North East LHIN Demographic, Socioeconomic, and Population Health Profile

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North East LHIN Demographic, Socioeconomic, and Population Health Profile November 2008 www.nelhin.on.ca

NORTH EAST LHIN DEMOGRAPHIC, SOCIOECONOMIC AND POPULATION HEALTH PROFILE Table of Contents Summary...ii Our population...ii NE LHIN Population Health Status...ii REFERENCE MAPS OF NORTH EAST LHIN PLANNING AREAS...1 DEMOGRAPHIC AND SOCIOECONOMIC PROFILE...2 Population Distribution Estimates and Projections...2 North East LHIN - 2006 Age-Sex Population Distribution...2 NE LHIN - 2008 & 2018 Population Distribution, Estimates & Projections (DEP) by Age and Sex...3 NE LHIN 2008 & 2018 Population Distribution, Estimates and Projections by Age and Sex...4 2006 Population Distribution by Age and Sex...5 2006 Population4 Age and Sex as percentages...5 North East LHIN 2008 & 2018 Population Distribution Estimates & Projections by Age and Sex...6 2006 and 2008 Socio-Demographic Characteristics...8 2006 Socio-Demographic Characteristics by Planning Area...8 2008 Socio-Demographic Characteristics by Planning Area...9 HEALTH STATUS...10 Life Expectancy, Mortality, and Potential Years of Life Lost...10 Life Expectancy and Infant Mortality by Planning Area...10 Potential Years of Life Lost (PYLL) and Age Standardized Mortality Rate (ASMR) by Planning Area...10 The Canadian Community Health Survey...11 Health Status and Perception of Health...12 Use of Preventative Care...12 Health Practices/Behaviours...13 Prevalence of Selected Chronic Conditions...13 i

North East LHIN Demographic, Socioeconomic and Population Health Profile Summary Our population The North East LHIN covers a large geographic area of approximately 400,000 square kilometres. With a 2006 population of approximately 560,000 persons, the overall population density in the NE LHIN is only 1.4 persons per square kilometre. When compared to the provincial population density of 13.4 persons per sq. km (Southern Ontario has a population density of approximately 100 persons per sq. km), it is not surprising that there are significant challenges to providing health care in the North East LHIN. Furthermore, according to the 2006 census, the North East LHIN has a much higher proportion of Aboriginals than Ontario as a whole, 10% and 2% respectively a significantly higher proportion of Francophones compared to Ontario, 24% and 4% respectively an older population than the province as a whole (17% of NE LHIN is aged 65 and over compared to 14% in Ontario) o the Aged Dependency Ratio (the percent people 65+ relative to working age group 15-64) is 24.5% in the North East vs. Ontario s Aged Dependency Ratio of 19.9% an overall lower education status than the rest of the province with, o only 50.3% of the North East population aged (25+) who have completed post-secondary education vs. the provincial rate of 56.8%, and o 25.9% of the North East population (age 25+) who do not have a high school (or equivalent) certificate vs. the provincial rate of 18.7% a lower employment status with, o an overall unemployment rate in the North East LHIN which is higher than the provincial rate, 8.4% vs. 6.4% respectively, o a participation rate (the percent of the population in the labour force) which is lower than Ontario s, 60.1% vs. 67.1% respectively, and o a youth (age 15-24) unemployment rate in the North East LHIN of 18.6% vs. the provincial rate of 14.5%. Additionally, the rate of population growth in the North East LHIN is nearly stagnant at less than 1%, whereas the provincial growth rate is nearly 8% since the 2001 Census. These geographic, demographic and socioeconomic realities are only some of the challenges to those providing health care in the North East LHIN. NE LHIN Population Health Status The Canadian Community Health Survey (CCHS 4.1, 2007) reports that there is a smaller proportion of NE LHIN residents who report their health as very good or excellent compared to Ontarians overall. Also, the CCHS shows a higher prevalence of self-reported activity limitation in the NE LHIN compared to Ontario, 40.9% vs. 33.1%, and a higher proportion of persons who report pain or discomfort as limiting their activities, 17.2% vs. 13.0%. Furthermore, the North East LHIN has higher percentages of people whose health practices are known to compromise health status when compared to Ontario. These include: daily smokers, 26.8% vs. 20.6%, exposure to second hand smoke at home, 9.6% vs. 5.7%, and exposure to second hand smoke in vehicles, 13.2% vs. 8.0% adults who are current drinkers reporting heavy drinking, 26.5% vs. 21.1%, and adults who are obese, 22.4% vs. 16.1%. Not surprisingly, the CCHS also shows a higher prevalence of chronic diseases in the North East LHIN, including: ii

