[Show abstract][Hide abstract] ABSTRACT: This article compares influenza vaccination rates in 1996/97 and 2000/01 and describes the characteristics of adults who were vaccinated.
The data on influenza vaccination are from the 1996/97 National Population Health Survey and the 2000/01 Canadian Community Health Survey, both conducted by Statistics Canada. Data on hospitalizations and deaths are from the Hospital Mortality Data Base and the Canadian Mortality Data Base, respectively.
Cross-tabulations were used to estimate rates of vaccination among seniors, people with chronic conditions, and the total population aged 20 or older. Multiple logistic regression was used to assess relationships between being vaccinated and selected characteristics.
Between 1996/97 and 2000/01, the percentage of Canadians aged 20 or older who reported having had a flu shot the previous year rose from 16% to 28%. Rates were higher for seniors and people with chronic conditions. The odds of vaccination were high for residents of middle-to-high income households, people with at least some postsecondary education, former smokers, and people with a regular doctor. Smokers and people who reported their health as good to excellent had lower odds of being vaccinated.
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 04/2004; 15(2):33-43. · 2.67 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This article focuses on rates of revascularization and mortality among people admitted to hospital after an acute myocardial infarction (AMI).
The hospital data are from the Person-oriented information Database. Information on deaths is from the Canadian Mortality Database.
Hospital records for Nova Scotia, Saskatchewan, Alberta and British Columbia were linked to identify AMI patients admitted between April 1, 1995 and March 31, 1996. Patients with no admission for AMI in the previous 12 months were followed for one year to determine what percentage underwent percutaneous transluminal coronary angioplasty and/or coronary artery bypass graft surgery. The risk of being revascularized and the risk of dying were estimated.
In the year after hospitalization, 25% of AMI patients were revascularized. Rates of revascularization were relatively low for women, very elderly people, and individuals with other health problems. Revascularization was significantly associated with a lower risk of dying for male, but not female, AMI patients.
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 02/2002; 13(2):35-46. · 2.67 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Cardiovascular disease and cancer are important health problems worldwide, yet our knowledge of these conditions is derived principally from populations of European descent. To investigate ethnic variations in major causes of death in Canada, the authors examined total and cause-specific mortality among European, south Asian, and Chinese Canadians.
Canadians of European, south Asian and Chinese origin were identified in the Canadian Mortality Database by last name and country of birth and in the population census by self-reported ethnicity. Age-standardized death rates by cause, per 100,000 population, were calculated for ages 35 to 74 years from 1979 to 1993 and in 5-year intervals grouped around census years (1979/83, 1984/88 and 1989/93).
Rates of death from ischemic heart disease were highest among Canadians of south Asian origin (men 320.2, women 144.5) and European origin (men 319.6, women 109.9) and were markedly lower among Canadians of Chinese origin (men 107.0, women 40.0); the rates declined significantly in all 3 groups over the study period. Rates of death from cerebrovascular disease were relatively low and showed less ethnic variation (Canadian men of European, south Asian and Chinese origin 49.5, 47.0 and 45.8 respectively; Canadian women of European, south Asian and Chinese origin 34.8, 39.0 and 42.2 respectively) and declined similarly in all groups over time. Rates of death from cancer were highest among Canadians of European origin (men 343.6, women 236.2), intermediate among those of Chinese origin (men 258.1, women 161.6) and lowest among those of south Asian origin (men 122.3, women 131.3). Over time, cancer mortality increased in Canadians of European origin but remained constant or declined in those of south Asian and Chinese origin.
Substantial differences exist in rates of death from ischemic heart disease and cancer among European, south Asian and Chinese Canadians.
Canadian Medical Association Journal 08/1999; 161(2):132-8. · 5.96 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We examined seasonal variations in mortality from acute myocardial infarction (AMI) and stroke by age using 300,000 deaths in the Canadian Mortality Database for the years 1980 to 1982 and 1990 to 1992.
The effect of age on environmental determinants of AMI and stroke is not well understood.
Seasonal variations were analyzed by month and for the four seasons (winter beginning in December). A chi-square test was used to test for homogeneity at p < 0.01, and relative risk ratios (RRs) for high and low periods were determined in relation to the overall mean. For each of four age subgroups, the magnitude of the seasonal variation was reported as the difference in mortality between the highest and lowest frequency seasons.
