Health Reports最新文献

Background: Throughout the COVID-19 pandemic, Canadian public health officials have mandated and recommended precautions to slow the spread of COVID-19. This study examined which population groups were less compliant with precautions, such as mask-wearing and self-isolating, and where they were located in Canada.

Data and methods: Results are from the Canadian COVID-19 Antibody and Health Survey, a national survey aimed at estimating how many Canadians who were older than one year and living in private households had antibodies in their blood against the SARS-CoV-2 virus. Questionnaire data were collected in the 10 provinces and 3 territorial capitals, from November 2020 to April 2021. Respondents were asked about compliance with precautions related to COVID-19. Weighted prevalences and logistic regression models were used to identify which population groups were less compliant with precautions to prevent the spread of COVID-19, and where they were located in Canada.

Results: Significant differences in compliance with precautions were found by sex, region, urban versus rural location, age, income, presence of chronic conditions, household size and work status. With covariate adjustment, Canadians who were less compliant with precautions were males, those living in the territorial capitals, those in rural areas, and people aged 34 and younger (compared with people aged 65 and older). Additional differences were found when analyzing compliance with consistently recommended precautions compared with those usually recommended.

Interpretation: As Canada continues to navigate the waves of the pandemic, and with the emergence of new variants, precautions are still being mandated or recommended in many jurisdictions and locations. Continuing to understand which population groups were less compliant in earlier waves and where they were located in Canada can be beneficial to ongoing and future public health efforts to slow the transmission of COVID-19.

Background: In 2018, Canada legalized the use and sale of non-medical cannabis, with most provinces also permitting home cultivation. To advance the knowledge of home cultivation patterns in Canada within the context of legalization, this study examines (1) the demographics and use patterns of cannabis home growers before and after legalization and (2) the relationship between home cultivation and cannabis-related risks, including workplace use and driving after cannabis use(DACU).

Data and methods: The study is based on seven waves of the National Cannabis Survey, dating from 2018 to 2019. Descriptive statistics were used to analyze home cultivation across several individual and sociodemographic characteristics pre- and post-legalization. Logistic regression was used to examine whether home cultivation is correlated to selected cannabis-related risks.

Results: The rate and demographics of home cultivation remained relatively unchanged post-legalization. Those most likely to cultivate cannabis post-legalization were male; 35 years and older; not single; married, common law, divorced, separated or widowed; lived in the Atlantic provinces; consumed cannabis medically or medically and non-medically on a daily or almost daily basis; had more than a high school diploma; and reported "smoking" as their primary consumption method. Home cultivation was correlated to workplace use but not to DACU.

Interpretation: The research provides early insights into home cultivation within a legalized framework. It also shows a relationship between home cultivation and certain cannabis-related risks (e.g., workplace use), suggesting a need for future research to determine whether tailored education and policy interventions are needed to target cannabis home growers.

Introduction: The Canadian Community Health Survey (CCHS) - Nutrition 2004 (n=35,107; interview dates from January 2004 to January 2005) linked to the Canadian Vital Statistics - Death Database (CVSD) (2011) represents a novel linkage of a population-based, nationally representative nutrition survey with routinely collected mortality records (including date and cause of death). The linkage was done through individual tax data in Canada, and contains longitudinal records for 29,897 Canadians aged 0 years and older-1,753 of whom died-in the 10 provinces of Canada. The median follow-up time was 7.49 years, with 102,953 person-years among males and 114,876 person-years among females (unweighted), and included a special sampling survey weight (for linked data) to account for those who did not agree to share and link their information. The CCHS - Nutrition 2004 linked to CVSD has been used to evaluate associations between lifestyle and sociodemographic characteristics and mortality. Using these data, statistical methods have been developed and tested to control random and systematic measurement errors when evaluating the relationship between different dietary exposures (evaluated using repeated 24-hour dietary recalls) and health outcomes. The linked data are available through Statistics Canada's Research Data Centres.

Background: Mental health among Canadians has worsened since the start of the COVID-19 pandemic. The purpose of this study was to identify profiles of mental health difficulties and to quantify the relationships between mental health profiles, negative impacts related to the pandemic and suicidal ideation.

Data and methods: Participants were 22,721 adults (18 years and older) from the 2020 and 2021 Survey on COVID-19 and Mental Health. Latent profile analysis was used to identify patterns of anxiety, depression and psychological distress. The relationships between mental health profiles, negative impacts and suicidal ideation were examined using logistic regression models.