arthritis/rheumatism, 23.8% vs. 16.2% asthma, 10.0% vs. 8.1% high blood pressure, 20.5% vs. 16.4% diabetes, 7.5% vs. 6.1%, and heart disease, 7.9% vs. 4.8% (2005 data; 2007 data were not available). In addition, the CCHS indicates a lower rate of contact with a medical doctor in the previous 12 months in the North East LHIN 75.8% vs. 80.6%; and a smaller proportion or persons who report having a medical doctor 85.0% vs. 90.4%. Mortality, Potential Years of Life Lost, and Hospitalization An analysis by MOHLTC-Health Analytics (previously the Health System Intelligence Project) of age-standardized mortality and hospitalization rates, as well as rates for potential years of life lost (PYLL 1 ) by ICD-10 chapter, for the years 2002 to 2004 is also quite revealing. The analysis indicates that, in the North East LHIN: PYLL are significantly higher than provincial rates for all causes, and select causes including Respiratory system diseases, Circulatory system diseases, Neoplasms overall and Malignant Neoplasms specifically All-causes age-standardized mortality ratio (ASMR), as well as ASMRs for circulatory system diseases, respiratory system diseases, and neoplasms are all significantly higher than their respective provincial rates. The leading causes of mortality in the North East are circulatory disease (233.3/100,000) followed by neoplasms [cancer] (201.9/100,000). Life expectancy at birth for males and females is significantly lower compared to Ontario (2001). 77.7 years vs. 79.7 years for both sexes combined Life expectancy at age 65 is also lower in NE LHIN at 17.7 years compared to Ontario s 19.0 years The high prevalence of chronic heart conditions - as evidenced by the CCHS and MOHLTC reports and data - naturally places a burden on the health care system in the North East LHIN, in turn reducing the quality of life for those who suffer from the condition. However, the Sudbury Regional Hospital is the only centre performing by-pass surgery under the Wait Times Strategy in the North East. What follows are a number of tables, charts and graphs detailing the population and health profile of the North East LHIN. At the time of compilation of the following tables, only CCHS cycle 3.1 (2005) data were available. Cycle 4.1 (2007) data presented in this summary will be made available in the near future. Also, only All Causes Age Standardized Mortality Rates and PYLL are presented here. Breakdowns by specific causes for these indicators will be included soon. Please watch for these updates. 1 Potential Years of Life Lost (PYLL) rates are useful for quantifying the number of years of life lost from deaths that occur prematurely (i.e. before age 75) iii

Reference Maps of North East LHIN Planning Areas The North East LHIN is broken down into seven Planning Areas (PA). These planning areas are roughly equivalent to what are referred to by Statistics Canada as Census Divisions (CD) and what are know provincially as Counties. This allows for maximum use of existing census demographic, socioeconomic, and health status and utilization data. Additionally, most planning areas also coincide with Public Health Units (PHU) for which invaluable data on health practices and prevalence of select chronic conditions are available through the Canadian Community Health Survey (CCHS). The James & Hudson Bay Coasts (Coast) Planning Area includes a small number of communities from the Cochrane District as well as some from the Kenora District. Combined, the Cochrane and Coast Planning Areas are equivalent to the Porcupine Health Unit. Therefore, Canadian Community Health Survey data represent values for both Cochrane and the Coast PA s. North West LHIN James and Hudson Bay Coasts (1302) LHIN Boundaries (Version 11) Sub-LHIN Boundaries (Version 7.1) Sub-LHIN Planning Areas North East LHIN Also, Nipissing and Parry Sound Planning Areas, combined, are roughly equivalent to the North Bay Parry Sound Health Unit 2. Because of the methods used in the CCHS it is impracticable to distinguish values for these PAs. Map produced by MOHLTC Health Analytics, 2008. Algoma (1301) Cochrane (1307) Manitoulin- Sudbury (1305) Timiskaming (1306) Nipissing (1303) 0 80 160 320 kms Parry Sound (1304) 2 The Renfrew PHU extends into a sparsely inhabited section of the Nipissing District much of which is Algonquin Park. 1

Demographic and Socioeconomic Profile Population Distribution Estimates and Projections A convenient way to represent the age and sex structure of an area is to use a population pyramid. The proportion of persons in each age band (5 year groups in this case) is represented by individual bars in the pyramid. The proportion of males and females is found on either side of the centre of the pyramid. Below are population pyramids from the 2006 Census of Population (Statistics Canada), and 2008 population estimates as well as 2018 population projections calculated by Environics Analytics for the North LHIN. For comparative purposes, an outline of the respective Ontario population pyramid is superimposed. Detailed numbers and percentages are also presented for reference purposes. Please refer to the Statistics Canada website for technical notes on the 2006 Census of Population at http://www12.statcan.ca/census-recensement/index-eng.cfm North East LHIN - 2006 Age-Sex Population Distribution 2006 NE LHIN Census vs. 2006 Ontario Census 2006 Census 2006 Actual Age Group 85+ 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 Male Female Ontario 5 4 3 2 1 0 1 2 3 4 5 Percentage of Total Population Source: 2006 Census (1) Note: (1) Demographic Estimates and Projections (DEP) data is not directly comparable to 2006 Census because 2008 estimates adjust for the Census undercount Table prepared by 2

NE LHIN - 2008 & 2018 Population Distribution, Estimates & Projections (DEP) by Age and Sex 2008 NE LHIN Estimate vs. 2008 Ontario Estimate 2018 NE LHIN Projection vs. 2018 Ontario Projection 2008 DEP 2018 DEP Age Group 85+ 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 Male Female Ontario 5 4 3 2 1 0 1 2 3 4 5 Percentage of Total Population Age Group 85+ 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 Mal 5 4 3 2 1 0 1 2 3 4 5 Percentage of Total Population Femal Ontario Source: 2008 & 2018 Demographic Estimates and Projections (DEP) (1). DEP figures have been adjusted to account for the 2006 Census undercount. Note: (1) DEP data is not directly comparable to 2006 Census because 2008 estimates adjust for the Census undercount Table prepared by 3

NE LHIN 2008 & 2018 Population Distribution, Estimates and Projections by Age and Sex 2008 NE LHIN Estimate vs. 2018 NE LHIN Projection 2008 DEP Ag e Gr ou p 85+ 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 Male Female 2018 5 4 3 2 1 0 1 2 3 4 5 Percentage of Total Population Source: 2008 & 2018 Demographic Estimates and Projections (DEP) (1). DEP figures have been adjusted to account for the 2006 Census undercount. Note: (1) DEP data is not directly comparable to 2006 Census because 2008 estimates adjust for the Census undercount Table prepared by 4

