2004 Community Health Assessment Report
The 2004 Community Health Assessment Report provides a portrait of the health and well-being of residents living in the Winnipeg Health Region. This Report builds a foundation of information to support evidence based planning and decision making.
Volume I – Executive Summary
Highlights findings from the Population Health Profiles and the Data Book.
Volume II – Population Health Profiles
A report on health outcomes and determinants of health for various population subsets in the WHR. These populations include the 12 community areas (CAs) that comprise the WHR, and populations of special interest.
Background
Methods
Profiles
Community Areas
- Community Area Overview
- St. James-Assiniboia
- Assiniboine South
- Fort Garry
- St. Boniface
- St. Vital
- Transcona
- River East
- Seven Oaks
- Inkster
- Point Douglas
- Downtown
- River Heights
Population Subsets (Special Interest / Priority / Vulnerable)
- Introduction to Populations Of Special Interest
- Children & Youth
- Seniors
- Aboriginal People
- Immigrants
- Persons with Disabilities (Incl. Mental Health)
Appendices
Volume III – Data Book
A compendium of indicators that measure health status, determinants of health, health system performance, and population and health system characteristics.
Background
Methods
- Manitoba Health Performance Measurement Framework
- WRHA Population Health Assessment Framework
- Data Sources & Limitations
- Data Analysis
- Data Presentation
Indicators – Health Status & Determinants of Health & Well-Being
Characteristics of a population and its health state. Population characteristics include ethnicity and culture, personal behaviour and lifestyle, as well as living and working conditions that will typically effect health states. Measures of health status include life expectancy, disease prevalence, potential years lost due to disease or injury, as well as self-reported ratings on well-being.
Age-specific and condition-specific mortality rates such as life expectancy, PYLL, infant mortality, and deaths due to disease, injury and suicide.
PYLL – Due for Selected Causes (Cancer, Respiratory, Circulatory, Injury)
Leading Causes of Unintentional Injury Death
Leading Causes of Death by Selected Disease Categories
Leading Causes of Death by Geography
Leading Causes of Death by Age
Leading Causes of Death by PYLL
Life expectancy and disability-free life expectancy.
Attributes of health status of an individual or collective population that contribute to disease, distress or interfere with daily activities. These include acute and chronic disease, mental health disorders and injury. Other factors influencing health status are pregnancy, aging, stress and congenital anomalies.
Pelvic Inflammatory Disease (PID) & Ectopic Pregnancies (EP)
Prevalence of Arthritis/Rheumatism
Asthma Prevalence (Self Reported)
Asthma Diagnosis through Physician Visit
Prevalence of Hypertension Treatment
AMI (Acute Myocardial Infarction)
Suicide: Proportion of population having serious thoughts about suicide
Proportion of Population with Anti-depressants Prescriptions
Unintentional Injury Hospitalization
Human Immunodeficiency Virus (HIV)
Hepatitis B (acute cases) Incidence
Childhood Immunization: Hepatitis B Immunization for Grade 4 Students (Pending)
Childhood Immunization: Immunization Coverage for 1,2 and 7 year olds
Levels of human function associated with the consequences of disease, disorders, injury and other health conditions. This includes measures of disability and daily function.
Proportion of Population that has Limits to their Daily Function
Broad measures of physical, mental and social well-being of individuals.
Aspects of personal behaviour and risk factors that epidemiological studies have shown to influence health status. Examples include smoking, heavy drinking, physical activity and breast feeding.
Body Mass Index (International Standard)
Proportion of Population who are Heavy Drinkers
Proportion of Population who are Regular Smokers
Smoking Initiation by Age & Gender
Number of Different Drugs per User
Proportion of Population With One or More Antibiotic Prescriptions
Number of Prescriptions for Antibiotics
Personal resources. Factors such as social support and life stress.
Census Families in Private Households by Size
Private Households by Household Type
Socio-economic characteristics and working conditions of the population that have been shown to influence health status. Factors such as level of education, literacy, unemployment, income inequality and decision participation in the work place.
Income Inequality: Median Household Income
Income Inequality: Median Individual Income
Employment Income by Work Activity
Labour Force Participation Rates
Hours Spent Looking After Children Without Pay
Hours Spent Providing Unpaid Care or Assistance to Seniors
Environment factors such as air and water quality, waste management and community safety, that have the potential to influence health in a population.
Dwellings by Condition of Dwelling
Dwellings by Period of Construction
Early experiences affecting brain development and health in later life. Includes school readiness. The physical, social, mental, emotional and spiritual development of children and youth are affected by the other determinants of health.
Breastfeeding Practices – Initiation
Breastfeeding Practices – Duration
Childhood Immunization: Immunization Coverage for 1, 2, and 7 Year Olds
Childhood Immunization: Hepatitis B Immunization for Grade 4 Students (Pending)
Children and Youth Injury Death
The basic biology and organic make-up of the human body are a fundamental determinant of health. In some circumstances, genetic endowment appears to predispose certain individuals to particular disease or health problems.
