1. health and fitness

Community
Check-Up:
A PHU Status Report
Foyez Haque, MBBS, MHSc,
Public Health Epidemiologist
Published by the Porcupine Health Unit
Timmins, Ontario
© September 2006
Acknowledgements
I would like to take the opportunity to thank those who helped me to
make this Community Check-Up a reality. Foremost, I would like to thank
the management committee at the Porcupine Health Unit for their continued enthusiasm, for their encouragement, and for their valuable comments.
A special thanks goes to Dr. Alberto G. de la Rocha for his detailed revision.
Thanks to fellow epidemiologists Lee Sieswerda, Jane Hohenadel, Darshaka Malaviarachchi, Adam Stevens, and Mamdouth Shubair for helping
me to use their published templates and for supporting me when I was in
the middle of an ocean of numbers without any life support. Thanks to
Isabel Dagg and Lynda Collins of Genetics services and Anna Gauthier of
Dental services for providing statistics on their services as well as valuable
comments. Eric Glaister deserves more than a pat on the back for helping me to continue working on different datasets on one single computer
without any interruption. Thanks to Bonnie Schultz and Rita Numainville,
for preliminary editing and clerical support, and Gary Schelling for assisting
me with the design, layout and distribution of this report.
Finally, I would like to extend my appreciation to my wife Yasmin Azher,
whose support, even during her pregnancy and delivery of our baby boy,
Rahat S. Haque, has made this work possible.
Foyez Haque, MBBS, MHSc
Public Health Epidemiologist
Community Check-Up: Porcupine Health Unit
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Community Check-Up: Porcupine Health Unit
Contents
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i
Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Executive Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
1
Demography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2
Environment & Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3
Reproductive Outcomes & Child Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
4
Genetic Diseases & Congenital Anomalies. . . . . . . . . . . . . . . . . . . . . . . . . . . 45
5
Health Risk Behaviour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
6
Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
7
Dental Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
8
Mental Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
9
Communicable & Infectious Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
10 Morbidity Patterns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
11 Cancer Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
12 Mortality Patterns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Community Check-Up: Porcupine Health Unit
List of tables
Table 1:
2001 Population distribution for the Porcupine Health Unit area, by CSD. . . . . . . . . . . . . . . . . . . . . . 2
Table 2: Changes in the population of Cochrane District including Hornepayne
(Algoma Census Division) from 1991 to 2001. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Table 3: Distribution of total population by ethnic origin. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Table 4:
Population estimates for first nation communities in the Porcupine Health Unit area . . . . . . . . . . . . . 5
Table 5:
2001 Education level ­— Age 20 and over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Table 6: Highest level of schooling for population age 20 and over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Table 7:
2000 Income distributions for population age 15 years and over . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Table 8:Description regarding water treatment systems in Timmins. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Table 9: 2004 water distribution miscellaneous summary20
Table 10: Rate of neural tube defects (NTDs), Canada, 1991-1999. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Table 11:
Rate of neural tube defects (NTDs), by province/territory, Canada, 1997-1999 combined. . . . . . . . . . 31
Table 12: Maternal mortality ratio (MMR) per 100,000 live births, according to age in Canada
(excluding Quebec), 1997 -2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Table 13: Rate and duration of breastfeeding, by maternal age. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Table 14: Rate and duration of breastfeeding by region/province. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Table 15: Proportion of overweight and obesity, Ontario. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Table 16: Gastrointestinal infections in the Porcupine Health Unit, 1990-2004, Rate/100,000 . . . . . . . . . . . . . 82
Table 17: Rate of hepatitis among the population of the Porcupine Health Unit area, 1990-2004, Rate/100,00083
Table 18: Vaccine-preventable diseases, Porcupine Health Unit, Rate/100,000 . . . . . . . . . . . . . . . . . . . . . . . 84
Table 19: Sexually transmitted infections in the Porcupine Health Unit Rate/100,000 population. . . . . . . . . . . 85
Table 20: Leading causes of hospitalization in the Porcupine Health Unit area . . . . . . . . . . . . . . . . . . . . . . . . 91
Table 21: Age-specific death counts and rates (per 1000 population), Porcupine Health Unit and Ontario
(1997–2001). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
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Community Check-Up: Porcupine Health Unit
Table 22: Cause specific deaths by ICD9-Chapter for the Porcupine Health Unit and Ontario,
1997–2001, five-year average. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Table 23: Potential years of life lost by cause and sex, Porcupine Health Unit, 1997-2001, rate per 100,000,
five-year average. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Community Check-Up: Porcupine Health Unit
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List of figures
Boundaries of the Porcupine Health Unit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiv
Figure 1: Aboriginal population. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Figure 2: Aboriginal group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Figure 3: Comparison of hourly AQI reading by category between Timmins and Sudbury. . . . . . . . . . . . . . . . 14
Figure 4: Comparison of fine particulate matter in Sault Ste. Marie, Timmins, North Bay, 2003. . . . . . . . . . . . 15
Figure 5: The Mattagami Watershed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Figure 6:
Exceedances in acceptable E. coli levels.Average Proportions of Geometric Means (GM) > 100,
Gillies Lake, 2001­–2005. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Figure 7:
Comparison of crude birth rate between the Porcupine Health Unit and Ontario . . . . . . . . . . . . . . . 26
Figure 8:
Comparison of preterm birth rate between the Porcupine Health Unit and Ontario. . . . . . . . . . . . . . 27
Figure 9:
Comparison of low birth weight between the Porcupine Health Unit, Ontario and Canada. . . . . . . . 28
Figure 10: Infant Mortality Rate, Canada, 1960-1995. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Figure 11: Infant mortality rate, comparing Cochrane District, Ontario and Canada. . . . . . . . . . . . . . . . . . . . . 32
Figure 12: Causes of Infant Death in Canada (excluding Ontario), 1999. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Figure 13: Trends of teen pregnancy in the Porcupine Health Unit area and Ontario, 1996-2001. . . . . . . . . . . . 34
Figure 14: Comparison of teenage pregnancy rate among the Northern Health Units and Ontario, 2001. . . . . . 35
Figure 15: Comparison of teenage abortion rate in Northern Health Units and Ontario, 2001. . . . . . . . . . . . . . 36
Figure 16: SIDS Rates, Provinces & Territories, 1996. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Figure 17: Percentage of breastfeeding or bottle-feeding within the first 48 hours after the child’s birth,
all Northern health units. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Figure 18: Percentage of respondents with children born in 2000-02 who breastfed in the first 48 hours
after the child’s birth, all Northern health units. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Figure 19: Leading causes of referral to PHU Genetic Services Program in 2004. . . . . . . . . . . . . . . . . . . . . . . . 46
Figure 20:Congenital anomalies in different PHU communities (1989-2000). . . . . . . . . . . . . . . . . . . . . . . . . 47
Figure 21: Activity levels for Ontario and Porcupine Health Unit, ages over 12, 2001-02. . . . . . . . . . . . . . . . . . 50
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Community Check-Up: Porcupine Health Unit
Figure 22: Leisure activity in Ontario and Porcupine Health Unit, ages over 12, 2001-02. . . . . . . . . . . . . . . . . . 51
Figure 23: Type of smoking behaviour in Ontario and Porcupine Health Unit area, 2001-02. . . . . . . . . . . . . . . 52
Figure 24: Proportion of daily smokers in Ontario and Porcupine Health Unit area, 2001-02. . . . . . . . . . . . . . . 53
Figure 25: Proportion of individuals ( >12 years of age) exposed to second-hand smoke at home in Ontario
and Porcupine Health Unit area, 2001–02. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Figure 26: Frequency of drinking 5 or more drinks on one occasion in last 12 months, in Canada, Ontario and
Porcupine Health Unit area, 2001-02. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Figure 27: Percentage of Canadian population aged 15 years or older who used marijuana in past years,
by age group, 1994 & 2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Figure 28: Percentage reporting marijuana use during past year, Grade 7–12, 1993–2003. . . . . . . . . . . . . . . . 58
Figure 29: Self-reported drug use (among those who reported taking drugs) in the last 12 months
in Timmins high schools, 1998–2000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Figure 30: Self-reported drug use (among those who reported taking drugs) in the last 12 months
in Timmins high schools, 1998–2000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Figure 31: Prevalence of obesity among boys and girls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Figure 32: Weight categories for Ontario and Porcupine Health Unit, ages over 18, 2001–02. . . . . . . . . . . . . . 66
Figure 33: Weight categories for Porcupine Health Unit, by gender, ages over 20-64, 2001–02. . . . . . . . . . . . . 67
Figure 34: Weight categories for Porcupine Health Unit, by age group (over 18), 2001–02. . . . . . . . . . . . . . . . 68
Figure 35: Vegetables and fruit consumption per day for Ontario and Porcupine Health Unit, 2001–02. . . . . . . 69
Figure 36: Vegetables and fruit consumption per day for Porcupine Health Unit, by gender, 2001–02. . . . . . . . 70
Figure 37: Vegetables and fruit consumption per day for Porcupine Health Unit, for ages over 18, 2001–02
(5–10 servings per day). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Figure 38: Percentage of children with acute tooth decay (1996–2005). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Figure 39: Caries-free 5 year old children in various Northern Ontario health units, 2002–04 . . . . . . . . . . . . . . 75
Figure 40: Mean deft score for 5-year-old children in various Northern Ontario health units, 2002–04. . . . . . . . 76
Figure 41: Prevalence of mental illnesses, comparing rates between males & females in Canada, 2002–03. . . . 78
Figure 42: Prevalence of mental illnesses, in Timmins, 2004–05 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Figure 43: Comparison of chlamydia infection among Canada, Ontario and Porcupine Health Unit
(1996–2002). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Community Check-Up: Porcupine Health Unit
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Figure 44: Inpatient hospitalizations for Canada, 1995–96 to 2004–05. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Figure 45: Leading causes of hospitalization in Ontario and in the Porcupine Health Unit area, 2000–2004. . . . 89
Figure 46: Comparison of age-specific respiratory & cardiovascular rates, Porcupine Health Unit area,
2000–2004. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Figure 47: Leading cause of cancer incidence, in both genders, Porcupine Health Unit area, 2002. . . . . . . . . . . 94
Figure 48: Trends of the incidence of trachea, bronchus and lung cancer, in Ontario and
Porcupine Health Unit area, 1983–2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Figure 49: Trends of the incidence of prostate cancer, in Ontario and Porcupine Health Unit area, 1983–2002. . 96
Figure 50: Trends of breast cancer incidence, in Ontario and Porcupine Health Unit area, 1983–2002. . . . . . . . 97
Figure 51: Mortality due to cancer of the trachea, bronchus and lung, in Ontario and
Porcupine Health Unit area, 1983–2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Figure 52: Mortality due to breast cancer, in Ontario and Porcupine Health Unit area, 1983–2002 . . . . . . . . . . 99
Figure 53: Mortality due to prostate cancer, in Ontario and Porcupine Health Unit area, 1983–2002. . . . . . . . . 100
Figure 54: Mortality due to colon cancer, in Ontario and Porcupine Health Unit area, 1983–2002. . . . . . . . . . . 101
Figure 55: Life expectancy at birth, male and female, in Ontario, 1979–1999. . . . . . . . . . . . . . . . . . . . . . . . . 105
Figure 56: Life expectancy at age 65, male and female, in Ontario, 1979–1999. . . . . . . . . . . . . . . . . . . . . . . . 106
Figure 57: Life expectancy at birth, Northern health units and Ontario, 2001. . . . . . . . . . . . . . . . . . . . . . . . . . 107
Figure 58: Life expectancy at age 65, Northern health units and Ontario, 2001. . . . . . . . . . . . . . . . . . . . . . . . 108
Community Check-Up: Porcupine Health Unit
Preface
The Porcupine Health Unit is an organization that works with communities
in our area to promote and protect health. Together, we are committed
to understand our health and safety and their determinants, and provide
a variety of relevant, responsive and effective programs that will improve
and protect our health.
The Community Check-Up, Porcupine Health Unit Status Report supports
the health unit’s mission statement by describing the health status of the
population of the area. This report describes the core indicators set by the
Mandatory Health Programs and Services Guidelines by the Ministry of
Health and Long-Term Care. Other than the core indicators, this report also
describes the mental health status of the population of the City of Timmins. By reckoning the indicators, this report helps health planners to take
necessary measures to achieve the goals of their programs.
The various indicators in the Community Check-Up provide a snapshot of
how the Porcupine Health Unit is doing in public health areas. They include
the demographics of the area, air and water quality, crude birth rate, preterm birth rate, teenage pregnancy rate, physical activity, smoking status,
alcohol drinking status, body weights, indices of dental health, communicable diseases, morbidity and mortality rates, cancer rates and potential
years of life lost.
With each indicator in this report, a description and a graph or table have
been attached. To allow the readers to evaluate the progress, comparisons
Community Check-Up: Porcupine Health Unit
xi
were made between Ontario and Canada (where applicable). This report
uses the most up-to-date data available at the time of writing to describe
the determinants of health of the Porcupine Health Unit area. Data that
are used to publish this report come from provincial and national data
sources, i.e., Statistics Canada: Census 2001, the Provincial Health Planning
Database (PHPDB), the Health Planning Service Database (HELPS) , 1.1 and
2.1 , the Canadian Community Health Survey (CCHS), the Integrated Public Health Information System (iPHIS), and Cancer Care Ontario Data (SEER
Stat 5.3.1).
The intent of this publication is to provide updated information to health
planners, local community leaders, community partners and the residents
of the Porcupine Health Unit area, helping them make our community safe
and helping them protect our health.
All data were analyzed using SPSS 13.0 (SPSS Inc., Illinois, USA) and STATA
9.1 (STATA Corp., Texas, USA) and are presented according to source
guidelines, including weighted values and collapsing response categories,
where required. A P-value less than 0.05 was considered statistically significant. When rates were compared among different years, the population
estimates were extracted from the PHPDB database and also from 2001
Census.
During the CCHS data analysis, when the number of observations for a
variable was (on which an estimate was based) less than 30, the weighted
estimate was not published in this report, regardless of the value of the
coefficient of variation.
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Community Check-Up: Porcupine Health Unit
Executive Summary
Community Check-Up: A Porcupine Health Unit Status Report highlights
the health status of the people living in the geographic area served by the
Porcupine Health Unit.
G Between 1996 and 2001, the population declined in the area served by
the Porcupine Health Unit. In particular, the population of the City of
Timmins (the largest city in the catchment area) has declined 8%.
G In the area, over eleven percent (11%) of the population are aborig-
inal people.
G With respect to education level, 38.8% of the area’s population do
not have a secondary school certificate: higher than Ontario at 25.6%
and Canada at 27.9%. A lower proportion of people (7.8%) in the area
have a university degree when compared to Ontario (19.2%) and Canada (16.9%).
G Timmins air quality was better than other Northern Ontario cities in
2003. There were no adverse particles or organisms in the Timmins
drinking water in the year 2004.
G There was a decline in the crude birth rate in the Porcupine Health Unit
area as well in Ontario.
G In the last 30 years, the infant mortality rate has subsided in both the
health unit area and in Canada as a whole. In 2001, the teen pregnancy
rate was 43.5/1,000 in the Porcupine Health Unit area, compared to
30.5/1,000 in Ontario.
Community Check-Up: Porcupine Health Unit
xiii
G Sixty-five percent (65.1%) of mothers in the Porcupine Health Unit area
breastfed their babies within 48 hours of birth, compared to 77.2% of
mothers in all Northern Ontario health unit areas.
G Hornepayne had the highest prevalence of congenital anomalies
(519.0/10,000 live births) when compared to other jurisdictions within
the Porcupine Health Unit catchment area.
G Twenty-seven percent (27.1%) of people over the age of 12, in the Por-
cupine Health Unit area, identified themselves as a daily smoker, compared to 16.7% in the Province of Ontario.
G The Porcupine Health Unit area population had a higher rate of drink-
ing 5 or more drinks (on more than one occasion, in the last 12 months)
(30.2%) compared to that of Ontario (20.5%) and Canada (20.7%) in
the year 2001– 02.
G Marijuana was the most popular substance abused by youths in Tim-
mins in 2002.
G Twenty percent (20.1%) of the population of the Porcupine Heath Unit
over 18 years of age were obese, compared to 13.4% of Ontarians in
2001–02.
G Twenty-nine percent (29.2%) of the population of the health unit area
ate the recommended 5–10 servings of fruit and vegetables per day,
compared to 36% (36.5%) of Ontarians.
G The percentage of children with acute tooth decay has increased from
11.2% in 1996–97 to 14.7% in 2004– 05.
G Forty-seven percent (47%) of the mentally ill population suffered from
mood disorders and 38% suffered from psychotic or schizophrenic disorders during 2004–05 in Timmins.
G Salmonella was the most prevalent gastrointestinal micro-organism
(11.2/100,000 population) in the health unit area.
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Community Check-Up: Porcupine Health Unit
G In 2004, 24.7/100,000 population suffered from hepatitis C in the catch-
ment area.
G Chlamydia trachomatis had the highest prevalence rate (226.7/100,000
population) of sexually transmitted infections reported in 2004.
G Cardiovascular disease was the highest leading cause of hospitalization
in the Porcupine Health Unit area, (15.6%) followed by neurological
and psychiatric disease (12.2%) and pregnancy and child birth (12.1%).
G In the Porcupine Health Unit area, cancer of the trachea, bronchus
and lung were the most prevalent cancers (61.9/100,000), followed by
breast (61.6/100,000) and prostate cancer (56.3%).
G In Ontario, the difference in life expectancy at birth among males and
females has been narrowing over the last 20 years (1979–99).
G Diseases of the circulatory and blood-forming system were the highest
leading causes of mortality (33.3%) in the Porcupine Health Unit area,
followed by cancer (27.6%) and respiratory disease (9.5%).
G Cancer was the highest leading cause of potential year of life lost
(1,654/100,000) in the health unit area, followed by injury and poisoning (1,231/100,000) and cardiovascular disease (1,178/100,000) in the
years 2000–04.
Community Check-Up: Porcupine Health Unit
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Boundaries of the Porcupine Health Unit
Porcupine
Source: xvi
Community Check-Up: Porcupine Health Unit
http://www.alphaweb.org/map.asp. Accessed on April 06, 2006.
