Geographic Variation in Cardiovascular Disease Mortality: A Study of Linking Risk Factors and Built Environment at a Local Health Unit in Canada

Abstract

Cardiovascular disease (CVD) is one of the leading causes of death in Canada. CVD risk factors and outcome data are used to determine trends of disease risk to inform public health program planning for prevention and control of disease and risk reduction or elimination. Recent efforts to map CVD and its associated risk factors at the health region level have provided further insights into variation in determinants across populations. In this chapter, geographic information system (GIS) and spatial analysis were utilized to enhance CVD surveillance to identify the patterns and relationships between CVD mortality and its potential risk factors. Ordinary Least Squares (OLS) regression and Geographically Weighted Regression (GWR) approaches were used to explore geographical variation in the rate of CVD mortality. After consideration of potential environmental, epidemiological, demographic, and socioeconomic factors, spatial statistics analysis revealed geospatial clustering for CVD mortality and the “hot spots” or “cold spots.” Within a mixed rural-suburban setting in Ontario, Canada, there was an evidence of significant built environmental factors and immigrant time associated with the rate of CVD mortality. Moreover, this pilot work suggests that the integration of geospatial information with routinely collected surveillance data appears feasible within the structure and resources of local public health units as a means to assist in the identification of regional variation in the burden of CVD.