br />
69.1%<br />
77.6%<br />
74.1%<br />
82.5%<br />
82.1%<br />
80.8%<br />
80.1%<br />
79.7%<br />
88.6%<br />
86.6%<br />
85.9%<br />
0% 25% 50% 75% 100%<br />
Six-Year High School Dogwood Completion Rates, by Sex<br />
by School District, 2009/10<br />
Boys Girls<br />
Coquitlam<br />
Abbotsford<br />
Delta<br />
Burnaby<br />
Langley<br />
Surrey<br />
Mission<br />
BC<br />
Maple Ridge-Pitt Meadows<br />
New Westminster<br />
Chilliwack<br />
<strong>Fraser</strong>-Cascade<br />
62.1%<br />
76.4%<br />
72.0%<br />
69.2%<br />
69.1%<br />
75.2%<br />
86.9%<br />
77.9%<br />
85.6%<br />
78.9%<br />
83.2%<br />
77.4%<br />
80.1%<br />
75.0%<br />
77.3%<br />
91.4%<br />
86.1%<br />
89.9%<br />
82.4%<br />
88.3%<br />
85.1%<br />
87.0%<br />
82.6%<br />
77.0%<br />
0% 25% 50% 75% 100%<br />
Source: BC Ministry of Education.<br />
33
Six-Year High School Dogwood Completion Rates<br />
for Aboriginal Students, by School District, 2009/10<br />
Aboriginal Students All Students<br />
80.1%<br />
Mission<br />
63.9%<br />
88.6%<br />
Coquitlam<br />
63.9%<br />
77.6%<br />
Maple Ridge-Pitt Meadows<br />
62.9%<br />
82.5%<br />
Langley<br />
62.5%<br />
86.6%<br />
Delta<br />
62.4%<br />
85.9%<br />
Abbotsford<br />
61.1%<br />
70.0%<br />
<strong>Fraser</strong>-Cascade<br />
52.6%<br />
82.1%<br />
Surrey<br />
51.8%<br />
79.7%<br />
BC<br />
50.4%<br />
69.1%<br />
Chilliwack<br />
45.4%<br />
74.1%<br />
New Westminster<br />
42.2%<br />
80.8%<br />
Burnaby<br />
30.1%<br />
0% 25% 50% 75% 100%<br />
Six-Year High School Dogwood Completion Rates<br />
for ESL ‡ Students by School District, 2009/10<br />
Abbotsford<br />
Coquitlam<br />
Delta<br />
Maple Ridge-Pitt Meadows<br />
Burnaby<br />
Surrey<br />
Langley<br />
BC<br />
Mission<br />
New Westminster<br />
90.4%<br />
90.4%<br />
89.9%<br />
85.4%<br />
84.8%<br />
84.7%<br />
84.6%<br />
81.5%<br />
78.2%<br />
77.1%<br />
Chilliwack<br />
67.1%<br />
<strong>Fraser</strong>-Cascade<br />
*<br />
0% 25% 50% 75% 100%<br />
‡ ESL = English as a Second Language; * Data suppressed because there were nine or fewer ESL students.<br />
Source: BC Ministry of Education.<br />
34
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
50%<br />
Highest Level of Education Achieved (Ages 25+),<br />
Less than High School*, Census 2006<br />
40%<br />
30%<br />
25.2%<br />
20%<br />
16.7%<br />
20.1%<br />
13.2%<br />
15.1%<br />
16.6%<br />
10%<br />
0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Highest Level of Education Achieved (Ages 25+),<br />
Less than High School*, by LHA, Census 2006<br />
Hope<br />
Abbotsford<br />
Agassiz/Harrison<br />
Mission<br />
Chilliwack<br />
Surrey<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
Maple Ridge<br />
Langley<br />
New Westminster<br />
Burnaby<br />
Delta<br />
Coquitlam<br />
South Surrey/White Rock<br />
West Side (VCHA)<br />
4.9%<br />
25.8%<br />
23.2%<br />
22.1%<br />
21.3%<br />
20.9%<br />
20.7%<br />
16.7%<br />
16.6%<br />
15.8%<br />
15.5%<br />
14.6%<br />
14.5%<br />
13.3%<br />
11.4%<br />
10.9%<br />
Best LHA in BC<br />
0% 10% 20% 30% 40% 50%<br />
* No certificate, diploma, or degree.<br />
Source: Statistics Canada, Census 2006.<br />
35
50%<br />
Highest Level of Education Achieved (Ages 25+),<br />
with University Bachelor's Degree or Higher, Census 2006<br />
40%<br />
33.8%<br />
30%<br />
20%<br />
19.6%<br />
20.4%<br />
21.7%<br />
10%<br />
12.4%<br />
11.2%<br />
0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Highest Level of Education Achieved (Ages 25+),<br />
University Bachelor's or Higher Degree by LHA, Census 2006<br />
West Side (VCHA)<br />
Burnaby<br />
Coquitlam<br />
South Surrey/White Rock<br />
New Westminster<br />
BC<br />
Delta<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Surrey<br />
Langley<br />
Abbotsford<br />
Maple Ridge<br />
Mission<br />
Hope<br />
Chilliwack<br />
Agassiz/Harrison<br />
29.5%<br />
25.1%<br />
24.5%<br />
23.9%<br />
21.7%<br />
21.5%<br />
19.6%<br />
16.4%<br />
15.4%<br />
14.0%<br />
12.6%<br />
10.9%<br />
10.5%<br />
10.2%<br />
9.9%<br />
55.6% - Best LHA in BC<br />
Source: Statistics Canada, Census 2006.<br />
0% 20% 40% 60% 80% 100%<br />
36
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
[This page was left blank intentionally]<br />
37
Lone-Parent Families<br />
What are we looking at?<br />
A lone-parent family refers to a mother<br />
or a father, with no spouse or commonlaw<br />
partner present, living in a dwelling<br />
with one or more children. Here,<br />
children refer to blood, step- or adopted<br />
children (regardless of age or marital<br />
status) who are living in the same<br />
dwelling as their parent.<br />
Limitations<br />
The Canadian census does not include<br />
institutionalized residents.<br />
Why do we care?<br />
Lone-parent families are more likely to<br />
have lower incomes than families with<br />
both parents present, and therefore are<br />
more likely to have a lower standard of<br />
living and poorer health status.<br />
Research also suggests that families<br />
with single parents often live in<br />
situations that are associated with an<br />
increased risk of a number of negative<br />
social, behavioural, and emotional<br />
outcomes for children.<br />
Percent Lone-Parent Families, by Family Head, 2006<br />
Percent of Census Families<br />
50%<br />
40%<br />
30%<br />
20%<br />
10%<br />
0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Female head 11.9% 11.3% 12.6% 12.2% 12.2% 12.0%<br />
Male head 2.9% 2.9% 2.9% 3.3% 4.0% 3.0%<br />
Source: Statistics Canada, Census 2006.<br />
• Across BC, females head the majority<br />
of lone-parent families; this is true in<br />
all of our LHAs. Lone-parent families<br />
headed by females earn less than do<br />
those headed by males (see Individual<br />
and Family Income on page 40).<br />
• Maple Ridge LHA (22.7%) has the<br />
largest proportion of lone-parent<br />
families that are headed by a male<br />
(data not shown).<br />
• Lone-parent families may need more<br />
services and enhanced access than<br />
others, particularly those with low<br />
income.<br />
• Hope and New Westminster LHAs<br />
have the largest percentages of loneparent<br />
families in <strong>Fraser</strong> <strong>Health</strong>.<br />
38
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Percent of Lone-Parent Families, <strong>Fraser</strong> <strong>Health</strong>,<br />
by Family Head<br />
15%<br />
Female head<br />
Male head<br />
11.2%<br />
12.2%<br />
11.9%<br />
Percent of Census Families<br />
10%<br />
5%<br />
2.2%<br />
2.9% 2.9%<br />
0%<br />
1996 2001 2006<br />
Source: Statistics Canada, Census 1996, 2001, and 2006.<br />
Percent Lone-Parent Families, 2006<br />
Hope<br />
New Westminster<br />
Burnaby<br />
Mission<br />
Surrey<br />
Chilliwack<br />
BC<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Agassiz/Harrison<br />
Coquitlam<br />
Maple Ridge<br />
Abbotsford<br />
Langley<br />
Delta<br />
South Surrey/White Rock<br />
17.9% (415)<br />
16.7% (2,605)<br />
16.6% (9,285)<br />
16.0% (1,760)<br />
15.2% (14,375)<br />
15.2% (3,355)<br />
15.1%<br />
14.8% (59,700)<br />
14.7% (345)<br />
14.7% (8,215)<br />
14.5% (3,505)<br />
14.1% (4,915)<br />
13.8% (4,630)<br />
12.8% (3,610)<br />
11.9% (2,680)<br />
Source: Statistics Canada, Census 2006.<br />
0% 10% 20% 30% 40% 50%<br />
Percent (Count) of Census Families<br />
39
Individual and Family Income<br />
What are we looking at?<br />
Average individual income refers to the<br />
average total annual income after-tax<br />
for individuals age 15-years and older<br />
who reported income on the Census.<br />
Average family income refers to the<br />
average combined income for all<br />
members of an economic family after<br />
tax. An economic family refers to a<br />
group of two or more persons who live<br />
in the same dwelling and are related to<br />
each other by blood, marriage,<br />
common-law, or adoption.<br />
Lone-parent families refer to a male or a<br />
female lone-parent living with at least<br />
one child in the same dwelling.<br />
All income measures in this report are<br />
based on after-tax income from 2005 as<br />
reported on the 2006 Census. After-tax<br />
income is a better measure of spending<br />
power than total income because it<br />
accounts for both the reduced spending<br />
power that results from paying taxes<br />
and the added spending power that<br />
might be gained through government<br />
transfers (such as income assistance).<br />
• Men earn more on average than<br />
women earn.<br />
• Despite having the highest average<br />
income among LHAs, women in South<br />
Surrey/White Rock LHA still make less<br />
than the average income for men in<br />
<strong>Fraser</strong> <strong>Health</strong> overall.<br />
• Lone-parent families headed by males<br />
have higher average incomes across<br />
<strong>Fraser</strong> <strong>Health</strong> and BC than those that<br />
are headed by females.<br />
• Hope and Agassiz/Harrison LHAs have<br />
the lowest average incomes in <strong>Fraser</strong><br />
<strong>Health</strong>.<br />
Limitations<br />
Average family income does not account<br />
for family size or for how income might<br />
be distributed among family members.<br />
Census data reports on income for the<br />
year prior to the Census and excludes<br />
any who did not participate in the 2006<br />
Canadian Census.<br />
For information on low income and lowincome<br />
cut-offs (LICOs), please see the<br />
following section on Low Income<br />
Population on page 44.<br />
Why do we care?<br />
Income is a socioeconomic indicator<br />
used to study the links between social<br />
conditions and health. People with<br />
higher incomes tend to have better<br />
health status than those with lower<br />
incomes.<br />
40
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Average 2005 Family Income<br />
$100,000<br />
$80,000<br />
$60,000<br />
$68,641<br />
$59,301<br />
$74,207<br />
$63,770<br />
$65,351<br />
$67,200<br />
$40,000<br />
$20,000<br />
$0<br />
FHA IHA VCHA VIHA NHA BC<br />
Average 2005 Family Income, by LHA<br />
South Surrey/White Rock<br />
Delta<br />
Langley<br />
Coquitlam<br />
Maple Ridge<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
Surrey<br />
Abbotsford<br />
New Westminster<br />
Burnaby<br />
Mission<br />
Chilliwack<br />
Hope<br />
Agassiz/Harrison<br />
$85,376<br />
$78,763<br />
$73,583<br />
$72,370<br />
$69,780<br />
$68,641<br />
$67,200<br />
$65,663<br />
$65,195<br />
$65,157<br />
$63,531<br />
$61,648<br />
$60,139<br />
$51,317<br />
$49,943<br />
Source: Statistics Canada, Census 2006.<br />
$0 $25,000 $50,000 $75,000 $100,000<br />
41
Average 2005 Individual Income, Females, by LHA<br />
South Surrey/White Rock<br />
Delta<br />
New Westminster<br />
Coquitlam<br />
Langley<br />
Maple Ridge<br />
BC<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Burnaby<br />
Surrey<br />
Abbotsford<br />
Chilliwack<br />
Mission<br />
Hope<br />
Agassiz/Harrison<br />
$27,994<br />
$25,180<br />
$24,911<br />
$24,418<br />
$24,241<br />
$23,497<br />
$23,408<br />
$23,083<br />
$22,451<br />
$21,384<br />
$21,330<br />
$21,107<br />
$21,013<br />
$20,645<br />
$19,630<br />
$0 $10,000 $20,000 $30,000 $40,000 $50,000<br />
Average 2005 Individual Income, Males, by LHA<br />
South Surrey/White Rock<br />
Delta<br />
Langley<br />
Maple Ridge<br />
Coquitlam<br />
BC<br />
<strong>Fraser</strong> <strong>Health</strong><br />
New Westminster<br />
Chilliwack<br />
Abbotsford<br />
Mission<br />
Burnaby<br />
Surrey<br />
Hope<br />
Agassiz/Harrison<br />
$38,946<br />
$38,118<br />
$36,537<br />
$36,401<br />
$34,652<br />
$34,148<br />
$34,013<br />
$32,998<br />
$32,391<br />
$32,118<br />
$30,424<br />
$30,371<br />
$27,155<br />
$26,454<br />
$46,318<br />
Source: Statistics Canada, Census 2006.<br />
$0 $10,000 $20,000 $30,000 $40,000 $50,000<br />
42
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Average 2005 Income for Lone-Parent Families<br />
with Female Head<br />
South Surrey/White Rock<br />
Langley<br />
Delta<br />
Burnaby<br />
Surrey<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Maple Ridge<br />
Coquitlam<br />
BC<br />
New Westminster<br />
Abbotsford<br />
Mission<br />
Chilliwack<br />
Agassiz/Harrison<br />
Hope<br />
$48,679<br />
$45,055<br />
$44,807<br />
$41,430<br />
$40,632<br />
$40,531<br />
$39,885<br />
$39,542<br />
$39,031<br />
$38,331<br />
$37,866<br />
$37,190<br />
$33,407<br />
$30,545<br />
$27,580<br />
$0 $20,000 $40,000 $60,000 $80,000 $100,000<br />
Average 2005 Income for Lone-Parent Families<br />
with Male Head<br />
South Surrey/White Rock<br />
Delta<br />
Langley<br />
Coquitlam<br />
Mission<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Surrey<br />
Maple Ridge<br />
Burnaby<br />
BC<br />
Abbotsford<br />
New Westminster<br />
Chilliwack<br />
Hope<br />
Agassiz/Harrison<br />
$63,257<br />
$57,536<br />
$56,807<br />
$56,065<br />
$55,385<br />
$55,180<br />
$54,016<br />
$53,926<br />
$52,248<br />
$47,598<br />
$46,979<br />
$41,672<br />
$41,149<br />
$30,157<br />
$80,050<br />
Source: Statistics Canada, Census 2006.<br />
$0 $20,000 $40,000 $60,000 $80,000 $100,000<br />
43
What are we looking at?<br />
Low income is measured using the<br />
after-tax Low Income Cut-Offs (LICOs),<br />
a well-established measure of relative<br />
poverty and income distribution. The<br />
1992 Family Expenditure Survey found<br />
that, on average, Canadian families<br />
spend 43% of their after-tax income on<br />
basic necessities (food, shelter, and<br />
clothing). The low-income population,<br />
including families and individuals, are<br />
defined as those whose annual incomes<br />
fall below the LICO because they spend<br />
an additional 20% (i.e., more than<br />
63%) of their income on necessities.<br />
LICOs are calculated by the household<br />
size and the population size in the area<br />
of residence. 3<br />
The after-tax LICOs take into account<br />
the reduced daily spending power of<br />
families and individuals because of<br />
income taxes paid, which are set by<br />
government tax law and policies.<br />
The economic family consists of two or<br />
more people living together who are<br />
related by blood, marriage, commonlaw,<br />
or adoption.<br />
The “Living Wage” is another way of<br />
looking at this issue. 4 Different from the<br />
legislated minimum wage, a living wage<br />
is based on the real costs of living in a<br />
particular community and represents the<br />
hourly wage needed for a household to<br />
Low Income Population<br />
meet its basic needs. In <strong>2011</strong>, the living<br />
wage for two working parents in Metro<br />
Vancouver was calculated at $18.81 per<br />
hour for each parent, which is almost<br />
double the minimum wage. Visit A Living<br />
Wage for Families for more information.<br />
Why do we care?<br />
With less disposable income than the<br />
average family or individual, people with<br />
low incomes have a lower standard of<br />
living. They have less money available<br />
for other expenses such as health,<br />
education, transportation, or recreation.<br />
For example, in 2009, a single income<br />
earner making minimum wage will have<br />
a yearly salary (based on 2000 hours) of<br />
$13,930 ($1,161 per month) after-tax 5 ,<br />
which falls below the LICO and even<br />
further below the living wage. A man<br />
under the age of 30 living alone will<br />
spend nearly 80% of this salary on<br />
housing and food alone ($648 and<br />
$269.36 monthly for housing and food,<br />
respectively). 6 While income assistance<br />
is available, not all individuals and<br />
families with low income receive it. In<br />
several of our communities, about 20%<br />
of children under age 6 are living in lowincome<br />
families (pg 47); this has health<br />
and educational implications for the<br />
individual and for society, today and into<br />
the future.<br />
3 Statistics Canada. (2009). Low income cut-offs: What are<br />
the LICOs? Retrieved September 1, 2010, from<br />
http://www.statcan.gc.ca/pub/75f0002m/2009002/s2-<br />
eng.htm<br />
4 Ivanova, I., Klein, S., First Call BC Child and Youth<br />
Advocacy Coalition, A Living Wage for Families, & Canadian<br />
Centre for Policy Alternatives, BC Office. Working for a living<br />
wage: Making paid work meet basic family needs in Metro<br />
Vancouver. <strong>2011</strong> update. Canadian Centre for Policy<br />
Alternatives, BC Office. Retrieved December 1 <strong>2011</strong> from<br />
http://livingwageforfamilies.ca/<br />
5 Government of Alberta, Employment and Immigration<br />
(2009). Alberta minimum wage profile: April 2008 to March<br />
2009. Retrieved January 28, 2010 from:<br />
http://employment.alberta.ca.<br />
6 Dietitians of Canada, BC Region and the Community<br />
Nutritionists Council of BC (2009). The cost of eating in BC<br />
2009. Retrieved January 15, 2010 from:<br />
http://www.dietitians.ca/Secondary-Pages/Public/The-Costof-Eating-in-British-Columbia.aspx<br />
44
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Low income is also often associated with<br />
poor health status. Low income restricts<br />
a family’s ability to purchase adequate<br />
quantities of nutritious foods. People<br />
with little money to spend on food often<br />
have to purchase foods that satisfy<br />
hunger but are not nutritious.<br />
• Although Vancouver Coastal <strong>Health</strong><br />
has a larger proportion of low-income<br />
population, <strong>Fraser</strong> <strong>Health</strong> has a larger<br />
number of low-income people and<br />
families due to its larger population.<br />
There are an estimated 41,400 lowincome<br />
families in <strong>Fraser</strong> <strong>Health</strong>. Lowincome<br />
families typically have higher<br />
health care needs and require special<br />
consideration during service planning<br />
for issues such as transportation costs<br />
or the ability to afford recommended<br />
interventions like improved nutrition.<br />
• Proportions of families and individuals<br />
with low income vary widely among<br />
<strong>Fraser</strong> <strong>Health</strong> LHAs. Burnaby LHA has<br />
the largest proportion of low-income<br />
economic families, almost three times<br />
the proportion in South Surrey/White<br />
Rock. Burnaby LHA also has the<br />
largest proportions of low-income<br />
seniors and low-income families with<br />
children under age 6. It is important to<br />
target services in areas with high<br />
proportions of low-income seniors and<br />
families with young children.<br />
• In <strong>Fraser</strong> <strong>Health</strong>, 28% of lone-parent<br />
families headed by females have low<br />
income compared to 15% of loneparent<br />
families headed by males.<br />
Poverty reduction strategies can<br />
reduce the disparities and negative<br />
health outcomes that children living in<br />
low-income families can experience.<br />
Limitations<br />
The 2006 Census collected data on<br />
income earned in 2005, the year before<br />
the Census. Average family income does<br />
not take into account family size, or how<br />
income is shared and distributed among<br />
each member of the family. Statistics<br />
Canada clearly and consistently maintains<br />
that the LICOs are not measures<br />
of poverty; rather they reflect a<br />
consistent, well-defined methodology,<br />
which identifies those who are relatively<br />
worse-off financially than average.<br />
50%<br />
40%<br />
30%<br />
20%<br />
10%<br />
0%<br />
Burnaby<br />
New Westminster<br />
Surrey<br />
Coquitlam<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
Hope<br />
Mission<br />
Maple Ridge<br />
Abbotsford<br />
Agassiz/Harrison<br />
Delta<br />
Chilliwack<br />
Langley<br />
South Surrey/White Rock<br />
Low Income Population, 2005<br />
Total* Economic family** Lone-parent family<br />
FHA 13.2% 14.3% 25.1%<br />
IHA 9.1% 9.4% 20.4%<br />
VCHA 19.0% 19.0% 26.6%<br />
VIHA 9.8% 9.3% 19.2%<br />
NHA 8.5% 9.1% 21.2%<br />
BC 13.1% 13.3% 23.3%<br />
Low Income Population, 2005<br />
9.5%<br />
9.3%<br />
9.0%<br />
8.8%<br />
8.0%<br />
10.6%<br />
10.5%<br />
9.6%<br />
13.2%<br />
13.1%<br />
11.9%<br />
14.7%<br />
14.0%<br />
16.3%<br />
20.6%<br />
0% 10% 20% 30% 40% 50%<br />
Note: Categories are not exclusive:<br />
*Total low-income population includes all persons in lowincome<br />
private households including individuals and all<br />
family compositions;<br />
**Low Income Economic families include low income,<br />
lone-parent families.<br />
Source: Statistics Canada, Census 2006<br />
45
Low Income Economic Families, 2005<br />
Burnaby<br />
Coquitlam<br />
New Westminster<br />
Surrey<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
Hope<br />
Maple Ridge<br />
Abbotsford<br />
Mission<br />
Agassiz/Harrison<br />
Delta<br />
Chilliwack<br />
Langley<br />
South Surrey/White Rock<br />
12.0%<br />
11.8%<br />
11.3%<br />
10.8%<br />
9.9%<br />
8.8%<br />
8.2%<br />
8.2%<br />
8.1%<br />
7.5%<br />
7.4%<br />
6.7%<br />
6.6%<br />
5.9%<br />
17.3%<br />
0% 10% 20% 30% 40% 50%<br />
Low Income Lone-Parent Economic Families, 2005<br />
New Westminster<br />
13.6%<br />
34.4%<br />
Hope<br />
*<br />
33.9%<br />
Surrey<br />
Maple Ridge<br />
Burnaby<br />
Coquitlam<br />
18.7%<br />
18.6%<br />
17.7%<br />
14.6%<br />
30.2%<br />
30.2%<br />
29.7%<br />
29.4%<br />
Agassiz/Harrison<br />
*<br />
29.3%<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Abbotsford<br />
BC<br />
Chilliwack<br />
14.7%<br />
13.7%<br />
13.9%<br />
14.3%<br />
27.5%<br />
26.7%<br />
25.6%<br />
24.2%<br />
Mission<br />
23.0%<br />
7.4%<br />
Delta<br />
21.7%<br />
Female head<br />
9.6%<br />
Langley<br />
20.5%<br />
Male head<br />
10.1%<br />
South Surrey/White Rock<br />
6.8%<br />
15.9%<br />
0% 10% 20% 30% 40% 50%<br />
Note: *Statistics Canada did not calculate proportions for communities with small numbers (< 50).<br />
Source: Statistics Canada, Census 2006.<br />
46
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Children Under Age 6 Living in Low-Income Families, 2005<br />
Burnaby<br />
Agassiz/Harrison<br />
Hope<br />
Surrey<br />
New Westminster<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
Coquitlam<br />
Mission<br />
Abbotsford<br />
Chilliwack<br />
Delta<br />
South Surrey/White Rock<br />
Maple Ridge<br />
Langley<br />
16.1%<br />
15.3%<br />
15.1%<br />
13.2%<br />
12.7%<br />
12.7%<br />
12.1%<br />
11.1%<br />
10.7%<br />
10.6%<br />
9.9%<br />
22.5%<br />
21.4%<br />
19.2%<br />
19.0%<br />
0% 5% 10% 15% 20% 25%<br />
Low Income Seniors Age 65+, 2005<br />
Burnaby<br />
New Westminster<br />
Coquitlam<br />
Surrey<br />
Maple Ridge<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Delta<br />
Langley<br />
BC<br />
Mission<br />
Abbotsford<br />
Chilliwack<br />
South Surrey/White Rock<br />
Agassiz/Harrison<br />
Hope<br />
*<br />
*<br />
11.5%<br />
10.7%<br />
10.2%<br />
9.1%<br />
8.4%<br />
7.3%<br />
7.3%<br />
5.7%<br />
4.3%<br />
4.1%<br />
3.6%<br />
14.6%<br />
14.5%<br />
0% 5% 10% 15% 20% 25%<br />
Note: * Statistics Canada did not calculate proportions for communities with small numbers (< 50).<br />
Source: Statistics Canada, Census 2006.<br />
47
Income Assistance<br />
What are we looking at?<br />
This indicator reports the proportion of<br />
people with little or no income who<br />
receive government transfers. Income<br />
Assistance (IA) data are shown for<br />
children ≤14-years of age (previously<br />
reported for ages ≤18 years) receiving<br />
income support under BC’s Employment<br />
& Assistance program; the program<br />
covers adults and children ages ≤64-<br />
years along with people on temporary<br />
assistance and people with disabilities.<br />
The Guaranteed Income Supplement<br />
(GIS) is the assistance program for<br />
seniors (ages 65 and older) payable to<br />
pensioners with limited or no income<br />
beyond the Old Age Security plan.<br />
Why do we care?<br />
This is an indicator of poverty. However,<br />
not everyone with low income receives<br />
income assistance.<br />
Low income and poverty are associated<br />
with lack of adequate food, clothing,<br />
and shelter, which have significant<br />
implications for social and physical wellbeing.<br />
Children and the elderly are<br />
among society’s most vulnerable and<br />
are typically the most strongly affected<br />
by low income and poverty.<br />
10%<br />
8%<br />
6%<br />
4%<br />
2%<br />
0%<br />
10%<br />
Rock has the smallest proportions on<br />
both measures.<br />
• Among IA recipients in <strong>Fraser</strong> <strong>Health</strong><br />
33% of immigrant recipients are<br />
children, compared to 27% among<br />
Canadian-born recipients (not shown).<br />
Limitations<br />
Income assistance data are reported for<br />
September 2010, providing only a snapshot<br />
of benefit recipients.<br />
Children (Aged ≤14) Receiving Income Assistance Benefits:<br />
September 2010<br />
3.1%<br />
4.8%<br />
1.8%<br />
3.9%<br />
6.2%<br />
Source: Ministry of Human Resources compiled and provided<br />
by BC Stats.<br />
3.4%<br />
FHA IHA VCHA VIHA NHA BC<br />
Seniors 65+ Receiving Maximum GIS, 2010<br />
8%<br />
• There is disparity between <strong>Fraser</strong><br />
<strong>Health</strong> LHAs in terms of the proportion<br />
of children on income assistance, with<br />
higher prevalence in the east.<br />
• Surrey has the largest proportion of<br />
GIS recipients and the fourth largest<br />
proportion of children on income<br />
assistance, while South Surrey/White<br />
6%<br />
4%<br />
2%<br />
0%<br />
3.7%<br />
1.3%<br />
5.9%<br />
1.1%<br />
2.4%<br />
Source: Ministry of Human Resources compiled and provided<br />
by BC Stats.<br />
3.1%<br />
FHA IHA VCHA VIHA NHA BC<br />
48
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Children (Aged ≤14) Receiving Income Assistance Benefits:<br />
September 2010<br />
Hope<br />
Mission<br />
Chilliwack<br />
Surrey<br />
BC<br />
New Westminster<br />
Burnaby<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Abbotsford<br />
Agassiz/Harrison<br />
Langley<br />
Coquitlam<br />
Maple Ridge<br />
Delta<br />
South Surrey/White Rock<br />
0.8%<br />
1.5%<br />
4.1%<br />
3.4%<br />
3.2%<br />
3.1%<br />
3.1%<br />
2.9%<br />
2.6%<br />
2.4%<br />
2.3%<br />
2.3%<br />
5.1%<br />
4.9%<br />
8.5%<br />
0% 2% 4% 6% 8% 10%<br />
Seniors 65+ Receiving Maximum GIS, 2010<br />
Surrey<br />
Burnaby<br />
Coquitlam<br />
<strong>Fraser</strong> <strong>Health</strong><br />
New Westminster<br />
BC<br />
Delta<br />
Mission<br />
Abbotsford<br />
Hope<br />
Maple Ridge<br />
Langley<br />
Agassiz/Harrison<br />
Chilliwack<br />
South Surrey/White Rock<br />
3.7%<br />
3.5%<br />
3.1%<br />
2.7%<br />
2.3%<br />
2.2%<br />
1.9%<br />
1.7%<br />
1.5%<br />
1.5%<br />
1.2%<br />
0.9%<br />
5.1%<br />
6.0%<br />
6.9%<br />
0% 2% 4% 6% 8% 10%<br />
Source: Ministry of Human Resources compiled and provided by BC Stats.<br />
49
Unemployment Rate & EI Beneficiaries<br />
What are we looking at?<br />
Based on the 2006 Census, the unemployment<br />
rate is the percentage of<br />
unemployed people in the labour force 7<br />
during the week (Saturday to Sunday)<br />
before Census Day (May 16, 2006).<br />
Employment insurance (EI) beneficiaries<br />
are unemployed people receiving<br />
benefits through the EI program, not<br />
including people on parental or sick<br />
leave. Data represent the average of the<br />
most recent September (2010) and the<br />
previous June, March, and December.<br />
Why do we care?<br />
When someone loses their job or is not<br />
able to find work, not only do they lose<br />
their income, they can also lose their<br />
personal work relationships, daily<br />
routines, self-esteem, and sense of<br />
purpose. Unemployment can negatively<br />
affect emotional and mental well-being.<br />
It can also affect an individual’s ability<br />
to afford housing and enough nutritious<br />
food, which can affect overall health.<br />
Limitations<br />
The unemployment rate excludes people<br />
not in the labour force (i.e., who have<br />
never worked or who did not look for<br />
work in the week prior to Census Day).<br />
Not all people who are unemployed<br />
collect benefits; some are not covered<br />
by the system (e.g., self-employed),<br />
some are ineligible for benefits (e.g.,<br />
voluntary resignation without justifiable<br />
cause), some fail to make a claim, and<br />
others have used all of their benefits.<br />
12%<br />
10%<br />
8%<br />
6%<br />
4%<br />
2%<br />
0%<br />
Unemployment Rate, Ages 25+<br />
FHA IHA VCHA VIHA NHA BC<br />
1996 9.9% 7.7% 7.6% 8.2% 10.7% 8.4%<br />
2001 9.1% 5.9% 6.6% 7.4% 11.0% 7.2%<br />
2006 5.6% 4.5% 4.9% 4.8% 8.1% 5.1%<br />
Source: Statistics Canada, Census 2006.<br />
• Unemployment is higher in <strong>Fraser</strong><br />
<strong>Health</strong> than BC overall; rates are<br />
highest in Hope, Agassiz/Harrison, and<br />
Burnaby LHAs.<br />
• Northern <strong>Health</strong> has the highest<br />
unemployment rate and largest<br />
proportion of EI beneficiaries.<br />
• Vancouver Coastal and Vancouver<br />
Island have the lowest rates of<br />
unemployment and the smallest<br />
proportions of EI beneficiaries.<br />
7 Statistics Canada defines labour force as all employed and<br />
unemployed people age 15+; not including institutional<br />
residents. See the 2006 Census Dictionary for more details.<br />
% 19-64 Year Olds<br />
5%<br />
4%<br />
3%<br />
2%<br />
1%<br />
0%<br />
EI Beneficiaries Ages 19 to 64, September 2010*<br />
2.0%<br />
2.7%<br />
1.6%<br />
1.8%<br />
3.6%<br />
* Data represent a four-month average of EI beneficiaries in<br />
December 2009 and March, June, and September 2010.<br />
Source: Ministry of Housing and Social Development,<br />
Human Resources and Skills Development Canada and BC<br />
Stats. Retrieved September 1, <strong>2011</strong> from:<br />
http://www.bcstats.gov.bc.ca/data/sep/choose.asp<br />
2.1%<br />
FHA IHA VCHA VIHA NHA BC<br />
50
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Unemployment Rate by LHA and Sex, Ages 25+, 2006<br />
Hope<br />
Agassiz/Harrison<br />
Burnaby<br />
Surrey<br />
New Westminster<br />
Abbotsford<br />
BC<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Chilliwack<br />
Coquitlam<br />
Mission<br />
Delta<br />
Maple Ridge<br />
South Surrey/White Rock<br />
Langley<br />
Source: Statistics Canada, Census 2006.<br />
5.1%<br />
3.8%<br />
5.5%<br />
4.4%<br />
5.5%<br />
3.5%<br />
5.4%<br />
4.7%<br />
5.3%<br />
3.7%<br />
4.9%<br />
4.3%<br />
4.8%<br />
3.0%<br />
4.6%<br />
3.5%<br />
4.0%<br />
3.3%<br />
3.9%<br />
3.1%<br />
3.6%<br />
3.1%<br />
3.4%<br />
2.2%<br />
6.9%<br />
7.6%<br />
6.7%<br />
6.5%<br />
9.1%<br />
9.3%<br />
Women<br />
Men<br />
0% 2% 4% 6% 8% 10%<br />
EI Beneficiaries as Percent of Population Ages 19 to 64, by LHA,<br />