Some persons or groups may face additional health risks due to a socio-economic environment that is largely determined by dominant cultural values that contribute to the perpetuation of conditions such as marginalization, stigmatization, loss or devaluation of language and culture and lack of access to culturally appropriate heath care and services.
Gender refers to the array of society-determined roles, personality traits, attitudes, behaviours, values, relative power & influence that society ascribes to the two sexes on a differential basis. Factors to consider are comparison of PYLL between men and women, depression rates between the genders, mortality rates for specific conditions (cancer, heart disease) between men and women, hiring policy related to affirmative.
Safety in the community and criminal activity can affect other determinants of health such as lifestyle and healthy child and youth development.
Indicators – Health System Performance
Outcomes of programs and services of a health system that provide relative measures of performance. In a population of a given health state or geography, what are the facilities and services available that provide health care and are they helping the people who use it? Health infrastructure measures are also included in this part. This part incorporates methodologies from AIM quality dimensions (CCHSE) and the Manitoba Health Performance Measured Framework.
The extent to which service(s) and resources (e.g. financial, human, information, equipment) are available to meet the needs of the client and/or community population(s).
Hospital Beds per 1000 Residents in the Area
Full-time Equivalent Physicians per 1000 Residents
The ease with which the client and/or community obtains required or available services in the most appropriate setting (Source: Adapted from CCHSA).
e.g. influenza immunization rates, waiting time for surgical and diagnostic procedures, eligibility policy for home care, operating room criteria for slating surgical cases.
Admission to PCH per 1000 in the Last Year
Residents of PCH per 1000 Population
GP and Specialist Visits by Location per 1000 Residents
All Patients: Location of Residence (Pending)
The extent to which services are provided and/or activities are conducted to meet client and/or community needs at the most beneficial or appropriate time (Source: Adapted from CCHSA).
e.g. waitlists for services by department, EMS response times, median waiting time for elective surgery, prioritization criteria for waiting lists.
The extent to which coordinated services are provided across the continuum, over time (Source: Adapted from CCHSA).
e.g. patients cared for by multiple departments, percent of departments regionalized/integrated.
The extent to which decisions are made and services are delivered in a fair and just way (Source: Adapted from CCHSA).
e.g. Yearly visit rate to specialist physicians by community area/region.
The extent to which services meet the needs of the client and/or community population(s), reflecting best practices (Source: Adapted from CCHSA).
e.g. alternate level of care days, hysterectomy rates, clinical practice guidelines for surgical procedures.
The extent to which individuals’ knowledge, skills, and attitudes are appropriate to the service provided (Source: Adapted from CCHSA).
The extent to which services, interventions, or actions achieve optimal results (Source: Adapted from CCHSA).
e.g. Immunization rates, screening rates, re-admissions within 7 days of discharge.
The extent to which potential risks and/or unintended results are avoided or minimized (Source: Adapted from CCHSA).
e.g. patient injuries by department/cause, complaints, medical errors or adverse drug reactions, use of physical and chemical restraints for inpatient clients.
The extent to which services and/or activities conform to ethical principles, values, conventions, laws, and regulations (Source: Adapted from CCHSA).
e.g. issues reviewed by the ethics committee.
The extent to which resources (inputs) are brought together to achieve optimal results (outputs) with minimal waste, re-work, and effort (Source: Adapted from CCHSA).
e.g. length of stay, surgical day case rates, alternate level of care days, cost per case mix, day surgeries as a percent of total surgeries, use of caremaps.
The extent to which the mission, vision, goals & objectives are clear, well integrated, coordinated and understood both internally and externally. These are reflected in organization plans, delegations of authority, and decision-making processes (Source: Adapted from CCHSA).
e.g. Consistency of board end statements with community health needs.
The extent to which relevant information is exchanged with the client, family and/or community in a manner that is ongoing, consistent, understandable and useful (Source: Adapted from CCHSA).
e.g. client involvement in care plan, consumer complaints relating to communication, consent for treatment.
Easily Accessible Information on Services by Region and Community
The extent to which information to be kept confidential is safeguarded (Source: Adapted from CCHSA).
e.g. processes in place to protect client confidentiality, complaints relating to confidentiality, PHIA legislation.
The extent to which the client and/or community actively participates as a partner in decision-making, and in service planning, delivery, and evaluation (Source: Adapted from CCHSA).
e.g. type of community partners/interagency committees, involvement of public in health planning, clients satisfaction with participation levels, community representation.
The extent to which politeness, consideration, sensitivity and respect are incorporated into interactions with the client and/or community (Source: Adapted from CCHSA).
e.g. client satisfaction, client letters of appreciation, patient rights.
The extent to which the organization supports and strengthens the community and its development, and contributes to its overall health (Source: Adapted from CCHSA).
e.g. RHA involvement in community events.
