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Background: Girls and young women experience poorer mental health than boys and young men, although the reverse is true for substance use disorders. Few population-based studies examine girls' and young women's experiences accessing and receiving mental health and substance use (MHSU) health care support, particularly across sociodemographic groups.

Data and methods: Data from the 2022 Mental Health and Access to Care Survey were used to estimate the proportions of girls and young women who met the criteria for at least one MHSU disorder and who accessed formal MHSU health supports. The types of supports accessed, reasons for not accessing services, and associations between sociodemographic characteristics and the likelihood of indicating that the supports they accessed were helpful were examined. Girls and women aged 15 to 29 were studied, with an analytical sample of 1,254.

Results: Among girls and young women aged 15 to 29, 38.5% met the criteria for one or more MHSU disorders in 2022; of those, 54.6% had accessed formal MHSU health supports. Lesbian and bisexual girls and young women with an MHSU disorder were more likely to access formal supports and more likely to have found the supports helpful compared with their heterosexual peers. Racialized girls and young women were less likely than their non-racialized peers to report the care they received was helpful.

Interpretation: Some sociodemographic differences in the experiences of girls and young women accessing and receiving formal care for MHSU disorders were observed. Results indicated a need to improve the accessibility of formal MHSU supports for this population.

Background: The population aged 85 and older is one of the fastest-growing age groups. Identifying distinct health status and care-receiving profiles can improve the understanding of the heterogeneity in this age group. Unmet home care needs are associated with negative health consequences and can challenge the ability of those 85 and older to age in the community.

Data and methods: A representative sample of 4,083 community-dwelling Canadians aged 85 years and older from the 2019/2020 Canadian Health Survey on Seniors (CHSS) was used to identify health and care-receiving profiles applying latent class analysis. Multinomial logistic regression was used to examine factors associated with the profiles. Multivariable logistic regression was applied to evaluate the association between the profiles and unmet home care needs.

Results: An estimated 201,000 Canadians aged 85 years and older (28.2%) were classified as "healthiest-low care receiving", 180,000 (25.3%) as "moderately healthy-moderate care receiving," 194,000 (27.2%) as "moderately unhealthy-low care receiving," and 137,000 (19.2%) as "poor health-high care receiving." Increasing age and being an immigrant were associated with poorer health status and a higher likelihood of receiving care. An estimated 46,000 Canadians aged 85 years and older (6.5%) reported having unmet home care needs. Individuals with the profiles characterized by poorer health and a higher likelihood of receiving care were more likely to have unmet home care needs.

Interpretation: The findings of this study highlight the importance of considering multiple health and care-receiving factors to better illuminate unmet home care needs among community-dwelling Canadians aged 85 years and older.

Background: It is not clear whether the increased mortality pattern observed in a prior analysis of the Canadian Census Health and Environment Cohorts for HIV/AIDS, diabetes, prostate cancer, and uterine cancer among Black adults is reflected in incident hospitalization (a marker of severity) or the diagnosis of these diseases, nor is it clear whether disparities exist regarding early screening and survivability.

Methods: To understand the paths that contribute to differential mortality patterns, standard Cox proportional hazard models were used to assess the incidence risk of diagnosis (uterine and prostate cancer) and incident hospitalization (HIV and diabetes) among 161,520 Black adults, compared with 6,866,070 White adults. Competing risk regression was used to evaluate the cumulative risk of death for the four disease outcomes since diagnosis or hospitalization. For the observed differential cancer mortality, mediation analysis was conducted to investigate the role of cancer diagnosis at follow-up (a proxy for delayed diagnosis that is not entirely indicative of late-stage cancer).

Results: Across all examined outcomes, except for uterine cancer, Black adults had elevated incident diagnoses or hospitalizations compared with White adults. Notably, Black males demonstrated a risk of incident prostate cancer and hospitalizations from HIV and diabetes twice as high relative to White males. For Black females, the risk of incident HIV hospitalization was 12 times as high. However, Black females were 15% less likely to be diagnosed with uterine cancer, compared with White females. Cumulative mortality risk analysis showed significantly lower survivability (two times lower) among Black females diagnosed with uterine cancer, relative to White females. Delayed diagnosis mediated a marginally higher proportion of the total differential uterine cancer mortality among Black females (14.9%; 95% confidence interval [CI]: 10.5% to 23.1%), compared with White females (8.9%; 95% CI: 6.3% to 13.9%).

Interpretation: This study unveils substantial parallels between heightened incidence risk and relative mortality for most of the four explored outcomes between Black and White adults in Canada. Notably, the study highlights a lower incident diagnosis of uterine cancer among Black females, despite a relatively higher uterine cancer mortality. Three in every 20 uterine cancer deaths were mediated through the time of uterine cancer diagnosis (relatively delayed in Black females), underscoring the need for targeted interventions and early detection strategies to address health disparities in this population.

Background: During the COVID-19 pandemic in Canada, there was a decrease in population positive mental health (PMH); however, many individuals still reported high levels of PMH. One potential protective factor could be a sense of control, which involves perceptions of personal mastery and minimal perceived constraints. Limited Canadian research has been conducted on the link between sense of control and PMH during the pandemic.

