The Chief Health Officer for Prince Edward Island, Dr Heather Morrison, has published the first public report of health on the island. It is a good read, and well worth the trouble. I have excerpted a section of the executive summary for a quick overview.
The Health Trends section is presented in four sub-sections: demographics, health status and determinants, common & chronic conditions, and communicable diseases. In this document, Islanders are commonly compared with the entire Canadian population as an assessment of how different or how similar PEI rates are with the national rates.
Below is a summary of the key findings within each sub-section.
- PEI, similar with Canada and many other countries worldwide, has an aging population- Based on current projections by the year 2020, 1 in 5 Islanders will be over the age of 65. By 2040, 1 in 3 Islanders will be over the age of 65.
- Male Islanders born in 2007 are expected to live for 78 years and female Islanders for 83 years, both are similar to Canadian expectancies. Life expectancies have been slowly increasing over time and Canada boasts one of the highest life expectancies in the world.
- Cancer, heart disease and stroke are the leading causes of death in both PEI and Canada.
- Fewer low birth weight babies are born in PEI compared to Canada and this rate has remained stable over time.
- PEI's education levels, similar to Canada's, are improving.
- PEI's average annual income per person has risen over the past ten years but still remains lower than Canada's.
- The unemployment rate in PEI has decreased since the early 1990's but remains consistently higher than the Canadian rate.
Health Status & Determinants
- Almost two-thirds of Islanders and 60% of Canadians report their health as very good or excellent.
- The majority of Islanders and Canadians report their mental health as very good or excellent.
- Islanders are less likely than Canadians to consume 5 or more fruits and vegetables per day.
- Breastfeeding initiation rates have steadily increased over time, but still have room for improvement.
- More Islanders are likely to be obese than Canadian counterparts.
- PEI and Canada have similar rates of children and young adults who report being either overweight or obese.
- Islanders are less likely to be physically active than Canadians.
- More Islanders report heavy drinking than Canadians and this has not changed over time.
- The same proportion of Islanders report daily smoking as Canadians. This rate declined between 1995 and 2005 and has remained stable since that time.
- Fewer Islanders are exposed to second hand tobacco smoke in public places compared to Canadians.
- Over half of all Islanders intend to do something to improve their health in the next year. The overwhelming majority intend to get more exercise.
- More Islanders report a strong sense of belonging to their community compared with other Canadians.
Common & Chronic Conditions
- Islanders are more likely to suffer from "any chronic condition" (arthritis, asthma, heart and stroke, diabetes or cancer) than Canadians overall.
- Prostate (males), breast (females), lung and colorectal cancer are the most common cancers diagnosed in both PEI and Canada.
- Islanders (aged 50 to 74) are less likely than their Canadian counterparts to be screened for colorectal cancer by either FOBT or colonoscopy/sigmoidoscopy. In 2011, the FOBT screening program was expanded Island-wide for all Islanders 50-75 years of age.
- A similar proportion of Islanders and Canadians are living with Type II diabetes which is more likely to occur in males and rises considerably after age 45.
- One in every 5 Islanders has been diagnosed with hypertension. Hypertension is more likely to occur in females.
- One in every 10 Islanders has been diagnosed with asthma which is more prevalent in our younger population.
- The proportion of Islanders being diagnosed with COPD has been increasing since 2000.
- The most common sexually transmitted infection in 2010 in PEI was Chlamydia which accounted for over 75% of all sexually transmitted and bloodborne infections. Over two thirds of reported chlamydia cases occurred in people aged 20-29 years.
- Influenza was the most common vaccine preventable disease in PEI during the 2010-2011 influenza season. Age and sex were evenly distributed. Almost 50% of individuals who had lab-confirmed influenza were hospitalized. It is well established that the number of lab-confirmed cases greatly underestimates the actual number of influenza cases.
- Among enteric, foodborne and waterborne illnesses, Campylobacteriosis accounted for 39% of all reported cases, followed closely by Salmonellosis (37%) and parasitic infections (17%). Over 60% of the Salmonellosis cases were S. enteritidis which was the first time this serotype was that predominant in PEI.
- The number of new Hepatitis C cases in PEI increased between 2009 and 2010. This increase was paralleled with an increase in Hepatitis C testing.
- In total 5 cases of Pertussis were reported in 2010. This increasing trend has been seen in all parts of North America. To enhance efforts to protect Island infants from pertussis, a Cocooning Strategy has commenced across the province that provides Pertussis (dTAP) vaccination for new mothers post-delivery in the hospitals, and additional close contacts (e.g. father, grandparent, nanny etc) through Public Health Nursing. This strategy aims to prevent adults from transmitting pertussis to their infants.
Over the past century, improvements in health and quality of life have made Canada one of the healthiest nations in the world. This report provides comparisons with the rest of Canada and comparisons over time on a number and range of indicators. In many areas PEI is similar to the rest of Canada and has shown improvement over time. Islanders enjoy a similar life expectancy to the rest of Canada and the majority of us report our overall health as very good or excellent.
However, there are some areas which are concerning and require attention. It is no surprise that we are an ageing population and as we age our risk of having one or more chronic diseases increases. Having a chronic disease can interfere with lifestyle, sense of wellbeing, and limit opportunity for independence. While some risk factors like ageing and genetics are inevitable, many risk factors can be modified or changed. Such modifiable risk factors include being overweight or obese, being physically inactive, and smoking. While smoking rates have remained stable since 2005, Islanders are more likely to be obese or overweight, than the rest of Canada. As well Islanders are less likely to be physically active than the rest of Canadians. It is daunting to think that children today may be the first generation to see a declining life expectancy due to increasing risk factors such as obesity and lack of physical activity, which inevitably contributes to the earlier onset of chronic diseases such as Type II Diabetes and high blood pressure. In addition to concerns about increasing chronic diseases is the challenge faced by well established public health programs. Declining immunizations rates in a population can lead to resurgence of diseases such as mumps, measles, and pertussis which have previously been controlled.
The good news is that more than half of Islanders indicated they plan to do something to improve their health in the next year, with the majority indicating they plan to become more physically active. As well, Islanders report a strong sense of belonging to their community which is an important aspect of mental health and social wellbeing. Both of these factors may have a protective affect against life's stressors. Individuals taking action at any time to improve health, whether it is to stop smoking, increase physical activity, or having a child immunized, will contribute to healthier communities over time.
The role of public health includes developing and influencing public policy to ensure the population is as healthy as possible as well as preventing injury, illness, and premature death. This is accomplished through education and awareness, public health programs such as immunization and food protection, and gathering and reporting accurate and timely information to support program and policy decisions.
Priorities for the CPHO going forward include:
1) Maintaining a strong focus on Health Protection programs which are legislated under the Public Health Act, including Food Protection, Immunization and Communicable Disease surveillance and follow up.
2) Improving immunization rates of children to ensure better protection against vaccine preventable diseases. It is also a priority to increase awareness regarding adult immunization.
3) Maintaining a robust surveillance system in order to appropriately inform program and public health policy development.
4) Working with partners within the Department of Health and Wellness, other government departments and all Islanders towards attaining healthy weights. This includes working to improve breastfeeding rates and developing a provincial breastfeeding policy.
5) Working with Islanders in collaboration with our partners, particularly health promotion, to address the significant burden that high rates of chronic diseases such as heart disease, cancer and diabetes place on our society. Our primary focus must be to prevent and reduce the rates of chronic diseases.
Again, this is just a summary of the entire report, and I would encourage you to take the time and review it.
For a review of this report from the island newspaper, see the Guardian.