Local issues and Primary Care

With great excitement, the Globe & Mail has announced a new Toronto hub: Toronto reporters, reviewers, columnists and visual journalists in one place: globeandmail.com/toronto. They plan on featuring blogs,

"We've signed a deal with Torontoist, the city's best comprehensive blog, to bring you intensely local tales from every corner of Toronto."

What about the rest of us chumps?

The numbers are interesting. With 11.4 million people in the province of Ontario (Statcan.ca)and 5.5 million in the Greater Toronto Area, Toronto has 2.5 million people, most of us do not live there. Now, I know that people visit and work in the GTA, but they have far different concerns that remain unaddressed in media.

It would really be nice if we could find more information on non-Toronto regions and municipalities somewhere in the media! It ocurs to me that issues that affect

For the many who retire in Muskoka, for example, there are difficult issues not yet addressed in Toronto-centric media: environment (noise & light pollution, wells and septic systems), social, tourism, employment, education, addictions, access to services, rural politics, access to health care, media, transportation peculiar to those NOT in a city.

In fact, what I believe is that since about 50% of us DO NOT live in the GTA and we have more in common than we might expect.

In a study by Dr. Hsien Seow, he found that "patients living in rural areas used 20% less nursing and 7% less personal support hours/week, that those living in non-rural areas."
Do you suppose this is by choice? Or do we have access issues? Local papers constantly feature ads for nurses or PSWs. Most of my friends in the business of senior care state this concern.

The Ontario LHIN (gatekeepers of health care dollars) has published,

May 2, 2006	North Simcoe Muskoka (NSM) Population Health Profile (PDF)
	--NSM LHIN's overall population health profile.

Interesting information: relative to the province, NSM has a higher

• annual average population growth rate
• proportion of older people, daily smokers,
  
• prevalence of activity limitations,arthritis/rheumatism
• age-standardized all-cause mortality and hospitalization rates.

We have a lower

• percentage of immigrants, visible minorities and Francophones
• percentage of the population who have had contact with a physician
• life expectancy at birth for both men and women
• low proportion of young adults.

Simcoe Muskoka health statistics are clear:

"The population in Simcoe Muskoka is aging, which is consistent with trends across Ontario and Canada. In Simcoe Muskoka the percentage of those 45- to 64-years-old increased to 27% of the total population in 2006 from 23% of the total population in 2001. The proportion of seniors (65+) also increased slightly to 14% in 2006 from 13% in 2001."

What seems clear is that we must concentrate as much on accessing health care in all regions of the province, not just in the city.

Phone-in shows do not take this into account. Summer visitors, and seasonal residents, complain about taxes, but when they drop of a heart attack in rural climes, they want roads and infrastructure that easily conveys them to a hospital.

Most of us succumb to circulatory system diseases or Neoplasms (tumours), resulting in hospital visits and Primary Care interventions.

It behooves you to be prepared, and ensure that your health care plan takes into account long-term issues, and the ability to access treatment where and when you retire. Those who retire in northern, rural communities fail to realize the disparities between rural and urban delivery of services. Many require transportation to and from the city.


Reference
Seow, H. (2008). The use of end-of-life homecare services in Ontario, Canada: Is it associated with using fewer acute care services? (hsienseow@gmail.com)