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HEALTHCARE

Presented By: Kristen W., Michelle Q., Ronald B., Diana M.,& Vanessa C.

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+Compression of Morbidity Morbidity: The presence or rate of the disease or

illness.

Compressions: The concept of pushing all the morbidity of one’s life into as short of a time period as possible.

The goal of living a disease and illness free life as long as possible.

It’s having a minimum number of years that a person spends suffering while maximizing their total numbers of years.

By living a healthy lifestyle, age-related morbidity can be reduced or postponed.

+Compression of Morbidity (cont.) Developed in 1980 by James Fries, MD.

“By postponing the age at which chronic infirmity begins, disability and morbidity could be compressed into a shorter period of the average human life span. A society in which the active and virtual years of life would increase in length, the disabilities and frailties of aging would be postponed, and the number of lifetime disability and morbidity would decrease.” -James Fries

People who engage in a healthy lifestyle are less susceptible to develop diseases or an illness than those who do not live a healthy lifestyle

+ How does healthcare impact compression of morbidity?

*Healthcare allows access to medical services that help prolong life.*

+How does healthcare impact compression of morbidity? (cont.)

Medical Services – For acute and chronic illnesses (to cure, slow progression, and/or relieve symptoms) Rx Drugs Surgery Therapy Specialized Care

Those without access to healthcare (not government-funded or cannot afford it) are at risk of developing illness and diseases that may have been prevented or treated easily/quickly. This leads to more costly ER trips that can force a person into bankruptcy or even more costly, death.

+Overview of the Canadian

health care system

National Health insurance program offered as “Medicare” prepaid basis.

Canada Health Act- values of equity and solidarity.

Roles and Responsibilities are shared between the federal and provincial-territorial governments.

Fund Services in the form of fiscal transfers.

Health Care includes services such as physicians and other health professionals, and care in hospitals.

All necessary drug therapy administered within the Canadian hospital setting is insured and publicly funded.

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Provincial/Territorial Health Insurance Card areasThe Canada Health Act separates health coverage by provinces and territories they provide some groups with supplemental health benefits not covered by the Act. The level and scope of coverage for supplemental benefits varies between jurisdictions.

+Provinces and territories

The provinces and territories of Canada combine to make up the world's second largest country. The major difference between a Canadian province and a territory is that provinces are jurisdictions that receive their power and authority directly from the Constitution Act, 1867, whereas territories derive their mandates and powers from the federal government.

Currently, the ten provinces are: Alberta, British Columbia, Manitoba, New Brunswick, Newfoundland and Labrador, Nova Scotia, Ontario, Prince Edward Island, Quebec, and Saskatchewan, while the three territories are Northwest Territories, Nunavut, and Yukon.

+Statistics Canada

10 Leading Causes of Death

Cause of death 2005 2004

2004–2005

Rank Number % Rank Number % % change

Total, All causes of death ... 230,132 100.0 ... 226,584 100.0 1.6

10 leading causes of death ... 179,866 78.2 ... 178,842 78.9 0.6

Malignant neoplasms (cancer) 1 67,343 29.3 1 66,947 29.5 0.6

Diseases of heart (heart disease) 2 51,574 22.4 2 52,000 22.9 -0.8

Cerebrovascular diseases (stroke) 3 14,054 6.1 3 14,626 6.5 -3.9

Chronic lower respiratory diseases 4 10,515 4.6 4 10,041 4.4 4.7

Accidents (unintentional injuries) 5 9,506 4.1 5 8,986 4.0 5.8

Diabetes mellitus (diabetes) 6 7,881 3.4 6 7,823 3.5 0.7

Influenza and pneumonia 7 5,845 2.5 7 5,729 2.5 2.0

Alzheimer's disease 8 5,762 2.5 8 5,536 2.4 4.1

Intentional self-harm (suicide) 9 3,743 1.6 9 3,613 1.6 3.6

Nephritis, nephrotic syndrome and nephrosis (kidney disease)

10 3,643 1.6 10 3,541 1.6 2.9

Note: The order of the causes of death in this table is based on the ranking of the 10 leading causes in 2005. Source: Statistics Canada. CANSIM Table 102-0561.

+10 Leading Causes of Death In 2005, the 10 leading causes of death in Canada

accounted for 78% of all deaths. Cancer, heart disease and stroke, the three leading causes of death, were responsible for 58% of all deaths in Canada.

From 2001 to 2005, the number of deaths increased as Canadian population aged, but mortality rates decreased. The age–standardized mortality rates

dropped sharply for stroke (20%), followed by heart disease (15%) and cancer (5%) in the same period.

From 2004 to 2005, the relative burden of deaths due to unintentional injuries had the largest increase (6%), followed by Chronic lower respiratory diseases (5%) and Alzheimer’s disease (4%). In contrast, the relative burden of stroke had the sharpest decline (-4%).