2006 Population Distribution by Age and Sex 2006 Population counts by age and sex 2006 TOTAL POPULATION MALE POPULATION FEMALE POPULATION NORTH EAST ONTARIO NORTH EAST ONTARIO NORTH EAST ONTARIO Total Pop 551,691 12,160,282 268,485 5,930,700 279,205 6,229,580 0-4 24,995 670,765 12,690 343,475 12,115 327,290 5-9 29,265 721,590 15,100 369,675 14,115 351,920 10-14 35,320 818,445 18,330 420,705 17,140 397,740 15-19 37,775 833,110 19,470 427,185 18,285 405,930 20-24 32,350 797,260 16,190 400,450 16,115 396,815 25-29 27,260 743,695 13,215 360,525 14,165 383,170 30-34 28,865 791,955 14,015 382,030 14,895 409,925 35-39 33,355 883,985 16,150 430,220 17,160 453,770 40-44 44,065 1,032,415 21,470 507,130 22,655 525,285 45-49 47,235 991,975 23,075 486,390 24,160 505,585 50-54 43,655 869,400 21,345 423,345 22,195 446,060 55-59 40,770 774,530 20,375 378,535 20,295 395,995 60-64 32,750 581,980 16,220 283,545 16,475 298,440 65-69 27,465 466,240 13,285 222,635 14,040 243,600 70-74 23,465 401,950 11,355 187,505 12,100 214,440 75-79 18,565 338,910 8,420 149,585 10,005 189,325 80-84 12,075 250,270 5,020 97,240 7,400 153,035 85+ 8,630 191,810 2,640 60,550 5,920 131,260 2006 Population age and sex as percentages 2006 TOTAL POPULATION MALE POPULATION FEMALE POPULATION NORTH EAST ONTARIO NORTH EAST ONTARIO NORTH EAST ONTARIO Total Pop 100 * % 100% 48.7% 48.8% 50.6% 51.2% 0-4 4.5% 5.5% 2.3% 2.8% 2.2% 2.7% 5-9 5.3% 5.9% 2.7% 3.0% 2.6% 2.9% 10-14 6.4% 6.7% 3.3% 3.5% 3.1% 3.3% 15-19 6.8% 6.9% 3.5% 3.5% 3.3% 3.3% 20-24 5.9% 6.6% 2.9% 3.3% 2.9% 3.3% 25-29 4.9% 6.1% 2.4% 3.0% 2.6% 3.2% 30-34 5.2% 6.5% 2.5% 3.1% 2.7% 3.4% 35-39 6.0% 7.3% 2.9% 3.5% 3.1% 3.7% 40-44 8.0% 8.5% 3.9% 4.2% 4.1% 4.3% 45-49 8.6% 8.2% 4.2% 4.0% 4.4% 4.2% 50-54 7.9% 7.1% 3.9% 3.5% 4.0% 3.7% 55-59 7.4% 6.4% 3.7% 3.1% 3.7% 3.3% 60-64 5.9% 4.8% 2.9% 2.3% 3.0% 2.5% 65-69 5.0% 3.8% 2.4% 1.8% 2.5% 2.0% 70-74 4.3% 3.3% 2.1% 1.5% 2.2% 1.8% 75-79 3.4% 2.8% 1.5% 1.2% 1.8% 1.6% 80-84 2.2% 2.1% 0.9% 0.8% 1.3% 1.3% 85+ 1.6% 1.6% 0.5% 0.5% 1.1% 1.1% * The sum of age groups may not add to 100.0 due to random rounding of census numbers. Source: 2006 Census (1) Note: (1) Demographic Estimates and Projections (DEP) data is not directly comparable to 2006 Census because 2008 estimates adjust for the Census undercount Tables prepared by 5

North East LHIN 2008 & 2018 Population Distribution Estimates & Projections by Age and Sex 2008 and 2018 Population counts by age and sex TOTAL POPULATION MALE POPULATION FEMALE POPULATION NORTH EAST ONTARIO NORTH EAST ONTARIO NORTH EAST ONTARIO 2008 2018 2008 2018 2008 2018 2008 2018 2008 2018 2008 2018 Total Pop 581,902 588,021 13,021,604 14,358,613 288,049 290,215 6,441,422 7,106,083 293,853 297,806 6,580,182 7,252,530 0-4 25,239 26,799 694,459 748,094 12,953 13,746 355,721 383,300 12,286 13,053 338,738 364,794 5-9 29,085 25,270 744,449 738,184 14,934 12,934 378,246 377,059 14,151 12,336 366,203 361,125 10-14 34,913 26,215 823,523 768,359 17,796 13,427 418,035 391,266 17,117 12,788 405,488 377,093 15-19 40,223 29,968 892,121 819,218 20,661 15,360 455,231 414,611 19,562 14,608 436,890 404,607 20-24 38,392 36,074 915,631 957,196 19,659 18,360 469,494 485,685 18,733 17,714 446,137 471,511 25-29 34,296 41,928 895,599 1,081,869 17,500 21,517 458,007 552,310 16,796 20,411 437,592 529,559 30-34 30,208 40,293 869,030 1,094,973 15,247 20,531 437,612 558,655 14,961 19,762 431,418 536,318 35-39 34,815 35,963 919,051 976,807 17,478 18,229 458,720 494,965 17,337 17,734 460,331 481,842 40-44 41,095 31,263 1,016,444 901,398 20,271 15,696 506,695 450,832 20,824 15,567 509,749 450,566 45-49 49,156 35,173 1,056,230 930,867 24,404 17,549 527,004 461,353 24,752 17,624 529,226 469,514 50-54 46,871 40,653 946,637 1,040,776 23,030 19,916 466,534 515,037 23,841 20,737 480,103 525,739 55-59 42,055 47,761 813,905 1,062,419 21,005 23,493 399,942 526,124 21,050 24,268 413,963 536,295 60-64 37,089 44,443 681,634 915,092 18,538 21,529 335,369 445,329 18,551 22,914 346,265 469,763 65-69 29,812 38,130 506,517 753,019 14,411 18,555 243,954 360,769 15,401 19,575 262,563 392,250 70-74 24,156 31,594 411,407 592,644 11,545 15,143 192,522 280,216 12,611 16,451 218,885 312,428 75-79 20,098 23,013 348,939 396,079 9,203 10,417 156,796 179,242 10,895 12,596 192,143 216,837 80-84 13,633 16,010 260,986 272,344 5,757 6,977 105,698 115,510 7,876 9,033 155,288 156,834 85+ 10,766 17,471 225,042 309,275 3,657 6,836 75,842 113,820 7,109 10,635 149,200 195,455 Source: 2008 & 2018 Demographic Estimates and Projections (DEP) (1). DEP figures have been adjusted to account for the 2006 Census undercount. Note: (1) DEP data is not directly comparable to 2006 Census because 2008 estimates adjust for the Census undercount Table prepared by 6