By month, AMI deaths were highest in January (RR = 1.090) and lowest in September (RR = 0.904), a relative risk difference of 18.6%. The seasonal mortality variation in AMI deaths (winter vs. summer) increased with increasing age: 5.8% for <65, 8.3% for 65 to 74, 13.4% for 75 to 84 and 15.8% for >85 years (p < 0.005 for trend). Stroke mortality peaked in January (RR = 1.113) and had a trough in September (RR = 0.914), a relative risk difference of 19.9%. The seasonal variation in stroke mortality also increased with age. Seasonal variations were not seen in those aged <65 years, compared with 11.6% for 65 to 74, 15.2% for 75 to 84 and 19.3% for >85 years (p < 0.005 for trend).
The elderly demonstrate a greater winter increase in AMI and stroke mortality than younger individuals. An understanding of these seasonal patterns may provide novel avenues for research in cardiovascular disease prevention.
Journal of the American College of Cardiology 06/1999; 33(7):1916-9. DOI:10.1016/S0735-1097(99)00137-0 · 16.50 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This article describes rates of and times to revascularization procedures for heart attack patients.
The data are from Statistics Canada's Person-Oriented Information Data Base. Hospital discharge records for heart attack patients were linked for fiscal years 1992/93 and 1993/94.
Hospital patients admitted between April 1 and September 30, 1993 with a primary diagnosis of acute myocardial infarction (AMI) were followed for six months to determine what percentage underwent percutaneous transluminal coronary angioplasty and/or coronary artery bypass graft surgery. Analyses of time-to-procedure were performed for those patients who had not been hospitalized for AMI in the previous 12 months.
Approximately 24,000 Canadians were discharged from hospital during the first half of fiscal year 1993/94 with a diagnosis of AMI. Within six months, 8.7% had an angioplasty and 6.7% had a bypass; overall, 14.9% were revascularized. Women were less likely than men to have a bypass, but angioplasty rates did not differ significantly. The rate of revascularization declined with age. After adjusting for age and sex, rates were higher in the western provinces.
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 02/1998; 10(3):63-76 (ENG); 67-81 (FRE). · 2.67 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The self-reported prevalence of risk factors for heart disease among Canadians with and without heart disease is estimated. The characteristics associated with these risk factors are examined in order to identify groups to be targeted for primary and secondary prevention.
The data are from the household component of the 1994/95 National Population Health Survey (NPHS).
For the population aged 20 and older with and without heart disease, bivariate and multiple regression analyses were used to determine associations between four risk factors (smoking, high blood pressure, diabetes, and inactivity) and demographic characteristics and socioeconomic status.
According to the NPHS, 4.4% of people aged 20 and older reported that they heart disease. However, many more adults had risk factors for this disease. As well, about one-quarter of those without heart disease and half of those with heart disease had two or more risk factors. To some extent, many of these risks are modifiable. The groups particularly at risk were people older than 35, those with less than high school graduation, those in households with inadequate income, people who consumed three or more drinks a day, and residents of the Atlantic provinces, Quebec and Ontario.
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 02/1998; 9(4):19-29(Eng); 19-30(Fre). · 2.67 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This article provides an overview of patients who were hospitalized in 1993/94 because of acute myocardial infarction (AMI) and projects how many AMI patients there could be in the future.
The Person-Oriented Information Data Base was used for this analysis.
Hospital inpatients who had a primary diagnosis of AMI were analyzed, as well as their subsequent hospitalizations for coronary heart disease in the fiscal year. The age-sex specific hospitalization rates were used with population projections to estimate future hospital use.
Of the nearly 45,000 Canadians who were discharged from hospital in 1993/94 with a primary diagnosis of AMI, most (72%) had only one hospital stay within the fiscal year, but 18% had two related stays, and 10% had three or more. AMI patients were hospitalized an average of 14.6 days. The projected number of AMI patients and the number of hospital days used will increase by approximately 36% each decade to the year 2026.
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 02/1998; 10(2):21-8 (Eng); 23-31 (Fre). · 2.67 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The study of ethnic differences in disease is a methodological challenge as ethnicity is often not identified in existing datasets and surrogate measures need to be used. We have developed a novel methodology combining last name and country of birth to study mortality patterns of Canadians of South Asian (SA) and Chinese (CH) ethnic origin and have compared death rates among SA, CH, and White (WH) Canadians.
SA and CH were identified in the Canadian Mortality Data Base (CMDB) using the last name and country of birth of the deceased. Records of people who had been born in countries with large South Asian and Chinese populations (e.g. India, Pakistan, China, Hong Kong) were selected and manually screened by last name. A name directory was then created of distinct South Asian and Chinese names and this directory was used to search all other records in the CMDB for SA and CH deaths. Where necessary, other identifying characteristics such as first name and parents' last name were also used. Population counts were obtained from the Census self-reported question on ethnicity for SA and CH. WH were identified as non-immigrant Canadians who were neither SA nor CH. The method of assigning ethnicity in the CMDB and Census were assessed for comparability and issues of validity and reliability were addressed.
