Health Reports最新文献

Background: The COVID-19 pandemic has highlighted several issues among health care workers in Canada's long-term care and seniors' (LTCS) homes, including labour shortages, staff retention difficulties, overcrowding, and precarious working conditions. There is currently a lack of information on the health, well-being and working conditions of health care workers in LTCS homes - many of them immigrants - and a limited understanding of the relationship between them. This paper examines differences between immigrant and non-immigrant workers' health outcomes and precarious working conditions during the pandemic.

Data and methods: The data were from the 2021 Survey on Health Care Workers' Experiences During the Pandemic, which collected information on LTCS home health care workers' (n=2,051) health, employment or work experiences, and working environment during the COVID-19 pandemic. Summary statistics and multivariable logistic regressions were conducted to examine the association between precarious work and workers' health (life stress, mental health and general health), stratified by immigrant status. Selected working characteristics were included in the regression models as covariates, namely occupation, number of locations worked, facility ownership status and number of years worked.

Results: Immigrant health care workers were more likely than non-immigrant health care workers to experience precarious work in LTCS homes. Precarious work - characterized by income loss, reduced hours of work, and unpaid leave - was associated with stress and poor general health among immigrant and non-immigrant workers in the sector. Employment precarity was also associated with poor mental health for immigrant workers, but there was no association for non-immigrant workers.

Interpretation: Employment precarity and the health and well-being of health care workers warrants further attention, in particular among immigrants employed in the LTCS residential care sector.

Background: Sexual health education delivered in school, provided by parents, or provided by other formal sources has been associated most closely with increased rates of condom use and improvements in many other sexual risk behaviours. Friends and the internet are other information sources, although quality and accuracy are not always as high. Nationally representative Canadian data about where adolescents obtain their sexual health information are lacking.

Data and methods: Weighted data from the 2019 Canadian Health Survey on Children and Youth were used to examine the sources typically used to obtain sexual health information by 15- to 17-year-olds, as well as the prevalence and characteristics of adolescents reporting not having an adult to talk with about sexual health and puberty.

Results: Most 15- to 17-year-olds in Canada reported having at least one source of sexual health information (96.6%). More than half identified school (55.6%) and parents or guardians (51.2%) as sources of sexual health information. The internet (45.9%), friends (36.2%), and health care professionals (20.9%) were other common sources. Whereas 61.2% of adolescents identified more than one source of sexual health information, 3.4% reported not having any source. Nearly 15% of adolescents reported not having an adult to talk with about sexual health or puberty. Differences in sources consulted and having an adult to talk with depended on many factors, including sexual attraction and/or gender diversity, sex, immigrant status, racialized status, lower-income status, strength of parent-adolescent relationship, region of residence, and mental health.

Interpretation: An improved understanding of the sources of sexual health information used by adolescents and identification of characteristics associated with adolescents reporting not having an adult to talk with could help develop strategies to improve sexual health outcomes via better access to sexual health promotion and educational resources.

Background: Immunization against vaccine-preventable diseases such as shingles and pneumococcal disease is especially pertinent among older Canadians. However, vaccine uptake remains low.

Data and methods: Data from the Canadian Health Survey on Seniors (CHSS) - 2019/2020 were used to examine receipt of shingles and pneumococcal vaccines among Canadians aged 65 and older living in the community. Multivariable logistic regression was used to identify individual predisposing, enabling and needs-related factors associated with receipt of each type of vaccination. Reasons reported for not getting vaccinated were also examined.

Results: Based on the 2019/2020 CHSS, an estimated 36.3% of Canadians aged 65 and older (2.3 million people) had received the shingles vaccine, while 51.1% (3.1 million) had received the pneumococcal vaccine. Being a woman, having higher socioeconomic status, having had the flu shot and having a regular health care provider were associated with increased odds of vaccination. Being an immigrant, living outside large population centres, and belonging to South Asian or Chinese population groups were associated with lower odds of vaccination. Over one-third of unvaccinated people did not think the shingles vaccine (39.7%) or the pneumococcal vaccine (36.6%) was necessary. Other frequently reported reasons for non-vaccination were not having heard of the vaccine or the doctor not mentioning it; for the shingles vaccine, 12% cited cost as a reason.

