Performance Reporting — Continued

Goal 2: Improved Health and Wellness for British Columbians
Objective 1: Reduce occurrence of preventable illness and disability.
Strategies:
• Deliver effective strategies to prevent or delay onset of selected illnesses and injuries.	Underway
• Ensure compliance with and enforcement of health regulations that protect the health of the public.	Ongoing

Achievements:

Performance Measures

Incidence of selected communicable diseases (Acute hepatitis B; Cryptosporidiosis; and E.coli 0157) (Goal 2: PM#1)

These indicators measure the success of provincial health programs in preventing and controlling selected communicable diseases.

Results

Measure	2002 Target	2002 Actual	Status
Incidence of: Acute hepatitis B	2.6 cases per 100,000 population	1.8 cases per 100,000 population (2002)	Exceeded target
Incidence of: Cryptosporidiosis (a measure of drinking water quality)	4 cases per 100,000 population	3.1 cases per 100,000 population (2002)	Exceeded target
Incidence of: E.coli 0157 (a measure of food safety)	Rate to remain below 4 cases per 100,000 population	3.4 cases per 100,000 population (2002)	Exceeded target
Baseline: 2000

Source: Epidemiology Services, BC Centre for Disease Control.

 

Potential Years of Life Lost (PYLL) due to cancer, heart disease, and injuries (Goal 2: PM#2)

This indicator measures Potential Years of Life Lost (PYLL) for selected causes, expressed as age-standardized rates per 1,000 standard population. PYLL is the number of years of life "lost" when a person dies before an established cut-off point, in this case, age 75. It focuses on premature deaths — deaths that occur in the younger age groups and that can, in theory, be prevented or at least postponed. PYLL is a generally accepted, overall indicator of population health and is a good measure of the effectiveness of prevention programs.

Cardiovascular disease, cancer, and injuries (external causes) have been selected because they account for approximately two-thirds of total PYLL (cardiovascular disease: 15%, cancer: 30%, injuries: 22%).

Note: The 2002 rate for injuries (external causes) is not yet available as these deaths are subject to coroner review and may require lengthy investigations before a final cause of death is determined.

Results

Measure	2002 Target	2002 Actual	Status
PYLL due to cancer	12.6 PYLL per 1,000 population	11.9 PYLL per 1,000 population (2002)	Exceeded target
PYLL due to cardio-vascular (heart) disease	6.7 PYLL per 1,000 population	5.9 PYLL per 1,000 population	Exceeded target
PYLL due to injuries	14.3 PYLL per 1,000 population	Data not available until Fall 2003	Pending*

*	Final results will be released in December in a supplement to this annual report.

Note:	Potential Years of Life Lost Rate (PYLLSR) per 1,000 Standard population (Canada Census 1991). Data for 2002 for external causes are not yet available.

Source: BC Vital Statistics Agency

 

 

Immunization rates — 2 year olds with up-to-date immunizations (Goal 2: PM#3a)

This indicator measures the effectiveness and use of immunization programs. Low rates may indicate a problem in access or delivery of these services. Immunization programs for children remain among the most cost-effective ways to improve health status and reduce health care costs. In BC, all infants and preschool children have access to immunizations, protecting them from the following nine serious diseases: diphtheria, tetanus, polio, pertussis, haemophilus influenza type b, mumps, measles, rubella, and hepatitis B. (The hepatitis B immunization program was implemented in 2001; data is not yet available for this age group).

In 2001, about half of health regions estimated that over 80 per cent of children had been fully immunized by their second birthday. In BC, while these programs are publicly funded, the reported immunization rates for two-year-olds, while relatively stable in recent years, show a slight decline for the second year in a row. The reason for the decline is not known, but factors that can influence immunization rates include concerns over the efficacy and safety of vaccines and the perception certain diseases are rare and no longer pose a threat to public health. The ministry will be working with the BC Centre for Disease Control and health authorities to examine the data and to ensure the decline in immunization rates does not become a trend.

Note: For some areas of the province, immunization statistics remain unavailable due to various data collection and retrieval issues. The Ministry of Health Planning is reviewing methods to support improved data reporting to improve accuracy.

Results

2002 Target	2002 Actual	Status
82%	DPTP: 81.1% Hib: 81.7% MMR/MR 80.5%	Missed target

Notes:
1.	Complete data were not available for Fraser and Vancouver Coastal Health Authorities.
2.	Statistics are determined from an audit of a one-month sample of Child Health Records, done in April of each year.
3.	MMR/MR = Measles Mumps Rubella or Measles Rubella (2 doses).
4.	DPTP = Diphtheria Pertussis Tetanus Polio (4 doses).
5.	Hib = Haemophilus Influenza b (4 doses).

Source: Disease and Injury Prevention Branch, Ministry of Health Services.

