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David Spurgeon Quebec
Rates of childhood obesity in Canada have almost tripled over the past 20 years, says a report on health services in 2001 from the Canadian Institute for Health Information.
The prevalence of obesity among 7 to 13 year olds rose from 5% in 1981 to 17% in 1996 for boys and 15% for girls. Canadian children are considerably more likely to be overweight than their English, Scottish, and Spanish peers, says Health Care in Canada 2000.
Another, more recently published research paper from the Institut de la Statistique du Québec showed that almost a quarter of 9 year olds and half of 16 year olds in that province were at risk of heart disease in later life because of lifestyle factors, such as obesity, physical inactivity, or smoking.
The publication of he both reports follows on from several recent studies questioning Canada’s ability to maintain services without fundamental changes to the healthcare system. The healthcare bill exceeded $C100bn (£44bn; $US65bn; €69bn) for the first time in 2001, with public sector spending accounting for almost three quarters of the total, the report by the Canadian Institute for Health Information shows.
Almost a third of the total ($C32.2bn) went on hospitals. Drugs accounted for $C15.5bn, and doctors took the third largest share, at just under $C14bn, equivalent to $C446 per head. Since 1977 spending on drugs has been higher than on doctors’ services.
Canada spent about 9.4% of its gross domestic product on health care in 2001. Only three countries in the Organisation for Economic Cooperation and Development spent more—the United States (12.9%), Switzerland (10.4%), and Germany (10.3%).
One in five hospital admissions among men and just over 11% of those among women in 1999-2000 were for heart disease and stroke, the report shows. Almost 13% of patients who had had a heart attack and just under one in five patients with stroke died within 30 days of admission, but death rates for stroke across the 36 regions ranged from 15% to 35%.
People living in poorer areas were less likely to receive some specialist treatments for heart attack and more likely to die than those living in wealthier areas.
Survival rates for cancer sometimes depended on where patients lived, but nationally five year survivals for prostate and breast cancers were 87% and 82% respectively.
Spending on the care of people at home increased by more than 350% between 1989 and 1999 but amounted to only 4.7% of the total healthcare budget in 1999.
Health Care in Canada 2002 can be accessed at http://secure.cihi.ca/
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What can you learn from this BMJ paper? Read Leanne Tite's Paper+