2008 and 2018 Population age and sex as percentages TOTAL POPULATION MALE POPULATION FEMALE POPULATION NORTH EAST ONTARIO NORTH EAST ONTARIO NORTH EAST ONTARIO 2008 2018 2008 2018 2008 2018 2008 2018 2008 2018 2008 2018 Total Pop 100.0% 100.0% 100.0% 100.0% 49.5% 49.4% 49.5% 49.5% 50.5% 50.6% 50.5% 50.5% 0-4 4.3% 4.6% 5.3% 5.2% 2.2% 2.3% 2.7% 2.7% 2.1% 2.2% 2.6% 2.5% 5-9 5.0% 4.3% 5.7% 5.1% 2.6% 2.2% 2.9% 2.6% 2.4% 2.1% 2.8% 2.5% 10-14 6.0% 4.5% 6.3% 5.4% 3.1% 2.3% 3.2% 2.7% 2.9% 2.2% 3.1% 2.6% 15-19 6.9% 5.1% 6.9% 5.7% 3.6% 2.6% 3.5% 2.9% 3.4% 2.5% 3.4% 2.8% 20-24 6.6% 6.1% 7.0% 6.7% 3.4% 3.1% 3.6% 3.4% 3.2% 3.0% 3.4% 3.3% 25-29 5.9% 7.1% 6.9% 7.5% 3.0% 3.7% 3.5% 3.8% 2.9% 3.5% 3.4% 3.7% 30-34 5.2% 6.9% 6.7% 7.6% 2.6% 3.5% 3.4% 3.9% 2.6% 3.4% 3.3% 3.7% 35-39 6.0% 6.1% 7.1% 6.8% 3.0% 3.1% 3.5% 3.4% 3.0% 3.0% 3.5% 3.4% 40-44 7.1% 5.3% 7.8% 6.3% 3.5% 2.7% 3.9% 3.1% 3.6% 2.6% 3.9% 3.1% 45-49 8.4% 6.0% 8.1% 6.5% 4.2% 3.0% 4.0% 3.2% 4.3% 3.0% 4.1% 3.3% 50-54 8.1% 6.9% 7.3% 7.2% 4.0% 3.4% 3.6% 3.6% 4.1% 3.5% 3.7% 3.7% 55-59 7.2% 8.1% 6.3% 7.4% 3.6% 4.0% 3.1% 3.7% 3.6% 4.1% 3.2% 3.7% 60-64 6.4% 7.6% 5.2% 6.4% 3.2% 3.7% 2.6% 3.1% 3.2% 3.9% 2.7% 3.3% 65-69 5.1% 6.5% 3.9% 5.2% 2.5% 3.2% 1.9% 2.5% 2.6% 3.3% 2.0% 2.7% 70-74 4.2% 5.4% 3.2% 4.1% 2.0% 2.6% 1.5% 2.0% 2.2% 2.8% 1.7% 2.2% 75-79 3.5% 3.9% 2.7% 2.8% 1.6% 1.8% 1.2% 1.2% 1.9% 2.1% 1.5% 1.5% 80-84 2.3% 2.7% 2.0% 1.9% 1.0% 1.2% 0.8% 0.8% 1.4% 1.5% 1.2% 1.1% 85+ 1.9% 3.0% 1.7% 2.2% 0.6% 1.2% 0.6% 0.8% 1.2% 1.8% 1.1% 1.4% Source: 2008 & 2018 Demographic Estimates and Projections (DEP) (1). DEP figures have been adjusted to account for the 2006 Census undercount. Note: (1) DEP data is not directly comparable to 2006 Census because 2008 estimates adjust for the Census undercount Table prepared by 7

