Health models

Microsimulation in health

The Health Analysis Division of Statistics Canada is a pioneer of policy-relevant health-related computer simulation models. These models are tools to evaluate the impact of health interventions and policies at the population level. No single data source can ever be expected to provide enough information about treatment options, health outcomes, equity and cost-effectiveness when choices have to be made between and among different policy and program interventions.

Drawing from the rich banks of data within Statistics Canada, and building upon the analytic work of academic colleagues and collaborators, these microsimulation models realistically represent the Canadian population with attributes such as risk factor exposures, health histories and demographic characteristics typical of Canadians. The models simulate histories for individual persons in continuous time and add the individuals up to create aggregate results for the total population. The models generate realistic future projections of status quo trends and provide users with the ability to test "what if scenarios" related to potential policy and program interventions.

For some thoughts related to the use of microsimulation to project the future health of Canadians, please read an entry from the StatCan Blog.

Population health mode, POHEM

The Population Health Model (POHEM) is a microsimulation model of diseases and risk factors in which the basic unit of analysis is the individual person. The simulation creates and ages a large sample population representative of Canada, one individual at a time, until death. The life trajectory of each simulated person unfolds by exposure to different life-like events, such as smoking initiation and cessation, changes in weight and/or leisure time physical activity, and incidence of diseases such as osteoarthritis, diabetes, cardiovascular disease, and dementia.

POHEM combines data from a wide range of sources, including nationally representative cross-sectional and longitudinal surveys, vital statistics, and Census, as well as parameters in the published literature.

The model inputs may also be altered at the user's request to investigate 'what if' scenarios. These scenarios can be very useful for policy makers, by providing information beyond what is available from retrospective population studies.


OncoSim, previously known as the Cancer Risk Management Model (CRMM), is a free, web-based simulation tool that evaluates cancer control strategies. Combining data from the real world, expert opinion and the published literature, OncoSim projects health and economic outcomes, and attributes them to 27 risk factors, such as smoking and inadequate physical activity. It currently models four cancer sites (breast, colorectal, lung, and cervical) and related screening programs in detail, and provides high-level projections for 28 other cancer sites. This unique and sophisticated tool is used by decision-makers across Canada to better understand the impact and value of cancer control interventions.

OncoSim is led and supported by the Canadian Partnership Against Cancer, with model development by Statistics Canada, and is made possible through funding by Health Canada.

Neurological disease models

In 2009, the Health Analysis Division at Statistics Canada received funding through the National Population Health Study of Neurological Conditions to develop a microsimulation model to project the future health and economic burden of seven neurological conditions: Alzheimer's disease and other dementias, cerebral palsy, epilepsy, multiple sclerosis, Parkinson's disease/parkinsonism, hospitalized traumatic neurological injury, and hospitalized traumatic spinal cord injury. This model, referred to as POHEM-Neurological, projects the incidence and prevalence of these key neurological conditions, their impact on mortality, life expectancy, disability-adjusted life years and health-adjusted life expectancy (HALE) and the direct costs of treatment and indirect costs (lost wages and tax revenue). POHEM-Neurological also includes the impact on families and caregivers. Select projections from POHEM-Neurological are available in the publication Mapping Connections: An Understanding of Neurological Conditions in Canada, published by the Neurological Health Charities Canada.

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