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Population risk and burden of health behavioural related all-cause, premature, and amenable deaths in Ontario Canada: Canadian Community Health Survey linked mortality files

Rosella LC, Kornas K, Huang A, Grant L, Bornbaum C, Henry D. Ann Epidemiol. 2019; Jan 25 [Epub ahead of print].

Purpose — To examine the association of all-cause and premature mortality with four modifiable lifestyle behaviours and quantify the burden of behavioural related premature death in Ontario, Canada.

Methods — We analyzed a cohort of 149,262 adults in the 2000-2010 Canadian Community Health Surveys, linked to vital statistics data to ascertain deaths until December 31st 2015. The strength of the association between behaviours (smoking, body mass index (BMI), physical inactivity, and alcohol consumption) and all-cause and premature mortality was estimated using sex-specific cox proportional hazards models. We estimated the proportion of deaths from causes amenable to the health system by behaviour.

Results — After full adjustment, hazard ratios (95% confidence interval) for premature mortality were significantly increased for heavy smokers vs. non-smokers (males: 5.48 (4.55-6.60); females 4.45 (3.49-5.66)); obese class III vs. normal weight (males: 2.47 (1.76-3.48); females: 1.73 (1.29-2.31)); and physically inactive vs. active (males: 1.25 (1.07-1.45); females: 1.70 (1.41-2.04)). In both sexes, a disproportionate burden of amenable deaths were experienced by heavy smokers, severely obese, physically inactive and heavy drinkers.

Conclusions — The findings emphasize the importance of prevention to reduce the prevalence of risk behaviours that contribute to a large burden of premature deaths that are amenable to the health system.

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