Researchers\u00a0tracked\u00a05.5 million middle-aged adults from 2008 to 2012, looking for heart attacks, strokes\u00a0and deaths from cardiovascular issues. None of the adults \u2014\u00a0all between 40 and\u00a079 \u2014\u00a0had\u00a0a history of cardiovascular disease.<\/p>\n
“What we found were rather striking two-fold differences in the incidence of cardiovascular disease between Ontarians living in different parts of the province,” said lead author Dr. Jack Tu, a senior scientist at the Toronto-based\u00a0Institute for Clinical Evaluative Sciences.<\/p>\n
Tu, who’s also a cardiologist at Sunnybrook’s Schulich Heart Centre and was an expert adviser for CBC’s\u00a0Rate My Hospital project<\/a>, has long studied regional variations in cardiovascular deaths.<\/p>\n
His latest “big data” study with the Cardiovascular Health in Ambulatory Care Research Team included data from various health-care databases maintained by Ontario government, and broke information\u00a0down by Local Health Integration Networks (LHINs).<\/p>\n
3 healthiest areas all in GTA<\/h2>\n
The research\u00a0found the healthiest three LHINs\u00a0were all in the Greater Toronto Area, with the Mississauga Halton LHIN, Toronto Central LHIN\u00a0and Central LHIN coming out on top.<\/p>\n
Those three had the fewest cardiovascular health issues during the study period, with\u00a03.2 to 3.5 events out of every 1,000 person-years\u00a0\u2014\u00a0a statistical measurement used to express incidence rates.<\/p>\n
The four least-healthy\u00a0LHINs\u00a0were the North East LHIN and North West LHIN\u00a0\u2014\u00a0both in northern Ontario\u00a0\u2014 along with the North Simcoe Muskoka LHIN and Erie St. Clair LHIN.<\/p>\n
![\"Health](\"https:\/\/i.cbc.ca\/1.4052407.1491215724!\/fileImage\/httpImage\/image.jpg_gen\/derivatives\/original_620\/health-groups.jpg\")
<\/p>\n
The incidence of major cardiovascular events across health service regions, also known as Local Health Integration Networks, across Ontario throughout the five years of the study period. (CMAJ)<\/p>\n
Those areas were found to have\u00a0the most cardiovascular health issues, with 4.8 to 5.7 events out of every 1,000 person-years \u2014\u00a0or roughly double those of the most healthy LHINs.<\/p>\n
“Those living in the areas with the lowest burden of disease were the most likely to have received cardiovascular preventative services \u2014 such as having an annual physical, seeing their doctor to have their cholesterol and diabetes checked, and having their blood pressure controlled,” noted Tu.<\/p>\n
In contrast, people in the least-healthy areas were less likely to receive preventive screening tests or have an annual physician, and also visited a family doctor less often. They were also more likely to be obese or smoke, and have the lowest intake of fruits and vegetables.<\/p>\n
Improving access to boost health<\/h2>\n
The researchers determined improving access to preventive health-care services could boost cardiovascular health.<\/p>\n
Tu said his team account for the\u00a0many other factors that contributed\u00a0to each person’s health, such as their ethnic background or whether they were immigrants.<\/p>\n
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- Heart health impacted by sleep disruptions, shift work, study finds<\/strong><\/a><\/li>\n<\/ul>\n
By using a statistical analysis method to make predictions, the researchers determined that factors within Ontario’s health system, such as access to preventive health care, account for roughly 15 per cent of the difference in health levels between different regions.<\/p>\n
“The data suggests that there’s a significant number of Ontarians who are not being fully assessed for cardiovascular risk in the middle-age range,” Tu said.<\/p>\n
‘It’s a wake up call for all of us’<\/h2>\n
Toronto emergency room physician Dr. Brett Belchetz agreed, and praised the research for its “incredible size” and the length of the followup time.<\/p>\n
“The disparity here is obviously far greater than I ever would’ve expected. The outcomes are far worse for rural areas than I ever would’ve expected. I think it’s a wake-up call for all of us in the province that we have a bigger problem on our hands than we realized,” said Belchetz, who was not involved in the research.<\/p>\n
![\"Dr.](\"https:\/\/i.cbc.ca\/1.4052278.1491179595!\/fileImage\/httpImage\/image.jpg_gen\/derivatives\/original_220\/dr-jack-tu.jpg\")
<\/p>\n‘What we found were rather striking two-fold differences in the incidence of cardiovascular disease between Ontarians living in different parts of the province,’ says Dr. Jack Tu, lead study author and a senior scientist at the Toronto-based Institute for Clinical Evaluative Sciences. (Evan Mitsui\/CBC)<\/p>\n
Belchetz said it has\u00a0long been known that access to care is trickier in rural communities, thanks to reduced access to lab testing and a lower physician-to-patient ratio. Increased access to doctors, screening, and better education are all key to reducing the health divide, he said.<\/p>\n
“The fact that we’re seeing rates of these types of illnesses that are almost double in rural areas than they are in cities \u2014 that’s something that’s unacceptable,” he added.<\/p>\n
Tu acknowledged there were limitations to the research, which was funded primarily by an operating grant from the Institute of Circulatory and Respiratory Health-Canadian Institutes of Health Research.<\/p>\n
There was\u00a0a lack of complete data for every health indicator used for the millions of people in the study, for instance, and the team also couldn’t\u00a0be 100 per cent sure of a causal relationship between various risk factors and someone having a cardiovascular issue.<\/p>\n
But he still stressed the importance of patients taking their health care into their own hands by getting fully assessed and screened\u00a0\u2014\u00a0wherever they live\u00a0\u2014\u00a0and said policymakers need to consider geography when they’re determining health-care policies.<\/p>\n
\n\n\n\n\n\n\n","protected":false},"excerpt":{"rendered":"Where you live in Ontario could have a lot to do with\u00a0your risk of having a heart attack or stroke,\u00a0a massive new study has found. The peer-reviewed research, published on Monday in the Canadian Medical Association Journal, hammered home the\u00a0stark divide in health outcomes throughout the province. It found\u00a0people in northern Ontario\u00a0faced nearly double the Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-166268","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts\/166268","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/comments?post=166268"}],"version-history":[{"count":0,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts\/166268\/revisions"}],"wp:attachment":[{"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/media?parent=166268"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/categories?post=166268"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/tags?post=166268"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}