his section presents information about chronic and infectious disease, as well as self-rated health.
Why is this important?
A person's health can affect all other aspects of their life. Chronic and infectious diseases can impact a person's mental health, quality of life and lead to premature death.[1,2,3,4]
Change in behaviours and habits can be part of preventing and managing disease. Addressing root causes of poor health such as adverse childhood experiences and barriers to the social determinants of health are also important parts of reducing risk for and incidence of disease.[5,6]
Indicators
Chronic Disease
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Chronic diseases are long-term illnesses that do not get better on their own and often get worse over time. Chronic diseases can often be managed but are rarely cured completely.[7] Early identification can support good treatments that improve people's health and quality of life. People living with a chronic disease often require medication and other supports from health care providers to achieve and maintain their health.[3]
In Ontario, cancer, cardiovascular diseases (such as heart failure and stroke), respiratory diseases (such as chronic obstructive pulmonary disease (COPD)), and diabetes are the leading causes of chronic disease-related deaths.[8]
Measures
The incidence rate is a measure of the number of new cases of a disease that develop within a population during a given period of time.
The prevalence rate is a measure of the total number of cases of a disease existing within a population during a given period of time, regardless of when the disease was first developed. Prevalence is based on both incidence and duration of illness. High prevalence of a disease within a population might reflect high incidence or prolonged survival or both. In contrast, low prevalence might indicate low incidence or a rapidly fatal disease or both.[22]
When considered with the incidence and prevalence of chronic disease within a population, the hospitalization rate and mortality rate provide information about the severity of illness. For example, in a population with a low prevalence rate (the number of people who have the disease is low) but a high hospitalization or mortality rate, those with the disease may experience more severe illness.
Incidence, prevalence, hospitalization, and mortality rates have implications for the overall health of the population and the use of health care services (to diagnose and manage the disease and to prevent complications), as well as for preventative health care.
The incidence, prevalence, hospitalization, and mortality rates of chronic disease presented below are based on health care administrative data.[9,10,11] These rates have been age-standardized to the 2011 Canadian population. Since these rates vary by age,[12] the populations have been given the same age distribution so that the comparison is more representative.[13]
Cancer Incidence and Mortality
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The incidence rate was estimated as the number of people (excluding people with an existing cancer diagnosis) who were diagnosed with any cancer within the calendar year. The mortality rate was estimated as the number of people who died from any cancer within the calendar year.[9]
Key Findings
In 2018, there were 532 new cases (incidence) of cancer per 100,000 people in Wellington-Dufferin-Guelph. That same year, there were 199 deaths due to cancer per 100,000 people.
From 2011 to 2018, the incidence rates of cancer in Wellington-Dufferin-Guelph were lower than the rates in Ontario. In 2010, the incidence rate for cancer was higher in Wellington-Dufferin-Guelph, when compared to Ontario. In contrast, between 2010 and 2018, the mortality rates of cancer in Wellington-Dufferin-Guelph were higher than the rates in Ontario (except in 2011 when the rate was slightly lower in Wellington-Dufferin-Guelph). In general, the incidence and mortality rates of cancer in Wellington-Dufferin-Guelph and Ontario decreased slightly between 2010 and 2018.
*Wellington-Dufferin-Guelph includes Wellington County (including Guelph) and Dufferin County.
Source: Ontario Health (Cancer Care Ontario). (2021). Cancer care profiles. https://www.cancercareontario.ca/en/data-research/view-data/cancer-statistics/ontario-cancer-profiles
The incidence and mortality rates of cancer increase with age; the rates are highest among those age 80 years and older.
Limitations
Only cases of cancer diagnosed among residents of Ontario are included in the data. Cases for which residence was outside of Ontario or unknown were excluded. The data does include Ontario residents that were diagnosed with cancer or treated outside of Ontario.
The prevalence of cancer has not been age-standardized. Comparing the prevalence in Wellington-Dufferin-Guelph to the prevalence in Ontario or other areas should be done with caution.
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Cardiovascular Disease Incidence, Prevalence, and Hospitalizations
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Hypertension (high blood pressure) is not a cardiovascular disease. However, it is considered a major risk factor for cardiovascular disease, including stroke and ischemic heart disease. Additionally, if a person has hypertension, it is treated even if they do not have a definitive cardiovascular disease diagnosis.[8]
The incidence and prevalence rates for hypertension are presented here because they provide an indication of the preventative health care needed to mitigate future incidence of cardiovascular disease.
