What the rates of heart disease at each level, and does the workplace impact risk for heart disease?
The most common chronic illness’ that I observe in the population I work with is mental illness, cardiovascular disease and diabetes. In my role working for a mid-sized municipal government, we have access to only aggregate data around the health of employees. However, the workforce is highly varied and what we observe amongst the staff population that I work with could be comparable to the greater regional health surveillance metrics available. For example, when it comes to age demographics the staff range from young adults up to those working part-time post retirement. The employee groups also include those in various fields of work such as professional, manual labour and public facing service roles, as well as job types include those which work business hours and shift work. With cardiovascular disease being a major illness amongst the population I work with as well as the general public, in this blog I take a closer look at this condition; what are the rates of heart disease at the national, provincial, and local level? and How is the workplace a determinant of heart disease?
Heart Disease – A Public Health Concern at all Levels
Heart disease is an important chronic illness to take action on because not only is it the second leading cause of death in Canada (Public Health Agency of Canada, 2018), but it has risk factors such as lifestyle behaviors and the environment which could be influenced at every level of the social ecological model of health. The term “heart disease” includes heart attack, stroke and heart failure (Public Health Agency of Canada, 2018), and like many chronic illness’, has a component of genetic and modifiable risk factors.
How prevalent is heart disease in Canada, Alberta and in the local community which I serve?
National
The Canadian Chronic Disease Indicators (2019) tool indicates that 5.9% of adults over the age of 20 report having a diagnosis of either heart disease or stroke; 4.8% of females and 7.1% of males. (Figure 1. below). However, that does not encompass all the individuals who are diagnosed and being treated for an illness which is a risk factor for heart disease. The most commonly prescribed drugs for Canadians are for those to treat high blood pressure (16%) and high blood cholesterol (12%) (Statistics Canada, 2021); both conditions are a risk factor for heart disease.
Figure 1. This figure, retrieved from the Canadian Chronic Disease Indicators tool, displays a sex comparison of the total population of Canadians (5.9%) who reported being diagnosed with cardiovascular disease in 2019.
Provincial
The rate of cardiovascular disease in Alberta is 8.99% (Chen et al., 2021). Though, again this does not include individuals who have hypertension and high blood pressure is a known risk factor for both stroke and heart disease (Heart and Stroke Foundation Canada, n.d.). In a paper published last year, Ye, et al., (2021) observe that participants of Alberta’s Tomorrow Project cohort are having an increasing trend of living with at least one or more chronic illness, which is being led in prevalence by hypertension (18.5%), depression (18.1%) and chronic pain (12.8%). Alberta’s Tomorrow Project is a longitudinal study which began in 2000 to follow 55,000 Albertans for 50 years to better understand what causes and prevents chronic illness amongst Albertan's (2021).
Local
I was unable to locate data specific to the local community on the prevalence of heart disease, however, the Alberta Community Health Dashboard (2018) is a helpful tool to view rate of risk factors for cancer in various regions throughout the province. The screenshot below is for Sherwood Park, the local municipality that I work for. Many of the risk factors for Cancer overlap to risk for heart disease, including drinking, stress, nutrition, physical activity, sodium intake, and smoking. This figure helps to fill in the gap of local data; that many within the target population I serve may also have these risk factors for heart disease.
Figure 2. Retrieved from the Alberta Community Health Dashboard (2018), this image shows the percentage of residents with a risk factor for cancer. There is overlap between health risk factors for cancer and heart disease.
How Does the Workplace or Work Determine Risk for Heart Disease?
There appears to be some associations with the work and the work environment being an influencing factor to heart disease risk. In a study by Nowrouzi-Kia, et al., they reviewed data from the Canadian Community Health Survey from 2001-2014 to look for associations between cardiovascular disease and three job risks; number of hours worked per week, physical job demands, and type of occupation. Their results found trends, sometimes with statistical significance, that the last two indicators are associated with a higher risk for heart disease (2018). In another study by Smith et al., researchers looked at 7300 Ontario employees for 12 years and found that for those who predominantly stood in their job had a higher risk (6.6%) to get heart disease than workers who mostly sat (2.8% risk) (2018). Those authors recommend a combination of sitting, standing and physical movement during the workday to have a positive impact on cardiovascular health.
