Health Reports最新文献

Background: The lifetime probabilities of developing (LP_dev) cancer and dying (LP_dying) from cancer are useful summary statistics that describe the impact of cancer within a population. This study aims to present detailed LP_dev and LP_dying for cancer by sex and cancer type and to describe changes in these lifetime probabilities over time among the Canadian population.

Data and methods: Cancer incidence data (1997 to 2018) were obtained from the Canadian Cancer Registry. All-cause and cancer mortality data (1997 to 2020) were obtained from the Canadian Vital Statistics - Death Database. LP_dev and LP_dying were calculated using the DevCan software, and trends over time were estimated using Joinpoint.

Results: The LP_dev for all cancers combined was 44.3% in Canada in 2018, with all results excluding Quebec. At the age of 60, the conditional probability of developing cancer was very similar (44.0% for males and 38.2% for females). The LP_dying was 22.5% among the Canadian population in 2020, while the probability of dying from cancer conditional on surviving until age 60 was 25.1% for males and 20.5% for females. Generally, males experienced higher LP_dev and LP_dying for most specific cancers compared with females.

Interpretation: LP_dev and LP_dying for cancer mirror cancer incidence and mortality rates. Cancer-specific changes in these probabilities over time are indicative of the cancer trends resulting from cancer prevention, screening, detection, and treatment. These changes in LP_dev and LP_dying provide insight into the shifting landscape of the Canadian cancer burden.

Background: The Public Health Agency of Canada monitors the psychological and social well-being of Canadian youth using the Children's Intrinsic Needs Satisfaction Scale (CINSS). Validation analyses of the CINSS have been conducted, but not in the 2019 Canadian Health Survey on Children and Youth (CHSCY), a more recent and representative national survey with a different sampling frame, collection method and other measured outcomes. This study tested the validity of the CINSS in the 2019 CHSCY.

Data and methods: Data were collected in all provinces and territories from February 11 to August 2, 2019. The CINSS was administered to respondents aged 12 to 17 years and was designed to assess relatedness, autonomy and competence at home, at school and with friends. Descriptive statistics for CINSS items and subscales were obtained. Confirmatory factor analysis (CFA) was conducted to test how well a correlated traits correlated uniqueness (CTCU) model fit the CINSS data. Associations with mental health and other psychosocial variables were examined.

Results: In general, items within the CINSS were correlated in expected ways, and support was found for a CTCU model in the CFA. While response distributions on the CINSS items were skewed, the CINSS subscales had acceptable internal consistency and were associated with self-rated mental health, happiness, life satisfaction, perceived stress, bullying victimization and behaviour problems in line with expectations.

Interpretation: This study supports the validity of the CINSS. Inclusion of the CINSS in future youth health surveys would allow for continued public health surveillance of the psychological and social well-being of youth in Canada.

Background: Accessibility of food retail in communities may play a role in shaping the food choices of local residents. However, previous studies have shown mixed results. This study examined associations between the local restaurant environment and the frequency of eating food from restaurants and intake of sugary drinks among Canadian children and youth.

Data and methods: The study cohort consisted of 23,776 participants (aged 1 to 17 years) in the 2019 Canadian Health Survey on Children and Youth who resided in large urban population centres across the Canadian provinces. Measures of geographic access to various restaurant types within walking distance of participants' residential areas came from the 2018 Canadian Food Environment Dataset. Poisson regression models with robust standard errors assessed associations between measures of absolute densities (number per km²) of full-service, fast-food and other restaurants, and the relative density of fast-food restaurants (as a percentage of total restaurants) with the frequency of eating food from fast-food or full-service restaurants and sugary drink intake in the previous seven days.

Results: After adjustment for a range of sociodemographic covariates, there were no consistent associations between absolute and relative measures of restaurant access and the frequency of eating food from restaurants or intake of sugary drinks.

Interpretation: Results reveal no consistent relationships between local restaurant exposures and the frequency of eating food from restaurants or sugary drink intake among Canadian children and youth. Efforts to create environments that foster healthy food choices among young people will remain important but will likely need to target multiple activity spaces beyond the local neighbourhood.

Background: Household air conditioning is one of the most effective approaches for reducing the health impacts of heat exposure; however, few studies have measured the prevalence of household air conditioning in Canada.

Data and methods: Data were obtained from the 2017 Canadian Community Health Survey and the 2017 Households and the Environment Survey. Statistics Canada linked the survey respondents and created survey weights. Four heat-vulnerable populations were defined: older adults, older adults living alone, older adults with at least one health condition associated with reduced thermoregulation and older adults living alone and with a health condition associated with reduced thermoregulation. Weighted ratios and logistic regression models were used to analyze person-level air conditioning rates for national, regional and heat-vulnerable populations.