The incidence rate was estimated as the number of people who were diagnosed with hypertension within the calendar year. The prevalence rate was estimated as the number of people who had ever been diagnosed with hypertension.[10]
Hospitalization data is available for cardiovascular disease (all types), ischemic heart disease (which can lead to heart attack), and stroke. The hospitalization rate was estimated as the number of hospitalizations due to the disease.[11]
Key Findings
In 2017, there were 1,644 new cases (incidence) of hypertension per 100,000 people (age 20 years and older) in Wellington-Dufferin-Guelph. That same year, there were 22,145 total cases (prevalence) of hypertension per 100,000 people (age 20 years and older).
Between 2008 and 2017, the incidence and prevalence rates of hypertension in Wellington-Dufferin-Guelph were lower than the rates in Ontario. In general, the incidence rate of hypertension in Wellington-Dufferin-Guelph and Ontario steadily decreased between 2008 and 2017. After an increase from 2008 to 2011, the prevalence rate of hypertension also steadily decreased in both Wellington-Dufferin-Guelph and Ontario.
*Wellington-Dufferin-Guelph includes Wellington County (including Guelph) and Dufferin County.
Source: Public Health Ontario. (2020, June 30). Chronic disease incidence and prevalence snapshot. https://www.publichealthontario.ca/en/data-and-analysis/chronic-disease/chronic-diseaseincidence-prevalence
The incidence and prevalence rates of hypertension increase with age; the rates are highest among those 75 years and older.
*Wellington-Dufferin-Guelph includes Wellington County (including Guelph) and Dufferin County.
Source: Public Health Ontario. (2020, June 30). Chronic disease incidence and prevalence snapshot. https://www.publichealthontario.ca/en/data-and-analysis/chronic-disease/chronic-diseaseincidence-prevalence
In 2019, there were 988 hospitalizations for cardiovascular disease, 319 hospitalizations for ischemic heart disease, and 125 hospitalizations for stroke per 100,000 people in Wellington-Dufferin-Guelph.
Between 2008 and 2019, the hospitalization rate for cardiovascular disease, ischemic heart disease, and stroke in Wellington-Dufferin-Guelph was (in most years) higher than the rate in Ontario. Overall, the hospitalization rate for cardiovascular disease and ischemic heart disease decreased between 2008 and 2019. The hospitalization rate for stroke fluctuated during that same period.
The hospitalization rates for cardiovascular disease, ischemic heart disease, and stroke increase with age; the rates are highest among those age 75 years and older.
Limitations
Incidence and prevalence are based on people age 20 years and older. Hospitalized patients include people from birth and are based on different population data than the incidence and prevalence rates. Therefore, the hospitalization rates cannot be directly compared to the incidence and prevalence rates.
The hospitalization rate is based on the number of hospitalizations, not the number of individuals hospitalized. A person could be hospitalized multiple times for the disease. Each time they are hospitalized counts toward to the total number of hospitalizations.
The incidence, prevalence, and hospitalization rates only include people who are eligible for health care in Ontario and have a valid Ontario health card.
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COPD Incidence, Prevalence, and Hospitalizations
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The incidence rate was estimated as the number of people who were diagnosed with COPD within the calendar year. The prevalence rate was estimated as the number of people who had ever been diagnosed with COPD.[10] The hospitalization rate was estimated as the number of people who were hospitalized for COPD within the calendar year.[11]
Key Findings
In 2017, there were 500 new cases (incidence) of COPD per 100,000 people (age 20 years and older) in Wellington-Dufferin-Guelph. That same year, there were 6,713 total cases (prevalence) of COPD per 100,000 people (age 20 years and older).
Between 2008 and 2017, the incidence and prevalence rates of COPD in Wellington-Dufferin-Guelph were lower than the rates in Ontario. Overall, the incidence rate of COPD in Wellington-Dufferin-Guelph and Ontario decreased slightly between 2008 and 2017 (however, there were slight increases in 2010, 2011, and 2016). During that same period, the prevalence rate increased slightly (although it decreased between 2016 and 2017).
*Wellington-Dufferin-Guelph includes Wellington County (including Guelph) and Dufferin County.
