Transcript Measuring Community Wellbeing & Development

Genuine Progress Index for Atlantic Canada
Indice de progrès véritable - Atlantique
Measuring Community
Wellbeing & Development
JAG, Sydney, 6 June, 2003
Community GPI based on simple
questions:
How healthy is our community?
What kind of community are we
leaving our children?
Uncertain Answers: More
possessions, growth,
but….
•Stress, obesity, asthma, environmental illness
•Insecurity, inequality, unemployment, child
poverty
•Decline of volunteerism
•Natural resource depletion, species loss
•Less fish, condition of forests, soils
•Global warming
E.g.: Cape Breton in
CCHS – causes for
concern
• High unemployment and low-income rates
• Much higher incidence of chronic illness,
disability, and premature death than
Halifax
• Highest age-standardized mortality rate in
Maritimes
• Highest death rate from circulatory
disease, heart disease in Maritimes – 30%
above nat.av.
Of 21 Atlantic health districts,
Cape Breton has highest rates
of:
• Cancer death (231.8 per 100,000) – 25%
higher than the national average, lung
cancer
• Deaths due to bronchitis, emphysema, and
asthma (9.2 per 100,000) –50%+ higher
than the national average
• High blood pressure– 21.7%, (24.3%
women 19% men = 72% higher than the
Canadian rate.
Cape Breton = highest:
• Arthritis and rheumatism: 31% of
women, 23% of men
• Activity limitation (34%)
• Life expectancy: 72.8 years for men, and
79.4 for women. (Canada: 75.4 years men and 81.2 years -women
Disability-free life
expectancy
• Cape Bretoners have an average
disability-free life expectancy of only
61.8 years, seven fewer than the
national average, and the lowest of all
the 139 health regions in Canada.
• This means that Cape Bretoners can
expect to live considerably more years
with a disability than other Canadians.
Potential years of life lost
• highest number of potential years of life lost
due to both cancer and circulatory diseases
• Cape Bretoners lose 2,261.9 potential years of
life per 100,000 population due to cancer –
41% higher than the national average of
1,603.7
• and they lose 1,684 potential years of life per
100,000 population due to circulatory diseases
– 65% higher than the national average of
1,020.7
Cape Breton = lowest
mammogram screening,
highest breast cancer rate
Conventional measures of social
progress & wellbeing send the
wrong message:
 Sickness, crime, pollution, resource depletion, long
work hours (stress) make economy grow – which
in turn means we are “better off”??
 GDP can grow as poverty, inequality increase. GDP
ignores work that contributes directly to
community health (volunteers, work in home)
 We need better indicators of health & wellbeing:
GPI values health and its determinants – equity,
livelihood security, education, environment,
unpaid work, etc.
Community GPI
Initiative came from community groups.
Many community partnerships
include:
• Cape Breton Wellness Centre, community
health boards, regional public health
authorities, Atlantic Centre of Excellence for
Women’s Health, NS Citizens for Community
Development Society
• CB regional police, Glace Bay Citizens Service
League, Rotary Clubs, Kings and Cape Breton
Community Economic Development Agencies
Community-GovernmentUniversity Partnerships:
• Federal: Canadian Population Health
Initiative, National Crime Prevention Centre,
HRDC, Health Canada (PPHB Atlantic),
Canadian Rural Partnership, Rural
Secretariat, Statistics Canada
• University College of Cape Breton, Acadia U.
• Dalhousie Univ. Population Health Research
Unit; St. Mary’s University Time Use
Research Program
Tool for community health
and wellbeing - Goals:
Community: vision, mobilize, learn, act, assess:
• Vision - community indicator selection
• Mobilize communities - common goals
• “Learning about ourselves” – relationships
among variables = unique database
• Turn new-found knowledge into action
• Track progress
Process as Result
• Indicator selection, creating survey
• Results and report releases bring
together stakeholders and disparate
groups
• Scan existing programs, identify gaps
• New ideas: e.g. restorative justice,
family-friendly work arrangements
The Means:
• 3,600 surveys - random, 15+, confidential
• CI 95% +/- 3%; 2 cross-tabulations
• Detailed: 2 hrs; Glace Bay: 82% response
• Survey includes health, care-giving, time
use, voluntary work, security, income
employment, environmental issues
• Data entry & cleaning, access guidelines
Balance community-based research
with methodological rigour
• Statistics Canada oversight, advice, review
• Frame questions to compare results with
provincial & national averages
• Improve methods, indicators, survey tools,
data sources - never a final product
• Model for other communities (e.g. Sydney,
Whitney Pier) - template for adaptation
What’s in the Glace Bay and Kings
County GPI Surveys?
1) Demographics & Employment
• Age, sex, household, marital, education, income
• Employment, unemployment, out of work
• Job characteristics - types of jobs (p-t, f-t, etc),
benefits, work from home, occupation
• Work schedule, hours, shifts, job security,
underemployment, job sharing - work reduction
2) Health and Community
• Core values, caregiving, volunteer work,
community service
• Stress, mental health, social supports,
children’s health
• Weight, smoking, physical activity,
screening (Pap, mammogram, blood
pressure)
• Pain, disability, disease, medications,
health care use
3) Peace and Security
• Victimization and costs of crime
• Neighbourhood safety, fear, selfprotection
• Opinions about police, courts, prisons
• Identify community problems drinking? bullying? domestic violence?
drugs? Etc.
4) Time Use Diary
• Work: Household work, paid work,
voluntary work, caregiving, education
• How we spend free time - TV, reading,
socializing, spiritual practice, sport,
exercise
• Travel, personal activities, child care
• Window on quality of life
5) Environment
• Energy use
• Transportation patterns
• Water quality
• Recycling and waste
• Food consumption - food diary and
nutrition
Community Action
• Community access to results - special
software packages, news stories, etc.
• Meet to discuss results and identify
policy priorities / actions
• Community prioritizes indicators for
annual benchmarks of progress
• Community training - adaptations
Emphasis on practical action E.g:
• Teenage smoking; overweight; exercise - e.g.
promote school-based programs
• Screening rates - mammography, pap smears - notify health officials of needs
• Identify counselling needs - employment,
domestic violence, mental health
• Education - nutrition, recycling, energy use
• Glace Bay police inspector – vandalism focus
Present Smoking Habits
(Non-smokers include both those who quit smoking and those who never smoked)
100
90
80
76.1
73.7
71.6
70.4
69.5
70
70.4
68.4
Percentage
64.5
60
Daily
Occasional
Non-Smokers
50
40
31.3
30
25.8
25.6
23.5
10
21.2
19.4
20
27.2
25.1
4.5
4.3
4.4
5.1
4.1
4.5
4.2
4.4
Male
Female
Male
Female
Male
Female
Male
Female
0
Canada
Nova Scotia
Cape Breton
Glace Bay
Current smokers by
employment status
100
90
80
Percentage
70
60
53.9
50
40
35.3
35.1
30.9
30
23
20
10
0
Retired (N=502)
Employed
(N=585)
Home Maker
(N=236)
Unemployed
(N=185)
Student and
Other (N=175)
Daily Cigarette Consumption
and Employment Status
18
16
14.5
Mean Cigarettes/Day
14
12.53
12
10.6
9.8
10
8
7.78
6
4
2
0
Retired (N=234)
Employed
(N=296)
Home Maker
(N=120)
Unemployed
(N=118)
Student and
Other (N=77)