Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-13T03:44:05.521Z Has data issue: false hasContentIssue false

Trends in the Health Status of Older Manitobans, 1985 to 1999

Published online by Cambridge University Press:  31 March 2010

Verena H. Menec*
Affiliation:
University of Manitoba
Lisa Lix
Affiliation:
University of Manitoba
Leonard MacWilliam
Affiliation:
University of Manitoba
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Verena H. Menec, Ph.D., Department of Community Health Sciences, University of Manitoba, 750 Bannatyne Avenue, Winnipeg, MB R3E ON3. (menec@cc.umanitoba.ca)

Abstract

Trends in the health status of the entire senior population aged 65 years or older in Manitoba were examined over a 14-year period (1985–1999) using administrative data (about 150,000 individuals). Significant health gains were apparent for a number of important indicators, including acute myocardial infarction, stroke, cancer, and hip fractures, although some of these gains were restricted to urban areas. Improvements in these health indicators are significant, as they can have major implications for individuals' need for health services and ability to live independently. In contrast, chronic diseases were on the rise, with the prevalence of diabetes, hypertension, and dementia increasing substantially over the 14-year period. These trends suggest a need for a policy emphasis on prevention, such as reducing the prevalence of obesity, which is one risk factor for diabetes. Moreover, having sufficient care options in place for the growing number of individuals with dementia is an issue that will have to be addressed.

