A profile of cardiovascular disease in northern Ontario: public health planning implications.

Cardiovascular disease (CVD) is a leading cause of death in Northern Ontario and therefore considered an important issue. To this end, this paper examines CVD trends in Northern Ontario and the prevalence of known risk factors that give an insight into these trends. Ontario Health Survey 1990, Ontario Health Survey 1996, Canadian Institute for Health Information (1990-95) and Vital Statistics (1990-95) were examined. It was determined that CVD rates in Northern Ontario significantly exceeded those of the province. Further, high prevalence of modifiable risk factors, such as smoking, fat intake, physical inactivity and obesity are all experienced in Northern Ontario when compared to the province. Planning implications, as they relate to collaboration, delivery of services, determinants of health, multiple risk factors and monitoring and evaluation are also discussed.

Factors associated with seat belt use: an evaluation from the Ontario Health Survey.

This study examines the factors associated with seat belt use for drivers and passengers in Ontario. Using the 1990 Ontario Health Survey, a population-based survey of non-institutionalized Ontario residents, factors associated with seat belt use among drivers and passengers were identified and are reported as unadjusted and adjusted odds ratios (OR; 95% CI). Seat belt non-use in Ontario drivers was most strongly associated with younger age (p < 0.0001), high risk health behaviours (drinking and driving (OR: 2.43), speeding (OR: 2.04), smoking (OR: 1.66)), being male (OR: 1.87), living in northern (OR: 1.80) or rural (OR: 1.69) regions, and achieving lower education (OR: 1.46). Seat belt non-use in passengers was associated with younger age (p < 0.0001), smoking (OR: 1.62), being male (OR: 1.68), living in northern (OR: 1.63) or rural (OR: 1.46) regions, and low education (OR: 1.31). Vehicular trauma is a major public health problem and seat belt use has been shown to reduce injuries in the event of a crash. Any strategy to increase seat belt use in Ontario should be targeted to involve both drivers and passengers. Attention should be paid to increasing seat belt usage by younger adults, males, and especially those living in northern and rural regions.

The effect of a community-based police surveillance program on snowmobile injuries and deaths.

Serious snowmobile injuries are preventable and associated with late-night travel, alcohol use, and speed. We studied the effectiveness of a community-based policing (STOP) program in the prevention of serious injuries related to snowmobile trauma in Sudbury, Ontario. Volunteers were trained in police protocol and were appointed special constables to increase policing on snowmobile trails from 1993-95. Snowmobile admissions and deaths in Sudbury were examined; the pre- (1990-1992) and post- (1993-1995) STOP seasons were compared. In the pre-STOP period, 102 injuries, 87 admissions, and 15 deaths occurred compared to 57 injuries (p = 0.0004), 53 admissions (p = 0.00001) and 4 deaths (p = 0.13) in the post-STOP period. All other event and demographic features of the crashes remained similar. Significant economic savings were realized from this intervention; acute care costs savings exceeded $70,000/year and costs from death decreased by $5 million. An intervention involving enforcement on snowmobile trails can reduce the incidence of injuries from snowmobile-related trauma.

A cost-benefit analysis of prenatal screening for toxoplasmosis.

The objective of this study was to examine critically the validity of a toxoplasma prenatal screening program, in the context of a cost-benefit analysis, as it relates to the Canadian experience. Recently, studies have suggested that early treatment of infected infants with a combination of pyrimethamine and sulfadiazine is effective in reducing the sequelae of toxoplasmosis. It was concluded that a carefully planned screening program for detecting and treating infants infected with Toxoplasma gondii during pregnancy is cost beneficial. The cost of delivering a screening and treatment program is less than half of what it would cost to provide comprehensive long term medical, educational and other social services for the estimated 1000 children born each year with congenital toxoplasmosis. Even if an incidence as low as two infected infants per 1000 pregnancies is assumed and only 400 children were affected, the screening and preventive therapy program would be justified.

Regional variations of northern health: the epidemic of fatal trauma in northeastern Ontario.

OBJECTIVE: To examine the causes of traumatic death in a northern region of Ontario. METHODS: Prevalence study of trauma deaths occurring within the region of Northeastern Ontario over the years 1989-1991; regional data were compared with provincial data. RESULTS: 1,027 patient records were identified over the study period (51.4 deaths per 100,000 population/year). Non-intentional trauma accounted for 70% of all trauma deaths in the region; suicide (25%; 12.8/100,000) and homicide (5%; 2.4/100,000) were less common. Motorized vehicle trauma accounted for most of the non-intentional traumatic death (39%; 20.4/100,000). Age-standardized mortality ratios were 67% above the provincial average for non-intentional trauma, 71% above the provincial average for suicides, 55% above the provincial average for homicides, and 68% higher for all forms of traumatic death. CONCLUSIONS: Traumatic death is a major health problem in northern areas; reduction of these rates depends on the development of an effective injury prevention strategy.