Source: Public Health Ontario. (2020, June 30). Chronic disease incidence and prevalence snapshot. https://www.publichealthontario.ca/en/data-and-analysis/chronic-disease/chronic-diseaseincidence-prevalence
In 2019, there were 231 hospitalizations for COPD per 100,000 people in Wellington-Dufferin-Guelph. Between 2008 and 2019, the hospitalization rate for COPD in Wellington-Dufferin-Guelph was higher than the rate in Ontario. In general, the rate did not change substantially between 2008 and 2019.
The incidence, prevalence, and hospitalization rates of COPD increase with age; the rates are highest among those 75 years and older.
Limitations
Incidence and prevalence are based on people age 20 years and older. Hospitalized patients include people from birth and are based on different population data than the incidence and prevalence rates. Therefore, the hospitalization rates cannot be directly compared to the incidence and prevalence rates.
The hospitalization rate is based on the number of hospitalizations, not the number of individuals hospitalized. A person could be hospitalized multiple times for the disease. Each time they are hospitalized counts toward to the total number of hospitalizations.
The incidence, prevalence, and hospitalization rates only include people who are eligible for health care in Ontario and have a valid Ontario health card.
Looking for more information?
Please download the excel sheet below for more information about this measure.
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Diabetes Incidence, Prevalence, and Hospitalizations
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The incidence rate was estimated as the number of people who were diagnosed with any type of diabetes within the calendar year. The prevalence rate was estimated as the number of people who had ever been diagnosed with any type of diabetes.[10] The hospitalization rate was estimated as the number of people who were hospitalized for any type of diabetes within the calendar year.[11]
Key Findings
In 2017, there were 658 new cases (incidence) of diabetes per 100,000 people (age 20 years and older) in Wellington-Dufferin-Guelph. That same year, there were 8,838 total cases (prevalence) of diabetes per 100,000 people (age 20 years and older).
Between 2008 and 2017, the incidence and prevalence rates of diabetes in Wellington-Dufferin-Guelph were lower than the rates in Ontario. In general, the incidence rate of diabetes in Wellington-Dufferin-Guelph and Ontario did not change substantially between 2011 and 2017, with an increase in 2009 and slight decrease from 2010 through 2011. The prevalence rate of diabetes in Wellington-Dufferin-Guelph and Ontario increased between 2008 and 2017.
*Wellington-Dufferin-Guelph includes Wellington County (including Guelph) and Dufferin County.
Source: Public Health Ontario. (2020, June 30). Chronic disease incidence and prevalence snapshot. https://www.publichealthontario.ca/en/data-and-analysis/chronic-disease/chronic-diseaseincidence-prevalence
In 2019, there were 121 hospitalizations for diabetes per 100,000 people in Wellington-Dufferin-Guelph.
Between 2008 and 2019, the hospitalization rate for diabetes in Wellington-Dufferin-Guelph was higher than the hospitalization rate in Ontario, except in 2013, 2016, and 2017 when the rate in Wellington-Dufferin-Guelph was lower than Ontario. Overall, the hospitalization rate for diabetes in Wellington-Dufferin-Guelph and Ontario did not change substantially between 2008 and 2017.
The incidence, prevalence, and hospitalization rates of diabetes generally increase with age. However, the incidence is highest among people age 65 to 74 years, followed by people age 75 years and older.
Limitations
Incidence and prevalence are based on people age 20 years and older. Hospitalized patients include people from birth and are based on different population data than the incidence and prevalence rates. Therefore, the hospitalization rates cannot be directly compared to the incidence and prevalence rates.
The hospitalization rate is based on the number of hospitalizations, not the number of individuals hospitalized. A person could be hospitalized multiple times for the disease. Each time they are hospitalized counts toward to the total number of hospitalizations.
The incidence, prevalence, and hospitalization rates only include people who are eligible for health care in Ontario and have a valid Ontario health card.
Looking for more information?
Please download the excel sheet below for more information about this measure.
Download Full Dataset
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Why are Chronic Diseases Important?