Résumé

Les tendances relatives à l'état de santé de toute la population du Manitoba âgée de 65 ans ou plus ont été étudiées sur une période de 14 ans, au moyen de données administratives (environ 150 000 personnes). Des gains considérables en santé ont été observés pour un certain nombre d'indicateurs, notamment du point de vue des infarctus aigus du myocarde, des accidents cérébraux vasculaires, des cancers et des fractures de la hanche. Cependant, certains de ces gains n'ont été observés que dans les zones urbaines. Les améliorations relatives à ces indicateurs de la santé sont importantes, puisqu'elles peuvent avoir des conséquences majeures sur les besoins des personnes en matiàre de soins de santé et sur leur aptitude à vivre de façon autonome. Par contre, la prévalence de maladies chroniques a augmenté ; le diabàte, l'hypertension et la démence ayant augmenté de façon substantielle au cours de la période de 14 ans. Ces tendances laissent supposer qu'il faut mettre l'accent sur les politiques de prévention, afin notamment de réduire la prévalence de l'obésité, qui constitue l'un des facteurs de risque du diabàte. Par ailleurs, il faudra se pencher sur la question de savoir si l'on dispose de suffisamment d'options en matiàre de soins pour le nombre croissant de personnes atteintes de démence.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barer, M.L., Evans, R.G., & Hertzman, C. (1995). Avalanche or glacier? Health care and the demographic rhetoric. Canadian Journal on Aging, 14(2), 193224.CrossRefGoogle Scholar
Black, C., Roos, N.P., Fransoo, R., & Martens, P. (1999). Comparative indicators of population health and health care use for Manitoba's Regional Health Authorities: A POPULIS project. Winnipeg: Manitoba Centre for Health Policy.Google Scholar
Blanchard, J.F., Ludwig, S., Wadja, A., Dean, H., Anderson, K., Kendall, O., & Depew, N. (1996). Incidence and prevalence of diabetes in Manitoba, 1986–1991. Diabetes Care, 19, 807811.CrossRefGoogle ScholarPubMed
Brownell, M., Lix, L., Ekuma, O., Derksen, S., De Haney, S., Bond, R., Fransoo, R., MacWilliam, L., & Bodnarchuk, J. (2003). Why is the health status of some Manitobans not improving? The widening gap in the health status of Manitobans. Winnipeg: Manitoba Centre for Health Policy.Google Scholar
Canadian Study of Health and Aging Working Group. (1994). Canadian Study of Health and Aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150, 899913.Google Scholar
Carrière, K.C., Roos, L.L., & Dover, D.C. (2000). Across time and space: Variations in hospital use during Canadian health reform. Health Services Research, 35, 467487.Google ScholarPubMed
Chen, J., & Millar, W.J. (2000). Are recent cohorts healthier than their predecessors? Health Reports, 11(4), 923.Google ScholarPubMed
Crimmins, E.M., & Saito, Y. (2001). Trends in healthy life expectancy in the United States, 1970–1990: Gender, racial, and educational differences. Social Science & Medicine, 52, 16291641.CrossRefGoogle ScholarPubMed
Cutler, D.M. (2001). Declining disability among the elderly. Health Affairs, 20, 1127.Google ScholarPubMed
Doblhammer, G., & Kytir, J. (2001). Compression or expansion of morbidity? Trends in healthy life expectancy in the elderly Austrian population between 1978 and 1998. Social Science and Medicine, 52, 385391.CrossRefGoogle ScholarPubMed
Dunn, O.J. (1961). Multiple comparisons among means. Journal of the American Statistical Association, 56, 5264.CrossRefGoogle Scholar
Dunn, J.E., Furner, S.E., & Miles, T.P. (1993). Do falls predict institutionalization in older persons? An analysis of data from the Longitudinal Study of Aging. Journal of Aging and Health, 5, 194207.Google Scholar
Evans, R.G., McGrail, K.M., Morgan, S.G., Barer, M.L., & Hertzman, C. (2001). Apocalypse no: Population aging and the future of health care systems. Canadian Journal on Aging, 20 (Suppl. 1), 160191.CrossRefGoogle Scholar
Foot, D.K., & Stoffman, D. (1996). Boom, bust, and echo: How to profit from the coming demographic shift. Toronto: MacFarlane Walter & Ross.Google Scholar
Fries, J.F. (1983). The compression of morbidity. Milbank Quarterly, 61, 397419.CrossRefGoogle ScholarPubMed
Gee, E.M., & Gutman, G.M. (2000). The overselling of population aging: Apocalyptic demography, intergenerational challenges, and social policy. Don Mills, ON: Oxford University Press.Google Scholar
Health Canada. (2001). Canadian cancer statistics 2001. Ottawa: Author, National Cancer Institute of Canada.Google Scholar
Heart and Stroke Foundation. (1999). The changing face of heart disease and stroke in Canada 2000. Ottawa: Author.Google Scholar