September 2010*<br />
Abbotsford<br />
Hope<br />
Surrey<br />
Mission<br />
BC<br />
New Westminster<br />
South Surrey/White Rock<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Maple Ridge<br />
Chilliwack<br />
Agassiz/Harrison<br />
Delta<br />
Burnaby<br />
Coquitlam<br />
Langley<br />
1.8%<br />
1.8%<br />
1.7%<br />
1.7%<br />
1.7%<br />
1.6%<br />
1.5%<br />
2.1%<br />
2.1%<br />
2.0%<br />
2.0%<br />
2.3%<br />
2.2%<br />
2.7%<br />
2.7%<br />
0% 1% 2% 3% 4% 5%<br />
% 19-64 Year Olds<br />
*Note: Data represent a four-month average of EI beneficiaries in December 2009 and March, June, and September<br />
2010.<br />
Source: Ministry of Housing and Social Development, Human Resources and Skills Development Canada and BC<br />
Stats. http://www.bcstats.gov.bc.ca/data/sep/choose.asp.<br />
51
Food Security<br />
What are we looking at?<br />
Food security measures people’s<br />
physical and economic access to safe,<br />
nutritious food. Food insecurity means<br />
either being worried about or not having<br />
enough food or quality or variety of<br />
foods to eat. The data is presented for<br />
the household, such that a household is<br />
food insecure if either an adult or a child<br />
or both experience food insecurity.<br />
The Canadian Community <strong>Health</strong> Survey<br />
sought data at the regional level<br />
through a series of questions used to<br />
formulate a food security index;<br />
summary responses are reported here.<br />
The BC <strong>Health</strong> and Wellness Survey<br />
(BC-HWS) sought to provide data at a<br />
more local level than previously<br />
available. The BC-HWS included six<br />
questions pertaining to respondent food<br />
security during the 12 months prior to<br />
survey participation. In 2006, only five<br />
communities in the <strong>Fraser</strong> <strong>Health</strong> region<br />
were surveyed.<br />
The sampling method, the questions to<br />
assess food security and the methods<br />
for analysis differ in the two surveys.<br />
Results are therefore not comparable.<br />
Why do we care?<br />
Food security is an integral part of<br />
healthy eating. A healthy, nutritious diet<br />
is in turn the basis for chronic disease<br />
prevention and healthy growth and<br />
development. When people experience<br />
food insecurity and do not have access<br />
to a ready supply of adequate foods,<br />
their health is compromised regardless<br />
of the availability of health care<br />
services.<br />
Households with lower incomes have<br />
higher rates of food insecurity, with<br />
30.2% of British Columbians at the<br />
lowest income quintile, based on<br />
household size, experiencing moderate<br />
or severe food insecurity.<br />
Where can we improve?<br />
• Women are more likely to be food<br />
insecure than men.<br />
• Of the communities surveyed in the<br />
BC-HWS, the highest percentage of<br />
food insecure respondents was in<br />
Mission; 1 in 5 women in Mission<br />
were food insecure.<br />
• In Hope and New Westminster, 40%<br />
of those who were food insecure<br />
reported that they did not have<br />
anywhere to go for help.<br />
Limitations<br />
Data are limited to those communities<br />
selected to participate in the BC-HWS<br />
2006 pilot study and cannot be<br />
generalized beyond areas sampled.<br />
Data from the two surveys cannot be<br />
compared to one another as they ask<br />
different questions and have other<br />
methodological differences.<br />
52
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Response<br />
Household Food Insecurity, 2007/08<br />
Percent of Respondents (95% Confidence Interval)<br />
Food secure<br />
Food insecure with<br />
moderate or severe hunger<br />
<strong>Fraser</strong> North 94.3% (92.5%-96.1%) 5.7% (3.9%-7.5%)<br />
<strong>Fraser</strong> South 94.2% (92.4%-96.0%) 5.8% (4.0%-7.6%)<br />
<strong>Fraser</strong> East 95.1% (93.4%-96.7%) 4.9% (3.3%-6.6%)<br />
BC 92.7% (92.1%-93.3%) 7.3% (6.7%-7.9%)<br />
Notes: The categories of food security are based on a method used by the United States Department of Agriculture.<br />
Detailed definitions can be found in the <strong>Health</strong> Canada report entitled ‘Income-Related Household Food Security in<br />
Canada’. 8<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Survey (CCHS), 2007/08.<br />
Percent of Male and Female Respondents<br />
Experiencing Food Insecurity*<br />
25%<br />
Males<br />
Females<br />
Percent of Respondents<br />
20%<br />
15%<br />
10%<br />
5%<br />
7.2%<br />
18.2%<br />
19.9%<br />
16.6%<br />
14.6%<br />
10.8%<br />
10.1% 10.3% 10.2%<br />
9.1%<br />
5.3% 5.4%<br />
0%<br />
Hope Mission Port<br />
Moody<br />
South Surrey<br />
White Rock<br />
New<br />
Westminster<br />
BC<br />
*Note: Respondents indicating that they either lacked money to have enough food, quality or variety of foods to eat,<br />
or who worried there might not be enough food are counted herein as respondents experiencing food insecurity.<br />
Source: BC Stats (2006), Ministry of Labour and Citizens' Services, and the Provincial <strong>Health</strong> Services Authority, 'BC<br />
<strong>Health</strong> and Wellness Survey.'<br />
8 <strong>Health</strong> Canada, Office of Nutrition Policy and Promotion <strong>Health</strong> Products and Food Branch (2007). Income-Related Household<br />
Food Security in Canada. Retrieved December 15, 2009 from http://www.hc-sc.gc.ca/fn-an/alt_formats/hpfbdgpsa/pdf/surveill/income_food_sec-sec_alim-eng.pdf.<br />
53
Food Insecurity, 2006<br />
HOPE<br />
Somewhere To<br />
Go**<br />
n = 30<br />
60%<br />
Food Secure<br />
n = 347<br />
87%<br />
Food Insecure*<br />
n = 50<br />
13%<br />
Nowhere To Go**<br />
n = 20<br />
40%<br />
Food Secure<br />
n = 341<br />
85%<br />
MISSION<br />
Food Insecure*<br />
n = 58<br />
15%<br />
Somewhere To<br />
Go**<br />
n = 43<br />
74%<br />
Nowhere To Go**<br />
n = 15<br />
26%<br />
Food Secure<br />
n = 385<br />
92%<br />
PORT MOODY<br />
Food Insecure*<br />
n = 35<br />
8%<br />
Somewhere To<br />
Go**<br />
n = 30<br />
85%<br />
Nowhere To Go**<br />
n = 5<br />
15%<br />
54
Food Insecurity, 2006<br />
SOUTH SURREY/WHITE ROCK<br />
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Food Secure<br />
n = 377<br />
93%<br />
Food Insecure*<br />
n = 30<br />
7%<br />
Somewhere To<br />
Go**<br />
n = 21<br />
70%<br />
Nowhere To Go**<br />
n = 9<br />
30%<br />
NEW WESTMINSTER<br />
Food Secure<br />
n = 354<br />
87%<br />
Food Insecure*<br />
n = 55<br />
13%<br />
Somewhere To<br />
Go**<br />
n = 33<br />
60%<br />
Nowhere To Go**<br />
n = 22<br />
40%<br />
Notes: *Food insecure respondents indicated that they either lacked money to have enough food, quality or variety<br />
of foods to eat, or that they worried there might not be enough food. **Respondents reported whether or not<br />
they had somewhere to go if they were worried about not having enough food or having poor quality food.<br />
Source: BC Stats (2006), Ministry of Labour and Citizens' Services, and the Provincial <strong>Health</strong> Services Authority, 'BC<br />
<strong>Health</strong> and Wellness Survey.'<br />
55
What are we looking at?<br />
Homeless people include those with no<br />
physical shelter (“street”), those in<br />
temporary emergency shelters, safe<br />
houses for youth, transition houses for<br />
women and their children (“sheltered”),<br />
or those temporarily staying somewhere<br />
where they do not pay rent (“hidden”).<br />
24-hour homeless counts are conducted<br />
periodically in Metro Vancouver and the<br />
Upper <strong>Fraser</strong> Valley; this section reports<br />
on counts done in 2008 and <strong>2011</strong> where<br />
available. 9,10 Metro Vancouver data for<br />
<strong>2011</strong> was taken from the preliminary<br />
report as the final report was not ready<br />
at time of preparing this profile. As<br />
such, only total counts are shown and<br />
further analyses and discussion of the<br />
numbers of homeless people who are<br />
sheltered or unsheltered will appear in<br />
the 2012 <strong>Health</strong> <strong>Profile</strong>.<br />
Why do we care?<br />
People lose their homes because they<br />
cannot afford to keep them or because<br />
they do not have the supports that they<br />
need to carry them through financial<br />
downturn or an episode of mental illness<br />
or addiction. Because mental illness and<br />
addictions tend to be cyclical yet long-<br />
9 van Wyk, R., van Wyk, A., & Bullock, N. (2008). We need<br />
to get a home: Report on homelessness in the upper <strong>Fraser</strong><br />
Valley, March 2008 survey. Abbotsford, BC: Upper <strong>Fraser</strong><br />
Valley Homelessness Survey Steering Committee.<br />
van Wyk, A. & van Wyk, R. (<strong>2011</strong>). Homelessness in the<br />
<strong>Fraser</strong> Valley: Report on the <strong>2011</strong> <strong>Fraser</strong> Valley Regional<br />
District homelessness survey.<br />
10 Social Planning and Research Council of BC, Eberle<br />
Planning and Research, Jim Woodward and Associates Inc.,<br />
Graves, J., Huhtala, K., Campbell, K., et al. (2008). Still on<br />
our streets...results of the 2008 Metro Vancouver homeless<br />
count. Vancouver, BC: Greater Vancouver Regional Steering<br />
Committee on Homelessness.<br />
Metro Vancouver Homeless Count <strong>2011</strong>: Preliminary Report.<br />
Retrieved November 1, <strong>2011</strong> from<br />
www.metrovancouver.org/planning/homelessness.<br />
Homelessness<br />
term, people may have difficulty maintaining<br />
long-term employment. In<br />
addition, alternate funding sources,<br />
including rent banks where available,<br />
may not be adequate to allow for permanent<br />
housing.<br />
A person without a home faces an<br />
increased risk of illness and death and<br />
meets barriers to social, economic, and<br />
health services.<br />
A growing number of people are<br />
homeless for longer than a year. They<br />
use large amounts of health care and<br />
other public services. Permanent<br />
supportive housing is a cost-saving<br />
solution to chronic homelessness.<br />
• The most recent survey shows the<br />
number of people who are homeless<br />
appears to be dropping.<br />
• In <strong>2011</strong>, 1,189 <strong>Fraser</strong> <strong>Health</strong> residents<br />
were counted as being homeless,<br />
roughly 40% of all homeless people<br />
counted across Metro Vancouver and<br />
the <strong>Fraser</strong> Valley Regional District.<br />
• In 2008, there were 2,660 street or<br />
sheltered homeless people in Metro<br />
Vancouver and an estimated 1,545 to<br />
16,846 hidden homeless. 10,11<br />
• The major change from 2008 to <strong>2011</strong><br />
was the increase in the proportion of<br />
homeless people who are in shelters<br />
rather than on the street (not shown).<br />
• As of March 31, 2009, <strong>Fraser</strong> <strong>Health</strong><br />
Mental <strong>Health</strong> and Substance Use had<br />
880 supported housing units and 600<br />
licensed residential beds, typically with<br />
11 Eberle, M., et al. (2009). Results of the pilot study to<br />
estimate the size of the hidden homeless population in<br />
Metro Vancouver. Retrieved November 4, 2010 from:<br />
http://intraspec.ca/HiddenHomelessreportjun102009.pdf.<br />
56
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
lengthy waitlists. There are also 194<br />
year-round shelter beds and 213<br />
extreme weather mats.<br />
Limitations<br />
Homeless counts are 24-hour snapshots<br />
capturing only those met during this<br />
time and likely underestimate the<br />
number of people who are homeless.<br />
Based on preliminary data, Metro<br />
Vancouver data may change with the<br />
final report.<br />
Homeless People in <strong>Fraser</strong> <strong>Health</strong><br />
1,500<br />
2002 2004/2005 2008 <strong>2011</strong><br />
1,364<br />
1,250<br />
1,189<br />
1,095<br />
1,000<br />
# Homeless<br />
750<br />
500<br />
394<br />
346<br />
461<br />
505<br />
498<br />
411<br />
465<br />
345<br />
250<br />
172<br />
223<br />
200<br />
0<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East <strong>Fraser</strong> <strong>Health</strong><br />
Sources: Metro Vancouver Homeless Counts, 2002, 2005, 2008, and <strong>2011</strong> (preliminary report); Upper <strong>Fraser</strong> Valley<br />
Homelessness Surveys, 2004, 2008, and <strong>2011</strong>.<br />
57
Number and Percentage of Homeless by Age Group, 2008<br />
50%<br />
40%<br />
30%<br />
20%<br />
10%<br />
0%<br />
≤24 25-34 35-44 45-54 55-64 65+ Unknown<br />
% of All Ages 13.0% 16.7% 26.7% 23.7% 6.8% 1.2% 11.9%<br />
Upper <strong>Fraser</strong> Valley 43 86 109 79 31 5 112<br />
Metro Vancouver 364 436 726 661 180 32 261<br />
Total 407 522 835 740 211 37 373<br />
Note: Metro Vancouver includes Vancouver and municipalities in <strong>Fraser</strong> <strong>Health</strong> (Burnaby, Delta, White Rock, the<br />
Langleys, Maple Ridge, New Westminster, Pitt Meadows, Surrey, and the Tri-Cities). The upper <strong>Fraser</strong> Valley<br />
includes regions in <strong>Fraser</strong> East (Abbotsford, Mission, Chilliwack, Agassiz/Harrison, Hope, and Boston Bar).<br />
Sources: Metro Vancouver Homeless Count, Upper <strong>Fraser</strong> Valley Homelessness Survey, 2008.<br />
Number and Percentage of Homeless by Gender, 2008<br />
Gender<br />
Upper<br />
<strong>Fraser</strong> Valley<br />
Metro<br />
Vancouver<br />
Total<br />
Percentage<br />
Female 142 619 761 24.4%<br />
Male 292 1,679 1,971 63.1%<br />
Transgendered 0 22 22 0.7%<br />
Unknown 31 340 371 11.9%<br />
Total 465 2,660 3,125 100.0%<br />
Sources: Metro Vancouver Homeless Count, Upper <strong>Fraser</strong> Valley Homelessness Survey, 2008.<br />
58
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Number and Percentage of Homeless by<br />
Type of <strong>Health</strong> Condition*, 2008<br />
100%<br />
80%<br />
60%<br />
40%<br />
20%<br />
0%<br />
Medical condition/<br />
Physical disability<br />
Mental illness Addiction Other<br />
% of All Respondents 74.0% 32.1% 61.3% 0.4%<br />
Upper <strong>Fraser</strong> Valley 109 69 150 11<br />
Metro Vancouver 1,722 725 1,365<br />
Total 1,831 794 1,515 11<br />
Note: * A respondent may have more than one health condition, so percentages do not sum up to 100%.<br />
Number and Percentage of Homeless by<br />
Length of Time of Homelessness, 2008<br />
50%<br />
40%<br />
30%<br />
20%<br />
10%<br />
0%<br />
What are we looking at?<br />
Two major categories of serious crime<br />
are reported herein: 1) violent crimes<br />
(homicide, attempted murder, sexual<br />
and non-sexual assault, and robbery)<br />
and 2) property crimes (break-and-enter<br />
only). The total serious crime rate<br />
includes only violent and property crime<br />
as described above. Other crimes, such<br />
as prostitution, mischief, gaming, motor<br />
vehicle theft, etc. are not included.<br />
Similarly, the two categories exclude<br />
offences under federal statutes (e.g.,<br />
drug offences) or provincial statutes<br />
(e.g., Securities Act, Liquor Control and<br />
Licensing Act). Criminal Code traffic<br />
offences, provincial and municipal traffic<br />
offences and violations, and other bylaw<br />
infractions are also excluded.<br />
The crime rate is the number of criminal<br />
code offences per 1,000 people based<br />
on the number of crimes reported within<br />
each jurisdiction.<br />
Geographic variation in crime rates may<br />
reflect differences in policing policies<br />
and practices between jurisdictions and<br />
also victim willingness to report crimes.<br />
A high crime rate often indicates a core<br />
area, where business and entertainment<br />
centres serve a large number of people,<br />
including people from other areas.<br />
Why do we care?<br />
Crime can affect health and well-being<br />
in a number of ways. Violent crimes<br />
directly impact health, whereas overall<br />
crime can indirectly impact health by<br />
increasing stress and anxiety, lowering<br />
the sense of community belonging, and<br />
limiting outdoor physical activity due to<br />
safety concerns.<br />
Serious Crime Rates<br />
• The overall crime rate is declining in<br />
BC; 12 in <strong>Fraser</strong> <strong>Health</strong>, the total and<br />
property crime rates have declined,<br />
but violent crimes increased.<br />
• Property crime is highest in Hope and<br />
Chilliwack, but violent crime is highest<br />
in New Westminster and Surrey.<br />
Limitations<br />
Unreported offences are not included<br />
and can be significant for certain types<br />
(e.g., property crime, sexual assault).<br />
Serious Crimes in BC <strong>Health</strong> Authorities, by Type<br />
per 1,000<br />
20.0<br />
15.0<br />
10.0<br />
5.0<br />
0.0<br />
FHA IHA VCHA VIHA NHA BC<br />
Violent Crime 3.78 2.75 3.93 2.35 4.63 3.46<br />
Property Crime 9.70 7.75 8.71 7.70 9.67 8.82<br />
Total Serious Crime 13.48 10.50 12.64 10.04 14.30 12.28<br />
% Change<br />
Rates per 1,000 People, 2007-2009 Average<br />
% Change in Crime Rates Between 2004-2006 & 2007-2009<br />
20%<br />
10%<br />
0%<br />
-10%<br />
-20%<br />
-30%<br />
-40%<br />
FHA IHA VCHA VIHA NHA BC<br />
Violent Crime 12.0% 16.2% -7.2% 0.2% 3.8% 4.1%<br />
Property Crime -21.3% -30.4% -29.9% -24.3% -24.5% -25.6%<br />
Total Serious Crime -14.2% -22.2% -24.1% -19.7% -17.2% -19.1%<br />
Source: Canadian Centre for Justice Statistics, Statistics<br />
Canada, and BC Stats; as reported in BC Stats’ Socioeconomic<br />
<strong>Profile</strong>s: Retrieved September 1, <strong>2011</strong> from:<br />
www.bcstats.gov.bc.ca/data/sep/choose.asp<br />
12 Province of British Columbia (<strong>2011</strong>). Crime statistics in<br />
British Columbia 2009. Retrieved November 2, <strong>2011</strong> from:<br />
http://www.pssg.gov.bc.ca/police_services/publications/.<br />
60
7.6<br />
8.9<br />
13.7<br />
13.0<br />
14.6<br />
14.6<br />
14.4<br />
15.5<br />
14.8<br />
14.8<br />
HEALTH DETERMINANTS<br />
SOCIAL & ECONOMIC ENVIRONMENT<br />
Serious Crime Rates per 1,000 People, by Type of Crime,<br />
2007-2009 Average<br />
Hope<br />
Chilliwack<br />
New Westminster<br />
Surrey<br />
Mission<br />
Langley<br />
Maple Ridge<br />
Burnaby<br />
Abbotsford<br />
South Surrey/White Rock<br />
Coquitlam<br />
Delta<br />
2.4<br />
2.0<br />
3.1<br />
3.6<br />
4.0<br />
3.7<br />
3.2<br />
4.0<br />
4.2<br />
4.8<br />
5.5<br />
5.0<br />
5.6<br />
6.6<br />
8.8<br />
10.0<br />
9.7<br />
10.8<br />
10.9<br />
10.4<br />
10.4<br />
11.6<br />
14.1<br />
0.0 5.0 10.0 15.0 20.0 25.0 30.0<br />
per 1,000 People<br />
17.7<br />
22.4<br />
27.2<br />
Total Serious Crime<br />
Property Crime<br />
Violent Crime<br />
Source: Canadian Centre for Justice Statistics, Statistics Canada, and BC Stats; as reported in BC Stats’ Socioeconomic<br />
<strong>Profile</strong>s: Retrieved September 1, <strong>2011</strong> from: www.bcstats.gov.bc.ca/data/sep/choose.asp<br />
61
HEALTHY CHILD DEVELOPMENT<br />
What are we looking at?<br />
Low birth-weight rate measures the<br />
number of live infants weighing less<br />
than 2,500 grams at birth per 1,000 live<br />
infants born each year.<br />
Why do we care?<br />
Low birth-weight is linked to infant<br />
mortality, physical disability, and longterm<br />
health problems, including heart<br />
disease, diabetes, chronic respiratory<br />
problems, difficulty learning, poor vision,<br />
and cerebral palsy. 13<br />
The main reasons for low birth-weight<br />
are premature birth (before 37 th week),<br />
stunted growth for gestational age, or<br />
both. Low birth-weight is more likely<br />
with multiple pregnancies, which are<br />
more common in women treated for<br />
infertility. Infection, genetics, human<br />
physiology, physical and social environments,<br />
nutrition and lifestyle, together<br />
with health service utilization, can also<br />
influence birth-weight. Low birth-weight<br />
is associated with smoking, poor diet<br />
during pregnancy, alcohol and/or drug<br />
abuse, low levels of vitamin D,<br />
preeclampsia, poverty, low education,<br />
and very young and older mothers.<br />
• Rates of low birth-weight infants in BC<br />
have been increasing steadily since<br />
1999-2003, with consistently higher<br />
rates in <strong>Fraser</strong> <strong>Health</strong> than BC overall.<br />
Low Birth-Weight Rate<br />
per 1,000 Live Births<br />
per 1,000 Live Births<br />
80<br />
60<br />
40<br />
20<br />
60<br />
55<br />
50<br />
45<br />
0<br />
• In <strong>Fraser</strong> <strong>Health</strong>, women ages 40 and<br />
older have the highest rate of low<br />
birth-weight infants, more than double<br />
that of women age 20 to 34-years.<br />
Limitations<br />
Data do not identify the cause of low<br />
birth-weight. The mother’s age affects<br />
low birth weight, and rates across LHAs<br />
were not adjusted for the age structure<br />
of the female population within the LHA.<br />
58.6<br />
Low Birth-Weight Rate, 2005-2009<br />
53.0<br />
57.6<br />
51.8<br />
48.9<br />
FHA IHA VCHA VIHA NHA BC<br />
53.5 53.2 53.1<br />
50.8 50.6<br />
Low Birth-Weight Rates<br />
50.2 50.2<br />
52.0 51.8<br />
<strong>Fraser</strong> <strong>Health</strong><br />
50.8<br />
53.7<br />
52.5<br />
54.9<br />
53.5<br />
BC<br />
56.2<br />
54.7<br />
57.7<br />
58.8<br />
55.8<br />
58.6<br />
55.6 55.9 55.8<br />
13 BC Ministry of Children and Family Development. (2006).<br />
Indicators of early childhood health and well-being in British<br />
Columbia, third report. Retrieved September 2, <strong>2011</strong> from<br />
http://www.cf.gov.bc.ca/early_childhood/pdf/early_indicator<br />
s_third_report.pdf<br />
40<br />
1995-<br />
99<br />
1996-<br />
00<br />
1997-<br />
01<br />
1998-<br />
02<br />
1999-<br />
03<br />
2000-<br />
04<br />
2001-<br />
05<br />
2002-<br />
06<br />
Source: VISTA Database, BC Vital Statistics Agency,<br />
Ministry of <strong>Health</strong> Services.<br />
2003-<br />
07<br />
2004-<br />
08<br />
2005-<br />
09<br />
62
HEALTH DETERMINANTS<br />
HEALTHY CHILD DEVELOPMENT<br />
Low Birth-Weight Rates, by LHA, 2005-2009<br />
Agassiz/Harrison<br />
Surrey<br />
New Westminster<br />
Coquitlam<br />
South Surrey/White Rock<br />
Delta<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Burnaby<br />
Maple Ridge<br />
BC<br />
Langley<br />
Abbotsford<br />
Chilliwack<br />
Hope<br />
Mission<br />
68.2<br />
65.1<br />
62.7<br />
60.3<br />
59.3<br />
58.6<br />
58.6<br />
57.0<br />
56.7<br />
55.8<br />
52.7<br />
51.0<br />
49.5<br />
49.2<br />
49.1<br />
0 20 40 60<br />
80<br />
per 1,000 Live Births<br />
Low Birth-Weight Rates by Age of Mother, 2005-2009<br />
160<br />
140<br />
120<br />
per 1,000 Live Births<br />
100<br />
80<br />
60<br />
40<br />
20<br />
0<br />
15-19 20-24 25-29 30-34 35-39 40-44 45+<br />
<strong>Fraser</strong> <strong>Health</strong> 62.2 53.6 53.2 55.4 69.1 95.1 128.7<br />
BC 53.7 51.7 51.8 53.0 62.5 87.6 142.3<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
63
Breastfeeding<br />
What are we looking at?<br />
Breastfeeding data are derived from two<br />
sources: the BC Perinatal Database<br />
Registry and the Canadian Community<br />
<strong>Health</strong> Survey (CCHS).<br />
The BC Perinatal Database Registry is a<br />
province-wide database that collects<br />
data on health outcomes, processes of<br />
care, and resources for maternal, fetal,<br />
and newborn care. 14 Rates of exclusive<br />
breastfeeding (that is no other food or<br />
liquid, not even water, is given to the<br />
newborn) and partial breastfeeding<br />
(both breast milk and other supplements<br />
given to the newborn) among newborns<br />
discharged from <strong>Fraser</strong> <strong>Health</strong> hospitals.<br />
Data from the CCHS reports the selfreported<br />
duration of exclusive breastfeeding<br />
by mothers between the ages of<br />
15 and 55 years who had a child during<br />
the five years preceding the survey<br />
year. Women who were breastfeeding<br />
at the time of the survey were excluded.<br />
Why do we care?<br />
Breastfeeding is both the natural and<br />
the most environmentally friendly way<br />
to feed human babies from birth to two<br />
years of age and beyond. Research has<br />
shown that babies who do not receive<br />
human breast milk and mothers who do<br />
not breastfeed are at increased risk of<br />
health problems. Babies who do not<br />
receive human breast milk are at higher<br />
risk of infectious diseases, sudden infant<br />
death, asthma, insulin-dependent (type<br />
14 BC Perinatal Database Registry.<br />
http://www.bcphp.ca/Perinatal%20Database%20Registry.ht<br />
m<br />
1) diabetes, leukemia, lymphoma, and<br />
obesity. 15 Mothers who do not<br />
breastfeed are at increased risk of<br />
postpartum depression and, in later<br />
years, of type 2 diabetes and breast and<br />
ovarian cancers. 16<br />
Where can we improve?<br />
• Overall exclusive breastfeeding rates<br />
at discharge have not improved in<br />
<strong>Fraser</strong> <strong>Health</strong> hospitals since 2006/07.<br />
• Mothers who live in Burnaby have the<br />
lowest exclusive breastfeeding rates<br />
among all <strong>Fraser</strong> <strong>Health</strong> LHAs in<br />
2010/11.<br />
Limitations<br />
Exclusive breastfeeding at discharge<br />
rates are for the number of babies, not<br />
mothers, and do not include babies<br />
delivered unexpectedly at the four (of<br />
twelve) <strong>Fraser</strong> <strong>Health</strong> hospitals without<br />
maternity wards. Data for 2010/11 may<br />
not be complete. Different <strong>Fraser</strong> <strong>Health</strong><br />
hospitals may use different guidelines<br />
for coding type of infant feeding. CCHS<br />
duration of breastfeeding data is selfreported<br />
and not comparable to BC<br />
Perinatal Database Registry data.<br />
15 Bartick M, Reinhold A. The burden of suboptimal<br />
breastfeeding in the United States: a pediatric cost analysis.<br />
Pediatrics. 2010 May;125(5):e1048-56.<br />
16 Ip S, Chung M, Raman G, Trikalinos TA, Lau J. A summary<br />
of the Agency for <strong>Health</strong>care Research and Quality's<br />
evidence report on breastfeeding in developed<br />
countries. Breastfeed Med. 2009 Oct;4 Suppl 1:S17-30.<br />
64
HEALTH DETERMINANTS<br />
HEALTHY CHILD DEVELOPMENT<br />
100%<br />
75%<br />
Newborn Exclusive Breastfeeding Rate* at Discharge,<br />
<strong>Fraser</strong> <strong>Health</strong> Hospitals, 2006/07 to 2010/11<br />
50%<br />
25%<br />
0%<br />
ARH/<br />
MSA<br />
BH CGH LMH PAH RCH RMH SMH Total<br />
2006/07 59% 57% 71% 69% 75% 72% 76% 61% 66%<br />
2007/08 63% 67% 73% 50% 71% 68% 70% 60% 64%<br />
2008/09 61% 71% 77% 58% 68% 65% 79% 62% 65%<br />
2009/10 61% 63% 79% 68% 70% 65% 78% 66% 67%<br />
2010/11 65% 52% 68% 70% 73% 65% 75% 60% 64%<br />
*Percent of newborns at <strong>Fraser</strong> <strong>Health</strong> hospitals, including non-<strong>Fraser</strong> <strong>Health</strong> residents who were exclusively<br />
breastfeeding at discharge.<br />
Note: ARH=Abbotsford Regional Hospital, BH=Burnaby Hospital, CGH=Chilliwack General Hospital,<br />
LMH=Langley Memorial Hospital, PAH=Peace Arch Hospital, RCH=Royal Columbia Hospital, RMH=Ridge<br />
Meadows Hospital, SMH=Surrey Memorial Hospital.<br />
Newborn Feeding at Discharge, by Mother's LHA of Residence,<br />
2010/11<br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
Abb<br />
Ag/<br />
Har<br />
Bby Chwk Coq Dlta Hope Lngly Mpl<br />
Rdg Mssn N.<br />
West<br />
Formula 47 ≤5 5 35 48 34 21 ≤5 5 62 29 20 8 206 ≤5 0<br />
Partial Breastmilk 569 17 585 243 529 132 17 323 213 113 185 1,745 34<br />
Excl Breastmilk 1,038 64 778 657 1,126 274 37 924 624 293 335 3,064 77<br />
Srry<br />
W.<br />
Rock<br />
Note : Data include newborns to <strong>Fraser</strong> <strong>Health</strong> residents discharged from <strong>Fraser</strong> <strong>Health</strong> sites. Residence code<br />
and postal code were used to determine LHA of residence.<br />
Source: BC Perinatal Database Registry.<br />
65
Newborn Feeding at Discharge by Age of Mother,<br />
<strong>Fraser</strong> <strong>Health</strong>, 2010/11<br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
14-19 20-24 25-29 30-34 35+ All 14+<br />
Formula 18 72 149 167 138 544<br />
Partial Breastmilk 85 512 1,309 1,716 1,237 4,859<br />
Excl Breastmilk 165 1,101 2,799 3,362 2,044 9,471<br />
Note : Data include newborns to <strong>Fraser</strong> <strong>Health</strong> residents discharged from <strong>Fraser</strong> <strong>Health</strong> sites. Residence<br />
code and postal code were used to determine LHA of residence.<br />
Source: BC Perinatal Database Registry.<br />
100%<br />
Exclusive Breastfeeding for At Least 4 Months<br />
Among Mothers Aged 15 to 55 in Past 5 Years, 2005<br />
64.9%<br />
65.3%<br />
75%<br />
54.2%<br />
59.5%<br />
50.4%<br />
60.6%<br />
50%<br />
25%<br />
0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Surveys, 2005.<br />
66
HEALTH DETERMINANTS<br />
HEALTHY CHILD DEVELOPMENT<br />
[This page was left blank intentionally]<br />
67
What are we looking at?<br />
Children in Government Care represents<br />
children and youth (ages up to and<br />
including 18 years old) who are in the<br />
care of provincial child care authorities,<br />
including all cases from the Ministry of<br />
Children and Family Development, from<br />
Delegated Aboriginal Agencies, and from<br />
Community Living BC. The majority of<br />
these children are from disadvantaged<br />
or single parent families. Children with<br />
Aboriginal ancestry are greatly overrepresented.<br />
Why do we care?<br />
The rate of children in government care<br />
is an important indicator of children's<br />
risk and vulnerability associated with<br />
social, economic, and behavioural<br />
factors. Children in care are more<br />
prone to poor health and life<br />
outcomes, including mental disorders,<br />
intentional and unintentional injuries,<br />
riskier sexual practices occurring at<br />
younger ages, and poor educational<br />
attainment. 17<br />
• <strong>Fraser</strong> <strong>Health</strong> overall had the second<br />
lowest rate of children in government<br />
care in BC. With 7.7 children<br />
per 1,000 18-years or younger,<br />
Vancouver Coastal <strong>Health</strong> had the<br />
lowest rate.<br />
• Among <strong>Fraser</strong> <strong>Health</strong> LHAs, Hope and<br />
Agassiz/Harrison have the highest<br />
rates of children in government care.<br />
Children in Government Care<br />
per 1,000 children age ≤18<br />
20<br />
15<br />
10<br />
5<br />
0<br />
• Approximately one in every ten (9.4%)<br />
Aboriginal children in <strong>Fraser</strong> <strong>Health</strong> were<br />
in government care compared to 0.5%<br />
of non-Aboriginal children in the region.<br />
Among the five health authorities in BC,<br />
