Older Adult Health Status Report (LHIN)

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Older Adult Profile
• Older Adult Population • Projected Population Growth • Life Expectancy
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Social Determinants of Health

• Income
• Education Level
• Workforce Participation & Employment
• Housing
• Immigration
• Food Security
• Transportation
• Has a Medical Doctor


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General Health

• Perceived Physical Health
• Chronic Disease(s)
• Dental Health
• Activity Difficulties/Limitations
• Help Needed for Tasks
• Pain and Discomfort (including Arthritis and Back Problems)


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Mental Health (coming soon)

• Self-Rated Mental Health
• Life Satisfaction
• Life Stress
• Mental Illness (has Mood and/or Anxiety Disorders)
• Dementia Projections
• Mental Health and Related Emergency Department Visits and Hospitalizations

Lifestyle and Health Behaviours (coming soon)

• Fruit and Vegetable Consumption
• Physical Activity
• Alcohol Consumption
• Smoking Status
• Illicit Drug Use & Cannabis Use
• Flu Shot

Social Supports and Connections (coming soon)

• Marital Status
• Living Arrangements
• Sense of Community Belonging
• Elder Abuse (information)

Falls (coming soon)

• Fall-Related Emergency Department Visits
• Fall-Related Hospitalizations
• Fall-Related Mortality

Health Care Utilization (coming soon)

• Home Care
• Long-Term Care
• Use of and Reason for Emergency Medical Services
• Reasons for Emergency Department Visits
• Reasons for Hospitalizations
• Leading Causes of Death

Methods

APHEO Indicators

Some indicators for this report were selected from the list of core indicators recommended by the Association for Public Health Epidemiologists of Ontario (APHEO). APHEO has recognized the need for consistency among health reports.1 Its Core Indicators Working Group (CIWG) has aimed to systematically define and operationalize a core set of health indicators in Ontario. The CIWG works to ensure the Core Indicators are accurate, up-to-date and reflect the legislative requirements set in the Ontario Public Health Standards.1

Numerous APHEO indicators were assessed in this report. These include indicators related to the population; social environment and health; mortality, morbidity and health-related quality of life; chronic disease and injuries; behaviour and health; mental health; and use of health services.

Additional indicators were chosen for examination based on consultations with Health Analytics and Health Promotion management at Wellington-Dufferin-Guelph Public Health. Consideration was also paid to meeting the data requirements set out in the Ontario Public Health Standards, the Accountability Agreement Indicators of the Ministry of Health and Long-Term Care, and Wellington-Dufferin-Guelph Public Health’s Key Performance Indicators for monitoring set out in the 2011-2016 strategic plan.

Levels of Geography

Data in this report are shown for Wellington-Dufferin-Guelph (WDG) and for the province of Ontario to provide a comparison. Where possible, figures were calculated for Wellington and Dufferin Counties and the City of Guelph. In some cases, small numbers prevented the release of figures for these stratified geographies.

The accompanying interactive report enables the user to work with dynamic data. Users will be able to combine these regions in varying combinations to obtain information that is more specific to their data needs. A separate interactive report is also available for the LHIN sub-regions of WDG.  

Age Groupings

Age groupings in this report allow for comparisons between older adults, the under 55 age group and the total population. The age of older adults is stratified by 10-year groups to allow comparisons within this age group. In some cases, small numbers prevented the release of figures for stratified age groupings.

Time Period

Data from 2007-2014 were used from the Canadian Community Health Survey (CCHS) and grouped into two years to prevent the release of small figures. From IntelliHEALTH, data for population projections are used for the period 2017-2041 and for life expectancy are used for the period 2006-2012. Other data retrieved from IntelliHEALTH are used for the period from 2006-2015/16. Data from 2010-2036 are used for the dementia projections. EMS data were provided for the years 2013-2016 for the data on the number of annual calls.

 

References

  1. Association for Public Health Epidemiologists in Ontario (APHEO) [Internet]. Toronto: APHEO; c2011. Core indicators for public health in Ontario. 2014 [cited 2017 June 20]. Available from: http://core.apheo.ca/index.php?pid=55
Data Sources

The data used in this report were obtained from eight external sources. These include:

  • The Canadian Community Health Survey (CCHS)
  • IntelliHEALTH
    • National Ambulatory Care Reporting System (NACRS)
    • Discharge Abstract Database (DAD)
    • Vital Statistics: Live Births and Deaths
    • Population Estimates and Projections
  • Census and National Health Survey (NHS)
  • Dufferin County Paramedic Services
  • Guelph-Wellington Paramedic Services
  • Central West Local Health Integration Network
  • Waterloo-Wellington Local Health Integration Network
  • Dementia Projections for the Counties, Regional Municipalities and Districts of Ontario (using CSHA Prevalence Data) by Hopkins & Hopkins

Canadian Community Health Survey (CCHS)

Data from the Canadian Community Health Survey (CCHS) were used to provide estimates for several indicators, including the indicators included in Chapters 2: Social Determinants of Health; Chapter 3: General Health; Chapter 4: Mental Health; Chapter 5: Lifestyle and Health Behaviours; and Chapter 6: Social Supports and Connections.