Results: Three mental health profiles were identified. Individuals were classified as having no mental health difficulties (Profile 1, 65.70%), low-to-moderate mental health difficulties (Profile 2, 25.52%) and severe mental health difficulties (Profile 3, 8.78%). Individuals in Profiles 2 and 3 were at greater odds than individuals in Profile 1 of experiencing emotional distress; the death of a family member, friend or colleague; difficulty in meeting financial obligations or essential needs; the loss of a job or income; feelings of loneliness or isolation; physical health problems; challenges in personal relationships with household members; and other impacts. Individuals in Profile 2 (4.27%, odds ratio (OR) = 24.30) and Profile 3 (19.09%, odds ratio (OR) = 115.75) were considerably more likely to have contemplated suicide since the onset of the pandemic compared with those in Profile 1 (0.16%).

Interpretation: Individuals who experienced high levels of anxiety, depression and psychological distress were most vulnerable to negative impacts related to the pandemic and suicidal ideation.

Background: Recently, the Canadian 24-Hour Movement Guidelines for Adults were released, and included a revised physical activity (PA) recommendation. The recommendation of 150 minutes per week of moderate-to-vigorous intensity PA (MVPA) was revised, from requiring that MVPA be accrued in bouts of 10 minutes or more (bouted) to having no bout requirement (non-bouted). The objective of this study was to assess whether there were differences in sociodemographic, health and fitness characteristics of Canadians who met the bouted and non-bouted PA recommendations.

Data and methods: Using adult (aged 18 to 79 years) accelerometer data from three combined cycles of the nationally representative Canadian Health Measures Survey (N = 7,102), this study compared adherence to the bouted and non-bouted recommendations. Differences in sociodemographic, health and fitness measures were assessed using independent t-tests and chi-squares. Multivariate linear and logistic regressions controlling for age, sex, household education and smoking examined associations with health and fitness measures.

Results: More adults met the PA recommendation using the non-bouted versus bouted (45.3% vs. 18.5%) requirement. Characteristics of those who met the bouted and only the non-bouted recommendations were similar. Exceptions among those who met only the non-bouted recommendation compared with meeting the bouted recommendation included fewer adults aged 65 years and older; lower MVPA, recreation PA and transport PA; and higher sedentary time, light PA and grip strength.

Interpretation: Although the removal of the 10-minute bout requirement increased the proportion of Canadian adults who met the PA recommendation, there were no substantial differences in the sociodemographic and health characteristics of the populations captured by the bouted and non-bouted definitions. Results help to inform the transition in reporting for PA surveillance.

Background: Globally, the suicide rate is two times higher for males than for females. Previous studies in Newfoundland and Labrador did not examine age-specific rates by sex. The objectives of this study were to determine suicide rates by sex and age group and to compare the demographic and clinical characteristics of males and females who died by suicide.

Data and methods: This observational study analyzed a routinely collected dataset based on all medical examiner-determined suicide deaths among people aged 10 years and older in Newfoundland and Labrador, Canada, between 1997 and 2016. Age-standardized and age-specific suicide rates and rate ratios were calculated based on the number of deaths during the period, and descriptive statistics were used to compare demographic and clinical characteristics between males and females.

Results: The age-standardized suicide rate was 4.6 times higher among males than females and was higher for males in most age groups. Rates were highest in the young adult age groups for males (20 to 24 years) and females (35 to 39 years). Males who died by suicide were more likely to be from a rural community and to have died by firearm; females were more likely to die by self-poisoning and to have had a mental illness or substance use history.

Interpretation: The results are broadly consistent with previous research, though this is the first study to report age-specific suicide rates among females across the life course in Newfoundland and Labrador. The results underscore the need to design public health and clinical interventions that account for sex differences in suicide risks.

Background: Vaping is more prevalent among younger than older Canadians. While vaping is less harmful than combustible tobacco, it is not without health risk.

Data and methods: Data from the 2019 Canadian Health Survey on Children and Youth were used to estimate vaping prevalence. Logistic regression models assessed the association of sociodemographic, youth, parenting and peer factors with vaping. The 2020 Canadian Community Health Survey identified adolescents who reported vaping before tobacco smoking. Data from the 2019 Canadian Tobacco and Nicotine Survey were used to examine vaping of e-liquids containing nicotine and flavours.

Results: Vaping rates for 15- to 17-year-olds were nearly four times (21.3%) higher than those of 12- to 14-year-olds (5.4%). Two-thirds (66.1%) of 12- to 17-year-olds who had used both tobacco and e-cigarettes reported trying e-cigarettes first. E-liquids containing nicotine were used by 89.3% of 15- to 19-year-olds who reported vaping in the past 30 days; comparable with older adults. For both younger and older adolescents, having friends who engaged in negative behaviours, having been employed, and having consumed alcohol increased the odds. For 12- to 14-year-olds, attention deficit hyperactivity disorder was a risk factor, whereas having parents who usually knew who they were with and higher relatedness scores were protective. Among older adolescents, being male, being Canadian-born, having lower grades, and using tobacco or cannabis increased the odds of vaping.

Interpretation: An adolescent's risk of vaping was most strongly correlated with other substance use, although other youth, parenting and peer characteristics also mattered. Because most of the data presented were collected before the COVID-19 pandemic and new vaping regulations, ongoing monitoring remains important.