1 g Demography
The Porcupine Health Unit area is located in the northeastern part of the
Province of Ontario and extends from the Cochrane District to the south,
and north to Attawapiskat, east to the Province of Quebec and west to the
District of Kenora. The health unit also serves the Hornepayne Township
in the District of Algoma. Statistics Canada also included the Attawapiskat
and Peawanuck reserve census subdivisions of Kenora District as part of
the health unit in the 2001 census. A detailed 2005 edition of the Population Profile is available in the Porcupine Health Unit website at www.
porcupinehu.on.ca.
Population according to age and gender
From the year 1991 to the year 2001, the population in the 0–44 year-old
group has steadily decreased in the Porcupine Health Unit area. In the 0–9
year-old group, the decrease was from 15.7% to 12.7%; in the 10–19 yearold group, the decrease was from 16% to 15.4%. The decrease was more
substantial in the 20–44 year-old group, dropping from 40% to 35.6%.
As a counterpoint, the older population, from 45 to 64 years of age, has
experienced a 5% increase. The most notable change occurred in the
population over 65 years of age. The proportion of the people in this age
group (12.1%) was close to equal to the national proportion (13.0%). The
proportion of males and females was almost equal in the general popula-
Community Check-Up: Porcupine Health Unit
Table 1:
2001 Population distribution for the Porcupine Health Unit area,
by CSD
Census Subdivision and Type
Pop.
2001
Pop. 1996
(unadjusted)
Cochrane T (Dissolved)
5,690 5,955 (4,443)
Glackmeyer TP
1,070 105
New Post 69 A R
Cochrane Office Area Total
Constance Lake 92 R
5,795
723 Hearst T
5,825
Mattice-Val Cote TP
891 % Change
1996–2001
Land area
(km2)
-4.5
538.7
6.9
0 (1,092)
-2.0 1.2
450.7
71 47.9 0.1
1.2
6,060 (5,606)
-4.6
539.9
458.8
596
21.3
0.8
26.2
6,049 -3.7 6.7
98.7
935
-4.7 1.0
414.6
Hearst Office Area Total
7,439
7,580
-1.9
8.5
539.5
Hornepayne TP
1,362 1,480
-8.0 1.6
204.5
Iroquois Falls T–Office Area Total
5,217 Fauquier-Strickland TP
678 5,714 -8.7 5.9
599.4
7471 (684)
-9.2 0.8
1,013.6
Kapuskasing T
9,238 10,036 -8.0 10.5
83.9
Moonbeam TP
1,201 1,322 -9.2 1.4
235.2
Opasatika TP
325 349 -6.9 0.4
330.0
1,112 -8.1 1.2
382.6
13,566 (13503)
-7.7
14.2
2,045.3
127
92 38.0 0.1
78.7
Black River-Matheson TP
2,912 3,222 (3220)
-9.6 3.3
2,291.0
Matheson Office Area Total
3,039
3,349 (3312)
-9.3
3.5
2,369.7
Attawapiskat 91 A R
1,293 1,258 2.8 1.5
2.02
F Factory Island 1 R
1,430 1,286 11.2 1.6
3.1
601
-26.6
0.5
4.2
0
359.5
Val Rita-Harty TP
1,022
Kapuskasing Office Area Total
Abitibi 70 R
Fort Albany (Part) 67 R-Cochrane
12,464
441
1
Fort Albany (Part) 67 R-Kenora
0 1,004 Marten Falls 65 R
02
204 0.02
0
81.4
Moose Factory 68 R
0
0
0
0
168.8
2
2
New Post 69 R
0
0
0
19.1
Peawanuck S-E
193 239 -19.2 0.2
1.5
3,357
4,592
26.8
3.8
639.6
1,939 (1,939)
-51.7 1.1
533.8
1,982 -7.7 2.1
199.8
0
0
58.33 James Bay Area Total
Moosonee T - Office Area Total)
Smooth Rock Falls T–Office Area Total
936 1,830 Flying Post 73 R
0
0
0
Timmins C
43,686 47,499 -8.0 49.8
2,961.5
Timmins Office Area Total
43,686
47,499 -8.0 49.84
3,019.9
1
Cochrane UNO North Part
3,702 (4,187)
-20.3 3.4
130,594.9
Cochrane UNO SE Part
21 29 -27.6 0.02
53.1
Cochrane UNO SW Part
0
2
-100.0 0
553.4
3,733 (4,218)
-20.44
3.4
131,201.4
Cochrane UNO Total
Health Unit Total
Source: 2,949 2,970
88,095
97,425 (92,074)
-9.8 (-9.7)
Porcupine Health Unit Area Population Profile 1999, Statistics Canada–2001 Census
1. Counts have been adjusted to reflect 2001 Census boundaries
2. Incompletely Enumerated Indian Reserves and Indian Settlements
% of 2001
Population
Community Check-Up: Porcupine Health Unit
141,892.9
Table 2: Changes in the population of Cochrane District including Hornepayne
(Algoma Census Division) from 1991 to 2001
Males
Age
0-9
1991
7,360
6,660
5,365
% Gender
15.8
14.5
13.1
15.3
14.2
12.4
8.0
7.3
6.54
7.7
7.0
7,910
7,650
6,825
7,345
16.4
16.1
15.76
8.3
8.1
19,���
380
% Gender
% Area Pop.
1991
1996
2001
14,985
13,550
11,030
6.2
15.7
14.3
12.74
7,190
6,490
15,255
14,840
13,315
15.2
15.3
14.99
7.9
7.7
7.6
7.5
16
15.7
15.37
18,575
15,390
18,815
18,120
15,415
38,195
36,695
30,805
40.2
39.0
35.53
39.0
38.5
35.60
20.3
19.6
17.8
19.7
19.1
17.8
40.0
38.7
35.57
9,320
10,120
10,770
8,760
9,610
10,230
18,080
19,730
21,000
19.3
21.2
24.86
18.2
20.4
23.63
9.8
10.7
12.4
9.2
10.1
11.8
18.9
20.8
24.3
4,025
4,415
4,665
4,995
5,480
5,795
9,020
9,895
10,460
% Gender
8.3
9.3
10.77
10.4
11.6
13.38
% Area Pop.
4.2
4.7
5.4
5.3
5.8
6.7
9.4
10.4
12.1
48,260
47,650
43,315
47,275
47,060
43,295
95,535
94,710
86,610
50.5
50.3
50.0
49.5
49.7
50.0
Number
Number
Number
% Area Pop.
Number
All Ages
2001
5665
% Gender
65+
1996
6,890
% Area Pop.
45-64
1991
7,625
% Gender
20-44
2001
Both
Number
% Area Pop.
10-19
1996
Females
Number
% Area Pop.
Source: Notes:
Porcupine Health Unit Area Population Profile 1999, Statistics Canada–2001 Census
Total population number may differ from other tables due to rounding from the age-sex subtotals.
Percents may not add to 100 due to rounding. Abitibi and Constance Lake are enumerated in 1986
census as reserve type CSDS.
Blue colour denotes the decreasing trend of the population group
Red colour denoted the increasing trend of the population group
tion (50.01% vs. 49.99%), but interestingly, the proportion
of females 65 years or older was higher than the male proportion (13.4% female vs. 10.8% male). This rate reflected
the provincial and national figure at 14.4% and 11.3% for
female and male respectively.
From 1986 to 2001, significant density changes occurred in
the population of a number of groups. A notable density
decrement — ranging from 10 to 29 percent — took place
among the 0–44 age group. In contrast, the 45 to > 65 age
group experienced a density increment ranging from 20 to
Community Check-Up: Porcupine Health Unit
Table 3: Distribution of total population by ethnic origin
Ethnic Origin
Porcupine
Health Unit
(% Pop.)
Timmins
(% Pop.)
Ontario
(% Pop.)
Canada
(% Pop.)
Canadian
56.1
52.4
29.7
39.4
French
40.3
43.3
10.9
15.8
English
15.3
18.8
24.0
20.2
Irish
11.2
13.9
15.6
12.9
10.3
4.6
2.2
3.4
Scottish
9.1
11.3
16.3
14.0
German
4.3
5.0
8.6
9.3
Italian
3.6
5.9
6.9
4.3
Metis
3.2
4.0
0.5
1.0
Polish
2.1
2.8
3.4
2.8
Ukrainian
1.9
2.5
2.6
3.6
Finnish
1.6
2.4
0.6
0.4
Dutch (Netherlands)
1.3
1.4
3.9
3.1
North American Indian
Source: Statistics Canada, 2001 Census
31 percent (Table 2).
Aboriginal Population
The population of the First Nation reserves does not always
conform to the estimates enumerated by Statistics Canada due to a lack of community participation in the census. In several First Nation Bands, the Chief’s offices enumerate their own population. Table 4 shows the discrepancy
between the 2001 census and the original source.
Community Check-Up: Porcupine Health Unit
Table 4:
Population estimates for first nation communities in the
Porcupine Health Unit area
Census Division
Kenora District
Census Subdivision
Attawapiskat
Population Estimates
Community
1
1,520
1,293
2002
1,5642
0
2004
1
67
193
2002
Marten Falls/Ogaki
3061
0
2002
Constance Lake
1
787
723
2002
Fort Albany Part
1,0653
441
2003
Moose Factory
1
1,559
0
2002
931
0
2002
1
123
127
2002
01
0
2002
Kashechewan (Fort Albany Part)
Peawanuck/Weenusk
Cochrane District
Stats Can
Year of
Estimate
New Post*
Wahgoshig/Abitibi
Flying Post
Sources:
1. Registered Indian Populations estimated by Ministry of Indian and Northern Affairs, December 2002
2. Enumerated by Chief’s office in March 2004
3. Enumerated by Chief’s office in November 2003
* New Post has changed their name to Taykwa Tagamou Nation.
The difference between the two estimates is more than
4,000. In some jurisdictions, census estimates showed a
population of zero even though the local authorities enumerated a significant number of people.
Community Check-Up: Porcupine Health Unit
Figure 1: Aboriginal population
100
Percentage of Population
80
60
40
20
0
PHU
PHU
Ontario
Ontario
Canada
Canada
m Aboriginal
11.4
1.7
3.3
m Non-Aboriginal
88.6
98.3
96.7
Source: Statistics Canada
Figure 1 shows the distribution of the aboriginal and nonaboriginal population estimated by the 2001 census. Note
that, as seen in Table 4, Kashachewan (Fort Albany Part),
Marten Falls and Moose Factory were estimated with a zero
population whereas the community statistics showed a significant population. Therefore, Figure 1 represents a slight
under-estimation of the aboriginal population in the Porcupine Health Unit area.
Aboriginal people required two sets of data: identity and
origin (20% sample data). Identity referred to belonging to
at least one aboriginal group: North American Indian, Métis
and Inuit (Eskimo) and/or those identified as Treaty Indian
or Registered Indian as per the Indian Act of Canada. Mem-
Community Check-Up: Porcupine Health Unit
80
Figure 2: Aboriginal
group
Percentage of Aboriginal Groups
70
60
50
40
30
20
10
0
North
American
Indian
Métis
Inuit
Multiple
Aboriginal
Other
Aboriginal
m PHU
71.9
25.2
0.2
0.3
2.5
m Ontario
69.9
25.7
0.7
0.9
2.8
m Canada
62.4
29.9
4.6
0.7
2.4
Source: Statistics Canada
bers of an Indian band or First Nation (Statistics Canada–
Catalogue No. 92-378-XIE 2001 Census Dictionary–Internet
version) were also included.
Origin referred to those who reported at least one aboriginal origin (North American Indian, Métis, or Inuit) in the ethnic origin question. Ethnic origin is defined as ethnic or cultural groups to which the respondent’s ancestor belonged
(Statistics Canada–Catalogue No. 92-378-XIE 2001 Census
Dictionary–Internet version).
The Porcupine Health Unit area had a higher proportion
(11.4%) of aboriginal people than the rest of Ontario (1.7%)
or Canada (3.3%). A higher proportion of all aboriginal
groups were included in the census.
Community Check-Up: Porcupine Health Unit
Table 5:
2001 Education level ­— Age 20 and over
Education Level
PHU Area
Timmins
Ontario
Canada
< Grade 9
15.0 %
11.6% 8.7%
10.5% Grade 9-13 without secondary certificate
23.8%
23.5% 16.9%
17.4% Grade 9-13 with certificate
13.5%
13.5% 14.2%
13.9% Trades certificate or diploma
14.4%
14.0% 10.2%
11.8% 6.0%
6.6% 6.6%
6.4% 16.2%
18.2% 17.1%
16.2% University without degree
3.4%
3.5% 7.1%
7.0% University with degree
7.8%
9.3% 19.2%
16.9% 62,065
30,990
College without diploma/certificate
College with diploma/certificate
Total Population 20+
Source: Statistics Canada, 2001 Census
The majority of aboriginal people (71.9%) were North
American Indian, 25.2% were Métis and Inuit, and a smaller
portion of aboriginal people were recorded as “multiple
aboriginal” and “other”. The North American Indian population dropped in 2001 census to 71.9% from 87.2% in the
1996 census. The proportion of “other aboriginal groups”
rose from 1.8% in the 1996 census to 2.5% in the 2001 census (Porcupine Health Unit Area Population Profile, 1999).
Education
In Table 5, individuals in the Porcupine Health Unit area, Timmins, Ontario and Canada, who are older than 20 years of
age, are grouped by the highest level of education attained.
Community Check-Up: Porcupine Health Unit
Table 6: Highest level of schooling for population age 20 and over
Less than
Grade 9
(% pop.)
Trades or
High school
non-university
Completed University
certificate or higher certificate or diploma
(% pop.)
(% pop.)
or higher
(% pop.)
Timmins
10.7
41.7
30.2
8.4
Kapuskasing
13.2
23.4
30.6
7.0
Hearst
18.0
20.1
25.8
7.5
Iroquois Falls
11.8
22.2
31.4
7.2
Cochrane
13.3
23.4
24.6
4.7
Smooth Rock Falls
13.9
24.1
29.0
3.6
Hornepayne
10.1
22.1
23.1
8.0
Porcupine Health Unit
13.7
22.0
28.7
7.0
Ontario
8.1
25.6
27.2
17.5
Canada
9.8
24.9
28.4
15.4
Source:
Statistics Canada, 2001 Census
Over one-third (38.8%) of the population of the heath unit
area over the age of 20 had not received a secondary school
certificate, compared to the population of Timmins (35.1%),
Ontario (25.6%), and Canada (27.9%). Within the Porcupine
Health Unit area, 7.8% of the population had a university
degree, as did 9.3% of the population of Timmins. This rate
was significantly lower than that of Ontario (19.2%) and
Canada (16.9%). These numbers included students who
were still pursuing their formal education.
Community Check-Up: Porcupine Health Unit
Table 7:
2000 Income distributions for population age 15 years and over
Income Variable
Average income
Cochrane
District
Ontario
Canada
$ 27,939
$ 32,865
$ 29,769
Males 15+
$ 35,676
$40,900
$ 36,865
Females 15+
$ 19,938
$ 25,129
$ 22,885
Median1 income
$ 20,499
$ 24,816
$ 22,120
$ 30,675
$ 31,560
$ 29,276
14,342
$ 18,899
$ 17,122
Average household2 income
$ 53,051
$ 66,836
$ 58,360
Median household income
$ 45,352
$ 53,626
$ 46,752
2.5
2.7
2.6
For unattached individuals
39.6%
34.0%
38.0%
For economic families4
11.8%
11.7%
12.8%
For households
14.8%
14.4%
16.2%
Employment
76.3%
78.7%
77.1%
Government transfer (e.g., OAS, GIS, CPP or QPP)
14.2%
9.8%
11.6%
Other income (e.g., Retirement pensions, alimony,
interest income)
9.4%
11.5%
11.3%
Males 15 +
Females 15 +
Avg. number persons per household
Incidence of low income3:
Composition of total income:
Sources: Statistics Canada, 2001 Census
Notes:
1 Median income: Dollar amount that marks the midpoint of a distribution of household ranked by the
size of household income.
2 Household: A person or a group of persons who occupy the same dwelling and do not have a usual
place of residence elsewhere in Canada
3 Low income: Income levels at which families or unattached individuals spend 20% more than average
on food, shelter and clothing.
4 Economic family: A group of two or more persons who live in the same dwelling and are related to
each other by blood, marriage, common-law or adoption.
10
Community Check-Up: Porcupine Health Unit
Income distribution
Table 7 provides information on income distribution for
Cochrane District, compared to Ontario and Canada. The
median income ($20,499) of people in the Cochrane District who were over 15 years of age was lower than that
of Ontario ($24,816) and Canada ($22,120). The average
income ($53,051) in the District was also lower than that of
Ontario ($66,836) and Canada ($58,360).
The average number of persons per household in the Porcupine Health Unit catchment area was 2.5, which was close
to that of Ontario (2.7) and Canada (2.6).
In the Cochrane District, those whose income came from
employment was 76.3% compared to Ontario at 78.7%
and Canada at 77.1%.
Community Check-Up: Porcupine Health Unit
11
12
Community Check-Up: Porcupine Health Unit
2 g Environment & Health
Air Quality
The Mobile Air Quality Index (AQI) Unit of the Air Monitoring Section,
Environmental Monitoring and Reporting Branch of the Ontario Ministry
of Environment monitored hourly concentrations of smog-related pollution in the Timmins area to assess the ambient quality during the summer of the year 2003. 1 Three sites were chosen to monitor air quality, (a)
South Porcupine, (b) Downtown Timmins and (c) Baker Lake. Ozone (O3),
fine particulate matter (PM2.5), nitrogen dioxide (NO2) and sulphur dioxide
(SO2) were monitored in all three sites and compared with fixed locations
in Sudbury, Sault Ste. Marie and North Bay.
Ozone (O3)
The Timmins area showed a lower level of ozone than the provincial recommendation of the one-hour ambient air quality criterion (AAQC) of 80
ppb. The highest one-hour ozone concentration in Timmins area recorded during the study period was 68 ppb. This level was lower than that of
North Bay and Sudbury.
Parts Per Billion (PPB): Parts Per Billion denotes one particle of a given substance for
every 999,999,999 other particles.