<strong>Fraser</strong> <strong>Health</strong> had both the highest<br />
proportion and the largest number<br />
(2,931) of Aboriginal children in care.<br />
Limitations<br />
The rate of children in government care,<br />
as shown here, is a snapshot or a point<br />
estimate for a particular time in the year<br />
(in this case, December 2010). Therefore,<br />
the rate of children in government care<br />
for other periods may vary throughout the<br />
year. Interpret rates for LHAs with small<br />
population counts, such as Hope and<br />
Agassiz/Harrison, with caution.<br />
7.7<br />
Children in Government Care (Age ≤18),<br />
December 2010<br />
12.6<br />
5.3<br />
13.4 13.6<br />
FHA IHA VCHA VIHA NHA BC<br />
Source: Ministry of Children and Family Development; as<br />
reported in BC Stats’ Socioeconomic <strong>Profile</strong>s: Retrieved<br />
September 1, <strong>2011</strong> from:<br />
http://www.bcstats.gov.bc.ca/data/sep/choose.asp<br />
9.2<br />
17 Provincial <strong>Health</strong> Officer’s Annual Report 2006. An Ounce of<br />
Prevention: A review of health promotion and selected<br />
outcomes for children and youth in BC schools. Retrieved April<br />
4, 2007, from:<br />
http://www.health.gov.bc.ca/pho/pdf/phoannual2006.pdf<br />
68
HEALTH DETERMINANTS<br />
HEALTHY CHILD DEVELOPMENT<br />
Children in Government Care (Age ≤18), by LHA<br />
December 2010<br />
Hope<br />
Agassiz/Harrison<br />
Mission<br />
Chilliwack<br />
Abbotsford<br />
BC<br />
Langley<br />
Maple Ridge<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Surrey<br />
Delta<br />
New Westminster<br />
Coquitlam<br />
South Surrey/White Rock<br />
Burnaby<br />
5.0<br />
4.5<br />
4.2<br />
4.0<br />
6.9<br />
6.0<br />
8.4<br />
7.7<br />
9.2<br />
8.8<br />
10.4<br />
16.5<br />
16.2<br />
26.5<br />
38.0<br />
0 10 20 30 40<br />
per 1,000 children age ≤18<br />
50<br />
Source: Ministry of Children and Family Development; as reported in BC Stats’ Socioeconomic <strong>Profile</strong>s. Retrieved<br />
September 1, <strong>2011</strong> from: http://www.bcstats.gov.bc.ca/data/sep/choose.asp<br />
15%<br />
Children in Care as Percent of Population Aged ≤18,<br />
as of January 31, 2009<br />
Status Indians<br />
Other Residents<br />
10.8%<br />
10%<br />
9.1%<br />
8.2%<br />
9.4%<br />
6.5%<br />
5%<br />
0.8%<br />
0.4% 0.3% 0.5% 0.5%<br />
0%<br />
<strong>Fraser</strong> East <strong>Fraser</strong> South <strong>Fraser</strong> North FHA BC<br />
Source: British Columbia. Provincial <strong>Health</strong> Officer’s Annual Report 2007. 18<br />
18 British Columbia. Provincial <strong>Health</strong> Officer. 2009. Pathways to <strong>Health</strong> and Healing: 2nd Report on the <strong>Health</strong> and Well-being of<br />
Aboriginal People in British Columbia. Provincial <strong>Health</strong> Officer's Annual Report 2007. Victoria, BC: Ministry of <strong>Health</strong>y Living and<br />
Sport.<br />
69
Early Childhood Development<br />
What are we looking at?<br />
The Early Development Instrument<br />
(EDI) is a tool used by the Human Early<br />
Learning Partnership (HELP) 19 to<br />
measure kindergarten children’s state of<br />
development in neighbourhoods across<br />
the province. HELP is an organization of<br />
academic, government, and community<br />
partners in British Columbia that aims to<br />
understand early child development.<br />
The EDI includes five areas or domains<br />
of development: physical health and<br />
well-being; social competence; emotional<br />
maturity; language and cognitive<br />
development; and communication skills<br />
and general knowledge. Each child is<br />
scored from 0 to 10 on each domain;<br />
children with scores in the lowest 10%<br />
are considered vulnerable. Data has<br />
been collected through four cycles each<br />
spanning more than one school year:<br />
Wave 1 (2001/02 to 2003/04), Wave 2<br />
(2004/05 to 2006/07), Wave 3 (2007/08<br />
to 2008/09), and Wave 4 (2009/10 to<br />
2010/11).<br />
The EDI is not used to label or identify<br />
individual children. Rather, it provides<br />
population-level data on the number<br />
and proportion of children within a given<br />
geographic area who are vulnerable and<br />
in what aspects of their development<br />
they are vulnerable.<br />
Why do we care?<br />
Research shows that early childhood<br />
experiences have life-long effects on<br />
health, social, and emotional well-being.<br />
Social, familial, economic, school, neigh-<br />
bourhood, and policy environments can<br />
affect early child development both<br />
independent of and in combination with<br />
biological characteristics.<br />
• Six of <strong>Fraser</strong> <strong>Health</strong>’s 13 LHAs had<br />
more than 30% of kindergarteners<br />
who were vulnerable on at least one<br />
domain of development, with South<br />
Surrey/White Rock having the lowest<br />
proportion of vulnerable children.<br />
• South Surrey/White Rock has the<br />
smallest proportion of kindergarteners<br />
who are vulnerable on all five EDI<br />
domains (data not shown).<br />
• Hope had the highest proportions of<br />
kindergarten children vulnerable on<br />
the domains of physical health and<br />
well-being (27%), social competence<br />
(22%), and communication skills<br />
(17%) (data not shown).<br />
• Five LHAs (Burnaby, Hope, Mission,<br />
and New Westminster,) had at least<br />
15% of children vulnerable on<br />
communication skills (data not<br />
shown).<br />
Limitations<br />
School district participation is voluntary,<br />
so not all schools are included.<br />
Kindergarteners who are home schooled<br />
or learning through distance education<br />
programs are not included in this data.<br />
EDI scores are based on kindergarten<br />
teachers’ observation of each child over<br />
several months.<br />
19 Human Early Learning Partnership. Retrieved September<br />
20, <strong>2011</strong>, from: http://www.earlylearning.ubc.ca/<br />
70
Kindergarten Children Vulnerable on<br />
at Least One Scale of the EDI, 2010/11<br />
HEALTH DETERMINANTS<br />
HEALTHY CHILD DEVELOPMENT<br />
Hope<br />
Mission<br />
Chilliwack<br />
Surrey<br />
Coquitlam<br />
Burnaby<br />
BC<br />
Langley<br />
New Westminster<br />
Delta<br />
Maple Ridge<br />
Agassiz/Harrison<br />
South Surrey/White Rock<br />
Abbotsford<br />
§<br />
19%<br />
35%<br />
34%<br />
34%<br />
33%<br />
32%<br />
31%<br />
29%<br />
28%<br />
27%<br />
25%<br />
23%<br />
43%<br />
0% 10% 20% 30% 40% 50%<br />
Note: § Suppressed because there were fewer than 35 EDI children.<br />
% of Kindergarteners<br />
Kindergarten Children Vulnerable on at Least One Scale of the EDI<br />
LHA Wave 1* Wave 2* Wave 3* Wave 4*<br />
Burnaby 33% 33% 32% 32%<br />
New Westminster 33% 30% 24% 28%<br />
Coquitlam 20% 23% 27% 33%<br />
Maple Ridge 24% 25% 25% 25%<br />
Delta 22% 30% 27% 27%<br />
Langley 20% 23% 25% 29%<br />
Surrey 28% 32% 30% 34%<br />
South Surrey/White Rock 16% 19% 17% 19%<br />
Abbotsford 27% 34% 28% §<br />
Mission 32% 29% 35% 35%<br />
Chilliwack 28% 36% 33% 34%<br />
Hope 36% 43% 40% 43%<br />
Agassiz/Harrison 28% 22% 29% 23%<br />
BC n/a n/a 29% 31%<br />
Notes: n/a: not available. *Wave 1 includes 2001/02, 2002/03, 2003/04; Wave 2 includes 2004/05, 2005/06,<br />
2006/07; Wave 3 includes 2007/08, 2008/09 data where available; Wave 4 includes 2009/10 and 2010/11.<br />
§ Suppressed because there were fewer than 35 EDI children.<br />
Source: Human Early Learning Partnership (HELP), as posted September 19, <strong>2011</strong>.<br />
71
Grades 4 and 7 Foundation Skills Assessment<br />
What are we looking at?<br />
The Foundation Skills Assessment (FSA)<br />
is an annual, province-wide assessment<br />
of academic skills among students in<br />
Grades 4 and 7; it provides a snapshot<br />
of how well BC students are learning<br />
foundation skills in reading, writing, and<br />
math. 20<br />
This indicator reports the percentage of<br />
students in Grades 4 and 7 that meet<br />
provincial performance standards for<br />
each of the foundation skills; the<br />
performance standards are posted on<br />
the BC Ministry of Education website. 20<br />
Why do we care?<br />
There is a strong correlation between<br />
FSA scores and eventual school<br />
completion. Schooling is linked to<br />
income, with those with less education<br />
being more likely to have lower<br />
incomes. A lack of education and<br />
poverty are both associated with<br />
unhealthy lifestyles and poor well-being.<br />
• In all three categories, <strong>Fraser</strong> <strong>Health</strong><br />
students had comparable results to<br />
overall results for BC.<br />
• A larger percentage of students in<br />
Vancouver Coastal <strong>Health</strong> are meeting<br />
standards in FSA scores in all skills<br />
compared to students in <strong>Fraser</strong> <strong>Health</strong>.<br />
• Hope, Agassiz/Harrison, and Surrey<br />
LHAs have the lowest percentages of<br />
students meeting the standards.<br />
Percent of Students<br />
Percent of Students<br />
Percent of Students<br />
Limitations<br />
The FSA is only one measure of student<br />
performance.<br />
Students Meeting Standard on Foundation Skills Assessment<br />
Reading Tests, 2007/08 to 2009/10 Average<br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Grade 4 80.8% 81.3% 85.6% 80.9% 74.4% 81.3%<br />
Grade 7 77.6% 75.8% 83.7% 75.3% 70.5% 77.6%<br />
Students Meeting Standard on Foundation Skills Assessment<br />
Writing Tests, 2007/08 to 2009/10 Average<br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Grade 4 83.8% 78.6% 86.3% 77.9% 74.0% 81.7%<br />
Grade 7 83.9% 80.1% 88.2% 77.5% 74.8% 82.4%<br />
Students Meeting Standard on Foundation Skills Assessment<br />
Math Tests, 2007/08 to 2009/10 Average<br />
100%<br />
75%<br />
50%<br />
25%<br />
20 BC Ministry of Education. Foundation Skills Assessment.<br />
Retrieved September 6, <strong>2011</strong> from<br />
http://www.bced.gov.bc.ca/assessment/fsa/<br />
0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Grade 4 77.3% 76.6% 82.9% 75.8% 66.3% 77.2%<br />
Grade 7 78.2% 70.0% 86.3% 70.5% 62.7% 76.0%<br />
Source: BC Ministry of Education; compiled and provided by<br />
BC Stats.<br />
72
HEALTH DETERMINANTS<br />
HEALTHY CHILD DEVELOPMENT<br />
Percentage of Students Meeting Standards on<br />
Foundation Skills Assessment, by Local <strong>Health</strong> Area,<br />
2007/08 to 2009/10 Average<br />
Local <strong>Health</strong> Area<br />
Reading Writing Math<br />
Grade 4 Grade 7 Grade 4 Grade 7 Grade 4 Grade 7<br />
Burnaby 81.2% 82.3% 84.2% 87.9% 82.6% 86.3%<br />
New Westminster 81.1% 74.9% 81.7% 87.1% 79.9% 75.8%<br />
Coquitlam 83.1% 77.6% 85.6% 86.5% 80.9% 78.7%<br />
Maple Ridge 78.1% 73.4% 79.8% 81.3% 71.5% 71.5%<br />
Delta 84.7% 82.4% 87.6% 88.3% 80.5% 82.6%<br />
Langley 83.8% 80.9% 85.3% 81.9% 80.5% 80.5%<br />
Surrey 75.1% 73.7% 80.9% 80.6% 69.8% 75.3%<br />
South Surrey/White Rock 85.6% 85.8% 85.4% 85.8% 84.3% 85.6%<br />
Abbotsford 85.7% 79.8% 86.9% 87.8% 84.1% 81.8%<br />
Mission 77.2% 77.9% 79.6% 79.7% 72.4% 73.6%<br />
Chilliwack 85.4% 73.6% 88.8% 81.5% 80.5% 68.5%<br />
Hope 77.5% 63.6% 66.8% 71.1% 61.3% 51.7%<br />
Agassiz/Harrison 78.0% 59.2% 73.9% 68.3% 64.5% 63.3%<br />
<strong>Fraser</strong> <strong>Health</strong> 80.8% 77.6% 83.8% 83.9% 77.3% 78.2%<br />
BC Total 81.3% 77.6% 81.7% 82.4% 77.2% 76.0%<br />
Source: BC Ministry of Education; compiled and provided by BC Stats in Socio-Economic <strong>Profile</strong>s. Retrieved<br />
September 6, <strong>2011</strong> from http://www.bcstats.gov.bc.ca/data/sep/choose.asp<br />
73
PHYSICAL ENVIRONMENT<br />
Motor Vehicle Use<br />
Definition<br />
Mo tor vehicle use is estimated using<br />
proxy indicators. The first reports the<br />
number of licensed passenger vehicles<br />
with active registration in e ach area and<br />
the numbe r of vehicles per person. The<br />
percentage change in numbers<br />
of<br />
license d passenger vehicles with active<br />
registrati ons from 2006 to 2010 as of<br />
December 31 of each year is compared<br />
to the percentage change in the number<br />
of people living in the area.<br />
The second indicator reports the modes<br />
of transportation used to travel to work<br />
and location of workplace, as measured<br />
in the Census surveys. Mode of trans-<br />
portation is shown as the percent<br />
of<br />
persons traveling to work by 1) motor<br />
vehicles ( car, van, or truck), 2) public<br />
transport, 3) bicycle or walking, and 4)<br />
other. The location of workplace is a<br />
proxy for the percentage of persons<br />
who need to commute to work.<br />
Why do we care?<br />
High use of motor vehicles in an area<br />
affects health by worsening air quality<br />
and increasing traffic injuries. Time<br />
spent in vehicles reduces opportunities<br />
for healthy activities such as physical<br />
exercise and spending time with the<br />
family and community.<br />
• Only about 1 in 4 people in <strong>Fraser</strong><br />
<strong>Health</strong> take transit, bike/walk, or<br />
carpool to work.<br />
• Chilliwack and Abbotsford LHAs in<br />
<strong>Fraser</strong> East have high proportions of<br />
residents driving to work, despite<br />
having som e of the largest proportions<br />
of reside nts who w ork within their own<br />
municip ality. In contrast, New<br />
Westminster<br />
LHA has the largest proportion<br />
of residents working outside their<br />
municip ality, but a lso has the largest<br />
proportion of residents taking<br />
public<br />
transit.<br />
Limitatio<br />
ns<br />
These indicators do not measure the<br />
availability of public transit or walkability<br />
of neighbo urhoods. Modes of transportation<br />
data are not available at the<br />
<strong>Fraser</strong> <strong>Health</strong> level. The number of<br />
commercial vehicles is not included in<br />
counts. Some vehicles emit more air<br />
pollutants than others do.<br />
The number of licensed vehicles is only<br />
a proxy for actual usage. It does not<br />
measure usage patterns such as trip<br />
duration or distance, trip frequency, or<br />
number of occupants.<br />
• Langley has the highest ratio of<br />
vehicles per population, but Port<br />
Moody has the largest percentage<br />
increase in population and number of<br />
vehicles between 2006 and 2010.<br />
74
HEALTH DETERMINANTS<br />
PHYSICAL ENVIRONMENT<br />
Number of Licensed Passenger Vehicles, 2010<br />
City<br />
# Vehicles # Vehicles per person<br />
Langley 66,320 0.63<br />
Hope 3,850 0.61<br />
White Rock 10,960 0.57<br />
Delta 51,370 0.51<br />
Chilliwack 39,140 0.50<br />
Port Moody 16,960 0.50<br />
Port Coquitlam 27,930 0.49<br />
Coquitlam 60,980 0.48<br />
Pitt Meadows 8,730 0.48<br />
Maple Ridge 36,150 0.47<br />
Surrey 209,700 0.45<br />
Mission 17,000 0.45<br />
Abbotsford 61,300 0.44<br />
Burnaby 100,060 0.44<br />
New Westminster 28,210 0.42<br />
<strong>Fraser</strong> <strong>Health</strong>* 738,660 0.48<br />
BC 2,065,000 0.46<br />
Note: * <strong>Fraser</strong> <strong>Health</strong> total is a sum of passenger vehicles licensed in all municipalities listed.<br />
25%<br />
Percentage Change in Licensed Passenger Vehicles<br />
and Total Population from 2006 to 2010<br />
20%<br />
Percent Change<br />
15%<br />
10%<br />
5%<br />
0%<br />
Lngly Hope<br />
W.<br />
Rock Dlta Chwk Pt<br />
Mdy<br />
Pt<br />
Coq<br />
# Vehicles 7.9% 1.3% 3.3% 1.7% 10.3%16.1% 5.2% 6.2% 11.6% 7.5% 11.6% 4.7% 7.2% 6.5% 10.9% 8.2% 6.0%<br />
Total Population 8.2% 1.3% 1.9% 0.5% 9.4% 18.0% 5.3%<br />
Coq<br />
Pitt<br />
Mead<br />
Mpl<br />
Rdg<br />
Srry Mssn Abby Bby<br />
New<br />
West<br />
FH*<br />
5.9% 11. 3% 6.9% 12.0% 5.1% 6.8% 8.0% 10.5% 8.4% 6.8%<br />
* <strong>Fraser</strong> <strong>Health</strong> total is a sum of passenger vehicles licensed in all municipalities listed; data for Agassiz and Boston Bar is not available.<br />
Source: Insurance Corporation of British Columbia, 2010; Population data from BC Stats, Service BC, BC Ministry of<br />
Labour and Citizens' Services, P.E.O.P.L.E. 36 Projections.<br />
BC<br />
75
Mode of Transportation to Work, <strong>Fraser</strong> <strong>Health</strong>, 2006<br />
Car, truck, van<br />
(as driver) ,<br />
75.5%<br />
Car, truck, van<br />
(as passenger),<br />
7. 8%<br />
Public transit,<br />
11.3%<br />
W alk or bicycle,<br />
4.3%<br />
Motorcycle, taxi,<br />
other, 1. 1%<br />
Source: Statistic Canada, Census 2006.<br />
100%<br />
Location of Workplace, <strong>Fraser</strong> <strong>Health</strong><br />
75%<br />
50%<br />
25%<br />
0%<br />
Municpality of<br />
residence<br />
Different<br />
municipality<br />
At home<br />
Outside<br />
Canada<br />
No fixed<br />
workplace<br />
1996 27.1% 53.3% 7.9% 0.5% 11.2%<br />
2001 27.6% 52.2% 8.0% 0.6% 11.6%<br />
2006 28.2% 49.5% 7.7% 0.7% 13.9%<br />
Source: Statistic Canada, Census 1996, 2001, 2006.<br />
76
HEALTH DETERMINANTS<br />
PHYSICAL ENVIRONMENT<br />
Mode of Transportation to Work, 2006<br />
100%<br />
75%<br />
Percent of Population<br />
50%<br />
25%<br />
0%<br />
Bby<br />
New<br />
West<br />
Coq<br />
Mpl<br />
Rdg Delta Lngly Sry SS/<br />
WR<br />
Abb Mssn Chwk<br />
Ag/<br />
Har<br />
Hope FH BC<br />
Motorcycle, taxi, other 0.9% 1.1% 0.9% 1.3% 1.3% 1.1% 1.1% 1.4% 1.1% 1.4% 1.1% 1.2% 0.3% 1.1% 1.5%<br />
Walk or bicycle 5.3% 7.0% 4.1% 3.9% 4.3% 4.6% 2.9% 4.9% 4.2% 3.1% 5.7% 10.5%12.1% 4.3% 8.9%<br />
Public transit 25.0%26.7%12.9% 7.9% 9.1% 3.5% 11.5% 6.9% 1.4% 2.9% 1.1% 0.8% 0.8% 11.3%10.3%<br />
Car, truck, van (as passenger) 5.9% 4.9% 7.4% 7.2% 7.3% 7.3% 9.3% 5.7% 10.7% 7.6% 9.2% 6.9% 9.9% 7.8% 7.7%<br />
Car, truck, van (as driver) 62.8%60.3%74.7%79.7%78.0%83.5%75.2%81.1%82.7%85.0%82.8%80.8%76.8%75.5%71.6%<br />
100%<br />
Location of Workplace, 2006<br />
Percent of Population<br />
75%<br />
50%<br />
25%<br />
0%<br />
Bby<br />
New<br />
West<br />
Coq<br />
Mpl<br />
Rdg Delta Lngly Sry SS/<br />
WR Abb Mssn Chwk Hope Ag/<br />
Har<br />
No fixed workplace 11.3% 12.6% 11.7% 13.9% 13.5% 14.0% 16.1% 12.4% 15.6% 18.4% 14.8% 16.5% 12.7% 13.9% 13.1%<br />
Outside Canada 1.4% 0.5% 0.7% 0.3% 0.7% 0.4% 0.6% 1.1% 0.6% 0.3% 0.4% 0.6% 0.3% 0.7% 0.7%<br />
At home 6.9% 5.2% 7.3% 7.2% 8.5% 9.9% 5.6% 12.6% 9.1% 8.6% 10.0% 8.3% 14.8% 7.7% 9.0%<br />
Different municipality 52.2% 66.7% 63.2% 53.8% 53.8% 52.6% 46.0% 46.8% 28.3% 48.5% 28.3% 27.4% 44.6% 49.5% 39.6%<br />
Municpality of residence 28.2% 15.0% 17.1% 24.7% 23.5% 23.0% 31.6% 27.0% 46.4% 24.2% 46.5% 47.4% 27.7% 28.2% 37.6%<br />
Source: Statistic Canada, Census 2006.<br />
FH<br />
BC<br />
77
Exposure to Second-hand Smoke<br />
What are we looking at?<br />
Second-hand smoke or environmental<br />
tobacco smoke is composed of the<br />
smoke exhaled by a smoker and the<br />
smoke released from the burning end of<br />
a cigarette, pipe or cigar. This indicator<br />
reports the percent of people 12 years<br />
and older who reported exposure to<br />
second-hand smoke on the Canadian<br />
Community <strong>Health</strong> Survey (CCHS). Since<br />
2007, data for the CCHS are collected<br />
yearly instead of every two years, with<br />
half the number of respondents. Data<br />
was combined for two years to obtain<br />
estimates that are more reliable. In the<br />
graphs, columns represent point<br />
estimates and whisker lines represent<br />
the 95% confidence intervals.<br />
Why do we care?<br />
Tobacco smoke contains over 4,000<br />
chemicals, 50 of which are associated<br />
with or are known to cause cancer.<br />
Smokers inhale about one-third of the<br />
smoke from a burning cigarette. The<br />
remaining smoke contaminates the<br />
surrounding environment to be inhaled<br />
by anyone in that area.<br />
Scientific evidence from the last 30<br />
years shows that people repeatedly<br />
exposed to second-hand smoke are<br />
more likely to develop and die from<br />
heart problems, lung cancer, and<br />
breathing problems. Second-hand<br />
smoke can also cause chest and/or ear<br />
infections, excessive coughing, and<br />
throat irritation.<br />
Pregnant women, fetuses, and young<br />
children can experience additional<br />
effects of second-hand smoke such as<br />
pregnancy complications, low<br />
birth-<br />
weight, reduced lung development,<br />
increased risk of sudden infant death<br />
syndrome (SIDS), ear infections, and<br />
increased severity of asthma and other<br />
respiratory illnesses. Children of<br />
smokers are twice as likely to smoke.<br />
Tobacco smoke can present problems<br />
both indoors and outdoors. Most<br />
Canadians spend more time indoors<br />
than outdoors: in homes, workplaces,<br />
cars, and other public places such as<br />
restaurants, schools, shopping malls and<br />
arenas. Tobacco smoke is a serious<br />
contaminant of indoor air.<br />
Outdoors, the U.S. Environmental Protection<br />
Agency estimates that the risk of<br />
developing cancer from exposure to<br />
second-hand smoke is about 57 times<br />
greater than the combined risk posed by<br />
all outdoor air contaminants regulated<br />
under U.S. environmental law. 21<br />
• Although exposure to second-hand<br />
smoke in the home has declined in<br />
recent years, exposure in public places<br />
remains prevalent, with about 129,000<br />
in <strong>Fraser</strong> <strong>Health</strong> exposed in 2009/10.<br />
• The proportion of those aged 12 to 19<br />
who are exposed to second-hand<br />
smoke has dropped in all three<br />
settings (the home, public places, and<br />
vehicles)<br />
• People 34 and younger are more likely<br />
to be exposed to second-hand smoke,<br />
especially in public places.<br />
Limitations<br />
Self-report methods are known to<br />
underestimate socially undesirable<br />
behaviours like smoking.<br />
21 Cunningham, Rob. Smoke & Mirrors - The Canadian<br />
Tobacco War. Ottawa: International Development Research<br />
Centre, 1996.<br />
78
HEALTH DETERMINANTS<br />
PHYSICAL ENVIRONMENT<br />
20%<br />
Non-Smokers (Age 12+) Exposed to<br />
Second-hand Smoke, by Location, 2009/10<br />
15%<br />
10%<br />
5%<br />
0%<br />
Home<br />
Public Places<br />
Vehicle<br />
<strong>Fraser</strong> North 3.3% 13.2% 5.7%<br />
<strong>Fraser</strong> South 3.1% 9.2% 3.0%<br />
<strong>Fraser</strong> East 5.0% 11.9% 6.6%<br />
BC 3.2%<br />
11.5% 5.2%<br />
Use with caution, estimates are less reliable due to small sample sizes<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Survey, 2009/10.<br />
Non-Smokers Exposed to Second-Hand Smoke,<br />
25%<br />
by Age and Location, British Columbia, 2009/10<br />
20%<br />
15%<br />
10%<br />
5%<br />
0%<br />
Home Public Places Vehicle<br />
12 to 19 years 8.1% 17.4% 10.7<br />
20 to 34 years 3.2% 16.3% 7.8<br />
35 to 44 years 2.0% 11.1% 4.7<br />
45 to 64 years 2.9% 9.6% 3.7<br />
65 years and over 1.4% 5.4% 1.5<br />
Use with caution, estimates are less reliable due to small sample sizes<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Survey, 2003, 2005, 2007/08 and 2009/10.<br />
Note: Bars represent point estimates; whisker lines represent<br />
95% confidence intervals.<br />
79
15%<br />
Non-Smokers (Age 12+) Exposed to<br />
Second-hand Smoke in Home, 2003 to 2009/10<br />
12%<br />
9%<br />
6%<br />
3%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
2003 5.6% 5.0% 5.6% 5.6%<br />
2005 4.0% 4.5% 6.1% 4.8%<br />
2007/08 4.0% 3.2% 3.8% 4.0%<br />
2009/10 3.3% 3.1% 5.0% 3.2%<br />
Use with caution, estimates for HSDAs are less reliable due to small sample sizes.<br />
Non-Smokers (Age 12+) Exposed to<br />
Second-hand Smoke in Public Places, 2003 to 2009/10<br />
20%<br />
16%<br />
12%<br />
8%<br />
4%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
2003 11.9% 11.6% 12.8% 12.3%<br />
2005 10.9% 13.8% 10.3% 10.5%<br />
2007/08 12.5% 8.5% 8.4% 10.9%<br />
2009/10 13.2% 9.2% 11.9% 11.5%<br />
20%<br />
Non-Smokers (Age 12+) Exposed to<br />
Second-hand Smoke in Vehicles, 2003 to 2009/10<br />
16%<br />
12%<br />
8%<br />
4%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
2003 6.4% 5.9% 6.8% 6.8%<br />
2005 4.6% 6.1% 8.9% 5.7%<br />
2007/08 5.6% 5.5% 4.8% 5.6%<br />
2009/10 5.7% 3.0% 6.6% 5.2%<br />
Use with caution, estimates for HSDAs are less reliable due to small sample sizes.<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Survey, 2003, 2005, 2007/08 and 2009/10.<br />
Note: Bars represent point estimates; whisker lines represent 95% confidence intervals.<br />
80
HEALTH DETERMINANTS<br />
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81
HEALTHY LIVING<br />
What are we looking at?<br />
This indicator reports the percent of<br />
people 12 years and older who reported<br />
being current daily or occasional<br />
smokers on the Canadian Community<br />
<strong>Health</strong> Survey (CCHS). Current Smokers<br />
reported that they had smoked at least<br />
100 cigarettes during their lifetime and<br />
had smoked in the 30 days preceding<br />
the survey. Since 2007, data for the<br />
CCHS are collected yearly instead of<br />
every two years, with half the number<br />
of respondents. Data was combined for<br />
two years to obtain estimates that are<br />
more reliable. In the graphs, columns<br />
represent point estimates and whisker<br />
lines 95% confidence intervals.<br />
Data on hospitalizations and deaths due<br />
to tobacco are from the BC Alcohol and<br />
Other Drug Monitoring Project. 22<br />
Why do we care?<br />
Smoking causes illness, disability, and<br />
premature death. It is the single most<br />
significant cause of lung cancer, chronic<br />
respiratory disease and heart disease.<br />
Smoking also harms those indirectly<br />
exposed to tobacco smoke, particularly<br />
children and partners of regular<br />
smokers.<br />
• In 2009/10, there were roughly<br />
204,000 current smokers age 12<br />
years and older in <strong>Fraser</strong> <strong>Health</strong>.<br />
• None of the HSDAs in BC have<br />
reached the BC <strong>Health</strong>y Living<br />
Tobacco Use<br />
Alliance (BCHLA) target of reducing<br />
smoking rates to 10% by 2010.<br />
<strong>Fraser</strong> East HSDA has the highest<br />
smoking rates in <strong>Fraser</strong> <strong>Health</strong>.<br />
• Young adults aged 20 to 34 have the<br />
highest smoking rates.<br />
• Males and people with low income<br />
and low education tend to have<br />
higher smoking rates.<br />
• Aboriginals have the highest smoking<br />
rates in <strong>Fraser</strong> <strong>Health</strong>.<br />
• In general, smoking rates and<br />
hospitalizations due to illness from<br />
tobacco across <strong>Fraser</strong> <strong>Health</strong> and BC<br />
are down. However, hospitalization<br />
rates in <strong>Fraser</strong> <strong>Health</strong> continue to be<br />
higher than the overall BC rate.<br />
• Tobacco continues to be a significant<br />
cause of death in <strong>Fraser</strong> <strong>Health</strong> and<br />
BC.<br />
• LHAs in <strong>Fraser</strong> East generally have<br />
higher rates of hospitalization than<br />
other <strong>Fraser</strong> <strong>Health</strong> LHAs or BC<br />
overall. The mortality rate, which<br />
had been trending down, appears to<br />
have reversed and is now increasing.<br />
Limitations<br />
Survey data underestimates smoking<br />
rates and other socially undesirable<br />
behaviours like smoking.<br />
22 BC Alcohol and Other Drug Monitoring Project:<br />
http://carbc.ca/MonitoringProject/MortalityandMorbidity/tabi<br />
d/412/Default.aspx<br />
82
HEALTH DETERMINANTS<br />
HEALTHY LIVING<br />
30%<br />
Current S mokers (Age 12+ ), 2009/10<br />
25%<br />
20%<br />
BCHLA Target ≤ 10%<br />
15.7%<br />
13.8%<br />
16.6%<br />
Best HSDA<br />
in BC<br />
13.0%<br />
16.7%<br />
15%<br />
10%<br />
5%<br />
0%<br />
<strong>Fraser</strong> North<br />
<strong>Fraser</strong> South<br />
<strong>Fraser</strong> East<br />
North Shore/<br />
Coast Garibaldi<br />
BC<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Survey, 2009/10.<br />
30%<br />
Current Smokers (Age 12+), 2003 to 2009/10<br />
25%<br />
20%<br />
15%<br />
10%<br />
5%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
2003 18.5% 14.8% 19.5% 18.8%<br />
2005 14.5% 17.6% 17.8% 17.8%<br />
2007/08 17.1% 16.7% 16.5% 18.2%<br />
2009/10 15.7% 13.8% 16.6% 16.7%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Surveys, 2003, 2005, 2007/08, and 2009/10.<br />
Note: Bars represent point estimates; whisker lines represent 95% confidence intervals.<br />
83
50 %<br />
Current Smokers, by Age Group, 2005<br />
40 %<br />
30 %<br />
20 %<br />
10 %<br />
0 %<br />
12-19 20-34 35-44 45-64 65+<br />
FHA 8.5% 21.3% 17.3% 17.7% 9.0%<br />
BC 9.9% 25.2% 20.6% 17.4% 9.5%<br />
<strong>Fraser</strong> <strong>Health</strong> Current Smokers Aged 12+,<br />
Selected Groups, 2005<br />
Females<br />
Males<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Average= 16.1%<br />
Household Income < $30,000<br />
Household Income ≥ $80,000<br />
High school education<br />
University education<br />
White<br />
East Asian/ South Asian<br />
Aboriginal<br />
0% 10% 20% 30% 40% 50%<br />
Use with caution, estimates are less reliable due to small sample sizes<br />
Note: Household income
HEALTH DETERMINANTS<br />
HEALTHY LIVING<br />
Age and Sex Standardized Hospitalization Rate<br />
Attributable to Tobacco<br />
800<br />
600<br />
Rate per 100,000<br />
400<br />
200<br />
0<br />
2002 2003 2004 2005 2006 2007 2008 2009<br />
<strong>Fraser</strong> East 699.1 684.9 654.4 661.7 653.6 671.8 617.1 670.5<br />
<strong>Fraser</strong> North 618.6 653.3 603.1 605.2 591.3 573.5 554.0 536.2<br />
<strong>Fraser</strong> South 628.2 621.3 625.9 634.6 597.9 589.4 592.5 562.0<br />
<strong>Fraser</strong> <strong>Health</strong> 635.3 642.3 621.2 628.0 604.2 597.5 581.4 570.7<br />
BC 601.1 602.6 591.8 602.0 577.8 562.7 559.1 544.5<br />
Age and Sex Standardized Hospitalization Rate<br />
Attributable to Tobacco, by LHA, 2009<br />
Hope<br />
Chilliwack<br />
Maple Ridge<br />
Langley<br />
Mission<br />
Abbotsford<br />
New Westminster<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Coquitlam<br />
Delta<br />
Surrey<br />
BC<br />
Agassiz/Harrison<br />
South Surrey/White Rock<br />
Burnaby<br />
724.0<br />
664.6<br />
662.4<br />
641.2<br />
630.8<br />
624.1<br />
570.7<br />
552.6<br />
546.1<br />
545.2<br />
544.5<br />
535.0<br />
488.5<br />
455.4<br />
870.4<br />
0 200 400 600 800 1000<br />
Rate per 100,000<br />
Source: Buxton, J., Tu, A., & Stockwell, S. (<strong>2011</strong>). Mortality and Morbidity Data. BC Alcohol and Other Drug<br />
Monitoring Project. Retrieved August 4, <strong>2011</strong> from:<br />
http://carbc.ca/AODMonitoring/ResearchComponents/HospitalizationsDeaths.aspx.<br />
85
140<br />
120<br />
100<br />
Age and Sex Standardized Mortality Rate<br />
Attributable to Tobacco<br />
Rate per 100,000<br />
80<br />
60<br />
40<br />
20<br />
0<br />
2002 2003 2004 2005 2006 2007 2008 2009<br />
