Health Reports最新文献

Background: The fitness levels of Canadian adults declined substantially between 1981 and the years 2007 to 2009, suggesting a reduction in population health. This paper updates the fitness trends of Canadians aged 20 to 69 years by extending the time period to 2017.

Data and methods: The Canadian Health Measures Survey is a repeated cross-sectional survey that is conducted to produce nationally representative health estimates. Descriptive statistics are presented for fitness measures in 2016 and 2017 by age and sex, and trends in fitness were calculated spanning a period of 10 years (2007 to 2017). The associations between fitness measures and meeting the 2020 Canadian physical activity recommendations were also assessed.

Results: From 2007 to 2017, there were few statistically significant changes in the fitness levels of Canadian adults. When all ages were combined, there were declining trends in predicted cardiorespiratory fitness, from 39.5 to 36.7 mL•kg⁻¹•min⁻¹ among men and 34.0 to 32.2 mL•kg⁻¹•min⁻¹ among women. Trends indicated declining flexibility among men. In general, meeting the current Canadian moderate-to-vigorous physical activity recommendation was associated with better fitness, particularly in the categories of predicted cardiorespiratory fitness and body composition.

Interpretation: The periodic assessment of fitness in Canadians provides valuable insight into population health. The present update provides evidence that fitness levels among adults have generally stabilized over the past 10 years. Taken with the reported declines in fitness that occurred from 1981 to the 2007-to-2009 period, this study shows that the fitness of Canadian adults remained low between 2007 to 2009 and 2016 to 2017. It is necessary to explore new ways to help improve the fitness levels of the Canadian population.

Background: There are important information gaps concerning the prevalence and distribution of infection control practices (ICPs) within workplaces continuing to operate during the COVID-19 pandemic.

Data and methods: To address these gaps, this paper examines the prevalence of workplace ICPs among employed respondents to Statistics Canada's Labour Force Survey in the months of July, August and September 2020 (n = 53,316). The article also seeks to identify sociodemographic, occupational and workplace factors associated with the level and type of workplace ICPs. ICPs included the reorganization of the workplace to allow for physical distancing, increased access to hand sanitizer or handwashing facilities, enhanced cleaning protocols and access to personal protective equipment. Multivariable regression models were used to examine the number of ICPs in place and the absence of specific ICPs.

Results: Generally high levels of reported protections among workers (15% of the sample had three ICPs and 72% had four or more ICPs) were observed. However, certain subgroups of workers were less likely to have ICPs in place. These included workers who were male; those with lower levels of education, shorter job tenure, or non-permanent work; and those working in the agricultural, construction, transportation and warehousing, and education industries.

Interpretation: In a large sample of Canadian employees, generally high levels of workplace ICPs to reduce the transmission of COVID-19 were observed. Groups with lower levels of ICPs included workers at the start of their employment, workers with low levels of education, and certain industry groups.

Background: First Nations people were reported to have a shorter life expectancy and were more likely than their non-Indigenous counterparts to die prematurely from avoidable causes.

Methods: Using the 2006 Canadian Census Health and Environment Cohort (CanCHEC), the number and rates of deaths for a 10-year follow-up period for on- and off-reserve First Nations people and the non-Indigenous population were calculated by sex, age and region.

Results: According to the 2006 CanCHEC data, First Nations people showed higher age-standardized mortality rates (ASMRs) compared with the non-Indigenous population. On-reserve First Nations people showed higher ASMRs than off-reserve First Nations people. First Nations people's excess mortality, compared with their non-Indigenous counterparts, was caused by deaths from diabetes, heart diseases, chronic liver disease and cirrhosis, unintentional injuries, and intentional injuries (suicide and assault). The mortality differential between First Nations people and the non-Indigenous population was found to be more pronounced among younger age groups.

Interpretation: First Nations people's excess mortality can be better understood by examining specific causes for specific population groups, based on age, sex, being on- or off-reserve, and region.

Background: A comprehensive evaluation of progress in cancer survival for all cancer types combined has not previously been conducted for Canada. The cancer survival index (CSI) is superior to age standardization in measuring such progress.

Data and methods: Data are from the population-based Canadian Cancer Registry, record-linked to the Canadian Vital Statistics Death database. CSI estimates for both sexes combined were calculated as the weighted sum of the sex- and cancer-specific age-standardized net survival estimates. Sex-specific CSI estimates were calculated separately using sex-specific cancer type weights.

Results: From the 1992-to-1994 period to the 2015-to-2017 period, the five-year CSI increased 8.6 percentage points to 63.7%. It increased by 8.9 percentage points to 61.8% among males, and by 8.2 percentage points to 65.8% among females. The contribution of a cancer and sex combination to change in the CSI over time is a function of its assigned weight and changes in its age-standardized net survival. Female breast was the most influential cancer and sex combination, contributing 10.1% to the overall increase, followed by prostate (8.2%) and female lung (7.3%). The increase in the index since the 2005-to-2007 period was most impacted by lung cancer among both females (11.1%) and males (9.4%). While prostate cancer survival increased over the entire study period, it has recently decreased, resulting in a counterproductive 8.1% contribution since the 2005-to-2007 period.

Interpretation: Steady progress has been made in overall cancer survival in Canada since the early 1990s. Female breast cancer has contributed the most to this progress overall, but more recently female lung cancer has been the most influential.

