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Chronic Diseases and Healthy Behaviour

Chronic diseases such as heart disease, stroke and cancer of the lungs are the leading causes of death in Niagara.  These diseases often require hospitalization and medical treatment which directly impacts health care costs, families and productivity.

Although Chronic diseases are among the most common and costly health problems, they are also among the most preventable.  Making healthy choices such as being physically active every day; eating healthy, nutritious foods; living tobacco/smoke free and limiting alcohol use goes a long way to prevent and help control the effects of such diseases.

In Niagara we have a higher percentage of adults over the age of 18 years who are overweight and obese when compared to Ontario. Interestingly, Niagara residents over the age of 20 also report being either moderately active or inactive.

As well there is a significant rise in smoking and binge drinking rates amongst Niagara youth. To ensure optimal health for all Niagara residents, we all need to promote healthy behaviours, create healthy environments and develop healthy public policies wherever we live, learn, work and play.

The data tables below provide a snapshot of chronic disease and healthy behaviour indicators across Niagara and Ontario. 

Risk Factors

Chronic diseases often develop as a result of one or more of a few common modifiable factors, called risk factors.  Therefore, reducing or eliminating the occurrence of a specific risk factor could significantly reduce the occurrence of a disease. 

Smoking | Obesity | Alcohol consumption| Physical activity | Healthy eating

Smoking

Smoking in Youth & Adults
  Niagara Ontario
Youth ages 12-19 that are current daily or occasional smokers 17.6%† 9.5%
Youth ages 12-19 years that are exposed to passive smoke in the home everyday or almost everyday 20.1%†,* 15.6%
Youth ages 12-19 years that are exposed to passive smoke in a car everyday or almost everyday 13.6% †,* 18.3%
Adults ages 20+ that are current daily or occasional smokers 32.2% 30.1%

* Significantly different from Ontario. † Interpret with caution, data was limited due to low numbers.

Source: Canadian Community Health Survey 4.1, 2007, Statistics Canada, Share File, Ontario MOHLTC.

Youth Smoking
Niagara has a high number of youth smokers. 17.6% of Niagara youth aged 12-19 reported smoking daily or occasionally, which is much higher than that of Ontario (9.5%).

In regards to passive smoking, 20.1% of Niagara youth aged 12-19 are exposed to passive smoke in the home everyday or almost everyday, which is much higher than that reported for Ontario as a whole (15.6%).

Adult Smoking
32.2% of Niagara adults over the age of 20 reported smoking daily or occasionally. This is very similar to the percentage of adults that reported smoking in Ontario (30.1%).

Obesity

Obesity in Youth & Adults
  Niagara Ontario
Youth ages 12-17 years who are overweight or obese (International Classification System) 31.7% †,* 20.0%
Adults ages 18+ years who are overweight or obese (BMI ≥25.0) 53.6% †,* 46.3%

* Significantly different from Ontario. † Interpret with caution, data was limited due to low numbers.

Source: Canadian Community Health Survey 4.1, 2007, Statistics Canada, Share File, Ontario MOHLTC.

Youth Obesity
Niagara has a high number of obese youth in comparison to Ontario. 31.7% of Niagara youth aged 12-17 years old are considered to be overweight or obese.  This is much higher than the 20.0% reported for Ontario.

Adult Obesity
The percentage of obese and overweight individuals continues to rise as people get older. 53.6% of Niagara adults over the age of 18 are overweight or obese (Body Mass Index ≥25), according to self report, which again, is much higher than Ontario (46.3%).