CCHS collects data on mental health, physical health, and social and economic factors. Data are collected from persons aged 12 and over that live in a private dwelling. The surveyed sample includes people from each of the 115 health regions across Canada. Excluded from the survey are people that reside on Aboriginal Reserves and Crown Lands, full-time members of the Canadian Forces, institutionalized persons, and residents of certain remote regions. The CCHS represents approximately 98% of the Canadian population over the age of 12 years. Data from 2007-2014 were used and grouped into two year groups to prevent the release of small figures.

All reported estimates (percentages) from the CCHS conform to the reporting guidelines described in the 2011 CCHS User Guide.11 As per these guidelines, all reported estimates whose coefficient of variation (CV) falls within the marginal range (16.6 ≤ CV ≤ 33.3) are considered for general unrestricted release but are accompanied by a notation cautioning of their high sampling variability. The remaining reported estimates, which are not accompanied by a CV, can be interpreted with confidence as their CV falls within the acceptable range (0.0 ≤ CV ≤ 16.5). All estimates with a CV within the unacceptable range (CV > 33.3) were not included in the report.

IntelliHEALTH

Data from IntelliHEALTH Ontario were used to for indicators included in Chapter 1: Older Adult Profile; Chapter 4: Mental Health; Chapter 7: Falls; and Chapter 8: Health Care Utilization. All IntelliHEALTH data are presented as percentages or standardized rates per 1,000 people. Rates were calculated using population estimates provided by Statistics Canada, for the years 2006-2015.

Population Projections (chapter 1) were calculated using data provided by the Ontario Ministry of Finance (MOF). Population projections are produced by the MOF following every Census and updated regularly based on post-censal population estimates.

The Vital Statistics database collects information on all births (live births and stillbirths) and deaths registered in Ontario during a calendar year. This database was used to retrieve data on life expectancy (chapter 1) and cause of mortality (chapter 8). Vital Statistics data were retrieved for the period from 2006 to 2012.

The National Ambulatory Care Reporting System (NACRS) database collects information on all hospital and community based ambulatory care, including: emergency visits, day procedures, and outpatient and community based clinics that provide dialysis, cardiac catheterization, and oncology services. NACRS was used to retrieve data on mental health related (chapter 4), fall-related (chapter 7) and all causes (chapter 8) for emergency department visits and fall-related hospitalizations (chapter 7). NACRS data were retrieved for the period from 2006 to 2015.

The Discharge Abstract Database (DAD) collects information on hospital discharges. DAD was used to retrieve data on all-cause hospitalizations (chapter 8). DAD data were retrieved for the period from 2006 to 2015.

The Ontario Mental Health Reporting System (OHMRS) database collects information on adult inpatient mental health admissions and services. OHMRS was used to retrieve data on mental health related hospitalizations (chapter 4). OHMRS data were retrieved for the period from 2006 to 2015.

Census / National Health Survey (NHS)

Data from the 2011 and 2016 national censuses and the 2011 National Health Survey were used for indicators included in Chapter 1: Older Adult Profile; Chapter 2: Social Determinants of Health; Chapter 3: General Health; and Chapter 5: Social Supports and Connections.

The national census is carried out every five years in Canada and it surveys every Canadian resident across the country. The census provides a wide range of data on the Canadian population, including information on age and sex, type of dwelling, families and marital status, income, immigration, housing, education and labour. This data can be stratified into smaller geographical areas, by age and sex.

Emergency Medical Services (EMS)

Data on the use of emergency medical services (EMS) by residents of WDG (chapter 8) were provided courtesy of the Dufferin County Paramedic Services and Guelph-Wellington Paramedic Services. Both provided data on the number of annual EMS calls made from 2012 to 2016 and the leading primary complaints made by male and female patients 55 years and older when utilizing EMS, for the year 2016.

Local Health Integration Networks (LHINs)

Data on the use of long-term care homes and home care services was provided courtesy of the Central West LHIN and the Waterloo-Wellington LHIN. Data for number of long term care residents and homecare service recipients were provided for the period from 2012 to 2016. Data on the number of long term care beds were provided for the current year, as of October 1st, 2017.

Dementia Projections

Dementia projection data are provided for Wellington-Dufferin-Guelph and Ontario. These projections were obtained from a report published in 2010 by Robert W. Hopkins, Ph. D, with the Geriatric Psychiatry Programme. All dementia projections in this report are provided for the counties, regional municipalities, and census divisions of Ontario using data from 2010. Projections are made for each year from 2010 to 2036.

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