2006 and 2008 Socio-Demographic Characteristics 2006 Socio-Demographic Characteristics by Planning Area PLANNING AREAS ALGOMA COCHRANE JAMES AND HUDSON BAY COASTS (4) MANITOULIN- SUDBURY NIPISSING PARRY SOUND TIMISKAMING NE LHIN ONTARIO LHIN RANGE Total population (2006) 117,461 78,692 4,258 192,392 84,688 40,918 33,283 551,691 12,160,282 4,258-192,392 Senior population, age 65+ (2006) 18.6% 14.1% 3.3% 15.1% 16.0% 21.4% 18.2% 16.5% 13.6% 3.3% - 21.4% Population with English mother tongue Population with French mother tongue 82% 44.7% 36.6% 65.3% 69.6% 91.2% 70.4% 68.7% 68.4% 36.6% - 91.2% 6.8% 49.0% 0.4% 25.9% 24.9% 3.0% 24.6% 23.1% 4.1% 0.4% - 49.0% Population of Aboriginal identity 11.0% 7.8% 96.2% 9.2% 8.7% 5.4% 5.0% 9.2% 2.0% 5.0% - 96.2% Participation Rate (age 15+) Unemployment rate (age 15+) Economic families below LICO (2) (2005) Families (with children) headed by a lone parent 57.5% 62.6% 47.1% 61.9% 59.8% 57.8% 58.5% 60.2% 67.1% 47.1% - 62.6% 8.9% 8.2% 16.6% 8.4% 8.3% 6.7% 8.2% 8.4% 6.4% 6.7% - 16.6% 10.3% 9.0% 6.7% 9.1% 11.6% 7.7% 9.1% 9.6% 11.7% 6.7% - 11.6% 16.2% 13.6% 35.7% 16.4% 16.4% 11.7% 12.6% 15.4% 15.8% 11.7% - 35.7% Population (aged 25+) without (3) certificate, diploma, degree 24.3% 30.4% 62.0% 24.1% 23.9% 25.9% 31.8% 25.7% 18.7% 23.9% - 62.0% Population (aged 25+) with completed post-secondary education 49.6% 46.6% 30.7% 52.2% 52.5% 46.4% 45.7% 50.0% 56.8% 30.7% - 52.5% Child dependency ratio 23.0% 25.3% 65.0% 24.8% 24.3% 22.0% 24.0% 24.3% 26.6% 22.0% - 65.0% Senior dependency ratio 28.2% 20.6% 5.7% 22.3% 23.6% 33.3% 27.6% 24.5% 19.9% 5.7% - 33.3% Total dependency ratio 51.2% 45.8% 70.7% 47.1% 47.9% 55.3% 51.6% 48.8% 46.5% 45.8% - 70.7% Source: 2006 Census (1) For details on the census see: http://www12.statcan.ca/census-recensement/index-eng.cfm. In some cases, very minor differences may be found between this table and the summary presented at the beginning of this document due to rounding and different vintages of source data. Notes: (1) Census Data and Demographic Estimates and Projections (DEP) are not directly comparable due to 2006 Census undercount (2) Low Income Cut-Off: the threshold below which a family spends 20% more of their income on food, shelter, and clothing than the average family. Average expenditures are adjusted for both community and family size. (3) Includes high school graduation certificate or equivalent (4) The values for the Coast PA should be used with caution due to a large portion of population which is not enumerated in the 2006 Census. 8

2008 Socio-Demographic Characteristics (1) by Planning Area PLANNING AREAS ALGOMA COCHRANE JAMES AND HUDSON BAY COASTS (4) MANITOULIN- SUDBURY NIPISSING PARRY SOUND TIMISKAMING NE LHIN ONTARIO LHIN RANGE Total population (2008) 123,167 82,283 7,826 201,376 89,206 43,204 34,908 581,970 13,021,604 7,826-201,376 Senior population, age 65+ (2008) 19.4% 14.6% 9.5% 15.6% 16.4% 21.8% 18.6% 16.9% 13.5% 9.5% - 21.8% Population with English mother tongue Population with French mother tongue 81.3% 44.9% 46.9% 64.3% 69.3% 91.7% 69.7% 68.1% 70.4% 44.9% - 91.7% 7.6% 48.2% 0.6% 26.4% 25.5% 2.5% 25.4% 23.2% 4.2% 0.6% - 48.2% Population of Aboriginal identity N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A - N/A Participation rate (age 15+) Unemployment rate (age 15+) Economic families below LICO (2) (2005) Families (with children) headed by a lone parent 56.4% 61.9% 53.6% 60.8% 59.8% 56.8% 57.9% 59.3% 67.8% 53.6% - 61.9% N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A - N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A - N/A 15.6% 13.1% 34.3% 16.0% 15.8% 11.3% 13.2% 15.2% 15.3% 11.3% - 34.3% Population (aged 20+) without (3) certificate, diploma, degree 32.1% 37.6% 51.3% 31.3% 30.4% 36.1% 38.0% 33.2% 25.0% 30.4% - 51.3% Population (aged 20+) with completed post-secondary education 42.8% 40.3% 26.3% 43.9% 45.1% 40.1% 38.7% 42.6% 49.3% 26.3% - 45.1% Child dependency ratio 21.3% 23.0% 51.8% 22.9% 22.5% 20.8% 21.7% 22.6% 25.1% 20.8% - 51.8% Senior dependency ratio 29.2% 21.0% 15.9% 22.6% 24.0% 33.7% 27.7% 25.0% 19.5% 15.9% - 33.7% Total dependency ratio 50.5% 44.0% 67.7% 45.5% 46.5% 54.6% 49.4% 47.6% 44.6% 44.0% - 67.7% Source: 2008 Demographic Estimates and Projections (DEP) (1). DEP figures have been adjusted to account for the 2006 Census undercount Notes: (1) Census Data and Demographic Estimates and Projections (DEP) are not directly comparable due to 2006 Census undercount (2) Low Income Cut-Off: the threshold below which a family spends 20% more of their income on food, shelter, and clothing than the average family. Average expenditures are adjusted for both community and family size. (3) Includes high school graduation certificate or equivalent (4) The values for the Coast PA should be used with caution due to a large portion of population which is not enumerated in the Census. 9

