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Tip of the Iceberg

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Hill, Pugliese, Park, Minore, Gray, and Russell. Northern Health ... Mary Ellen Hill, Irene Pugliese Jungwee ... More people resuming smoking or other ... – PowerPoint PPT presentation

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Title: Tip of the Iceberg


1
Tip 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
2
Research 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

3
Objectives
  • 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

4
Model
  • 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

5
Mixed 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)

6
Affected 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)

7
Affected 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

8
Health 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)

9
Chronic 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)

10
Negative 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

11
Risk Factors
12
Diet and Physical Activity
13
Associations 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

14
Mental 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

15
Access 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

16
Qualitative 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

17
Providers 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

21
Community 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

22
Thank 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
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