Community Needs Assessment 2019 Update Report

Community Needs Assessment (CNA)

The 2019 Update primarily utilized data available from secondary sources and did not collect any information directly from the residents in Windsor and Essex County. A comprehensive CNA, such as the 2016 report, collected information from residents through community surveys and focus groups.

The purpose of this 2019 Update was to provide a report on the status of key health areas of concern and identify any new or emerging trends previously unidentified. Additionally, the 2019 Update will assist the WECHU and the community partners to review their programs and services, help to identify priorities and continue to build on the successful partnership and collaboration in addressing the health needs of the residents of Windsor and Essex County.

Methods

The Windsor-Essex County Health Unit’s (WECHU) CNA 2019 Update Report provides a general overview of health related determinants and outcomes pertaining to Windsor and Essex County residents, using primarily secondary sources of data. The data in this 2019 Update highlights continuing trends from the 2016 Community Needs Assessment, but also points to new trends in the health of Windsor and Essex County residents.

Summary of Findings

Population Demographics

Windsor and Essex County has a population of 398,953 people (2016 Census). The latest population projections (based on the 2011 Census), show that the local population is expected to grow to approximately 421,000 people by 2019 and 450,000 people by 2029.
As of 2016, 17.7% of the local population are seniors (65 years of age or older). The proportion of seniors in Windsor and Essex County is projected to grow steadily - by 2029, seniors are projected to account for approximately 24% of the local population.
Windsor and Essex County’s rate of unemployment in 2016 (7.3%) was comparable to the rest of the province (7.3%); however, Windsor and Essex County residents have a lower before-tax income for all types of income (i.e., individual full-time worker, household, etc.) compared to Ontario.
Poverty remains a significant issue in Windsor and Essex County. One in four children under five years (26.0%), one in five children under 17 years (22.6%), and one in ten seniors (11.4%) in Windsor and Essex County live in poverty.

General Health

The rate of preventable deaths among Windsor and Essex County residents (140.1 deaths per 100,000 residents) remains significantly higher than Ontario’s rate (121.8 deaths per 100,000 residents). Preventable deaths contribute to a shorter life expectancy and a higher likelihood of premature death among Windsor and Essex County residents.

Health Care Access

The rate of general/family physicians in Windsor and Essex County is 98.5 per 100,000 residents, which is similar to the rate in Ontario. The rate of specialist physicians in WEC (69.4 specialists per 100,000 residents), however, was significantly lower than the rate in Ontario (110.7 specialists per 100,000 residents).
In the past year, approximately seven-percent of Windsor and Essex County residents (7.2%) reported not being able to receive health care when they needed it, which is similar to Ontario (7.3%).

Chronic Disease

Approximately two out of every three (64.5%) residents in Windsor and Essex County are overweight or obese, making it the most common chronic health problem locally.
The proportion of residents who are overweight or obese is significantly higher in Windsor and Essex County compared to Ontario (58.3%).
Cardiovascular disease is the leading cause of chronic disease death in Windsor and Essex
County and the rate of these deaths (215.2 deaths per 100,000 residents) is significantly higher to what is observed in Ontario (170.0 deaths per 100,000 residents).
The number of new cases of lung cancer every year among residents in Windsor and Essex County is significantly higher compared to Ontario (80.7 new cases in Windsor and Essex County versus 67.8 new cases in Ontario per 100,000 residents).

Mental Health

Approximately 14% of residents in Windsor and Essex County reported that they consulted with a mental health professional in the past 12 months, which is similar to Ontario; these professionals include family doctors, social workers, psychiatrists, and psychologists.
The rate of mental health-related emergency department visits for Windsor and Essex County residents (2,499.6 visits per 100,000 residents in 2017) was significantly higher than Ontario (2,181.9 visits per 100,000 residents in 2017). The rate was significantly higher in 10 of the 11 years from 2007 to 2017.
The rate of Windsor and Essex County residents visiting the emergency department for mental health-related outcomes was seven-times higher for residents of low socioeconomic status compared to residents of high socioeconomic status.

Environmental Health

The annual average temperature and the annual precipitation in Windsor and Essex County is steadily increasing every 10 years. These trends have contributed to an increase in the number of heat-related emergency department visits and the impact of flooding in Windsor and Essex County.
Annually, between 2003 and 2014, there were 13 days (median) with smog advisories in Windsor and Essex County.
In 2016, Windsor and Essex County became the first region in Canada to find an established population of Ae. Albopictus mosquitoes, a mosquito species that has the potential to carry the Zika Virus.
The number of ticks reported to the Windsor-Essex County Health Unit (including blacklegged species which are potential carriers of Lyme disease) has increased from 2013 to 2018 (93 ticks reported in 2013 compared to 338 ticks reported in 2018).
The Windsor-Essex County Health Unit conducted a three-year study on indoor radon levels locally. Radon levels were above the Canadian guideline of 200 Bq/m³ for 11% of homes in Windsor and Essex County. Essex County had a significantly greater proportion of homes with radon levels above the guideline (18%) compared to the City of Windsor (6%). Homes with two levels were found to have higher radon concentrations than three and four-level homes. Moreover, homes built in 2011 or later were found to have higher radon concentrations than older builds.

Maternal and Child Health

7.0% of pregnant women in Windsor and Essex County reported smoking during pregnancy. Folic acid prior to and during pregnancy is significantly lower in Windsor and Essex County (7.0%) compared to Ontario (31.3%), even though folic acid is strongly recommended for optimum fetal development.
The pregnancy rate among females of reproductive age (15 to 49 years of age) is significantly lower in Windsor and Essex County (48.8 pregnancies per 1,000 residents) than Ontario (53.1 pregnancies per 1,000 residents). The birth rate in Windsor and Essex County (9.3 births per 1,000 residents) is also significantly lower than Ontario (9.6 births per 1,000 residents).
The proportion of Windsor and Essex County mothers who reported an intention to breastfeed (exclusively or in combination with breast-milk substitute) is significantly lower (89.6%) than mothers in Ontario (94.0%). At 6-months postpartum, only 60.1% of mothers reported that they were breastfeeding, and only 15.5% reported that they were exclusively breastfeeding.
In Windsor and Essex County, a significantly higher proportion of infant mothers are single parents (6.2%) compared to Ontario (4.7%). Additionally, 6.6% of parents or parenting partners in Windsor and Essex County are involved with child protection services, a significantly higher proportion compared to Ontario (3.9%).

Oral Health

Inadequate access and cost remain barriers to dental care for Windsor and Essex County residents; 23.7% reported that they lack dental insurance that covered all or part of the cost of seeing a dental professional.
Coverage for dental care was especially low for seniors (65+ years) in Windsor and Essex County, as 47.7% reported that they have no coverage.
Indicators show an overall trend of declining oral health status among children in Windsor and Essex County compared to Ontario.

Immunization

Immunization coverage for children (at age 7, 12, and 17 years) in Windsor and Essex County is similar to Ontario.
Coverage estimates in 7-year olds only met the national average of 95% for two diseases (meningococcal disease and rubella).
Coverage estimates in 12-year olds did not meet the national goal of 90% for meningococcal disease, hepatitis B, and human papilloma virus.
Coverage estimates in 17-year olds only met the national goal for measles, mumps, and rubella.

Conclusion

This 2019 Update provides a broad assessment of local health statistics and emerging trends within WEC. The findings highlight opportunities for the WECHU and its community partners in addressing and prioritizing the health needs of our community. Furthermore, this report also provides information on some of the disparities and health inequities found within WEC.