Alcohol Consumption

Alcohol consumption summary
  Niagara Ontario
Overall population    
Population ages 12+ who report drinking daily or occasionally 60.7%* 74.4%
Population ages 12+ who reported consuming 5 or more drinks on at least one occasion during the previous 12 months 42.5% * 35.0%
Youth    
Youth ages 12-19 that are current daily or occasional drinkers 49.9% † 45.8%
Youth ages 12-19 who reported consuming 5 or more drinks on at least one occasion during the previous 12 months 33.2% * 25.5%
Adult    
Adults ages 20+ who reported drinking daily or occasionally 66.2% * 79.8%
Adults ages 20+ who reported consuming 5 or more drinks on at least one occasion during the previous 12 months 44.2% * 36.8%

* Significantly different from Ontario. † Interpret with caution, data was limited due to low numbers. Source: Canadian Community Health Survey 4.1, 2007, Statistics Canada, Share File, Ontario MOHLTC.

Population alcohol consumption
60.7% of Niagara residents over the age of 12 report drinking daily or occasionally, which is much lower than Ontario (74.4%). However, Niagara has a much higher population who consumed 5 or more drinks on one occasion (42.5%), which is considered high risk drinking, than Ontario as a whole (35.0%).

Youth alcohol consumption
Niagara has a slightly higher percentage of youth drinkers than Ontario. 49.9% of youth aged 12-19 living in the Niagara region are current daily or occasional drinkers, in comparison to 45.8% in Ontario. Niagara also reports a higher number of youth who participate in high risk drinking than Ontario.  33.2% of Niagara youth aged 12-19 reported consuming 5 or more drinks on one occasion in comparison to 25.5% of Ontario youth.

Adult alcohol consumption
Niagara has a much lower percentage of adult drinkers than Ontario. In Niagara, 66.2% of adults over the age of 20 reported drinking occasionally or daily in comparison to 79.8% in Ontario. However, Niagara has a much higher adult population that participates in high risk drinking. 44.2% of Niagara adults over the age of 20 report having consumed 5 or more drinks on at least one occasion in the past year; whereas, 36.8% of Ontarians over the age of 20 have reported the same.

Physical Activity

Physical Activity
  Niagara Ontario
Youth ages 12-19 that are moderately active or very active 79.1% * 68.6%
Adults ages 20+ that are moderately active or very active 54.7% * 47.4%

* Significantly different from Ontario.

Source: Canadian Community Health Survey 4.1, 2007, Statistics Canada, Share File, Ontario MOHLTC.

Niagara has a higher percentage of active youth than Ontario. 79.1% of Niagara residents aged 12-19 are moderately or very active compared to 68.6% in Ontario.

Niagara also has a higher percentage of active adults than that of Ontario. 54.7% of Niagara residents over the age of 20 are moderately or very active compared to 47.4% in Ontario. Interestingly, for both Niagara and Ontario, the percentage of active adults is much lower than the percentage of active youth, indicating that physical activity decreases as age increases.

Healthy Eating

Healthy Eating of Fruits and Vegetables
  Niagara Ontario
Population ages 12+ that have consumed fruits and vegetables five or more times daily 43.9% 41.9%

Source: Canadian Community Health Survey 4.1, 2007, Statistics Canada, Share File, Ontario MOHLTC.

43.9% of Niagara residents aged 12 or older consumes fruits and vegetables more than five times daily.  This is very similar the percentage for Ontario (41.9%).

Cancer

Cancer incidence | Cancer deaths | Cancer risk | Cancer screening

Cancer incidence

Top 5 Cancer incidence . Rate per 100,000 population
  Females Males
Rank Niagara region Ontario Niagara region Ontario
1 Breast 99.2 Breast 98.9 Prostate 128.9 Prostate 133.9
2 Lung 48.5 Lung 43.1 Lung 76.0 Lung 63.0
3 Colorectal 39.1 Colorectal 41.6 Colorectal 58.9 Colorectal 60.0
4 Uterine 20.4 Bladder 20.6 Bladder 20.4 Bladder 22.8
5 Ovarian 12.3 Skin 20.5 Kidney 15.6 Skin 15.2

Sources: Cancer incidence 2006 (contains 2004 cancer data), Cancer Care Ontario, obtained from SeerSTAT.

In Niagara, the top 5 cancers in regards to incidence are similar to those of Ontario.

