Quantifying the iceberg effect for injury: using comprehensive community health data.

BACKGROUND: Injury is the leading cause of preventable morbidity and mortality in Canada. The "ice berg" effect in injuries was proposed to address the injury statistics that are often poorly documented. The aim of this investigation was to quantify the severity and magnitude of iceberg effect in Ontario, Canada. METHODS: Data from Vital Statistics (1999, mortality), Canadian Institute for Health Information (2001, hospitalizations), Census (2001, demographic information), National Ambulatory Care Reporting System (2001, emergency department visits), and the Canadian Community Health Survey (2000/01, other injuries) were used to construct the Ontario injury iceberg for ages 12 years and older. RESULTS: There were 79,577 fatalities in Ontario in 1999; 2,645 were attributable to injuries (crude rate: 2.3 per 10,000). Of the 913,540 hospitalizations (2001), 67,301 were caused by injuries. There were 3,520,253 emergency department (ED) visits (2001) and 959,278 were attributable to injuries. For injuries treated elsewhere, the most common treatment site was the physician's office (23.3%). The most common cause of injuries (CCHS) was falls (37.4%) and exertion/movement (20.5%). There were 1,928,000 injuries causing functional impairment (one injury to five individuals in the population). INTERPRETATION The high ratio of injury-related ED visits to deaths illustrated the high volume of injuries that present to the ED. The ratio of injuries resulting in functional impairment to the population demonstrates.that such injuries can be problematic, even if not resulting in hospitalization. Constructing the injury iceberg using valid data should assist researchers and decision-makers in priority setting.

Child and adolescent health in Northern Ontario: a quantitative profile for public health planning.

Health in Northern Ontario is poorer than in the province of Ontario. Late childhood is the period in which adult habits and health behaviours are solidified, thus, health indicators are important to guide the development and implementation of disease prevention strategies. The Northern Ontario Child and Youth Health Report evaluated the health of children in Northern Ontario. The importance of public health planning is presented with the value of health status information for youth. The hospitalization rate for Northern Ontario youths was higher than for Ontario. In both areas, injuries and poisonings were the leading cause of hospitalization (7-13 year olds), however rates in the North were higher. Hospitalizations for injuries and poisonings were double the provincial rate in 14-19 year olds. The mortality rate for all youth was significantly higher. Health risk behaviour prevalence (e.g., alcohol consumption) was higher in the region. Current data emphasize the need for primordial and primary prevention in regional health planning and are also useful in secondary and tertiary prevention. Data for public health planning is critical to address population health needs and prevent chronic diseases.