On December 19, Southern Health-Santé Sud released its Community Health Assessment (CHA) which showed that our region enjoys overall health that is above the provincial average in many ways, despite low vaccination rates, long personal care home admission wait times, and some financial and social supports falling short.

Factors that determine how healthy we are focus on more than just the biological data available to the public as recorded by healthcare institutions. Characteristics of our region have a significant impact on the need for appropriate services and programs, such as what type of people make up our population, what our workplaces look like, and how our communities respond to our need for social support.

The 387-page CHA report was provincially coordinated by the Community Health Assessment Network (CHAN) using data from the 2016 census, Healthy Child Manitoba, CancerCare, the 2017–2018 Canadian Patient Experiences Survey-Inpatient Care, first-person case studies, and survey participants. The information presented in the CHA is foundational to forecast future issues that will require dedicated strategies in both the short- and long-term.

“The Community Health Assessment provides a picture of the overall health of people in the region. With this CHA, we focused on indicators that have proven over time to be really good for measuring population health,” says Southern Health CEO Jane Curtis. “The data will ensue continued conversations about health equity in our region with a focus to drill down in our data so we can understand what the data mean and how it reflects on the health of different population groups.”

A lot of work has gone into examining the state of our current health and producing a report to inform the public and policy-makers about said health. 

Noteworthy Results 

So how healthy are we? Here are some of the noteworthy results about the health in our area.

In the area of healthy child development, some of our strengths were in the area of mother and baby health, where pregnant mothers were screened with the lowest amount of risk factors in the province. However, more than one in five in-hospital births were by C-section and the percentage of C-section births increased significantly over time.

Another positive is that the health of mothers and babies at birth is quite good. However, by Kindergarten 27 percent of children struggled to meet age-appropriate developmental expectations.

Southern Health reports low teen pregnancy rates, but we also boast the lowest percentage of 17-year-olds with recommended doses for several vaccines (diphtheria, tetanus, pertussis, and HPV).

A review of seniors services showed that median wait times for admission from the hospital to personal care homes is about 16 weeks, which is higher than the provincial average, and that number is increasing significantly over time. Personal care home admission from the community is about 26 weeks, which is also higher than the provincial average.

Community health, substance use, and sexually transmitted infections were also covered in the report. The overall results show a region where people say they feel a strong sense of belonging in their communities.

Our area experiences social supports that are better than the rest of Manitoba, and this is improving over time, as reflected in the status of families with two parents, healthy workplaces, and beneficial community relationships. We have the lowest percentage of lone-parent families in the province—of these, the majority are led by women.

Substance use disorders were significantly lower than the provincial average and the majority of respondents reported never using their cell phone while driving.

Gonorrhea increased four-fold over four years and syphilis increased six-fold over four years.

Preventive services consist of measures taken toward increased overall health and greater disease prevention, but only 48 percent of adults aged 65+ received influenza immunizations, which is much below the national target. On top of that, we also have the lowest percentage of older adults immunized for pneumonia in the province, cancer screening is lower than the rest of the province for colorectal, breast and cervical cancers, and the number of people with dental insurance is lower than the province.

As far as general health issues go, life expectancy in our area is reported to be among the highest in the province and mortality indicators remained stable over time.

“The region was significantly better than the provincial average on many health outcomes including diabetes, ischemic heart disease, arthritis, osteoporosis, total respiratory morbidity, and potentially avoidable deaths,” reads the report.

Heart attack rates are still higher than the provincial average, but they have improved significantly over time. The leading cause of premature deaths in our area is cancer, and 19 percent of patients who received a cancer diagnosis were diagnosed in late stage.

An increase in chronic disease, especially of the kidney, is noted in our area.

“As the population grows and ages, more people are living with chronic diseases,” says the CHA. “Rates have increased significantly over time with diabetes, total respiratory morbidity, and childhood asthma. A major finding was around end-stage kidney disease. The region is projected to experience the highest increase in the province for renal therapies by 2024.”

According to the Canadian Medical Association (CMA), social determinants of health “are systematic social and economic conditions that influence a person’s health. They include income, housing, education, gender and race, and have a greater impact on individual and population health than biological and environmental conditions. Their impact can be even greater than that of the health care system itself.”

Among the statistics presented on disease and biological health issues, the CHA also prominently featured a presentation on statistics around where we access healthcare, a study on the demographics of our area, and the overall determinants of quality health.

“About 50 percent of an individual’s health is determined by their life experiences (e.g., income, early childhood development, disability, etc.),” says the CMA. “Only 25 percent of an individual’s health is determined by the health care they receive (e.g., access to health care, the healthcare system, wait times, etc.), and 15 percent is determined by an individual’s biology (e.g., genetics). Finally, the environment determines about 10 percent of an individual’s health (e.g., air quality, civic infrastructure, etc.).” 

The Region 

Southern Health-Santé Sud covers a thriving multicultural region covering an expanse of 27,025 square kilometres of south central and eastern Manitoba. It is one of the fastest growing areas in the province, growing by more than nine percent (in excess of 16,000 new residents) over five years, representing the largest percentage of population growth in the province, mostly in the areas surrounding the southern edge of Winnipeg, as well as Winkler and Morden.

These population numbers are projected to increase by another 25 percent to 250,000 by 2030.

The population is made up of a higher ratio of younger to older ages, meaning there are typically more children than adults in our communities. Our families have the second highest dependency ratio in province, indicating higher pressure on the working-age population to support youth and older adults.

The report identified that 13 percent of us are Indigenous, and 14 percent of us claim immigrant status.

Our region reported that we most commonly access healthcare for minor health problems at a local physician’s office or walk-in clinic. Residents report waiting more than two weeks longer to be seen for minor health problems compared to the provincial average. Eighty-four percent report having access to a regular health provider, but residents receiving the majority of their care from only one primary care provider are fewer than the provincial average, and they are decreasing over time. When they do need to coordinate care, 45 percent of those surveyed report excellent or very good coordination between healthcare providers.

There continues to be a wide variety of social detriments to health that plague our region. A wide income gap is prevalent among our population, with a difference of more than $52,000 between the highest and lowest average household incomes. This is a considerable difference, since the median household income for the region is about $60,000.

Overall, our communities are experiencing better socioeconomic conditions than the rest of the province, although material wealth is much lower.

“It is well known that income is the most important social determinant of health,” reads the CHA. “The underlying causes of health inequities are largely social and economic in nature. The actions needed to reduce inequities go beyond the healthcare system and are vital to improving the health of all Manitobans.

The report goes on to say, “Health inequities are unfair and modifiable… The interventions needed go beyond health care services and supporting healthy behaviours, to the types of public policies, programs and services a society chooses. For example, decades ago, the poverty rates amongst older adults in Canada was substantially reduced by introducing a universal public pension program. Language surrounding health inequities will hopefully lead us to talk about why these differences exist and what kind of changes are likely to get at the root causes to make the biggest difference in narrowing persisting gaps among population groups. CHAs provide a better understanding of what contributes to health inequities and what we need to address in order to advance health equity for our population.”