Chronic Health Diseases and Cardiovascular Diseases in Ontario

It was predicted that by 2020, chronic health disease will account for 73% of all deaths and 60% of the world’s burden of diseases (Russell et al., 2009).  Chronic diseases progress slowly and require ongoing monitor and treatment.  While most of these chronic diseases are preventable, it remains the leading cause of death globally. 

Using this information, it was determined that there should be more focus across Canada to increase the quality of care to decrease the mortality rates caused by chronic health diseases and to provide patients with better disease outcomes, improving chronic disease management (Russell et al., 2009). 

Chronic diseases remain the leading cause of death in Ontario (Ontario Public Health, n.d.). It is recognized that mortality rates can be reduced however, Ontario’s public’s health’s initiative to provide high quality yet equitable care is limited to the social health determinants of a population and a lack of financial support from the provincial government (Ontario Public Health, n.d.).  The management and treatment of chronic diseases is costly and is creating a financial burden on Canada’s healthcare system.  The World Health Organization (WHO), however has recognize this issue worldwide and has encouraged nations to prioritize the management of chronic diseases to reduce mortality rates.

Canada’s model of obtaining care from a primary care provider (PCP) worked efficiently for years.  A PCP was the first point of contact for non-life-threatening health issues and if a specialist needs to assess the patient, a referral will be sent out by the PCP.  However, today with the increase of prevalence of chronic diseases with an aging population, the country is overburdened by the lack of resources to keep up with the demand.  Historically, there was always a shortage of PCPs within Ontario, however, the COVID-19 pandemic has made it even more difficult to find a family doctor since many family doctors planned to either retire or change their practice.  This factor prevents the diagnosis of a chronic disease and/or limits how the disease is monitored. 

Cardiovascular disease (CVD) is a leading cause of death in Northern Ontario (Sahai et al., 2000).  It is the chronic disease that causes the highest amount of hospitalization.

Furthermore, there was a higher prevalence of modifiable risk factors such as tobacco smoking, alcohol consumption, poor diet, physical inactivity and obesity compared to the rest of Ontario.  These factors result from a combination of patient collaboration, healthcare delivery, determinants of health, multiple risk factors and monitoring (Sahai et al, 2000)

The results of all this research are for Canada to create strategy and action plans.  For CVD, it has been recognized that the modifiable factors that lead to chronic disease can be improved in Canadians to reduce the prevalence of chronic diseases and the mortality rate.

A Steering Committee was formed in October 2006 to create the Heart Health Strategy to deal with the chronic disease issue in Canada (Smith, 2009). The committee was comprised of multidisciplinary experts who came up with a strategy that consists of six recommendations (Smith, 2009).

1.        Environment – Creating a heart healthy environment can lead to education to improve the quality and types of food that Canadians eat, targeting obesity.  This recommendation can also lead to targeting tobacco cessation and promoting increased physical activity (Smith, 2009).

2.        Support – Identifying areas to support Canadians to lead a healthier lifestyle. Help Canadians lead healthier lives by providing reliable and credible information to the public and/or patients, improving disease screening as well as providing education (Smith, 2009).

3.        Indigenous populations – Working on improving the resources allocated to the Indigenous population and reducing the disparity of healthcare access.  Outreach programs to provide more care to low education and low economic status individuals (Smith, 2009).

4.        Continuous strive to address systemic gaps in the healthcare system – To address inefficiencies and to deliver care more proficiently i.e. introduce the care provided by nurse practitioners who can commit to monitoring patients routinely throughout their conditions (Smith, 2009).

5.        Build the knowledge infrastructure –increase education and research on CVD (Smith, 2009).

6.        Health promotion – Providing incentives and targeting secondary and post-secondary graduates to work in healthcare (Smith, 2009).

Smith stated that the targets of the Heart Health Strategy recommendation are to do the following by 2020:

·       Decrease annual deaths from heart attack and stroke by 25%;

·       Bring CV disease burden among Aboriginal and Indigenous populations in line with other Canadians;

·       Decrease high blood pressure by 32%;

·       Decrease hospitalizations for stroke by 25%; and

·       Decrease the smoking rate by 25% (Smith, 2009).