Using this method, 10,989 SA and 21,548 CH deaths were identified. There was marked heterogeneity in birthplace, with only 56% of SA born in South Asia and only 74% of CH born in Greater China. Last names had high validity for self-reported ethnicity in a population sample of SA and were highly reproducible. Mortality rates varied dramatically between groups studied. SA and WH had high rates of ischemic heart disease while stroke mortality was similar among all three groups. Cancer death rates were high in CH and WH and much lower in SA.
Last names and country of birth can be used to determined ethnicity of SA and CH with validity and reliability, and leads to a more accurate classification than country of birth alone. The contrasting patterns observed in mortality from major causes of death suggest many interesting hypotheses for further study.
Ethnicity and Health 11/1997; 2(4):287-95. DOI:10.1080/13557858.1997.9961837 · 1.67 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Statistics summarizing Canadians' use of hospital services are usually based on simple discharge totals, without any attempt to distinguish which discharges may have belonged to the same person. This leads to a distorted view of the prevalence of illness and the resources required to serve each patient. Statistics based on the number of people going to hospital shed new light on the demand for resources by various groups, now and in the future.
Leadership in health services = Leadership dans les services de santé 01/1996; 5(5):27-32.
[Show abstract][Hide abstract] ABSTRACT: Hospital morbidity data are useful for administrative purposes, but because Canadian data are based on the number of hospital visits for a given diagnosis rather than the number of patients with the diagnosis, they have historically been ineffective in determining how many people have been hospitalized with a given condition. Now, by linking computerized patient data, the records of the same patient can be combined. Linked records can be used to estimate disease prevalence, examine health care utilization, and evaluate the effectiveness of medical treatments, procedures and programs. Hospital morbidity records for the fiscal year 1989/90 were linked by person to study hospital utilization in New Brunswick and Saskatchewan. Approximately 11% and 12% of their populations, respectively, were admitted to hospital in the study period. The percentage of the population that was hospitalized increased with age from 50 onwards. About one in four hospital patients were admitted to hospital more than once in 1989/90, and approximately 4% were admitted four or more times. Cancer diagnoses were associated with the highest hospital re-admission rates. About half of hospitalized patients spent five days or less in hospital over the period studied. At the other extreme, 10% of patients, referred to as "high users," accounted for about half of the hospital days--but only 1% of the population in these two provinces. Typically, high users are patients with chronic conditions or illnesses severely affecting cognitive or physical abilities. This profile of high users suggests that high medical costs are due not so much to intensive care of terminally ill patients, but to ordinary medical and palliative care of chronically and seriously ill patients. Restructuring health care data so that all of the records for one patient could be linked would help identify problem areas in the health care system and help evaluate new ways of delivering health care.
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 02/1994; 6(2):253-77. · 2.67 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This article examines suicide mortality rates and trends in Canada for first-generation immigrants and the Canadian-born population. Data are analyzed by age, sex and country of birth. Since 1950, suicide rates worldwide for both men and women have been increasing. In North America and most of Europe, suicide has been one of the major causes of death for many years. In Canada, suicide rates are also rising. However, this increase is due entirely to a rise in the rate for men; the rate for women has remained relatively stable. Several differences are apparent between the rates for the Canadian-born population and those for first-generation immigrants. For example, three times as many Canadian-born men as women commit suicide. For first-generation immigrants, the ratio is two to one. Suicide mortality rates for the Canadian-born are higher than those for first-generation immigrants in every age group except for the 65 and over groups. Canadian born males have higher ASMR than first generation immigrant males. The rates for women show that first-generation immigrant women have higher suicide mortality rates than their Canadian-born counterparts, and that the highest rate for all women is for immigrants born in Asia.
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 02/1990; 2(4):327-41. · 2.67 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Cardiovascular disease (CVD) is the major cause of death in Canada, as it is in most industrialized countries. Studies have shown that CVD mortality rates vary among ethnic groups. Since about one in six Canadian residents is a first generation immigrant, it is important to consider ethnic background when interpreting Canadian health statistics or planning health services. Overall, lower CVD mortality rates were found for first generation Canadians from Latin America, China and South Asia; higher rates are indicated for those from Scandinavia and Africa. The rates for North America are similar to those found for Eastern and Western Europe. Between two five-year time periods (1969-73 and 1984-88), CVD mortality rates generally were found to decrease, except for immigrants from Africa (age 35+). The rates were consistently higher for males than for females.
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 02/1990; 2(3):203-28. · 2.67 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objectives This article provides an overview of patients who were hospitalized in 1993/94 because of acute myocardial infarction (AMI) and projects how many AMI patients there could be in the future.