Community Check-Up: Porcupine Health Unit
13
Figure 3: Comparison of hourly AQI reading by category between
Timmins and Sudbury
100
95.2
90.6
Timmins
Percent of Hours
80
Sudbury
60
40
20
9.4
4.8
0
Source: Very Good/Good
Moderate
Air Monitoring Section, Environmental Monitoring and Reporting Branch, Ontario Ministry of the Environment, Timmins Air Quality Study, 2003
The air quality, due to ozone, in the Timmins area rendered
“very good” and “good” designations 95.2 percent of the
time (Figure 3). In only 4.8 percent of the time was air quality recorded as “moderate”. Sudbury recorded “very good”
and “good” air quality 90.6 percent of the time and 9.4 percent of the time air quality was recorded as “moderate”.
Fine Particulate Matter (PM2.5)
During the study period, Sault Ste. Marie had the highest
24-hour PM2.5 concentration, at 30.1 µg/m3, compared to
North Bay at 20.1 µg/m3 and Timmins at 16.3 µg/m3 (Figure
4). The 24-hour PM2.5 concentrations in Timmins remained
far below the provincial standard of 30 µg/m3 and also
significantly lower than that of North Bay and Sault Ste.
Marie.
14
Community Check-Up: Porcupine Health Unit
Figure 4: Comparison of fine particulate matter in
Sault Ste. Marie, Timmins, North Bay, 2003
Max
Min
75%
25%
Median
30
Concentration (µg/m3)
24
18
12
6
0
Sault Ste. Marie
Source: Timmins
North Bay
Air Monitoring Section, Environmental Monitoring and Reporting Branch, Ontario Ministry of the Environment, Timmins Air Quality Study, 2003
Sulphur Dioxide (SO2)
The Timmins area showed a lower level of SO2 one-hour
average concentration (15 ppb) than Sudbury (70 ppb).
These two levels were far below than the provincial onehour SO2 AAQC of 250 ppb.
Nitrogen Dioxide (NO2)
The one-hour average concentration of NO2 in Timmins was
recorded at 18 ppb, which was well below the provincial
standard of 200 ppb set by the Ministry of Environment. The
highest 24-hour average concentration in Timmins (5.2 ppb)
was also far below than the provincial standard set by the
Ministry (100 ppb).
By and large, the general wet and cool conditions experienced during the summer of the study period in Timmins were not conducive to the production of high smogrelated pollutant levels. During smog alerts in Southern
Community Check-Up: Porcupine Health Unit
15
Figure 5: The Mattagami Watershed
OKE
WILHELMINA
GEARY
MAHAFFY
CRAWFORD
LUCAS
DUFF
MANN
NEWMARKET
Jocko Creek
AITKEN
MOBERLY
THORBURN
REID
CARNEGIE
PROSSER
TULLY
LITTLE
McCART
CALVERT
BYERS
LOVELAND
MACDIARMID
KIDD
WARK
EVELYN
GOWAN
DUNDONALD
Frederick House Lake
CLERGUE
FORTUNE
North Porcupine River
Bigwater Lake
JAMIESON
MONTCALM
COTE
ROBB
STRACHAN
MURPHY
JESSOP
Kamiskotia Lake
HOYLE
MATHESON
GERMAN
CODY
MACKLEM
STOCK
Mattagami River
ENID
WHITNEY
MASSEY
TURNBULL
GODFREY
MOUNTJOY
Bob's Lake
TISDALE
BOND
Pearl Lake Porcupine River
STRACHAN
CURRIE
Night Hawk Lake
Timmins
Redstone River
MELROSE
WHITESIDES
CARSCALLEN
KEEFER
DENTON
Whitefish River
BRISTOL
OGDEN
DELORO
SHAW
PRICE
ADAMS
ELDORADO
CARMAN
THOMAS
LANGMUIR
BLACKSTOCK
TIMMINS
McEVAY
FASKEN
MICHIE
NORDICA
SHERATON
EGAN
FREY
Grassy Lake
Tatachikapika River
THORNELOE
Night Hawk River
Kenogamissi Lake
Kamiskotia River
SEWELL
HILLARY
REYNOLDS
McKEOWN
FRIPP
MCARTHUR
DOUGLAS
CHILDERHOSE
DOYLE
MUSGROVE
BARTLETT
GEIKIE
FALLON
Beaucage Lake
REEVES
Misty Lake
Akweskwa Lake
PHARAND
Little Night Hawk Lake
CLEAVER
MCNEIL
Whitefish Lake
SHEBA
ROBERTSON
KENOGAMING
PENHORWOOD
East Night Hawk Lake
Grassy River
Mountjoy River
Kenogaming Lake
McBRIDE
CROTHERS
HASSARD
BEEMER
ENGLISH
ZAVITZ
Mountjoy Lake
HINCKS
ARGYLE
BADEN
West Night Hawk Lake
ALMA
HARDIMAN
REGAN
CAIRO
Pineland Lake
NORTHRUP
ROBLIN
MIDDLEBORO
HAZEN
POWELL
GOUIN
MOHER
SEMPLE
HUTT
MONTROSE
BANNOCKBURN
YARROW
EMERALD
McOWEN
GARDHOUSE
WIGLE
NURSEY
SOTHMAN
HALLIDAY
MIDLOTHIAN
BURROWS
KEMP
MOND
RAYMOND
CABOT
KELVIN
NATAL
CONNAUGHT
CHURCHILL
DOON
Tatachikapika Lake
Mattagami Lake
DESROSIERS
GENOA
WHALEN
CARTER
STETHAM
RANKIN
MATTAGAMI
VAN HISE
Makami Lake
MALLARD
ERIC
FRATER
SOMME
JACK
NOBLE
TOGO
Nabakwasi River
Makami River
Gogama
Mesomikenda Lake
HUFFMAN
POTIER
NEVILLE
OSWAY
KNIGHT
ST. LOUIS
TYRRELL
MACMURCHY
GROVES
BRUNSWICK
Minisinakwa Lake
Donnegana River
FINGAL
ARBUTUS
YEO
CHESTER
BENNEWEIS
CHAMPAGNE
Nabakwasi Lake
LONDONDERRY
MIRAMICHI
GARVEY
GARIBALDI
ASQUITH
FAWC&55
ALCONA
SMUTS
INVERGARRY
VROOMAN
WESTBROOK
SHEARD
BISCOTASI
OGILVIE
BROWNING
ARDEN
Donnegana Lake
EDINBURGH
INVERNESS
HENNESSY
MOFFAT
BREBEUF
BLEWETT
BEULAH
AMYOT
PAUDASH
HODGETTS
1:500,000
BAYNES
LAMPMAN
SHELLEY
DUBLIN
Source: 16
ONAPING
MARSHAY
SCOTIA FRECHETTE
Mattagami Region Conservation Authority, Timmins.
Community Check-Up: Porcupine Health Unit
0
4.5
9
18
27
36
Km
Ontario, the elevated pollutant concentrations — especially
ozone — were transported into Timmins, but did not raise
the AAQC to the provincial standard of 80 ppb. This study
suggests that even during smog alerts in Southern Ontario,
Timmins experienced a less significant quantity of ozone
and other particulate matters.
Municipal Drinking Water Quality
The Mattagami River in Timmins (Figure 5), is the largest
river system in the Upper Mattagami Watershed. It flows
northward to James Bay from its headwaters along the
Arctic Divide south of Gogama. The river, from the divide
to the Sandy Falls Dam, is 251 kilometres in length and
drains 8,426 square kilometres. The Mattagami River has
four major tributaries, the Grassy River, the Tatachikapika
River, the Mountjoy River and the Kamiskotia River. The
City of Timmins Water Filtration Plant is upstream of the
Upper Mattagami watershed. The Mattagami Region Conservation Authority covers over 11,000 square kilometres of
land and water, including all of the Upper Mattagami River
watershed and part of the Porcupine River system. Flood
control, erosion control, land management and conservation education are the main objectives of the Authority’s
programs.2
This water quality report was written using information
taken from the 2004 Timmins Water Filtration Plant Compliance Report.3 The Timmins Water Filtration Plant, under
the authority of City of Timmins, is a conventional filtration
plant which receives untreated water from the Mattagami
River at a maximum daily rate of 54,600 m3/day (Table 8).
The facility receives water from the Mattagami River which
is screened for prevention of intrusion of floating debris.
Community Check-Up: Porcupine Health Unit
17
Table 8:
Source Name/
Description
Mattagami River
Description regarding water treatment systems in Timmins
Source:
Type
Taking
Specific
Purpose
Taking
Major
Category
Max.
Taken per
Minute
(litres)
River
Municipal
Water supply
37,916
Max. Num. Max. Taken Max. Num.
Zone/
Of Hrs
per Day
of Days
Easting/
Taken per
(million Taken per
Northing
Day:
litres)
Year:
24
54.6
Total Taking
54.6
365
17 4734430 5371230
Source: Larose B. City of Timmins, 2004 Timmins Water Filtration Plant Compliance Report, 2005.
The untreated water flows into a raw water well where a
combination of four low lift pumps lift the water up into a
mixing chamber for chemical treatment.
When the water reaches the mixing chamber, a combination of aluminum sulphate, hydrated lime and a secondary flocculate are rapidly mixed into the untreated water
to begin treatment. After this process, the flow of water
is split into two portions to feed the Microfloc and Degremont operating systems as required.
The original Microfloc plant uses separate vessels to first
coalesce the chemicals and water in a flocculation tank and
then sends the water into a settling tank to remove the colour and turbidity from the water prior to filtration. In the
Degremont section of the treatment plant, the water and
chemicals are mixed together in one single tank where both
flocculation and settling takes place in a unique upflow system prior to filtration.
The water from each plant then enters six filters to remove
the small particles of flocculation which are too light in
18
Community Check-Up: Porcupine Health Unit
weight to settle. Once the water passes through the filters,
it is pumped into the blending chamber where chlorination
and pH control takes place. To provide the necessary alkalinity adjustment and to effectively reduce water corrosion
within the distribution system, the hydrated lime is added.
Three 4.54 million litre storage tanks called Clear Wells hold
the treated water before pumping it into the distribution
system. Four electric high lift pumps are used singly or in
combination to supply the required amount of water and
pressure to meet the demand of the population. The backup system for power outage consists of two diesel generators that start automatically to ensure no interruption of
electric service. There is another diesel pump which has to
be started manually by the operators when needed.
In addition to the storage at the plant, there are two facilities within the distribution system with a capacity of 10.4
million litres each. One is a standpipe which is 39.6 meters
high and 18.3 meters in diameter, situated in the Hollinger
Park. The associated Hollinger Park pumping station has
two pumps which supply Schumacher. The second facility
is an in-ground storage tank located in the northern part
of the City of Timmins. This station has two electric pumps
and a diesel pump for fire fighting, capable of supplying
the potable water demands of the Mountjoy area of Timmins. Only one of the electric pumps can be remotely started from the filtration plant at the present time.
The Ontario Ministry of the Environment (MOE) enacted the
Safe Drinking Water Act in 2002, following the Escherichia coli
(E. coli) outbreak in Walkerton. The City of Timmins maintains a
minimum of 0.20 mg/L of chlorine in the distributed water. The
city ensures that the disposal of all designated chemical substan-
Community Check-Up: Porcupine Health Unit
19
Table 9: 2004 water distribution miscellaneous summary
(Treated and chlorinated water as found within the distribution system)
Parameter
Asbestos
Calcium
Copper
Chlorine (Free Available)
Chlorine (Total Available)
Colour (TCU)
Conductivity (umho)
Cyanide
Dioxins (Total) (pg/L)
Fluoride
Formaldehyde + metabolites
Furans (Total) (pg/L)
Hardness
Iron
Lead
Manganese
Nitrate
Nitrite
Nitrilotriacetic acid (NTA)
Nitrogen (Kjeldahl)
Nitrosodiumethylamine (NDMA)
(ug/L)
Organic Carbon (Dissolved)
pH (0-14)
Radionuclides (Artificial)
Radionuclides (Natural)
Sodium
Sulphate
Trihalomethanes (Total THMs)
Turbidity (NTU)
Zinc
O.D.W.S.
mg/L
Total
Samples
<1.0000
N/A
N/A
>0.050
>0.050
5.0
N/A
0.20
0.015
1.20
N/A
0.015
80-100
0.3000
0.0100
0.0500
10.000
1.000
0.40
0.150
36
36
36
0.0090
36
5.0
6.5-8.5
0.1000
0.1000
20.0
500.0
0.1000
5.0
5.0
36
36
36
36
36
36
36
2,816
36
36
36
36
36
36
36
36
36
36
36
36
36
36
36
36
Samples
Above
Detection
0
36
36
2,816
2,816
36
36
0
0
10
3
0
36
36
2
36
36
0
0
11
Average
mg/L
Range
mg/L
Health
Exceedance
ND
29.4
0.014
1.11
1.23
1.5
177
ND
ND
0.052
0.076
ND
97.2
0.38
0.004
0.021
0.180
ND
ND
0.290
N/A
27.0-53.0
0.001-0.032
0.00-1.56
0.02-1.74
0.0-11.0
139.0-215.0
N/A
N/A
0.030-0.090
0.056-0.092
N/A
68.1-125.0
0.05-0.76
0.002-0.006
0.007-0.058
0.100-0.310
N/A
N/A
0.220-0.460
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
3
0.0300
0.0240-0.0420
no
36
36
7
0
36
36
36
2,816
8
3.13
7.62
0.2100
ND
14.23
38.6
0.051
0.69
0.018
2.10-4.75
7.45-8.01
0.1000-0.3000
N/A
1.10-39.20
34.0-41.0
0.035-0.078
0.34-127.0
0.011-0.031
no
no
no
no
no
no
no
no
no
Source:
Larose, B. City of Timmins, 2004 Timmins Water Filtration Plant Compliance Report, 2005.
Notes:
• O.D.W.S. denotes “Ontario Drinking Water Standards”
• < denotes less than method detection limit (MDL) • > denotes greater than method detection limit (MDL)
• mg/L denotes milligrams per litre (equivalent to ppm/parts
per million)
• ug/L denotes micograms per litre (equivalent to ppb/parts ber
billion)
• pg/L denotes picograms per litre (equivalent to ppt/parts per
trillion)
20
Community Check-Up: Porcupine Health Unit
• ND denotes non-detectable using standard methods of
analysis
• N/A denotes not applicable under these circumstances
• umho denotes micro mhos (opposite of resistance)
• Bq/L denotes beqerals per litre (measure of radioactivity)
• TCU denotes True Colour Units
• NTU denotes Nephelometric Turbidity Units (Light Scattering
Capabilities)
ces (e.g., asbestos, mercury, etc.) is done in an appropriate manner, with accompanying documentation. The city also ensures
the production of an Annual Compliance Report every year.
In 2004, all water supplied from the Timmins Water Filtration
Plant (TWFP) met or exceeded the requirements of Ontario
Drinking Water Standards. Only 33 samples (1.13%) of 2,917
bacteriological samples collected from the regular Timmins
distribution system location indicated the presence of adverse
indicator bacteria, heterotrophic plate counts, general bacteria counts or chemical parameters which affect water conditions. These adverse samples were a result of either erroneous
reporting or water failure, not adverse water conditions, produced by the Timmins Water Filtration Plant. One sample was
reported as adverse from the treated water system due to lack
of the chemical parameters with the water supply.
Ninety-one (91) samples — or 6.5% of the 1,408 samples that
were collected to support the non-routine functions within the
Timmins distribution system — showed the presence of adverse
indicator bacteria, heterotrophic plate counts, general bacteria
counts or chemical parameters which adversely affect water conditions. (Presence of indicator bacteria do not cause disease, rather they indicate potential bacterial onset.) These adverse conditions were due to construction in different areas of Timmins.
More than 200 analytical results for inorganic, organic and
radiological parameters met or exceeded the requirements of
the Ontario Drinking Water Standards. A high level of Nitrosodiumethylamine (NDMA) in a few samples raised some concern. After checking with the Ministry of Environment, it was
confirmed that a sample preparation anomaly resulted in a
false positive result. Table 9 shows the summary of laboratory
parameters.
Community Check-Up: Porcupine Health Unit
21
Figure 6:
Exceedances in acceptable E. coli levels.Average Proportions of
Geometric Means (GM) > 100, Gillies Lake, 2001­–2005
50
39.5
40
40.1
33.1
30
20
26.5
18.4
10
0
2001
2002
2003
N=12
2004
2005
Source: Porcupine Health Unit, Inspection Department, 2006
Posted bathing beaches
Gillies Lake is located in the northern part of the City of
Timmins. This lake is monitored annually for public swimming. The water samples are taken during the summer
months when the beach is open to the public for swimming. Figure 6 shows the proportions of geometric means
of E. coli above 100 for the beach, sampled from 2001 to
2005. Figure 6 shows that acceptable E. coli levels below 100
were found during the reported 5-year period. During the
same time period, the beach was never closed due to water
contamination.
22
Community Check-Up: Porcupine Health Unit
Chapter 2 References
1. Air Monitoring Section, Environmental Monitoring and Reporting Branch,
Ontario Ministry of the Environment, Timmins Air Quality Study, 2003.
2. Percival, C. Communications Specialist, Source Water Protection, Mattagami
Region Conservation Authority, Timmins, (personal communication).
3. Larose, B. City of Timmins, 2004 Timmins Water Filtration Plant Compliance
Report, 2005.
Community Check-Up: Porcupine Health Unit
23
24
Community Check-Up: Porcupine Health Unit
3 g Reproductive Outcomes
& Child Health
Crude Birth Rate
Crude birth rate is defined as the number of total live births divided by
the total population of the area multiplied by 100. Both Ontario and the
Porcupine Health Unit area experienced a decline in the crude birth rate
since the year 1992.
Community Check-Up: Porcupine Health Unit
25
Figure 7:
Comparison of crude birth rate between the Porcupine Health Unit
and Ontario
15
Rate / 1,000
10
5
0
1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
m PHU
16.0
16.0
15.5
16.0
14.8
15.5
15.1
13.4
13.2
12.5
11.6
10.5
10.8
9.9
10.0
10.3
m ON
14.1
13.9
14.0
14.3
14.6
14.3
14.2
13.8
13.5
13.3
12.6
11.8
11.6
11.4
10.9
11.0
Source: Provincial Health Planning Database, extracted July 5, 2005. Health Planning Branch, Ministry of
Health and Long-Term Care, Ontario.
