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Back to Basics, 2011 POPULATION HEALTH : Vital & Health Statistics. Presented by Robert Spasoff, MD Epidemiology & Community Medicine. 78.1: VITAL STATISTICS INFORMATION.
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Back to Basics, 2011POPULATION HEALTH :Vital & Health Statistics Presented by Robert Spasoff, MD Epidemiology & Community Medicine
78.1: VITAL STATISTICS INFORMATION • What are the key causes of illness or death in Canada? Common things are common – using epidemiology can help you run a better clinical practice • How have disease incidence and mortality changed in Canada in the past 20 years? • Little good information on disease incidence except for reportable diseases and cancer (cancer registries)
TOPICS • Demography, population dynamics • Mortality, and inequalities therein • Morbidity • Summary measures of population health • Aboriginal health
Canadian Historical Population Pyramids • http://www12.statcan.ca/english/census01/products/analytic/companion/age/cda01pymd.cfm
Standardization • An older method of adjusting for confounding (usually used for differences in age between two populations) • Refers observed events to a standard population, producing hypothetical values • Direct: yields age-standardized rate (ASMR) • Indirect: yields standardized mortality ratio (SMR)
Mortality dataThree ways to summarize them • Mortality rates (crude, specific, standardized) • PYLL: subtracts age at death from some “acceptable” age of death. Emphasizes causes that kill at younger ages. • Life expectancy: average age at death if current mortality rates continue. Derived from life table.
Loses a lot of detail here
2 3 4 5 1 2 3 4 5 Income adequacy quintiles Remaining Life Expectancy at age 25. Based on 10-year follow-up to 1991 census
Remaining life expectancy at age 25 (conditional on surviving to age 25), 1991-2001
Probability of survival to age 75 (conditional on surviving to age 25), 1991-2001
Leading causes of death • Cardiovascular disease: 37% • Heart disease: 20% • Other circulatory disease: 10% • Stroke 7% • Cancer: 28% • Lung cancer: 9% (M); 6% (W) • Breast cancer: 4% (W) • Prostate cancer: 4% (M) • Respiratory Disease: 10% • Injuries: 6% • Diabetes: 3% • Alzheimer’s: 1%
Impact of different causes of death in Canada 2001: • Mortality rates and PYLL • Source: Statistics Canada
CANCER: 30.3% Circ Disease: 27.6% †† † † Pneumonia & influenza grouped with respiratory disease. Would increase infectious % to about 3.4%.
CANCER: 29.8% Circ Disease: 29.0% EXTERNAL CAUSES: 4.8%+ { † † † Pneumonia & influenza grouped with respiratory disease. Would increase infectious % to about 3.5%.
CANCER: 31.6% Circ Disease: 27.3% EXTERNAL CAUSES: 3.4%+ { † † † Pneumonia & influenza grouped with respiratory disease. Would increase infectious % to about 3.3%.
Deaths due to Cardiovascular Disease and Cancer, Canada, 1979-2004: Sex ratio (M/F)
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Overall trends in mortality from Cancer 1976-2005: rates and numbers
Cancer and AgeAge-Specific Incidence Rates for All Cancers by Sex, Canada, 2003 Surveillance Division, CCDPC, Public Health Agency of Canada
Cancer and AgeAge-Specific Mortality Rates for All Cancers by Sex, Canada, 2003 Surveillance Division, CCDPC, Public Health Agency of Canada
Summary measuresof population health • Combine mortality and morbidity statistics, in order to provide a more comprehensive population health indicator, e.g., QALY • Years lived are weighted according to quality of life, disability, etc. • Two types: • Health expectancies point up from zero • Health gaps point down from ideal (Japan)
2001 Life Expectancy andHealth-Adjusted Life Expectancy • HALE always < LE • Females live longer (but gap is narrowing) • Females suffer more morbidity
Canadian population pyramids A. First Nations and overall population compared B. Animated display, showing changing Canadian population 1901 - 2001 Link to Statistics Canada