 

 

Immunization rates — Influenza vaccination, population age 65 and over (Goal 2: PM#3b)

This indicator measures immunization rates for influenza vaccination for persons 65 years of age and older. Influenza is a major cause of illness, hospitalization and death among older adults. Annual influenza vaccination reduces the risk of disease and may lessen the severity of illness. It is also effective preparation for an influenza pandemic, anticipated within the next five to ten years. Full implementation of the immunization program — with immunization of 80 per cent of adults age 65 and older — could prevent half of the deaths, hospitalizations and physician visits for influenza.

Results

2002 Target	2002 Actual	Status
2% increase Baseline: 2001	9.3% increase	Exceeded target

	1995	1996	1997	1998	1999	2000	2001	2002
Influenza Vaccination Rate (65+)	55.2%	53.9%	53.3%	55.5%	64.0%	64.8%	61.4%	67.1%

Note:	Data not available for 2002 for Northern Health Authority. Final results will be released in December in a supplement to this annual report. Prior to 2000, data excludes Vancouver and Capital health regions.

Source: Disease and Injury Prevention Branch, Ministry of Health Services.

 

Utilization of screening programs for at risk groups (screening mammography) (Goal 2: PM#4)

This indicator measures the use of mammograms to screen 50- to 74-year-old women every two years for cancer. It is calculated as the number of women being screened at least once at a screening mammography program facility (SMPBC), divided by the female population in that age group. Screening mammography is an important service for the early detection of illness, and reaching a larger proportion of the population is important in improving population health. The estimated biannual screening rate increased to 51 per cent in 2001/02. Data for this measure is not yet available for 2002/03.

Results

2002 Target	2002 Actual	Status
53%*	Data for this measure is not available for 2002/03.	Pending**

*	The 2002/03 target has been adjusted from the original target value of 58%, published in the 2002/03 Service Plan, as the original value was based in part on an estimate of Medical Service Plan volume levels for diagnostic services provided to women (an estimated 10% of women receive diagnostic services biannually). As this measure is intended to capture participation levels in the screening mammography program alone, diagnostic services have now been removed from the calculation of this measure. The original target value has been accordingly prorated by 10% to arrive at the revised screening mammography program's target value of 53%.
**	Final results will be released in December in a supplement to this annual report.

Note:	Screening Mammography Program (SMP) data extracted in August 2002.

Source: SMPBC Trends, Health Data Warehouse; Population data: BC Stats and Health Data Warehouse.

 

Goal 2: Improved Health and Wellness for British Columbians
Objective 2: Reduce inequalities in health status among specific populations in British Columbia.
Strategies:
• Support initiatives to improve Aboriginal health through the formalized participation of Aboriginal people in the planning and delivery of health care	Underway
• Support initiatives to improve the health status of people with mental illnesses.	Underway

Achievements:

• The Ministry of Health Planning is working with Aboriginal health stakeholders to develop a Provincial Aboriginal Health Services Strategy (PAHSS). This work will contribute to Aboriginal health by increasing access to appropriate health services, by enhancing participating of Aboriginal people in decision making and by promoting better integration of Aboriginal specific care with mainstream health care services and programs.
• Honouring Our Health — An Aboriginal Tobacco Strategy for BC was released in 2001. It is the first of its kind in Canada and is currently being evaluated.
  Health authorities have completed Aboriginal Health Plans for each region, working with Aboriginal communities and organizations.
• The province is working with federal and First Nations agencies to develop a comprehensive Aboriginal health database to identify population, incidence of chronic diseases and access to standardized treatment resources or protocols.
• The province has distributed an Aboriginal Health Care Service Provider Manual and First Nations Companion Handbook to the BC HealthGuide.
• A comprehensive mental health strategy was launched to focus on: early detection and evidence-based care; develop a permanent communications infrastructure to improve mental health literacy; better integrate mental health care throughout the health system; and focus on self-management and clinical practice guidelines.

---

Performance Measures

Improved health status for Aboriginal peoples measured by infant mortality and life expectancy (Goal 2: PM#7)

These indicators measure infant mortality and life expectancy rates for Aboriginal peoples. As a group, Aboriginal peoples have a level of health below that of the general population.

Infant Mortality Rate: The infant mortality rate for the Aboriginal status Indian population in the province moved from a high of 15.4 to a low of 4.0 during 1991 to 2001. The 2001 rate of 4.3 infant deaths per 1,000 live births was only slightly higher than the overall provincial rate of 4.0. Although, the gap has remained relatively stable for the past three years, this is a vast improvement over rates that were more than double the provincial rate in the early 1990s. 2002 infant mortality rates data for Aboriginal peoples is not yet available.

Life Expectancy: For British Columbians, life expectancy (five-year average) has risen steadily in the last decade from 78.6 to 79.9 in the general population, and from 69.8 to 72.7 in the status Indian population. Although still less than the general population, the gap in life expectancy between the status Indian and general population has decreased slightly in the last decade.