Figure 7 shows that the Porcupine Health Unit area had a
higher crude birth rate than the province during the latter
part of the 80s whereas, through the 90s, the crude birth
rate of Ontario surpassed the rate of the area.
Preterm Birth Rate
Preterm birth is defined as the birth of a baby with a gestational age of less than 37 completed weeks or 259 days. The
rate of preterm birth is defined as the number of preterm
births for each 100 live births in a particular year. Preterm
birth is responsible for 75–85% of all perinatal mortality in
Canada. Neuro-developmental handicaps, chronic respiratory infections and ophthalmological problems are associated with preterm birth. Preterm birth mostly occurs in mul26
Community Check-Up: Porcupine Health Unit
Figure 8:
9
Comparison of preterm birth rate between the Porcupine Health Unit
and Ontario
8
7
Rate / 100 live births
6
5
4
3
2
1
0
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
m PHU
4.9
4.5
4.5
5.2
4.5
5.4
4.8
5.2
4.7
4.0
6.0
5.0
4.7
5.1
4.9
3.6
m ON
5.1
5.0
5.4
5.1
5.2
5.8
6.0
7.3
7.3
8.1
8.4
7.0
5.9
5.8
6.0
5.7
Source: Provincial Health Planning Database, extracted July 5, 2005. Health Planning Branch, Ministry of
Health and Long-Term Care, Ontario.
tiple births but it can also occur in singleton birth. The data
that is presented in this chapter is from singleton births in
the Province of Ontario and the Porcupine Health Unit.
Since 1986, the Porcupine Health Unit area has had a lower
rate of preterm birth than the province. Figure 8 compares
the two rates.
Even though the exact cause of preterm birth is unknown,
multiple risk factors have shown to be associated with preterm birth. Genital tract infection, maternal smoking during pregnancy, pre-eclampsia, previous preterm birth and
abruptio placenta, stress, anxiety and depression are a few
known risk factors.
Community Check-Up: Porcupine Health Unit
27
Figure 9:
Comparison of low birth weight between the Porcupine
Health Unit, Ontario and Canada
6
Percent of live births
5
4
3
2
1
0
1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
m PHU
5.1
4.9
4.5
5.5
3.2
5.3
4.5
4.3
4.5
4.2
4.6
5.1
3.7
4.7
4.9
3.6
m ON
5.4
5.4
5.5
5.3
5.4
5.6
5.6
6.0
6
6.1
6.0
5.9
5.8
5.8
5.7
5.6
m Can
5.5
5.5
5.6
5.5
5.5
5.5
5.5
5.7
5.8
5.8
5.7
5.8
5.7
5.6
5.6
5.5
Source: Provincial Health Planning Database, extracted July 5, 2005. Health Planning Branch, Ministry of
Health and Long-Term Care, Ontario.
There is a limitation in the data that has been presented here.
The birth registration rate was lower in the early 90s in Ontario,
which may result in an under-representation of preterm births
both in Ontario and the Porcupine Health Unit area. 1
Low Birth Weight Rate
Low birth weight is defined as the birth of a baby with a
weight less than 2,500 grams. The low birth weight rate
can be defined as the total number of live births with birth
weight less than 2,500 grams, divided by the total number of live births, multiplied by 100. This indicator is the
key determinant of infant mortality and morbidity. Low
birth weight can occur due to premature birth or reduced
growth during the gestational period.
28
Community Check-Up: Porcupine Health Unit
In this analysis, the effect of prematurity due to multiple
births was minimized by excluding multiple births during
calculation, hence only singleton births were considered. In
recent years, there has been an increased registration of live
births with a birth weight of less than 500 grams. To improve
the comparability of this indicator, those babies with birth
weight less than 500 grams were also excluded. The age of
the mother, gestational age, type of birth, parity, smoking
during pregnancy, physical and social environment and genetic factors are the risk factors for low birth weight baby.
Figure 9 shows that the low birth weight rate was lower in
the health unit area than the provincial and national rate.
One of the objectives of the Mandatory Health Programs
and Services Guidelines is to curb the low birth weight rate
to lower than 4%. In the years 1990, 1998 and 2001, the
low birth weight rate was lower than 4% (3.2%, 3.7% and
3.6%, respectively) in the Porcupine Health Unit area.
Neural Tube Defects
A neural tube defect is the congenital anomaly of the central nervous system which is the most common and serious
defect among all the congenital anomalies. Even though
the rates of neural tube defects are decreasing since the
1980s, 2 it continues to be an important cause of morbidity
and mortality during early childhood. 3
Neural tube defects occur when the neural tube fails to
close in the embryo in the first trimester of the pregnancy.
Anencephaly and spina bifida are the most common neural
tube defects. Anencephaly occurs when the cranial end of
the neural tube fails to close and spina bifida occurs when
Community Check-Up: Porcupine Health Unit
29
Table 10: Year
Rate of neural tube defects (NTDs), Canada, 1991-1999
NTD cases
Cases per
10,000 births
Total births
NTD cases
(excluding NS*)
Cases per
10,000 births
(including NS)
1991
389
389,926
10.0
1992
370
384,740
9.6
1993
345
377,167
9.1
1994
349
375,451
9.3
1995
340
368,100
9.2
1996
257
356,188
7.2
278
366,811
7.6
1997
257
341,122
7.5
267
351,139
7.6
1998
188
334,133
5.6
196
343,822
5.7
1999
185
328,493
5.6
195
338,133
5.8
Source: Total births
Health Canada. Canadian Congenital Anomalies Surveillance System (CCAS), 1991–1999.
* Nova Scotia data were not available to CCAS before 1996
the caudal part of the neural tube fails to close. The effect
of neural tube defects can vary from no symptoms at all to
serious mental or physical handicaps.
Several studies have demonstrated the protective effect of
folic acid supplementation during early pregnancy for the
prevention of neural tube defects. 4-9 The rate of neural tube
defects decreased 44%, from 10 cases per 10,000 in 1991 to
5.6 cases per 10,000 in 1997 (Table 10). In November 1998,
the addition of folic acid to white flour and pasta products
(labelled “enriched”) became mandatory in Canada. This
fortification added approximately 0.1 mg of folic acid to
the average woman’s diet every day. Due to this measure,
a lower number of neural tube defects have been reported
in Canada in recent years.
30
Community Check-Up: Porcupine Health Unit
Table 11:
Rate of neural tube defects (NTDs), by province/territory, Canada,
1997-1999 combined
Province/territory
Number of
NTD cases
Total Births
NTD cases per 10,000
total births
Cases
Newfoundland
95% CI
15
15,538
9.7
5.4–15.9
0
4,550
0.0
0.0–8.1
Nova Scotia
28
29,346
9.5
6.3–13.8
New Brunswick
19
24,017
7.9
4.8–12.3
Quebec
121
225,053
5.4
4.5–6.4
Ontario
265
406,064
6.5
5.8–7.4
Manitoba
36
43,232
8.3
5.8–11.5
Saskatchewan
22
37,957
5.8
3.6–8.8
Alberta
52
113,844
4.6
3.4–6.0
100
129,230
7.7
6.3–9.4
Yukon
0
1,213
0.0
0.0–30.2
Northwest Territories
0
3,050
0.0
0.0–12.0
658
1,033,094
6.4
5.9–6.9
Prince Edward Island
British Columbia
Canada
Source:
Health Canada. Canadian Congenital Anomalies Surveillance System, 1997-1999.
Note:
Nunavut is included in the Northwest Territories in the Data for 1999.
Infant Mortality Rate
Infant mortality rate is defined as the number of children
dying, under one year of age, divided by the number of
live births for that year. It is a significant indicator of the
quality of preventive medicine and health care measures
provided to infants and pregnant women. Infant mortality is strongly associated with maternal health and socioeconomic determinants.
In Canada, as in the rest of the world, higher socioeconomic
conditions helped create an environment conducive to a lower
percentage of infant mortality (4.5 per 1,000) compared to low
socioeconomic conditions (7.5 per 1,000). The infant mortality
rate has subsided in Canada linearly since 1960 (Figure 10).
Community Check-Up: Porcupine Health Unit
31
Figure 10: Infant Mortality Rate, Canada, 1960-1995
Infant deaths per 1,000 live births
30
25
20
15
10
5
0
1960
Sources: 1970
1980
Year
1990
Statistics Canada, Selected Infant Mortality Statistics, Canada, 1960-1995. Statistics Canada, Births and
Deaths, 1995.
Figure 11: Infant mortality rate, comparing Cochrane District, Ontario and Canada
Rate / 1,000 live births
10
8
6
4
2
0
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
m PHU
5.0
7.2
5.6
4.9
1.7
7.9
8.6
2.1
6.5
4.3
8.5
m ON
5.9
6.2
6.0
5.9
5.7
5.5
5.0
5.4
5.3
5.4
5.3
m Can
6.1
6.3
6.3
6.1
5.6
5.5
5.3
5.3
5.3
5.2
5.4
Source: 32
Provincial Health Planning Database, extracted July 5, 2005. Health Planning Branch, Ministry
of Health and Long-Term Care, Ontario.
Community Check-Up: Porcupine Health Unit
Figure 12: Causes of Infant Death in Canada (excluding Ontario), 1999
28.5
Congenital
Anomalies
22.6
26.5
14.7
Asphyxia
0.8
10.1
32.6
5.3
Immaturity
23.4
3.8
12.5
Infection
6.7
Sudden
Infant Death
Syndrome
2.1
29.2
11.2
1.1
Unexplained
Sudden Infant
Death
5.6
Neonatal death
2.6
Postneonatal death
0.7
External
Causes
7.0
Infant death
2.8
16.4
17.0
16.6
Other
0
Source: 5
10
15
20
Percentage
25
30
35
Statistics Canada. Canadian Vital Statistics System, 1999 (*Data for Ontario excluded due to data
quality issue)
The downward trend of infant mortality has also spread
throughout the Cochrane District. When the data on infant
mortality in the area was compared with that of Ontario
and Canada (Figure 11), the average infant mortality rate
for 11 years (from 1992 to 2002) was not significantly different, although, in a few instances, the rate of the area was
higher than the provincial or national average.
Community Check-Up: Porcupine Health Unit
33
Figure 13: Trends of teen pregnancy in the Porcupine Health Unit area and
Ontario, 1996-2001
60
PHU
51.7
50
47.5
44.7
40.1
40
Ontario
46.4
44.6
38.8
35.7
43.5
36.3
32.7
30
30.5
20
10
0
1996
Source:
1997
1998
1999
2000
2001
Health Planning System (HELPS), Public Health Branch, Ministry of Health and Long-Term Care,
Ontario
Teen Pregnancy Rate
The rate of teen pregnancy has been decreasing for the last
quarter century in Canada due to increased availability of contraceptives and to increased awareness of the risk of acquiring
sexually transmitted infections, like AIDS. 10 The same trend has
been found in Ontario and in the Porcupine Health Unit area.
Figure 13 shows that, in Ontario, the rate of teen pregnancy has declined steadily from 1996 to 2001. In the
Porcupine Health Unit, the rate went up in 1998 and
1999 and then declined again in 2000.
Even though Canadian society has changed its view on
teen pregnancies and births by unmarried women, the
risk of serious health consequences for the babies of
teen mothers persists. Teen pregnancy can also be linked
34
Community Check-Up: Porcupine Health Unit
Figure 14: Comparison of teenage pregnancy rate among the Northern Health
Units and Ontario, 2001
80
70.7
70
Rate/ 1,000 teens
60
50
43.5
41.1
40
41.2
34.8
33.5
33.2
30.5
30
20
10
Source:
o
tari
On
U
Thu
nde
rB
Tim
iska
Dis
ay
min
tH
tric
tric
Dis
nd
ya
bur
gH
U
U
tH
U
PH
U
rn H
ste
No
rth
we
Sud
No
rth
Bay
and
Alg
Dis
om
tric
aH
tH
U
U
0
Health Planning System (HELPS), Public Health Branch, Ministry of Health & Long-Term Care, Ontario
to low birth weight and other medical conditions.
11
Anemia, hypertension, renal disease, eclampsia and depressive disorders are a few of the health risks for teen pregnant mothers. Also, teenagers who engage in unprotected
sex are susceptible to sexually transmitted infections. 10, 12, 13
There are financial consequences for teen pregnancy. A
teenage girl’s opportunity for education is impeded due to
pregnancy, as is the prospect of acquiring an appropriate
well-paying job. 14 In addition, the cost of living is increasing every year and dual incomes are necessary to maintain
a healthy lifestyle. Unfortunately, mothers who are 15♠–17
years old are likely to be unmarried or living alone, increasing their hardships. 12
Community Check-Up: Porcupine Health Unit
35
Figure 15: Comparison of teenage abortion rate in Northern Health Units
and Ontario, 2001
25
19.2
Rate/ 1,000
20
17.6
14.8
14.7
15
15.9
15.1
14.4
11.2
10
5
Source:
o
tari
On
U
min
iska
ay
rB
Thu
nde
Tim
tric
Dis
tric
Dis
nd
ya
bur
Sud
gH
U
tH
U
tH
U
PH
rn H
ste
we
rth
No
No
rth
Bay
and
Alg
Dis
om
tric
aH
tH
U
U
U
0
Health Planning System (HELPS), Public Health Branch, Ministry of Health and Long-Term Care,
Ontario
Figure 14 shows that, in the year 2001, the rate of teen pregnancy was 30.5/1,000 in Ontario. The highest rate was observed
in the Northwestern Health Unit (70.7/1,000). The Porcupine
Health Unit reported the second highest rate (43.5/1,000).
Among the health units, the lowest number of teen pregnancies was observed in the Sudbury and District Health Unit at
33.2/1,000.
Historically, most teen pregnancies resulted in live births
rather than abortion. With the advent of various safe methods of abortion, most teen pregnancies are now terminated through abortion. The rate of abortion has declined
in the population of the Porcupine Health Unit: decreasing
38% in 2001 from that in 1996 (14.4 from 19.9). Among
the northern health units, the abortion rate was the
36
Community Check-Up: Porcupine Health Unit
Figure 16: SIDS Rates, Provinces & Territories, 1996
Provinces/Territories
P.E.I.
Nfld.
Y.T.
B.C.
Que.
Ont.
Canada
Man.
N.S.
Alta.
N.B.
N.W.T.
0
0.5
1
1.5
2
2.5
3
3.5
SIDS deaths per 1,000 live births
Source: Statistics Canada. Canadian Vital Statistics System, 1996.
highest in the Algoma Health Unit (19.2/1,000) and the lowest in the Timiskaming Health Unit (11.2/1,000 teens) in 2001
(Figure 15).
Sudden Infant Death Syndrome (SIDS)
Sudden infant death syndrome can be defined as the sudden and unexpected death of an apparently healthy infant
who is under one year of age and in which the cause of
death remains unexplained after all known and possible
causes have been ruled out by autopsy, medical history and
death scene investigation. 15
Sudden infant death syndrome is one of the leading causes of death of infants between 28 days and one year of
age. 16 In 1996, there were 2,051 infant deaths reported and,
among them, 168 (8.2%) were attributed to sudden infant
death syndrome. The rate of sudden infant death syndrome
Community Check-Up: Porcupine Health Unit
37
Table 12: Maternal mortality ratio (MMR) per 100,000 live births, according to age
in Canada (excluding Quebec), 1997 -2000
Age
(Years)
Source:
Maternal
deaths
Live births
MMR
Rate
95% CI
< 20
2
62,236
3.2
0.4–11.7
20–24
4
187,062
2.1
0.6–5.4
25–29
16
321,753
5.0
2.8–8.1
30–34
24
316,588
7.6
4.9–11.3
35–39
15
142,968
10.5
5.9–17.3
40 and over
3
24,221
12.4
2.6–36.2
Total
64
1,054828
6.1
4.7–7.7
Health Canada. Special Report on maternal mortality and severe morbidity in Canada.
Canadian Perinatal Surveillance System. 2004
declined in Canada from 1.2 per 1,000 live births in 1980 to
0.9 per 1,000 live births in 1996. 16, 17
Figure 16 shows the rate of sudden infant death syndrome
in each province of Canada and it is worth noting that
the rate of the syndrome is high in the Canadian aboriginal population. 15 As the number of cases of sudden infant
death syndrome less than one in Canada, the rate for the
Porcupine Health Unit area was not available.
Shaken Baby Syndrome
Shaken baby syndrome is defined as a condition when a parent or caregiver shakes an infant or young child so violently
that the child suffers from a serious morbid condition, and
possibly even succumbs to death. Injuries that are included
in the shaken baby syndrome are: intracranial haemorrhage
(bleeding in and around the brain), retinal haemorrhage,
fractures of the ribs and long bones. Bruises, laceration and
other fractures also can occur from the impact of shaking. 18
38
Community Check-Up: Porcupine Health Unit
As shaken baby syndrome is not defined by a single disease or
is not coded by the International Classification of Disease (ICD),
the data for this syndrome is not available in Canada. However,
one Canadian study 19 indicates that the median age of infants
that suffered from shaken baby syndrome was 4.6 months and
56% were boys. Seizure-like activities were noted among 45%
of children, decreased levels of consciousness in 43%, respiratory difficulty in 34%, and bruising was noted in 46% of cases.
Nineteen percent (19%) of children died as a direct result of
shaking, 55% suffered from ongoing neurological problems
and 65% had visual impairment.
Shaken baby syndrome is a form of child abuse and warrants police investigation when suspected. Provincial and
territorial child welfare authorities also investigate incidents
to determine the safety of the child in the current parental
or care-giver home.
