Saskatoon Health Region Rural Health Status

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Saskatoon Health RegionRural Health Status
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• PHARE Symposium
• October 21, 2008
• Josh Marko, MPH
• Dr. Cory Neudorf MHO, Tracy Creighton, Tanis
  Kershaw,
• Cristina Ugolini, MPA
• Saskatoon Public Health Observatory
• Saskatoon Health Region
• Evidence, Action, Equity
• Making Population Health Information Count

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Purpose of our report

• a basic promise that the Health Region will be
  more aware of and address unique rural needs
• To provide an overview of common health
  indicators for rural residents of the Saskatoon
  Health Region
• Compare these indicators to residents of urban
  areas
• pg. 17 Saskatoon Health Region Strategic Plan
  January 2007 to March 2010

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Background What have we read?

• rural areas generally showed a health
  disadvantage for many health related measures
• CPHI, 2006
• health indicators have consistently shown that
  the health status of people living in rural
  communities, especially northern communities, is
  not as good as the rest of the Canadian
  population
• Romanow, 2002
• Overall, the health of rural residents is worse
  than their urban counterparts.
• Kirby Panel Report, 2002

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What are our main findings?

• Health status measures in rural SHR are not as
  discouraging as shown nationally.
• Higher proportion of seniors in rural SHR
• Poverty not as concentrated in rural SHR compared
  to urban, though there are pockets on First
  Nations Reserves.
• Pregnancy outcomes for the most part better in
  rural. However life expectancy, infant mortality
  and teen pregnancy on Reserves worse.
• Need to improve certain health behaviours
  (physical activity and fruit and vegetable
  consumption) for rural residents.

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How do we define rural?

• Rural and Small Town Definition
• population living in towns and municipalities
  outside the commuting zone of larger urban
  centres
• DuPlessis V, Beshiri R, Bollman RD. (2002)

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Rural and Small Town

• Further defined as Metropolitan Influenced Zones
  (MIZ)
• 4 zones for SHR (map)
• 2007 Populations
• CMA Strong MIZ 245,959
• Moderate MIZ 18,508
• Weak MIZ 18,117
• No MIZ 8,525
• First Nations Reserves 2,859

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(No Transcript)
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Population age groups, SHR, 2007
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Average annual personal income,15 years and older
with income, SHR all MIZ areas, 2001 - 2006
Source Census 2006
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Rural Poverty
Source 2006 census
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Health Behaviours

• Canadian Community Health Survey 1.1-3.1 merged
  dataset
• Rural sample n668
• None of the results age sex standardized
• Variance estimation procedure done using design
  effect not bootstrapped

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CCHS results, SHR, 2001-2005 combined
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Life expectancy at birth, SHR, 2004
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Pregnancy related outcomes, SHR, 1997-2006
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Major causes of mortality, SHR, 1995-2006
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All cause hospitalization - age sex standardized
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Implications

• Health services in future needs to be sensitive
  of growing senior population in rural SHR.
• First Nations Reserves are where pockets of
  disparity most acute.
• Healthy eating and physical activity
  interventions should be explored in rural SHR.

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Challenges and Limitations

• Small population sizes
• Residence does not equate to where people have
  lived all their lives
• How to change things, intervention literature not
  explored as yet

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Questions?Queries?Comments?