Health Inequities in Manitoba: Is the Socioeconomic Gap

Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time?
Chapter 7: Mental Health
Cumulative Mental Illness
Definition
The grouping “Cumulative Mental Illness” was created to provide an overall indicator of the
prevalence of mental illness, accounting for the co–occurrence among mental illnesses. Five–year
period prevalence of cumulative mental illness was the proportion of the population aged 10 and older
that had a diagnosis for any of the following over a five–year period: depression, anxiety, substance
abuse, personality disorders, or schizophrenia. Refer to the Glossary for more details on the coding
of each diagnosis.
Note: Cumulative mental illness rates from previous recent findings are slightly higher than results
in this report, due to the exclusion of drugs in the definitions for this report compared to the RHA
Indicators Atlas 2009 (Fransoo et al., 2009). This is in an attempt to make the definition consistent across
all time periods, as the drug data are only available after 1995.
Time Periods Five–year period prevalence (%)
T1: 1984/85–1988/89 15.99
T2: 1989/90–1993/94 17.66
T3: 1994/95–1998/99 19.40
T4: 1999/00–2003/04 23.24
T5: 2004/05–2008/09 23.56
Key findings: Cumulative Mental Illness
Manitoba overall rates:
• From the first time period T1 (1984/85–1988/89) to the last time period T5 (2004/05–2008/09),
the provincial prevalence of cumulative mental illness increased from 15.99% to 23.56% of the
population.
Rates by neighbourhood income quintile over time:
Rural:
• From T1 to T5, the percent of the population aged 10 or older with cumulative mental illness
increased steadily for all rural neighbourhood income quintiles. The increase was greatest in R1.
• The disparity between R1 and R5 increased over time. The rate ratio of R1 compared to R5 was
almost non–existent in the first time period at 0.98 (i.e., R1 and R5 are very similar, hence the ratio
is close to 1). It increased to 1.10 in the last time period, for a statistically significant increase of
12%. The absolute difference gap of cumulative mental illness comparing R1 to R5 also statistically
significantly increased over time, from 0.21 fewer people per 100 having cumulative mental illness
in R1 compared to R5 in the first time period, to 1.83 more people with cumulative mental illness per
100 in R1 compared to R5 in the last time period. Although this difference is statistically significant, it
represents a minimal change in disparity over time.
Manitoba Centre for Health Policy 139