Results: Approximately 61% of the national population had household air conditioning. Regional rates ranged between 32% in British Columbia and 85% in Ontario. People living alone and people who did not own a home were significantly less likely to have air conditioning in Canada and in most regions. One heat vulnerable group, older adults living alone, had significantly lower air conditioning rates compared with the national and Ontario averages, at 56% and 81%, respectively.

Interpretation: This study is the first to quantify air conditioning prevalence in Canada at the person-level. The results of this study may inform heat-health policies and climate change adaptation strategies that aim to identify populations with high risks of heat-related mortality or morbidity and low access to household air conditioning.

Background: Prevalence of loneliness among Canadians has become an important concern because of its wider consequences on health and well-being. However, there are limited Canadian studies about loneliness disaggregated by gender and across various subgroups of older Canadians, particularly immigrant subgroups.

Data and methods: Data from the Canadian Health Survey on Seniors (CHSS) - 2019/2020 were used to estimate the prevalence of loneliness among older Canadians in a nationally representative sample of 38,941 Canadians aged 65 and older. The association between immigrant status and loneliness was assessed using multivariable logistic regression adjusted for demographic, socioeconomic and health characteristics. Analyses were conducted for men and women combined and separately.

Results: In 2019/2020, an estimated 1.1 million older Canadians (19.2%) experienced loneliness, with women having significantly higher likelihood of being lonely than men. Among men, both European and non-European immigrants were more likely to experience loneliness than the Canadian-born population. Among women, the likelihood of loneliness was higher among European immigrants than among those born in Canada. For both men and women, immigrants who migrated as adults (from ages 18 to 44) and long-term immigrants (20 years or more in Canada since immigration) were at higher risk of loneliness than the Canadian-born population. The likelihood of being lonely was higher among people living with multimorbidity or experiencing barriers to social participation.

Interpretation: The findings underscore the importance of considering immigrant subgroups and gender in examining loneliness among older Canadians and when developing policies and programs to address loneliness.

Background: Traumatic brain injuries (TBIs) are a major public health concern impacting the lives of many Canadians. Among all TBIs, concussions are the most common. However, to date, the incidence of concussions among the Canadian population, has remained unknown. To address this data surveillance gap, this study presents national estimates on the percentage of Canadians aged 12 years or older (excluding those living in the territories) who sustained one or more concussions in 2019.

Data and methods: This study used data collected from the Traumatic Brain Injury Rapid Response (TBIRR) module of the 2020 Canadian Community Health Survey, a cross-sectional health survey. Descriptive statistics and logistic regressions were conducted to summarize the information in the TBIRR module.

Results: This study found that approximately 1.6% of Canadians aged 12 years or older reported sustaining one or more concussions in 2019. Age was significantly associated with concussion incidence after controlling for sex and annual household income, and the locations and activities surrounding respondents' most serious concussions varied by age group. Over one-third of respondents sustained multiple concussions.

Interpretation: The results suggest that certain populations, particularly younger individuals, may be more affected by concussions. While circumstances surrounding concussions vary by age group, the most important contributing factors were sports or physical activities among youth and falls among the adult population. Monitoring concussions among the national population is an important activity in injury surveillance, as it can help evaluate the efficacy of injury prevention intervention and better understand knowledge gaps and the burden of this injury.

Background: The 2018 Cannabis Act legalizing the production, sale, and use of cannabis for non-medical purposes renewed interest in the importance of ongoing and more detailed monitoring of cannabis consumption and consequences. Some cannabis users will experience impaired control over their use of cannabis, putting them at risk for cannabis use disorder (CUD, sometimes called addiction) and other harms. Including the Severity of Dependence Scale (SDS) in the annual Canadian Community Health Survey (CCHS) would allow for monitoring of one of the more harmful consequences of cannabis use in the post-legalization period.

Data and methods: Data from the nationally representative 2019-2020 CCHS were used to examine cannabis consumers with and without impaired control. Respondents who used cannabis in the past year were categorized according to their SDS scores: those with impaired control (SDS ≥ 4) versus those without impaired control (SDS < 4). Cross-tabulations were used to examine the sociodemographic, mental health, health behaviour and cannabis exposure characteristics of those with impaired control. Multivariable logistic regression models assessed associations between these characteristics and the risk of impaired control. The prevalence of self-reported cannabis-related problems experienced by consumers-with and without impaired control-is also presented.

Results: In 2019-2020, 4.7% of past-year cannabis consumers scored ≥ 4 on the SDS and were considered to have impaired control. Multivariable logistic regression suggested that the odds of having impaired control remained higher for people who were male, were aged 18 to 24 years, were single or never married, were from lower-income households, were diagnosed with an anxiety or a mood disorder, started consuming cannabis at age ≤ 15, and consumed at least monthly.