Breastfeeding
Breastfeeding is required for the development of a healthy
child. The benefits of breastfeeding are enormous: it helps
to develop the child normally, both mentally and physically,
and helps to prevent breast disease in the mothers. Breastfeeding protects the child from infections, 20 Haemophilus
influenza (during the first 6 months of life), 21 otitis media, 22
sudden infant death syndrome. 23 Other important benefits
of breastfeeding include improved cognitive development
and a reduced incidence of immune-related disease (Type-1
diabetes and inflammatory bowel disease) and childhood
cancers. A reduction of the risk of breast cancer, 24 and uterine cancer 25 in the mothers are other benefits. The cognitive developmental benefits of breastfeeding depends on
the duration of breastfeeding. 26
Community Check-Up: Porcupine Health Unit
39
Figure 17: Percentage of breastfeeding or bottle-feeding within the first
48 hours after the child’s birth, all Northern health units
Percentage of respondents
100
80
60
40
20
0
North Bay
& District
Northwestern
Sudbury &
District
Timiskaming
Algoma
Thunder
Bay
PHU
Muskoka/
Parry
Sound
All Northern
HUs
m Breastfeeding
75.2
78.3
65.4
67.3
68.2
84.2
67.6
77.8
73
m Bottle-feeding
22.3
17.9
29.4
29.8
29.4
14.1
28.3
18.4
23.6
Source: Sinclair, S., Houston, V., Shields, K., Snelling, S.: Breastfeeding practices in Northern Ontario,
a report from the Northern Ontario Perinatal and child health survey consortium. PHRED,
Sudbury and District Health Unit, 2003
There is also a direct economic benefit to breastfeeding. A
study of women, infants and children who were enrolled
in a special supplemental nutrition program 27 indicated
that Medicaid expenditures during the first 6 months of the
infant’s life were reduced $478/infant due to breastfeeding.
This implies that breastfeeding benefits the health care system financially. Mothers who do not breastfeed incur additional cost related to formula purchases.
Figure 17 shows the percentage of breastfeeding or bottlefeeding in all northern health units within the first 48 hours
after a child’s birth. The rate of breastfeeding in the Porcupine
Health Unit area was one of lowest rates among the northern health units. The rate of bottle-feeding in the health unit
area was one of the highest among the same group.
40
Community Check-Up: Porcupine Health Unit
Table 13: Rate and duration of breastfeeding, by maternal age
Maternal age
(years)
Percentage of children whose mother reported breastfeeding,
regardless of duration
Canada (excluding the territories)
1994–1995
1996–1997
1998–1999
PHU area
2004–2005
<20
66.3
72.4
73.4
38.0
20–24
67.9
74.2
75.3
59.6
25–29
73.4
74.6
81.4
62.9
30–34
77.7
81.7
83.5
63.4
>35
80.9
82.8
86.5
75.0
All ages
75.1
78.5
81.9
61.1
Sources:Canadian Perinatal Health Report, 2003, Canadian Perinatal Surveillance System,
Health Canada and Breastfeeding survey, Porcupine Health Unit
Table 14: Rate and duration of breastfeeding by region/province
Region/
province
Source: Percentage of children <2 years of age whose mother
reported breastfeeding regardless of duration
Canada (excluding the territories)
1994–1995
1996–1997
1998–1999
Atlantic provinces
66.3
72.4
73.4
Quebec
67.9
74.2
75.3
Ontario
73.4
74.6
81.4
Prairie provinces
77.7
81.7
83.5
British Columbia
80.9
82.8
86.5
All provinces
75.1
78.5
81.9
Canadian Perinatal Health Report, 2003, Canadian Perinatal Surveillance System,
Health Canada
A breastfeeding survey was conducted by the Porcupine
Health Unit in 2005 28 and it showed that, by and large, the
breastfeeding initiation rate was lower among all ages of
women compared to women across Canada. Table 13 illustrates the age distribution of women and the breastfeeding
initiation rate. The breastfeeding initiation rate was significantly lower among mothers who were less than 20 years
Community Check-Up: Porcupine Health Unit
41
Figure 18: Respondents with children born in 2000-02 who breastfed in the
first 48 hours after the child’s birth, all Northern health units
Percentage of respondents
100
%
88.4
83.6
80
80.4
79.8
74.5
77.2
73.1
71.6
65.1
60
40
20
s
HU
ern
ing
rth
am
All
No
isk
ay
rB
nde
Tim
tric
Dis
tric
nd
ya
bur
HU
U
tH
U
tH
U
PH
HU
we
Dis
Thu
No
Sud
rth
Bay
No
rth
and
ste
tric
Dis
oun
ry S
Par
kasko
Mu
rn
tH
U
dH
U
aH
om
Alg
Source: U
0
Sinclair, S., Houston, V., Shields, K., Snelling, S.: Breastfeeding practices in Northern Ontario, a
report from the Northern Ontario Perinatal and child health survey consortium. PHRED,
Sudbury and District Health Unit, 2003
of age in the Porcupine Health Unit area than the rate of sameaged women across Canada (38% vs. 73.4%).
Figure 18 shows the percentage of respondents in all northern
health units with children born from 2000 to 2002 who breastfed
in the first 48 hours after birth. According to this figure, the Porcupine Health Unit had the lowest breastfeeding initiation
rates when compared with other health units.
42
Community Check-Up: Porcupine Health Unit
Chapter 3 References
1. Canadian Perinatal Surveillance System, Public Health Agency of Canada,
Ottawa, Canadian Perinatal Health Report, 2003
2. Wen, S.W., Liu, S., Joseph, K.S., Rouleau, J., et al. “Patterns of infant mortality
caused by major congenital anomalies.” Teratology. 2000; 61: 342-6
3. Van Allen, M.I., McCourt, C., Lee, N.S. Preconception health: folic acid for the
primary prevention of neural tube defects. A resource document for health
professionals, 2002. Ottawa: Minister of Public Works and Government
Services, Canada 2002
4. Milunsky, A., Jick, H., Jick, S.S., Bruell, C.L., et al. “Multivitamin/folic acid
supplementation in early pregnancy reduces the prevalence of neural tube
defects.” JAMA. 1989; 262 (20) : 2847-52
5. Wald. N., Sneddon, J., Densem, J., Frost, C., et al. “Prevention of neural tube
defects: results of the Medical Research Council Vitamin Study.” Lancet.
1991; 338: 131-7
6. Czeizel, A.E., Dudas, I. “Prevention of the first occurrence of neural tube
defects by periconceptional vitamin supplementation.” N Eng J Med. 1992;
327: 1832-5
7. Mulinare, J., Cordero, J.F., Erickson, J.D., Berry, R.J. “Periconceptional use of
multivitamins and the occurrence of neural tube defects.” JAMA. 1988; 260
(21): 3141-5
8. Bower, C., Stanley, F.J. “Dietary folate as a risk factor for neural tube defects:
evidence from a case-control study in Western Australia.” Med J Aus. 1989;
150 (11): 613-9
9. Werler, M.M., Shapiro, S., Mitchell, A.A. “Periconceptional folic acid exposure
and the risk of occurrence of neural tube defects.” JAMA. 1993; 269: 125761
10.Society of Obstetricians and Gyaecologists of Canada (SOGC). Sex Sense:
Canadian Contraceptive Guide. Ottawa: SOGC, 2000
11.Federal/Provincial/Territorial Advisory Committee on Population Health.
Statistical Report on the Health of Canadians. Ottawa, Health Canada, 1999
12.Combes-Orme, T. “Health effects of adolescent pregnancy: Implications for
social workers.” Fam Soc. 1993; 74(6): 344-54
13.Turner, R.J., Grindstaff, C.F., Phillips, N. “Social support and outcome in
teenage pregnancy.” J Health Soc Behav. 1990; 31 (1): 43–57
14.The Alan Guttmacher Institute. Facts in Brief: Teen Sex and Pregnancy, 1999.
New York: The Alan Guttmacher Institute, 1999
Community Check-Up: Porcupine Health Unit
43
15.Molckovsky, A., Pirzada, K.S. The Toronto notes: A comprehensive medical
review textbook for the 2004 Medical Council of Canada Qualifying
Examination. 20th Edition. Toronto Notes Medical Publishing. 2004 Inc. P6-7
16.Statistics Canada. Canadiana Vital Statistics System, 1996
17.Statistics Canada. Mortality–summary list of causes, 1995. Catalogue 84-209XPB
18.Health Canada. Joint Statement on Shaken Baby Syndrome. Minister of Public
Works and Government Services, Ottawa, 2001
19.King, W.J., MacKay, M., Sirnick, A. “Shaken Baby Syndrome in Canada:
clinical characteristics and outcomes of hospital cases.” CMAJ. 2003; 168 (2):
155-9
20.Lerman, Y., Slepon, R., Cohen, D. “Epidemiology of acute diarrheal diseases
in children in a high standard of living settlement in Israel.” Pediatr Infect Dis J.
1994; 13(2): 116-22
21.Cochi, S.L., Fleming, D.W., Hightower, A.W., Limpakarnjanarat, K., et al.
“Primary invasive Haemophilus influenza type b disease, a population based
assessment of risk factors.” J Pediatr. 1986: 108 (6): 887-96
22.Teele, D.W., Klein, J.O., Rosner, B. “Epidemiology of otitis media during the
first seven years of life in greater Boston: a prospective cohort study.” J Infect
Dis. 1989; 160 (1): 83-94
23.Hoffman, H.J., Damusk, K., Hillman, L., Krongrad, E. Risk factors for SIDS:
results of the National Institute of Child Health and Human Development SIDS
Cooperative Epidemiologic Study. Ann NY Acad Sci. 1988; 533: 13-30
24.Schack-Nielsen, L., Larnkjaer, A., Michaelsen, K.F. “Long term effects of
breastfeeding on the infant and mother.” Adv. Exp. Med. Biol. 2005; 569: 16-23
25.Brock, K.E. “Sexual, reproductive and contraceptive risk factors for carcinomain-situ of the uterine cervix in Sidney.” Med J Aust. 1989; 150 (3): 125–130
26.Anderson, J.W., Johnstone, B.M., Ramley, D.T. “Breast-feeding and cognitive
development: a meta-analysis.” Am J Clin Nutr. 1999; 70(4): 525-35
27.Montgomery, D.L., Splett, P.L. “Economic benefit of breast-feeding infants
enrolled in WIC.” J Am Diet Assoc. 1997; 97 (4): 379-85
28.Yuskow, S., Mills, M.M., Haque, F., Corstorphine, N., et al. Porcupine Health
Unit breast feeding survey. Unpublished data.
44
Community Check-Up: Porcupine Health Unit
4 g Genetic Diseases &
Congenital Anomalies
Due to many recent scientific advances in genetics, including the Human
Genome Project, the profile of genetic diseases is rising. One in every
twenty Canadians experiences a gene-related disease or disability by age
25. 1 About half of the admissions in pediatric hospitals 2 and twelve percent
of all adult admissions in general hospitals are due to genetic diseases. 3
Several thousand diseases have been identified as genetic diseases. Some
genetic diseases occur at high rates in particular geographic areas of Canada or subgroups of the Canadian population. 4 If certain genetic diseases
that occur in the Cochrane District or in the area of the Porcupine Health
Unit can be identified, then preventive and therapeutic measures can be
taken. For individuals who are at risk of genetic diseases, genetic technologies can curb the risk by modifying the environmental risk factor.
The Genetics Program of the health unit is responsible for the diagnosis
and follow-up care of symptoms associated with genetic diseases. The program staff gather medical data on the clients. To reach a diagnosis, a geneticist takes a medical history, does a physical examination, and reviews all
assessments done by other health care professionals.
Community Check-Up: Porcupine Health Unit
45
Figure 19: Leading causes of referral to PHU Genetic Services Program in 2004
Cancer - 40%
Prenatal - 28%
Neurological - 6%
Metabolic - 6%
Development delay - 20%
Source: Genetic Services Program, Porcupine Health Unit
The Porcupine Health Unit genetic nurses also counsel
patients with genetic diseases on the natural progression of
the disease and necessary symptoms that require immediate medical attention. In addition, the health unit nurses
counsel using a family pedigree for the genetic disease and
advise how it can affect offspring. Cytogenetic and molecular blood tests and urine tests can also be ordered. The program also sends genetic assessment letters to family physicians for the follow-up and monitoring of the patients.
No intervention has yet been discovered to prevent genetic
diseases, but some interventions are taken to ameliorate
the symptoms of the diseases. If any genetic disease can be
diagnosed prenatally, parents are offered choices to either
continue or discontinue the pregnancy. The sooner a disease is diagnosed, the sooner interventions can be taken
to alleviate the severe symptoms. For instance, in the case
46
Community Check-Up: Porcupine Health Unit
Figure 20: Congenital anomalies in different PHU communities (1989–2000)
600
519.0
500
449.2
Rate/ 10,000 births
400
300
299.6
291.2
238.5
186.2
200
183.2
154.9
111.1
100
nee
oso
ock
hR
Sm
oot
Mo
ls
Fal
son
the
Ma
ng
asi
Kap
usk
alls
is F
quo
Iro
Ho
rne
pay
ne
t
ars
He
ane
chr
Co
Tim
min
s
0
Source:
Health Planning System (HELPS), Public Health Branch, Ministry of Health and Long-Term Care,
Ontario
of haemochromatosis, the blood is drained from the body
based on ferritin and total iron level thus preventing morbidity and mortality.
Since 1983, the Porcupine Health Unit has provided genetic
screening. The genetic program started in Northeastern
Ontario in the year 1976 in Sudbury. Figure 19 shows the
major causes of referral to the Porcupine Health Unit Genetics Services.
Figure 20 shows the rate of congenital anomalies in the
communities within the Porcupine Health Unit area for the
years 1989 to 2000. The rate was the highest in the Hornepayne area (519.0 per 10,000 live births) and was the lowest
in the Smooth Rock Falls area (111.1 per 10,000 live births).
Community Check-Up: Porcupine Health Unit
47
Chapter 4 References
1. Baird, P.A., Anderson, T.W., Newcombe, H.B., Lowry,
R.B. “Genetic Disorders in Children and Young Adults: A
Population Study.” Am J Hum Genet. 1988; 42 (5): 677- 693
2. Hall, J.G., Plowers, E.K., McIlvaine, R.E., Ean, V.H. “The
frequency and financial burden of genetic disease in a
pediatric hospital.” Am J Med Genet. 1978; 1 (4): 417-436
3. Childs, B. “Gene Mutation as a Cause of Human Disease,”
in Mutagenic Effects of Environmental Contamination, ed.
Sutton, H.E. and Harris, M.I. New York: Academic Press,
1972. 3-14
4. Scriver, C.R., “Window panes of eternity: health, disease, and
inherited risk,” Yale J Biol Med. 1982; 55: 506-509.
48
Community Check-Up: Porcupine Health Unit
5 g Health Risk Behaviour
Physical Activity
Physical activity levels are an important indicator used by policy makers to
implement healthy living and healthy weight programs. The activity level
is divided into three categories: (a) Active, an energy expenditure value
of 3.0 kcal/kg/day or higher; (b) Moderately Active, an energy expenditure value of 1.5–2.9 kcal/kg/day; and (c) Inactive, an energy expenditure
value of 1.5 kcal/kg/day. The activity level categories are extracted from
frequency, duration and intensity of the respondent’s participation in leisure-time physical activity in the Canadian Community Health Survey.
Community Check-Up: Porcupine Health Unit
49
Figure 21: Activity levels for Ontario and Porcupine Health Unit,
ages over 12, 2001-02
50
%
Ontario
47.1
48.2
PHU
Percentage
40
30
26.1
27.0
24.2
238.47
23.3
20
10
0
111.11
Physically Active
Source: Moderately Active
Inactive
CCHS 2.1, Statistics Canada
As Figure 21 shows, when comparing levels of physical activity between the Porcupine Health Unit and the Province of
Ontario, the differences were negligible.
50
Community Check-Up: Porcupine Health Unit
Figure 22: Leisure activity in Ontario and Porcupine Health Unit,
ages over 12, 2001-02
80
70
%
73.6
66.0
Ontario
60
PHU
50.6
Percentage
50
44.5
40
35.8
30
25.1
33.6
22.8
20
8.4
10
0
Source: Walking
Gardening
Swimming
Home exercise
6.9
No physical
activity
CCHS 2.1, Statistics Canada
Among the listed leisure activities, the people of the Porcupine Health Unit area enjoyed walking and gardening
more than their counterparts in Ontario (Figure 22). The differences were statistically significant. Swimming and home
exercise were not chosen as popular leisure activities by the
people of the health unit area. Figure 22 also shows that
the proportion of inactive people (at leisure activities) was
lower in the Porcupine Health Unit area than in Ontario.
Community Check-Up: Porcupine Health Unit
51
Figure 23: Type of smoking behaviour in Ontario and Porcupine Health Unit
area, 2001-02
50
%
Ontario
40
PHU
Percentage
30
20
37.1
39.3
40.6
28.5
27.1
16.7
10
3.2
0
Source: Daily
1.9
Occasional
Former
Never
CCHS 2.1, Statistics Canada
Smoking
Smoking is not only associated with respiratory and cardiovascular diseases, but it is also associated with various cancers and degenerative diseases. The health risks of smoking
depend on various factors, i.e., age of smoking initiation,
cumulative exposure in years, number of cigarettes smoked
and interaction with other factors. Recent data shows that
the age of smoking initiation has decreased substantially.
Even though males used to initiate smoking at an earlier
age than females, recent data shows that this trend has
changed. The smoking initiation age has become the same
in both genders among the 12 to 19 year age group. 1
The “type of smoker” or smoking behavior indicator
describes the proportion of persons over the age of 12,
52
Community Check-Up: Porcupine Health Unit
Figure 24: Proportion of daily smokers in Ontario and Porcupine
Health Unit area, 2001-02
%
14.5
15
12.6
12
Percentage
9.2
9
7.6
6
3
0
Male
Female
Male
PHU
Ontario
Source: Female
CCHS 2.1, Statistics Canada
who identified themselves as “daily”, “occasional”, “former” and “never” smoker. In spite of the decline in the
number of “daily” smokers in the Province of Ontario, 2 the
rate did not decline in the Porcupine Health Unit area. The
proportion of people who identified themselves as a “daily”
smoker was higher among the population of the Porcupine
Health Unit (27.1%) than that of Ontario (16.7%) (Figure
23). This difference was statistically significant.
When the proportion of “daily” smokers was compared
between genders in both Ontario and the Porcupine Health
Unit, it showed that a higher proportion of males smoked
“daily” compared to their female counterparts (Figure 24). In
Ontario, this difference was statistically significant, whereas
in the health unit area the difference was not.