Chronic diseases are the leading cause of disability and death in the world.[14] They are also expensive to treat. In Ontario, chronic diseases account for an estimated $10.5 billion in direct health care costs.[8]
The chances you will get a chronic disease go up if you have a poor diet, use tobacco, exceed recommended limits for alcohol consumption, and/or are not physically active.[8] Change in behavior can be part of decreasing these modifiable risk factors. Age and heredity are the two main non-modifiable risk factors that can lead to chronic disease.[3]
Risk factors and likelihood of developing chronic disease are also influenced by the social, economic and physical conditions that a person experiences, including adverse childhood experiences and the social determinants of health (such good working conditions and food security).[3,5,6]
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Reportable Infectious Disease
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Reportable infectious diseases include vaccine preventable diseases (e.g. measles), sexual transmitted infections (e.g. chlamydia), enteric diseases (e.g. hepatitis A), vector borne diseases (e.g. lyme disease) and tuberculosis.[15]
Every year, infectious diseases (both individual cases and outbreaks of disease) cause illness and death in Canada.[16] The spread of infectious disease can be prevented by hand washing, getting vaccinated, staying home when ill, preparing food safely, practicing safe sex, and not sharing personal items.[17]
From 2000-2009, each year infectious disease caused 2.4 to 4.4% of all deaths that occurred in Guelph Wellington and Dufferin.[18]
For more information see: Infectious Disease in Wellington-Dufferin-Guelph.
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Self-Rated Health
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Self-rated health is your perception of your own physical health. This measure presents the subjective measure of an individual's physical health as either excellent, very good, good, fair or poor. Self-perceived health was captured as part of the Canadian Community Health Survey (CCHS).
The CCHS uses probability sampling. Therefore, each person in the sample represents (besides themselves) several other persons in the sample. A sample weight is calculated based on the number of people that that person represents within the population. For example, in a random sample of 1% of the population, each person would represent 100 persons in the population.[19]
Measures
Self-Rated Physical Health (2015-2017)
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Key Findings
From 2015 to 2017, 67% of Guelph residents, 59% of Wellington County residents and 61% of Ontario residents rated their health as very good or excellent.
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*Wellington County does not include City of Guelph.
Source: Canadian Community Health Survey (CCHS). Statistics Canada, Annual Content (2015-2017), Ontario Share File distributed by the Ontario Ministry of Health and Long-Term Care.
Prepared by: Wellington-Dufferin-Guelph Public Health.
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Self-Rated Physical Health by Age (2015-2017)
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Key Findings
In general, as people age they are less likely to report that their physical health is very good or excellent. From 2015 to 2017, this trend had one notable exception in Guelph, where 67% of 12 to 19 year olds reported their health as very good or excellent; this was the same as people 35 to 54 years old and less than people 20 to 34 years olds (74%). In contrast, people 75 years old and older living in Guelph were more likely to report their health as very good or excellent (54%) when compared to their counterparts in Wellington County (40%) and Ontario as a whole (41%).
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*Wellington County does not include City of Guelph.
Source: Canadian Community Health Survey (CCHS). Statistics Canada, Annual Content (2015-2017), Ontario Share File distributed by the Ontario Ministry of Health and Long-Term Care.
Prepared by: Wellington-Dufferin-Guelph Public Health.
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Why is Self-Rated Physical Health Important?
When people are asked to rate their health, they take into consideration more aspects of their life than could be covered through a survey or questionnaire. Self-rated Health is a strong predictor of mortality, morbidity and functional limitation. [20] It is also a reliable way to understand a person's overall health. [21]Limitations
Self-reported information is influenced by response bias and person's ability to accurately remember their past behaviours, experiences, and perceptions.
Looking for more information?
Please download the excel spread sheet below for more information about this measure.
