Abstract
Given that chronic diseases account for 88% of all deaths in Canada, robust surveillance and monitoring systems are essential for supporting implementation of health promotion and chronic disease prevention policies. Canada has a long tradition of monitoring premature mortality expressed as potential years of life lost (PYLL), dating back to the seminal work by Romeder and McWhinnie in the late 1970s, who pioneered the use of PYLL as a tool in health planning and decision-making. The utility of PYLL for monitoring progress was expanded in the 1990s through the national comparable Health Indicators Initiative, following which PYLL has been monitored for several decades nationally, provincially, regionally and locally as part of health systems’ performance measurement. Yet the potential for using PYLL in health promotion and chronic disease prevention has not been maximized. Linking PYLL with public health programs and initiatives aimed at health promotion and chronic disease prevention, introduced starting in the 1990s, would inform whether these efforts are making progress in addressing the burden of premature mortality from chronic diseases. Promoting the use of PYLL due to chronic diseases would contribute toward providing a more complete picture of chronic diseases in Canada.
Key words: Potential years of life lost, chronic disease prevention, health promotion, Canada, burden of disease
Résumé
Étant donné que les maladies chroniques sont à l’origine de 88% des décès au Canada, il est essentiel d’avoir des systèmes de surveillance et de contrôle robustes pour appuyer la mise en œuvre des politiques de promotion de la santé et de prévention des maladies chroniques. Le Canada a une longue tradition de surveillance de la mortalité prématurée, exprimée en années potentielles de vie perdues (APVP); cette tradition remonte aux travaux phares de Romeder et McWhinnie qui, à la fin des années 1970, ont été les pionniers de l’utilisation des APVP comme outil de planification sanitaire et de prise de décision. L’utilité des APVP pour faire le suivi des progrès réalisés s’est accrue dans les années 1 990 avec l’initiative nationale des Indicateurs comparables de la santé, depuis laquelle on suit les APVP au pays à l’échelle provinciale, régionale et locale lorsqu’on mesure le rendement des systèmes de santé. Pourtant, les possibilités d’utilisation des APVP pour la promotion de la santé et la prévention des maladies chroniques ne sont pas pleinement exploitées. Le maillage des APVP avec des programmes et initiatives de santé publique introduits dans les années 1990 pour promouvoir la santé et prévenir les maladies chroniques permettrait de savoir si ces efforts progressent vers l’allégement du fardeau de la mortalité prématurée due aux maladies chroniques. Promouvoir l’utilisation des APVP en raison des maladies chroniques contribuerait à dessiner un portrait plus détaillé des maladies chroniques au Canada.
Mots clés: années potentielles de vie perdues, prévention des maladies chroniques, promotion de la santé, le Canada, charge de morbidité
Footnotes
Acknowledgements: KM holds a Career Development Award in Prevention Research funded by the Canadian Cancer Society (grant #702936). All interpretations and opinions in this commentary are those of the authors.
Conflict of Interest: None to declare.
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