Females
For females, Niagara and Ontario share breast, lung, and colorectal as three of the top 5 cancers.  Uterine and ovary completes the top 5 for Niagara; while, bladder and skin complete the top 5 for Ontario. 

Males
For males, Niagara and Ontario share four of the top 5 cancers:  prostate, lung, colorectal, and bladder. The only difference between them is that Niagara reports kidney as the fifth top cancer, while Ontario reports skin cancer as the remaining top cancer.

Cancer Deaths

Top 5 cancer deaths. Rate per 100,000 population
  Females Males
Rank Niagara region Ontario Niagara region Ontario
1 Lung 35.5 Breast 33.0 Lung 54.0 Lung 53.3
2 Breast 24.7 Lung 24.0 Colorectal 25.4 Colorectal 25.4
3 Colorectal 16.9 Colorectal 17.1 Prostate 20.8 Prostate 22.9
4 Ovarian 10.8 Uterine 7.7 Pancreas 10.1 Pancreas 9.8
5 Pancreas 6.1 Thyroid 7.4 Oesophagus 7.7 Oesophagus 7.3

Sources: Cancer incidence 2006 (contains 2004 cancer data), Cancer Care Ontario, obtained from SeerSTA.T

In Niagara, the top 5 cancers in regards to death rates are similar to those of Ontario.

Females
For females, Niagara and Ontario share breast; lung; and colorectal as three of the top 5 cancers. Ovary and pancreas complete the top 5 for Niagara; while, uterine and thyroid gland complete the top 5 for Ontario. 

Males
For males, Niagara and Ontario the same top 5 cancers in regards to death rates:  lung, colorectal, prostate, pancreas and oesophagus.

Cancer Risk

Percentage of adults ages 18+ years who have any part of body sunburned in past 12 months

Niagara 34.3%* - Ontario 65.7%

* Significantly different from Ontario.

Source: Canadian Community Health Survey 4.1, 2007,
Statistics Canada, Share File, Ontario MOHTLC.

34.3% of Niagara adults aged 18 or older been sunburnt within the last year. This is much lower than the percentage for Ontario as a whole (65.7%).

Usage of sunscreen by Niagara residents ages 18+

Always or Often: 39.4% - Sometimes: 19.2% - Rarely: 14.6% - Never: 26.8%

Source: Rapid Risk Factor Surveillance System (Jan to Dec, 2008).

39.4% of Niagara residents aged 18 or older always or often use sunscreen, 19.2% sometimes use sunscreen, 14.6% rarely use sunscreen, and 26.8% never use sunscreen.

Cancer Screening

Cancer Screening among Adults
  Niagara Ontario
Adults ages 50-74 that have reported ever receiving a Fecal occult blood test 42.0% * 39.8%
Of those reporting receiving a Fecal occult blood test, percentage receiving one in the last two years 63.3% * 62.3%
Adults ages 50-74 that have reported ever receiving a Colonoscopy or sigmodoscopy 32.4% * 36.1%
Of those reporting receiving a Colonoscopy or sigmodoscopy, percentage receiving one in the last two years 36.4% * 46.9%
Female population ages 50-74 that have reported ever having a mammography 89.9%   89.5%
Of those reporting receiving a mammography, percentage receiving one in the last two years 70.0% * 82.0%

* Significantly different from Ontario.

Source: Canadian Community Health Survey 4.1, 2007, Statistics Canada, Share File, Ontario MOHLTC.

Niagara is similar to Ontario in regards to percentage of the population receiving cancer screening tests. 42.0% of adults in Niagara ages 50-74 have received a Fecal occult blood test, a screening tool for colorectal cancer; 32.4% of the same age group reported having received a Colonoscopy or sigmodoscopy. For females of Niagara ages 50-74, 89.9% reported having had a mammography. 

These numbers are very similar to those for Ontario.  The only difference being that a greater percentage of people in Ontario who received a Colonoscopy / sigmodoscopy or mammography had received these tests in the last 2 years (46.9% and 82.0%, respectively) than those who reported receiving the same tests in Niagara (36.4% and 70.0%, respectively).

