Community Health Trends and Challenges

Aging Population

The proportion of the population aged 65 and older in 2015 was 28.8% in the 100-Mile House Local Health Area (LHA), compared to 17.1% in Cariboo-Chilcotin LHA[1] and 17.5% in BC[2],[3]. 100-Mile House LHA therefore has an older population than both the Cariboo-Chilcotin LHA and BC overall.

In 100-Mile House Local Health Area, it is anticipated that, by 2025, 40.4% of the population will be 65 years of age or older[4]. This is compared to 24.6% for Cariboo-Chilcotin Local Health Area and 22.4% for BC[5].


An aging population is expected to cause additional strain on the health care system. For example, based on a community survey in 2014, 47% of adults 65 years or older in the Central Interior Rural region had hypertension and 28% had osteoarthritis. Consistent with the large seniors’ population in the CIRD region, use of home health services has increased in recent years. For example, home support hours per 1,000 population aged 75+ increased by 9% in the Cariboo-Chilcotin Local Health Area from 2013/14 to 2015/16. While 100-Mile House rates increased only marginally during this same period, they were one-third higher than Interior Health (Health Authority for BC’s Interior region) rates in 2015/16 (25,790 vs. 19,385 hours/1000 population, respectively).[6]

 


[1] Cariboo-Chilcotin LHA = Williams Lake and surrounding region

[2] Primary Care Home Profile: 100 Mile House (025). March 2017. BC Ministry of Health

[3] Primary Care Home Profile: Cariboo Chilcotin (027). March 2017. BC Ministry of Health

[4] Primary Care Home Profile: 100 Mile House (025). March 2017. BC Ministry of Health

[5] Primary Care Home Profile: Cariboo Chilcotin (027). March 2017. BC Ministry of Health

[6] Health Services used by Residents of the Cariboo-Chilcotin/100 Mile House Geographic Service Area. Fiscal years 2012/1 to 2015/16. Feb 21, 2017. Interior Health.

High Service Use for Mental Health and Substance Use

Mental health and substance use (MHSU) is a notable healthcare concern in the communities of Williams Lake, 100-Mile House, and surrounding regions. While the age-standardized prevalence of Episodic Depression/Anxiety per 1000 population is 69 in BC for 2014/15, and 69 in the Cariboo-Chilcotin Local Health Area[1], it is 103 in the 100-Mile House Local Health Area[2][3]. In 2013, 276 individuals were diagnosed with Depression and/or Anxiety in Cariboo-Chilcotin Local Health Area[4], and 171 in 100-Mile House Local Health Area[5]. Of note, these numbers for mental health only comprise individuals who have sought help, making them just the tip of the iceberg of individuals living with a mental health condition.

The mental health and substance use population represents a high user group of health services. In 2014/15, 100-Mile House Local Health Area, the average number of General Practitioner visits per user for individuals under 75 years old with mental health/substance use concerns was 9.1 visits per user, compared with 5.0 for non-mental health/substance use patients. In the Cariboo-Chilcotin Local Health Area in 2014/15, mental health/substance use patients used an average of 8.5 general practitioner visits compared with 4.5 for non-mental health/substance use patients.[6][7]

Over the three years between 2013/14 and 2015/16, the number of MHSU service days per 1,000 population increased from 252 to 342 in the Cariboo-Chilcotin Local Health Area

 


[1] Cariboo-Chilcotin Local Health Area = Williams Lake and surrounding region

[2]Primary Care Home Profile: 100 Mile House (025). March 2017. BC Ministry of Health

[3] Primary Care Home Profile: Cariboo Chilcotin (027). March 2017. BC Ministry of Health

[4] BC Community Health Profile: Williams Lake. 2017. PHSA.

[5] BC Community Health Profile: 100 Mile House. 2017. PHSA.

[6]Primary Care Home Profile: 100 Mile House (025). March 2017. BC Ministry of Health

[7] Primary Care Home Profile: Cariboo Chilcotin (027). March 2017. BC Ministry of Health

[8] Health Services used by Residents of the Cariboo-Chilcotin/100 Mile House Geographic Service Area. Fiscal years 2012/1 to 2015/16. Feb 21, 2017. Interior Health.