Data and methods: This study used cross-sectional data from the 2020 and 2021 Survey on COVID-19 and Mental Health, which included adults (18 years and older) living in the 3 territorial capitals and 10 provinces in Canada. Two facets of sense of control were measured with the Sense of Mastery Scale: personal mastery and perceived constraints. Three PMH outcomes were measured using single-item measures of self-rated mental health (SRMH), community belonging, and life satisfaction. Regression analyses were conducted to examine associations between the two sense of control facets and the three PMH outcomes.

Results: Higher personal mastery was associated with higher average life satisfaction and a greater likelihood of high SRMH and strong community belonging. In contrast, greater perceived constraints were associated with lower average life satisfaction and a lower likelihood of high SRMH and strong community belonging. Sociodemographic differences on the facets were observed.

Interpretation: Adults in Canada with a higher sense of control during the pandemic tended to have better PMH than those who felt like they had less control. Further research on mental health promotion efforts involving sense of control is needed.

Background: Multimorbidity is a significant challenge for health care systems worldwide. There are limited data, particularly in a Canadian context, on multimorbidity prevalence and incidence, and how these differ by multimorbidity complexity, sex, age, and neighbourhood income quintile.

Methods: This study included administrative data from residents of British Columbia, Canada, from 2001/2002 to 2019/2020. This study analyzed trends in the prevalence and incidence of multimorbidity (two or more conditions) and complex multimorbidity (five or more conditions) by sex, age, and neighbourhood income quintile. This study also identified the most prevalent disease combinations.

Results: More than 25% of adults and 60% of seniors met criteria for multimorbidity in 2019/2020. From 2001/2002 to 2019/2020, age-standardized multimorbidity prevalence increased annually by an average of 1.5% in females and 2.9% in males, and incidence decreased by 3.3% in females and 1.1% in males. Complex multimorbidity prevalence increased annually by an average of 4.8% in females and 5.7% in males, and incidence increased by 1.1% in females and 2.2% in males. Younger age groups had higher average annual increases in multimorbidity prevalence and incidence. Multimorbidity risk was higher in lower income quintiles, relative to higher income quintiles, and these disparities were larger for complex, relative to standard, multimorbidity. Highly prevalent single diseases tended to form the most prevalent disease combinations, and the most prevalent disease combinations varied by income quintile.

Interpretation: These findings suggest that the burden and complexity of multimorbidity continue to rise in British Columbia. Population trends in multimorbidity have important implications for projecting future disease burden and health care planning.

Background: Ambulatory care sensitive conditions (ACSCs) are illnesses that can be effectively treated and managed in primary care settings. Hospitalizations for ACSCs are therefore considered avoidable and may indicate poor access to quality primary care. This study examined trends in avoidable hospitalizations in Canada among racialized groups.

Data and methods: The 2016 Canadian Census Health and Environment Cohort was used to estimate annual age-standardized hospitalization rates (ASHRs) for ACSCs among people aged 10 to 74 from 2016/2017 to 2021/2022. ASHRs were disaggregated by sex and racialized group. Rate ratios (RRs) and 95% confidence intervals (CIs) were calculated to assess relative inequality. Logistic regression models were run, adjusting for age, sex, immigrant status, household income, and education.

Results: Across all study years, the odds of avoidable hospitalizations were significantly higher among males, Black people, and non-immigrants, and significantly lower among Chinese people and people in the category "other racialized groups not included elsewhere." In 2020/2021, during the COVID-19 pandemic, RRs for Black females compared with non-racialized females decreased (2019/2020: RR=1.12, 95% CI=1.07 to 1.61; 2020/2021: RR=0.99, 95% CI=0.94 to 1.04), while they significantly increased for Black males compared with non-racialized males (2019/2020: RR=1.30, 95% CI=1.25 to 1.35; 2020/2021: RR=1.63, 95% CI=1.41 to 1.88).

Interpretation: This study reveals inequalities in avoidable hospitalizations in Canada, pronounced for the Black population compared with the non-racialized population, especially during the pandemic (2020/2021 and 2021/2022). Future studies examining the factors driving these inequalities (e.g., access to primary care, most prevalent conditions, geography) may inform targeted interventions.

Background: The prevalence of Canadians living with obesity has increased over the past four decades. Disease and mortality risk increase as the number of years lived with obesity increases.

Methods: This study used self-reported weight history and health data collected from 2007 to 2011 via the Canadian Health Measures Survey (n = 5,761) to examine whether increased exposure to obesity during adulthood increases the odds of having poor health outcomes.

