New public health research debunks “grey tsunami”
An examination of chronic diseases among Ontarians has uncovered that the aging population is not the much-touted heavy burden on Canada’s health-care system. The results, published in the Canadian Journal of Public Health (CJPH), indicate the volume of multimorbidity — the presence of three or more chronic conditions — is derived from adults as young as 35 years old. Multimorbidity has been associated with increased physician and specialist appointments, medication use, emergency department use and hospitalization.
“Too much rhetoric has been narrowly focused on Canada’s aging population,” says Louise Potvin, CJPH editor-in-chief. “It’s distracting from very real and critical issues that compound chronic illness, such as insufficient and unequal access to quality health care, and inadequate disease prevention and health promotion interventions for younger and middle-aged people.”
The cross-sectional population-based study included absolute numbers of multimorbidity by age, a finding not usually reported, but of great use to public health policy and primary care strategies. In 2013, more than 73 per cent of Ontarians over the age of 80 had multimorbidity compared to 50 per cent of those aged 65-79, and nearly 20 per cent of those between 45 and 64. However, in absolute numbers, the highest volume of multimorbidity is seen between the ages of 45 and 64, with approximately 754,663.
“In focusing primarily on advanced age, governments and policy-makers cannot fully appreciate the causes and solutions to multimorbidity in the middle years — and the potential impact on population health,” said Bridget Ryan, the study’s lead author, an assistant professor at Western University in the Departments of Family Medicine and Epidemiology and Biostatistics and an Institute for Clinical Evaluative Sciences (ICES) Fellow. “Our goal with this study is to demonstrate the need for more attention and resources directed to the prevention and management of chronic diseases earlier in life.”
Of the 17 chronic conditions accounted for in this research, the most prevalent were hypertension, mood disorders, arthritis, diabetes and chronic obstructive pulmonary disease. Increased attention on chronic conditions and multimorbidity can help inform prevention and management strategies, as well as provide insights into how external factors — such as income and geography — influence population health.
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The Canadian Journal of Public Health aims to advance public health research and practice in Canada and around the world, contributing to the improvement of the health of populations and the reduction of health inequalities. The independent journal publishes peer-reviewed original research and scholarly articles submitted in either English or French that are relevant to population and public health. CJPH is an official publication of the Canadian Public Health Association.