Health Status Life Expectancy, Mortality, and Potential Years of Life Lost Life Expectancy and Infant Mortality by Planning Area ALGOMA COCHRANE and JAMES AND HUDSON BAY COASTS (2) MANITOULIN- SUDBURY NIPISSING PARRY SOUND (1) TIMISKAMING NE LHIN ONTARIO LHIN RANGE Life expectancy at birth (in years), 2001 Life expectancy at age 65 (in years), 2001 Total 78.1 76.5 77.3 78.1 79.3 77 77.7 (2) 79.7 76.5-79.3 Male 75.3 73.6 74.4 75.6 77.1 73.5-77.4 73.5-77.1 Female 81.0 79.4 80.2 80.6 81.5 80.4-82.0 79.4-81.5 Total 18.1 16.9 17.6 17.9 18.6 17.1 17.7 (2) 19.0 16.9-18.6 Male 16.1 15.0 15.6 16.2 16.7 15.2 - - 15.0-16.7 Female 19.9 18.6 19.4 19.5 20.3 18.7 - - 18.6-20.3 Infant mortality at under 1 year of age (per 1,000), 2001 Total 7.3 7.0 8.0 5.7 4.4 4.2 5.2 5.4 4.2-8.0 Male 8.1 6.8 9.2 7.7 1.8 8.4-5.8 1.8-9.2 Female 6.4 7.2 6.7 3.8 7.4 0.0-5.1 0.0-7.4 Bolded values indicate values that are statistically significantly different than the provincial rate. Source: Public Health Agency of Canada, Surveillance Division, Centre for Chronic Disease Prevention and Control, Chronic Disease Infobase. http://cvdinfobase.ca/ncdasp/profile_e.aspx. Accessed Aug 15, 2008. Statistics Canada. Table 102-0218 - Life expectancy, abridged life table, by age group and sex, three-year average, Canada, provinces, territories, health regions and peer groups, occasional (years), CANSIM (database). http://cansim2.statcan.ca/cgi-win/cnsmcgi.exe? Lang=E&CANSIMFile=CII\CII_1_E.htm&RootDir=CII/ (accessed: November 17, 2008) and http://www.statcan.ca/english/freepub/82-221-xie/2006001/tables/1412_01.htm. Source: MOHLTC, Health Analytics, 2008. (1) The Parry Sound Planning Area data also includes data from a portion of the Muskoka Public Health Unit as both areas were part of a merged PHU at the time of data collection. (2) Based on 2001 mortality and population statistics from the Provincial Health Planning Database Potential Years of Life Lost (PYLL) and Age Standardized Mortality Rate (ASMR) by Planning Area Per 100,000 Average 2002-2004 ALGOMA COCHRANE JAMES AND HUDSON BAY COASTS (1) MANITOULIN- SUDBURY NIPISSING PARRY SOUND TIMISKAMING NE LHIN ONTARIO LHIN RANGE Total 6,650 7,482 N/A 6,829 6,479 6,441 7,583 6,657 4,735 6,441-7,583 PYLL Male 8,631 9,450 N/A 8,814 8,082 8,823 9,880 8,700 5,791 8,082-9,880 Female 4,685 5,441 N/A 4,842 4,883 3,957 5,244 4,652 3,677 3,957-5,244 Total 658 778 1,707 706 698 636 765 708 574 636-1,707 ASMR Male 818 979 1,899 866 873 783 961 877 698 783-1,899 Female 780 913 2,261 855 854 745 901 848 477 745-2,261 Bolded values indicate values that are statistically significantly different than the provincial rate. Source: MOHLTC Health Analytics 2007. Data uses mortality (vital statistics) from 2002 to 2004 from the PHPDB (version 17.02). Denominator uses population estimates from 2003 (sublhin population estimates created by HSIP). Age standardization uses the 1991 Canadian population. (1) values are unreliable. 10

The Canadian Community Health Survey The Canadian Community Health Survey (CCHS) is conducted by Statistics Canada and provides invaluable information related to health status, health care utilization and health determinants. The CCHS is a cross-sectional survey that relies upon a large sample of respondents and is designed to provide reliable estimates at the health region level 3. In Ontario this means that data are available at the LHIN and Public Health Unit (PHU) levels. Strictly speaking, information is not available at the NE LHIN Planning Area (PA) level. However, there is strong correspondence between Planning Areas and Public Health Units in the North East. The table below illustrates the correspondence between PAs and PHUs in the North East LHIN. North East LHIN Planning Area Algoma Cochrane James and Hudson Bay Coasts Manitoulin-Sudbury Nipissing* Parry Sound Timiskaming Ontario Public Health Unit (CCHS data) District of Algoma Health Unit Porcupine Health Unit Sudbury & District Health Unit North Bay Parry Sound District Health Unit Timiskaming Health Unit *The Renfrew PHU extends into a sparsely inhabited section of the Nipissing District, much of which is Algonquin Park. The James & Hudson Bay Coasts (Coast) Planning Area includes a small number of communities from the Cochrane District as well as some from the Kenora District. Combined, the Cochrane and Coast Planning Areas are equivalent to the Porcupine Health Unit. Therefore, Canadian Community Health Survey data represent values for both Cochrane and the Coast PA s. Nipissing and Parry Sound Planning Areas, combined, are roughly equivalent to the North Bay Parry Sound Health Unit 4. Because of the methods used in the CCHS it is impracticable to distinguish values for these individual PAs. Unless otherwise indicated, values represent percent of persons aged 12 and up for both sexes. Lower Confidence Intervals (LCI) and Upper Confidence Intervals (UCI) are also included. These are useful to compare PHU values to the Ontario values, however a more precise measure of statistical significance (whether or not a PHU value is statistically different from the Ontario value) has been calculated by Statistics Canada for each value and is indicated by bold values in the following tables. Please refer to the Statistics Canada website for technical notes.http://www.statcan.ca/cgi-bin/imdb/p2sv.pl?function=getsurvey&sdds=3226&lang=en&db=imdb&dbg=f&adm=8&dis=2 3 Statistics Canada, 2008 http://www.statcan.ca/cgi-bin/imdb/p2sv.pl?function=getsurvey&sdds=3226&lang=en&db=imdb&dbg=f&adm=8&dis=2 4 The Renfrew PHU extends into a sparsely inhabited section of the Nipissing District, much of which is Algonquin Park. 11