Psychological impacts from work and the work environment may also impact risk for heart disease. Acute intense stress and chronic stress can have a negative impact on heart health (Heart and Stroke Foundation, n.d.). Since work stress is reported as the top source of stress for 26% of Canadians (LifeWorks, 21 July, 2022) job-related stress could be inferred as a risk for heart disease as well.
Not only is the workplace potentially a contributing impact to heart disease risk, but the workplace also poses an opportunity to play a role in preventative interventions to their employees. Interventions at the workplace level can look like programs, policies and practices that address workplace stress, nutrition, physical activity, tobacco reduction, and others strategies specific to the management of co-morbidities of heart disease such as obesity, diabetes mellitus and depression (Calitz, et al., 2021).
Summary
Overall, heart disease carries with it a high burden of mortality and morbidity and should be a public health concern at the national, provincial, and local levels throughout Canada. As discussed, the workplace can have a both positive and negative impact on risk for heart disease. Employers should take preventative action to promote heart health and protect their workforce from occupational risks that would be detrimental to heart health.
- Kylie
References
Alberta Health Services, Healthier Together. (2018). Alberta Community Health Dashboard. Government of Alberta. Retrieved November 3, 2022 from https://www.healthiertogether.ca/prevention-data/alberta-community-health-dashboard/community-cancer-prevention-screening-dashboard/
Alberta's Tomorrow Project. (2021). All about Alberta's Tomorrow Project. Retrieved November 4, 2022 from https://myatp.ca/about-atp
Calitz, C., Pratt, C., Pronk, N. P., Fulton, J. E., Jinnett, K., Thorndike, A. N., Addou, E., Arena, R., Brown, A. G. M., Chang, C., Latts, L., Lerner, D., Majors, M., Mancuso, M., Mills, D., Sanchez, E., & Goff, D. (2021). Cardiovascular Health Research in the Workplace: A Workshop Report. Journal of the American Heart Association, 10(17), e019016. https://doi.org/10.1161/JAHA.120.019016
Centre for Surveillance and Applied Research, Public Health Agency of Canada. (2021). Canadian Chronic Disease Indicators Data Tool, 2021 Edition. Retrieved November 3, 2022 from https://health-infobase.canada.ca/ccdi/data-tool/?Dom=1
Government of Canada, S. C. (2021, June 28). The Daily — Prescription medication use among Canadian adults, 2016 to 2019. https://www150.statcan.gc.ca/n1/daily-quotidien/210628/dq210628e-eng.htm
Heart and Stroke Foundation. (n.d.). Heart disease. Retrieved November 8, 2022 from https://www.heartandstroke.ca/heart-disease
LifeWorks, Mental Health Index. (21 July, 2022). Canadians equally stressed at work as they are in their personal lives. Retrieved November 8, 2022 from https://lifeworks.com/en/news/canadians-equally-stressed-work-they-are-their-personal-lives#:~:text=The%2026%20per%20cent%20of%20Canadians%20that%20report%20personal%20stressors,depression%20(27%20per%20cent)
Nowrouzi-Kia, B., Li, A. K. C., Nguyen, C., & Casole, J. (2018). Heart Disease and Occupational Risk Factors in the Canadian Population: An Exploratory Study Using the Canadian Community Health Survey. Safety and Health at Work, 9(2), 144–148. https://doi.org/10.1016/j.shaw.2017.07.008
Public Health Agency of Canada. (2018). Report from the Canadian chronic disease surveillance system: Heart disease in Canada, 2018. Retrieved November 7, 2022 from https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/diseases-conditions/report-heart-disease-canada-2018/pub1-eng.pdf
Smith, P., Ma, H., Glazier, R. H., Gilbert-Ouimet, M., & Mustard, C. (2018). The Relationship Between Occupational Standing and Sitting and Incident Heart Disease Over a 12-Year Period in Ontario, Canada. American Journal of Epidemiology, 187(1), 27–33. https://doi.org/10.1093/aje/kwx298
Statistics Canada. (28 June, 2021). Prescription medication use among Canadian adults, 2016 to 2019. Retrieved November 8 from https://www150.statcan.gc.ca/n1/daily-quotidien/210628/dq210628e-eng.htm
Bình luận