Health / Environmental Issues Partnership
The extent to which care/services provided meet the expectations of the client, community, providers and funding bodies (Source: Adapted from CCHSA).
e.g. client satisfaction level, public satisfaction level
The extent to which the organization fosters a climate of openness, free expression of ideas, and information sharing (Source: Adapted from CCHSA).
e.g. staff satisfaction scores on worklife, internal communication mechanisms, frequency of staff meetings, staff grievances, arbitration proceedings, collective.
The extent to which staff have clearly defined job scope and objectives, and these are aligned with team and organization goals (Source: Adapted from CCHSA).
e.g. staff have up to-date job descriptions, performance appraisals completed on schedule, new employees receiving orientation.
The extent to which staff input is encouraged and used in decision-making (Source: Adapted from CCHSA).
e.g. opportunities for staff input in decision-making, recommendations made by staff & instituted, staff representation on CQI planning teams/hospital board.
The extent to which staff creativity, innovation, and initiative is encouraged. The necessary training and development, to attain organizational goals and personal/professional development objectives, is provided (Source: Adapted from CCHSA).
e.g. budget allocated to education activities, staff participation/type of staff development initiatives, staff receiving CQI training.
The extent to which the organization provides a safe, healthy, and supportive environment, recognizes staff contribution, and links staff feedback to improvement opportunities (Source: Adapted from CCHSA).
e.g. occupational health injuries, work days lost due to sickness or injuries, staff recognition activities, average length of service, turnover rate.
The operating and capital funds available to the organization and its program/units including recent increases/decreases in funding, flexibility to change priorities, access to additional resources if needed and demands on the organization to respond to changing standards and needs.
e.g. percent of mental health budget allocated to child/adolescent services, percent budget allocated to training and development.
Health workforce structure and distribution.
e.g. number of staff, their level of qualification and training, number of specialists/capita, vacancy rates per staff category, essential services.
Staff Education Needs Assessment
The formal structure/ processes of the organization.
e.g. The degree of development of leadership and team building, reporting mechanisms, strategic planning activities, program evaluation, internal and external collaboration and partnerships and communication, management:staff ratio.
New Programs/Services with Impact Analysis and Evaluation Strategy
Management and Leadership Training
Information & Technology – Human knowledge, available technology, degree of integration of internal and external information systems.
e.g. new business intelligence initiatives, IT vacancy rate, number of programs without IT support.
Percent Budget Spent on eHealth Support
Physical structures and equipment.
e.g. size and condition of buildings and equipment and their suitability to the population(s) served, the degree of accessibility to those with disabilities and special needs and the degree of difficulty in upgrading or modifying existing property.
Physical Structure – Existing Hospitals
The tracking and forecasting of any health event or health determinant through the collection, integration and analysis of data and the dissemination of information to those who need to know.
e.g. epidemiological research, monitoring, population-based screening, case finding, health surveys.
Immunization for Pneumococcal Disease for Population Aged 65+ (Pending)
Influenza Immunization for Seniors
Childhood Immunization: Immunization Coverage for 1, 2, and 7 year olds
Research funding and structures.
e.g. proportion of the provincial health budget allocated to medical research, research dollars in high priority areas.
Indicators – Community & Health System Characteristics
Integrates the concepts of population health status and health system performance. Viewing how a given population utilizes health services provides insight into current and future demands on the health system by a population. Utilization and per capita resources compared across jurisdictions, geographies and population sectors, provide a relative measure of system load.
Projected counts for general and special populations.
WHR Population Projections (Under revision)
Rates of use of health care services and procedures.
e.g. hospital days per capita, CABG rates, hip replacement rates, out of region referrals as a percent of total services.
GP and Specialist Visits by Location per 1000 Residents
Contact with Alternative Health Care Provider
Contact with Health Professionals about Mental Health
Top Diagnosis for Physician Visits
Hospital Beds per 1000 Residents in the Area
Hospital Utilization – Inflow-Outflow
All Patients: Location of Residence (Pending)
All Patients: Volume Metrics of Hospital Care (Pending)
All Patients: Reasons for Hospital Care (Pending)
WHR Residents: Location of Hospital Care (Pending)
WHR Residents: Volume Matrix of Hospital Care (Pending)
WHR Residents: Reasons for Hospital Care
PCH Beds per 1000 Population Age 75 and Over
Admission to PCH per 1000 in the Last Year
Residents of PCH per 1000 Population
Median Length of Waiting Times Before Admission to PCH
Level of Care on Admission to PCH
Median LOS for PCH Residents by Location
Home Care: Average Number of Days per Case
Dollars spent on health care.
e.g. Percent of administrative cost of total operating costs, PCH resident direct costs of total resident days, total food services costs of total meal days, acute total drug costs excluding anti-neoplastics of total inpatient days.