<strong>Fraser</strong> East 118.1 112.8 114.0 117.0 105.3 112.8 111.9 116.7<br />
<strong>Fraser</strong> North 103.9 111.2 104.2 105.4 101.0 95.6 97.4 95.4<br />
<strong>Fraser</strong> South 92.4 96.4 104.9 97.6 93.2 95.9 101.5 82.2<br />
<strong>Fraser</strong> <strong>Health</strong> 101.1 105.0 106.3 104.0 98.3 99.0 102.0 93.5<br />
BC 106.2 104.0 105.1 102.0 97.7 98.8 98.7 91.9<br />
Age and Sex Standardized Mortality Rate<br />
Attributable to Tobacco, by LHA, 2009<br />
Hope<br />
Chilliwack<br />
Mission<br />
Agassiz/Harrison<br />
New Westminster<br />
Maple Ridge<br />
Abbotsford<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Langley<br />
Coquitlam<br />
BC<br />
Burnaby<br />
Surrey<br />
Delta<br />
South Surrey/White Rock<br />
94.4<br />
93.5<br />
92.9<br />
92.1<br />
91.9<br />
88.9<br />
83.6<br />
77.8<br />
69.9<br />
134.8<br />
125.7<br />
118.4<br />
117.2<br />
111.9<br />
170.8<br />
0 40 80 120 160 200<br />
Rate per 100,000<br />
Source: Buxton, J., Tu, A., & Stockwell, S. (<strong>2011</strong>). Mortality and Morbidity Data. BC Alcohol and Other Drug<br />
Monitoring Project. Retrieved August 4, <strong>2011</strong> from:<br />
http://carbc.ca/AODMonitoring/ResearchComponents/HospitalizationsDeaths.aspx.<br />
86
HEALTH DETERMINANTS<br />
HEALTHY LIVING<br />
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87
Fruit and Vegetable Consumption<br />
What are we looking at?<br />
Fruit and vegetable consumption refers<br />
to the number of times a day that a<br />
person eats a serving of fruit and/or<br />
vegetables. Canada’s Food Guide to<br />
<strong>Health</strong>y Living recommends eating 5 to<br />
10 servings of fruits and vegetables<br />
every day.<br />
The proportion of the population aged<br />
12+ who reported eating five or more<br />
fruits and/or vegetables in the Canadian<br />
Community <strong>Health</strong> Survey (CCHS) are<br />
presented. Since 2007, data for the<br />
CCHS are collected yearly instead of<br />
every two years, with half the number<br />
of respondents. Data was combined for<br />
two years to obtain estimates that are<br />
more reliable. In the graphs, columns<br />
represent point estimates and vertical<br />
whisker lines represent the 95%<br />
confidence intervals.<br />
Why do we care?<br />
A healthy diet rich in fruits and<br />
vegetables can help reduce the risk of<br />
cancer and other chronic diseases.<br />
Naturally low in calories and fat, most<br />
fruits and vegetables are healthier than<br />
processed snack foods. Fruits and<br />
vegetables are excellent sources of fibre<br />
and essential vitamins and minerals,<br />
which contribute to overall good health<br />
and well-being.<br />
• <strong>Fraser</strong> <strong>Health</strong> is far below the BC<br />
<strong>Health</strong>y Living Alliance (BCHLA)<br />
target of increasing the proportion of<br />
the population eating five or more<br />
daily servings of fruits/vegetables to<br />
70% by 2010.<br />
• There has been no significant<br />
improvement in the proportion of the<br />
100%<br />
population consuming five or more<br />
servings of fruits/vegetables from<br />
2003 to 2009/10 in <strong>Fraser</strong> <strong>Health</strong><br />
HSDAs.<br />
Limitations<br />
This indicator looks at the number of<br />
servings consumed each day, but does<br />
not measure the variety of fruits and<br />
vegetables eaten or how processed they<br />
are, nor does it look at consumption<br />
from other food groups.<br />
75%<br />
50%<br />
25%<br />
0%<br />
41.3%<br />
53.6%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong><br />
Survey, 2009/10.<br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
45.8%<br />
Consumption of 5 or More Servings of<br />
Fruits/Vegetables Daily (Age 12+), 2009/10<br />
BCHLA Target = 70%<br />
42.9%<br />
Best HSDA<br />
in BC<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East North Shore/<br />
Coast Garibaldi<br />
Consumption of 5 or More Servings of<br />
Fruits/Vegetables Daily (Age 12+), 2003 to 2009/10<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
2003 39.0% 42.3% 41.1% 42.6%<br />
2005 44.7% 40.6% 39.7% 43.7%<br />
2007/08 45.2% 38.9% 39.4% 43.4%<br />
2009/10 45.8% 42.9% 41.3% 43.8%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong><br />
Survey (CCHS 2003, 2005, 2007/08 and 2009/10).<br />
43.8%<br />
BC<br />
88
HEALTH DETERMINANTS<br />
HEALTHY LIVING<br />
100%<br />
Consumption of Five or More Servings of<br />
Fruits/Vegetables Daily (Age 12+), by Sex, 2009/10<br />
75%<br />
50%<br />
25%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
Females 49.4% 47.6% 46.0% 48.9%<br />
Males 42.1% 38.2%<br />
36.4% 38.5%<br />
Consumption of Five or More Servings of<br />
Fruits/Vegetables Daily, by Age Group, 2009/10<br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
12 to 19 years 47.7% 54.7% 45.4% 48.7%<br />
20 to 34 years 45.6% 35.1% 39.6% 40.3%<br />
35 to 44 years 38.0% 46.8% 39.3% 42.9%<br />
45 to 64 years 46.7% 40.0% 38.5% 43.1%<br />
65 years and over 53.4% 48.6% 48.7% 48.4%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Survey, 2009/10.<br />
Note: Bars represent point estimates; whisker lines represent 95% confidence intervals.<br />
89
Self-Reported Leisure Time Physical Activity<br />
What are we looking at?<br />
Leisure time physical activity refers to<br />
how much one exercises outside of the<br />
workplace. The Canadian Community<br />
<strong>Health</strong> Survey (CCHS) assesses the<br />
average daily amount of physical activity<br />
during leisure time for the past three<br />
months using the following definitions:<br />
Inactive:
HEALTH DETERMINANTS<br />
HEALTHY LIVING<br />
100%<br />
Moderately or Physically Active Population (Age 12+),<br />
2003 to 2009/10<br />
75%<br />
50%<br />
25%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
2003 57.5% 59.4% 57.8% 59.9%<br />
2005 57.9% 54.7% 54.5% 59.0%<br />
2007/08 53.2% 54.2% 56.1% 57.7%<br />
2009/10 54.6% 54.1% 55.9% 59.3%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Survey, 2003, 2005, 2007/08 and 2009/10.<br />
Moderately or Physically Active Population (Age 12+),<br />
by Sex, 2009/10<br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
Females 55.0% 51.9% 52.4% 57.9%<br />
Males 54.2% 56.4%<br />
59.6% 60.8%<br />
Moderately or Physically Active Population, by Age Group, 2009/10<br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
12 to 19 years 78.9% 72.9% 78.2% 75.8%<br />
20 to 34 years 57.6% 53.8% 68.2% 60.1%<br />
35 to 44 years 49.0% 55.5% 53.6% 57.5%<br />
45 to 64 years 47.4% 48.7% 43.2% 56.6%<br />
65 years and over 52.2% 49.5% 47.1% 54.2%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Survey, 2009/10.<br />
Note: Bars represent point estimates; whisker lines represent 95% confidence intervals.<br />
91
Overweight and Obesity:<br />
Self-Reported Body Mass Index<br />
What are we looking at?<br />
Body Mass Index (BMI) is a measurement<br />
used to estimate a person’s<br />
healthy or normal weight based on their<br />
height. It is calculated using selfreported<br />
height and weight information<br />
collected via the cyclical Canadian<br />
Community <strong>Health</strong> Survey (CCHS).<br />
BMIs are reported for respondents aged<br />
18 years and older, using internationally<br />
recognized BMI classifications:<br />
Underweight =
HEALTH DETERMINANTS<br />
HEALTHY LIVING<br />
100%<br />
Overweight and Obese Population Age 18+, 2009/10<br />
75%<br />
50%<br />
BCHLA Target ≤ 30%<br />
39.7%<br />
48.1%<br />
52.0%<br />
Best HSDA<br />
in BC<br />
44.7%<br />
31.7%<br />
25%<br />
0%<br />
<strong>Fraser</strong> North<br />
<strong>Fraser</strong> South<br />
<strong>Fraser</strong> East Vancouver BC<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Survey, 2009/10.<br />
Overweight and Obese Population Age 18+, 2003 to 2009/10<br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South<br />
<strong>Fraser</strong> East BC<br />
2003 40.5% 44.1% 50.2% 43.4%<br />
2005 41.4% 47.9% 56.5% 46.1%<br />
2007/08 43.7% 44.1% 50.1% 44.5%<br />
2009/10 39.7% 48.1%<br />
52.0% 44.7%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Survey, 2003, 2005, 2007/08, and 2009/10.<br />
Note: Bars represent point estimates; whisker lines represent 95% confidence intervals.<br />
93
50%<br />
Overweight Population and Obese Population<br />
Age 18+, 2009/10<br />
40%<br />
30%<br />
20%<br />
10%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
Overweight 27.2% 34.2% 33.7% 31.3%<br />
Obese 12.6% 13.8% 18.3% 13.5%<br />
100%<br />
Overweight and Obese Population Age 18+,<br />
by Sex, 2009/10<br />
75%<br />
50%<br />
25%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East British Columbia<br />
Females 28.2% 34.1% 45.3% 34.9%<br />
Males 50.9% 61.8% 58.5% 54.5%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Survey, 2009/10.<br />
Note: Bars represent point estimates; whisker lines represent 95% confidence intervals.<br />
94
HEALTH DETERMINANTS<br />
HEALTHY LIVING<br />
100%<br />
Overweight and Obese Population,<br />
by Age Group, 2009/10<br />
75%<br />
50%<br />
25%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East British Columbia<br />
20 to 34 years 22.2% 39.1% 39.3% 32.4%<br />
35 to 44 years 37.3% 50.5% 51.3% 44.4%<br />
45 to 64 years 51.9% 52.9% 60.4% 52.6%<br />
65 years and older 51.1% 54.4% 58.5% 50.2%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong> Survey, 2009/10.<br />
Note: Bars represent point estimates; whisker lines represent 95% confidence intervals.<br />
95
Vitamin D Inadequacy<br />
What are we looking at?<br />
Data report the proportion of Canadians<br />
with adequate, inadequate, or deficient<br />
vitamin D levels reported by age and by<br />
sex. Vitamin D is measured by a blood<br />
test for 25-hydroxyvitamin D (25(OH)D),<br />
which is changed in the kidneys to the<br />
active form of vitamin D used by the<br />
body. Data is from the Canadian <strong>Health</strong><br />
Measures Survey (CHMS). 27<br />
Why do we care?<br />
Vitamin D deficiency is a 25(OH)D level<br />
less than 20-25 nanomoles/litre<br />
(nmol/L), a level below which children<br />
can get rickets and adults osteomalacia<br />
(soft bones), 28 or as less than 37.5<br />
nmol/L, a level below which adults can<br />
get osteoporosis. 29 Vitamin D levels<br />
between 37.5 and 75 nmol/L are called<br />
inadequate or insufficient. Both<br />
inadequate and deficient vitamin D<br />
levels are linked to increased risk of fall,<br />
fracture, diabetes, cancer, tuberculosis,<br />
multiple sclerosis, and other problems. 28<br />
Vitamin D is made in our skin with<br />
exposure to the ultraviolet in sunlight<br />
with wavelength 280-315 nm, wavelengths<br />
blocked by glass, plastic, and<br />
sunscreen. Even the most vitamin D-rich<br />
foods provide little vitamin D compared<br />
to sun exposure. 28 Sunshine in even<br />
southern Canada is not strong enough<br />
to make vitamin D from October to<br />
March. 30 Long-term exposure to sun<br />
strong enough to maintain vitamin D<br />
levels can damage skin and cause skin<br />
cancer, so dermatologists recommend<br />
vitamin D supplements instead. 28<br />
Factors that put people at risk of having<br />
low vitamin D levels include: wearing<br />
sunscreen, not being outdoors in the<br />
sun, having darker skin 28,31 or a higher<br />
body mass index 30 , and being 50 years<br />
old or older. 28<br />
• The majority of Canadians do not have<br />
adequate levels of vitamin D.<br />
• Canadian guidelines for vitamin D<br />
intake do not reflect research findings<br />
from the last few decades and<br />
recommend amounts of vitamin D too<br />
low to achieve adequate levels.<br />
• Osteoporosis Canada recommends<br />
400-1,000 IU daily under age 50 and<br />
800-2,000 IU daily over age 50 for<br />
adults who do not have osteoporosis<br />
nor any issue absorbing vitamin D. 28<br />
Limitations<br />
Data is not available at the provincial or<br />
<strong>Health</strong> Authority level.<br />
27 Statistics Canada (2009). Canadian <strong>Health</strong> Measures<br />
Survey. Retrieved September 17, 2010 from:<br />
http://www.statcan.gc.ca/cgibin/imdb/p2SV.pl?Function=getSurvey&SDDS=5071&lang=e<br />
n&db=imdb&adm=8&dis=2.<br />
28 Hanley DA et al. Vitamin D in adult health and disease: a<br />
review and guideline statement from Osteoporosis Canada.<br />
CMAJ 2010 182: E610-E618.<br />
29 Langlois K et al. Vitamin D status of Canadians as<br />
measured in the 2007 to 2009 Canadian <strong>Health</strong> Measures<br />
Survey. <strong>Health</strong> Reports, Vol. 21, no. 1, March 2010: 47-55.<br />
30 Canadian Paediatric Society. Vitamin D supplementation:<br />
Recommendations for Canadian mothers and infants: a<br />
Canadian Paediatric Society Position Statement. Paediatric<br />
Child <strong>Health</strong> 12(7) Sept 2007: 583-589.<br />
31 Weiler HA et al. Canadian Aboriginal Women Have a<br />
Higher Prevalence of Vitamin D Deficiency than Non-<br />
Aboriginal Women Despite Similar Dietary Vitamin D Intakes<br />
J. Nutr. 2007 137:461-465.<br />
96
HEALTH DETERMINANTS<br />
HEALTHY LIVING<br />
25-Hydroxyvitamin D Levels in Canadians Age 6 to 79 Years,<br />
by Age and Sex, 2007 to 2009<br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
FemaleMale FemaleMale FemaleMale FemaleMale FemaleMale FemaleMale<br />
6 to 11 years 12 to 19 years 20 to 39 years 40 to 59 years 60 to 79 years Total 6 to 79<br />
years<br />
Adequate (>75 nmol/L) 45.1% 51.9% 35.3% 35.0% 36.3% 22.9% 34.1% 33.2% 46.0% 43.3% 37.8% 33.0%<br />
Inadequate (37.5-75 nmol/L) 48.3% 45.9% 55.8% 50.5% 54.0% 61.4% 57.3% 53.0% 48.3% 48.0% 53.9% 54.1%<br />
Deficient (
DISEASE PREVENTION<br />
Primary Prevention<br />
School Immunization Coverage<br />
Definition<br />
In BC, publicly funded vaccines are<br />
currently available to protect children<br />
against the following serious diseases:<br />
diphtheria, pertussis (whooping cough),<br />
tetanus (lockjaw), polio, Haemophilus<br />
influenza type B infection, hepatitis B,<br />
pneumococcal infection, meningococcal<br />
C infection, measles, mumps, rubella,<br />
varicella (chickenpox), and human papillomavirus<br />
(HPV) infection. Immunization<br />
coverage rates are based on school<br />
enrolment, calculated as the percentage<br />
of children fully immunized for each<br />
vaccine by the end of each school year.<br />
Beginning in 2010, the definition of upto-date<br />
for age for mumps (requiring<br />
two doses) was separated from rubella<br />
(requiring one dose).<br />
The definition of up-to-date for varicella<br />
includes children who are vaccinated<br />
and those protected by having had the<br />
disease previously.<br />
Why do we care?<br />
Vaccination is one of the most effective<br />
health procedures for reducing or<br />
eliminating illness and death linked to<br />
communicable disease. Widespread<br />
immunization coverage in a community<br />
reduces the number of susceptible<br />
people, thereby lessening the chance of<br />
a disease spreading in a population.<br />
Poor coverage can lead to the return of<br />
a disease that had been eliminated<br />
previously. When immunization rates<br />
fall, the corresponding disease will come<br />
back.<br />
• Across BC, immunization coverage<br />
rates for diphtheria, pertussis, tetanus,<br />
and polio (DaPTP) have dropped<br />
among Kindergarten students. In<br />
<strong>2011</strong>, coverage in <strong>Fraser</strong> <strong>Health</strong> has<br />
dropped slightly to 75.7% from 78.4%<br />
in 2005 (data not shown).<br />
• Immunization coverage for meningococcal<br />
C among Grade 6 students<br />
declined between 2003 (93.9%) and<br />
<strong>2011</strong> (86.8%); immunization coverage<br />
for hepatitis B declined between 2002<br />
(92.6%) and <strong>2011</strong> (81.0%). Similar<br />
trends are seen across the province<br />
(data not shown).<br />
Limitations<br />
Data for some home-schooled students<br />
are not available and are therefore not<br />
included in rates.<br />
Caution is needed when comparing to<br />
previous years due to changes in the<br />
definitions for coverage; revisions were<br />
made to the DaPTP definition starting in<br />
2005 and to mumps and rubella in<br />
2010.<br />
Information on child history of varicella<br />
disease or vaccination may be not be<br />
completely reported by parents, so the<br />
proportion of children protected against<br />
varicella is likely underestimated.<br />
98
DISEASE PREVENTION<br />
PRIMARY PREVENTION<br />
Kindergarten Immunization Coverage: Up-to-Date for Age, <strong>2011</strong><br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
DaPTP* Measles Mumps<br />
Rubella<br />
Hepatitis<br />
B<br />
Varicella<br />
Meningo<br />
C*<br />
<strong>Fraser</strong> <strong>Health</strong> 75.7% 87.7% 87.7% 89.8% 89.8% 89.6% 89.7%<br />
BC 76.0% 87.6% 87.5% 90.2% 88.7% 89.1% 89.1%<br />
* DaPTP = Diphtheria, Pertussis, Tetanus and Polio; Meningo C = Meningococcal C<br />
Grade 6 Immunization Coverage: Up-to-Date for Age, <strong>2011</strong><br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
Hepatitis B<br />
Meningococcal C Varicella HPV*<br />
<strong>Fraser</strong> <strong>Health</strong> 81.0% 86.8% 84.6% 68.4%<br />
BC 84.0% 87.7%<br />
87.8% 68.2%<br />
* HPV = Human Papillomavirus<br />
Source: British Columbia Centre for Disease Control (BCCDC), <strong>2011</strong>.<br />
99
Grade 9 Immunization Coverage: Up-to-Date for Age, <strong>2011</strong><br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
Tetanus/diptheria Acellular pertussis HPV*<br />
<strong>Fraser</strong> <strong>Health</strong> 88.3% 85.1% 60.4%<br />
BC† 88.2% 86.4% 61.7%<br />
* HPV = Human Papillomavirus<br />
†<br />
BC rates do not include Vancouver or Richmond <strong>Health</strong> Service Delivery Areas.<br />
Source: British Columbia Centre for Disease Control (BCCDC), <strong>2011</strong>.<br />
100
DISEASE PREVENTION<br />
PRIMARY PREVENTION<br />
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101
Influenza Immunization Coverage<br />
What are we looking at?<br />
Seasonal influenza (flu) immunization<br />
coverage is reported for seniors aged 65<br />
and older who reside in long-term care<br />
facilities, and for health care workers in<br />
long term care facilities and hospitals.<br />
Long-term care facilities include<br />
contracted facilities, <strong>Fraser</strong> <strong>Health</strong><br />
owned and operated facilities, privatepay<br />
facilities, and mental health facilities<br />
with over 15 beds and more than half<br />
the residents are aged 65 and older.<br />
<strong>Health</strong> care workers include regular,<br />
casual, and contract staff members<br />
where data is available. Immunization<br />
coverage for volunteers is not included.<br />
The BC Ministry of <strong>Health</strong> set long-term<br />
targeted rates for seasonal influenza<br />
immunization coverage of 90% for<br />
residents and 80% for staff members of among health care workers.<br />
long-term care facilities, and 60% for<br />
staff members of acute care hospital.<br />
Why do we care?<br />
Influenza can be a serious respiratory<br />
infection, leading to complications and<br />
even death, particularly in very young<br />
children, the elderly, and anyone who<br />
has pre-existing medical conditions.<br />
Immunization is an effective way to<br />
prevent influenza and to reduce<br />
complications and death among cases<br />
where infection is not prevented.<br />
The majority of residents in long-term<br />
care facilities are elderly and many have<br />
chronic medical conditions, putting them<br />
at risk for more severe disease and<br />
complications. Protecting long-term care<br />
residents requires immunizing not only<br />
the residents but also the health care<br />
workers providing them with care, and<br />
family and friends who visit regularly.<br />
Immunizing health care workers in<br />
hospitals helps prevent influenza<br />
infection in workers and their vulnerable<br />
patients who are at risk of complications<br />
and death.<br />
Where can we improve?<br />
• Influenza immunization rates declined<br />
among residents and even more so<br />
among health care workers, especially<br />
in the 2009/10 season. Of note, in the<br />
2009/10 season, pandemic influenza<br />
immunization and recommendations to<br />
delay distribution of the seasonal<br />
influenza vaccine until after the<br />
pandemic vaccine contributed to lower<br />
seasonal influenza vaccine uptake<br />
• The seasonal influenza immunization<br />
rate among health care workers in<br />
<strong>Fraser</strong> <strong>Health</strong> hospitals was the lowest<br />
of all BC health authorities in 2010/11.<br />
Rates in all health authorities fall short<br />
of the long-term target set by the<br />
Ministry of <strong>Health</strong>.<br />
Limitations<br />
Some of the <strong>Fraser</strong> <strong>Health</strong> owned and<br />
operated facilities did not report<br />
immunization data for residents.<br />
102
Influenza Immunization Among Residents of<br />
Long-Term Care Facilities, 2010/11<br />
DISEASE PREVENTION<br />
PRIMARY PREVENTION<br />
100%<br />
90.4%<br />
84.9%<br />
92.2%<br />
89.7% 90.0% 89.6%<br />
80%<br />
.<br />
d<br />
Percent Immunize<br />
60%<br />
40%<br />
20%<br />
0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Source: British Columbia Centre for Disease Control (BCCDC), <strong>2011</strong>.<br />
Seasonal Influenza Immunization Among Residents<br />
in Long-Term Care Facilities<br />
100%<br />
Percent Immunized<br />
90%<br />
80%<br />
70%<br />
60%<br />
Target ≥ 90%<br />
50%<br />
2006/07 2007/ 08 2008/09 2009/10 2010/11<br />
<strong>Fraser</strong> North 93.9% 93.6% 91.5% 90.8% 90.8%<br />
<strong>Fraser</strong> South 92.8% 93.5% 90.5% 90.2% 90.3%<br />
<strong>Fraser</strong> East 93.0% 89.3% 90.3% 87.4% 90.0%<br />
<strong>Fraser</strong> <strong>Health</strong> 93.3% 92.6% 90.9% 89.9% 90.4%<br />
Source: Public <strong>Health</strong>, <strong>Fraser</strong> <strong>Health</strong>, <strong>2011</strong>.<br />
103
Influenza Immunization Among <strong>Health</strong> Care Workers<br />
in Long-Term Care Facilities, 2010/11<br />
100%<br />
80%<br />
Percent Immunized<br />
60%<br />
40%<br />
58.3%<br />
47.6%<br />
53.2%<br />
47.2% 49.1%<br />
55.5%<br />
20%<br />
0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Source: British Columbia Centre for Disease Control (BCCDC), <strong>2011</strong>.<br />
Seasonal Influenza Immunization Among <strong>Health</strong> Care Workers<br />
in Long-Term Care Facilities<br />
100%<br />
Percent Immunized .<br />
80%<br />
60%<br />
40%<br />
20%<br />
Target ≥ 80%<br />
0%<br />
2006/07 2007/08 2008/09 2009/10 2010/11<br />
<strong>Fraser</strong> North 75.2% 75.2% 68.1% 57.4% 57.7%<br />
<strong>Fraser</strong> South 69.6% 74.3% 67.9% 51.7% 57.2%<br />
<strong>Fraser</strong> East 70.3% 67.0% 63.7% 51.2% 62.3%<br />
<strong>Fraser</strong> <strong>Health</strong> 71.9% 73.2% 67.2% 53.6% 58.4%<br />
Source: Public <strong>Health</strong> and Workplace <strong>Health</strong>, <strong>Fraser</strong> <strong>Health</strong>, <strong>2011</strong>.<br />
104
DISEASE PREVENTION<br />
PRIMARY PREVENTION<br />
100%<br />
Influenza Immunization Among <strong>Health</strong> Care Workers<br />
in Hospitals, 2010/11<br />
80%<br />
Percent Immunized<br />
60%<br />
40%<br />
30.5%<br />
44.3%<br />
46.4%<br />
39.3%<br />
41.7%<br />
45.9%<br />
39.8%<br />
20%<br />
0%<br />
FHA IHA VCHA VIHA NHA PHSA BC<br />
Source: British Columbia Centre for Disease Control (BCCDC), <strong>2011</strong>.<br />
Seasonal Influenza Immunization Among <strong>Health</strong> Care Workers<br />
in Hospitals<br />
100%<br />
Percent Immunized .<br />
80%<br />
60%<br />
40%<br />
20%<br />
Target ≥ 60%<br />
0%<br />
2006/07 2007/08 2008/09 2009/10 2010/11<br />
<strong>Fraser</strong> North 41.9% 41.2% 34.2% 17.5% 32.7%<br />
<strong>Fraser</strong> South 39.4% 38.8% 32.2% 14.2% 27.0%<br />
<strong>Fraser</strong> East 39.9% 42.2% 33.1% 18.2% 33.1%<br />
<strong>Fraser</strong> <strong>Health</strong> 40.5% 40.4% 33.2% 16.3% 30.5%<br />
Source: Workplace <strong>Health</strong>, <strong>Fraser</strong> <strong>Health</strong>, <strong>2011</strong>.<br />
105
Secondary Prevention<br />
Screening Mammography Program (SMP)<br />
What are we looking at?<br />
Screening Mammography Program<br />
(SMP) participation rates represent the<br />
number of women age 50 to 69 years at<br />
time of screening who have been<br />
screened as a proportion of all women<br />
age 50 to 69 years. The BC Ministry of<br />
<strong>Health</strong> has set a long-term target of<br />
screening at least 70% of women ages<br />
50 to 69 every two years.<br />
Why do we care?<br />
Breast cancer is the most frequently<br />
diagnosed cancer among women in BC.<br />
It is the second leading cause of death<br />
due to cancer in women. Mammograms<br />
are breast x-rays that can show cancer<br />
two or three years before the cancer is<br />
large enough for someone to detect<br />
through physical breast examination.<br />
Mammography screening helps identify<br />
abnormal cell growth, increasing the<br />
likelihood of early detection of breast<br />
cancer and the earlier<br />
cancer is<br />
detected, the greater the chances for<br />
survival. Studies show that screening<br />
mammography reduces the number of<br />
deaths due to breast cancer.<br />
below the target of screening 70% of<br />
eligible women.<br />
• Participation rates in all but one <strong>Fraser</strong><br />
<strong>Health</strong> LHA have gone up slightly since<br />
2007-2008; the rate in Agassiz/ Harrison<br />
has dropped (data not shown).<br />
• Among LHAs, South Surrey/White Rock<br />
(59.0%) had the highest participation<br />
rate in 2009-2010, followed by Delta<br />
(55.8%), and Burnaby (55.5%); Mission<br />
(46.0%), Hope (47.4%), and Surrey<br />
(48.0%) had the lowest participation<br />
rates of eligible women screened.<br />
Limitations<br />
Rates are calculated based on women<br />
who were aged 50-69 years and living in<br />
<strong>Fraser</strong> <strong>Health</strong> when the mammogram<br />
was done.<br />
• Screening mammography participation<br />
has increased marginally since the<br />
2007-2008 period, with little variation<br />
across BC health authorities.<br />
• In 2009-2010, VCHA and VIHA had the<br />
highest participation rates, but the rate<br />
in <strong>Fraser</strong> <strong>Health</strong> was only slightly lower.<br />
Rates in all health authorities and all<br />
communities in <strong>Fraser</strong> health are far<br />
106
DISEASE PREVENTION<br />
SECONDARY PREVENTION<br />
Screening Mammography Participation, Women Ages 50-69<br />
100%<br />
75%<br />
BC Target ≥ 70%<br />
50%<br />
25%<br />
0%<br />
FHA<br />
IHA VCHA VIHA NHA BC<br />
2007-2008 48.6% 49.7% 51.9% 51.8% 46.9% 50.3%<br />
2008-2009 49.2% 50.8% 51.6% 51.8% 47.5% 50.7%<br />
2009-2010 53.1% 53.0% 55.3% 54.6% 49.9% 53.9%<br />
Screening Mammography Participation, Women Ages 50-69,<br />
2009-2010<br />
South Surrey/White Rock<br />
Delta<br />
Burnaby<br />
Abbotsford<br />
Langley<br />
Coquitlam<br />
BC<br />
Chilliwack<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Maple Ridge<br />
New Westminster<br />
Agassiz/Harrison<br />
Surrey<br />
Hope<br />
Mission<br />
59.0%<br />
55.8%<br />
55.5%<br />
55.2%<br />
55.1%<br />
55.0%<br />
53.9%<br />
53.5%<br />
53.1%<br />
51.9%<br />
49.2%<br />
48.1%<br />
48.0%<br />
47.4%<br />
46.0%<br />
BC Target ≥ 70%<br />
0% 25%<br />
50% 75% 100%<br />
Source: BC Cancer Agency; SMP database, received September 7, <strong>2011</strong> from Population Oncology.<br />
107
Tertiary Prevention<br />
Diabetes Mellitus (DM) Management<br />
What are we looking at?<br />
This measure reports the proportion of<br />
patients in the provincial primary health<br />
care (PHC) diabetes registry who have<br />
their haemoglobin A1C levels measured<br />
at least twice in a year.<br />
The Canadian Diabetes Association<br />
recommends that diabetics have their<br />
haemoglobin A1C levels tested every<br />
three months. The BC Ministry of <strong>Health</strong><br />
(MoH) set a long-term target for health<br />
authorities to increase the proportion of<br />
diabetics having haemoglobin A1C tests<br />
twice a year to 70% or higher.<br />
Why do we care?<br />
Diabetes mellitus is a serious chronic<br />
condition that affects the body’s ability<br />
to produce insulin or to use it properly.<br />
Improperly managed, diabetes can<br />
cause disabling and life-threatening<br />
complications including heart disease,<br />
stroke, kidney disease, and many<br />
others.<br />
Controlling blood glucose levels is crucial<br />
to reducing diabetics’ risk of long-term<br />
complications. Haemoglobin A1C tests<br />
are used to measure overall blood<br />
glucose control over the three previous<br />
months, whereas blood glucose tests<br />
are used to measure the blood sugar<br />
level at the time the test is taken.<br />
• Only 49% of <strong>Fraser</strong> <strong>Health</strong> diabetics<br />
had two or more haemoglobin A1C<br />
tests in 2009/10. Among provincial<br />
health authorities, Vancouver Island<br />
had the largest proportion of diabetics<br />
getting two or more tests; none of the<br />
health authorities has reached the<br />
long-term target for 70% of diabetics<br />
to have A1C levels tested twice a year.<br />
• While the proportion of registered<br />
diabetics having at least twice yearly<br />
haemoglobin A1C testing is increasing,<br />
none of the LHAs in <strong>Fraser</strong> <strong>Health</strong><br />
have yet achieved the MoH target of<br />
70%.<br />
Limitations<br />
Diabetics who are not in the provincial<br />
PHC registry are not included in these<br />
findings.<br />
Duplicate tests are included although<br />
some patients occasionally get duplicate<br />
tests for verification within a very short<br />
time.<br />
100%<br />
75%<br />
50%<br />
25%<br />
0%<br />
Diabetics Having Two or More A1C Tests per Year,<br />
2009/10<br />
MoH long-term target ≥ 70%<br />
49%<br />
52%<br />
48%<br />
54%<br />
47%<br />
Source: Ministry of <strong>Health</strong>, PHC, Diabetes Registry as of<br />
November 2010.<br />
50%<br />
FHA IHA VCHA VIHA NHA BC<br />
108
DISEASE PREVENTION<br />
TERTIARY PREVENTION<br />
Diabetics Having Two or More A1C Tests per Year<br />
100%<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
75%<br />
50%<br />
40% 40% 41%<br />
42%<br />
39% 39% 40% 41%<br />
44%<br />
43%<br />
46%<br />
45%<br />
48%<br />
47%<br />
50% 50% 50%<br />
49% 49% 49%<br />
25%<br />
0%<br />
00/01 01/02 02/03 03/04 04/05 05/06 06/07 07/08 08/09 09/10<br />
Diabetics Having Two or More A1C Tests per Year, 2009/10<br />
South Surrey/White Rock<br />
Agassiz/Harrison<br />
Chilliwack<br />
Burnaby<br />
Coquitlam<br />
Langley<br />