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References
[1] Canadian Mental Health Association. (2017). The relationship between mental health, mental illness and chronic physical conditions. https://ontario.cmha.ca/documents/the-relationship-between-mental-health-mental-illness-and-chronic-physical-conditions/
[2] Clow, B. (2017). Infectious diseases and population mental health promotion for children and youth. Canada: National Collaborating Centres for Public Health. http://nccph.ca/images/uploads/general/05_Infectious_diseases_MentalHealth_NCCPH_2017_EN.pdf
[3] Ministry of Health and Long-Term Care. (2007). Preventing and managing chronic disease: Ontario's framework. http://www.health.gov.on.ca/en/pro/programs/cdpm/pdf/framework_full.pdf
[4] Kwong, J. C., Crowcroft, N. S., Campitelli, M. A., Ratnasingham, S., Daneman, N., Deeks, S. L., & Manuel, D. G. (2010). Ontario Burden of Infectious Disease Study Advisory Group; Ontario Burden of Infectious Disease Study (ONBOIDS): An OAHPP/ICES Report. Toronto: Ontario Agency for Health Protection and Promotion, Institute for Clinical Evaluative Sciences. http://www.publichealthontario.ca/en/eRepository/ONBoID_ICES_Report_ma18.pdf
[5] Felitti, V. J., Anda, R. F., Nordenberg, M. D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M .P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245-258. https://doi.org/10.1016/s0749-3797(98)00017-8
[6] Mikkonen, J., & Raphael, D. (2010). Social determinants of health: The Canadian facts. Toronto: York University School of Health Policy and Management. http://www.thecanadianfacts.org/The_Canadian_Facts.pdf
[7] Bernell, S., & Howard, S. W. (2016). Use your words carefully: What is a chronic disease? Frontiers in Public Health, 4, 159. https://doi.org/10.3389/fpubh.2016.00159
[8] CCO & Ontario Agency for Health Protection and Promotion (Public Health Ontario). (2019). The burden of chronic diseases in Ontario: Key estimates to support efforts in prevention. Public Health Ontario. https://www.publichealthontario.ca/-/media/documents/c/2019/cdburden-report.pdf?la=en
[9] Ontario Health (Cancer Care Ontario). 2021. Ontario cancer profiles: Data sources and notes. https://www.cancercareontario.ca/sites/ccocancercare/files/assets/OCPSourceNotes_0_0.pdf
[10] Public Health Ontario. (2020). Technical notes: Chronic disease incidence and prevalence snapshot. https://ws1.publichealthontario.ca/appdata/Snapshots/Chronic%20Disease%20Incidence%20Prevalence/Chronic_Disease_Incidence_Prevalence_Snapshot_Technical_Notes.pdf
[11] Public Health Ontario. (2021). Technical notes: Chronic disease hospitalization snapshot. https://ws1.publichealthontario.ca/appdata/Snapshots/Chronic%20Disease%20Hospitalization/Chronic_Disease_Hospitalization_Snapshot_Technical_Notes.pdf
[12] Public Health Agency of Canada. (2020). Aging and chronic diseases: A profile of Canadian seniors. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/aging-chronic-diseases-profile-canadian-seniors-report.html
[13] Statistics Canada. (2017). Age-standardized rates. https://www.statcan.gc.ca/en/dai/btd/asr
[14] World Health Organization (n.d.). Global health estimates: Life expectancy and leading causes of death and disability. https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates
[15] Association of Public Health Epidemiologists in Ontario. (2015). Infectious disease incidence. http://core.apheo.ca/index.php?pid=167
[16] Wellington-Dufferin-Guelph Public Health. (2013). Infectious disease in Wellington-Dufferin- Guelph. http://www.wdgpublichealth.ca/sites/default/files/wdgphfiles/infectious-disease-hs-report-2013.pdf
[17] Mayo Clinic. (2017). Infectious diseases. http://www.mayoclinic.org/diseases-conditions/infectious-diseases/manage/ptc-20168678
[18] Trotz-Williams, L., & Paphitis, K. (2012). Infectious disease in Wellington-Dufferin-Guelph. Available at: https://www.wdgpublichealth.ca/sites/default/files/file-attachments/report/hs_report_2012-infectious-disease-in-wdg_access.pdf
[19] Statistics Canada. (2015). Canadian Community Health Survey - Annual Component (CCHS). http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226
[20] Manor, O., Matthews, S., & Power, C. (2001). Self-rated health and limiting longstanding illness: Inter-relationships with morbidity in early adulthood. International Journal of Epidemiology, 30(3), 600–607. https://doi.org/10.1093/ije/30.3.600
[21] Schnittker, J., & Bacak, V. (2014). The increasing predictive validity of self-rated health. PLoS ONE, 9(1), e84933. https://doi.org/10.1371/journal.pone.0084933
[22] CDC (2012). Principles of Epidemiology in Public Health Practice, Third Edition. An Introduction to Applied Epidemiology and Biostatics Lesson 3: Measures of Risk. Section 2: Morbidity Frequency Measures. https://www.cdc.gov/csels/dsepd/ss1978/lesson3/section2.html
