'Huge' life-expectancy gap between Winnipeg's neighbourhoods highlights areas in need: experts

A "huge" gapin life expectancy and overall health between two Winnipeg neighbourhoods points to inequities in levels of income, housing, education and nutrition, experts say, and lays out priorities for future social and health-care planning.

On average, people living in Point Douglas South, which has the shortest life expectancy in the city, die 18 years before people who live in Inskter West, which has the longest, according to data revealed in the latest WRHA community health assessment.

Based on figures from 2012-2016, men in Point Douglas South lived on average to age 69, while men in Inkster West lived on average to 87. Women in Point Douglas South lived on average to age 73, while women in Inkster West lived to 90.

"Those kind of life expectancy gaps are huge," said Randy Fransoo, a senior research scientist for the Manitoba Centre for Health Policy, whose report is a primary source for the Community Health Assessment.

According to the community assessment, Point Douglas has the highest rates of suicide, hypertension, heart and kidney disease in the city, and the lowest after-tax income, compared to River East North, which had the the highest.

Mothers living in Point Douglas were nine times more likely to receive "inadequate prenatal care"compared to mothers in River East North, despite Point Douglas having the highest birth rate. People living there were more than five times as likely to die from a preventable cause and least as likely to have post-secondary education.

"It is a huge difference. And most of that is related to the social determinants of health, as we call it," said Fransoo.

Those include a person's housing, income, nutrition, ethnicityand level of education, according to the medical lead for the primary healthcare (My Health) team for downtown andPoint Douglas.

"In urban areas, where there are significant amounts of poverty, not only are the rates of chronic disease higher but the complications associated with those chronic diseases are much higher as well, and that would include things like diabetes, COPD, cardiovascular disease as well as mental health," said Dr. Michael Hochman.

The report also showed the highest rates of substance use disorder and mental illness, including mood disorders and anxiety, in the inner city.

"These people tend to be quite complex and have very challenging life circumstances and they are quite sick and they typically have a number of medical co-morbidities and are on a number of medications.

"We need to work towards more proactive and preventative strategies to address those larger issues, like homelessness, in order to provide people with enhanced opportunities to take care of themselves."

Decreased continuity of care, clinic visits

According to the community health assessment, Manitobans' rates of visits to doctors and nurse practitioners were stable, but the continuity of caredecreased across the region overall, and lower-income areas showed fewer visits to doctors and specialists.

Rates of sexually transmitted infections, including syphilis and gonorrhea, are skyrocketing, with a 394 per cent increase in syphilis and 297 per cent increase in gonorrhea between 2014 and 2018.

"Being more flexible and opportunistic when a patient presents is critical. As well as co-ordinating services, utilizing other capacities like outreach, and going to the patient at times," saidHochman.

"We have a social worker whose job is specifically to help people navigate support services that they're entitled to. But if you don't have ID, if you haven't paid your taxes, there's so many benefits that you can't access."

Overall health status, life expectancy higher

Across the region, rates of immunization were lower than national targets, including fewer than 65 per cent of children up to date with their measles, mumps and rubella vaccinations, compared to a 95 per cent national target.

But overall life expectancy was higher across the region, as well as health status, with an increase of about a year for both women (83.4) and men(79.4), fewer hospitalizations and deaths due to heart attack and stroke and a lower mortality rate for all cancers.

"The good news is life expectancy is getting higher, the bad news is the prevalence of chronic disease is also increasing as our population continues to grow and especially to age," said Fransoo.

"Overall the population is getting healthier. But that doesn't mean everyone is getting healthier."

The report isdone by each of the five regional health authorities in the province every five years. Both Fransoo and Hochman hopethe highlighted inequities lead to action.

"You either invest ahead of time to reduce the long-term risk of these things or you are faced with a larger hill to climb and a larger bill at the end," said Hochman.

Life expectancy by neighbourhood, 2012-16

Hover over neighbourhood to see data from WRHA community health assessment. Does not include sub-neighbourhoods.