Biomedical subjects

Helen Johansen

Publications and source records attributed to Helen Johansen.

23 records · Page 2Linked to original sources

PubMed2003

Sex difference in hospitalization due to asthma in relation to age.

To describe the sex and age differences in asthma hospitalization among the Canadian population, we conducted an analysis based on a total of 9,486,173 hospital records in Canada for a 3-year period (1994/1995, 1995/1996, and 1996/1997), including 204,304 asthma patients and 288,977 asthma-related records. Asthma as one of the first five diagnoses, accounted for 3.0% of total hospitalizations, which was almost constant across the 3-year study period. The 3-year cumulative incidence of asthma hospitalization was substantially higher for young boys than girls, and it was reversed for adults. The incidence ratio for females vs. males for asthma hospitalization reached 2.8 for individuals 25 to 34 years of age, decreased gradually with increasing age, and then approached unity for those aged 80 years or more. The data suggest that sex is an important determinant for asthma, and the sex effect varies considerably over a life span.

Adolescent↗

PubMed2003

Burden of cardiovascular disease in Canada.

BACKGROUND: This report updates the death estimates for cardiovascular disease (CVD) in Canada and introduces a population-based perspective on disease prevalence and health-related quality of life (HRQOL) burden. METHODS: The Canadian Mortality Database was used to estimate the mortality of men and women in different age groups for the 139 Canadian health regions from 1950 to 1999. Heart disease prevalence and its impact on HRQOL were estimated using the 2000-2001 Canadian Community Health Survey (CCHS). Life table techniques were used to estimate the impact of heart disease on life and health expectancy. RESULTS: Although CVD remains the leading cause of death in Canada, between 1950 and 1999 the death rates from CVD dropped from 702 per 100,000 to 288 per 100,000 men, and from 562 per 100,000 to 175 per 100,000 women. Results from the CCHS indicated that 5.4% of men and 4.6% of women reported having heart disease as diagnosed by a medical professional. Of these individuals, 14% of men and 21% of women reported difficulty ambulating - about six times more than people without heart disease. In total, 4.5 years of life expectancy and 2.8 years of health expectancy were lost due to CVD. The study also found large differences in the burden of CVD among men and women and across the 139 Canadian health regions. CONCLUSIONS: CVD is a major disease burden in terms of both mortality and HRQOL and is an important source of health inequalities between populations in Canada. Any attempt to improve the health of Canadians or to reduce health inequalities should include interventions to reduce CVD mortality and morbidity. Given the present impact of CVD on HRQOL, reducing or eliminating heart disease may potentially result in an increase in life expectancy that will be larger than the gains in health expectancy.

Activities of Daily Living↗

PubMed2003

Risk factors for cardiovascular disease in Canada.

BACKGROUND: This paper provides an update of the prevalence of important cardiovascular disease (CVD) risk factors in subgroups of the Canadian population. To improve awareness of the impact of CVD risk factor variations on disease burden, smoking-attributable mortality (SAM) has been estimated for the first time for each health region in Canada. METHODS: The 2000/01 Canadian Community Health Survey (CCHS) was used to estimate the prevalence of current smoking, obesity, physical inactivity, low income, diabetes and hypertension. Combining smoking prevalence data from the 2000/01 CCHS, mortality data from the 1995 to 1997 Canadian Mortality Database, and relative risk estimates (relating smoking and smoking-associated deaths) from the American Cancer Society's Cancer Prevention Study II, SAM values were generated using population-attributable risk techniques. RESULTS: Based on self-reported data, the 2000/01 CCHS shows that 26.0% of Canadians currently smoke, 14.9% are obese, 53.5% are physically inactive, 11.3% have low income, 13.0% have hypertension and 4.2% have diabetes. Cardiovascular and all-cause SAM were estimated at 18,209 and 44,271 annual deaths, and contributed to 23% and 22% of total CVD and all-cause mortality in Canada, respectively. There are large variations in the prevalence of CVD risk factors and in SAM estimates between sexes and across age groups and geographic regions. CONCLUSIONS: The high prevalence of potentially modifiable CVD risk factors and the large variation that exists between subgroups of the Canadian population suggest that the burden of CVD could be reduced through risk factor modification. While prevalence data for risk factors in a population give an initial understanding of some of the contributing causes of a disease, the actual burden of disease caused by a risk factor is also modified by the magnitude of the increased risk to mortality and morbidity, and is best represented by its estimated attributable mortality and morbidity.

Adolescent↗

PubMed2002

Revascularization and heart attack outcomes.

OBJECTIVES: This article focuses on rates of revascularization and mortality among people admitted to hospital after an acute myocardial infarction (AMI). DATA SOURCE: The hospital data are from the Person-oriented information Database. Information on deaths is from the Canadian Mortality Database. ANALYTICAL TECHNIQUES: Hospital records for Nova Scotia, Saskatchewan, Alberta and British Columbia were linked to identify AMI patients admitted between April 1, 1995 and March 31, 1996. Patients with no admission for AMI in the previous 12 months were followed for one year to determine what percentage underwent percutaneous transluminal coronary angioplasty and/or coronary artery bypass graft surgery. The risk of being revascularized and the risk of dying were estimated. MAIN RESULTS: In the year after hospitalization, 25% of AMI patients were revascularized. Rates of revascularization were relatively low for women, very elderly people, and individuals with other health problems. Revascularization was significantly associated with a lower risk of dying for male, but not female, AMI patients.

Adult↗

PubMedDate not supplied

Declining use of mastectomy for invasive breast cancer in Canada, 1981-2000.

OBJECTIVE: To evaluate the rate and magnitude of change in surgical practice for breast cancer in Canada in relation to publication dates of clinical trials and consensus conferences. METHODS: Hospital separations with a diagnosis of invasive breast cancer were extracted from the Hospital Morbidity File from 1981 to 2000. Age-standardized rates of in-patient procedures for breast-conserving surgery and mastectomy were analyzed by province and age group and by geographic region. RESULTS: In Canada, mastectomy rates decreased from 62.2 to 37.9 per 100,000 between 1981 and 2000; declines were largest between 1984 and 1985, following publication of the NSABP B-06 clinical trial in March 1985, and between 1991 and 1993, after the US NIH Consensus Conference in February 1991. Mastectomy rates plateaued between 1985 and 1991, and from 1993 to 2000; the transitory peak in 1988 corresponded to publicity surrounding Nancy Reagan's choice of mastectomy in 1987. Regional variations from the main pattern led to increasingly divergent mastectomy rates over time. Women aged 80+ were less likely to be treated by any surgery. INTERPRETATION: Publication of clinical trial results and consensus conferences were associated with changes in surgical treatment for breast cancer in Canada. However, divergent mastectomy rates among Canadian regions point to inconsistent adoption of less invasive therapy despite a publicly-funded health care system and national consensus guidelines.

Adult↗