BC<br />
Delta<br />
New Westminster<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Abbotsford<br />
Mission<br />
Surrey<br />
Maple Ridge<br />
Hope<br />
54%<br />
52%<br />
52%<br />
51%<br />
50%<br />
50%<br />
50%<br />
49%<br />
49%<br />
49%<br />
47%<br />
47%<br />
46%<br />
44%<br />
42%<br />
MoH long-term target ≥ 70%<br />
0% 25%<br />
50% 75% 100%<br />
Source: Ministry of <strong>Health</strong>, PHC, Diabetes Registry as of November 2010.<br />
109
110<br />
[This page was left blank intentionally]
HEALTH STATUS<br />
<strong>Health</strong> Status<br />
General <strong>Health</strong> Status<br />
It is important to know how we rate our physical and mental health. There is an increased risk<br />
of death among those who report that their health is poor. Our emotional and psychological<br />
well-being is also important. Poor coping skills for dealing with stress can make a person<br />
vulnerable to health problems. People who are vulnerable because of lower educational<br />
attainment or low er socioeconomic status both tend to have poorer health and more difficulty<br />
accessing prevention services and care. Trend information on other general health status<br />
indicators helps identify new issues.<br />
Morbidity<br />
It is important to look at what is making people sick. Chronic diseases are among the most<br />
common and costly health problems, yet they are largely preventable. A chronic disease can<br />
seriously affect the quality of life.<br />
Mortality<br />
It is important to look at the reasons why people are dying. Many deaths may be untimely and<br />
unnecessary because effective public health and medical interventions exist.<br />
111
General <strong>Health</strong> Status<br />
Life Expectancy at Birth<br />
What are we looking at?<br />
Life expectancy is the average number of<br />
years that a newborn baby can expect to<br />
live if the mortality trends that exist when<br />
the baby is born continue. It is calculated<br />
using age-specific mortality rates reported<br />
as the number of years. Data represent<br />
five-year averages (2006 to 2010).<br />
Why do we care?<br />
Socioeconomic status and individual<br />
health practices affect health and life<br />
expectancy. Individuals and society can<br />
address these factors with potential for<br />
both individual and societal benefit.<br />
• For BC residents born between 2006<br />
and 2010, life expectancy is longest for<br />
those born in the Vancouver Coastal<br />
area.<br />
• Across B C,<br />
women tend to live longer<br />
on average than men do. In <strong>Fraser</strong><br />
<strong>Health</strong>, women can expect to outlive<br />
men by 4.1 years.<br />
• Eastern areas of <strong>Fraser</strong> <strong>Health</strong> tend to<br />
have markedly lower life expectancies<br />
than western areas. This may be related<br />
to socioeconomic and lifestyle factors,<br />
which also follow an east to west<br />
gradient.<br />
Years<br />
Life expectancy measures years of life<br />
without consideration for health status<br />
or quality of life.<br />
Years<br />
90<br />
85<br />
80<br />
75<br />
70<br />
65<br />
FHA IHA VCHA VIHA NHA<br />
Females 83.8 83.0 85.4 83.6 81.2 83.9<br />
Males 79.7 78.3 81.1 79.1 76.6 79.5<br />
Overall 81.8 80.6 83.3 81.4 78.8 81.7<br />
90<br />
85<br />
80<br />
75<br />
Life Expectancy at Birth by Sex, 2006-2010<br />
Canada = 80.9 (2006-2009)<br />
Sources: BC Stats, Ministry of Labour and Citizens’<br />
Services, as of April <strong>2011</strong>. Canadian data from Statistics<br />
Canada, retrieved December 14, <strong>2011</strong> from:<br />
http://www5.statcan.gc.ca/cansim/a05?lang=eng&id=<br />
1020512&paSer=&pattern=102-<br />
0512&stByVal=3&csid=<br />
Overall Life Expectancy at Birth<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
BC<br />
Limitations<br />
The methodology used to calculate life<br />
expectancy can vary between different<br />
regions, affecting comparability since<br />
different methods can alter estimates by a<br />
fraction of a year.<br />
70<br />
65<br />
1987-<br />
1991<br />
1992-<br />
1996<br />
1997-<br />
2001<br />
2002-<br />
2006<br />
Sources: BC Stats, Ministry of Labour and Citizens’<br />
Services, as of April <strong>2011</strong>.<br />
2005-<br />
2009<br />
2006-<br />
2010<br />
112
HEALTH STATUS<br />
GENERAL HEALTH STATUS<br />
Overall Life Expectancy at Birth, 2006-2010<br />
South Surrey/White Rock<br />
Coquitlam<br />
Burnaby<br />
Delta<br />
<strong>Fraser</strong><br />
BC<br />
Surrey<br />
Abbotsford<br />
Langley<br />
Maple Ridge<br />
Agassiz/Harrison<br />
New Westminster<br />
Chilliwack<br />
Mission<br />
Hope<br />
75.5<br />
83.4<br />
83.0<br />
83.0<br />
82.7<br />
81.8<br />
81.7<br />
81.6<br />
81.4<br />
81.4<br />
80.4<br />
80.4<br />
80.3<br />
80.0<br />
79.2<br />
65<br />
70 75 80 85 90<br />
Years<br />
Female Life Expectancy at Birth, 2006-2010<br />
Male Life Expectancy at Birth, 2006-2010<br />
S. Surrey/W. Rock<br />
85.4<br />
Coquitlam<br />
81.2<br />
Burnaby<br />
85.1<br />
S. Surrey/W. Rock<br />
81.1<br />
Coquitlam<br />
84.7<br />
Delta<br />
80.9<br />
Delta<br />
84.3<br />
Burnaby<br />
80.8<br />
BC<br />
83.9<br />
<strong>Fraser</strong><br />
79.7<br />
<strong>Fraser</strong><br />
83.8<br />
Surrey<br />
79.7<br />
Abbotsford<br />
83.7<br />
BC<br />
79.5<br />
Surrey<br />
83.5<br />
Langley<br />
79.3<br />
Agassiz/Harrison<br />
83.5<br />
Abbotsford<br />
79.1<br />
Langley<br />
83.3<br />
Maple Ridge<br />
78.3<br />
New Westminster<br />
82.4<br />
New Westminster<br />
78.1<br />
Maple Ridge<br />
82.4<br />
Chilliwack<br />
77.8<br />
Chilliwack<br />
82.2<br />
Agassiz/Harrison<br />
77.6<br />
Mission<br />
81.3<br />
Mission<br />
77.1<br />
Hope<br />
77.8<br />
Hope<br />
73.5<br />
65 70 75 80 85 90<br />
65 70 75 80 85 90<br />
Years<br />
Years<br />
Source: BC Stats, Ministry of Labour and Citizens’ Services. Retrieved August 31, <strong>2011</strong> from<br />
http://www.bcstats.go v.bc.ca/data/pop/pop/dynamic/LifeExpectancy.asp.<br />
113
Live Birth Rates & Related Indicators<br />
What are we looking at?<br />
Live Birth Rate: The live birth rate is the<br />
number of live births per 1,000 people<br />
in a given period. For small populations,<br />
a slight change in the number of live<br />
births can dramatically affect rates. So<br />
rates are calculated over a five-year<br />
period because single year rates can<br />
fluctuate from year to year.<br />
Caesarean Rate: The number of babies<br />
born by Caesarean section per 1,000<br />
live births for 2005-2009.<br />
Births to Older Mothers: The number of<br />
live babies born to women aged 35<br />
years and older expressed as a rate per<br />
1,000 live births for 2005-2009.<br />
Why do we care?<br />
Knowing the numbers of births in each<br />
LHA is important for planning prenatal,<br />
perinatal, and neonatal health services<br />
and childcare services.<br />
Mothers over age 35 face a higher risk<br />
of preeclampsia, gestational diabetes,<br />
and other complications that can<br />
increase the likelihood of a caesarean<br />
delivery. The risk of a baby having<br />
chromosomal anomalies such as Down’s<br />
syndrome increases with the age of the<br />
mother.<br />
• <strong>Fraser</strong> <strong>Health</strong> has a higher rate of live<br />
birth than BC overall (11.4 and 10.1<br />
respectively in 2009).<br />
• Birth rates in <strong>Fraser</strong> <strong>Health</strong> and BC<br />
have remained stable since 2000.<br />
• The live birth rate is highest among<br />
women 30- to 34-years old.<br />
• Caesarean rates among women tend<br />
to be higher in western LHAs than in<br />
eastern LHAs; this is likely due, in<br />
part, to western LHAs having higher<br />
birth rates among older mothers age<br />
35-years and older.<br />
Limitations<br />
Rates are not adjusted for regional<br />
population age structures, so data do<br />
not account for age differences between<br />
different area populations.<br />
Total Number of Live Births by LHA*,<br />
2009<br />
Local <strong>Health</strong> Area # Live Births<br />
Burnaby 2,367<br />
Coquitlam 2,269<br />
Maple Ridge 1,001<br />
New Westminster 732<br />
Delta 833<br />
Langley 1,473<br />
Surrey 5,185<br />
South Surrey/White Rock 530<br />
Abbotsford 1,765<br />
Mission 454<br />
Chilliwack 1,083<br />
Hope 69<br />
Agassiz/Harrison 98<br />
<strong>Fraser</strong> <strong>Health</strong> 17,859<br />
BC 44,908<br />
* The number of live births in each LHA is based on where<br />
the mother lives.<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry<br />
of <strong>Health</strong> Services.<br />
114
HEALTH STATUS<br />
GENERAL HEALTH STATUS<br />
18<br />
Live Birth Rates<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
0 Population<br />
per 1,00<br />
16<br />
14<br />
12<br />
10<br />
8<br />
6<br />
14.9 15.0<br />
13.6 13.4<br />
14.4<br />
12.9<br />
13.9<br />
12.4<br />
12.7<br />
11.2<br />
11. 7<br />
10. 4<br />
11.2 11.2<br />
10.8<br />
9.9 9.8 9.7<br />
11.3 11.4<br />
10.1 10.1<br />
4<br />
2<br />
0<br />
1989 '91 '93 '95 '97 '99 '01 '03 '05 '07 2009<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry of H ealth Services.<br />
120<br />
Live Births by Age of Mother, 2009<br />
100<br />
males in Age Group<br />
1,000 Fe<br />
per<br />
80<br />
60<br />
40<br />
20<br />
0<br />
10-14 15-19 20-24<br />
25-29 30-34 35-39 40-44 45+<br />
<strong>Fraser</strong> <strong>Health</strong> 0.1 7.8 42.5 95.2 112.3 57.3 10.4 0.1<br />
BC 0.1 10.2 41.1<br />
81.6 99.4 54.3 10.5 0.1<br />
Source: Birth counts from VISTA database, BC Vital Statistics Agency, BC Ministry of <strong>Health</strong>; rates were calculated<br />
using P.E.O.P.L.E. 36 projections, BC Stats, BC Ministry of Labour and Citizens’ Services.<br />
115
Live Birth Rates, 2005-2009<br />
Surrey<br />
Abbotsford<br />
Chilliwack<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Mission<br />
Agassiz/Harrison<br />
New Westminster<br />
Langley<br />
Maple Ridge<br />
Burnaby<br />
Coquitlam<br />
BC<br />
Hope<br />
Delta<br />
South Surrey/White Rock<br />
6.6<br />
13.5<br />
12.8<br />
12.2<br />
11.2<br />
11.1<br />
11.0<br />
10.9<br />
10.8<br />
10.5<br />
10.4<br />
10.0<br />
Lowest in BC = 5.4<br />
9.9<br />
Highest in BC = 20.0<br />
9.1<br />
8.7<br />
0 5 10 15 20<br />
per 1,000 Population<br />
Caesarean Rates, 2005-2009<br />
South Surrey/White Rock<br />
Delta<br />
Coquitlam<br />
Surrey<br />
Maple Ridge<br />
<strong>Fraser</strong> <strong>Health</strong><br />
New Westminster<br />
Burnaby<br />
BC<br />
Agassiz/Harrison<br />
Chilliwack<br />
Langley<br />
Mission<br />
Abbotsford<br />
Hope<br />
345.9<br />
345.5<br />
332.6<br />
322.5<br />
320.6<br />
311.8<br />
307.4<br />
306.9<br />
305.6<br />
291.3<br />
287.1<br />
287.0 Lowest in BC = 163.6<br />
284.3<br />
Highest in BC = 380.3<br />
275.4<br />
254.1<br />
0 100 200 300 400 500<br />
per 1,000 Live Births<br />
Source: BC Vital Statistics Agency. Selected Vital Statistics and <strong>Health</strong> Status Indicators, 2009.<br />
116
HEALTH STATUS<br />
GENERAL HEALTH STATUS<br />
Birth Rates for Older Mothers Age 35+, 2005-2009<br />
South Surrey/White Rock<br />
Burnaby<br />
Coquitlam<br />
New Westminster<br />
Delta<br />
BC<br />
Maple Ridge<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Langley<br />
Surrey<br />
Mission<br />
Agassiz/Harrison<br />
Chilliwack<br />
Abbotsford<br />
Hope<br />
312.1<br />
296.8<br />
291.7<br />
274.9<br />
264.0<br />
223.1<br />
215.4<br />
211.8<br />
196.9<br />
168.8<br />
148.3<br />
Lowest in BC = 64.5<br />
142.6<br />
Highest in BC = 457.2<br />
133.2<br />
123.2<br />
106.6<br />
0 100 200 300 400 500<br />
per 1,000 Live Births<br />
Source: BC Vital Statistics Agency. Selected Vital Statistics and <strong>Health</strong> Status Indicators, 2009.<br />
117
What are we looking at?<br />
The number of live births among teen<br />
mothers 15- to 19-years old, expressed<br />
as an annual rate per 1,000 females of<br />
the same age. Data exclude stillbirths<br />
and abortions.<br />
Why do we care?<br />
Teenage mothers and their babies tend<br />
to have more problems than do other<br />
mothers and their babies. For example,<br />
the incidence of preterm and low birthweight<br />
infants is higher for adolescent<br />
pregnancies. 32,33 Teenage mothers are<br />
also at higher risk for pregnancy-related<br />
high blood pressure and eclampsia.<br />
Teenaged mothers are more likely to<br />
live below the poverty level and become<br />
dependent on social assistance. They<br />
are also more likely than other mothers<br />
are to be lone-parents and tend to have<br />
less education than their non-mother<br />
peers. 34 Given the socioeconomic<br />
challenges they face, some young<br />
mothers are at higher risk of abusing or<br />
neglecting their children.<br />
Teen birth rates are influenced by<br />
various factors, such as socioeconomic<br />
status, sexual behaviours and practices,<br />
personal belief systems, knowledge and<br />
proper use of contraceptive methods,<br />
and the availability, accessibility, and<br />
32 Conde-Agudelo, A., Belizán, J.M., & Lammers, C. (2005).<br />
Maternal-perinatal morbidity and mortality associated with<br />
adolescent pregnancy in Latin America: Cross-sectional<br />
study. American Journal of Obstetrics and Gynaecology,<br />
192, 342-9.<br />
33 Konial-Griffin, D. & Turner-Pluta, C. (2000). <strong>Health</strong> risks<br />
and psychosocial outcomes of early childbearing: A Review<br />
of the literature. Journal of Perinatal & Neonatal Nursing,<br />
15(2), 1-17.<br />
34 Stewart, P. (1998). As cited on page 131 in:<br />
Canadian Institute of Child <strong>Health</strong>. (2000).The health of<br />
Canada’s children (3 rd Ed). Ottawa, ON: Author.<br />
Teen Birth Rate<br />
per 1,000 Teen Females<br />
30<br />
25<br />
20<br />
15<br />
10<br />
5<br />
0<br />
acceptability of family planning and<br />
related health services. 35<br />
• Overall, teen birth rates have dropped<br />
dramatically since 1988, but they<br />
appear to have stabilized since 2004.<br />
• LHAs in the east have higher teen<br />
birth rates than other LHAs in <strong>Fraser</strong><br />
<strong>Health</strong>.<br />
Limitations<br />
Some teen births are planned, especially<br />
for ethnic or cultural groups in which<br />
marriage before age 20 is common.<br />
Rates in areas with small populations,<br />
such as Hope or Agassiz/Harrison, may<br />
fluctuate from year to year, so interpret<br />
with caution.<br />
7.8<br />
Teen Birth Rates, Ages 15-19, 2009<br />
14.3<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry<br />
of <strong>Health</strong> Services.<br />
3.8<br />
12.2<br />
27.3<br />
35 Canadian Institute for <strong>Health</strong> Information, Working Group<br />
on Community <strong>Health</strong> Information Systems, Chevakier, S.,<br />
Choiniere, R., Ferland, M., Pageau, M., & Sauvageau, Y.<br />
(1995). Community health indicators: Definitions and<br />
interpretations. Ottawa, ON: Author.<br />
10.2<br />
FHA IHA VCHA VIHA NHA BC<br />
118
HEALTH STATUS<br />
GENERAL HEALTH STATUS<br />
Teen Birth Rates, Ages 15-19<br />
30<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
25<br />
23.4 23.5 24.1 23.3<br />
22.3 22.2 21.6<br />
s<br />
per 1,000 Tee n Fe male<br />
20<br />
15<br />
10<br />
5<br />
21.2<br />
19.8<br />
20.9<br />
19.8 19.8<br />
17.3<br />
18.3<br />
18.5<br />
16.9<br />
17.3<br />
15.2<br />
9.8<br />
16.2<br />
15.3<br />
13.8 13.1<br />
14.7 14. 4<br />
12.6<br />
11.8 11.0 10.7 10.7 10.6 10.4 10.2<br />
10.9 10.3 9.6<br />
8.9<br />
9.1<br />
7.3 7.9 7.8<br />
7.1<br />
0<br />
1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009<br />
Teen Birth Rates (Counts), Ages 15-19, 2009<br />
Hope<br />
Agassiz/Harrison<br />
Chilliwack<br />
Mission<br />
Abbotsford<br />
BC<br />
Surrey<br />
Langley<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Maple Ridge<br />
Coquitlam<br />
New Westminster<br />
Burnaby<br />
Delta<br />
South Surrey/White Rock<br />
10.9 ( 17)<br />
10.7 (48)<br />
10.2 (1,414)<br />
8.9 (112)<br />
8.0 (37)<br />
7.8 (405)<br />
6.6 (22)<br />
4.6 (35)<br />
4.1 (7)<br />
4.0 (25)<br />
3.4 (12)<br />
2.0 (5)<br />
22.7 (65)<br />
32.8 (10)<br />
41.5 (10)<br />
0 10 20 30 40 50<br />
per 1,000 Teen Females (Counts)<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
119
Self-Rated <strong>Health</strong><br />
What are we looking at?<br />
Self-rated health is a commonly used<br />
measure, which describes health status<br />
based on the respondent’s personal<br />
judgement. Self-rated health reflects not<br />
only physical health, but also a general<br />
sense of well-being.<br />
Data are generated through the cyclical<br />
Canadian Community <strong>Health</strong> Survey<br />
(CCHS) in which one question asks<br />
respondents aged 12+ to rate their own<br />
health as: excellent; very good; good;<br />
fair; or poor.<br />
In the graphs, bars represent point<br />
estimates and whisker lines represent<br />
the 95% confidence intervals.<br />
Why do we care?<br />
Self-reported health reflects global<br />
aspects of health and well-being that<br />
are not captured in other measures such<br />
as disease status and severity, physiological<br />
and psychological measures, and<br />
social and mental function.<br />
• At 52.7%, <strong>Fraser</strong> East HSDA has the<br />
smallest proportion of residents in<br />
<strong>Fraser</strong> <strong>Health</strong> with very good or<br />
excellent self-rated health; at 65.6%.<br />
North Shore/Coast Garibaldi HSDA in<br />
Vancouver Coastal <strong>Health</strong> has the<br />
highest proportion in the province.<br />
• Self-rated health has declined<br />
slightly in <strong>Fraser</strong> East and <strong>Fraser</strong><br />
South from 2003 to 2009/10, but the<br />
change is not statistically significant.<br />
• In 2005, those over age 45 years<br />
(data not shown) and those with low<br />
income or weak sense of community<br />
belonging were less likely to have<br />
100%<br />
80%<br />
60%<br />
40%<br />
20%<br />
very good or excellent self-rated<br />
health.<br />
• General health and mental health are<br />
closely related; those who report<br />
good mental health are more likely<br />
to report good self-rated health.<br />
Limitations<br />
Data reflects the respondent’s<br />
perspective of their health and not their<br />
actual health.<br />
0%<br />
58.3%<br />
59.9%<br />
52.7%<br />
65.6%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong><br />
Survey, 2009/10.<br />
100%<br />
80%<br />
60%<br />
40%<br />
20%<br />
0%<br />
Population Age 12+ with Very Good/Excellent<br />
Self-Rated <strong>Health</strong>, 2009/10<br />
Best HSDA<br />
in BC<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East North Shore/<br />
Coast Garibaldi<br />
Population Age 12+ with Very Good/Excellent<br />
Self-Rated <strong>Health</strong>, 2003 to 2009/10<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
2003 57.9% 62.7% 58.0% 60.1%<br />
2005 57.9% 61.3% 60.7% 59.5%<br />
2007/08 58.6% 58.6% 54.8% 57.8%<br />
2009/10 58.3% 59.9% 52.7% 59.6%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong><br />
Survey, 2003, 2005, 2007/08 and 2009/10<br />
Note: Bars represent point estimates; whisker lines<br />
represent 95% confidence intervals.<br />
59.6%<br />
BC<br />
120
HEALTH STATUS<br />
GENERAL HEALTH STATUS<br />
Population Aged 12+,<br />
b y Self-Rated <strong>Health</strong>, 2005<br />
50% <strong>Fraser</strong> <strong>Health</strong> BC<br />
40%<br />
30%<br />
20%<br />
10%<br />
0%<br />
Poor<br />
<strong>Fraser</strong> <strong>Health</strong> 3.1% 7.9% 28.6% 37.0% 23.3%<br />
BC 2.9%<br />
Fair<br />
Good Very Good Excellent<br />
8.8% 28.4% 37.5% 22.3%<br />
Very Good/Excellent Self-Rated <strong>Health</strong> (Age 12+),<br />
<strong>Fraser</strong> <strong>Health</strong>, by Selected Groups, 2005<br />
Females<br />
Males<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Average= 60.3%<br />
Household Income < $30,000<br />
Household Income ≥ $80,000<br />
White<br />
East Asian/ South Asian<br />
Aboriginal<br />
Very good/excellent self-rated mental health<br />
Poor/fair self-rated mental health<br />
Strong sense of community belonging<br />
Weak sense of community belonging<br />
Use with caution, estimates are less<br />
reliable due to small sample sizes<br />
0%<br />
20% 40% 60% 80% 100%<br />
Note: Household income
Self-Rated Mental <strong>Health</strong><br />
What are we looking at?<br />
Self-rated mental health measures<br />
respondents’ health status based on<br />
her/his personal judgement, reflecting<br />
psychological health as well as a general<br />
sense of well-being.<br />
Data are generated through the cyclical<br />
Canadian Community <strong>Health</strong> Survey<br />
(CCHS) with one question asking<br />
respondents age 12 years or older to<br />
rate their own mental health as:<br />
excellent; very good; good; fair; or<br />
poor. In the graphs, bars represent<br />
point estimates and whisker lines the<br />
95% confidence intervals.<br />
100%<br />
80%<br />
health as very good/ excellent than<br />
those with a weak sense of community<br />
belonging.<br />
Limitations<br />
The survey does not define ‘mental<br />
health,’ making it difficult to determine<br />
how respondents framed the question in<br />
terms of psychological, emotional, and/<br />
or cognitive elements of mental health.<br />
Population Age 12+ with Very Good/Excellent<br />
Self-Rated Mental <strong>Health</strong>, 2009/10<br />
71.7%<br />
71.6%<br />
71.0%<br />
74.2%<br />
71.0%<br />
Why do we care?<br />
A vital part of overall wellbeing, good<br />
mental health goes beyond the absence<br />
of mental illness. Good mental health<br />
enables people to feel good about<br />
themselves, maintain a positive outlook,<br />
and cope with the demands of life.<br />
Self-rated mental health is a single<br />
measure that has been shown to predict<br />
functional decline, health service usage,<br />
and overall well-being.<br />
60%<br />
40%<br />
20%<br />
0%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong><br />
Surveys, 2009/10.<br />
100%<br />
80%<br />
Best<br />
HSDA<br />
in BC<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East North Shore/<br />
Coast Garibaldi<br />
Population Age 12+ with Very Good/Excellent<br />
Self-Rated Mental <strong>Health</strong>, 2003 to 2009/10<br />
BC<br />
• There have been no statistically<br />
significant trends in self-rated mental<br />
health from 2003 to 2009/10.<br />
• Those with low income are less likely<br />
to rate their own mental health as<br />
very good/ excellent than those with<br />
high income.<br />
• Social relationships and mental health<br />
are connected. Those with a strong<br />
sense of community belonging are<br />
more likely to rate their own mental<br />
60%<br />
40%<br />
20%<br />
0%<br />
<strong>Fraser</strong> North <strong>Fraser</strong> South <strong>Fraser</strong> East BC<br />
2003 68.7% 73.9% 70.7% 70.6%<br />
2005 72.6% 75.0% 74.8% 72.5%<br />
2007/08 74.4% 71.2% 69.9% 71.4%<br />
2009/10 71.7% 71.6% 71.0% 71.0%<br />
Source: Statistics Canada, Canadian Community <strong>Health</strong><br />
Surveys, 2003, 2005, 2007/08 and 2009/10.<br />
Note: Bars represent point estimates; whisker lines<br />
represent 95% confidence intervals<br />
122
HEALTH STATUS<br />
GENERAL HEALTH STATUS<br />
Very Good/Excellent Self-Rated Mental <strong>Health</strong> (Age 12+),<br />
by Age Group, 2005<br />
100% <strong>Fraser</strong> <strong>Health</strong> BC<br />
80%<br />
60%<br />
40%<br />
20%<br />
0%<br />
12-19 20-34<br />
35-44 45-64 65+<br />
<strong>Fraser</strong> <strong>Health</strong> 77.3% 78.4% 74.8% 72.7% 67.8%<br />
BC 77.7% 75.0% 73.6% 71.5% 66.7%<br />
Very Good/Excellent Self-Rated Mental <strong>Health</strong> (Age 12+),<br />
<strong>Fraser</strong> <strong>Health</strong>, by Selected Groups, 2005<br />
Females<br />
Males<br />
Household Income < $30,000<br />
Household Income ≥ $80,000<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Average= 74.4%<br />
White<br />
East Asian/ South Asian<br />
Aboriginal<br />
Strong sense of community belonging<br />
Weak sense of community belonging<br />
Use with caution, estimates are less<br />
reliable due to small sample sizes<br />
0% 20%<br />
40% 60% 80% 100%<br />
Note: Household income
MORBIDITY<br />
Leading Causes of Hospitalization<br />
What are we looking at?<br />
The cause of hospitalization is coded as<br />
the principal diagnosis as extracted from<br />
patient hospital records. This is the<br />
diagnosis that the physician considers to<br />
be most responsible for the patient’s<br />
hospital stay. Data are grouped by<br />
diagnostic short code.<br />
Data are for acute inpatients, excluding<br />
newborns, stillbirths, rehab, and surgical<br />
daycare. Data are analyzed by place of<br />
residence including residents of <strong>Fraser</strong><br />
<strong>Health</strong> hospitalized outside the region.<br />
Along with general hospitalization rates,<br />
the five leading diagnoses are shown for<br />
all age groups. For this analysis, those<br />
conditions related to pregnancy and<br />
delivery were excluded from the top<br />
five; these accounted for 60.9% of all<br />
hospitalizations among women aged 17<br />
to 24 and 69.7% among women aged<br />
25 to 44.<br />
Also excluded from the top five is the<br />
category “persons encountering health<br />
services for specific procedures and<br />
healthcare” (Z00-Z99), which refers to<br />
follow-up medical surveillance or care.<br />
These accounted for 5% of all<br />
hospitalizations among men and women<br />
aged 45 to 64; 6.5% among males aged<br />
65 and older; and 6.9% among females<br />
aged 65 and older.<br />
Why do we care?<br />
This indicator reports the primary<br />
reasons for why people are admitted to<br />
hospital and how these reasons differ by<br />
age and sex. While data presented only<br />
account for a small percentage of all<br />
diagnosed illnesses, they help identify<br />
the most troublesome health problems<br />
in a community.<br />
• In <strong>Fraser</strong> <strong>Health</strong>, hospitalization rates<br />
are generally higher in eastern than<br />
western LHAs.<br />
• Hospitalization rates for men aged 65-<br />
years and older are higher than for<br />
women of the same age.<br />
• Mental illnesses are among the leading<br />
reasons for hospitalization among<br />
those age 17 to 44 years.<br />
Limitations<br />
Data refer to inpatient cases discharged<br />
from a hospital. Since someone can be<br />
admitted to and discharged from<br />
hospital more than once a year, data<br />
represent hospitalization events only,<br />
not the number of individuals with a<br />
specific illness.<br />
Hospitalization rates give information<br />
only on illnesses that require admission<br />
to hospital. Illnesses can be treated at<br />
home, in a doctor’s office, in hospital<br />
emergency departments, or in other<br />
settings and therefore the data do not<br />
provide complete information on the<br />
effects specific illnesses can have on the<br />
population or the healthcare system.<br />
Hospitalization data capture only the<br />
serious cases of a disease.<br />
124
HEALTH STATUS<br />
MORBIDITY<br />
Hospitalization Rate by Age Group & Sex, 2009/10*<br />
500<br />
te per 1,000 Population<br />
Ra<br />
400<br />
300<br />
200<br />
100<br />
0<br />
≤16 17-24 25-44 45-64 65-84 85+<br />
Female 25.1 62.7 113.1 62.7 172.9 394.6<br />
Male 28.9 25.0 31.7 67.8 198.8 457.7<br />
Hope<br />
Chilliwack<br />
Abbotsford<br />
South Surrey/White Rock<br />
New Westminster<br />
Agassiz/Harrison<br />
Mission<br />
BC<br />
Maple Ridge<br />
Langley<br />
Delta<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Surrey<br />
Coquitlam<br />
Burnaby<br />
Inpatient Discharge<br />
Rate, 2009/10*<br />
98.4<br />
94.5<br />
87.7<br />
87.1<br />
86.4<br />
86.0<br />
83.3<br />
79.9<br />
79.3<br />
77.9<br />
77.1<br />
68.9<br />
68.0<br />
67.6<br />
122.0<br />
0 20 40<br />
60 80 100 120 140<br />
Rate per 1,000 Population<br />
* Note: General hospitalization and discharge rates above consist of all diagnoses, including conditions related to<br />
pregnancy and delivery and “persons encountering health services for specific procedures and healthcare,”<br />
which are excluded from the following tables showing the leading five causes of hospitalization.<br />
Source: Discharge Abstract Database, 2009/10.<br />
125
Females Leading Cause of Hospitalization, 2009/10<br />
≤16 Years Old<br />
Diagnosis Cases Days<br />
% Total<br />
Discharges<br />
FH Rate<br />
per 1,000<br />
BC Rate<br />
per 1,000<br />
Intestinal infectious diseases 188 417 5.0% 1.3 1.3<br />
Influenza and pneumonia 184 678 4.9% 1.2 1.6<br />
Diseases of appendix 151 415 4.0% 1.0 1.0<br />
Other acute lower respiratory infections 143 436 3.8% 1.0 1.0<br />
Disorders related to length of gestation<br />
and fetal growth<br />
141 3,581 3.8% 0.9 0.9<br />
All Causes of Hospitalization 3,754 18,996 100% 25.1 27.2<br />
17 - 24 Years Old<br />
Diagnosis Cases Days<br />
% Total<br />
Discharges<br />
FH Rate<br />
per 1,000<br />
BC Rate<br />
per 1,000<br />
Mood [affected] disorders 191 1,780 3.6% 2.2 2.2<br />
Symptoms and signs involving the<br />
digestive system and abdomen<br />
151 355 2.8% 1.8 1.8<br />
Diseases of appendix 126 285 2.4% 1.5 1.7<br />
Poisoning by drugs, medicaments and<br />
biological substances<br />
93 180 1.7% 1.1 1.1<br />
Disorders of gallbladder, biliary tract<br />
and pancreas<br />
74 191 1.4% 0.9 1.1<br />
All Causes of Hospitalization 5,359 19,186 100% 62.7 67.3<br />
25 - 44 Years Old<br />
Diagnosis Cases Days<br />
Noninflammatory disorders of female<br />
genital tract<br />
% Total<br />
Discharges<br />
FH Rate<br />
per 1,000<br />
BC Rate<br />
per 1,000<br />
675 1,471 2.7% 3.0 3.5<br />
Mood [affected] disorders 590 7,105 2.3% 2.6 2.6<br />
Symptoms and signs involving the<br />
digestive system and abdomen<br />
Disorders of gallbladder, biliary tract<br />
and pancreas<br />
383 951 1.5% 1.7 1.9<br />
376 1,304 1.5% 1.7 1.9<br />
Benign neoplasms 370 996 1.5% 1.6 1.6<br />
All Causes of Hospitalization 25,415 83,927 100% 113.1 108.1<br />
Source: Discharge Abstract Database, 2009/10.<br />
126
HEALTH STATUS<br />
MORBIDITY<br />
Males Leading Cause of Hospitalization, 2009/10<br />
≤16 Years Old<br />
Diagnosis Cases Days<br />
% Total<br />
Discharges<br />
FH Rate<br />
per 1,000<br />
BC Rate<br />
per 1,000<br />
Influenza and pneumonia 269 897 5.8% 1.7 1.9<br />
Other acute lower respiratory infections<br />
Haemorrhagic and haemtological<br />
disorders of fetus and newborn<br />
239 658 5.1% 1.5 1.6<br />
Diseases of appendix 221 621 4.7% 1.4 1.4<br />