Results

2002/03 Target	2002 Actual	Status
Improvement in Status Indian infant mortality.	Infant mortality per 1,000 live births in 2002: Aboriginals: N/A Total BC population: 4.4 per 1,000	Pending*
Improvement in Status Indian life expectancy, from 1991-1999 baseline.	Life expectancy in 2002: Aboriginals: N/A Total BC population: 80.2 years	Pending*

*	2002 data for Aboriginal peoples are not yet available. Final results will be released in December in a supplement to this annual report.

 

Note:	2002 infant mortality and life expectancy data for Aboriginal peoples are not yet available.

Source: BC Vital Statistics Agency, BC Stats.

 

 

Goal 2: Improved Health and Wellness for British Columbians
Objective 3: People have the information they need to stay healthy.
Strategies:
• Promote behaviors that decrease people's risk of preventable illness.	Underway

Achievements:

• BC's Tobacco Control Strategy with performance indicators completed and approved, in principle, by the Minister. It includes a three-part approach: legislation and legal action to hold the industry accountable for its actions; prevention, cessation and enforcement programs; and public education.
• Under the Chronic Disease Prevention Strategy, the ministry has formed a Provincial Chronic Disease Alliance and started drafting evidence papers to track results of actions and interventions, thereby evaluating their potential to reduce the burden of disease.
• Under the BC HealthGuide Program, since April 2001, over 1.8 million books have been distributed; more than 1,000,000 hits have been made to BC HealthGuide OnLine; and 27,000 BC First Nations Health Handbooks have been distributed to Aboriginal communities throughout BC.
• Since opening, the BC NurseLine has provided health information and advice to over 240,000 callers.
• Through the Provincial Chronic Disease Strategy, the province provides Web-based access to information and tools for managing chronic diseases.
• Action Schools! BC is an interministerial and community-based initiative to promote physical activity among children and youth in schools and through public education. A Web site and resources have been developed as part of this project.

---

Performance Measures

Smoking rates (measured every 2 years) (Goal 2: PM#5)

This indicator measures the proportion of the population who are current smokers (those who smoke cigarettes on either a daily or occasional basis). Smoking is the most frequent cause of lung cancer and chronic respiratory disease, and also increases the risk of coronary heart disease, stroke, and Sudden Infant Death Syndrome (SIDS). The rate of smoking in BC is currently the lowest in Canada for the general population aged 15 years and older. Rates have been dropping since 1994, suggesting that provincial programs to reduce smoking have been effective.

Results

2002/03 Target	2003 Actual	Status
Smoking Rates for Adults Reduce smoking prevalence by 1% from 2000 baseline to 19% for population age 15 and older	Full year data not yet available for 2002	Pending*
Smoking Rates for Youth Reduce smoking prevalence by 1% from 2000 baseline to 17% for youth age 15 – 19	Full year data not yet available for 2002	Pending*

*	Final results will be released in December in a supplement to this annual report.

Notes:
1.	Includes daily and occasional smoking.
2.	Rates for ages 15 – 19 in earlier years are based on very small sample sizes and are less reliable.
3.	National Population Health Survey (NPHS) and Angus Reid data are for ages 12+.

Source: Data for 1991: Statistics Canada, General Social Survey (GSS). Data for 1994, 1996, and 1998: Statistics Canada, NPHS. Data for 1999 to 2000: Health Canada, Canadian Tobacco Use Monitoring Survey (CTUMS).

 

Rates of healthy behaviors and conditions (Goal 2: PM#6)

Physically Active: Percentage of population age 12 and older physically active enough to attain health benefits (measured every 2 years).

Body Mass Index: Rates of healthy behaviors and conditions — percentage of adults with a healthy body weight (measured every 2 years).

This indicator measures the percentage of the population who have an acceptable body weight and are physically active. Body Mass Index (BMI) is an indicator of obesity and therefore an indicator of risk for chronic disease in the adult population, particularly heart disease and diabetes. (Healthy body weight is defined as a Body Mass Index between 20.0 and 24.9.) Physical inactivity is also a risk factor and indicator of population risk for future chronic illness, such as heart disease, diabetes, and some cancers.

Data for these measures will be collected every two years through the Canadian Community Health Survey. 2002/03 data will be available next fall.

Results

2002/03 Target	2002/03 Actual	Status
Physically Active: Maintain at 27%	Data not yet available for 2002/03	Pending*
BMI: Maintain at 45%	Data not yet available for 2002/03	Pending*

*	Final results will be released in December in a supplement to this annual report.

Notes:
1.	Data are from the National Population Health Survey for 1994/95, 1996/97 and 1998/99; data from Canadian Community Health Survey for 2000/01.
2.	Acceptable body weight means a Body Mass Index of 20.0 – 24.9 for people aged 20 – 64 years (excluding pregnant women).
3.	Physically active is based on response to questions about the frequency, duration, and intensity of participation in leisure time physical activity, for people aged 12+ years.

Source: Disease and Injury Prevention Branch