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HIV/AIDS mortality in Canada: evidence of gender, regional and local area differentials
R S Hogg1, K V Heath, S A Strathdee
1British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, Canada.
Insights
Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) significantly impacted Canadian mortality, especially for men in major cities. This study highlights the disease
Area of Science:
- Epidemiology
- Public Health
- Demography
Background:
- HIV/AIDS emerged as a significant public health concern globally and in Canada.
- Understanding the specific mortality patterns associated with HIV/AIDS is crucial for targeted interventions.
Purpose of the Study:
- To evaluate the influence of Human Immunodeficiency Virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS) on mortality trends in Canada.
- To examine gender and regional disparities in HIV/AIDS-related deaths.
- To compare HIV/AIDS mortality with other leading causes of death.
Main Methods:
- A descriptive, population-based study was conducted using data from Statistics Canada (1987-1992).
- Mortality data for HIV/AIDS (ICD-9 042-044) and other leading causes (coronary heart disease, motor vehicle accidents, suicides, lung cancer, breast cancer) were analyzed.
- Standardized mortality ratios (SMR), potential years of life lost (PYLL), and life expectancy were calculated.
Main Results:
- Between 1987 and 1992, 5,546 deaths were attributed to HIV/AIDS in Canada, predominantly in men (5,229).
- Higher SMR for HIV/AIDS were observed in men in Vancouver, Toronto, and Montreal, and in women in Montreal.
- HIV/AIDS accounted for 3.6% of PYLL in men and 0.4% in women, becoming a leading cause of PYLL in major cities for men.
Conclusions:
- HIV/AIDS has substantially affected mortality patterns in Canada.
- The impact is most pronounced among men and in urban centers like Toronto, Vancouver, and Montreal.
- HIV/AIDS significantly reduced life expectancy at birth for men in these key cities during the study period.
Objective:
To assess the impact of HIV infection and AIDS on mortality patterns in Canada with specific reference to gender and regional differentials and to other leading causes of death.
Design:
Descriptive, population-based study.
Setting:
Canada.
Patients:
All persons for whom HIV/AIDS [ninth revision of the International Classification of Diseases (ICD-9) 042-044] was recorded as the underlying cause of death as reported to Statistics Canada between 1987 and 1992. For comparative purposes data was obtained on five other leading underlying causes of death including coronary heart disease (ICD-9 410-414), motor vehicle accidents (ICD-9 E810-E819), and suicides (ICD-9 E950-E959) in men and women, lung cancer (ICD-9 162) in men and breast cancer (ICD-9 174) in women. Population figures were obtained from Statistics Canada estimates.
Main Outcome Measures:
Age and cause-specific mortality rates, standardized mortality ratios (SMR), potential years of life lost (PYLL) before age 65 years, and life expectancy lost due to a select underlying cause of death.
Results:
Over the period 1 January 1987 to 31 December 1992, 5546 deaths attributed to HIV/AIDS (5229 in men and 317 in women) were recorded in Canada. SMR for men were significantly higher than the national average in the cities of Vancouver, Toronto and Montreal, whereas those for women were significantly greater only in Montreal. Deaths from HIV/AIDS accounted for 3.6% of PYLL in men and 0.4% of PYLL in women. In 1992, HIV/AIDS was the third leading cause of male PYLL surpassing lung cancer. In the cities of Montreal, Toronto, and Vancouver HIV/AIDS was the leading cause of PYLL and was responsible for significant decrease in life expectancy at birth in men over the study period.
Conclusions:
HIV/AIDS has had considerable impact on mortality within Canada, principally among men and particularly in the cities of Toronto, Vancouver and Montreal.