Trends in Mortality by Income in Urban Canada from 1971 to 1996 Part I

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 Group Statistics 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: russell.wilkins@statcan.ca 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 ASMR x 100,000 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 0 1971 1976 1981 1986 1991 1996 Q1 - Richest Q2 Q3 Q4 Q5 - Poorest Ischemic Heart Disease ASMR per 100,000 420 400 380 360 340 320 300 280 260 240 220 200 180 160 140 120 100 80 60 40 20 0 1971 1976 1981 1986 1991 1996 Q1-M Richest Q2-M Q3-M Q4-M Q5-M Poorest Q1-F Richest Q2-F Q3-F Q4-F Q5-F Poorest Ischemic Heart Disease, Males Per 100,000 420 400 380 360 340 320 300 280 260 240 220 200 180 160 140 120 100 1971 1976 1981 1986 1991 1996 Q1-M Richest Q2-M Q3-M Q4-M Q5-M Poorest Ischemic Heart Disease, Females ASMR per 100,000 170 160 150 140 130 120 110 100 90 80 70 60 50 1971 1976 1981 1986 1991 1996 Q1-F Richest Q2-F Q3-F Q4-F Q5-F Poorest Uterine Cancer ASMR x 100,000 14 13 12 11 10 9 8 7 6 5 4 3 2 1 0 1971 1976 1981 1986 1991 1996 Q1 - Richest Q2 Q3 Q4 Q5 - Poorest Liver Cirrhosis, Females ASMR x 100,000 12 11 10 9 8 7 6 5 4 3 2 1 0 1971 1976 1981 1986 1991 1996 Q1 - Richest Q2 Q3 Q4 Q5 - Poorest Liver Cirrhosis, Males ASMR x 100,000 30 28 26 24 22 20 18 16 14 12 10 8 6 4 2 0 1971 1976 1981 1986 1991 1996 Q1 - Richest Q2 Q3 Q4 Q5 - Poorest Injuries except MVTA+Suicide, Both Sexes ASMR x 100,000 45 40 35 30 25 20 15 10 5 0 1971 1976 1981 1986 1991 1996 Q1 - Richest Q2 Q3 Q4 Q5 - Poorest Pedestrians Hit by Motor Vehicles, Both Sexes ASMR x 100,000 6 5 4 Q1 - Richest 3 2 1 0 1971 1976 1981 1986 1991 1996 Q2 Q3 Q4 Q5 - Poorest Motor Vehicle Occupants, Both Sexes ASMR x 100,000 16 14 12 10 8 6 4 2 0 1971 1976 1981 1986 1991 1996 Q1 - Richest Q2 Q3 Q4 Q5 - Poorest Lung Cancer, Males ASMR x 100,000 95 90 85 80 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5 0 1971 1976 1981 1986 1991 1996 Q1 - Richest Q2 Q3 Q4 Q5 - Poorest Breast Cancer, Females ASMR x 100,000 32 30 28 26 24 22 20 18 16 14 12 10 8 6 4 2 0 1971 1976 1981 1986 1991 1996 Q1 - Richest Q2 Q3 Q4 Q5 - Poorest Prostate Cancer ASMR x 100,000 26 24 22 20 18 16 14 12 10 8 6 4 2 0 1971 1976 1981 1986 1991 1996 Q1 - Richest Q2 Q3 Q4 Q5 - Poorest Suicide, Males ASMR x 100,000 34 32 30 28 26 24 22 20 18 16 14 12 10 8 6 4 2 0 1971 1976 1981 1986 1991 1996 Q1 - Richest Q2 Q3 Q4 Q5 - Poorest Suicide, Females ASMR x 100,000 11 10 9 8 7 6 5 4 3 2 1 0 1971 1976 1981 1986 1991 1996 Q5 - Poorest Q1 - Richest Q2 Q3 Q4 Lung Cancer, Females ASMR x 100,000 35 30 25 20 15 10 5 0 1971 1976 1981 1986 1991 1996 Q1 - Richest Q2 Q3 Q4 Q5 - Poorest Mental Disorders, Both Sexes ASMR x 100,000 11 10 9 8 7 6 5 4 3 2 1 0 1971 1976 1981 1986 1991 1996 Q5 - Poorest Q1 - Richest Q2 Q3 Q4 Infectious Diseases, Both Sexes ASMR x 100,000 22 20 18 16 14 12 10 8 6 4 2 0 1971 1976 1981 1986 1991 1996 Q5 - Poorest Includes 1986 AIDS recoded to Infectious Diseases Q1 - Richest Q2 Q3 Q4 Ill-Defined Conditions, Both Sexes ASMR x 100,000 20 18 16 14 12 10 8 6 4 2 0 1971 1976 1981 1986 1991 1996 Q4 Q5 - Poorest Q1 - Richest Q2 Q3 Diabetes, Males ASMR x 100,000 22 20 18 16 14 12 10 8 6 4 2 0 1971 1976 1981 1986 1991 1996 Q5 - Poorest Q1 - Richest Q2 Q3 Q4 Diabetes, Females ASMR x 100,000 22 20 18 16 14 12 10 8 6 4 2 0 1971 1976 1981 1986 1991 1996 Q5 - Poorest Q1 - Richest Q2 Q3 Q4 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