Leading Causes of Death

Females
Rank (0-64 years)   (65+ years)  
1 Lung cancer 10.9% Ischaemic heart disease 26.4%
2 Breast cancer 8.3% Cerebrovascular disease 9.1%
3 Ischaemic heart disease 7.4% Dementia and Alzheimer Disease, APHEO 5.3%
4 Colorectal cancer 4.9% Lung Cancer 5.2%
5 Cerebrovascular diseases 4.0% Diabetes 4.8%
Males
Rank (0-64 years)   (65+ years)  
1 Ischaemic heart disease 15.3% Ischarmic heart disease 26.2%
2 Lung cancer 8.5% Lung Cancer 7.7%
3 Intentional self harm 5.3% Cerebrovascular diseases 6.1%
4 Transport accidents 4.2% Chronic lower respiratory disease 5.4%
5 Colorectal cancer 4.1% Diabetes 4.7%

Source: Causes of Death 2000-2004, Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO Data. Last Refreshed March 2009.

Females
Females of Niagara ages 0-64 share Ischaemic heart disease, cerebrovascular disease and lung cancer as leading causes of death with females of Niagara over the age of 65. For females ages 0-64, however, breast cancer and colorectal cancer complete the leading causes of death; whereas, dementia and Alzheimer's disease and diabetes complete the leading causes of death for females over the age of 65.

Males
Ischaemic heart disease and lung cancer make up the top two leading causes of death for both men ages 0-64 and men over the age of 65 in Niagara. The remaining three leading causes of death between these age groups, however, are completely different.  For men ages 0-64; intentional self harm, transportation accidents and colorectal cancer complete the list for leading causes of death.  Cerebrovascular disease, chronic lower respiratory disease and diabetes complete the list for men over the age of 65.

Leading Causes of Hospitalizations

Top 5 leading causes of hospitalizations for Niagara residents
Females
Rank (0-64 years)   (65+ years)  
1 Complications of pregnancy (labour and delivery) 21.4% Heart failure 5.7%
2 Complications of pregnancy (Antenatal) 14.8% Fracture of femur 4.8%
3 Liveborn infants according to place of birth 4.1% Chronic obstructive pulmonary diseases 4.3%
4 Mood, affective disorders 2.1% Acute myocardial infarction 4.2%
5 Disorders related to Short gestation and Low birth weight 2.0% Cerebrovascular diseases 3.9%
Males
Rank (0-64 years)   (65+ years)  
1 Liveborn infants according to place of birth 6.2% Heart failure 5.3%
2 Disorders related to Short gestation and Low birth weight 3.5% Acute myocardial infarction 4.9%
3 Acute myocardial infarction 3.0% Chronic obstructive pulmonary disease, bronchiectasis 4.7%
4 Complications of surgical and medical care 2.9% Cerebrovascular diseases 3.5%
5 Diabetes mellitus 2.1% Pneumonia 3.1%

Source: Causes of Hospitalization 2003-2007, Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO Data. Last Refreshed March 2009.

The leading causes of hospitalizations in Niagara differ by age category for each gender. 

Females
For females ages 0-64, the leading causes of hospitalization are complications of pregnancy (labour and delivery), complications of pregnancy (Antenatal), birth, mood and effective disorders and disorders related to Short gestation and Low birth weight.  For females over the age of 65, the leading cuases of hospitalization are: heart failure, chronic obstructive pulmonary diseases, Acute myocardial infarction and Cerebrovascular diseases .

Males
Birth, disorders related to Short gestation and low birth weight, Acute myocardial infarction, complications of surgical and medical care and diabetes are the leading causes of death for males ages 0-64 in Niagara.  For males over the age of 65 in Niagara; heart failure, Acute myocardial infarction, Chronic obstructive pulmonary diseases, Cerebrovascular diseases and Pneumonia are the leading causes of death.

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 Revised: Wednesday, February 03, 2010
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