THUNDER BAY - A new report on adult mortality in Ontario gives health planners and decision-makers information that could lead to changes aimed at reducing health disparities between different regions of the province.
One sign of disparity highlighted in the Ontario Atlas of Adult Mortality is premature mortality, defined as death before the age of 75. Health analysts see it as an important indicator because many of these deaths are deemed to be the result of conditions that should be treatable.
According to the team that produced the atlas, the population within the jurisdiction of the North West Local Health Integration Network has the highest premature death rate in the province. The rate in the northwest is also improving at a slower pace than the rest of Ontario.
The researchers found that between 1992 and 2015, decreases in premature mortality took place in all LHIN jurisdictions in the province—averaging about 20 per cent— with the exception of females in both the North West and North East LHINS. For males in the North West LHIN, the rate declined by 5 per cent to 45 deaths per 1000, but that is still the highest rate in the province.
Laura Rosella is an assistant professor of public health at the University of Toronto, and was the senior scientist working on the atlas project.
"If we have one public health system in Ontario, we should expect the gains that are being made to be realized across the system, and if they are not, then what's happening and why is that variation there?" she noted in an interview with tbnewswatch.com.
Rosella said the team has tried not to speculate as to the reasons for the differences between regions. "The focus was to map out what's happening. Explaining why it's happening is obviously much more complex."
However, there are some measurable risk factors presented in the atlas which Rosella said may offer suggestions for the variation in death rates.
Rates of obesity, smoking and alcohol consumption, as well as levels of inactivity, tend to be higher in the northwest. Rosella said those are important contributors to diabetes, cancer and cardiovascular disease, the three conditions most responsible for premature adult deaths in Ontario.
Aside from the health status of the people living in the different regions, Rosella said, "the types of medical care received across the province may also vary. And then of course there's differences in the make up of the population. Who's living in the different areas across the province?" She said these as well as socio-economic differences are all likely contributors.
Rosella expects the atlas will be put to good use by health planners and policy-makers who have already started to examine it, "looking into the trends, understanding how the investments that they are making are actually aligning or responding to what they are seeing here. And thinking about how this type of monitoring can happen on a regular basis to understand how the health system is functioning."
Some Findings in the Ontario Atlas of Adult Mortality
- All-cause and premature mortality declined 34 per cent from 1992 to 2015
- Premature mortality rates declined 20 per cent
- Ontario's health systems and broader policies around health-determinants have been successful at preventing early deaths over this time
- Geographic, socioeconomic and sex differences significantly affected the mortality trends of the past two decades
- Mortality inequalities between LHINS and socioeconomic groups have widened since 1992
- In the North West and North East LHINS, no measured improvement occurred in premature mortality among females, compared with a 19 per cent improvement across the province
(Source: Population Health Analytics Laboratory, University of Toronto)