Interpretation: A better understanding of the characteristics of cannabis consumers experiencing impaired control (a correlate of future CUD or addiction) could help with the development of more effective education, prevention and treatment strategies.

Background: Research has identified an association between sleep and obesity in the general population. It is also important to examine this association in a military population.

Data and methods: Data from the 2019 Canadian Armed Forces Health Survey (CAFHS) were used to estimate the prevalence of sleep duration, sleep quality characteristics, overweight and obesity for Regular Force members. The relationship of sleep duration and sleep quality with obesity was assessed with multivariable logistic regression that controlled for sociodemographic, work and health characteristics.

Results: Females were significantly more likely than males to report meeting recommended sleep duration (7 hours to less than 10 hours; 48.7% vs. 40.4%), trouble falling or staying asleep (32.3% vs. 23.5%), or that sleep was not refreshing (64.0% vs. 57.7%). Difficulty staying awake did not differ significantly between males and females (6.3% vs. 5.4%). Obesity, but not being overweight, was significantly more prevalent among those who had short (less than 6 hours) or borderline (6 hours to less than 7 hours) sleep duration, or poor sleep quality. Compared with recommended sleep duration, short sleep duration (adjusted odds ratio [AOR] 1.3; 95% confidence interval [CI]: 1.2 to 1.6) and borderline sleep duration (AOR 1.2; 95% CI: 1.1 to 1.4) were associated with obesity for males, but not females, in fully controlled models. Sleep quality indicators were not independently associated with obesity.

Interpretation: This study adds to the body of evidence that identifies an association between sleep duration and obesity. The results emphasize the importance of sleep as one of the components of the Canadian Armed Forces Physical Performance Strategy.

Background: To date, population estimates of hypertension prevalence among children and adolescents in Canada have been based on clinical guidelines in the National High Blood Pressure Education Program's 2004 Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents (NHBPEP 2004). In 2017, the American Academy of Pediatrics published updated guidelines in Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents (AAP 2017), followed by Hypertension Canada in 2020 with its publication of Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children (HC 2020). This study compares national child and adolescent hypertension prevalence estimates based on NHBPEP 2004, AAP 2017 and HC 2020.

Data and methods: Six cycles of data spanning 2007 to 2019 from the Canadian Health Measures Survey were used to compare blood pressure (BP) categories and the prevalence of hypertension by sex and age group under all sets of guidelines for children and adolescents aged 6 to 17. The impact of applying AAP 2017 across time and selected characteristics, the resulting reclassification into a higher BP category under AAP 2017, and differences in hypertension prevalence resulting from applying HC 2020 versus AAP 2017 were examined.

Results: Prevalence of Stage 1 hypertension was higher among children and adolescents aged 6 to 17 under AAP 2017 and HC 2020 than under NHBPEP 2004. Overall hypertension prevalence was also higher, and obesity was a major factor associated with being reclassified into a higher BP category under AAP 2017.

Interpretation: Implementation of AAP 2017 and HC 2020 is associated with significant changes in the epidemiology of hypertension. Understanding the impact of applying updated clinical guidelines may help inform population surveillance efforts to track hypertension prevalence among Canada's children and adolescents.

Introduction: Polysubstance use--the use of multiple substances on the same or different occasions--is a risk factor for substance use disorder. However, national surveillance of substance use in Canada has often focused on use of a single substance. To better understand and address polysubstance use, this study characterized the use of vaping products, cigarettes, inhaled cannabis, and alcohol among Canadians aged 15 years and older.

Methods: Nationally representative data from the 2020 Canadian Tobacco and Nicotine Survey were analyzed. Polysubstance use was assessed as use of at least two of the following in the past 30 days: smoking cigarettes, using vaping products (containing nicotine or flavours), using cannabis (in smoked and/or vaped form) and drinking alcohol (daily or weekly frequency).

Results: In 2020, past-30-day use of the examined substances was 4.7% for vaping products (1.5 million), 10.3% for cigarettes (3.2 million), 11.0% for inhaled cannabis (3.4 million), and 37.6% for weekly or daily use of alcohol (11.7 million). Polysubstance use was reported by 12.2% of Canadians (3.8 million) and was more prevalent among young Canadians, men and those who vaped. The most common combination of substances among polysubstance users included inhaled cannabis and weekly or daily use of alcohol (29.0%, or 1.1 million).

Conclusion: The use of vaping products, cigarettes, inhaled cannabis, and alcohol-individually and in combination-is substantial among Canadians. Frequent consumption of alcohol was most prevalent overall and, in contrast to the other examined substances, was common among Canadians of all ages. Findings may inform a polysubstance use approach for prevention policies and programs.