Community Check-Up: Porcupine Health Unit
53
Figure 25: Proportion of individuals ( >12 years of age) exposed to second-hand
smoke at home in Ontario and Porcupine Health Unit area, 2001–02
%
100
Ontario
Percentage
80
80.0
PHU
69.8
60
40
25.8
20
0
Source: 15.4
Exposed at home
Not exposed
CCHS 2.1, Statistics Canada
About twenty-six percent (25.8%) of people in the Porcupine Health Unit area were exposed to second-hand smoke,
whereas only fifteen percent (15.4%) of people in Ontario
were exposed (Figure 25). This difference was statistically
significant.
54
Community Check-Up: Porcupine Health Unit
Alcohol
Alcohol use in Canada, Ontario, and the Porcupine Health
Unit area is on the rise. The CCHS 2.1 data analysis suggests
that, in the past 13 years, the use of alcohol has increased in
the Porcupine Health Unit catchment area.
Non-drinkers were defined by Statistics Canada as the
proportion of the population, 12 years of age or older,
who had not consumed alcohol in the past 12 months. In
Ontario, the proportion decreased from 27% in the year
1996 –973 to 23% in 2001– 02. In 1990, 21% of the Porcupine Health Unit area population over 12 years of age
were identified as non-drinkers and 73% were identified
as current drinkers (drank alcohol at least once in the last
12 months), 4 whereas in 2001–02, twenty percent (20%)
of the population was identified as non-drinkers and 80%
identified as current drinkers. The rise in the proportion of
current drinkers is notable.
Low-risk drinkers were defined by the CCHS survey as the
proportion of drinkers, 20 years of age and over, who consumed 14 or fewer drinks per week for males or who consumed 9 or fewer drinks per week for females. In the Porcupine Health Unit area, 40% of the population were low-risk
drinkers, while in the province of Ontario, 49% (49.23%)
were low-risk drinkers. More women (22.3%) than men
(18.0%) in the Porcupine Health Unit area were low-risk
drinkers.
Heavy drinkers were identified as the proportion of current drinkers, aged 20 and over, who consumed more than
5 drinks on one occasion, more than once per month during the previous year. In the Porcupine Health Unit area,
Community Check-Up: Porcupine Health Unit
55
Figure 26: Frequency of drinking 5 or more drinks on one occasion in last 12
months, in Canada, Ontario & Porcupine Health Unit area, 2001-02
60
%
Canada
51.8
Ontario
53.7
PHU
50
42.2
Percentage
40
30.2
30
24.2
26.1
22.5
20
20.7
20.5
10
0
Never
Less than once a month
More than once a month
Frequency of having 5 or more drinks on one occasion
Source: CCHS 2.1, Statistics Canada
the proportion of heavy drinkers increased from 26% in
2000–01 to 30% in 2001–02.
Figure 26 compares the rate of alcohol drinkers who never
drank 5 or more drinks on one occasion in the last 12
months; 5 or more drinks on one occasion less than once a
month in the last 12 months; and 5 or more drinks on one
occasion more than once a month in the last 12 months.
Significantly, the proportion of heavy drinkers in the Porcupine Health Unit area was higher than that of both
Ontario and Canada.
56
Community Check-Up: Porcupine Health Unit
Figure 27: Percentage of Canadian population aged 15 years or older who
used marijuana in past years, by age group, 1994 & 2002
40
%
35
30
Percentage
25
20
15
10
5
0
15–17
18–19
20–24
25–34
35–44
45–54
m 1994
26
23
20
10
6
1
m 2002
29
38
35
18
11
6
Source: Statistics Canada
Substance Abuse
Substance abuse is an important public health issue and of
particular significance in the Porcupine Health Unit area. In
2004, Timmins experienced the shocking report of the death
of two teenagers who were victims of substance abuse.
Figure 27 outlines the distribution of marijuana use in different age groups across Canada and shows that the highest use of marijuana occurred from age 18 to 19 and then
it subsided according to age. The same figure also shows
that the use of marijuana increased significantly in all age
groups from 1994 to 2002.
Community Check-Up: Porcupine Health Unit
57
Figure 28: Percentage reporting marijuana use during past year, Grade 7–12,
1993–2003
35
1999
%
33.2
31.9
30
Percentage
2003
32.6
30.0
27.6
30.9
27.6 28.4
24.7
25
20
31.1
2001
19.2
20.8
15
10
5
0
Source: Toronto
North
West
East
Ontario Students Drug Use survey, 2003
Figure 28 shows the percentage of marijuana use among
students in Grades 7 to 12 in various regions of Ontario,
including Toronto. The graph shows that the rate of marijuana use increased in the period between 1999 and 2003.
The highest use was in the north region: 33.2%, compared
to 24.7% in Toronto. As the Porcupine Health Unit is located in the northern part of the province, the north region
cited above can contain data from the catchment area.
58
Community Check-Up: Porcupine Health Unit
Figure 29: Self-reported drug use (among those who reported taking drugs) in
the last 12 months in Timmins high schools, 1998–2000
50
%
Percentage
40
30
20
10
0
Marijuana
Hashish
Cocaine
Other
m Male
43.1
30.5
7.1
18.4
m Female
35.3
22.1
1.9
10.3
Source: Timmins Youth Needs Assessment Study, 1998–2000
A study was conducted by TYNA (Timmins Youth Needs
Assessment and Strategy Development) among high school
students in Timmins from 1998 to 2000. This is a very important study, as the data pertains to local students. About 17%
of the study participants stated that they used someone else’s
prescribed medication. Figure 29 shows that among those
who used illicit drugs, marijuana was the drug of choice, followed by hashish, cocaine and others. This figure also shows
that the prevalence of drug use was higher among males
than females.
Community Check-Up: Porcupine Health Unit
59
Figure 30: Self-reported drug use (among those who reported taking drugs) in
the last 12 months in Timmins high schools, 1998–2000
40
%
37.5
34.9
35
Marijuana
32.4
Hashish
Percentage
30
23.8
25
20
17.8
15.9
15
10
5
0
Source: 8.1
7.5
3.5
Daily
7.6
7.2
3.8
Almost daily
Weekly
Occasionally
Rarely
Never
Timmins Youth Needs Assessment Study, 1998–2000
About a quarter (23.8%) of high school students (who
reported some kind of drug use) said they used marijuana
occasionally whereas 15.9% used on weekly basis (Figure
30). Of the study participants, 44.3% said that it was very
easy to get marijuana in Timmins.
Boredom, peer pressure, stress, bad family influences, and
lack of parental attention were some of the important risk
factors for drug use in the area, according to the study participants. Inaccessibility of activities due to expense or lack of
transportation, lack of a place to “hang out”, and the long
winter season might be other reasons for illicit drug use.
According to the TYNA study participants, the most effective technique to prevent the use of illicit drugs could be
a presentation done by an individual who survived drug
dependency, or by a health care professional or member of
a law-enforcing agency. Respondents suggested that strict
60
Community Check-Up: Porcupine Health Unit
law enforcement (e.g., undercover police or unannounced inspections of
the school and schoolyard) could also be used to curb the prevalence of
drug abuse.
Chapter 5 References
1. Statistics Canada. Health Indicators, vol. 2004, no. 1. “Smoking initiation
2003.” Catalogue no. 820221-XIE
2. Statistics Canada. Report on smoking in Canada, 1985 to 2001. Catalogue
no. 82F0077XIE
3. Sudbury and District Health Unit. Alcohol Use: Results for Sudbury and
Districts from the Canadian community Health Survey. Sudbury: Public
Health Research, Education and Development (PHRED) Program, Sudbury
and District Health Unit, 2005
4. Ontario Ministry of Health and Long-term Care, Ontario Health Survey,
1990.
Community Check-Up: Porcupine Health Unit
61
62
Community Check-Up: Porcupine Health Unit
6 g Nutrition
Healthy Weights–BMI
This chapter focuses on body mass index (BMI) and nutrition. Obesity has
emerged as the most important public health concern in recent years.
Current data indicate that obesity is increasing among children at an epidemic rate.
The experience of obesity is not a pleasant one and carries some serious
consequences, including type 2 diabetes, coronary heart disease and
stroke, hypertension, osteoarthritis, cancers (breast, endometrial, colon,
prostate and kidney) and also gall bladder disease. 1 Other health risks
include dyslipidemia, insulin resistance, obstructive sleep apnea, respiratory problems, difficulty performing activities of daily living, impaired fertility and psychosocial problems. 1
Community Check-Up: Porcupine Health Unit
63
Figure 31: Prevalence of obesity among boys and girls
80
%
74.5
Boys
67.7
70
Girls
Percentage
60
50
40
30
17.3
20
14.5
13.5
10.8
10
1.5
0
Source: 0.3
Underweight
Acceptable
weight
Overweight
Obese
Healthy Measures study, Porcupine Health Unit, 2004
In 2004, the Porcupine Health Unit conducted a cross-sectional study on childhood obesity among school-age children in the City of Timmins. 2 The overweight and obesity rate in the total study population was 28%. Boys were
found to be more overweight and obese than girls (Figure
31). The study was also compared with other studies and
found that the rate of overweight and obesity is same as
that of other jurisdictions.
64
Community Check-Up: Porcupine Health Unit
Table 15: Proportion of overweight and obesity, Ontario
Ontario
1996–97
Ontario
2000–01
Ontario
2001–02
Acceptable Weight
(BMI 18.5–24.9)
48.2%
47.4%
41.8%
Overweight
(BMI 25.0–29.9)
33.1%
32.9%
30.0%
Obese
(BMI 30.0 or higher)
12.0%
15.3%
13.4 %
Body Mass Index
Source: Ontario Health Survey, 1990. Ministry of Health and Long-term Care, Ontario and CCHS
1.1 and 2.1
The adult BMI statistics in this section have been extracted
from the Canadian Community Health Survey, 2.1, which
was conducted in 2001–02. BMI is defined as weight in
kilograms divided by height in metres squared. In this
section, BMI has been calculated for those aged 18 and
above, excluding pregnant women. The international
standard for BMI has been used in this analysis. According to the international standard for BMI, underweight is
regarded as having a BMI under 18.5, acceptable weight is
18.5–24.9, overweight is 25.0–29.9, and obese is regarded
as having a BMI above 30.0. The rate of obesity in Ontario
has increased from 12% in the year 1996–97 to 13.4% in
2001–02 (Table 15).
Community Check-Up: Porcupine Health Unit
65
Figure 32: Weight categories for Ontario and Porcupine Health Unit,
ages over 18, 2001–02
50
%
Ontario
41.8
PHU
40
Percentage
31.2
30
33.1
30.0
20.1
20
13.4
10
0
Source:
Acceptable weight
BMI 18.5−24.9
Overweight
BMI 25.0−29.9
Obese
BMI > 30
CCHS 2.1, Statistics Canada
Figure 32 shows that the rate of obesity was higher in the
Porcupine Health Unit area than in the province (20.1%
vs. 13.4%, which was statistically different) and the rate of
overweight was higher in the area than in Ontario (33.1%
vs. 30.0%). This data analysis may not match the analysis
done by Statistics Canada because of a different methodology and also the inclusion of a “Not Applicable” category
in this analysis.
66
Community Check-Up: Porcupine Health Unit
Figure 33: Weight categories for Porcupine Health Unit, by gender,
ages over 20-64, 2001–02
25
%
Female
Male
20.4
Percentage
20
15
18.0
13.2
12.7
10.7
10
9.4
5
0
Source:
Acceptable weight
BMI 18.5-24.9
Overweight
BMI 25.0-29.9
Obese
BMI > 30
CCHS 2.1, Statistics Canada
According to Figure 33, males were more overweight and
obese than females in the Porcupine Health Unit area and
there was a statistically significant difference between
males and females in the overweight group.
Community Check-Up: Porcupine Health Unit
67
Figure 34: Weight categories for Porcupine Health Unit, by age group (over 18),
2001–02
20
%
18-34
18.0
35-44
Over 45
Percentage
15
13.9
10.9
10.6
10
8.4
6.7
6.7
5.4
5
0
Source:
3.8
Acceptable weight
BMI 18.5−24.9
Overweight
BMI 25.0−29.9
Obese
BMI > 30
CCHS 2.1, Statistics Canada
The prevalence of overweight and obesity were also analyzed according to age groups. The three groups were:
between ages of 18 and 34; between ages of 35 and 44; and
above the age of 45. Figure 34 shows that the prevalence of
acceptable weight, overweight and obesity was the highest
among people over the age of 45. This could be due to the
fact that a higher proportion of people in this age group
responded to the Canadian Community Health Survey.
68
Community Check-Up: Porcupine Health Unit
Figure 35: Vegetables and fruit consumption per day for Ontario and
Porcupine Health Unit, 2001–02
80
%
Ontario
70
PHU
63.3
60
55.3
Percentage
50
40
36.5
29.2
30
20
10
0
Source:
less than 5 servings
per day
5 – 10 servings
per day
CCHS 2.1, Statistics Canada
Vegetables and Fruit Consumption
It is important to have a balanced diet to maintain a healthy
life. According to Canada’s Food Guide to Healthy Eating,
5–10 servings of vegetables and fruit are recommended
per day. This section explores the data for the Porcupine
Health Unit compared with that of Ontario. The data were
also stratified according to age and gender. The data for
this section were extracted from the Canadian Community
Health Survey, 2.1.
Figure 35 shows that a lower percentage of people in the
Porcupine Health Unit area consumed the recommended 5–
10 servings of vegetables and fruit, compared with that of
Ontario. This difference was statistically significant. Twentynine percent of people in the health unit area consumed
Community Check-Up: Porcupine Health Unit
69
Figure 36: Vegetables and fruit consumption per day for Porcupine Health
Unit, by gender, 2001–02
35
%
Male
Female
34.7
30
28.7
Percentage
25
20
18.2
15
11.0
10
5
0
Source:
less than 5 servings
per day
5 – 10 servings
per day
CCHS 2.1, Statistics Canada
5–10 servings of vegetables and fruit, compared to thirty-six
percent of the Ontario population.
When vegetables and fruit consumption between two genders were compared, it showed that a lower percentage of
males (11.0%) consumed the recommended servings per
day than their female counterparts (18.2%), a statistically
significant difference (Figure 36).
70
Community Check-Up: Porcupine Health Unit
Figure 37: Vegetables and fruit consumption per day for Porcupine Health
Unit, for ages over 18, 2001–02 (5–10 servings per day)
15
%
12.1
Percentage
12
9
6.6
6.3
18–34
35–44
6
3
0
Source:
> 45
CCHS 2.1, Statistics Canada
Finally, the consumption of the recommended 5–10 servings of vegetables and fruit were compared among different age categories (Figure 37). Among the three age categories, a higher percentage of people in the age group
above 45 years consumed the recommended 5–10 servings
of vegetables and fruit every day than two other groups.
This difference was statistically significant.
Community Check-Up: Porcupine Health Unit
71
Chapter 6 References
1. Basrur, S., Chief Medical Officer of Health, Ontario. 2004
Chief Medical Officer of Health Report: Healthy Weights,
Healthy Lives. 2005
2. Haque, F., de la Rocha, A.G., Horbul, B.A., Desroches, P., et
al. Prevalence of childhood obesity in a Northeastern Ontario
city: a cross-sectional study. (Healthy Measure Study–2004)
96th Annual Canadian Public Health Association Conference,
Ottawa, 2005
72
Community Check-Up: Porcupine Health Unit
7 g Dental Health
The term caries-free children is defined as the children who have never
experienced dental caries or cavities. A dental caries is determined when
a lesion is found in a pit or on the surface of a tooth with an identifiable
softened floor, undermined enamel or softened wall. Teeth with temporary fillings also fall into this category. The objective of the Porcupine Health
Unit is to increase the proportion of children with good oral health.
Community Check-Up: Porcupine Health Unit
73
Figure 38: Percentage of children with acute tooth decay (1996–2005)
15
%
13.6
Percentage
12
12.2
11.2
12.5
13.1
13.7
14.2
14.7
10.8
9
6
3
0
Source: 1996/7
1997/8
1998/9
1999/
2000
2000/1
2001/2
2002/3
2003/4
2004/5
DIS data
The Porcupine Health Unit Dental Services annually provide
students in Grades JK, 2, 4, 6 and 8 with dental screening
to determine their oral health status. The percentage of
children with tooth decay has increased in the Porcupine
Health Unit area from 1996 to 2005 (Figure 38), and at the
same time, the number of caries-free children has declined
in the area.
A complete Dental Indices Survey (DIS) is provided following ministry protocols to collect data on the oral health of
young children in our population. Due to small sample size,
missing data, different methodology, the regional comparison of the caries-free children are presented only for 5-yearold children in Figure 39. The proportion of caries-free chil-
74
Community Check-Up: Porcupine Health Unit
Figure 39: Caries-free 5 year old children in various Northern Ontario
health units, 2002–04
80
%
70
60
Percentage
50
40
30
20
10
0
2002–03
2003–04
m PHU
58.0
52.0
m Sudbury
71.4
71.2
m North Bay
64.8
63.0
m Algoma
51.9
53.1
m Thunder Bay
59.9
66.1
Source:
DIS data
dren has declined from 58% in the year 2002–03 to 52% in
2003–04. In the year 2003–2004, the proportion was lowest
in the Porcupine Health Unit area at 52.0%, whereas the
Sudbury Health Unit area ranked the highest at 71.2%.
The Deft Index denotes the number of primary, decayed,
extracted or filled teeth due to dental decay and indicates
the severity of dental disease. This index is used as an indicator of the dental health status of young children in a community. The goal of the health unit is to achieve a lower deft
index. The lower the index, the better the dental health
status of the health unit population. One of the objectives
Community Check-Up: Porcupine Health Unit
75
Figure 40: Mean deft score for 5-year-old children in various Northern
Ontario health units, 2002–04
2.5
Mean deft score
2.0
1.5
1.0
0.5
0.0
2000–01
2001–02
2002–03
2003–04
m PHU
1.8
2.0
2.0
2.4
m Sudbury
1.5
1.2
1.1
1.2
no data
no data
1.5
1.7
m Algoma
2.0
2.2
2.4
2.3
m Thunder Bay
2.3
2.2
2.2
2.0
m North Bay
Source:
DIS data
of the Public Health Mandatory Health Programs and Service Guidelines is to reduce the prevalence of dental disease
in children.