Intestinal infectious diseases 215 470 4.6% 1.3 1.4<br />
178 329 3.8% 1.1 1.4<br />
All Causes of Hospitalization 4,660 22,515 100% 28.9 31.4<br />
17 - 24 Years Old<br />
Schizophrenia, schizotypal<br />
delusional disorders<br />
Diagnosis Cases Days<br />
and<br />
% Total<br />
Discharges<br />
FH Rate<br />
per 1,000<br />
BC Rate<br />
per 1,000<br />
196 3,966 8.3% 2.1 3.0<br />
Diseases of appendix 179 324 7.5% 1.9 2.0<br />
Mood [affected] disorders 176 2, 103 7.4% 1.9 1.9<br />
Injuries to the head<br />
In juries to the knee and lower leg<br />
141<br />
628 5.9% 1.5 1.7<br />
100 339 4.2% 1.1 1.3<br />
All Causes of Hospitalization 2,374 15,494 100% 25.0 29.3<br />
25 - 44 Years Old<br />
Diagnosis Cases Days<br />
Schizophrenia, schizotypal<br />
and<br />
delusional disorders<br />
Mental & behavioural disorders due to<br />
psychoactive substance use<br />
% Total<br />
Discharges<br />
521 9,739 7.4%<br />
FH Rate<br />
per 1,000<br />
BC Rate<br />
per 1,000<br />
2.3 3.0<br />
513 2,021 7.3% 2.3 2.6<br />
Mood [affected] disorders 442 4,725 6.3% 2.0 2.3<br />
Diseases of appendix<br />
Injuries to the knee and lower leg<br />
285 254 635<br />
805<br />
4.0%<br />
3.6%<br />
1.3<br />
1.1<br />
1.3<br />
1.3<br />
All Causes of Hospitalization 7,040 45,712 100% 31.7 35.9<br />
Source: Discharge Abstract Database, 2009/10.<br />
127
Females<br />
Leading Cause of Hospitalization, 2009/10<br />
45 - 64 Years O ld<br />
Diagnosis Cases Days<br />
Noninflammatory disorders of female<br />
genital tract<br />
Arthrosis 693 2,713<br />
% Total<br />
Discharges<br />
FH Rate<br />
per 1,000<br />
BC Rate<br />
per 1,000<br />
712 1,745 5.4%<br />
3.3 3.4<br />
Mood [affected] disorders 517 8,323 4.0% 2.4 2.4<br />
Benign neoplasms 505 1,410 3.9% 2.4 2.3<br />
Disorders of gallbladder, biliary tract<br />
and pancreas<br />
5.3% 3.2 3.2<br />
481 2,087 3.7%<br />
2.2 2.6<br />
All Causes of Hospitalization 13,069 87,979 100% 60.8 67.0<br />
65 - 84 Years Old<br />
Diagnosis Cases Days<br />
% Total<br />
Discharges<br />
FH Rate<br />
per 1,000<br />
BC Rate<br />
per 1,000<br />
Other forms of heart disease 1,177 9,851 7.0% 12.2<br />
12.3<br />
Arthrosis 1,015 5,010 6.1% 10.5 11.1<br />
Chronic lower respiratory diseases 758 8,274 4.5% 7.8 7.9<br />
Ischemic heart diseases 737 5,334 4.4% 7.6 8.7<br />
Other diseases of intestines 626 5,171 3.7% 6.5 7.0<br />
All Causes of Hospitalization 16,696 185,500 100% 172.9 178.5<br />
85 Years and Older<br />
Diagnosis Cases Days<br />
% Total<br />
Discharges<br />
FH Rate<br />
per 1,000<br />
BC Rate<br />
per 1,000<br />
Other forms of heart disease 757 8,756 10.8% 42.5 37.4<br />
Injuries to the hip and thigh 578 11,397 8.2% 32.5 29.2<br />
General symptoms and signs 375 5,902 5.3% 21.1 16.0<br />
Ischemic heart diseases 280 2,941 4.0%<br />
15.7 15.7<br />
Other disorders of urinary system 276 4,028 3.9% 15.5 12.6<br />
All Causes of Hospitalization<br />
Source: Discharge Abstract Database, 2009/10.<br />
7,023 106,658 100% 394.6 368.0<br />
128
HEALTH STATUS<br />
MORBIDITY<br />
Males Leading Cause of Hospitalization, 2009/10<br />
45 - 64 Years Old<br />
Diagnosis Cases Days<br />
% Total<br />
Discharges<br />
FH Rate<br />
per 1,000<br />
BC Rate<br />
per 1,000<br />
Ischemic heart diseases 1,263 6,497 8.8% 5.9 7.0<br />
Other forms of heart disease 640 3,675 4.4% 3.0<br />
3.3<br />
Arthrosis 503 1,741 3.5% 2.4<br />
2.8<br />
Mental & behavioural disorders due to<br />
psychoactive substance use<br />
479 2,423 3.3% 2.3 2.6<br />
Disorders of gallbladder, biliary tract<br />
and pancreas<br />
477 2,278 3.3% 2.2 2.2<br />
All Causes of Hospitalization 14,387 112,426 100% 67.8 74.7<br />
65 - 84 Years Old<br />
Diagnosis Cases Days<br />
% Total<br />
Discharges<br />
FH Rate<br />
per 1,000<br />
BC Rate<br />
per 1,000<br />
Other forms of heart disease 1,380 11,650 8.3% 16.4 16.5<br />
Ischemic heart diseases 1,369 9,324 8.2% 16.3 18.5<br />
Chronic lower respiratory diseases 706 7,589 4.2% 8.4 9.2<br />
Arthrosis 688 3,150 4.1% 8.2 8.8<br />
Cerebrovascular diseases 620 7,606 3.7% 7.4 7.1<br />
All Causes of Hospitalization 16,687 179,076 100% 198.8 210.3<br />
85 Years and Older<br />
Diagnosis Cases Days<br />
% Total<br />
Discharges<br />
FH Rate<br />
per 1,000<br />
BC Rate<br />
per 1,000<br />
Other forms of heart disease 507 6,653 11.9% 54.4 47.2<br />
Chronic lower respiratory diseases 238 3,351 5.6% 25.6 23.8<br />
Ischemic heart diseases 214 2,780 5.0% 23.0 23.1<br />
Influenza and pneumonia 214 1,850 5.0% 23.0 20.5<br />
General symptoms and signs 195 3,546 4.6% 20.9 17.3<br />
All Causes of Hospitalization 4,262 66,062 100% 457.7 432.3<br />
Source: Discharge Abstract Database, 2009/10.<br />
129
Cance<br />
r Incidence – Child & Adult<br />
What are we look<br />
ing at?<br />
Cancer inci<br />
dence mea<br />
sures the number<br />
of new cancer cases<br />
diagnosed durin<br />
g a<br />
given time period. Incidence rat<br />
es are<br />
given for children (ages<br />
≤19) and f<br />
or<br />
adults (a<br />
ges 20+). Data are expressed<br />
as annual age-standardized in<br />
cidence<br />
rates (ASIR) per 100,000 population.<br />
36, 37, 38<br />
Why do we care?<br />
Cancer is a common illness and one of<br />
the leading causes of death in Canada.<br />
Predominantly affecting the elderly,<br />
cancers are rare in children; childhood<br />
cancers account for less than 1% o<br />
f all<br />
cancer diagnoses in Canada. Howeve<br />
r, it<br />
is the most common disease-relat<br />
ed<br />
cause of death among those ≤19 yea<br />
rs<br />
of age and the second leading cause of<br />
death among children 1-14 years of ag<br />
e.<br />
Childhood cancers differ from what we<br />
see in adults; children are more likely to<br />
suffer blood and lymphatic nancies such as leukemia. Unlike adult<br />
cancers, childhood canc<br />
ers are seldom<br />
preventable. Adult cancers are typically<br />
malignant tumours starting in<br />
the glan<br />
ds<br />
or the tissues lining t<br />
he organs.<br />
Minimizing risk factors can help prevent<br />
cancer overall. For leading cancers in<br />
adults, the main risk factors<br />
are smoking<br />
and second-hand smoke exposure, d<br />
malign-<br />
iet<br />
36 <strong>Health</strong> Canada. (2010). <strong>Health</strong> concerns, diseases &<br />
conditions, cancer. Retrieved July 30, 2010, from<br />
http://www.hc-sc.gc.ca/hc-ps/dc-ma/cancer-eng.php<br />
37 Canadian Cancer Society. (2010). Statistics at a glance.<br />
Retrieved July 30, 2010, from<br />
http://www.cancer.ca/Canadawide/Aboutcancer/Cancerstatistics/Stats<br />
at a glance<br />
38 BC Cancer Agency. (2010). Childhood cancer. Retrieved<br />
July 30, 2010, from<br />
http://www.bccancer.bc.ca/PPI/TypesofCancer/ChildhoodCa<br />
ncer/default.htm<br />
and nutrition, occupation, excessive<br />
alco hol use, genetics, and physical<br />
inactivity. In Canada, the major leading<br />
cancers ar e breast (for women),<br />
prostate (for men), lung, and colorectal;<br />
a similar distribution of cancers is seen<br />
in <strong>Fraser</strong> <strong>Health</strong>.<br />
Early detection and screening, such as<br />
mammography or colonoscopy, are<br />
critical. The earlier can cer is detected,<br />
the sooner treatment can begin, and the<br />
better the odds of survival.<br />
• In children and in adults, males have a<br />
higher incidence of cancer than females.<br />
• Leukemia is the most com mon cancer in<br />
children.<br />
• In general, cancer incidence is higher in<br />
the east of <strong>Fraser</strong> <strong>Health</strong> than the west.<br />
• The incidence of prostate cancer is<br />
higher in <strong>Fraser</strong> <strong>Health</strong> than BC overall.<br />
Limitations<br />
Incidence r efers to the diagnosis of new<br />
cancer cases not cancer-related deaths.<br />
Some cance rs are readily curable while<br />
others are not.<br />
Rates among children are based on<br />
small case numbers, s o data analyses<br />
are limited to large geographic areas;<br />
small changes in the number of cases<br />
can influence rates greatly; particularly<br />
in areas that have small populations like<br />
Hope or Agassiz/Harrison.<br />
New diagnostic methods can influence<br />
rates for certain cancer sites with better<br />
identification and/or earlier detection.<br />
130
HEALTH STATUS<br />
MORBIDITY<br />
Childhood (Ages ≤19) Cancer Incidence in <strong>Fraser</strong> <strong>Health</strong>,<br />
20<br />
All Cancers by Sex<br />
15<br />
ASIR<br />
10<br />
5<br />
0<br />
Girls<br />
Boys<br />
2004 14.1 16.3<br />
2005 14.6 17.0<br />
2006 15.4 19.4<br />
2007 15.2 18.9<br />
2008 15.1<br />
18.1<br />
*Note: CNS denotes Central Nervous System.<br />
Childhood (Ages ≤19) Cancer Incidence in <strong>Fraser</strong> <strong>Health</strong>,<br />
20<br />
All Cancers by Sex<br />
15<br />
ASIR<br />
10<br />
5<br />
0<br />
2004 2005 2006 2007 2008<br />
Girls 14.1 14.6 15.4 15.2 15.1<br />
Boys 16.3 17.0 19.4 18.9 18.1<br />
Source: BC Cancer Agency.<br />
131
Cancer Incidence in <strong>Fraser</strong> <strong>Health</strong> and BC, All Cancers, Ages 20+<br />
2004 2005 2006 2007 2008<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Men 605.1 595.6 590.7 592.5 587.5<br />
Women 449.5 451.3 448.9 446.8 448.2<br />
BC<br />
Men 601.9 591.0 580.4 581.9 579.3<br />
Women 460.2 459.0 457.2 455.4 454.1<br />
Lung Cancer Incidence Among Women, Ages 20+, 2008<br />
Hope<br />
New Westminster<br />
Maple Ridge<br />
Mission<br />
Langley<br />
Chilliwack<br />
Agassiz/Harrison<br />
Coquitlam<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
Delta<br />
South Surrey/White Rock<br />
Burnaby<br />
Surrey<br />
Abbotsford<br />
88.6<br />
83.4<br />
81.1<br />
72.1<br />
69.7<br />
68.8<br />
65.9<br />
61.9<br />
61.7<br />
55.8<br />
54.9<br />
54.6<br />
52.7<br />
47.9<br />
123.7<br />
0 50 100 150 200<br />
ASIR<br />
Lung Cancer Incidence Among Men, Ages 20+, 2008<br />
Hope<br />
Mission<br />
Maple Ridge<br />
New Westminster<br />
Chilliwack<br />
Langley<br />
Agassiz/Harrison<br />
BC<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Coquitlam<br />
South Surrey/White Rock<br />
Burnaby<br />
Surrey<br />
Abbotsford<br />
Delta<br />
116.9<br />
108.4<br />
98.7<br />
93.7<br />
87.0<br />
78.8<br />
77.1<br />
76.8<br />
75.5<br />
70.1<br />
67.9<br />
66.8<br />
66.4<br />
60.6<br />
144.2<br />
0 50 100 150 200<br />
ASIR<br />
Source: BC Cancer Agency.<br />
132
HEALTH STATUS<br />
MORBIDITY<br />
Colorectal Cancer Incidence Among Women, Ages 20+, 2008<br />
Hope<br />
Chilliwack<br />
Coquitlam<br />
Mission<br />
Langley<br />
Agassiz/Harrison<br />
Maple Ridge<br />
New Westminster<br />
BC<br />
<strong>Fraser</strong> <strong>Health</strong><br />
South Surrey/White Rock<br />
Surrey<br />
Burnaby<br />
Delta<br />
Abbotsford<br />
75.5<br />
64.9<br />
60.2<br />
59.5<br />
58.1<br />
58.0<br />
56.6<br />
56.5<br />
53.9<br />
53.3<br />
51.1<br />
49.5<br />
49.3<br />
48.3<br />
45.6<br />
0 50 100 150 200<br />
ASIR<br />
Colorectal Cancer Incidence Among Men, Ages 20+, 2008<br />
Agassiz/Harrison<br />
New Westminster<br />
Chilliwack<br />
Mission<br />
Hope<br />
Langley<br />
Coquitlam<br />
BC<br />
South Surrey/White Rock<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Maple Ridge<br />
Delta<br />
Burnaby<br />
Abbotsford<br />
Surrey<br />
89.5<br />
85.9<br />
84.6<br />
84.4<br />
84.3<br />
81.3<br />
77.4<br />
77.0<br />
76.2<br />
75.2<br />
74.6<br />
73.7<br />
68.6<br />
65.7<br />
105.8<br />
0 50 100 150 200<br />
ASIR<br />
Source: BC Cancer Agency.<br />
133
Breast Cancer Incidence Among Women, Ages 20+, 2008<br />
Langley<br />
Hope<br />
New Westminster<br />
South Surrey/White Rock<br />
Maple Ridge<br />
Chilliwack<br />
BC<br />
Coquitlam<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Burnaby<br />
Abbotsford<br />
Delta<br />
Agassiz/Harrison<br />
Mission<br />
Surrey<br />
153.0<br />
149.9<br />
149.6<br />
149.3<br />
134.8<br />
134.8<br />
134.1<br />
132.5<br />
131.8<br />
129.3<br />
128.5<br />
128.1<br />
123.0<br />
117.2<br />
114.2<br />
0 50 100 150 200<br />
ASIR<br />
Prostate Cancer Incidence Among Men, Ages 20+, 2008<br />
Hope<br />
Langley<br />
Agassiz/Harrison<br />
Delta<br />
Abbotsford<br />
Chilliwack<br />
<strong>Fraser</strong> <strong>Health</strong><br />
New Westminster<br />
South Surrey/White Rock<br />
Mission<br />
Coquitlam<br />
Surrey<br />
BC<br />
Maple Ridge<br />
Burnaby<br />
216.3<br />
207.5<br />
207.2<br />
190.7<br />
184.7<br />
183.5<br />
175.3<br />
174.5<br />
174.2<br />
169.5<br />
168.7<br />
167.2<br />
162.3<br />
159.7<br />
159.3<br />
0 50 100 150 200 250<br />
ASIR<br />
Source: BC Cancer Agency.<br />
134
HEALTH STATUS<br />
MORBIDITY<br />
[This page was left blank intentionally]<br />
135
Human Immunodeficiency Virus (HIV)<br />
What are we looking at?<br />
Data report newly diagnosed cases of<br />
Human Immunodeficiency Virus (HIV)<br />
infection as a rate per 100,000 people.<br />
For those testing positive for HIV for the<br />
first time, infection may have occurred<br />
recently or some time in the past. Some<br />
may have been infected decades ago<br />
but are diagnosed only now. Rates of<br />
newly diagnosed cases will increase if<br />
more people become infected, but they<br />
can also increase if there is more testing<br />
among those infected previously,<br />
picking up people with existing but<br />
undiagnosed infections.<br />
Why do we care?<br />
HIV is a global epidemic that is<br />
preventable. HIV can be transmitted by<br />
sexual contact, blood-to-blood contact<br />
such as injection drug use (IDU), and<br />
perinatally (from a pregnant woman to<br />
her baby). HIV infection gradually<br />
destroys the immune system and the<br />
ability to fight other infections. As the<br />
disease progresses, HIV infection can<br />
lead to the development of Acquired<br />
Immune Deficiency Syndrome (AIDS).<br />
HIV also causes a general state of<br />
inflammation, which damages many<br />
organs and promotes chronic diseases<br />
such as heart disease, renal failure, and<br />
cancer.<br />
While highly active antiretroviral therapy<br />
reduces HIV transmission and greatly<br />
increases life expectancy for people<br />
infected with HIV, they still die sooner<br />
than those in the general population 39<br />
and they suffer side effects and reduced<br />
quality of life.<br />
More information on HIV is available in<br />
<strong>Fraser</strong> <strong>Health</strong>’s Annual Communicable<br />
Disease Report.<br />
• New Westminster has the highest rate<br />
of newly diagnosed HIV of the <strong>Fraser</strong><br />
<strong>Health</strong> LHAs, followed by Burnaby.<br />
• In 2010, more than 70% of newly<br />
diagnosed HIV cases likely contracted<br />
the infection through sexual activity.<br />
Limitations<br />
When a case address is unavailable, the<br />
ordering physician’s address is used to<br />
assign the case to a geographic area. A<br />
community where more people with HIV<br />
go to be diagnosed may therefore be<br />
reported as having higher rates than it<br />
actually has. In addition, HIV/AIDS<br />
cases in regional correction facility<br />
populations are not separated from<br />
cases in the general population.<br />
Rates of HIV infection are affected by<br />
factors such as changes in availability of<br />
preventive services (e.g., methadone<br />
therapy, harm reduction supply) or<br />
changes in drug consumption (e.g., a<br />
reduction in cocaine injection). Changes<br />
to the surveillance system for HIV have<br />
affected reported rates over the years, 40<br />
including better removal of duplicate<br />
reports.<br />
39 The Antiretroviral Therapy Cohort Collaboration. (2008).<br />
Life expectancy of individuals on combination antiretroviral<br />
therapy in high income countries: A collaborative analysis of<br />
14 cohort studies. Lancet, 372, 293--299.<br />
40 BC Centre for Disease Control, Annual surveillance report<br />
HIV and Sexually Transmitted Infections, 2009.<br />
136
HEALTH STATUS<br />
MORBIDITY<br />
Rate per 100,000<br />
15<br />
10<br />
5<br />
Rates of Newly Diagnosed HIV Cases<br />
<strong>Fraser</strong> <strong>Health</strong> & BC, 2001-2010<br />
Improved reportability<br />
& increased identification<br />
of positve contacts<br />
Immigration tests removed<br />
from first positives in BC<br />
Better removal<br />
of duplicates<br />
0<br />
FH BC FH BC FH BC FH BC FH BC FH BC FH BC FH BC FH BC FH BC<br />
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010<br />
FH Reports - outside BC 2 3 2 4 15 16 13 16 12 9<br />
FH Reports - in BC 87 101 95 109 88 73 81 69 87 72<br />
FH rates - outside BC 0.1 0.2 0.1 0.3 1.0 1.1 0.9 1.0 0.8 0.6<br />
FH rates - in BC 6.2 7.1 6.6 7.5 6.0 4.9 5.4 4.5 5.5 4.5<br />
BC rates - outside BC 0.1 0.4 0.3 0.5 1.2 1.2 1.3 1.3 1.0 0.8<br />
BC rates - in BC 10. 10. 9.9 10. 9.5 8.5 9.1 7.9 7.6 6.7<br />
Note: Many changes have been made to the HIV surveillance system that affect comparability from year to year. 41<br />
Total First Positive HIV cases by LHA, 2006-2010 Average<br />
New Westminster<br />
15.1<br />
1.9<br />
Burnaby<br />
6.1<br />
0.9<br />
<strong>Fraser</strong> <strong>Health</strong><br />
4.9<br />
0.9<br />
Hope<br />
Surrey<br />
Agassiz/Harrison<br />
Mission<br />
Abbotsford<br />
Maple Ridge<br />
Coquitlam<br />
South Surrey/White Rock<br />
Delta<br />
Langley<br />
Chilliwack<br />
4.9<br />
4.6<br />
4.5<br />
4.3<br />
4.2<br />
3.9<br />
3.8<br />
3.6<br />
3.4<br />
2.8<br />
1.7<br />
1.1<br />
1.0<br />
1.0<br />
0. 2<br />
0. 8<br />
0.7<br />
0.2<br />
0.3<br />
0.5<br />
2.5<br />
1st (+) in BC<br />
1st (+) in BC, previously (+) outside BC<br />
0 5 10 15 20<br />
Rate per 100, 000<br />
Source: Cognos Impromptu Web Reporting System, BC Centre for Disease Control. Data extracted on August 12,<br />
<strong>2011</strong>. Population estimates from BC Stats, Service BC, BC Ministry of Labour and Citizens' Services, P.E.O.P.L.E.<br />
36 Projections.<br />
41 BC Centre for Disease Control, & STI/HIV Prevention and Control. (2010). HIV/AIDS annual report 2009. Retrieved December 9,<br />
<strong>2011</strong> from http://www.bccdc.ca/NR/rdonlyres/A8CE7DC6-EBD3-4E90-9142-<br />
50B9367C8B35/0/STI_HIVReport_HIVAIDSUpdate2009_<strong>2011</strong>0401.pdf<br />
137
Distribution of Newly Positive for HIV by Exposure,<br />
<strong>Fraser</strong> <strong>Health</strong><br />
100%<br />
80%<br />
60%<br />
40%<br />
20%<br />
0%<br />
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010<br />
NIR/Unknown 13 2 2 1 1 1 1 2 3 5<br />
Other 1 4 1 1 4 2 1 3 4 5<br />
HET 28 33 40 32 23 24 33 26 35 30<br />
IDU 29 42 25 33 34 20 16 8 18 10<br />
MSM 16 20 27 42 26 26 30 30 27 22<br />
Notes: a) NIR/Unknown – No identified risk, b) HET – heterosexual contact, c) IDU – intravenous drug user, d) MSM<br />
– men who have sex with other men. In order to reflect best the current risk factors for acquiring HIV infection<br />
in <strong>Fraser</strong> <strong>Health</strong>, the data shown include only cases newly diagnosed in BC and not cases previously diagnosed<br />
outside of BC.<br />
Source: Cognos Impromptu Web Reporting System, BC Centre for Disease Control. Data extracted on August 12,<br />
<strong>2011</strong>.<br />
138
HEALTH STATUS<br />
MORBIDITY<br />
[This page was left blank intentionally]<br />
139
Chronic Disease<br />
Primary <strong>Health</strong> Care (PHC) Patient Registry –<br />
Case Definitions<br />
Registry Information<br />
The PHC Patient Registry is a provincial<br />
registry maintained by the Ministry of<br />
<strong>Health</strong> that includes individuals with<br />
claims for chronic disease management.<br />
The registry provides prevalence and<br />
incidence rates on various chronic<br />
diseases and health care performance.<br />
Prevalence data reported are the Age-<br />
Standardized Prevalence Rates (ASPR),<br />
which are direct age-standardized using<br />
five-year age groups based on 2001<br />
Census estimates for BC, except<br />
dementia.<br />
<strong>Health</strong> authority comparisons are based<br />
on rates calculated using three-year<br />
moving averages and the reference year<br />
is the middle year (2007/08, 2008/09,<br />
and 2009/10). All other rates, such as<br />
the rates for each LHA, are shown as<br />
single year. Compare single year rates<br />
with caution, especially in areas that<br />
have smaller populations because oneyear<br />
rates may fluctuate each year.<br />
Registry case definitions are reviewed<br />
periodically and definitions refined to<br />
address limitations associated with<br />
administrative data. Definitions can be<br />
refined to reduce the number of missing<br />
cases and the number of false positives.<br />
Some records in the registry meeting<br />
the case definition may not in fact have<br />
the specified chronic disease, but have<br />
been included in the registry for reasons<br />
such as error in the diagnostic code<br />
provided. In addition, the registry does<br />
not include those who are undiagnosed<br />
or who have other diagnoses given on<br />
their claims.<br />
The registry is cumulative, including<br />
anyone who met the current case<br />
definition from 1992/93 to the present.<br />
Cases are removed only if they no<br />
longer live in BC or if they died. Those<br />
meeting the case definition in the past<br />
remain in the register even if they no<br />
longer meet the current case definition.<br />
To protect client confidentiality, all<br />
registry cells with less than five cases<br />
are suppressed and totals adjusted prior<br />
to data distribution.<br />
Case Definitions<br />
Diabetes Mellitus<br />
The diabetes registry case definition is<br />
for one of the following scenarios to<br />
occur within 365 days:<br />
a) one hospitalization with a diabetes<br />
diagnosis; or<br />
b) two medical visits with a diabetes<br />
diagnosis; or<br />
c) two or more insulin prescriptions; or<br />
d) two or more prescriptions for an oral<br />
antihyperglycaemic (excluding metformin),<br />
or<br />
e) one prescription for insulin plus one<br />
prescription for an oral antihyperglycaemic<br />
(excluding metformin); or<br />
f) one prescription for metformin plus<br />
one prescription for an antihyperglycaemic<br />
(excluding metformin), or<br />
g) two prescriptions for metformin plus<br />
one medical visit with a diabetes<br />
diagnosis.<br />
140
HEALTH STATUS<br />
MORBIDITY<br />
Asthma<br />
Limited to those ages 5 to 54-years, the<br />
asthma registry case definition is for one<br />
of the following scenarios to occur<br />
within 365 days: one hospitalization with<br />
an asthma code, or two medical visits<br />
with an asthma code, or one medical<br />
visit with two prescriptions for asthma<br />
medications.<br />
Cardiovascular Disease<br />
There is no single register for cardiovascular<br />
disease; rather data are<br />
derived from merging three separate<br />
registries: a) angina, b) congestive heart<br />
failure (CHF), and c) acute myocardial<br />
infarction (AMI).<br />
Case criteria vary for each registry,<br />
cases are included in registries when<br />
one or more of the following scenarios<br />
occur within 365 days:<br />
a) Angina: one hospitalization with an<br />
angina diagnosis or one specialist<br />
visit with angina diagnosis and one<br />
nitrate prescription or two GP visits<br />
with angina diagnosis and one<br />
nitrate prescription.<br />
b) CHF: see definition below.<br />
c) AMI: one hospitalization with an AMI<br />
diagnostic code.<br />
Congestive Heart Failure (CHF)<br />
Current criteria in the CHF registry are<br />
one hospitalization or two medical visits<br />
with CHF diagnostic code and a prescription<br />
(ACE-I, loop diuretic, spironolactone,<br />
potassium sparing diuretic)<br />
within 365 days, or one specialist visit<br />
with CHF diagnostic code and a<br />
prescription within 365 days.<br />
visits with a depression diagnostic code<br />
in the specified 365-day period.<br />
Hypertension<br />
Limited to ages 20 and older, the<br />
registry criteria for hypertension are<br />
patients ages 20 and older with one<br />
hospitalization or two medical visits with<br />
a hypertension diagnostic code in the<br />
specified 365-day period.<br />
Stroke (Acute Cerebrovascular<br />
Syndrome - ACVS)<br />
The registry criteria for stroke include a<br />
hospitalization with diagnosis code for<br />
acute ischemic or haemorrhagic stroke.<br />
Chronic Obstructive Pulmonary<br />
Disease (COPD)<br />
Limited to ages 45 and older, the<br />
registry criteria for COPD are for<br />
patients ages 45 years and older with<br />
one hospitalization or two medical visits<br />
with a COPD-related diagnostic code in<br />
the specified 365-day period.<br />
Osteoarthritis<br />
Osteoarthritis registry criteria are one<br />
hospitalization or two medical visits with<br />
an osteoarthritis diagnostic code or two<br />
or more prescriptions for osteoarthritis<br />
medication within 365-days.<br />
Dementia<br />
Limited to ages 45 and older, registry<br />
criteria are for are one hospitalization or<br />
two medical visits during which the<br />
patient was age 45-years or older with a<br />
dementia diagnostic code within 365<br />
days.<br />
Depression/Anxiety<br />
Registry criteria for depression/anxiety<br />
are one hospitalization or two medical<br />
141
a) Diabetes Mellitus (DM)<br />
What are we looking at?<br />
The prevalence of diabetes mellitus (DM)<br />
refers to the percentage of the population<br />
who have diabetes mellitus, representing<br />
everyone registered in the Primary <strong>Health</strong><br />
Care (PHC) patient registry during the<br />
time shown.<br />
Data are direct age-standardized using<br />
five-year age groups based on 2001<br />
Census estimates for BC. For health<br />
authority comparisons, the rates shown<br />
are based on three-year moving averages<br />
where the reference year is the middle<br />
year (2007/08, 2008/09, and 2009/10).<br />
All other rates are single year rates.<br />
Why do we care?<br />
The prevalence of diabetes is increasing<br />
even though many of the risk factors are<br />
preventable. Diabetes is a costly disease<br />
for the health care system. Diabetes is a<br />
serious chronic condition affecting the<br />
body’s ability to produce and/or to use<br />
insulin properly. Even when well treated,<br />
diabetes can lead to a n umber of<br />
disabling or life-threatening complications,<br />
including hypertension, heart disease,<br />
stroke, and even premature death.<br />
Diabetes is the single largest cause of<br />
blindness in Canada and a leading cause<br />
of kidney failure and lower limb<br />
amputations. 42<br />
Babies who are breastfed are at lower risk<br />
of Type 1 diabetes. Not smoking, regular<br />
exercise, a healthy diet, and maintaining a<br />
healthy body weight help prevent Type 2<br />
ASPR<br />
diabetes. Control of blood sugar levels<br />
and of blood pressure and other risk<br />
factors can reduce the risk of<br />
complications.<br />
• <strong>Fraser</strong> <strong>Health</strong> has the highest agestandardized<br />
prevalence rates (ASPR)<br />
of diabetes mellitus in the province.<br />
Interior and Vancouver Island health<br />
authorities have the lowest prevalence<br />
rates.<br />
• Surrey and Abbotsford LHAs have the<br />
largest proportion of diabetics among<br />
<strong>Fraser</strong> <strong>Health</strong> LHAs, which may be due<br />
in part to the large South Asian<br />
43<br />
populations residing in those areas.<br />
Limitations<br />
See page 140 for case definitions and<br />
more information on registries and<br />
data limitations.<br />
10%<br />
8%<br />
6%<br />
4%<br />
2%<br />
0%<br />
Prevalence of Diabetes Mellitus,<br />
Based on Three-Year Moving Average, 2008/09<br />
6.2%<br />
5.0%<br />
4.6% 4.6%<br />
5.7%<br />
Source: Ministry of <strong>Health</strong>, PHC Diabetes Registry as of<br />
February <strong>2011</strong>.<br />
5.3%<br />
FHA IHA VCHA VIHA NHA BC<br />
42 Sanmartin, C., & Gilmore, J. (2006). Diabetes care in<br />
Canada: Results from selected provinces and territories, 2005.<br />
Retrieved April 4, 2007, from:<br />
http://www.statcan.ca/english/research/82-621-<br />
XIE/2006002/diabetic.htm.<br />
43 Kumar, S. S., and Houlden, R. L. (2005). Ethnocultural<br />
diversity and the diabetes epidemic in Canada: A call to<br />
action. Canadian Journal of Diabetes, 29(2), 84-85.<br />
142
HEALTH STATUS<br />
MORBIDITY<br />
Prevalence of Diabetes Mellitus<br />
10%<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
8%<br />
ASPR<br />
6%<br />
4%<br />
4.0%<br />
3.6%<br />
5. 0%<br />
4.7%<br />
4.5%<br />
4.2%<br />
4.0%<br />
4.2%<br />
4.4% 3.8%<br />
5.3%<br />
5.6%<br />
5.9%<br />
6.2%<br />
6.5%<br />
4.6%<br />
4.9%<br />
5.1%<br />
5.3%<br />
5.5%<br />
2%<br />
0%<br />
00/01 01/02 02/03 03/04 04/05 05/06 06/07 07/08 08/09 09/10<br />
Prevalence of Diabetes<br />
Mellitus, 2009/10<br />
Surrey<br />
Abbotsford<br />
Mission<br />
Burnaby<br />
New Westminster<br />
Maple Ridge<br />
Hope<br />
Chilliwack<br />
Langley<br />
Delta<br />
Agassiz/Harrison<br />
Coquitlam<br />
South Surrey/White Rock<br />
8.1% (33,950)<br />
7.1% (11,314)<br />
6.7% (3,188)<br />
6.4% (18,418)<br />
6.4% (5,162)<br />
6.2% (6,609)<br />
6.1% (864)<br />
5.9% (6,779)<br />
5.9% (9,490)<br />
5.9% (8,041)<br />
5.9% (752)<br />
5.8% (14,368)<br />
4. 3% (6,130)<br />
0% 2% 4% 6% 8% 10% 12%<br />
ASPR (Count)<br />
Source: Ministry of <strong>Health</strong>, PHC Diabetes Registry as of February <strong>2011</strong>.<br />
143
) Asthma<br />
What are we looking at?<br />
Asthma prevalence represents the proportion<br />
of people aged 5 to 54 years old<br />
registered with the Primary <strong>Health</strong> Care<br />
patient registry during the time shown.<br />
Data are direct age-standardized using<br />
five-year age groups based on 2001<br />
Census estimates for BC. Rates shown<br />
for health authority comparison are<br />
based on three-year moving averages<br />
where the reference year is the middle<br />
year (2007/08, 2008/09, and 2009/10).<br />
All other rates are single year.<br />
Why do we care?<br />
Caused by chronic inflammation of the<br />
airway, asthma makes it difficult to<br />
breath and can impair one’s ability to<br />
function in daily life. Asthma can cause<br />
people to need long-term medications<br />
that may have secondary effects or it<br />
can even cause death. 44<br />
Many factors increase the likelihood of<br />
developing asthma, such as having<br />
allergies, being overweight, smoking,<br />
being exposed to second-hand smoke,<br />
having a mother who smoked while<br />
pregnant, and being exposed to exhaust<br />
fumes (by living close to a busy road) or<br />
