A presentation made at the 2014 conference: Holding Power to Account: Investigative Journalism, Democracy and Human Rights by Dr. Noralou Roos
http://winnipeg2014.com/
6. 6
Maintain Neutral
Evidence-Based Position
This project is about getting the evidence right – if there is
anything we are missing – let us know. If we have anything
wrong let us know and provide the evidence demonstrating
this. We expect people will sometimes interpret the evidence
differently. That is ok, but we do want to make sure we have
the evidence right.
7. 7
Aging Population: What’s the Issue
• The aged are small part of population
• Population has been aging for years: we
know what to expect
• Real issue: we are doing too much and
spending too much
8. 8
More to Health than Healthcare
• How many years would you add to life
expectancy if wipe out cancer?
• How many years would you add if gave inner
core Winnipeggers the life expectancy of
affluent suburbanites?
Manton has estimated that if every child could be given a pill at birth – which would eliminate every type of cancer (and
the heroic assumption is made that people don’t die earlier of something else), this would add 3.8 years to males’ life
expectancy and 2.6 years to female’s. Estimates of the gains to life expectancy from the elimination of the other major
disease killer, coronary heart disease, are similarly modest (estimated to be a little over 3 years by Tsevat).
Manton K. The dynamics of population aging: Demography and policy analysis. Milbank Q. 69(2):309-338, 1991.
Tsevat J, Weinstein M, Williams W, Tosteson A, Goldman L. Expected gains in life expectancy from various coronary
heart disease risk factor modifications. Circulation 1991;83:1194-1201.
9. 9
Bus trip up Pembina
Highway to downtown:
Life Expectancy at birth (in
years):
South Pembina Highway:
Males: 81 years
Females: 87 years
Downtown:
Males: 67 years
Females: 71 years
Fransoo et al. 2009
What’s 3 years?
Males:76 ,Females:82
Males:78.8 ,Females:83.7
Males:68.9 ,Females:77.1
Males:67.2 ,Females:70.5
Males:74.6 ,Females:82.8
Males:75.9 ,Females:80.4
Males:76.9 ,Females:83.2
Males:80.5 ,Females:86.7
Males:79.7 ,Females:83.5
Change in Male and Female Life Expectancy South-North following Pembina Hwy (rte 42) and Main St (rte 52)
Manitoba RHA Indicators Atlas 2009
Fransoo R, Martens P, Burland E, The Need to Know Team, Prior H, Burchill C
10. 10
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More critical looks must be taken at PSA testing and mammography screening
Archives of Internal Medicine recently argued “less is more” There should be no imaging tests for low back pain unless specific symptoms, no annual ECGs or cardiac screening tests for low risk patients with no symptoms of heart disease
Compared to the 3-4 years of potential gain for wiping out cancer – we find males who live down town have a life expectancy 14 years shorter than males who live in the affluent suburbs down South Pembina highway; and women 16 years
And there is evidence that small income increases can produce health benefits: the province of Manitoba introduced the prenatal benefit – a maximum of $81/a month available during pregnancy for those with a net income under $32,000. An uptake of this benefit was associated with a reduction in low birthweight births, reduction in preterm births and an increase in breast feeding initiation (Manitoba Centre for Health Policy report).