Title: Tip of the Iceberg
1Tip of the Iceberg
- Effects of Forestry Closures
- On Health in
- Northwestern Ontario
Hill, Pugliese, Park, Minore, Gray, and
Russell Northern Health Research Conference May
29-30, 2009
2Research Team
- Mary Ellen Hill, Irene Pugliese Jungwee
Park, Bruce Minore - Centre for Rural and Northern Health Research
- Lakehead University
- Heather Gray, Cory Russell
- North West Local Health Integration Network
3Objectives
- Study commissioned by the NW LHIN to
determine whether, and to what extent, recent
restructuring in the forestry industry has
affected the health of people living in
Northwestern Ontario
4Model
- Murray Report (2005), examined the health and
socioeconomic impacts of the cod moratorium on
Newfoundland communities - Although not directly comparable, we used the
Murray report and similar studies of industry
closures to inform our study of NWO forestry
downturn
5Mixed Methods Study
- Quantitative Data (Identify affected communities
and examine changes in health status and social
well being using CCHS data) - Qualitative Data (Interviews with 15 health care
administrators and front-line providers to
determine more widespread effects)
6Affected Communities
- Defined as affected by forestry downturn if
community - Experienced forestry operations closures in past
5 years (Canadian Forestry Service Database) - Lost at least 10 of labour force in
resource-related sectors (Statistics Canada 2001
2006 census)
7Affected Communities
- Dorion
- Dryden
- Greenstone
- Ignace
- Kenora
- Machin
- Manitouwadge
- Marathon
- Nipigon
- Oliver Paipoonge
- Red Rock
- Schreiber
- Terrace Bay
- Kenora Unorg
- Rainy River Unorg
- Thunder Bay, large population and diverse
economy, treated as separate case
8Health Data (CCHS 3.1)
- 2005 data (telephone survey, self-report data)
- Sample based on 2001 census (20 sample,
collected January through December) - Aggregate analysis (compares affected communities
to City of Thunder Bay and Ontario)
9Chronic Conditions
- 75 of residents in affected communities had at
least one chronic condition - Rates of stroke (3) much higher than provincial
rates (1.1) - Heart disease rate (7) also higher than province
(4.8) - High blood pressure exceeded provincial rates
(18 vs. 15.2)
10Negative Self-Perceived Health
- Fair or poor health reported by 1 in 6 residents
of affected communities (16.4) and Thunder Bay
(15.9), much higher than province (11.0)
- No differences in mental health, stress or work
stress rates
11Risk Factors
12Diet and Physical Activity
13Associations Between Poor Health and Risk Factors
- Daily smokers about 5 times more likely to report
fair or poor physical health - Smoking also associated with chronic conditions
and poor mental health - People in food insecure households most likely to
have poor health and unmet needs
14Mental Health and Suicide
- Poor mental health associated with daily smoking
and heavy drinking - Heavy drinkers almost 6 times more likely than
others to seriously consider committing suicide
15Access to Services
- More than 1 in 4 from affected communities had no
regular doctor - More than 1 in 2 said no doctors available in
area or none taking new patients - Residents of affected communities also less
likely to see specialists or dentists
16Qualitative Analysis - Themes
- Unemployment as Determinant of Health
- Physical Health and Unemployment
- Mental Health Effects of Unemployment
- Family Health Unemployment
- Effects on Health Care Utilization
- Community Well-Being Policy Implications
17Providers Were Seeing More Physical Health
Problems
- High blood pressure (especially younger
individuals) - Injuries (people accepting more risky jobs to
support families) - Weight gain (people cannot afford to eat healthy
diets or participate in usual recreational
activities)
18 More Mental Health Problems
- More clients with sleep disorders and depression,
seeking medication - More people resuming smoking or other risky
behaviours - Unemployed facing chronic stress, exacerbated
when retraining - Older unemployed workers often expressing
suicidal thoughts
19 Widespread Family Health Effects
- Spouses stressed by partners heading west for
employment, involuntary separations, marital
problems - Children, youth anxious about pressures of having
to relocate and leave friends behind - Seniors worried about loss of family supports
when families have to relocate
20 Changing Healthcare Utilization
- Seeing more walk-in clients with mental health
issues in primary care clinics, mental health
services and ERs - Difficulties with transportation, affect ability
to access appointments - Loss of benefits creates difficulties paying for
prescriptions, so people skip medications,
conditions poorly controlled
21Community and Policy Effects
- Consensus effects observed were just tip of the
iceberg - Quality of life will decline as communities
cannot support services - More difficulty recruiting and retaining
professionals - Must revisit issues to understand full effects
22Thank you!
- We wish to thank the North West LHIN for
commissioning and funding this study - If you would like copy of the report, please
contact Dr. Mary Ellen Hill at the Centre for
Rural and Northern Health Research (Lakehead
University) (807) 766-7278 or
maryellen.hill_at_lakeheadu.ca
The Centre for Rural and Northern Health Research
is an academic and applied health research centre
funded through the Ontario Ministry of Health and
Long-Term Care