to chemicals that are used in farming,<br />
hairdressing, or manufacturing. 44<br />
Asthma can be triggered and made<br />
worse by allergens (e.g., animal, pollen,<br />
mould, and dust mites) and by nonallergic<br />
airway irritants (e.g., smoke,<br />
smog, and exercise, especially in cold<br />
ASPR<br />
air). 45 People of low socio-economic<br />
status are more likely to have asthma<br />
and can often encounter barriers to<br />
getting the appropriate medical care<br />
they need and they can face challenges<br />
paying for needed medication.<br />
• The prevalence of asthma is increasing<br />
and <strong>Fraser</strong> <strong>Health</strong> has the second<br />
highest prevalence of asthma among<br />
BC health authorities.<br />
• Asthma tends to be more common in<br />
people with low socio-economic status.<br />
• Asthma prevalence is higher in <strong>Fraser</strong><br />
<strong>Health</strong>’s eastern LHAs, which typically<br />
have lower socio-economic status then<br />
the more westerns LHA.<br />
10%<br />
8%<br />
6%<br />
4%<br />
2%<br />
0%<br />
Prevalence of Asthma, Ages 5-54,<br />
Based on Three-Year Moving Average, 2008/09<br />
7.6%<br />
7.1%<br />
6.1%<br />
8.0%<br />
7.1% 7.0%<br />
FHA IHA VCHA VIHA NHA BC<br />
Source: Ministry of <strong>Health</strong>, PHC Asthma Registry as of<br />
February <strong>2011</strong>.<br />
Limitations<br />
See page 140 for case definitions and<br />
more information on registries and data<br />
limitations.<br />
44 Mayo Clinic. (2010). Asthma risk factors. Retrieved<br />
October 18, 2010, from<br />
http://www.mayoclinic.com/health/asthma/DS00021/DSECT<br />
ION=risk-factors<br />
45 Asthma Society of Canada. (<strong>2011</strong>). Common asthma<br />
triggers: About inflammatory triggers. Retrieved December<br />
14, <strong>2011</strong> from<br />
http://www.asthma.ca/adults/about/inflammatoryTriggers.p<br />
hp<br />
144
HEALTH STATUS<br />
MORBIDITY<br />
Prevalence of Asthma, Ages 5-54<br />
10%<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
ASPR<br />
8%<br />
6%<br />
4%<br />
5.3%<br />
4.9%<br />
5.6%<br />
6.0%<br />
6.3%<br />
5.2%<br />
5.5%<br />
5.8%<br />
6.6%<br />
6.1%<br />
7.8%<br />
7.3%<br />
7.5%<br />
7.1%<br />
6.9%<br />
6.8% 7.0% 7. 3%<br />
6.6%<br />
6.4%<br />
2%<br />
0%<br />
00/01 01/02 02/03 03/04<br />
04/05 05/06 06/07 07/08 08/09 09/10<br />
Prevalence of Asthma, Ages 5-54, 2009/10<br />
Abbotsford<br />
Agassiz/Harrison<br />
Mission<br />
Langley<br />
Delta<br />
Surrey<br />
Maple Ridge<br />
Hope<br />
Chilliwack<br />
South Surrey/White Rock<br />
New Westminster<br />
Coquitlam<br />
Burnaby<br />
9.7% (12,198)<br />
9.6% (656)<br />
9.1% (3,584)<br />
8.8% (10,768)<br />
8.4% (8,046)<br />
8.4% (32,862)<br />
8.4% (7,383)<br />
7.7% (533)<br />
7.6% (5,805)<br />
7.4% (4,666)<br />
7.0% (4,199)<br />
6.7% (14,424)<br />
6.0% (13,256)<br />
0% 2% 4% 6% 8% 10% 12%<br />
ASPR (Count)<br />
Source: Ministry of <strong>Health</strong>, PHC Asthma Registry as of February <strong>2011</strong>.<br />
145
c) Cardiovascular Disease and Congestive Heart Failure<br />
What are we looking at?<br />
Prevalence rates for cardiovascular<br />
disease are based on cases registered in<br />
the relevant Primary <strong>Health</strong> Care (PHC)<br />
patient registries during the time shown.<br />
There is no single registry for cardiovascular<br />
disease; rather data are<br />
derived from merging three separate<br />
registries: a) angina, b) congestive heart<br />
failure (CHF), and c) acute myocardial<br />
infarction (AMI).<br />
The prevalence of congestive heart<br />
failure (CHF) represents all cases<br />
registered in the PHC patient registry for<br />
CHF during the time shown.<br />
For health authority comparisons, rates<br />
are based on three-year moving<br />
averages in which the reference year is<br />
the middle year (2007/08, 2008/09, and<br />
2009/10). All other rates are single year<br />
rates.<br />
Why do we care?<br />
Also known as ‘heart disease,’ cardiovascular<br />
diseases are the leading cause<br />
of death in Canada. 46,47 Cardiovascular<br />
disease is a broad term encompassing<br />
numerous diseases that affect the<br />
circulatory system, including ischemic<br />
heart disease, cerebrovascular disease<br />
(stroke), heart failure, peripheral<br />
vascular disease, rheumatic heart<br />
disease, and congenital heart disease.<br />
However, the PHC case definition is<br />
more limited, including only angina,<br />
46 Public <strong>Health</strong> Agency of Canada. (2008). Six types of<br />
cardiovascular disease. Retrieved August 11, 2009, from<br />
http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/cvd-mcveng.php<br />
47 Public <strong>Health</strong> Agency of Canada. (2008). Cardiovascular<br />
disease. Retrieved September 1, 2010, from<br />
http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/index-eng.php<br />
CHF, and AMI. Ischemic heart disease is<br />
the most common cardiovascular<br />
disease for both men and women.<br />
Congestive heart failure is a lifethreatening<br />
condition where the heart is<br />
not able to pump sufficient blood<br />
throughout the body. In most cases,<br />
CHF is a chronic long-term condition,<br />
but it can also develop quite suddenly.<br />
While some risk factors, like age, family<br />
history, or sex, cannot be changed,<br />
many risk factors can be avoided or<br />
reduced. Smoking, lack of exercise,<br />
unhealthy eating, high cholesterol, high<br />
blood pressure, and sodium intake are<br />
all modifiable factors that increase the<br />
46, 47<br />
risk of cardiovascular disease.<br />
• Vancouver Coastal has the lowest<br />
prevalence of cardiovascular disease<br />
among BC health authorities, while<br />
Vancouver Island has the lowest<br />
prevalence of CHF.<br />
• Generally, LHAs in eastern regions of<br />
<strong>Fraser</strong> <strong>Health</strong> have higher prevalence<br />
rates than LHAs in western regions.<br />
• With over 14,000 people affected,<br />
Surrey LHA (which does not include<br />
South Surrey) has more people with<br />
cardiovascular disease than does all of<br />
<strong>Fraser</strong> East (14,241 vs 13,796 people).<br />
Limitations<br />
See page 140 for case definitions and<br />
more information on registries and data<br />
limitations. The registry criteria for CHF<br />
has changed and data in this report<br />
cannot be compared to data reported in<br />
previous versions of this report.<br />
146
HEALTH STATUS<br />
MORBIDITY<br />
10%<br />
Prevalence of Cardiovascular Disease,<br />
Based on Three-Year Moving Average, 2008/09<br />
8%<br />
6%<br />
ASPR<br />
4%<br />
3. 2%<br />
3.5%<br />
2.5%<br />
2.8%<br />
3.7%<br />
3.0%<br />
2%<br />
0%<br />
FHA IHA VCHA<br />
VIHA NHA BC<br />
Source: Ministry of <strong>Health</strong> Services, PHC Angina, CHF, and AMI patient Registries as of February <strong>2011</strong>.<br />
10%<br />
Prevalence of Congestive Heart Failure,<br />
Based on Three-Year Moving Average, 2008/09<br />
8%<br />
6%<br />
ASPR<br />
4%<br />
2%<br />
1.3% 1.4%<br />
1.2%<br />
1.1%<br />
1.8%<br />
1.3%<br />
0%<br />
FHA IHA VCHA<br />
VIHA NHA BC<br />
Source: Ministry of <strong>Health</strong> Services, PHC Congestive Heart Failure Registry as of February <strong>2011</strong>.<br />
147
Prevalence of Cardiovascular Disease<br />
10%<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
8%<br />
6%<br />
ASPR<br />
4%<br />
2%<br />
3.1% 3.1% 3.2% 3.2% 3.3% 3.3% 3.3% 3.3% 3.2% 3.2%<br />
2.8% 2.9% 3.0% 3.0% 3.1% 3.1% 3.1% 3.1% 3.0% 3.0%<br />
0%<br />
00/01 01/02 02/03 03/04 04/05 05/06 06/07 07/08 08/09 09/10<br />
Prevalence of Cardiovascular Disease, 2009/10<br />
Hope<br />
Agassiz/Harrison<br />
Chilliwack<br />
Surrey<br />
Mission<br />
Maple Ridge<br />
Langley<br />
Abbotsford<br />
Delta<br />
New Westminster<br />
Coquitlam<br />
South Surrey/White Rock<br />
Burnaby<br />
4.1% (661)<br />
4.0% (569)<br />
3.5% (4,650)<br />
3.5% (14,241)<br />
3.5% (1,715)<br />
3.5% (3,796)<br />
3.5% (6,018)<br />
3.4% (6,201)<br />
3.1% (4,733)<br />
3.1% (2,755)<br />
2.9% (7,038)<br />
2.7% (5,227)<br />
2.6% (8,244)<br />
0% 2% 4% 6% 8% 10%<br />
ASPR (Count)<br />
Source: Ministry of <strong>Health</strong> Services, PHC Angina, CHF, and AMI patient Registries as of February <strong>2011</strong>.<br />
148
HEALTH STATUS<br />
MORBIDITY<br />
Prevalence of Congestive Heart Failure<br />
10%<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
8%<br />
6%<br />
ASPR<br />
4%<br />
2%<br />
0%<br />
1.2% 1.2% 1.2% 1.3% 1.3% 1.3% 1.3% 1.3% 1.3% 1.4%<br />
1.2% 1.2% 1.2% 1.2% 1.2% 1.3% 1.3% 1.3% 1.3% 1.3%<br />
00/01 01/02 02/03 03/04 04/05 05/06 06/07 07/08 08/09 09/10<br />
Prevalence of Congestive Heart Failure, 2009/10<br />
Mission<br />
Agassiz/Harrison<br />
Hope<br />
Abbotsford<br />
Surrey<br />
Maple Ridge<br />
Chilliwack<br />
Langley<br />
Delta<br />
New Westminster<br />
Burnaby<br />
South Surrey/White Rock<br />
Coquitlam<br />
1.8% (891)<br />
1.7% (240)<br />
1.6% (265)<br />
1.5% (2,972)<br />
1.5% (6,112)<br />
1.5% (1,619)<br />
1.4% (1,972)<br />
1.4% (2,544)<br />
1.3% (2,082)<br />
1.3% (1,196)<br />
1.2% (4,011)<br />
1.1% (2,379)<br />
1.1% (2,622)<br />
0% 2% 4% 6% 8% 10%<br />
ASPR (Count)<br />
Source: Ministry of <strong>Health</strong> Services, PHC Congestive Heart Failure Registry as of February <strong>2011</strong>.<br />
149
What are we looking at?<br />
The prevalence of depression/anxiety<br />
represents all residents with a history of<br />
depression/anxiety registered in the PHC<br />
patient registry for the given period.<br />
Why do we care?<br />
Occasional periods of unhappiness,<br />
grief, or sadness are normal. Major<br />
depression, on the other hand, causes<br />
prolonged feelings of hopelessness and<br />
a lack of self worth lasting more than<br />
two months and interfering with daily<br />
life. 48 Depression can affect people of<br />
any age and symptoms can alter the<br />
way someone thinks and behaves;<br />
depression can even cause physical<br />
effects. 48 Signs of depression include<br />
prolonged feelings of hopelessness or<br />
despair, detachment from life, lethargy,<br />
suicidal thoughts, change in appetite,<br />
and/or frequent headaches or stomach<br />
upsets.<br />
People with anxiety disorders experience<br />
excessive anxiety, fear, or worries that<br />
interfere with relationships, school and<br />
work performance, social activities, and<br />
recreation. 49 Anxiety disorders are the<br />
most common of all mental illnesses. 49<br />
Mood disorders like depression and<br />
anxiety have major economic implications<br />
through lost work productivity<br />
and related health care expenses. 49<br />
Canadians living in low-income neighbourhoods<br />
were found to be 85% more<br />
likely to be hospitalized for depression<br />
48 <strong>Health</strong> Canada. (2009). It's your health: Depression.<br />
Retrieved August 4, 2009, from http://www.hc-sc.gc.ca/hlvs/iyh-vsv/diseases-maladies/depression-eng.php<br />
49 <strong>Health</strong> Canada. (2002). A report on mental illnesses in<br />
Canada. Ottawa, Ontario: <strong>Health</strong> Canada. Retrieved August<br />
4, 2009 from http://www.phac-aspc.gc.ca/publicat/miicmmac/index-eng.php<br />
d) Depression/Anxiety<br />
ASPR<br />
than those living in higher income<br />
neighbourhoods. 50<br />
• The prevalence of anxiety/depression<br />
is increasing.<br />
• In Canada, roughly 16% of women<br />
and 11% of men will suffer serious<br />
depression during their lifetimes 48<br />
while about 16% of women and 9%<br />
of men experience anxiety disorders. 49<br />
• Vancouver Coastal has the lowest rate<br />
of depression/anxiety in BC.<br />
• LHAs in <strong>Fraser</strong> East have the highest<br />
rates of depression/anxiety in <strong>Fraser</strong><br />
<strong>Health</strong>, but account for only 20% of<br />
cases across the region; <strong>Fraser</strong> North<br />
has 1.8 times the number of cases<br />
and <strong>Fraser</strong> South 2.3 times the cases.<br />
30%<br />
20%<br />
10%<br />
0%<br />
Prevalence of Depression/Anxiety,<br />
Based on Three-Year Moving Average, 2008/09<br />
19.8%<br />
22.5%<br />
17.2%<br />
22.2%<br />
Source: Ministry of <strong>Health</strong> Services, PHC Depression<br />
Registry as of February <strong>2011</strong>.<br />
21.2%<br />
Limitations<br />
See page 140 for registry information,<br />
case definitions, and data limitations.<br />
19.8%<br />
FHA IHA VCHA VIHA NHA BC<br />
50 Canadian Institute for <strong>Health</strong> Information. (Feb. 24,<br />
2009). The association between socio-economic status and<br />
inpatient hospital service use for depression. Analysis in<br />
brief: Taking health information further. Ottawa, ON: CIHI.<br />
150
HEALTH STATUS<br />
MORBIDITY<br />
Prevalence of Depression/Anxiety<br />
30%<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
ASPR<br />
20%<br />
15.8%<br />
15.4%<br />
16.7%<br />
17.5%<br />
18.2%<br />
16.4%<br />
17.3%<br />
18.0%<br />
18.7% 19.0% 19.3% 19.6% 19.8% 20.0%<br />
18.5% 18.9% 19.3% 19.5% 19.8% 20.0%<br />
10%<br />
0%<br />
00/01 01/02 02/03 03/04<br />
04/05 05/06 06/07 07/08 08/09 09/10<br />
Prevalence of Depression/Anxiety, 2009/10<br />
Abbotsford<br />
Mission<br />
Chilliwack<br />
Hope<br />
South Surrey/White Rock<br />
Maple Ridge<br />
Delta<br />
Langley<br />
Agassiz/Harrison<br />
Surrey<br />
New Westminster<br />
Coquitlam<br />
Burnaby<br />
0%<br />
24.0% (33,256)<br />
23.7% (10,146)<br />
23.1% (20,635)<br />
22.2% (2,145)<br />
22.1% (22,157)<br />
21.9% (21,275)<br />
21.8% (25,092)<br />
21.7% (30,327)<br />
21.6% (1,962)<br />
19.9% (81,550)<br />
19.8% (14,947)<br />
17.6% (42,003)<br />
15.6% (41,643)<br />
10% 20% 30%<br />
ASPR (Count)<br />
Source: Ministry of <strong>Health</strong> Services, PHC Depression/Anxiety Registry as of February <strong>2011</strong>.<br />
151
What are we looking at?<br />
The prevalence of hypertension (high<br />
blood pressure) represents all residents<br />
aged 20 and older who have a history of<br />
hypertension and who are registered in<br />
the Primary <strong>Health</strong> Care (PHC) patient<br />
registry during the time shown.<br />
Data are direct age-standardized using<br />
five-year age groups based on 2001<br />
Census estimates for BC. For health<br />
authority comparisons, given rates are<br />
based on three-year moving averages<br />
where the reference year is the middle<br />
year (2007/08, 2008/09, and 2009/10).<br />
All other rates are single year rates.<br />
e) Hypertension<br />
Some risk factors for hypertension<br />
cannot be changed, such as age or a<br />
family history of cardiovascular disease<br />
or hypertension. However, numerous<br />
risk factors can be controlled, including<br />
tobacco use, drinking alcohol, physical<br />
activity, and being overweight. 54<br />
• <strong>Fraser</strong> <strong>Health</strong> has the second highest<br />
rate among BC health authorities,<br />
while Vancouver Coastal <strong>Health</strong> has<br />
the lowest.<br />
• With over 65,000 cases, Surrey LHA<br />
has the highest prevalence of hypertension<br />
in <strong>Fraser</strong> <strong>Health</strong>.<br />
Why do we care?<br />
Hypertension, or high blood pressure, is<br />
the leading modifiable risk factor for<br />
stroke and a major risk factor for heart<br />
disease, the two leading causes of<br />
hospitalization and death in Canada. 51,52<br />
Uncontrolled hypertension can cause<br />
serious harm, damaging arterial walls,<br />
accelerating the hardening of arteries,<br />
and/or leading to heart enlargement or<br />
failure. In turn, damage or hardening of<br />
the arteries can lead to heart disease,<br />
heart attack, stroke, kidney failure, loss<br />
of sight, and aneurysms. 53<br />
51 Jenkins, K., & Alberta <strong>Health</strong> Services. (2009). Do you<br />
know what your blood pressure is? You should! Retrieved<br />
August 6, 2009, from http://www.phac-aspc.gc.ca/cdmc/cvd-mcv/blood_pressure-tension_arterielle-eng.php<br />
52 Public <strong>Health</strong> Agency of Canada. (2009). Hypertension<br />
facts and figures. Retrieved August 6, 2009, from<br />
http://www.phac-aspc.gc.ca/cd-mc/cvdmcv/hypertension_figures-eng.php<br />
53 Public <strong>Health</strong> Agency of Canada. (2009). What can<br />
happen if I have uncontrolled high blood pressure and what<br />
can I do to lower it? Retrieved August 6, 2009, from<br />
http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/hbp-ha_02-<br />
eng.php<br />
ASPR<br />
30%<br />
20%<br />
10%<br />
0%<br />
Prevalence of Hypertension, Ages 20+,<br />
Based on Three-Year Moving Average, 2008/09<br />
13.9%<br />
12.7% 12.4%<br />
12.9%<br />
14.3%<br />
Source: Ministry of <strong>Health</strong>, PHC Hypertension Registry as of<br />
February <strong>2011</strong>.<br />
Limitations<br />
See page 140 for case definitions and<br />
more information on registries and data<br />
limitations.<br />
13.1%<br />
FHA IHA VCHA VIHA NHA BC<br />
54 Ministry of <strong>Health</strong>, BC Government. (2008). Hypertension<br />
– detection, diagnosis and management: A guide for<br />
patients. Retrieved December 14, <strong>2011</strong>, from<br />
http://www.bcguidelines.ca/pdf/hypertension_patient_guide<br />
.pdf<br />
152
HEALTH STATUS<br />
MORBIDITY<br />
Prevalence of Hypertension, Ages 20+<br />
30%<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
20%<br />
ASPR<br />
10%<br />
10.6%<br />
9.9%<br />
11.1%<br />
11.7% 12.1%<br />
10.4% 10.9% 11.3%<br />
12.6% 12.9% 13.4% 13.7% 13.9% 14.1%<br />
11.8% 12.1% 12.6% 12.9% 13.1% 13.3%<br />
0%<br />
00/01 01/02 02/03 03/04 04/05 05/06 06/07 07/08 08/09 09/10<br />
Prevalence of Hypertension, Ages 20+, 2009/10<br />
Surrey<br />
Maple Ridge<br />
Abbotsford<br />
Delta<br />
Langley<br />
Agassiz/Harrison<br />
Mission<br />
Hope<br />
New Westminster<br />
Coquitlam<br />
Burnaby<br />
Chilliwack<br />
South Surrey/White Rock<br />
15.5% (65,187)<br />
15.0% (16,313)<br />
14.7% (24,408)<br />
14.2% (20,177)<br />
14.0% (23,097)<br />
13.8% (1,818)<br />
13.7% (6,604)<br />
13.5% (1,973)<br />
13.4% (11, 305)<br />
13.4% (33,628)<br />
13.3% (39,381)<br />
13.3% (15,799)<br />
12.2% (18,808)<br />
0% 10% 20% 30%<br />
ASPR (Count)<br />
Source: Ministry of <strong>Health</strong>, PHC Hypertension Re gistry as of February <strong>2011</strong>.<br />
153
f) Stroke (Acute Cerebrovascular Syndrome)<br />
What are we looking at?<br />
The prevalence of stroke represents all<br />
clients with a hospitalization for stroke<br />
registered in the Primary <strong>Health</strong> Care<br />
(PHC) registry for the time shown.<br />
Why do we care?<br />
A stroke occurs when blood flow is cut<br />
off to part of the brain and brain cells in<br />
the affected area are damaged or die. 55<br />
Stroke is a major cause of death and<br />
disability in seniors. 56 Deaths due to<br />
stroke are dropping, but stroke survivors<br />
often experience some degree of<br />
disability long after the stroke and<br />
despite rehabilitation.<br />
Following a stroke, common outcomes<br />
include impaired vision, trouble using or<br />
understanding language, paralysis or<br />
weakness on one side of the body,<br />
tiredness, depression, and trouble<br />
55, 56<br />
thinking.<br />
While stroke is most common among<br />
older adults, a stroke can occur at any<br />
age. Besides age, other risk factors<br />
include obesity, hypertension, and a<br />
history of heart disease, physical<br />
inactivity, smoking, and heavy<br />
drinking. 55 A healthy diet high in<br />
unrefined plant foods and not high in<br />
salt or fat can help lower blood pressure<br />
and maintain a healthy body weight.<br />
A stroke is an emergency that requires<br />
immediate action to save lives and to<br />
ASPR<br />
reduce debilitating outcomes. 56 With<br />
stroke, “time is brain” because the<br />
longer it takes to reach care, more brain<br />
cells die.<br />
3%<br />
2%<br />
1%<br />
0%<br />
• Hospitalizations for stroke vary little<br />
between health authorities, and the<br />
overall trend over time has remained<br />
constant.<br />
Prevalence of Stroke,<br />
Based on Three-Year Moving Average, 2008/09<br />
0.5% 0.5% 0.5% 0.4%<br />
0.6%<br />
Source: Ministry of <strong>Health</strong>, PHC Stroke Registry as of<br />
February <strong>2011</strong>.<br />
Limitations<br />
See page 140 for case definitions and<br />
more information on registries and data<br />
limitations. The registry criteria for<br />
stroke has changed and data in this<br />
report cannot be compared to data<br />
reported in previous versions of this<br />
report.<br />
0.5%<br />
FHA IHA VCHA VIHA NHA BC<br />
55 Public <strong>Health</strong> Agency of Canada. (2005). Stroke info-sheet<br />
for seniors. Retrieved December 15, 2009, from<br />
http://www.phac-aspc.gc.ca/seniorsaines/publications/public/age/info/stroke/stroke-eng.php<br />
56 About.com. Senior health: Stroke research and treatment.<br />
Retrieved August 7, 2008, from<br />
http://seniorhealth.about.com/od/stroke/Stroke_Research_a<br />
nd_Treatment.htm<br />
154
HEALTH STATUS<br />
MORBIDITY<br />
3%<br />
Prevalence of Stroke<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
2%<br />
ASPR<br />
1%<br />
0.5% 0.5% 0.5% 0.5% 0.5%<br />
0.5% 0.5% 0.5% 0.5% 0.5%<br />
0.5% 0.5% 0.5% 0.5% 0. 5% 0.5% 0.5% 0.5% 0.5% 0.5%<br />
0%<br />
00/01 01/02 02/03 03/04 04/ 05 05/06 06/07 07/08 08/09 09/10<br />
Prevalence of Stroke, 2009/10<br />
Hope<br />
Maple Ridge<br />
Mission<br />
Langley<br />
Chilliwack<br />
Agassiz/Harrison<br />
New Westminster<br />
Abbotsford<br />
Burnaby<br />
Surrey<br />
Delta<br />
Coquitlam<br />
South Surrey/White Rock<br />
0.6% (99)<br />
0.6% ( 615)<br />
0.5% (275)<br />
0.5% (968)<br />
0.5% (680)<br />
0.5% (78)<br />
0.5% (480)<br />
0.5% (963)<br />
0.5% (1,549)<br />
0. 5% (1,989)<br />
0.5% (712)<br />
0.5% (1,082)<br />
0.4% (847)<br />
0% 1% 2% 3%<br />
ASPR (Count)<br />
Source: Ministry of <strong>Health</strong>, PHC Stroke Registry as of February <strong>2011</strong>.<br />
155
g) Chronic Obstructive Pulmonary Disease (COPD)<br />
What are we looking at?<br />
The prevalence of chronic obstructive<br />
pulmonary disease (COPD) represents<br />
all residents aged 45 years and older<br />
who have COPD and are registered in<br />
the Primary <strong>Health</strong> Care (PHC) patient<br />
registry during the time shown.<br />
Data are direct age-standardized using<br />
five-year age groups based on 2001<br />
Census estimates for BC. For health<br />
authority comparisons, given rates are<br />
based on three-year moving averages<br />
where the reference year is the middle<br />
year (2007/08, 2008/09, and 2009/10).<br />
All other rates are single year rates.<br />
air pollution makes symptoms worse,<br />
which can be particularly troublesome<br />
for people with COPD living in the <strong>Fraser</strong><br />
Valley because the valley’s shape tends<br />
to trap air pollution.<br />
• <strong>Fraser</strong> <strong>Health</strong> has similar prevalence of<br />
COPD as the BC average.<br />
• Among LHAs, the highest rates are in<br />
Hope, Mission, New Westminster,<br />
Maple Ridge, and Langley.<br />
• Because it has the largest population<br />
among our LHAs, Surrey LHA has the<br />
largest number of adults with COPD.<br />
Why do we care?<br />
COPD is a broad term for a group of<br />
respiratory diseases that block airflow,<br />
including emphysema and chronic<br />
bronchitis. COPD makes breathing very<br />
difficult; symptoms include shortness of<br />
breath, cough, and sputum production.<br />
In turn, breathing difficulties limit<br />
activity levels and reduce quality of life<br />
for patients. 57 COPD symptoms are<br />
uncommon among people younger than<br />
55 years, but damage to the lungs starts<br />
well before symptoms start showing. 57,58<br />
Smoking is by far the biggest preventimportant<br />
to continue initiatives that<br />
able risk factor for COPD 58 so it is very<br />
reduce smoking rates and limit exposure<br />
to second-hand tobacco smoke. Outdoor<br />
ASPR<br />
3%<br />
2%<br />
1%<br />
0%<br />
Prevalence of COPD, Ages 45+,<br />
Based on Three-Year Moving Average, 2008/09<br />
1.4%<br />
1.9%<br />
1.2%<br />
1.4%<br />
1.9%<br />
Source: Ministry of <strong>Health</strong>, PHC COPD Registry as of<br />
February <strong>2011</strong>.<br />
Limitations<br />
See page 140 for case definitions and<br />
more information on registries and data<br />
limitations.<br />
1.5%<br />
FHA IHA VCHA VIHA NHA BC<br />
57 Public <strong>Health</strong> Agency of Canada. (2008). Chronic<br />
obstructive pulmonary disease (COPD). Retrieved August 11,<br />
2009, from http://www.phac-aspc.gc.ca/cd-mc/crdmrc/copd-mpoc-eng.php<br />
58 Public <strong>Health</strong> Agency of Canada. (2008). What is COPD<br />
and can it be prevented? Retrieved August 11, 2009, from<br />
http://www.phac-aspc.gc.ca/cd-mc/crd-mrc/copd_preventmpoc_prevenir-eng.php<br />
156
HEALTH STATUS<br />
MORBIDITY<br />
Prevalence of COPD, Ages 45+<br />
3%<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
2%<br />
ASPR<br />
1%<br />
1.4% 1.4% 1.3% 1.3% 1.3% 1.3% 1.3% 1.3% 1.4% 1.4%<br />
1.5%<br />
1.3% 1.3% 1.3% 1.3% 1.3% 1.4% 1.4% 1.4% 1.4%<br />
0%<br />
00/01 01/02 02/03 03/04<br />
04/05 05/06 06/07 07/08 08/09 09/10<br />
Prevalence of COPD, Ages 45+, 2009/10<br />
Hope<br />
Mission<br />
New Westminster<br />
Maple Ridge<br />
Langley<br />
Agassiz/Harrison<br />
Chilliwack<br />
Coquitlam<br />
Abbotsford<br />
Surrey<br />
Burnaby<br />
South Surrey/White Rock<br />
Delta<br />
0%<br />
2.3% (373)<br />
1.9% (897)<br />
1.8% (1,565)<br />
1.8% (1,936)<br />
1.7% (2,890)<br />
1.6% (241)<br />
1.5% (1,976)<br />
1.4% (3,417)<br />
1.4% (2,451)<br />
1.4% (5,483)<br />
1.3% (4,113)<br />
1.2% (2,233)<br />
1.2% (1,789)<br />
1% 2% 3%<br />
ASPR (Count)<br />
Source: Ministry of <strong>Health</strong>, PHC COPD Registry as of Februa ry <strong>2011</strong>.<br />
157
h) Osteoarthritis (OA)<br />
What are we looking at?<br />
The prevalence of osteoarthritis (OA)<br />
represents all cases registered in the<br />
Primary <strong>Health</strong> Care (PHC) patient<br />
registry during the time shown.<br />
Data are direct age-standardized using<br />
five-year age groups based on 2001<br />
Census estimates for BC. For health<br />
authority comparisons, given rates are<br />
based on three-year moving averages<br />
where the reference year is the middle<br />
year (2006/07, 2007/08, and 2008/09).<br />
All other rates are single year rates.<br />
Why do we care?<br />
Osteoarthritis occurs when cartilage (the<br />
material that cushions bone ends) is<br />
damaged or wears down. While there<br />
are many different forms of arthritis,<br />
OA is the most common and is the<br />
most frequent joint problem among<br />
seniors. 59 The Public <strong>Health</strong> Agency of<br />
Canada estimates that OA affects 85%<br />
of Canadians by age 70. 59<br />
Characterized by pain, stiffness, and/or<br />
swelling in or around a joint, osteoarthritis<br />
can be very painful and is one<br />
of the main factors leading older adults<br />
to limit their activities. 59 Finger joints<br />
are the most likely joint to be affected,<br />
though OA can also cause pain in knees,<br />
hips, shoulders, elbows, wrists, or the<br />
back. 60<br />
59 Public <strong>Health</strong> Agency of Canada. (2000). Arthritis infosheet<br />
for seniors. Ottawa, ON: Minister of Public Works and<br />
Government Services Canada. Retrieved December 15, 2009<br />
from http://www.phac-aspc.gc.ca/seniorsaines/publications/public/age/info/arthritis/arthritis-eng.php<br />
60<br />
A <strong>Health</strong>y Me. (<strong>2011</strong>). Osteoarthritis Retrieved December<br />
14, <strong>2011</strong>, from http://ahealthyme.epnet.com/osteoarthritis<br />
ASPR<br />
10%<br />
8%<br />
6%<br />
4%<br />
2%<br />
0%<br />
Along with age, risk factors include<br />
excess weight, injury, heredity, and lack<br />
of physical activity. Fatigue, pain, and<br />
stiffness may lead people to avoid<br />
exercise, which ironically can worsen<br />
arthritic symptoms. 59<br />
• Among provincial health authorities,<br />
Vancouver Coastal has the lowest<br />
prevalence of osteoarthritis and lower<br />
than the BC average.<br />
• Among <strong>Fraser</strong> <strong>Health</strong> LHAs, Surrey has<br />
the highest prevalence rate and the<br />
largest number of cases, nearly double<br />
the number of cases in Burnaby, which<br />
has the lowest rate.<br />
Prevalence of Osteoarthritis,<br />
Based on Three-Year Moving Average, 2008/09<br />
6.0%<br />
6.4%<br />
4.6%<br />
6.0%<br />
6.7%<br />
Source: Ministry of <strong>Health</strong>, PHC Osteoarthritis Registry as<br />
of February <strong>2011</strong>.<br />
5.7%<br />
FHA IHA VCHA VIHA NHA BC<br />
Limitations<br />
See page 140 for case definitions and<br />
more information on registries and data<br />
limitations. The registry criteria for<br />
osteoarthritis has changed and data in<br />
this report cannot be compared to data<br />
reported in previous versions of this<br />
report.<br />
158
HEALTH STATUS<br />
MORBIDITY<br />
10%<br />
Prevalence of Osteoarthritis<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
8%<br />
ASPR<br />
6%<br />
4%<br />
4.7%<br />
4.4%<br />
4.9%<br />
4.6%<br />
5.1%<br />
4.8%<br />
5.3%<br />
5.0%<br />
5.5%<br />
5.2%<br />
5.6% 5.8% 5.9% 6.0% 6.1%<br />
5.4% 5.5% 5.6% 5.7% 5.8%<br />
2%<br />
0%<br />
00/01 01/02 02/03 03/04<br />
04/05 05/06 06/07 07/08 08/09 09/10<br />
Surrey<br />
Hope<br />
Agassiz/Harrison<br />
South Surrey/White Rock<br />
Abbotsford<br />
Delta<br />
Langley<br />
Mission<br />
Chilliwack<br />
Maple Ridge<br />
Prevalence of Osteoarthritis, 2009/10<br />
Coquitlam<br />
Burnaby<br />
7.0% (28,719)<br />
6.9% (1,013)<br />
6.9% (0,920)<br />
6.5% (10,349)<br />
6.4% (10,833)<br />
6.4% (9,113)<br />
6.2% (10,290)<br />
6.2% (3,028)<br />
6.1% (7,406)<br />
6.0% (6,556)<br />
New Westminster 5.8% (4,972)<br />
5.2% (12,966)<br />
5.0% (14,909)<br />
0% 2%<br />
4% 6% 8% 10%<br />
ASPR (Count)<br />
Source: Ministry of <strong>Health</strong>, PHC Osteoarthritis Regi stry as of February <strong>2011</strong>.<br />
159
What are we looking at?<br />
Dementia prevalence reports the percent<br />
of adults (45 years and older) with<br />
dementia, representing all cases in the<br />
PHC patient registry for the time shown.<br />
Why do we care?<br />
Dementia refers to a broad class of<br />
disorders characterized by progressive<br />
deterioration of the mind, including<br />
perception, thought, and memory. 61 The<br />
signs and symptoms of dementia include<br />
loss of memory, deterioration of<br />
judgment and reasoning skills, and<br />
changes in mood, behaviour, and<br />