Due to small sample size, missing data and different methodology, the regional comparison of the deft Index are presented only for 5-year-old children in Figure 40. The figure
shows that the deft Index increased 33% in the Porcupine
Health Unit area, from 1.8 in 2000–01 to 2.4 in 2003–04.
76
Community Check-Up: Porcupine Health Unit
8 g Mental Health
Mental illness can be defined as alterations in thinking, mood and/or
behaviour associated with significant distress and impaired functioning
over an extended period of time. The symptoms, which can vary from mild
to severe, will depend on the type of mental illness, the patient, the family
and the socio-economic environment. 1
Every individual goes through stressful events during his or her lifetime and
learns how to cope with it. When the event is overwhelming or prolonged,
it can lead to mental illness. Physical health and mental health are intermingled. People who suffer from physical ailments can also suffer from
depression or anxiety. On the other hand, people who suffer from mental
illness, such as eating disorders, can suffer weight loss or electrolyte imbalance. 1
Mental illness affects all ages. According to the Canadian Institute for
Health Information, the rate of hospitalization due to mental illness
in women in all age groups was higher than in their male counterparts.
About half of the hospital admissions (due to one of the seven most common mental illnesses) were in the 15 to 44 age group, whereas a quarter
(24%) of the hospitalizations were among the 45 to 64 age group. 1 These
data show the significance of preventive programs to curb the prevalence
of mental illnesses.
Community Check-Up: Porcupine Health Unit
77
Figure 41: Prevalence of mental illnesses, comparing rates between males &
females in Canada, 2002–03
40
%
39.6
30
27.1
25.7
25
Percentage
Female
Male
35
20
19.4
17.5
15
13.7
10
8.0
5
9.7
8.8
4.8
3.0
14.3
3.1
5.2
r
he
Ot
or
lat
e
d
dis
dis
ot
ic
Sb
s
ta
nc
e-
re
yc
h
nia
/p
s
hr
e
Sc
hiz
op
de
de
or
de
or
dis
na
lit
y
Pe
r
r
r
rs
r
de
or
so
M
oo
d
dis
iso
ga
nic
d
Or
An
xie
ty
dis
or
rd
de
r
er
0
Source:
Hospital Mental Health Database, Canadian Institute for Health Information, 2002–03
Mental illness has an enormous impact on the Canadian
economy. A comprehensive report has not yet been published to quantify the burden of mental illness on society.
However, one study, done by Health Canada in 1993, used
various administrative and survey data, including physician
billing data, hospitalization data and data on self-reported
activity restriction. This study estimated that the cost of mental illness was 7.33 billion Canadian dollars. 2 In 2001, another
study, which included the National Population Health Survey
data, showed that the annual economic impact of mental
health illness in Canada was 14.4 billion Canadian dollars. 3
The author concluded that this could be an underestimate.
The Canadian Institute for Health Information reported that
among the seven most common mental illnesses, mood
disorder had the highest prevalence rate (27.1% in males
78
Community Check-Up: Porcupine Health Unit
Figure 42: Prevalence of mental illnesses, in Timmins, 2004–05
50
%
46.8
38.2
40
Percentage
30
20
10
r
he
Ot
s
ap
dic
de
dis
d
De
ve
lo
pm
lat
e
re
st a
nc
e-
na
lit
y
so
Pe
r
2.1
en
ta
lh
an
or
or
dis
or
dis
d
oo
M
rs
rs
de
rs
de
de
or
dis
ot
ic
yc
h
0.6
Sc
hiz
op
hr
e
nia
/p
s
so
fa
er
rd
r
ce
ce
n
les
do
dis
ty
An
xie
Di
so
Ad
jus
tm
en
td
iso
or
rd
de
er
rs
s
0
3.9
2.3
0.8
Su
b
3.5
0.8
Source: Canadian Mental Health Association (Cochrane-Timiskaming Branch)
and 39.6% in females). Anxiety disorders (3.0% in males
and 4.8% in females) had the lowest prevalence in the year
2002–2003 (Figure 41) but due to lack of the original data,
the comparisons could not be analyzed statistically.
The Cochrane-Timiskaming Branch of the Canadian Mental
Health Association has provided data on the prevalence of
mental illnesses in the Timmins area (Figure 42). Due to the
lack of provincial data, the prevalence rate was not compared with that of the Province of Ontario. According to
these statistics, mood disorders had the highest prevalence
rate (48%), followed by schizophrenia and other psychotic
diseases (38%). Adjustment disorders had the lowest prevalence rate (1%) among the population of Timmins in the
year 2004–2005.
Community Check-Up: Porcupine Health Unit
79
Due to different methodologies and categorization, the prevalence rate
of Canada and Timmins was not compared; however, the trend of mental illnesses in Timmins area was similar to that of Canada.
Chapter 8 References
1. Stewart, P., Lips, T., Lakaski, C., Upshall, P. Health Canada. A Report on
Mental Illnesses in Canada. Ottawa, Canada 2002
2. Moore, R., Mao, Y., Zhang, J., Clarke, K. Economic Burden of Illness in
Canada, 1993. Health Canada, 1997 Ottawa
3. Stephens, T., Joubert, N. “The economic burden of mental health
problems.” Chronic Dis Can. 2001. 22(1): 18-23
80
Community Check-Up: Porcupine Health Unit
9 g Communicable &
Infectious Diseases
Gastrointestinal Infection
Gastrointestinal infections occur due to the invasion of organisms into
the human gastrointestinal tract. Proliferation of these organisms in the
human body causes a number of symptoms like nausea, vomiting, watery
or bloody diarrhea, abdominal distension or bloating. The organisms can
be ingested by eating uncooked or partially-cooked poultry, meat or fish.
These organisms can also be ingested by using contaminated kitchen utensils. Some gastrointestinal infections — e.g., Yersinia enterocolitica — occur
due to ingestion of unpasteurized milk or milk products. Among gastrointestinal infections, campylobacter, which causes bloody diarrhea, is the
most common type found in Canada.
Community Check-Up: Porcupine Health Unit
81
Table 16: Gastrointestinal infections in the Porcupine Health Unit, 1990-2004,
Rate/100,000
Year
Amoeba
Campylobacter
Cryptosporidium
Giardiasis
Salmonella
Shigela
1990
5.0
39.7
0
24.8
13.9
32.7
4.0
1991
6.0
45.1
0
25.0
26.0
3.0
7.0
1992
2.0
60.3
0
39.2
22.1
0
7.0
1993
6.0
38.2
0
26.1
20.1
0
6.0
1994
2.0
40.2
0
15.1
24.1
1.0
2.0
1995
3.0
40.1
0
17.0
18.0
0
3.0
1996
3.0
35.0
1.0
26.0
26.0
2.0
5.0
1997
6.0
32.2
1.0
20.1
14.1
1.0
7.0
1998
2.0
32.2
1.0
22.5
28.6
2.0
0
1999
1.0
28.0
0
19.7
19.7
0
1.0
2000
0
10.6
1.1
6.4
17.0
0
1.1
2001
0
9.7
1.1
11.8
5.4
0
0
2002
0
11.0
1.0
6.0
7.0
0
2.0
2003
1.0
10.9
5.0
5.0
9.9
0
1.0
2004
2.2
5.6
1.1
9.0
11.2
1.1
1.1
Source:
Yersinia
Integrated Public Health System (iPHIS) database, 2006
Table 16 shows that the rate of campylobacter infection
decreased in the Porcupine Health Unit area since the year
2000. Salmonella infection was predominant in the region
and, like campylobacter, the rate of infection has decreased
since 2000. Among the bacteria which cause non-bloody
diarrhea, giardiasis was the most prevalent in the region.
The rate of giardiasis has also subsided since 2000.
82
Community Check-Up: Porcupine Health Unit
Table 17: Rate of hepatitis among the population of the Porcupine Health Unit area,
1990-2004, Rate/100,000
Year
Hepatitis A
Hepatitis C
1990
2.0
18.8
1.0
1991
2.0
16.0
1.0
1992
0
6.0
16.1
1993
1.0
3.0
22.1
1994
0
1.0
21.1
1995
2.0
2.0
36.1
1996
2.0
3.0
61.9
1997
2.0
1.0
29.2
1998
0
2.0
35.8
1999
0
0
60.2
2000
0
1.1
40.3
2001
0
1.1
35.5
2002
4.0
3.0
24.9
2003
1.0
2.0
36.8
1.1
24.7
2004
Source: Hepatitis B
Integrated Public Health System (iPHIS) database, 2006
Hepatitis
Among the hepatitis viruses, hepatitis B is the only DNA
virus. All other hepatitis viruses are RNA viruses. The hepatitis A virus is spread by the fecal-oral route, while hepatitis
B is spread through sexual contact and by body fluids i.e.,
blood, saliva, semen or vaginal fluid. The hepatitis C virus is
spread through infected blood. From 1990 to 2004, hepatitis C was the most prevalent of all three serotypes in the
Porcupine Health Unit area (Table 17).
Community Check-Up: Porcupine Health Unit
83
Table 18: Vaccine-preventable diseases, Porcupine Health Unit, Rate/100,000
Year
Source: Diphtheria
Haemopilus
Influenza B
Measles
Whooping Cough
1990
0
1.9
1.9
36.7
1991
0
1.0
144.2
2.0
1992
0
0
0
4.0
1993
0
1.0
0
13.1
1994
1.0
0
0
88.5
1995
1.0
0
2.0
38.1
1996
0
0
0
2.0
1997
0
1.0
0
4.0
1998
0
0
1.0
147.2
1999
0
0
1.0
30.1
2000
0
0
0
2.1
2001
0
0
0
2.2
2002
0
1.0
0
17.0
2003
0
0
0
7.0
2004
0
0
0
4.5
Integrated Public Health System (iPHIS) database, 2006
Vaccine-Preventable Diseases
Diphtheria, haemophilus influenza B, measles and pertussis (whooping cough) were the most common vaccine-preventable diseases found in the population of the Porcupine
Health Unit area. The area experienced an outbreak of
whooping cough in 1998 (Table 18), after which the rate
subsided. The area also experienced an outbreak of measles
in 1991, when 144 children were infected.
84
Community Check-Up: Porcupine Health Unit
Table 19: Source: Sexually transmitted infections in the Porcupine Health Unit
Rate/100,000 population
Year
Chlamydia
Gonorrhea
HIV
Syphilis
1990
93.2
29.8
0
1.0
1991
123.2
3.0
2.0
0
1992
123.6
2.0
1.0
0
1993
103.5
1.0
1.0
1.0
1994
180.1
2.0
0
0
1995
175.4
4.0
0
1.0
1996
112.9
4.0
0
0
1997
110.7
1.0
0
0
1998
142.1
2.0
1.0
0
1999
139.2
2.1
1.0
0
2000
146.4
0
0
0
2001
200.4
1.1
0
0
2002
147.7
2.0
0
0
2003
187.1
2.0
0
0
2004
226.7
2.2
0
0
Integrated Public Health System (iPHIS) database, 2006
Sexually Transmitted Infections
The rise of some sexually transmitted infections (STIs) are
becoming one of the new challenges for the public health
sector. The rate of chlamydia infection has surmounted all
other STIs in the area (Table 19). The Porcupine Health Unit
has shown increases and decreases in chlamydia infections
over the years, however there has been an overall increase
(2.4 times the number of infections) from 1990 to 2004
(Table 19).
Community Check-Up: Porcupine Health Unit
85
Figure 43: Comparison of chlamydia infection among Canada, Ontario and
Porcupine Health Unit (1996–2002)
250
Rate / 100,000
200
150
100
50
0
1996
1997
1998
1999
2000
2001
2002
115.9
113.9
129.0
138.2
151.0
160.7
178.9
m Ontario
91.5
87.4
99.1
108.4
117.7
137.8
149.6
m Canada
114.1
111.7
144.1
139.9
147.9
201.6
164.3
m PHU
Sources: iPHIS and Statistics Canada
When the chlamydia infection rates in the Porcupine Health
Unit were compared with Ontario and Canada, the Porcupine Health Unit area had the highest rates in most years
from 1996 to 2002 (Figure 43).
86
Community Check-Up: Porcupine Health Unit
10 g Morbidity Patterns
Hospitalization
The rate of hospitalization in Canada continued to decline until the year
2003–04, when the rate started to rise again. Even using the age standardized rate for hospitalization, the data show that the trend is levelling off.
The average length of hospital stay increased in the past decade and then
it decreased in the year 2003–04 (from 7.0 to 6.9 days) and stayed at the
same rate in the year 2004–05. 1
Community Check-Up: Porcupine Health Unit
87
Figure 44: Inpatient hospitalizations for Canada, 1995–96 to 2004–05
3,500,000
Hospitalizations
3,000,000
2,500,000
2,000,000
1,500,000
Canada
(excluding Quebec)
1,000,000
Canada
500,000
0
1995-96
1996-97
1997-98
1998-99 1999-2000 2000-01
2001-02
2002-03
2003-04
2004-05
Fiscal year
Sources: Discharge Abstract Database and Hospital Morbidity Database, Canadian Institute for Health Information
In the last decade, the inpatient hospitalization rate has
declined 13%, while the average number of days spent in
the hospital has increased by 3%. In 1995–96, acute care
hospitals received 2.5 million hospitalizations and the average length of stay was 6.7 days. After a decade, the hospitalization rate declined to 2.2 million in 2004–05 and the
average length of stay increased to 6.9 days. 1 An increased
number of ambulatory care services might be responsible
for this change.
88
Community Check-Up: Porcupine Health Unit
Figure 45: Leading causes of hospitalization in Ontario and in the Porcupine
Health Unit area, 2000–04
20
Ontario
19.7
PHU
16.7
15.6
12.2
12.0
11.4
12.1
11.2
10
9.2
7.9
7.8
5.7
5.6
7.6
6.8
6.5
5.0
5
2.9
ry
to
ira
Re
sp
bir
th
c
ch
y&
nc
eg
na
al
gic
olo
Ne
ur
ild
hia
yc
ps
&
cu
us
M
tri
al
let
ke
los
iso
nin
y
ar
po
y&
In
jur
nit
ou
rin
cri
Ge
do
g
1.9
ne
ve
En
sti
ge
cu
rd
iov
as
Ca
Ca
Di
er
nc
0
lar
2.4
Pr
Percentage
15
Sources: Provincial Health Planning Database (PHPDB), extracted July, 26, 2005. Health Planning Branch,
Ministry of Health and Long-Term Care, Ontario.
Figure 45 shows a comparison of the leading causes of hospitalization in Ontario and in the Porcupine Health Unit
area. In Ontario, the leading cause of hospitalization was
pregnancy and childbirth (19.7%), whereas, in the Porcupine Health Unit area, cardiovascular disease (15.6%) was
the leading cause of hospitalization from 2000 to 2004.
Community Check-Up: Porcupine Health Unit
89
Figure 46: Comparison of age-specific respiratory & cardiovascular rates,
Porcupine Health Unit area, 2000–04
60
%
56.0
Respiratory
diseases
50
47.1
Cardiovascular
diseases
40
Percentage
34.4
30
25.3
20
13.5
10.0
10
0
Sources: 0.5
0–4
3.2
0.7
1.0 0.6
5 – 14
15 – 19
7.8
20 – 44
45 – 64
65+
Provincial Health Planning Database (PHPDB), extracted July, 26, 2005. Health Planning Branch,
Ministry of Health and Long-Term Care, Ontario.
Figure 46 shows the age-specific disease rate for cardiovascular and respiratory diseases. The rate of hospitalization for both diseases increased
with the increased age of the population. Respiratory diseases were
prevalent in the young population (0–4 years). The lowest rate of respiratory diseases was reported in the 15–19 age group. As respiratory
diseases (e.g., the common cold) are contagious, during the school year
or in the day-care setting, infants and pre-kindergarten students get
infected more often with respiratory diseases than their counterparts
who do not go to school or day care.
90
Community Check-Up: Porcupine Health Unit
Table 20: Leading causes of hospitalization in the Porcupine Health Unit area
(% of hospitalizations, 2000–04)
Cause
Cancer
PHU
Hornepayne
Hearst
I. Falls
Kapus­
kasing
SRF
Timmins
Matheson
Moosonee
Cochrane
5.6
2.9
5.9
7.0
7.1
4.4
5.5
3.9
1.4
5.6
Cardiovascular
15.6
9.5
12.7
15.4
14.3
18.0
17.0
15.9
8.4
15.2
Digestive
11.4
15.0
12.1
13.1
16.0
14.2
9.1
13.6
9.8
12.0
Endocrine
2.9
3.6
2.5
2.7
2.7
4.2
2.9
2.8
3.6
2.8
Genitourinal
6.8
6.8
7.6
6.3
6.7
6.4
6.7
6.3
5.8
8.3
Injury &
Poisoning
1.9
2.2
1.8
2.1
2.2
1.8
1.4
2.3
4.4
2.5
Musculo­
skeletal
6.5
11.2
8.8
8.2
6.4
7.4
5.7
5.6
4.2
7.0
Neurological &
Psychiatric
12.2
8.2
10.0
12.3
12.3
12.7
13.1
8.7
11.9
11.7
Pregnancy
12.1
11.6
15.2
7.7
9.0
5.7
13.6
9.0
20.5
10.4
Respiratory
11.2
9.6
9.5
11.9
10.7
9.2
11.4
17.1
9.8
11.0
Supp. Class
8.2
11.5
8.5
7.9
6.6
10.8
8.2
8.5
12.5
7.4
Sources: Provincial Health Planning Database (PHPDB), extracted July, 26, 2005. Health Planning Branch,
Ministry of Health and Long-Term Care, Ontario.
Community Check-Up: Porcupine Health Unit
91
92
Community Check-Up: Porcupine Health Unit
11 g Cancer Statistics
Cancer Incidence
Cancer is one of the leading causes of death in Canada. According to the
Canadian Cancer Society, an estimated 149,000 people were afflicted with
cancer and an estimated number of 69,500 cancer-related deaths occurred
in Canada in 2005. Traditionally, men were more often afflicted with cancer and subsequently died more often due to cancer than women (4.7%
for new cases and 11.9% for deaths). 1
Cancer incidence is defined as the number of new cancer cases that occur in
a population in a particular year. Cancer mortality is defined as the number
of deaths that occur due to cancer in a population in a particular year. Here,
both indicators have been reported per 100,000 population. In the calculation of both indicators, 1996 Canadian population estimates were used.