Interpretation: Understanding factors associated with uptake of vaccines and reasons for not obtaining them among older Canadians will help to inform policy and programs aimed at preventing the burden of these diseases.

Background: The Canadian Federal Public Service Workplace Mental Health Strategy (the Strategy) seeks to measure, report, and improve employee psychological health, recognizing the National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard) as a starting point. The present research introduced a new survey battery for the assessment of employee psychological health as profiles of burnout and work engagement. It also considered a wide range of predictors aligned with the Standard and several outcomes in accordance with the Job Demands-Resources (JD-R) Model to support the Strategy.

Data and methods: A total of 4,781 Statistics Canada employees completed an Employee Wellness Survey in late 2021, during the COVID-19 pandemic, for a response rate of 58%. Additional sociodemographic variables were linked from human resource databases. Survey weights were applied to adjust for non-response.

Results: Latent profile analysis uncovered four employee psychological health profiles, ranging from employees who were thriving (15%) to those who were doing well (34%), moving along (38%), or struggling (13%). Job autonomy, role clarity, person-job fit, work-life interference, and workplace incivility -- all workplace psychosocial factors aligned with the Standard -- were consistently associated with profile membership, as expected, and outcome levels were systematically less favourable from the thriving profile to the struggling profile.

Interpretation: The results support the validity of the employee psychological health profiles and predictors of profile membership, meeting expectations based on the JD-R literature. Key predictors can serve as metrics to monitor and as targets for workplace interventions designed to improve employee psychological health in support of the Strategy.

Background: The validity of survival estimates from cancer registry data depends, in part, on the identification of the deaths of deceased cancer patients. People whose deaths are missed seemingly live on forever and are informally referred to as "immortals." Their presence in registry data can result in inflated survival estimates. This study assesses the issue of immortals in the Canadian Cancer Registry (CCR) using a recently proposed method that compares the survival of long-term survivors of cancers for which "statistical" cure has been reported with that of similar people from the general population.

Data and methods: Data are from the population-based CCR record linked to the Canadian Vital Statistics - Death Database and tax data. Yearly interval-specific relative survival (IRS) estimates were derived up to 15 years after diagnosis for colon cancer cases, and for colon, rectal and melanoma cancer cases combined, diagnosed from 1992 to 2002.

Results: With increasing follow-up time since diagnosis, national colon cancer IRS estimates levelled off at 1.00, or slightly less, for each age group studied, indicating that survival did not exceed that of the general population. Similar results were obtained among males and females, and for colon, rectal and melanoma cancer cases combined. Provincial IRS point estimates for the three cancers combined also levelled off around 1.00, though with more variation in the estimates than at the national level.

Interpretation: Based on the results of this study, immortals do not appear to be an issue at either the national or the provincial level for survival estimates derived from CCR data.

Background: On average, 45% of Canadian adults meet the recommended 150 minutes per week of moderate-to-vigorous physical activity. This singular statistic masks a wide range of adherence levels among different groups within the population. The purpose of this paper is to determine how sex, age, and family arrangement intersect with known risk factors for physical inactivity to identify groups within the Canadian population most at risk of not meeting the physical activity recommendation.

Methods: Using six combined cycles of the Canadian Health Measures Survey (from 2007 to 2019), this study examines how the percentage of Canadian males and females aged 18 to 79 years meeting the physical activity recommendation differs across sociodemographic, family arrangement, and health factors. Logistic regression was used to examine whether the association between specific factors and adherence to the physical activity recommendation differed by sex. Latent class analysis was used to identify sex-specific combinations of sociodemographic, family arrangement and health-related factors within the Canadian population that are associated with varying levels of adherence to the physical activity recommendation.