communication ability leading to the loss<br />
of ability to perform activities of daily<br />
living. Alzheimer’s disease is a<br />
degenerative and eventually fatal brain<br />
disease that is by far the most common<br />
cause of dementia, accounting for about<br />
63% of all cases of dementia in Canada.<br />
Dementia not only implies a long period<br />
of disability for the person affected by<br />
the disease, it also places immense<br />
strain and significant financial pressure<br />
on family and caregivers. 61<br />
The risk of dementia increases with age.<br />
It is more common among women than<br />
among men and it is more common<br />
among the very old (85+) than among<br />
younger seniors (65-84). Factors known<br />
to increase the risk of dementia include<br />
hypertension, diabetes, high cholesterol,<br />
or having had a heart attack or stroke. 62<br />
Though the exact cause of dementias<br />
i) Dementia<br />
ASPR<br />
3%<br />
2%<br />
1%<br />
0%<br />
may be hard to determine, making<br />
healthy living choices that reduce the<br />
risk of other chronic disease are<br />
recommended as beneficial in reducing<br />
our risk of some forms of dementia.<br />
Staying as healthy and as mentally and<br />
socially active as possible can help<br />
prevent further cognitive decline among<br />
those who already have dementia. 62<br />
• Dementia prevalence in <strong>Fraser</strong> <strong>Health</strong><br />
(0.7%) is similar to BC overall (0.7%),<br />
but prevalence is increasing.<br />
• Dementia prevalence ranged from<br />
0.6% in Chilliwack LHA to 0.9% in<br />
Mission LHA.<br />
Limitations<br />
See page 140 for case definitions and<br />
registry and data limitation information.<br />
The registry criteria for dementia has<br />
changed and data in this report cannot<br />
be compared to data reported in<br />
previous versions of this report.<br />
Prevalence of Dementia, Ages 45+,<br />
Based on Three-Year Moving Average, 2008/09<br />
0.6% 0.7%<br />
0.8% 0.8%<br />
0.7% 0.7%<br />
FHA IHA VCHA VIHA NHA BC<br />
61 Dedgeon, S. (2010). Rising tide: The impact of dementia<br />
on Canadian society Alzheimer Society of Canada.<br />
62 Curtis, J., & Poore, R. (2009). <strong>Health</strong>LinkBC: Dementia.<br />
Retrieved July 14, 2010, from<br />
http://www.healthlinkbc.ca/kb/content/major/uf4984.html#<br />
uf4985<br />
Source: Ministry of <strong>Health</strong>, PHC Dementia Registry as of<br />
February <strong>2011</strong>.<br />
160
HEALTH STATUS<br />
MORBIDITY<br />
3%<br />
Prevalence of Dementia, Ages 45+<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
2%<br />
ASPR<br />
1%<br />
0.6% 0.6% 0.6% 0.6% 0. 6% 0.7% 0.7% 0.7% 0.7% 0.7%<br />
0.5% 0.5% 0.5% 0.6% 0. 6% 0.6% 0.6% 0.6% 0.6% 0.7%<br />
0%<br />
00/01 01/02 02/03 03/04 04/05 05/06 06/07 07/08 08/09 09/10<br />
Prevalence of Dementia, Ages 45+, 2009/10<br />
Mission<br />
Maple Ridge<br />
Delta<br />
South Surrey/White Rock<br />
New Westminster<br />
Langley<br />
Agassiz/Harrison<br />
Hope<br />
Surrey<br />
Coquitlam<br />
Abbotsford<br />
Burnaby<br />
Chilliwack<br />
0.9% (448)<br />
0.8% ( 907)<br />
0.8% (1,316)<br />
0.7% (1,876)<br />
0. 7% (749)<br />
0.7% (1,420)<br />
0.7% (111)<br />
0.7% (114)<br />
0.7% (2,693)<br />
0.6% (1,550)<br />
0.6% (1,385)<br />
0.6% (2,227)<br />
0.6% (912)<br />
0% 1%<br />
2% 3%<br />
ASPR (Count)<br />
Source: Ministry of <strong>Health</strong>, PHC Dementia Registry as of February <strong>2011</strong>.<br />
161
MORTALITY<br />
Infant Mortality<br />
What are we looking at?<br />
Infant mortality is expressed as the<br />
number of deaths of infants less than<br />
one year old as a rate per 1,000 live<br />
births.<br />
The low birth-weight (
HEALTH STATUS<br />
MORTALITY<br />
8<br />
Five-Year Infant Mortality,<br />
by <strong>Health</strong> Authority, 2005-2009<br />
Live Births<br />
ate per 1,000<br />
R<br />
6<br />
4<br />
2<br />
0<br />
FHA IHA VCHA VIHA NHA BC<br />
Count 287 117 208 145 73 830<br />
Rate 3.4 3.8 4.1 4.7 4.1 3.9<br />
80<br />
Five-Year Low Birth-Weight Infant Mortality,<br />
by <strong>Health</strong> Authority, 2005-2009<br />
LBW Live Births<br />
Rate per 1,000<br />
60<br />
40<br />
20<br />
0<br />
FHA IHA VCHA VIHA NHA BC<br />
Count 182 65 135 81 40 503<br />
Rate 36.8 39.4 46.8 50.6 46.1 42.1<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
Note: Bars represent point estimates; whisker lines represent 95% confidence intervals<br />
163
8<br />
Infant Mortality<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
Rate per 1,000 Live Births .<br />
6<br />
4<br />
2<br />
4.2<br />
4.0 4.0 4.0 4.1 4.2 4.2 4.1 4.0<br />
4.0 3.9 3.9<br />
3.7 3.8 3.9<br />
3.7<br />
3.6 3.6<br />
3.9<br />
3.4<br />
0<br />
1996-<br />
2000<br />
1997-<br />
2001<br />
1998-<br />
2002<br />
1999-<br />
2003<br />
2000-<br />
2004<br />
2001-<br />
2005<br />
2002-<br />
2006<br />
2003-<br />
2007<br />
2004-<br />
2008<br />
2005-<br />
2009<br />
80<br />
Low Birth-Weight Infant Mortality<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
Rate per 1,000 LBW Live Births<br />
60<br />
40<br />
20<br />
50.3<br />
48.6 48.3 48.6 49.3 49.7<br />
44.5 43.6 44.0 43.9<br />
45.4 46.7<br />
48.1 46.8<br />
43.1 42.7<br />
44.7<br />
40.6<br />
42.1<br />
36.8<br />
0<br />
1996-<br />
2000<br />
1997-<br />
2001<br />
1998-<br />
2002<br />
1999-<br />
2003<br />
2000-<br />
2004<br />
2001-<br />
2005<br />
2002-<br />
2006<br />
2003-<br />
2007<br />
2004-<br />
2008<br />
2005-<br />
2009<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
164
HEALTH STATUS<br />
MORTALITY<br />
Infant Mortality by LHA, 2005-2009<br />
Hope<br />
Mission<br />
Surrey<br />
BC<br />
Abbotsford<br />
<strong>Fraser</strong> <strong>Health</strong><br />
Coquitlam<br />
Langley<br />
Maple Ridge<br />
New Westminster<br />
Chilliwack<br />
Burnaby<br />
Agassiz/Harrison<br />
South Surrey/White Rock<br />
Delta<br />
4.8 (11)<br />
4.6 (112)<br />
3.9 (830)<br />
3.4 (29)<br />
3.4 (287)<br />
3.2 (33)<br />
3.1 (21)<br />
3.0 (14)<br />
2.7 (9)<br />
2.6 (13)<br />
2.6 (29)<br />
2.1 (
Five-Year Infant Mortality by Length of Gestation,<br />
2005-2009<br />
50<br />
Rate per 1,000 Live Births<br />
40<br />
30<br />
20<br />
10<br />
0<br />
FHA IHA VCHA VIHA NHA BC<br />
HEALTH STATUS<br />
MORTALITY<br />
<strong>Fraser</strong> <strong>Health</strong> Leading Causes of Infant Mortality, 2005-2009<br />
All other causes<br />
20%<br />
Total Infant Deaths = 287<br />
Congenital<br />
malformations &<br />
chromosome<br />
abnormalities<br />
20%<br />
Perinatal respiratory &<br />
cardiovascular disorders<br />
4%<br />
Premature/postmature &<br />
fetal growth disorders<br />
20%<br />
Other perinatal<br />
conditions<br />
9%<br />
Sudden infant death<br />
syndrome (SIDS)<br />
10%<br />
Fetus/newborn affected<br />
by maternal factors &<br />
pregnancy, labour &<br />
delivery complications<br />
17%<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
167
All Causes of Death – ASMR<br />
What are we looking at?<br />
The age-standardized mortality rate<br />
(ASMR) summarizes the age-adjusted<br />
death rates for a particular population.<br />
Death rates are standardized to a<br />
‘standard’ population (1991 Census).<br />
The ASMR represents the theoretical<br />
number of deaths per 10,000 people<br />
that would have occurred in the<br />
population in question if it had the same<br />
age group distribution as the ‘standard’<br />
population.<br />
Rate per 10,000<br />
80<br />
60<br />
40<br />
20<br />
ASMR for All Causes of Death, 2005-2009<br />
64.0<br />
55.3<br />
50.9 51.6<br />
50.9<br />
44.6<br />
• Vancouver Coastal <strong>Health</strong> had the<br />
lowest rate among the provincial<br />
health authorities; <strong>Fraser</strong> <strong>Health</strong> is<br />
not far off at 51 deaths for every<br />
10,000 people.<br />
• However, the ASMRs among <strong>Fraser</strong><br />
<strong>Health</strong> LHAs vary considerably, with<br />
rates higher in the east than in the<br />
west.<br />
0<br />
FHA IHA VCHA VIHA NHA BC<br />
Source: Vista Database, BC Vital Statistics Agency, Ministry<br />
of <strong>Health</strong> Services.<br />
Note: Bars represent point estimates; whisker lines<br />
represent 95% confidence intervals<br />
Limitations<br />
Only ASMRs calculated to the same<br />
standard population are comparable.<br />
The ASMR is a theoretical value used for<br />
rate comparison and does not represent<br />
the actual observed death rate.<br />
ASMR data are calculated for single<br />
years and for aggregated five-year<br />
periods.<br />
Data represent all causes of death and<br />
therefore do not indicate the specific<br />
cause of death nor differentiate rates<br />
from specific causes of death.<br />
168
HEALTH STATUS<br />
MORTALITY<br />
80<br />
ASMR for All Causes of Death<br />
60<br />
Rate per 10,000<br />
40<br />
20<br />
0<br />
1990 '91 '92 '93 '94 '95 '96 '97 '98 '99 2000 '01 '02 '03 '04 '05 '06 '07 '08 '09<br />
<strong>Fraser</strong> <strong>Health</strong> 64.7 65.4 65.3 65.0 62.9 62.5 64.6 61.4 59.4 57.4 55.1 55.8 53.6 54.7 53.8 53.7 52.2 50.7 51.4 46.9<br />
BC 66.6 65.4 65.0 66.1 64.4 63.1 63.7 61. 4 60.8 59.1 56.1 56.2 55.5 54.6 54.1 53.2 51.9 51.1 50.6 47.8<br />
ASMR for All Causes of Death, 2005-2009<br />
Hope<br />
Mission<br />
Chilliwack<br />
New Westminster<br />
Maple Ridge<br />
Langley<br />
Agassiz/Harrison<br />
Abbotsford<br />
Surrey<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
Delta<br />
Coquitlam<br />
Burnaby<br />
South Surrey/White Rock<br />
58.6<br />
58.6<br />
57.8<br />
53.3<br />
52.9<br />
51.4<br />
51.3<br />
50.9<br />
50.9<br />
47.7<br />
46.5<br />
46.1<br />
44.3<br />
64.1<br />
79.2<br />
0<br />
20 40 60 80 100<br />
Rate per 10,000<br />
Source: Vista Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
Note: Bars represent point estimates; whisker lines represent 95% confidence intervals.<br />
169
Potential Years of Life Lost – PYLL<br />
What are we looking at?<br />
Potential years of life lost (PYLL) refers<br />
to the number of years of life lost when<br />
someone dies before age 75, which is<br />
the presumed normal life expectancy<br />
used for the calculation. Data are shown<br />
as rates per 1,000 men or 1,000<br />
women, directly age-standardized to the<br />
1991 Census population. PYLL data are<br />
calculated for 2009 and an aggregated<br />
five-year period (2005 to 2009).<br />
Why do we care?<br />
PYLL is an indicator of premature death,<br />
emphasizing the causes of death that<br />
occur at younger ages over those that<br />
occur at older ages.<br />
Deaths due to motor vehicle collisions<br />
and suicide typically have higher PYLLs<br />
as they tend to occur among younger<br />
age groups. Deaths due to congenital<br />
abnormalities occur very early in life<br />
resulting in numerous life years lost.<br />
Smoking is frequently associated with<br />
premature death due to disease (e.g.,<br />
lung cancer, ischemic heart disease,<br />
etc.). Other risk factors for premature<br />
death include hypertension, high blood<br />
cholesterol, diabetes, and alcohol abuse.<br />
• For all causes of death, Vancouver<br />
Coastal <strong>Health</strong> has the lowest PYLL<br />
among provincial health authorities.<br />
• Men account for more years of life<br />
lost than women.<br />
• For women, the PYLL due to<br />
ischemic heart disease is significantly<br />
higher in <strong>Fraser</strong> <strong>Health</strong> than in BC<br />
overall. For men, the PYLL due to<br />
Standardized Rate per 1,000 .<br />
80<br />
60<br />
40<br />
20<br />
0<br />
homicide is significantly higher than<br />
the BC average.<br />
36.4<br />
Potential Years of Life Lost, 2009<br />
48.8<br />
32.8<br />
Source: VISTA Database, BC Vital Statistics Agency,<br />
Ministry of <strong>Health</strong> Services.<br />
Note: Bars represent point estimates; whisker lines<br />
represent 95% confidence intervals<br />
Limitations<br />
In <strong>Fraser</strong> <strong>Health</strong>, life expectancy is 79.3<br />
years for men and 83.5 years for<br />
women (2005-2009). Therefore, using<br />
age 75 as the ‘normal’ life expectancy<br />
underestimates the number of years lost<br />
by 4.3 years for men and by 8.5 years<br />
for women.<br />
PYLLs are only comparable when age<br />
standardized to the same standard<br />
population.<br />
46.1<br />
61.5<br />
FHA IHA VCHA VIHA NHA BC<br />
40.5<br />
170
HEALTH STATUS<br />
MORTALITY<br />
Potential Years Life Lost - Females 2005-2009<br />
Lung cancer<br />
Breast cancer<br />
Cancer of digestive organs<br />
Perinatal conditions<br />
Ischaemic heart diseases<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
Congenital anomalies<br />
Suicide<br />
Cancer of female genital organs<br />
Other nervous system disorders<br />
Motor vehicle collisions<br />
0 1 2 3 4 5 6<br />
PYLLSR<br />
Potential Years Life Lost - Males 2005-2009<br />
Ischaemic heart disease<br />
Cancer of digestive organs<br />
Suicide<br />
Motor vehicle collisions<br />
Lung cancer<br />
Perinatal conditions<br />
<strong>Fraser</strong> <strong>Health</strong><br />
BC<br />
Homicide<br />
Other nervous system disorders*<br />
Lymphoid and hematopoietic cancers<br />
Congenital anomalies<br />
0 1 2 3 4 5 6<br />
PYLLSR<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
Note: Bars represent point estimates; whisker lines represent 95% confidence intervals<br />
171
Age-Standardized Mortality Rate, by Natural Cause<br />
What are we looking at?<br />
The age-standardized mortality rate<br />
(ASMR) summarizes the age-adjusted<br />
death rates for a specific population.<br />
Mortality rates are standardized to a<br />
‘standard’ population (1991 Census).<br />
The ASMR represents the theoretical<br />
number of deaths per 10,000 people<br />
that would have occurred in the given<br />
population if it had the same age group<br />
distribution as the ‘standard’ population.<br />
Because data are age-standardized, the<br />
ASMR is a general mortality indicator<br />
useful for comparing death rates in<br />
different geographic locales and/or over<br />
time. ASMRs are given for select broad,<br />
prominent causes of death.<br />
Why do we care?<br />
Tracking mortality rates for major broad<br />
causes of death can highlight just how<br />
many deaths are due to preventable<br />
causes. For example, many deaths due<br />
to cancers, heart disease and<br />
respiratory disease are related to<br />
smoking, a sedentary lifestyle, and<br />
obesity.<br />
Cancer mortality includes deaths from<br />
all forms of malignant tumours.<br />
Cardiovascular mortality can be due to<br />
ischemic heart diseases, hypertension<br />
and hypertensive diseases, and more.<br />
Cerebrovascular mortality can result<br />
from circulatory system diseases that<br />
result in blood clots or bleeding inside<br />
the head causing death.<br />
Respiratory system mortality data<br />
includes chronic obstructive pulmonary<br />
disease (e.g., emphysema), influenza,<br />
ASMR<br />
ASMR<br />
ASMR<br />
20<br />
15<br />
10<br />
5<br />
0<br />
Cancer Mortality, 2005-2009<br />
FHA IHA VCHA VIHA NHA BC<br />
Count 13,421 8,999 9,083 9,415 2,534 43,455<br />
Rate 14.8 15.6 13.1 15.6 18.4 14.9<br />
20<br />
15<br />
10<br />
5<br />
0<br />
Cardiovascular Disease Mortality, 2005-2009<br />
FHA IHA VCHA VIHA NHA BC<br />
Count 11,054 7,046 6,835 7,387 1,594 33,919<br />
Rate 11.1 11.1 8.7 10.3 12.5 10.4<br />
5<br />
4<br />
3<br />
2<br />
1<br />
Cerebrovascular Disease Mortality, 2005-2009<br />
0<br />
FHA IHA VCHA VIHA NHA BC<br />
Count 3,400 2,310 2,762 2,511 502 11,486<br />
Rate 3.4 3.5 3.4 3.4 4.1 3.5<br />
Source: VISTA Database, BC Vital Statistics Agency,<br />
Ministry of <strong>Health</strong> Services.<br />
Note: Bars represent point estimates; whisker lines<br />
represent 95% confidence intervals<br />
172
HEALTH STATUS<br />
MORTALITY<br />
pneumonia, asthma, and others, but<br />
does not include cancers of the<br />
respiratory system.<br />
Infectious diseases are preventable and<br />
for most mortality is rare in most cases.<br />
Mortality rates from infectious disease<br />
can include HIV, viral hepatitis, bacterial<br />
intestinal infections, other bacterial<br />
diseases, and others. For more information<br />
on infectious diseases, refer to the<br />
<strong>Fraser</strong> <strong>Health</strong> Annual Communicable<br />
Disease Report. 64<br />
• Among the broad causes of death<br />
presented here, cancer deaths have<br />
the highest ASMR in every health<br />
authority and are the most frequent<br />
cause of death.<br />
• Vancouver Coastal <strong>Health</strong> has the<br />
lowest ASMRs for cancer and<br />
cardiovascular diseases.<br />
• Interior <strong>Health</strong> had the lowest ASMR<br />
for infectious diseases.<br />
• The declining trend has stalled for<br />
respiratory diseases.<br />
• Except for infectious diseases, ASMRs<br />
have generally gone down over time.<br />
Deaths due to infectious diseases have<br />
been steadily increasing over the past<br />
decade. The increase in infectious<br />
disease mortality appears to be driven<br />
by increased ASMRs from chronic viral<br />
hepatitis, other septicemia, and<br />
Clostridium difficile enterocolitis (data<br />
not shown).<br />
ASMR<br />
ASMR<br />
10<br />
8<br />
6<br />
4<br />
2<br />
0<br />
Limitations<br />
Mortality is the most serious possible<br />
outcome and reveals nothing about how<br />
many people are living with any given<br />
disease.<br />
Count<br />
5,534 3,328 3,781 3,306 783 16,735<br />
Rate 5.6 5.3 4.8 4.7 6.2 5.2<br />
2.0<br />
1.6<br />
1.2<br />
0.8<br />
0.4<br />
0.0<br />
Respiratory System Disease Mortality, 2005-2009<br />
FHA IHA VCHA VIHA NHA BC<br />
Infectious Disease Mortality, 2005-2009<br />
FHA IHA VCHA VIHA NHA BC<br />
Count<br />
975 431 928 501 132 2,968<br />
Rate 1.0 0.8 1.3 0.9 0.9 1.0<br />
Source: VISTA Database, BC Vital Statistics Agency,<br />
Ministry of <strong>Health</strong> Services.<br />
Note: Bars represent point estimates; whisker lines<br />
represent 95% confidence intervals<br />
64 <strong>Fraser</strong> <strong>Health</strong>. (2009). <strong>Fraser</strong> <strong>Health</strong> Communicable<br />
Disease Report 2008. Retrieved September 15, 2010 from<br />
http://www.fraserhealth.ca/media/CDReport2008.pdf<br />
173
30<br />
Cancer Mortality<br />
25<br />
20<br />
ASMR<br />
15<br />
10<br />
5<br />
0<br />
1996-<br />
2000<br />
1997-<br />
2001<br />
1998-<br />
2002<br />
1999-<br />
2003<br />
2000-<br />
2004<br />
2001-<br />
2005<br />
2002-<br />
2006<br />
2003-<br />
2007<br />
2004-<br />
2008<br />
2005-<br />
2009<br />
<strong>Fraser</strong> <strong>Health</strong> 16.8 16.5 16.2 15.9 15.8 15.7 15.4 15.3 15.2 14.8<br />
BC 16.7 16.4 16.2 16.0 15.8 15.7 15.5 15.4 15.2 14.9<br />
Cancer Mortality, 2005-2009<br />
Hope<br />
Mission<br />
Chilliwack<br />
Maple Ridge<br />
New Westminster<br />
Langley<br />
Coquitlam<br />
Delta<br />
Surrey<br />
Abbotsford<br />
South Surrey/White Rock<br />
Agassiz/Harrison<br />
Burnaby<br />
21.7 (146)<br />
18.8 (407)<br />
17.7 (1,022)<br />
17.6 (844)<br />
17.4 (692)<br />
15.8 (1,220)<br />
15.0 (1,542)<br />
14.6 (941)<br />
14.0 (2,416)<br />
13.9 (1,152)<br />
13.6 (1,147)<br />
13.6 (86)<br />
12.8 (1,788)<br />
0 5 10 15 20 25 30<br />
ASMR<br />
Note: Values in parentheses represent the observed number of deaths in each LHA. Bars represent point estimates;<br />
whisker lines represent 95% confidence intervals<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
174
HEALTH STATUS<br />
MORTALITY<br />
30<br />
Cardiovascular Disease Mortality<br />
25<br />
20<br />
ASMR<br />
15<br />
10<br />
5<br />
0<br />
1996-<br />
2000<br />
1997-<br />
2001<br />
1998-<br />
2002<br />
1999-<br />
2003<br />
2000-<br />
2004<br />
2001-<br />
2005<br />
2002-<br />
2006<br />
2003-<br />
2007<br />
2004-<br />
2008<br />
2005-<br />
2009<br />
<strong>Fraser</strong> <strong>Health</strong> 15.6 14.9 14.4 14.0 13.6 13.2 12.8 12.2 11.8 11.1<br />
BC 15.1 14.5 13.9 13.3 12.7 12.2 11.7 11.2 10.9 10.4<br />
Hope<br />
New Westminster<br />
Mission<br />
Maple Ridge<br />
Chilliwack<br />
Abbotsford<br />
Langley<br />
Surrey<br />
Burnaby<br />
Delta<br />
Coquitlam<br />
Agassiz/Harrison<br />
South Surrey/White Rock<br />
Cardiovascular Disease Mortality, 2005-2009<br />
14.3 (106)<br />
14.2 (666)<br />
13.2 (310)<br />
12.2 (624)<br />
12.1 (793)<br />
11.8 (1,168)<br />
11.7 (1,043)<br />
11.1 (1,869)<br />
10.5 (1,667)<br />
10.4 (711)<br />
9.5 (971)<br />
9.4 (70)<br />
9.3 (1,056)<br />
0 5 10 15 20 25 30<br />
ASMR<br />
Note: Values in parentheses represent the observed number of deaths in each LHA. Bars represent point estimates;<br />
whisker lines represent 95% confidence intervals.<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
175
10<br />
Cerebrovascular Disease Mortality<br />
8<br />
ASMR<br />
6<br />
4<br />
2<br />
0<br />
1996-<br />
2000<br />
1997-<br />
2001<br />
1998-<br />
2002<br />
1999-<br />
2003<br />
2000-<br />
2004<br />
2001-<br />
2005<br />
2002-<br />
2006<br />
2003-<br />
2007<br />
2004-<br />
2008<br />
2005-<br />
2009<br />
<strong>Fraser</strong> <strong>Health</strong> 4.9 4.7 4.3 4.1 3.9 3.8 3.7 3.7 3.5 3.4<br />
BC 4.8 4.6 4.4 4.2 4.1 3.9 3.8 3.7 3.6 3.5<br />
Maple Ridge<br />
Delta<br />
New Westminster<br />
Mission<br />
Langley<br />
Abbotsford<br />
Chilliwack<br />
Surrey<br />
Agassiz/Harrison<br />
Burnaby<br />
Coquitlam<br />
South Surrey/White Rock<br />
Hope<br />
Cerebrovascular Disease Mortality, 2005-2009<br />
4.1 (206)<br />
3.8 (266)<br />
3.7 (177)<br />
3.6 (84)<br />
3.5 (328)<br />
3.4 (339)<br />
3.4 (222)<br />
3.3 (550)<br />
3.3 (25)<br />
3.3 (512)<br />
3.1 (317)<br />
3.0 (352)<br />
2.9 (22)<br />
0 2 4 6 8<br />
ASMR<br />
10<br />
Note: Values in parentheses represent the observed number of deaths in each LHA. Bars represent point estimates;<br />
whisker lines represent 95% confidence intervals.<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
176
HEALTH STATUS<br />
MORTALITY<br />
12<br />
Respiratory System Disease Mortality<br />
10<br />
8<br />
ASMR<br />
6<br />
4<br />
2<br />
0<br />
1996-<br />
2000<br />
1997-<br />
2001<br />
1998-<br />
2002<br />
1999-<br />
2003<br />
2000-<br />
2004<br />
2001-<br />
2005<br />
2002-<br />
2006<br />
2003-<br />
2007<br />
2004-<br />
2008<br />
2005-<br />
2009<br />
<strong>Fraser</strong> <strong>Health</strong> 6.1 5.8 5.6 5.5 5.5 5.6 5.6 5.7 5.7 5.6<br />
BC 6.0 5.9 5.7 5.6 5.4 5.4 5.3 5.3 5.2 5.2<br />
Hope<br />
Mission<br />
Chilliwack<br />
Langley<br />
Maple Ridge<br />
Abbotsford<br />
Burnaby<br />
New Westminster<br />
Surrey<br />
Coquitlam<br />
Agassiz/Harrison<br />
Delta<br />
South Surrey/White Rock<br />
Respiratory System Disease Mortality, 2005-2009<br />
8.5 (63)<br />
7.6 (166)<br />
7.3 (478)<br />
6.3 (553)<br />
6.0 (298)<br />
5.7 (563)<br />
5.6 (911)<br />
5.6 (266)<br />
5.4 (882)<br />
4.9 (494)<br />
4.9 (36)<br />
4.8 (326)<br />
4.4 (498)<br />
0 2 4 6 8 10 12<br />
ASMR<br />
Note: Values in parentheses represent the observed number of deaths in each LHA. Bars represent point estimates;<br />
whisker lines represent 95% confidence intervals.<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
177
1.5<br />
Infectious Disease Mortality<br />
1.2<br />
ASMR<br />
0.9<br />
0.6<br />
0.3<br />
0.0<br />
1996-<br />
2000<br />
1997-<br />
2001<br />
1998-<br />
2002<br />
1999-<br />
2003<br />
2000-<br />
2004<br />
2001-<br />
2005<br />
2002-<br />
2006<br />
2003-<br />
2007<br />
2004-<br />
2008<br />
2005-<br />
2009<br />
<strong>Fraser</strong> <strong>Health</strong> 0.81 0.80 0.83 0.87 0.88 0.92 0.96 1.00 1.04 1.03<br />
BC 0.97 0.91 0.92 0.95 0.97 1.00 1.05 1.07 1.05 1.01<br />
Hope<br />
New Westminster<br />
Surrey<br />
Chilliwack<br />
Delta<br />
Langley<br />
Burnaby<br />
Maple Ridge<br />
Agassiz/Harrison<br />
Abbotsford<br />
Coquitlam<br />
Mission<br />
South Surrey/White Rock<br />
Infectious Disease Mortality, 2005-2009<br />
1.61 (12)<br />
1.32 (60)<br />
1.27 (223)<br />
1.14 (63)<br />
1.10 (71)<br />
1.07 (90)<br />
1.04 (152)<br />
1.01 (51)<br />
1.01 (7)<br />
0.93 (80)<br />
0.92 (97)<br />
0.90 (20)<br />
0.57 (49)<br />
0.0 0.5 1.0 1.5 2.0 2.5 3.0<br />
ASMR<br />
Note: Values in parentheses represent the observed number of deaths in each LHA. Bars represent point estimates;<br />
whisker lines represent 95% confidence intervals.<br />
Source: VISTA Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
178
HEALTH STATUS<br />
MORTALITY<br />
[This page was left blank intentionally]<br />
179
Age-Standardized Mortality<br />
Rate, by External Cause<br />
What are we looking at?<br />
The age-standardized mortality rate<br />
(ASMR) summarizes the age-adjusted<br />
death rates for a particular population.<br />
Mortality rates are standardized to a<br />
‘standard’ population (1991 Census).<br />
The ASMR represents the theoretical<br />
number of deaths per 10,000 people<br />
that would have occurred in the given<br />
population if it had the same age group<br />
distribution as the ‘standard’ population.<br />
Because data are age-standardized, the<br />
ASMR is a general mortality indicator<br />
useful for comparing death rates in<br />
different geographic locales and/or over<br />
time. Rates are shown for motor vehicle<br />
collisions, accidental falls, and suicide.<br />
Why do we care?<br />
Deaths due to external causes such as<br />
motor vehicle collision, falls, or suicide<br />
are largely preventable. A variety of<br />
strategies can reduce the number of<br />
people who die from unintentional and<br />
intentional injuries.<br />
Where can we improve?<br />
• In BC, <strong>Fraser</strong> <strong>Health</strong> has the largest<br />
numbers of deaths due to motor<br />
vehicle collisions, accidental falls,<br />
and suicides.<br />
• Vancouver Coastal <strong>Health</strong> has the<br />
lowest ASMR for motor vehicle<br />
collisions in the province.<br />
• ASMRs for motor vehicle collisions<br />
show an east-west gradient with<br />
higher rates in eastern LHAs. The<br />
biggest numbers of people who die<br />
are from Surrey, Coquitlam, and<br />
Abbotsford.<br />
ASMR<br />
2.0<br />
1.6<br />
1.2<br />
0.8<br />
0.4<br />
0.0<br />
Motor Vehicle Collision Mortality, 2005-2009<br />
FHA IHA VCHA VIHA NHA BC<br />
Count 559 508 248 287 230 1,834<br />
Rate 0.7 1.4 0.4 0.7 1.6 0.8<br />
ASMR<br />
ASMR<br />
2.0<br />
1.6<br />
1.2<br />
0.8<br />
0.4<br />
0.0<br />
Accidental Falls Mortality, 2005-2009<br />
FHA IHA VCHA VIHA NHA BC<br />
Count 467 427 338 461 101 1,794<br />
Rate 0.47 0.67 0.44 0.65 0.79 0.56<br />
2.0<br />
1.6<br />
1.2<br />
0.8<br />
0.4<br />
Suicide Rates, 2005-2009<br />
0.0<br />
FHA IHA VCHA VIHA NHA BC<br />
Count 634 418 527 452 179 2,212<br />
Rate 0.8 1.1 0.8 1.1 1.3 0.9<br />
Source: Vista Database, BC Vital Statistics Agency, Ministry<br />
of <strong>Health</strong> Services.<br />
Note: bars represent point estimates; whisker lines<br />
represent 95% confidence intervals<br />
180
HEALTH STATUS<br />
MORTALITY<br />
2.0<br />
Motor Vehicle Collision Mortality<br />
1.6<br />
ASMR<br />
1.2<br />
0.8<br />
0.4<br />
0.0<br />
1996-<br />
2000<br />
1997-<br />
2001<br />
1998-<br />
2002<br />
1999-<br />
2000-<br />
2003<br />
2004<br />
2001-<br />
2005<br />
2002-<br />
2006<br />
2003-<br />
2007<br />
2004-<br />
2008<br />
2005-<br />
2009<br />
<strong>Fraser</strong> <strong>Health</strong> 0.91 0.88 0.85 0.88 0.89 0.93 0.91 0.90 0.83 0.73<br />
BC 1.04 1.00 1.00 1.00 1.01 1.04 1.03 0.99 0.92 0.81<br />
Hope<br />
Agassiz/Harrison<br />
Mission<br />
Maple Ridge<br />
Abbotsford<br />
South Surrey/White Rock<br />
Chilliwack<br />
New Westminster<br />
Surrey<br />
Coquitlam<br />
Delta<br />
Burnaby<br />
Motor Vehicle Collision Mortality, 2005-2009<br />
1.86 (8)<br />
1.83 (6)<br />
1.16 (24)<br />
1.05 (43)<br />
1.01 (68)<br />
Langley 0. 92 (60)<br />
0.80 (28)<br />
0.73 (30)<br />
0.72 (23)<br />
0.70 (127)<br />
0.68 (71)<br />
0.38 (43)<br />
0.57 (28)<br />
0 1<br />
2 3 4 5<br />
ASMR<br />
Note: Values in parentheses represent the observed number of deaths in each LHA, bars represent point estimates;<br />
whisker lines represent 95% confidence intervals.<br />
Source: Vista Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
181
2.0<br />
Accidental Falls Mortality<br />
1.6<br />
ASMR<br />
1.2<br />
0.8<br />
0.4<br />
0.0<br />
1996-<br />
2000<br />
1997-<br />
2001<br />
1998-<br />
2002<br />
1999-<br />
2003<br />
2000-<br />
2004<br />
2001-<br />
2005<br />
2002-<br />
2006<br />
2003-<br />
2007<br />
2004-<br />
2008<br />
2005-<br />
2009<br />
<strong>Fraser</strong> <strong>Health</strong> 0.61 0.55 0.52 0.48 0.47 0.48 0.51 0.48 0.47 0.47<br />
BC 0.78 0.73 0.69 0.65 0.60 0.59 0.58 0.56 0.55 0.56<br />
Hope<br />
New Westminster<br />
Agassiz/Harrison<br />
Mission<br />
Langley<br />
Surrey<br />
Burnaby<br />
Chilliwack<br />
Maple Ridge<br />
Abbotsford<br />
South Surrey/White Rock<br />
Coquitlam<br />
Delta<br />
Accidental Falls Mortality, 2005-2009<br />
1.08 (8)<br />
0.65 (29)<br />
0.65 (5)<br />
0.61 (14)<br />
0.53 (50)<br />
0.51 (86)<br />
0.50 (79)<br />
0.49 (29)<br />
0.46 (24)<br />
0.43 (44)<br />
0.41 (41)<br />
0.39 (40)<br />
0.27 (18)<br />
0.0 0.5 1.0 1.5<br />
ASMR<br />
2.0<br />
Note: Values in parentheses represent the observed number of deaths in each LHA, bars represent point estimates;<br />
whisker lines represent 95% confidence intervals.<br />
Source: Vista Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
182
HEALTH STATUS<br />
MORTALITY<br />
2.0<br />
Suicide<br />
1.6<br />
ASMR<br />
1.2<br />
0.8<br />
0.4<br />
0.0<br />
1996-<br />
2000<br />
1997-<br />
2001<br />
1998-<br />
2002<br />
1999-<br />
2003<br />
2000-<br />
2004<br />
2001-<br />
2005<br />
2002-<br />
2006<br />
2003-<br />
2007<br />
2004-<br />
2008<br />
2005-<br />
2009<br />
<strong>Fraser</strong> <strong>Health</strong> 1.01 0.98 0.97 0.97 0.95 0.97 0.92 0.87 0.83 0.79<br />
BC 1.24 1.18 1.14 1.11 1.11 1.09 1.05 1.00 0.97 0.94<br />
Hope<br />
Agassiz/Harrison<br />
Chilliwack<br />
New Westminster<br />
Maple Ridge<br />
South Surrey/White Rock<br />
Abbotsford<br />
Langley<br />
Surrey<br />
Mission<br />
Coquitlam<br />
Burnaby<br />
Delta<br />
Suicide Rates, 2005-2009<br />
2.03 (7)<br />
1.65 (6)<br />
1.08 (45)<br />
1.05 (36)<br />
1.03 (48)<br />
0.93 (35)<br />
0.85 (57)<br />
0.82 (56)<br />
0.75 (143)<br />
0.71 (15)<br />
0.71 (76)<br />
0.69 (84)<br />
0.47 (26)<br />
0 1 2 3 4 5<br />
ASMR<br />
Note: Values in parentheses represent the observed number of deaths in each LHA, Bars represent point estimates;<br />
whisker lines represent 95% confidence intervals.<br />
Source: Vista Database, BC Vital Statistics Agency, Ministry of <strong>Health</strong> Services.<br />
183