Chronic diseases decline, but diabetes shows alarming growth, new Manitoba ‘health atlas’ reveals

The rates of heart attacks, strokes and nearly every major chronic disease have declined over the past two decades in Manitoba, but the rate of diabetes is soaring, says a comprehensive data study conducted by the Manitoba Centre for Health Policy (MCHP) at the University of Manitoba.

When researchers analyzed the prevalence (number of existing cases) and incidence (new cases) of chronic illnesses – including arthritis, heart disease, congestive heart failure and dementia – diabetes was the only one to see a significant increase.

“Over the 20-year period from 2004 to 2023, Manitobans’ health improved overall,” said study leader Lindsey Dahl, an epidemiologist at MCHP.

“But the number of Manitobans living with diabetes and the number who are diagnosed each year climbed to an alarming degree. We’re not seeing progress with the diabetes epidemic the way we are with other conditions.”

In the decade from 2013 to 2023, there was a 46 per cent increase in the number of Manitobans living with diabetes. “People are being diagnosed at a younger age and living longer with diabetes,” Dahl noted.

Comparing the three-year period 2020 to 2023 with the period 2015 to 2018, the number of new cases of diabetes rose by 21 per cent. “That represents more than 6,000 additional Manitobans newly diagnosed, compared to the previous period,” Dahl said.

The study, The 2024 Regional Health Authorities (RHA) Indicators Atlas, marks the sixth time that MCHP, part of UM’s Rady Faculty of Health Sciences, has taken a broad look at Manitobans’ health status and health-care use, at intervals of about five years.

The researchers studied de-identified (anonymous) health data stored in the Manitoba Population Research Data Repository at MCHP. They analyzed more than 110 health indicators, from doctor and nurse practitioner visits to hospitalizations, procedures such as hip replacements and cataract surgeries, and tests such as CT scans and MRIs.

The nearly 400-page study report includes a 20-year trend analysis for almost all the indicators.

“Keep in mind that while the rates of many diseases dropped, the actual number of Manitobans living with these conditions continues to rise because of population growth, and because the proportion of the population that is elderly is growing,” Dahl said.

While the atlas doesn’t reveal the reasons for trends, it’s likely that the decline in most chronic diseases reflects better prevention, earlier diagnosis and improved treatment, the scientist said.

“We assume diabetes is the exception because of risk factors that include unhealthy diet, obesity and physical inactivity, as well as socioeconomic factors such as food insecurity that put residents of lower-income communities at greater risk.”

The study used census data to determine income levels by area, confirming the relationship between lower income and poorer health.

Other 20-year trends identified in the study include:

• The rate of hospital use decreased. The causes of hospitalization remained stable.
• The rates of cardiac catheterizations, percutaneous coronary interventions (coronary angioplasties with stenting), hip replacements, CT scans and MRIs increased, while the rate of coronary artery bypass surgery decreased significantly.
• Looking at primary care, the report highlights three negative trends: the percentage of people with asthma receiving appropriate care dropped in recent years; the percentage of people with diabetes undergoing eye examinations also decreased; and the percentage of heart-attack patients receiving appropriate beta-blocker medications decreased.
• On a positive note, prescribing of benzodiazepines for older adults (not recommended because these sedating drugs carry risks for that age group) decreased significantly.
• The number of different prescription drugs dispensed per user increased significantly. Residents of lower-income areas received more types of drugs.
• The percentage of Manitobans dispensed an opioid decreased. Lower-income areas had a higher percentage of people dispensed an opioid.

“A key conclusion is that reducing health gaps related to income and the social determinants of health – such as nutritious food and stable housing – should remain a priority in Manitoba,” Dahl said.  

Manitoba’s five regional health authorities will use the findings in the atlas to help them assess the health of their communities and create strategic and operational plans.

The full study is available online.

Alison Mayes