Results: More males met the physical activity recommendation compared with females (49% versus 38%). Latent classes with the lowest adherence to the physical activity recommendation (19% among females and 29% among males) primarily included those who were single or married with no children and who had a high probability of having many risk factors for physical inactivity, including being older, having a lower education, having lower income, smoking, having central adiposity, and having poor or fair self-rated general health. Latent classes with the highest adherence to the physical activity recommendation (61% among females and 67% among males) primarily included individuals with no spouse and no children and who had a low probability of having any risk factors for physical inactivity. For females, an additional class (32% of which met the physical activity recommendation) comprised young single mothers who had several risk factors for physical inactivity, including having low income, smoking and having central adiposity.

Interpretation: Understanding how risk factors for physical inactivity intersect with sex, age, and family arrangement may inform strategies aimed at increasing physical activity among those who are most vulnerable.

Background: At the onset of the COVID-19 pandemic, there was an overrepresentation of males in COVID-19 deaths worldwide, with Canada reporting more female COVID-19 deaths. This paper examines the overrepresentation of female COVID-19 deaths in Canada, with an immigration lens.

Data and methods: Data were extracted from the COVID-19 Sex-Disaggregated Data Tracker to compare the sex distribution of COVID-19 deaths in Canada with that of other countries. A linkage of deaths to the Longitudinal Immigration Database (IMDB) allows for the comparison of sex-specific COVID-19 death rates by immigrant status for age and geography, as well as by major employment sector among immigrants, using the tax data from the IMDB.

Results: While there were proportionately more female than male COVID-19 deaths in Canada in the early months of the pandemic, this trend was mainly a phenomenon among non-immigrants aged 85 and older. In addition, COVID-19-specific death rates for males were higher than those for females across age groups by immigrant status, except for those aged 85 and older among the non-immigrant population. Among immigrants, the death rate among health care and social assistance workers was higher among males than among females (10.7 vs. 2.9 per 100,000 population). The initially observed overrepresentation of female COVID-19 deaths to male COVID-19 deaths in Canada evened out in the summer of 2021.

Interpretation: The higher proportion of female COVID-19 deaths was likely related to the high concentration of COVID-19 deaths in long-term care facilities, where a lower institutionalization rate for immigrants had been observed. Since the implementation of vaccination targeting long-term care facility residents in Canada, the overrepresentation of female COVID-19 deaths ceased.

Background: Canadian and international research has shown that the COVID-19 pandemic led to changes in health behaviours, including participation in physical activity and screen time.

Methods: The Canadian Community Health Survey asks Canadian adults (aged 18 to 64 years) and older adults (aged 65 and older) to report the time they spend active by domain: recreation, transportation, and household and/or occupation. Survey respondents are also asked to report their screen time on days they worked and days they did not work. The present analysis compares the physical activity from four cross-sectional samples collected during 2018 (n=50,093), January to mid-March 2020 (n=13,933), September to December 2020 (n=25,661) and January 2021 to February 2022 (n=45,742). Screen time is compared between 2018 and 2021. Sub-annual analyses examine how physical activity and screen time varied within and between years.

Results: The percentage of 18- to 64-year-old women meeting the physical activity recommendation did not change from 2018 (54.3%) to 2021 (55.1%), while a slight decrease was observed among men (63.0% in 2018 to 59.8% in 2021). The percentage of adults aged 65 years and older meeting the recommendation increased from 2018 to 2021 among both men (40.7% to 43.8%) and women (33.4% to 36.9%). Total physical activity decreased by 17.5 minutes per week among 18- to 64-year-old men and increased by 8.4 minutes per week among 18- to 64-year-old women. Men and women aged 65 and older increased their total physical activity by about 30 minutes per week from 2018 to 2021. The percentage of 18- to 64-year-old adults in the lowest screen time category decreased from 53.9% in 2018 to 45.0% in 2021 on work days and from 37.8% in 2018 to 28.0% in 2021 on non-work days. The percentage of adults aged 65 and older in the lowest screen time category decreased from 49.4% in 2018 to 37.8% in 2021 on work days and from 29.4% in 2018 to 21.5% in 2021 on non-work days.