Results: The percentage of respondents with an obesity-related chronic condition was lower among those who did not have obesity at the time of survey or report having obesity in the past (50.6%) compared with those who did not have obesity at the time of the survey but did in the past (65.9%) or who had obesity at the time of the survey and in the past (71.1%). Relative to never having obesity, having obesity in the past but not at present or having obesity in the past and at present were associated with increased odds of having a range of chronic conditions. The highest odds were observed for type 2 diabetes (odd ratio (OR) = 3.26, 95% confidence interval (CI): 2.40 to 4.43 and OR = 5.36, 95% CI: 3.88 to 7.41), hypertension (OR = 2.41, 95% CI: 1.69 to 3.44 and OR = 3.76, 95% CI: 2.84 to 4.97), and poor or fair self-rated general health (OR = 2.04, 95% CI: 1.51 to 2.76 and OR = 2.68, 95% CI: 2.11 to 3.40).

Interpretation: Having had obesity in the past, regardless of current obesity status, was associated with increased odds of poor health outcomes. Obesity history information should be considered when estimating the population burden of obesity.

Background: Studies have shown that excess all-cause mortality during the COVID-19 pandemic caused declines of life expectancy at birth (LE₀) in most countries around the world, after decades of improvement prior to the pandemic. However, those studies rarely examined the contributions from specific causes of death other than COVID-19.

Methods: This study used the Chiang method to estimate LE₀ for each year in British Columbia from 2000 to 2022 and the changes from 2019 to 2020, 2021, and 2022. Each death case was classified into 1 of 23 categories, including COVID-19, unregulated drug toxicity, cardiovascular diseases, and injuries, according to the International Classification of Diseases, 10th Revision (ICD-10). The changes in LE₀ were decomposed into age and causes of death using the Arriaga method.

Results: Compared with 2019, male LE₀ decreased by 1.16 years in 2020, 1.81 years in 2021, and 1.62 years in 2022; female LE₀ did not change in 2020, but decreased by 0.65 years in 2021, and by 0.56 years in 2022. COVID-19 and unregulated drug toxicity were the top two causes of deaths contributing to the LE₀ declines in males and females, with COVID-19 being the number one contributor in females and unregulated drug toxicity deaths as the number one contributor in males.

Interpretation: The COVID-19 pandemic impacted population health not only through its direct effects but also through indirect impacts on other health outcomes, including the unregulated drug toxicity crisis, the combination of which were driving factors in the decline in life expectancy at birth.

Background: Statistics Canada routinely collects information on functional health and related concepts. Recently, the Washington Group on Disability Statistics (WG) measure of disability has been introduced to the Canadian Community Health Survey (CCHS). The WG measure is used as a tool for developing internationally comparable data on disability. In alternate cycles of the CCHS, it replaces the Health Utilities Index Mark 3 (HUI3), a generic preference-based measure of health-related quality of life. The HUI3 is used to derive evaluative health measures common in population health and economic evaluations. Since the WG measure is not preference-based, it is unable to derive these measures. To address resulting data gaps, this study empirically maps the health state utility values of the HUI3 score from the WG measure.

Data and methods: Empirical mapping used a "head-to-head" subsample of the 2017 CCHS where WG and HUI3 measures were collected from the same respondents aged 40 and over. Empirical mapping used regression models to estimate the statistical relationship between WG and HUI3 measures in addition to health and demographic variables. Out-of-sample predictive performance was assessed through descriptive statistics, mean absolute error, and other measures of predictive accuracy.

Results: The preferred estimation strategy resulted in reasonably precise estimates of the HUI3 score corresponding to trends across health and demographic characteristics and reflecting distributional properties of the HUI3 score. Inclusion of different components of the WG measure influenced predictive accuracy.

Interpretation: Empirical mapping offers a potential method to estimate health state utility scores from the WG measure and addresses data gaps in health-related quality of life measures in the CCHS when HUI3 is not collected.

Background: Adolescents who engage in physical activity experience positive mental health outcomes. However, the increasing prevalence of physical inactivity combined with high screen time use among adolescents is a growing concern. Parents play an important role in shaping adolescents' physical activity and screen time levels through active participation and involvement.

Data and methods: This nationally representative cross-sectional study used self-reported data from the 2019 Canadian Health Survey on Children and Youth. The frequency of family physical activity included five categories from "never" to "daily." Outcome measures included achieving the physical activity (60 minutes or more of moderate-to-vigorous physical activity per day) and recreational screen time (two hours or less per day) recommendations, as well as mental health indicators. Logistic regression analyses examined the associations between family physical activity frequency and adolescents' physical activity, screen time, and mental health, with adjustments for relevant covariates.

Results: In adjusted models, across all outcomes, results showed that a higher frequency of family physical activity was associated with better outcomes in a dose-response relationship when compared with never engaging in family physical activity. The strongest associations for daily frequency of family physical activity (compared with never engaging in it) were with high life satisfaction (odd ratio [OR]: 4.25, 95% confidence interval [CI]: 3.16 to 5.72) and with high perceived mental health (OR: 3.60, 95% CI: 2.62 to 4.96). Subgroup analyses stratified by gender were generally consistent with the main results.

Interpretation: A higher frequency of family physical activity was associated with a greater likelihood of adhering to the physical activity and recreational screen time recommendations and better mental health in Canadian adolescents. Family physical activity may be an important way to promote adolescents' physical activity and positively influence their mental health.