+Patterns of Death In Canada - Youth Cohort

Ranking and number of deaths for the 10 leading causes by age group, Canada, 2005

1 to 14 15 to 24 25 to 34

Unintentional injuries 233

Unintentional injuries 1,015

Unintentional injuries 827

Cancer 116

Suicide 509

Suicide 511

Congenital abnormalities 68

Cancer 156

Cancer 346

Suicide 44

Homicide 136

Heart disease 173

Heart disease 31

Heart disease 67

Homicide 142

Homicide 22

Congenital abnormalities 34

HIV 51

Influenza and Pneumonia 17

Diabetes mellitus 18

Cerebro- vascular 39

Cerebro- vascular 10

Influenza and Pneumonia 13

Congenital abnormalities 32

+Patterns of Death In Canada - Middle CohortRanking and number of deaths for the 10 leading causes by age group, Canada, 2005

35 to 44 45 to 54 55 to 64

Cancer 1,490

Cancer 5,418

Cancer 11,440

Unintentional injuries 971

Heart disease 2,154

Heart disease 4,491

Suicide 876

Unintentional injuries 1,117

Unintentional injuries 821

Heart disease 639

Suicide 883

Diabetes mellitus 816

HIV 181

Liver disease 440

Cerebro- vascular 781

Liver disease 148

Cerebro-vascular 388

Chronic lower respiratory 628

Cerebro- vascular 143

Diabetes mellitus 363

Liver disease 603

Diabetes mellitus 127

HIV 146

Suicide 460

Homicide 103

Viral Hepatitis 144

Influenza and Pneumonia 266

Influenza and Pneumonia

Influenza and Pneumonia2

Nephritis 172

+Patterns of Death In Canada - Senior Cohort Ranking and number of deaths for the 10 leading causes by age group, Canada, 2005

65 to74 75 to 84 85 and over

Cancer 17,373

Cancer 20,973

Heart disease 19,616

Heart disease 7,914

Heart disease 16,479

Cancer 10,026

Chronic lower respiratory 1,973

Cerebro- vascular 4,850

Cerebro- vascular 6,018

Cerebro- vascular 1,811

Chronic lower respiratory 4,314

Chronic lower respiratory 3,405

Diabetes mellitus 1,539

Diabetes mellitus 2,800

Alzheimer's disease 3,360

Unintentional injuries 815

Alzheimer's disease 1,992

Influenza and Pneumonia 3,106

Liver disease 610

Influenza and Pneumonia 1,688

Diabetes mellitus 2,187

Influenza and Pneumonia 526

Unintentional injuries 1,601

Unintentional injuries 2,076

Nephritis 492

Nephritis 1,312

Nephritis 1,551

Aortic aneurysm 406

Parkinson's disease 888

Hypertention 735

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Place of residence All

deaths Deaths of 10 leading

causes % of 10 leading

causes

Canada 230,132 179,866 78.2

Newfoundland and Labrador

4,486 3,589 80.0

Prince Edward I sland 1,118 898 80.3

Nova Scotia 8,273 6,640 80.3

New Brunswick 6,175 4,903 79.4

Quebec 55,787 43,959 78.8

Ontario 85,591 67,059 78.3

Manitoba 9,856 7,613 77.2

Saskatchewan 8,850 6,870 77.6

Alberta 19,288 14,862 77.1

British Columbia 30,227 23,136 76.5

Yukon 164 140 85.4

Northwest Territories 148 102 68.9

Nunavut 115 104 90.4

Source: Statistics Canada. CANSIM Table 102-0563.

Geographic differences

Provinces and territories

+Gail’s thoughts on the Canadian Health Care system on how it affect’s older adults: It is an equitable system, providing basic health care

for all who need it through tax dollars.

Universal care with no user fees; allows access to good preventative care.

Fees for long-term residential care are calibrated to person’s income

Does not exceed 70% of their monthly income

Fees are based on income, not on assets.

+Gail’s thoughts continued…

“For older adults and anyone without extended health benefits, there is some coverage for drugs (for example, seniors without extra benefits pay for their drugs up to a limit 30% of their income, and then the government covers the rest of the costs each year).”

+How does Canada’s system contribute to the compression of morbidity?

“It is preventative health care and health promotion that makes all the difference!”

“The Canadian and the provincial governments have large scale, country-wide health promotion projects and educational campaigns about increasing exercise, healthy eating, diabetes management, aboriginal health needs, stopping smoking, etc. with the aim of helping people live longer in a healthy state. This is paying off, because the up-and-coming Baby Boomer generation is much healthier and more active in our country.”

+Challenge in Canada’s Health Care SystemNot many alternatives

As care becomes more costly, there are more and more limits on what the government will cover

Having to wait for appointments, diagnostic tests, surgeries, etc.

Limits on the numbers of acute care beds funded, which leads to premature discharge of patients

Doctors preferring private practice (more money) in other countries rather than government-funded practice (less money) in Canada

+What are the future concerns of the Canadian population due to the Compression of Morbidity?

Having enough resources (ie. acute beds, specialists, caregiver support, etc.) to care for elders in the last 6-12 months of life.

Nurses and physicians properly trained to care for older adults with co-morbidities and complexities.

“Many of these professionals prefer to work in the ‘sexier’ health care fields, eg. critical care, maternity and pediatrics, etc., rather than with old people”