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Canadian Journal of Public Health

, Volume 98, Issue 3, pp 228–234 | Cite as

Substance-attributable Morbidity and Mortality Changes to Canada’s Epidemiological Profile

Measurable Differences Over a Ten-year Period
  • Jayadeep Patra
  • Benjamin Taylor
  • Jürgen T. Rehm
  • Dolly Baliunas
  • Svetlana Popova
Article

Abstract

Background

Substance use is responsible for a large burden of disease in Canada, however updated data are needed for health care planning and policy development. This study replicates and makes improvements on 1992 estimates of substance-attributable morbidity and mortality for the year 2002. There are two objectives, the main one being to compare the substance-attributable morbidity and mortality in 1992 with 2002 using the same methods of calculation, and the second, to compare the two different methods of estimating the substance-attributable mortality and morbidity in 2002.

Method

Estimates of substance-attributable burden were made by combining relative risk data with exposure prevalence data and disease-related mortality and morbidity information from national databases. First, identical relative risk estimates for 1992 were used with the 2002 data in order to draw direct comparisons. In a second analysis, updated relative risk and attributable disease information (post-1992) was used to better estimate the mortality and morbidity for Canada in 2002.

Results

Overall, from 1992 to 2002, there were relative increases in substanceattributable mortality estimates for alcohol and illegal drugs, where the latter relatively increased more; and a relative decrease in tobacco-attributable mortality. In terms of absolute numbers in combined risk factors, deaths and hospital days for those under 70 years of age decreased mainly due to tobacco. Comparisons of the two methods showed that the updated method resulted in more conservative numbers than previous calculations.

Interpretation

There is an unacceptably high burden of substance-attributable disease in Canada in the early 2000s. Exposure changes and epidemiological shifts in population and diseases over the last 10 years have affected where the burden lies, but it is still vital to incorporate policy-based initiatives that have proven to be effective in reducing substanceattributable burden in practice.

MeSH terms

Substance-related disorders mortality morbidity epidemiology Canada 

Résumé

Contexte

La consommation de substances toxiques (alcool, drogue ou tabac) contribue beaucoup au fardeau des maladies au Canada, mais on manque de données à jour pour la planification et l’élaboration des politiques de santé. Cette étude reprend, en les améliorant, des estimations de 1992 portant sur la morbidité et la mortalité attribuables aux substances toxiques pour l’année 2002. Nous avions deux objectifs, le principal étant de comparer la morbidité et la mortalité attribuables à ces substances en 1992 et en 2002 à l’aide des mêmes méthodes de calcul, et le second, de comparer les deux méthodes utilisées pour estimer la mortalité et la morbidité attribuables aux substances en 2002.

Méthode

Nous avons estimé le fardeau des maladies attribuables aux substances toxiques en combinant les données sur le risque relatif, les données sur la prévalence de l’exposition et les données sur la mortalité et la morbidité liées aux maladies, tirées des bases de données nationales. Pour commencer, nous avons utilisé des estimations identiques du risque relatif pour 1992 et pour 2002 afin de pouvoir faire des comparaisons directes. Dans un deuxième temps, nous avons utilisé des données mises à jour sur le risque relatif et les données sur la mortalité et la morbidité liées aux maladies (après 1992) pour mieux estimer la mortalité et la morbidité au Canada en 2002.

Résultats

Globalement, entre 1992 et 2002, il y a eu des augmentations relatives dans les estimations de la mortalité attribuable à l’alcool et à la drogue (ces augmentations étaient relativement plus fortes dans le cas de la drogue), et une diminution relative de la mortalité attribuable au tabac. En chiffres absolus combinant tous les facteurs de risque, les décès et les jours d’hospitalisation chez les personnes de moins de 70 ans ont principalement diminué en raison du tabac. Nos comparaisons des deux méthodes montrent que la nouvelle méthode de calcul donne des estimations plus prudentes que la méthode antérieure.

Interprétation

Le fardeau des maladies attribuables aux substances toxiques était intolérablement élevé au Canada au début des années 2000. Les variations dans les niveaux d’exposition et les changements épidémiologiques dans la population et les maladies au cours des 10 dernières années ont contribué à repositionner ce fardeau, mais il est encore crucial d’adopter des initiatives stratégiques éprouvées pour le réduire dans la pratique.

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Copyright information

© The Canadian Public Health Association 2007

Authors and Affiliations

  • Jayadeep Patra
    • 1
    • 2
    • 3
  • Benjamin Taylor
    • 1
    • 3
  • Jürgen T. Rehm
    • 1
    • 3
    • 4
  • Dolly Baliunas
    • 3
  • Svetlana Popova
    • 1
    • 3
    • 5
  1. 1.Centre for Addiction and Mental HealthTorontoCanada
  2. 2.Department of Human Development and Applied PsychologyUniversity of TorontoCanada
  3. 3.Department of Public Health SciencesUniversity of TorontoCanada
  4. 4.Addiction Research InstituteZurichSwitzerland
  5. 5.Faculty of Social WorkUniversity of TorontoCanada

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