Hux, J.E., & Tang, M. (2002). Patterns of prevalence and incidence of diabetes. In Hux, J. E., Booth, G., & Laupacis, A. (Eds.), Diabetes in Ontario: An ICES practice atlas (module 1). Toronto: Institute for Clinical Evaluative Sciences.Google Scholar
Katzmarzyk, P.T. (2002). The Canadian obesity epidemic, 1985–1998. Canadian Medical Association Journal, 166, 10391040.Google ScholarPubMed
Kiel, D.P., O'Sullivan, P., Teno, J.M., & Mor, V. (1991). Health care utilization and functional status in the aged following a fall. Medical Care, 29, 221228.CrossRefGoogle ScholarPubMed
Liang, K.S., & Zeger, S.L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 78, 1322.Google Scholar
MacKenzie, G., & Wild, S. (1998, February 19). Crowding forces ER patients into hallways, lengthens wait. Winnipeg Free Press, p.A3.Google Scholar
Manitoba Bureau of Statistics. (2000). Manitoba Health Regions population projections June 1, 1998–June 1, 2025. Winnipeg: Government of Manitoba.Google Scholar
Manitoba Health. (2002). Manitoba's health indicators report. Winnipeg: Author.Google Scholar
Manton, K.G., Stallard, E., & Corder, L.S. (1998). The dynamics of dimensions of age-related disability 1982 to 1994 in the U.S. elderly population. Journal of Gerontology: Biological Sciences, 53A, B59B70.Google Scholar
Manuel, D.G., & Schulz, S.E. (2001). Adding years to life and life to years: Life and health expectancy in Ontario. Toronto: Institute for Clinical Evaluative Sciences.Google Scholar
Martel, L., & Belanger, A. (1999). An analysis of the change in dependence-free life expectancy in Canada between 1986 and 1996. Report on the Demographic Situation in Canada 1998–1999 (Catalogue 91-209-XPE). Ottawa: Statistics Canada.Google Scholar
Martens, P., Bond, R., Jebamani, L., Burchill, C., Roos, N., Derksen, S., Beaulieu, M., Steinbach, C., MacWilliam, L., Walld, R., Dik, N., Sanderson, D.,Information and Research Committee, Assembly of Manitoba Chiefs, Tanner-Spence, M., Leader, A., Elias, B., & O'Neil, J. (2002). The health and health care use of registered First Nations people living in Manitoba: A population-based study. Winnipeg: Manitoba Centre for Health Policy.Google Scholar
Meltzer, S., Leiter, L., Daneman, D., Gerstein, H.C., Lau, D., Ludwig, S., Yale, J.F., Zinman, B., & Lillie, D. (1998). 1998 clinical practice guidelines for the management of diabetes in Canada. Canadian Medical Association Journal, 159(Suppl. 8), S1S29.Google ScholarPubMed
Menec, V.H., MacWilliam, L., Soodeen, R.A., & Mitchell, L. (2002). The health and health care use of Manitoba's seniors: Have they changed over time? Winnipeg: Manitoba Centre for Health Policy.Google Scholar
Mokdad, A.H., Ford, E.S., Bowman, B.A., Nelson, D.E., Engelgau, M.M., Vinivor, F., & Marks, J.S. (2000). Diabetes trends in the U.S.: 1990–1998. Diabetes Care, 23, 12781283.CrossRefGoogle ScholarPubMed
National Advisory Council on Aging. (2001). Report Card Seniors in Canada. Ottawa, ON: Minister of Public Works and Government Services Canada.Google Scholar
Northcott, H.C. (1994). Public perceptions of the population aging “crisis.” Canadian Public Policy 20, 6677.CrossRefGoogle Scholar
Robinson, J.R., Young, T.K., Roos, L.L., & Gelskey, D.E. (1997). Estimating the burden of disease: Comparing administrative data and self-reports. Medical Care, 35, 932947.Google Scholar
Robson, W.B.P. (2001). Will the baby boomers bust the health budget? Demographic change and health care financing reform. Ottawa: Renouf.Google Scholar
Roos, L.L., & Nicol, J.P. (1999). A research registry: Uses, development, and accuracy. Journal of Clinical Epidemiology, 52, 3947.CrossRefGoogle Scholar
Sahyoun, N.R., Lentzner, H., Hoyert, D., & Robinson, K.N. (2001, March). Trends in causes of death among the elderly. Washington, D.C.: Department of Health and Human Services, Centers for Disease Control and Prevention.CrossRefGoogle ScholarPubMed
Statistics Canada. (1995). Canadian statistics: Selected leading causes of death by sex, Canada, 1997. Retrieved October 5, 2000 from http://www.statcan.ca/english/pgdb/health36.htm.Google Scholar
Statistics Canada. (1999). Health among older adults. Health Reports, 11, 4761.Google Scholar
Waidman, T.A., & Liu, K. (2000). Disability trends among elderly persons and implications for the future. Journal of Gerontology: Social Sciences, 55B, S298S307.CrossRefGoogle Scholar
Wennberg, J.E., Freeman, J.L., & Culp, W.J. (1987). Are hospital services rationed in New Haven or overutilized in Boston? Lancet, 1, 11851189.CrossRefGoogle ScholarPubMed
Wennberg, J.E., Freeman, J.L., Shelton, R.M., & Bubolz, T.A. (1989). Hospital use and mortality among Medicare beneficiaries in Boston and New Haven. New England Journal of Medicine, 321, 11681173.CrossRefGoogle ScholarPubMed