Chronic disease in Northern Ontario  Chronic disease in Northern Ontario is a population health problem. The population in Northern Ontario experiences worse outcomes on a number of important health indicators, including higher rates of chronic disease compared to the population in the rest of Ontario (Romanow, 2002). Northern Ontario is over 800,000 square kilometers, covering nearly 90% of the area of Ontario. Its population of close to 800,000 represents only 6% of the total population for the province. This large land area and relatively small population results in a density of approximately one person per square kilometre, compared to 115 persons per square kilometre in Southern Ontario. Northern Ontario's rural population comprises more than 30% of the total Northern population. In Southern Ontario, only 11% of the population lives in rural area. Over 50% of the North's population live in the five biggest cities of Thunder Bay, Sault Ste. Marie, Timmins, Greater Sudbury, and North Bay. With mining, forestry and tourism as the major local industries, there are peaks and troughs in the economy, and unemployment rates are usually higher than in the remainder of Ontario (MNDM, 2011). The estimated area of Local Health Integration Network (LHIN) 13 is 400,000 square kilometres or approximately 40% of Ontario, with a population of 551,691. In LHIN 13, 17% of the population is 65 years of age or older, which is significantly higher than the provincial average of 14%. LHIN 13 is diverse with 24% of the population Francophone and 10% of the population First Nations (North East LHIN, 2009). The estimated area of LHIN 14 is 470,000 square kilometers or approximately 47% of Ontario, with a population of 234,599. In LHIN 14, 14.3% of the population is 65 years of age or older. LHIN 14 is diverse with 3.5% of the population Francophone and 19.8% First Nations (North West LHIN, 2009). According to the World Health Organization, chronic diseases are defined as diseases of long duration which generally show slow progression (WHO, 2012a). Examples of chronic diseases are cardiovascular disease, respiratory disease, stroke, cancer, and diabetes. The main risk factors associated with chronic diseases are tobacco and alcohol use, physical inactivity and unhealthy diets (WHO, 2011). Almost 80% of Ontarians over the age of 45 have a chronic condition, and treatment for these diseases amount to 55% of Ontario's total health costs (MOHLTC, 2007).