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Trends in Mortality by Income in Urban Canada from 1971 to 1996.
PART II
Russell Wilkins, Edward Ng and Jean-Marie Berthelot
Health Analysis and Modeling GroupStatistics Canada, Ottawa
Session 65:
Causes of Death Analyses, Differentials and Trends Population Association of America (PAA)
2001 Annual Meeting, Washington DC 29-31 March 2001
Russell Wilkins
Health Analysis and Modeling Group
Statistics Canada, RHC-24A
Ottawa ON K1A OT6
Tel: 1-613-951-5305 Fax: 1-613-951-3959
Email: [email protected]
Trends by Cause, ASMR-All Ages
• Progress towards the goal of Health for All– Lower mortality
– Less inequality
• Lack of progress– Little change in mortality
– Less inequality but higher mortality
• Worsening– Higher mortality
– Greater inequality
Perinatal Conditions
0123456789
10111213141516
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Ischemic Heart Disease
020406080
100120140160180200220240260280300320340360380400420
1971 1976 1981 1986 1991 1996
Q1-M RichestQ2-MQ3-MQ4-MQ5-M PoorestQ1-F RichestQ2-FQ3-FQ4-FQ5-F Poorest
ASMR per 100,000
Ischemic Heart Disease, Males
100120140160180200220240260280300320340360380400420
1971 1976 1981 1986 1991 1996
Q1-M Richest
Q2-M
Q3-M
Q4-M
Q5-M Poorest
Per 100,000
Ischemic Heart Disease, Females
50
60
70
80
90
100
110
120
130
140
150
160
170
1971 1976 1981 1986 1991 1996
Q1-F Richest
Q2-F
Q3-F
Q4-F
Q5-F Poorest
ASMR per 100,000
Uterine Cancer
0123456789
1011121314
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Liver Cirrhosis, Females
0
1
2
3
4
5
6
7
8
9
10
11
12
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Liver Cirrhosis, Males
02468
1012141618202224262830
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Injuries except MVTA+Suicide, Both Sexes
0
5
10
15
20
25
30
35
40
45
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Pedestrians Hit by Motor Vehicles, Both Sexes
0
1
2
3
4
5
6
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Motor Vehicle Occupants, Both Sexes
0
2
4
6
8
10
12
14
16
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Lung Cancer, Males
05
101520253035404550556065707580859095
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Breast Cancer, Females
02468
101214161820222426283032
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Prostate Cancer
02468
101214161820222426
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Suicide, Males
02468
10121416182022242628303234
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Suicide, Females
0
1
2
3
4
5
6
7
8
9
10
11
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Lung Cancer, Females
0
5
10
15
20
25
30
35
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Mental Disorders, Both Sexes
0
1
2
3
4
5
6
7
8
9
10
11
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Infectious Diseases, Both Sexes
0
2
4
6
8
10
12
14
16
18
20
22
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Includes 1986 AIDS recoded to Infectious Diseases
Ill-Defined Conditions, Both Sexes
0
2
4
6
8
10
12
14
16
18
20
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Diabetes, Males
0
2
4
6
8
10
12
14
16
18
20
22
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Diabetes, Females
0
2
4
6
8
10
12
14
16
18
20
22
1971 1976 1981 1986 1991 1996
Q1 - Richest
Q2
Q3
Q4
Q5 - Poorest
ASMR x 100,000
Conclusions: Trends 1971-1996
• Lower mortality for all income quintiles, both sexes, and for most causes
• Persistence of an income gradient, though less steep than formerly• affects females as well as males, though less sharply
• highest relative risks in working ages (25-64)
• Elimination of the remaining disparities would result in gains in potential years of life equivalent to
eradicating one of the three leading causes of death
Conclusions: Trends 1971-1996 (cont.)
• Throughout this period, there were substantially diminished differences across the income quintiles, overall and for most causes of death
• many causes showed remarkable progress: reduced mortality and diminished differences
• a few causes showed higher mortality and greater inequality
• timing of the changes varied by cause