Interpretation: Physical activity among men aged 18 to 64 years decreased from 2018 to 2021, while women of this age group maintained their physical activity. Older adults increased their physical activity from 2018 to 2021. Many Canadian adults shifted from the lowest screen time category (two hours or less per day) to the highest screen time category (four hours or more per day) during the 2020 and 2021 pandemic years. It is unknown whether the short-term impact of the COVID-19 pandemic on physical activity and screen time will persist over time. Ongoing surveillance of the longer-term impacts of the pandemic on the health behaviours of Canadians is important.

Background: The COVID-19 pandemic has caused changes in health behaviours, including participation in physical activity and screen time. The purpose of this paper is to examine trends in physical activity and screen time among Canadian youth from January 2018 to February 2022.

Methods: The Canadian Community Health Survey asks Canadian youth (aged 12 to 17 years) to report the time they spend active by domain: recreation, transportation, school and household. Survey respondents are also asked to report their screen time on school days and non-school days. The present analysis compares the physical activity from four cross-sectional samples collected during 2018 (January to December; n=3,952), January to March 2020 (n=911), September to December 2020 (n=1,573), and January 2021 to February 2022 (n=3,501). Screen time is compared between 2018 and 2021/2022. Sub-annual descriptive analyses examine how physical activity and screen time varied within and between these years.

Results: Before the COVID-19 pandemic, half of Canadian youth met the physical activity recommendation (2018: 49.6%; January to March 2020: 53.7%). The percentage meeting the recommendation dropped in the first year of the pandemic (September to December 2020: 37.3%) and recovered slightly in 2021 (43.8%). From 2018 to 2021, total physical activity dropped by 8.3 minutes per day (58.1 minutes per week) among girls and by 2.1 minutes per day (14.7 minutes per week) among boys. The percentage of youth meeting the screen time recommendation on school days dropped from 40.7% in 2018 to 29.1% in 2021 and from 21.4% in 2018 to 13.2% in 2021 on non-school days.

Interpretation: The COVID-19 pandemic had a detrimental impact on the physical activity and screen time of youth, in particular among girls. This analysis provides an update on how the pandemic has continued to affect the physical activity and screen habits of youth in 2020, 2021, and early 2022.

Background: Cybervictimization has emerged as a potentially serious form of victimization and has been associated with negative mental health outcomes, including depression, anxiety, disordered eating, and suicidality. However, very little research has examined the prevalence and correlates of cybervictimization among diverse subpopulations of youth.

Data and methods: Data from 13,602 adolescents aged 12 to 17 were drawn from the 2019 Canadian Health Survey on Children and Youth. Adolescents reported on their experiences of cybervictimization in the past 12 months, general mental health, and eating disorder symptoms; adolescents aged 15 to 17 reported on suicidal ideation and attempt; and parents reported on problems with depression and anxiety. Logistic regression was used to estimate the odds of experiencing cybervictimization according to characteristics, including gender identity, population group, same-gender attraction, low family income, and the presence of chronic conditions and digital media habits. Logistic regression models were also used to estimate the odds of experiencing each mental health difficulty by sociodemographic characteristics and experience of cybervictimization.

Results: The odds of experiencing cybervictimization were higher among transgender and non-binary youth, females attracted to the same gender or unsure of their attraction, and adolescents living with chronic conditions (particularly females and those living in low-income households). Cybervictimization was consistently associated with a greater risk of poor general mental health, depression or anxiety, eating disorder symptoms, suicidal ideation, and suicide attempt. These associations did not differ according to the sociodemographic characteristics assessed. In terms of digital media habits, lower frequencies of use were generally associated with a lower likelihood of experiencing cybervictimization.

Interpretation: While certain population groups appear to be at a higher risk of experiencing cybervictimization, the experience of cybervictimization is associated with similar mental health indicators for all adolescents.