Health Status and Perception of Health CCHS cycle 3.1 (2005) Persons (12+) who reported: ALGOMA COCHRANE and JAMES AND HUDSON BAY COASTS (1) MANITOULIN- SUDBURY NIPISSING And TIMISKAMING NE LHIN Ontario PARRY SOUND (2) % LCI UCI % LCI UCI % LCI UCI % LCI UCI % LCI UCI % LCI UCI % LCI UCI Very good or excellent self-reported health 56.7 52.7 60.6 53.8 49.3 58.3 58.5 55.1 62.0 55.1 50.7 59.5 49.4 42.3 56.6 56.0 54.1 58.0 60.8 60.1 61.5 Very good or excellent self-reported mental health 67.6 63.8 71.4 68.7 64.7 72.7 72.5 69.4 75.6 69.3 65.4 73.2 63.7 57.1 70.3 69.5 67.7 71.3 72.8 72.2 73.5 Participation and activity limitation 33.4 29.6 37.3 35.7 31.6 39.8 32.5 29.4 35.6 39.1 35.0 43.2 33.7 29.0 38.4 34.8 33.0 36.5 29.4 28.7 30.0 Very strong or somewhat strong sense of belonging to local community 70.0 66.1 74.0 71.8 67.9 75.8 68.1 64.6 71.5 69.3 65.1 73.5 70.6 65.8 75.4 69.5 67.7 71.3 63.4 62.6 64.2 Life stress, quite a lot (18 years and over) 20.9 17.1 24.6 21.4 17.2 25.6 21.6 18.6 24.6 18.4 14.3 22.5 20.2 15.6 24.9 20.6 18.8 22.4 23.1 22.5 23.8 Obese, self-reported adult body mass index 30.00 or higher (18 years and over) 18.7 15.3 22.0 23.2 19.1 27.4 18.8 15.8 21.8 21.3 17.1 25.5 22.4 17.3 27.5 20.3 18.6 22.0 15.1 14.5 15.6 Overweight, self-reported adult body mass index 25.00 to 29.99 (18 years and over) 37.2 33.1 41.2 36.4 31.7 41.0 38.5 34.9 42.1 36.1 31.9 40.3 39.6 33.4 45.8 37.4 35.3 39.4 33.4 32.6 34.2 Self-reported youth body mass index, overweight or obese - - - 18.9* 9.4 28.3 29.3* 17.8 40.8 24.1* 11.6 36.6 - - - 24.1 18.2 30.0 18.1 16.5 19.8 1 or more two-week disability days 19.8 16.4 23.1 16.9 13.1 20.6 18.1 15.5 20.7 21.7 18.2 25.2 15.9* 10.4 21.4 18.9 17.4 20.4 17.1 16.6 17.6 Injuries within the past 12 months 11.4 8.7 14.1 16.4 13.1 19.7 14.3 11.7 16.9 15.8 12.8 18.7 13.5 9.1 18.0 14.3 12.9 15.7 13.5 13.0 14.0 Source: Canadian Community Health Survey cycle 3.1 (2005), Statistics Canada (table 105-0400, last updated on: 2007-04-27) provided by MOLTC, 2008. Bolded values indicate values that are statistically significantly different than the provincial rate. Statistical significance is calculated by Statistics Canada and may produce differing results than simple comparison of confidence intervals. (1) Porcupine Health Unit (2) North Bay Parry Sound District Health Unit - value too unreliable to publish * use with caution Use of Preventative Care CCHS cycle 3.1 (2005) Persons (12+) who reported: ALGOMA COCHRANE and JAMES AND HUDSON BAY COASTS (1) MANITOULIN- SUDBURY NIPISSING And TIMISKAMING NE LHIN Ontario PARRY SOUND (2) % LCI UCI % LCI UCI % LCI UCI % LCI UCI % LCI UCI % LCI UCI % LCI UCI Has a regular medical doctor 86.9 84.1 89.8 78.3 74.3 82.2 91.0 88.8 93.1 91.7 89.4 94.0 71.2 62.5 79.9 87.1 85.8 88.4 91.1 90.8 91.5 Contact with medical doctors in the past 12 months 75.3 71.6 79.1 75.6 71.5 79.7 78.0 75.0 81.0 79.1 75.5 82.8 75.3 70.6 80.0 77.2 75.4 78.9 81.5 80.9 82.0 Contact with dental professionals in the past 12 months 66.2 62.3 70.1 60.1 55.6 64.6 65.3 61.7 68.8 64.0 60.3 67.7 53.0 47.4 58.7 63.6 61.7 65.4 69.7 69.0 70.3 Contact with alternative health care providers in the past 12 months 10.1 7.5 12.8 11.7 8.1 15.3 11.2 9.0 13.5 9.9 7.4 12.3 6.6* 4.0 9.2 10.5 9.2 11.7 12.0 11.5 12.5 Influenza immunization, less than one year ago 42.5 38.4 46.7 40.1 35.6 44.6 42.3 39.0 45.5 46.4 42.1 50.8 44.1 38.8 49.5 43.1 41.2 44.9 41.1 40.4 41.8 Pap smear, within the last 3 years (18 to 69 years) 70.8 64.6 77.1 64.9 58.5 71.3 73.0 67.7 78.2 74.0 68.1 79.8 74.2 66.0 82.4 71.6 68.7 74.6 72.9 71.8 73.9 Received routine screening mammogram within the last 2 years (50 to 69 years) 42.6 33.4 51.8 46.0 35.5 56.5 56.4 48.0 64.8 50.8 41.7 59.9 33.6* 21.8 45.5 49.2 44.6 53.8 53.0 51.0 55.0 Source: Canadian Community Health Survey cycle 3.1 (2005), Statistics Canada (table 105-0400, last updated on: 2007-04-27) provided by MOLTC, 2008. Bolded values indicate values that are statistically significantly different than the provincial rate. Statistical significance is calculated by Statistics Canada and may produce differing results than simple comparison of confidence intervals. (1) Porcupine Health Unit (2) North Bay Parry Sound District Health Unit - value too unreliable to publish * use with caution rates for female respondents only 12

