Projections of Socioeconomic Trends in Obesity and Diabetes in Canada from 2001 to 2021: The Population Health Microsimulation Model (POHEM:CVD)

Thursday, 21 August 2014: 11:30 AM
Boardroom (Dena'ina Center)
Brendan T Smith, MS , University of Toronto, Toronto, ON, Canada
Sam Harper, PhD , McGill University, Montreal, QC, Canada
Peter M Smith, PhD , Monash University, Melbourne, Australia
Douglas G Manuel, MD , Ottawa Hospital Research Institute, Ottawa, ON, Canada
Deirdre Hennessy, PhD , Ottawa Hospital Research Institute, Ottawa, ON, Canada
Meltem Tuna, PhD , Ottawa Hospital Research Institute, Ottawa, ON, Canada
Cameron A Mustard , University of Toronto, Toronto, ON, Canada
INTRODUCTION: Reducing health inequalities is a major public health priority internationally. Social inequalities in obesity and diabetes have been previously reported in Canada. However, it is unclear how these trends will change over time. The objective was to project future trends in obesity and diabetes by socioeconomic position (SEP) from 2001-2021.

METHODS: All projections were conducted using the Population Health Model for Cardiovascular Disease. This continuous-time microsimulation model uses data from the cross-sectional 2001 Canadian Community Health Survey (CCHS) to simulate a baseline population of 22.5 million “actors” representative of the Canadian population over 20 years. Independent life trajectories are created for each actor, including full risk factor profiles updated each year using predictive algorithms to determine transitions between risk factor states. Obesity (body mass index≥30kg/m2) and diabetes (physician diagnosed) prevalence were estimated by SEP (education: less than secondary graduation, secondary graduation, some post-secondary and post-secondary graduation). The model was validated by comparing predicted obesity and diabetes prevalence by SEP to observed prevalence in the 2001-2011 versions of the CCHS.

RESULTS: Both obesity and diabetes are projected to increase from 2001-2021. Comparing lowest to highest education groups social inequalities in obesity at baseline (19% vs. 13%, risk difference(RD): 6%, prevalence ratio(PR): 1.5) were significantly reduced in 2021 (25% vs. 23%,RD: 2%,PR: 1.1) where as social inequalities in diabetes at baseline (9% vs. 3%,RD: 6%,PR: 3.0) increased on the absolute scale and remained on the ratio scale through 2021 (14% vs. 5%,RD: 9%,PR: 2.8).

CONCLUSIONS: Overall, this study suggests the prevalence of obesity and diabetes will increase across all education groups in Canada through 2021. Social inequalities in diabetes will increase, despite an elimination of social inequalities in obesity. Population health interventions that aim to reduce obesity and diabetes at a population level, and also across education levels are needed in Canada.

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