Background: Robust surveillance of vaping product use (with or without nicotine) in Canada has been limited by the use of multiple tools with varying designs and content. The objective of the current study was to examine trends over time in vaping prevalence and to examine associated factors using data from the Canadian Community Health Survey (CCHS).

Data and methods: Trends in the prevalence of past-30-day vaping over time were examined using data available from optional modules of the CCHS for Ontario from 2015 to 2018 and for Quebec from 2017 to 2019. Multiple logistic regression models were used to examine correlates of vaping in Quebec (2019) and Ontario (2018).

Results: Vaping increased in Quebec from 3.4% (233,000) in 2017 to 4.2% (296,000) in 2018 and 4.7% (333,000) in 2019. In Ontario, vaping remained stable in the years 2015 (3.1% or 357,000), 2016 (2.7% or 311,000) and 2017 (2.7% or 309,000), then increased in 2018 (3.4% or 404,000). Increases in vaping in both provinces were driven by youth. Vaping was significantly associated with young age and cigarette smoking in both provinces, as well as with cannabis use in the past 12 months among Quebec respondents.

Interpretation: In both provinces, increases in youth vaping were observed in recent years, and this is consistent with national trends. Study findings further our understanding of vaping behaviour and highlight the utility of the CCHS as an additional tool for surveillance of vaping product use among Canadians.

Background: There has been increasing scrutiny of opioid prescribing following injury because of concerns that prescribed opioids may contribute to addiction and overdose. This study aimed to better understand the relationship between injury, opioids prescribed before and after injury, and non-medical drug poisoning.

Data and methods: Working age (15 to 65 years old) residents of British Columbia's Fraser Health region with an injury that involved an emergency department visit were included. Factors examined included the prescription of opioid and opioid agonist therapy (OAT) medications before and after injury, age, sex, work-related injuries, and socioeconomic status, as well as how they were associated with non-medical drug poisoning risk and post-injury prescriptions.

Results: Opioid-naive individuals (those without an opioid prescription captured before their injury) who were prescribed OAT medication-a marker of opioid use disorder-following their injury had a higher risk of subsequent non-medical drug poisoning (Hazard ratio (HR): 21.4 to 22.4 compared with opioid-naive individuals without an opioid or OAT prescription). Post-injury opioid prescription in these individuals increased poisoning risk (HR: 1.27 compared with those without a prescription). Being of male sex (HR: 1.80), being younger (HR: 0.76 for every 10-year increase in age) and living in the lowest-income neighbourhoods (HR: 1.44 compared with the middle quintile) increased poisoning risk. Compared with injuries sustained outside of work, work-related injuries reduced risk (HR: 0.62).

Interpretation: Among a cohort of British Columbians visiting emergency departments following an injury, opioid prescribing in patients who were opioid-naive appears to be a minor contributor to non-medical drug poisoning, particularly when compared with other patient factors, such as being male, being younger and having a low socioeconomic status.

Background: Estimates of polypharmacy have primarily been derived from prescription claims, and less is known about the use of non-prescription medications (alone or in combination with prescription medications) across the frailty spectrum or by sex. Our objectives were to estimate the prevalence of polypharmacy (total, prescription, non-prescription, and concurrent prescription and non-prescription) overall, and by frailty, sex and broad age group.

Data: Canadian Health Measures Survey, Cycle 5, 2016 to 2017.

Methods: Among Canadians aged 40 to 79 years, all prescription and non-prescription medications used in the month prior to the survey were documented. Polypharmacy was defined as using five or more medications total (prescription and non-prescription), prescription only and non-prescription only. Concurrent prescription and non-prescription use was defined as two or more and three or more of each. Frailty was defined using a 31-item frailty index (FI) and categorized as non-frail (FI ≤ 0.1) and pre-frail or frail (FI > 0.1). Survey-weighted descriptive statistics were calculated overall and age standardized.

Results: We analyzed 2,039 respondents, representing 16,638,026 Canadians (mean age of 56.9 years; 51% women). Overall, 52.4% (95% confidence interval [CI] = 47.3 to 57.4) were defined as pre-frail or frail. Age-standardized estimates of total polypharmacy, prescription polypharmacy and concurrent prescription and non-prescription medication use were significantly higher among pre-frail or frail versus non-frail adults (e.g., total polypharmacy: 64.1% versus 31.8%, respectively). Polypharmacy with non-prescription medications was common overall (20.5% [95% CI = 16.1 to 25.8]) and greater among women, but did not differ significantly by frailty.

Interpretation: Polypharmacy and concurrent prescription and non-prescription medication use were common among Canadian adults, especially those who were pre-frail or frail. Our findings highlight the importance of considering non-prescribed medications when measuring the exposure to medications and the potential risk for adverse outcomes.