Health Practices/Behaviours CCHS cycle 3.1 (2005) Persons (12+) who reported: ALGOMA COCHRANE and JAMES AND HUDSON BAY COASTS (1) MANITOULIN- SUDBURY NIPISSING And TIMISKAMING NE LHIN Ontario PARRY SOUND (2) % LCI UCI % LCI UCI % LCI UCI % LCI UCI % LCI UCI % LCI UCI % LCI UCI Current daily or occasional smoker 23.7 19.8 27.5 30.2 26.5 34.0 24.0 20.7 27.2 26.6 22.9 30.3 26.3 20.0 32.6 25.6 23.8 27.4 20.7 20.1 21.3 Smoking initiation age (5 to 14 years) 39.3 33.6 45.0 41.7 36.3 47.1 39.7 35.6 43.8 38.7 33.1 44.3 43.4 36.3 50.4 39.9 37.5 42.4 32.7 31.9 33.5 Complete restriction on smoking at home 64.3 60.0 68.7 55.6 50.6 60.6 62.4 58.6 66.2 62.5 58.4 66.7 50.7 45.9 55.6 61.0 59.0 63.1 69.6 68.9 70.3 Complete restriction on smoking at work 62.6 56.2 69.0 65.3 58.8 71.8 67.7 62.8 72.6 69.7 64.0 75.4 58.1 48.6 67.7 66.0 63.3 68.8 67.5 66.7 68.3 Exposed to second-hand smoke at home 11.5 8.0 14.9 12.1 9.1 15.0 12.2 9.2 15.2 11.9 9.0 14.7 11.4 8.7 14.2 11.9 10.4 13.3 7.3 6.9 7.7 Exposure to second-hand smoke in the past month, in public places 13.6 10.2 17.1 15.6 11.8 19.4 10.4 7.6 13.2 14.5 11.0 18.1 19.3* 10.2 28.4 13.3 11.7 14.9 13.0 12.4 13.6 Exposure to second-hand smoke in the past month, in vehicles 12.8 9.7 16.0 13.4 9.8 17.0 10.5 8.0 13.0 13.0 9.8 16.1 8.8* 4.9 12.6 11.8 10.4 13.2 7.8 7.4 8.3 Exposure to second-hand smoke in the past month, in vehicles and/or public places 22.8 18.4 27.2 22.3 17.9 26.7 17.0 13.9 20.1 21.1 17.3 24.8 24.6* 16.1 33.1 20.4 18.6 22.2 17.3 16.7 18.0 5 or more drinks on one occasion, 12 or more times a year 23.9 19.6 28.2 23.8 19.9 27.7 23.2 19.7 26.6 24.5 20.9 28.1 25.3 19.7 30.9 23.8 22.0 25.6 21.5 20.8 22.1 Leisure-time physically active or moderately active 55.7 51.8 59.6 45.4 40.4 50.3 56.2 52.7 59.6 50.0 45.8 54.2 49.4 43.5 55.3 52.6 50.9 54.4 51.3 50.6 52.0 Source: Canadian Community Health Survey cycle 3.1 (2005), Statistics Canada (table 105-0400, last updated on: 2007-04-27) provided by MOLTC, 2008. Bolded values indicate values that are statistically significantly different than the provincial rate. Statistical significance is calculated by Statistics Canada and may produce differing results than simple comparison of confidence intervals. (1) Porcupine Health Unit (2) North Bay Parry Sound District Health Unit - value too unreliable to publish * use with caution Prevalence of Selected Chronic Conditions CCHS cycle 3.1 (2005) Persons (12+): ALGOMA NIPISSING COCHRANE and JAMES AND HUDSON BAY COASTS (1) MANITOULIN-SUDBURY And TIMISKAMING NE LHIN Ontario PARRY SOUND (2) % LCI UCI % LCI UCI % LCI UCI % LCI UCI % LCI UCI % LCI UCI % LCI UCI With arthritis or rheumatism 27.9 24.5 31.4 22.5 18.6 26.4 23.4 20.8 26.1 28.7 25.1 32.2 27.3 22.2 32.4 25.7 24.1 27.3 17.1 16.7 17.6 With asthma 8.3 6.2 10.3 9.6 7.0 12.3 8.9 7.1 10.7 8.9 6.4 11.4 8.5* 5.6 11.4 8.9 7.9 9.9 8.0 7.6 8.3 With diabetes 6.7 5.0 8.4 7.0 5.1 8.9 6.6 5.2 8.1 8.0 5.7 10.4 8.2 5.7 10.8 7.1 6.2 8.0 4.8 4.5 5.1 With high blood pressure 20.0 17.0 23.0 18.6 15.7 21.5 18.8 16.7 20.9 19.7 16.8 22.5 19.0 15.3 22.6 19.3 18.1 20.5 15.2 14.8 15.7 Source: Canadian Community Health Survey cycle 3.1 (2005), Statistics Canada (table 105-0400, last updated on: 2007-04-27) provided by MOLTC, 2008. Bolded values indicate values that are statistically significantly different than the provincial rate. Statistical significance is calculated by Statistics Canada and may produce differing results than simple comparison of confidence intervals. (1) Porcupine Health Unit (2) North Bay Parry Sound District Health Unit - value too unreliable to publish * use with caution 13