[9] ChangeMaker Consulting. Communities that Care – Williams Lake. 2016.

Low Capacity in Maternity Care

Cariboo-Chilcotin[1] and 100-Mile House local health areas (LHAs) both have disproportionately high rates of infant mortality and low birth weight compared with BC as a whole (Table 1). 100-Mile House LHA has significant challenges with capacity in maternity care. There are no family physicians in 100-Mile House providing maternity care, meaning maternity patients currently travel to Williams Lake to seek care. (Note that the Central Interior Rural Division is working on Maternity care options to improve this issue!)

Table 1. Birth statistics, average rates per 1,000 births.
Cariboo-Chilcotin LHA 100-Mile House LHA BC
Infant mortality (2008-2012)[2] 5.6 4.0 3.7
Low birth weight (2007-2011) [3],[4] 63 65 56

 


[1] Cariboo-Chilcotin LHA = Williams Lake and surrounding region

[2] Socioeconomic Profile: Local Health Area 25 – 100 Mile House. BC Stats.

[3] BC Community Health Profile: Williams Lake. 2017. PHSA.

[4] BC Community Health Profile: 100 Mile House. 2017. PHSA.

High Rates of Chronic Disease

Consistent with its aging population, high burden of disease in First Nations individuals, and challenges related to the social determinants of health, it is no surprise that certain chronic diseases are overrepresented in the . Notable conditions among the local population include hypertension, osteoarthritis, diabetes, depression, and asthma.

 

In 100-Mile House, over half (51.4%) of the population was living with an illness/chronic condition in 2014/15*, which is higher than the B.C. population rate of 40.2%. For example, compared with BC, 100-Mile House has disproportionately high rates of hypertension, episodic depression/anxiety, and Chronic Obstructive Pulmonary Disease (COPD), even after standardizing for age ([1][2]). The Cariboo-Chilcotin Local Health Area[3] had a rate of 41.2% in 2014/15, which is similar to the BC rate.[4][5]

 

Chronic Disease Age-standardized Incidence per 1,000 population and Prevalence (2013)

Cariboo-Chilcotin LHA

100-Mile House LHA

BC

Prevalence Incidence Prevalence Incidence Prevalence Incidence
Asthma 11.0% 6.3 12.0% 5.2 10.7% 6.0
COPD 6.8% 12.5 8.7% 13.0 6.0% 8.3
Diabetes 6.0% 5.6 5.6% 3.8 6.1% 5.1
Heart Failure 1.4% 2.1 1.6% 2.2 1.4% 2.3
High blood pressure 19.5% 21.4 21.1% 20.1 18.4% 17.3

 


[1] BC Community Health Profile: Williams Lake. 2017. PHSA.

[2] BC Community Health Profile: 100 Mile House. 2017. PHSA.

[3] Cariboo-Chilcotin LHA = Williams Lake and surrounding region

[4] Primary Care Home Profile: 100 Mile House (025). March 2017. BC Ministry of Health

[5] Primary Care Home Profile: Cariboo Chilcotin (027). March 2017. BC Ministry of Health

Disproportionate Burden of Disease among Local First Nations Patients

Higher chronic conditions in fifteen different areas were observed among First Nations compared to non-First Nations in 2013/14 within BC’s Interior Region (visit this link for insight into why). In particular, the following chronic conditions showed the greatest difference among First Nations in various age groups: heart failure, stroke, dialysis, rheumatoid arthritis, and epilepsy (see Figure).[1] Evidence also suggests that this trend can worsen with age, with chronic conditions and their complications tending to affect First Nations elderly populations to a greater degree than elderly non-First Nations populations.[2]

First Nations individuals living on-reserve often confront additional barriers to health-seeking in the catchment area of the Central Interior Rural Division, such as transportation and access to health services.

 


[1] First Nations Health Authority. First Nations Health Status and Health Services Utilization 2008/09 and 2013/14 – Interior Region.

[2] ibid