Community Check-Up: Porcupine Health Unit
93
Figure 47: Leading cause of cancer incidence, in both genders,
Porcupine Health Unit area, 2002
80
70
60
Rate / 100,000
61.9
59.0
61.6
56.3
50
40
30
20
12.6
9.7
10
11.0
12.4
9.1
7.7
ia
m
us
ph
leu
ke
er
Ut
r
de
ad
Bl
ix
rv
Ce
te
ta
os
Pr
as
Pa
nc
re
st
ea
Br
h
ac
om
St
Tr
ac
he
a,
Ly
br
m
on
ch
Co
us
lor
ec
, lu
ta
l
ng
0
Source: Cancer Care Ontario, 2004
Among the leading causes of cancer incidence in the Porcupine Health Unit area, the incidence rate of cancer of the
trachea, bronchus and lung was the highest (61.9/100,000)
in both genders, followed by breast cancer (61.6/100,000),
colorectal (59/100,000), and prostate (56.3/100,000). The
lowest prevalent, at 7.7/100,000, was the uterine cancer
rate (Figure 47).
94
Community Check-Up: Porcupine Health Unit
Figure 48: Trends of the incidence of trachea, bronchus and lung cancer,
in Ontario and Porcupine Health Unit area, 1983–2002
120
Rate / 100,000
100
80
60
40
20
0
1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
m Ontario
60.3 60.1 60.5 60.8 60.2 61.9 61.0 61.4 61.5 61.8 60.8 58.9 58.5 59.4 57.2 58.5 57.0 57.0 57.3 54.4
m PHU
93.4 98.0 92.7 95.1 91.0 105.0 84.4 80.4 94.5 90.8 74.0 112.0 86.0 79.0 56.8 78.1 75.9 77.1 90.4 61.9
Source: Cancer Care Ontario, 2004
Between 1983 and 2002, the incidence rate of cancers
of the trachea, bronchus and lung decreased 34% from
93.4/100,000 to 61.9/100,000 (Figure 48), whereas the provincial rate during this 20 years remained quite similar and
only decreased 10% (9.7%) in that two decade period. During the last 20 years, the incidence rate of trachea, bronchus
and lung cancers in the Porcupine Health Unit area was the
highest in 1994 (112/100,000) and lowest in 2002.
Community Check-Up: Porcupine Health Unit
95
Figure 49: Trends of the incidence of prostate cancer,
in Ontario and Porcupine Health Unit area, 1983–2002
100
Rate / 100,000
80
60
40
20
0
1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
m Ontario
31.4
33.4 34.2 34.8 35.9 36.0
m PHU
27.2
23.9 28.4
Source: 37.5
37.5
42.1
49.2 55.2 58.2 56.2 50.3 53.0
44.1 28.3 33.0 52.0 66.4 54.7 46.9 52.6
49.1
57.8
56.7 56.8 60.7 66.2 62.6
44.4 56.7 40.6
67.7
99.4
51.6
56.3
Cancer Care Ontario, 2004
Among the 10 leading cancer sites in males, prostate cancer
had the highest rate (30%), followed by trachea, bronchus
and lung (23%).2 The rate of prostate cancer increased significantly from 27.2/100,000 in 1983 to 56.3/100,000 in 2002
(Figure 49). This increase was more than double. During
the last 20 year period, the rate was the highest in 2000 at
99.4/100,000.
96
Community Check-Up: Porcupine Health Unit
Figure 50: Trends of breast cancer incidence,
in Ontario and Porcupine Health Unit area, 1983–2002
80
70
Rate / 100,000
60
50
40
30
20
10
0
1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
m Ontario
51.1
m PHU
53.2 47.4 52.6 46.0 34.2 56.3 46.6 50.2 41.8 46.9 56.6 46.9 42.9 37.5
Source: 52.7 53.4 51.2 52.8 56.4 55.6 55.0 58.7 59.6 57.0 56.6 56.9 56.5 58.7 57.8 58.8 56.3 56.1
61.9
41.4
67.6
57.7
51.9
57.9
61.6
Cancer Care Ontario, 2004
Among the 10 leading cancer sites in females, breast cancer
incidence was the highest (41%), followed by trachea, bronchus and lung (14%) in 2002.2 Breast cancer incidence went
up 16% (15.8%), during the last 20 years from 1983 to 2002
(Figure 50). The incidence of breast cancer was the highest
in 1999 (67.6/100,000) and the lowest in 1987 (34.2/100,000)
during the same time period. The provincial rate was lower
than that of the Porcupine Health Unit rate in 2002. Due
to calculation difficulties, the rates could not be compared
statistically.
Community Check-Up: Porcupine Health Unit
97
Figure 51: Mortality due to cancer of the trachea, bronchus and lung,
in Ontario and Porcupine Health Unit area, 1983–2002
100
Rate / 100,000
80
60
40
20
0
1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
m Ontario
48.4 49.6 49.7 48.0 48.9
m PHU
81.7 73.9 79.7 68.7 95.7 68.7
Source: 51.1
49.6 49.6 49.2 48.3 50.0 49.4
76.1
72.9 66.8 65.5
47.3
47.6
45.9 46.9
71.5 68.8 60.3 75.3 64.1
61.1
47.7
45.8
46.4 45.5
49.5
62.9
75.5 64.6
Cancer Care Ontario, 2004
Cancer Mortality
Among the leading causes of cancer mortality, trachea,
bronchus and lung cancer was the highest. In 2002, among
all cancer deaths, 38% of cancer deaths in males and 36% of
cancer deaths in females occurred due to cancer of trachea,
bronchus and lungs. 2 In both genders, the mortality rates
remained high over the last 20 years. A decline of twentyone percent (20.9%) occurred in cancer mortality of trachea,
bronchus and lung in the Porcupine Health Unit area from
1983 to 2002 (Figure 51), whereas in the province, there was
only a 6% decline in the same cancer mortality through the
same 20 year period.
98
Community Check-Up: Porcupine Health Unit
Figure 52: Mortality due to breast cancer, in Ontario and
Porcupine Health Unit area, 1983–2002
30
Rate / 100,000
25
20
15
10
5
0
1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
m Ontario
18.6 19.4
m PHU
29.5 16.6 19.6 14.2
Source: 19.6
19.7
19.3 18.8 19.4 18.3 18.0 18.0
17.9
18.2 18.0
17.4
17.7
15.9
13.8
14.4 20.6
17.1
18.3
17.9
8.5
17.4
17.7
16.6 15.0 14.9
8.8
7.5
15.5 14.6 14.4
12.1
15.9
14.0
Cancer Care Ontario, 2004
Among the ten leading causes of cancer mortality in females,
breast cancer mortality ranked second (17%), preceded by
mortality due to cancer of the trachea, bronchus and lung
(36%) in 2002.
Breast cancer mortality has declined in the Porcupine Health
Unit area in the last 20 years (Figure 52): 53% (52.7%) from
1983 (29.6/100,000) to 2002 (14/100,000). The highest proportion of deaths occurred in the year 1983 (29.6/100,000)
and the lowest proportion of deaths occurred in 1999
(7.6/100,000).
Community Check-Up: Porcupine Health Unit
99
Figure 53: Mortality due to prostate cancer, in Ontario and
Porcupine Health Unit area, 1983–2002
25
Rate / 100,000
20
15
10
5
0
1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
m Ontario
11.0 10.6 11.5
m PHU
15.5 11.2 24.5 12.3
Source: 11.0 12.2 12.3
17.0
6.5
11.9
12.0 12.2 12.6 12.8 12.7 12.6
12.5 18.1
11.4
11.9
11.8
11.5 10.9 10.6 10.6 10.3
17.0 16.5 15.9 19.2 15.0 10.8 14.8 11.7
13.2 11.3
13.1
Cancer Care Ontario, 2004
Prostate cancer was the second-leading cause of cancer
mortality among men in the Porcupine Health Unit area, at
15% in 2002. It was preceded by cancer of the trachea, bronchus and lungs (38%). The mortality trend due to prostate
cancer remained somewhat the same over the last 20 years
except for a peak in the year 1985 (24.5/100,000) (Figure 53).
There was only a 16% (15.5%) mortality decline from 1983
to 2002 in the health unit area, whereas there was only a
6% mortality decline in the province of Ontario.
100
Community Check-Up: Porcupine Health Unit
Figure 54: Mortality due to colon cancer, in Ontario and
Porcupine Health Unit area, 1983–2002
35
30
Rate / 100,000
25
20
15
10
5
0
1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
m Ontario
19.5 20.2 19.9 19.2 18.9 19.4 18.8 17.3 16.9 16.6 15.6 16.1 16.9 16.0 15.4 15.3 15.7 15.5 15.0 15.7
m PHU
22.0 21.1
Source: 19.1 33.2 33.6
8.7
20.3 21.7 22.3 22.9
9.1
17.9 24.4 29.3 10.5 25.4 21.7 13.7 14.9 23.2
Cancer Care Ontario, 2004
Mortality due to colon cancer ranked third in both genders
among the 10 leading causes of cancer mortality in the year
2002 (14% in females and 12% in males). There was a 6%
(5.5%) mortality increase in the health unit area (Figure 54)
whereas in the province there was a 20% (19.5%) decline.
Due to calculation difficulties the rates could not be statistically compared. There were some peaks during the last 20
years, two in the years 1986 and 1987 and the other two
were in 1995 and 1996.
Community Check-Up: Porcupine Health Unit
101
Chapter 11 References:
1. Canadian Cancer Society/National Cancer Institute of
Canada: Canadian Cancer Statistics 2005, Toronto, Canada,
2005
2. Haque, F. Epi News, Porcupine Health Unit. 6(1), 2005
102
Community Check-Up: Porcupine Health Unit
12 g Mortality Patterns
Age-Specific Death Rate
Age-specific death rate can be defined as the death rate for a specific age
group for a defined population for a certain period of time. This rate identifies which groups of people die more than others. The higher death rate
could be due to a number of different factors, e.g., age, gender, or the vulnerability of a group, exposure to certain risk factors, for example, young
adolescents exposed to injury.
The overall age-specific death rate is higher in the Porcupine Health Unit
area than it is in Ontario as a whole. This could be due to the higher-aged
population. In addition, respiratory diseases are more prevalent in this area,
due perhaps to the mining industry or higher smoking rates.
Community Check-Up: Porcupine Health Unit
103
Table 21: Age-specific death counts and rates (per 1000 population), Porcupine
Health Unit and Ontario (1997–2001)
Porcupine Health Unit Area
Age
Sources: Mean age specific
death counts
(1997–2001)
Age specific death
rate, per 1,000
population
(1997–2001)
Ontario
Mean age specific
death counts
(1997–2001)
Age specific death
rate, per 1,000
population
(1997–2001)
0-14
8.0
0.4
1,063.0
0.5
15-24
8.2
0.7
677.6
0.5
25-44
30.4
1.2
3,310.0
0.9
45-54
42.8
3.3
4,431.0
2.7
55-64
71.0
8.5
7,842.8
7.4
65-74
158.2
24.9
16,751.4
20.4
75+
348.0
82.7
46,862.0
71.0
All ages
666.6
37.8
80,937.9
7.1
Provincial Health Planning Database (PHPDB), extracted July, 26, 2005. Health Planning Branch,
Ministry of Health and Long-Term Care, Ontario.
Table 21 shows the age-specific death counts and rates per
1,000 population in the Porcupine Health Unit area and
Ontario. The table shows that the death rates increased as
the age of the population increased. It is notable that the
age-specific death rates above the age of 45 are higher in
the health unit area than in Ontario.
104
Community Check-Up: Porcupine Health Unit
Figure 55: Life expectancy at birth, male and female, in Ontario, 1979–1999
84
81
Years
78
75
72
Female
69
Male
Source: 99
98
19
97
19
96
19
95
19
94
19
93
19
92
19
91
19
90
19
89
19
88
19
87
19
86
19
85
19
84
19
83
19
82
19
81
19
80
19
19
19
79
66
Statistics Canada
Life Expectancy
Figure 55 shows the comparison of life expectancy at birth
in males and females in Ontario over the 20-year period
from 1979 to 1999. The life expectancy at birth has increased
in both genders over the last 2 decades. In males, the life
expectancy has increased 7%, whereas in females the
increase was 4%. If the trend continues, the gap between
these two rates will be decrease even more.
Community Check-Up: Porcupine Health Unit
105
Figure 56: Life expectancy at age 65, male and female, in Ontario, 1979–1999
24
21
18
Years
15
12
9
6
Female
3
Male
Source: 99
98
19
97
19
96
19
95
19
94
19
93
19
92
19
91
19
90
19
89
19
88
19
87
19
86
19
85
19
84
19
83
19
82
19
81
19
80
19
19
19
79
0
Statistics Canada
Figure 56 shows that life expectancy at age 65 has increased
in both genders: 15% in males and 6% in females. As noted
earlier, if the trend continues at the same rate in the future
,the gap between these two rates will decrease.
106
Community Check-Up: Porcupine Health Unit
Figure 57: Life expectancy at birth, Northern health units and Ontario, 2001
84
82
82.0
81.0
80
80.2 80.0 80.4
79.4
78
Years
80.6
77.4
77.4
76
75.3
75.6
74
73.6 73.6
74.4 74.3
73.5
72
70
Male
Source: ing
ay
Tim
isk
am
y
rB
ur
Th
un
de
U
db
PH
Su
rn
y
ste
Ba
No
rth
we
a
m
No
rth
rio
go
Al
ta
On
ing
ay
isk
am
y
ur
rB
Tim
No
Th
un
de
U
db
PH
Su
rn
y
ste
Ba
rth
we
a
m
rth
go
No
Al
On
ta
rio
68
Female
Statistics Canada
Figure 57 shows the life expectancy at birth in Northern
Ontario health unit areas, along with the provincial rate in
the year 2001. Life expectancies of the population of the
Porcupine Health Unit area were lower than that of Ontario
in both genders and the differences were statistically significant. In males, the lowest life expectancy was among
the population of the Timiskaming Health Unit area and in
females, the lowest life expectancy was in the Northwestern Health Unit area.
Community Check-Up: Porcupine Health Unit
107
Figure 58: Life expectancy at age 65, Northern health units and Ontario, 2001
24
21
20.4
18
19.4 19.5
18.5 18.6
18.7
17.2
16.1 16.2 15.8
15
Years
19.9 19.5
15.0
15.6 15.9 15.2
12
9
6
3
Male
Source: ing
ay
Tim
isk
am
y
rB
ur
Th
un
de
U
db
PH
Su
rn
y
ste
Ba
No
rth
we
a
m
No
rth
go
rio
ta
Al
On
ing
ay
isk
am
y
ur
rB
Tim
No
Th
un
de
U
db
PH
Su
rn
y
ste
Ba
rth
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No
Al
On
ta
rio
0
Female
Statistics Canada
When life expectancies (at the age of 65) of the people in
the Porcupine Health Unit area were compared with other
northern health unit areas and the province of Ontario, it
was found that the population of the Porcupine Health
Unit area had a lower life expectancy than their provincial
counterpart and the difference was statistically significant.
Among males, the lowest life expectancy, at age 65, was in
the Porcupine Health Unit area and in females, the lowest
life expectancy, at age 65, was in the Northwestern Health
Unit area.
108
Community Check-Up: Porcupine Health Unit
Table 22: Cause specific deaths by ICD9-Chapter for the Porcupine Health Unit
and Ontario, 1997–2001, five-year average
Porcupine Health Unit
Ontario
Mean number of
deaths
in 5 years
Proportional
mortality
(% of deaths)
921
184.2
27.6
115,054
23,010.8
28.4
52
10.4
1.6
5,112
1,022.4
1.3
Diseases of circulatory
system and blood
forming organs
1,113
222.6
33.3
149,167
29,833.4
36.9
Diseases of the digestive systems
125
25.0
3.8
15,882
3,176.4
3.9
Diseases of the endocrine glands
135
27.0
4.1
15,280
3,056.0
3.8
Diseases of genitourinary system
100
20.0
3.0
7,865
1,573.0
1.9
Symptoms and signs &
Ill-defined conditions
143
28.6
4.3
9,061
1,812.2
2.2
67
13.4
0.0
Number of
deaths
ICD9- Chapter
Neoplasms
Congenital anomalies,
skin breast and musculoskeletal diseases
Eye, ear, nost, throat
and Immunologic
Infectious
Number of
deaths
Mean number of
deaths
in 5 years
Proportional
mortality
(% of deaths)
41
8.2
1.2
4,491
898.2
1.1
Injury and poisoning
189
37.8
5.7
20,873
4,174.6
5.2
Neurological disease
199
39.8
5.9
24,940
4,988.0
6.2
1,596
319.2
0.4
8.7
Pregnancy & child
birth
Respiratory disease
Total
Sources: 315
63.0
9.5
35,301
7,060.2
3,333
666.6
100.0
404,689
80,937.8
100.0%
Provincial Health Planning Database (PHPDB), extracted July, 26, 2005. Health Planning Branch,
Ministry of Health and Long-Term Care, Ontario.
Community Check-Up: Porcupine Health Unit
109
Table 23: Potential years of life lost by cause and sex, Porcupine Health Unit,
1997-2001, rate per 100,000, five-year average
Cause of death
110
Male
Female
Cancer
1,654
1,755
1,913
Injury and poisoning
1,231
1,229
197
Cardiovascular diseases and blood forming
diseases
1,178
2,494
871
Ill defined diseases
464
505
2,020
Respiratory system diseases
326
273
280
Diseases of nervous system and psychiatric
diseases
318
375
110
Congenital diseases
224
69
17
Digestive system diseases
186
492
44
Endocrine gland diseases
174
720
24
Genitourinary system diseases
105
336
6
Infectious diseases
123
173
31
87
71
30
Musculo-skeletal diseases
Source: Both genders
PHPDB, 2005
Community Check-Up: Porcupine Health Unit