Health Inequities in Manitoba: Is the Socioeconomic Gap

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Chapter 5: Adult Health 98 University of Manitoba • The disparity between R1 and R5 increased substantially. The rate ratio of R1 compared to R5 was 1.07 in the first time period and 1.55 in the last time period, for a statistically significant increase of 45%. The absolute difference gap in IHD prevalence comparing R1 to R5 also statistically significantly increased by over 400% over time, from 0.50 more persons with IHD per 100 residents in the first time period (T1) to 2.59 more persons with IHD per 100 residents in the last time period (T8). Urban: • Comparing T1 to T8, IHD prevalence of all urban neighbourhood income quintile groups decreased over time. The decrease was fairly steady for U2 to U5. It was more variable for U1 where rates decreased to T4, increased to T5, and then decreased to T8. • The disparity between R1 and R5 was stable by one measure and increased by another measure. The rate ratio of R1 compared to R5 was 1.07 in the first time period and 1.33 in the last time period, but this increase was not statistically significant. The absolute difference gap in IHD prevalence comparing R1 to R5 statistically significantly increased by 196% over time, from 0.51 more persons with IHD per 100 residents in U1 compared to U5 in the first time period (1984/85–1986/87) to 1.51 more persons with IHD per 100 residents in the last time period (2005/06–2006/07). Lorenz Curves: Rural over time: • In T1, 20.5% of persons with IHD were accounted for in the 18.9% of the population in the lowest neighbourhood income quintile group R1, with the Gini coefficient of 0.019 indicating a statistically significant, though small, disparity. • In T8, 24.4% of persons with IHD were accounted for in the 18.2% of the population in the lowest neighbourhood income quintile group R1, with the Gini coefficient of 0.074 indicating a statistically significant disparity. • The Gini coefficient increased from the first to the last time period (p
Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time? Disparity measures over time by rural and urban: • The disparity rate ratios (i.e., the ratio of the IHD prevalence in the lowest compared to the highest neighbourhood income group) are increasing over time for rural but not urban Manitoba. The ratios started out the same in T1 for rural and urban, the rate ratio in rural areas increased more than that in urban areas, though there are no statistically significant differences between urban and rural. • The disparity rate differences (i.e., the absolute difference of IHD prevalence between the lowest and highest neighbourhood income group) are increasing over time. In some years the absolute differences are similar in rural and urban. In T2, the differences were higher in urban compared to rural; and in the last three time periods, the absolute differences are higher in rural compared to urban areas. The disparity rate differences may be plateauing in rural neighbourhood income groups and decreasing slightly in urban neighbourhood income groups since the early 2000s. What is this telling us? • The socioeconomic gap in IHD prevalence is fairly small. • The socioeconomic gap in IHD prevalence is widening over time by all measures for rural Manitobans and by some measures for urban Manitobans. • By all measures, the socioeconomic gap is larger in rural than in urban Manitoba. • All neighbourhood income groups in both rural and urban Manitoba show decreasing IHD prevalence over time. Where to from here? • Although IHD disparity exists, the Lorenz curves are not very steeply bent. So although targeted interventions should occur for the lowest neighbourhood income quintile groups, universal approaches need to reduce the burden of IHD throughout the entire population. • IHD prevalence has decreased in rural and urban Manitoba in 20 years. Programs focussed on decreasing IHD should continue. Manitoba Centre for Health Policy 99
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HEALTH INEQUITIES IN MANITOBA: Is t
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About the Manitoba Centre For Healt
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Dr. Patricia Martens acknowledges t
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Key findings: High School Completio
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List of Figures Figure 1.1 Distribu
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Figure 4.27 Adjusted Lorenz Curve f
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Figure 6.15 Hospitalization Due to
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List of Tables Table E.1 Changes in
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Figure A3.6 Adjusted Lorenz Curve f
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Executive Summary Health status and
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(derived from Table E.1’s columns
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Table E.1: Continued Indicator RURA
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Table E.1: Continued Indicator RURA
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Table Table E.2: E.2: Is Is the the
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This page edited May 18, 2011. Tabl
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References Commission on Social Det
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Health Inequities in Manitoba: Is t
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Table 2.1: Neighbourhood Income Qui
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Table 2.3: Neighbourhood Table 2.3:
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Figure 3.2: Premature Mortality Rat
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Figure 3.10: Potential Years of Lif
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Cumulative Percent of Potential Yea
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Figure 3.18: Under Five Mortality R
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Figure 7.10: Dementia Prevalence Ov
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Figure 7.18: Prevalence of Complete
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Reference Health Inequities in Mani
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Figure 8.2: Post-AMI Care: Beta-Blo
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Reference Health Inequities in Mani
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Table 9.1: Continued Indicator RURA
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Table 9.1: Continued Health Inequit
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Table A2.3: Crude Numbers of Mortal
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Table A2.5: Crude Numbers for High
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Table A2.7: Crude Numbers for Denta
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Table A2.11: Crude Numbers for Isch
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Table A2.13: Crude Numbers for Cont
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CONFIDENTIAL ‐‐ NOT FOR DISTRIB
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Table A2.17: Crude Numbers for Cumu
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Figure A3.2: High School Appendix C
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Health Inequities in Manitoba: Is the Socioeconomic Gap

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