Background: As Canadian immigration levels increase, knowledge concerning immigrant health becomes increasingly important for health system policy and planning. This study compares the rate of all-cause hospitalization among immigrants with that of their Canadian-born counterparts.

Data and methods: Using records from the Discharge Abstract Database (2004/2005 to 2016/2017) and the Ontario Mental Health Reporting System (2006/2007 to 2017/2018) linked to the 2016 Longitudinal Immigration Database, this study compared the age-standardized hospitalization rates (ASHRs) among immigrants with those of the Canadian-born population; the latter were obtained from a linkage based on the 2011 National Household Survey. Comparisons were made at the International Classification of Diseases chapter level by immigrant landing year, admission category and world region of birth. Quebec data were not available.

Results: Overall, ASHRs among immigrants were lower than for the Canadian-born population. Immigrants in the economic class had the lowest ASHR, followed by those in the family class and among refugees. After pregnancy was excluded, leading hospitalization causes were similar for immigrants and the Canadian-born population, where top causes included digestive system and circulatory diseases, injuries, and cancer. In male and female immigrants, the ASHRs were lowest among those from East Asia. By landing year, males arriving earlier had the highest ASHR compared with the most recent arrivals. When pregnancy was excluded and while the differential in ASHRs among females by landing year remained, the magnitude was smaller.

Interpretation: These results corroborate those from previous studies suggesting a healthy immigrant effect, but also reveal heterogeneity in ASHRs within the immigrant population. They provide a baseline for comparison of health status between populations, which enables further monitoring and informs health-system policy and planning.

Background: Public health measures related to the COVID-19 pandemic have upended the way Canadians eat and shop for food. Since the pandemic began, many Canadians have reported consuming food away from home (FAFH) less often. FAFH tends to be less healthful than food prepared at home. Little is known about patterns of Canadians' FAFH consumption before the pandemic. This study used 2015 national-level nutrition data, the most recent available, to characterize patterns of FAFH consumption and selected markers of dietary intake.

Data and methods: National-level food intake data came from the first 24-hour dietary recall provided by 20,475 respondents aged 1 or older to the 2015 Canadian Community Health Survey-Nutrition. Mean daily intakes of selected food subgroups and nutrients, adjusted for total energy intake, were compared between those who had consumed any food in a restaurant on the previous day and those who had not. Estimates were generated overall and for eight age and sex groups.

Results: In 2015, overall, 21.8% of Canadians had consumed FAFH in a restaurant on the previous day. Eating out was most common among males aged 19 to 54 (27.7%) and least common among young children aged 1 to 5 (8.4%). Compared with Canadians who had not eaten out on the previous day, those who had eaten out had consumed, on that day, fewer servings of whole fruit; whole grains; dark green and orange vegetables; other vegetables (excluding potatoes); milk and fortified soy-based beverages; and legumes, nuts and seeds, on average. Those who had eaten out had consumed, on average, less fibre and total sugar, and more total fat, saturated fat and sodium on that day. There were few differences for meat and poultry, fish and seafood, and protein intake.

Discussion: On the day that Canadians ate out in a restaurant, their dietary intake was generally less favourable than that of Canadians who did not eat out. If Canadians continue to eat at home more and to consume less FAFH, as early pandemic-period reports suggest, then results can be used to gauge the potential dietary implications of these shifts.

Background: Cancer incidence rates have been shown to vary by ethnicity, and the increasing awareness of and interest in reporting ethnic health inequalities have been growing internationally. The objective of this study was to assess cancer incidence and mortality rates by ethnicity in Canada.

Data and methods: The study used the 2006 Canadian Census Health and Environment Cohort, linked to the Canadian Cancer Registry and the Canadian Vital Statistics-Death Database, to determine cancer cases and mortality from 2006 to 2016. Ethnicity was categorized as non-Indigenous North American (NINA); European; Caribbean; Latin, Central and South American (LCSA); African; East Asian; South Asian; and West Central Asian and Middle Eastern.

Results: Europeans had the highest standardized incidence rates, while NINA had the highest mortality rates. Rates varied substantially by ethnicity and immigrant status. The top three cancers accounted for 46.5% to 61.9% of all new cancers, while the top three cancer deaths accounted for 36.1% to 61.9% of all deaths. The distribution of cancers within the top 10 cancers and the top 10 cancer deaths also differed; e.g., stomach cancer was found to be more prevalent in the East Asian, LCSA, African and Caribbean groups. Non-immigrant African males had the highest cancer incidence rates, and non-immigrant South Asian females had the highest mortality rates.

Discussion: There is considerable variability in cancer incidence and cancer mortality rates by ethnicity, and this study addresses the knowledge gap in Canada in this area. Establishing baseline indicators, such as cancer rates by ethnicity, is essential to understanding the differences within the diverse Canadian population and to informing targeted interventions that may help reduce health inequalities.

Background: This study assessed the use of and exposure to handheld laser devices by Canadians and the potential associated health risks.

Data and methods: The 2019 Canadian Community Health Survey collected data from 12,397 Canadians on the prevalence of handheld laser exposure or use, and associated eye or skin injuries.

Results: In 2019, an estimated 12.4% (95% CI: 11.4% to 13.4%) of Canadians reported using a handheld laser device or being exposed to its beam in the previous year, and those between the ages of 12 and 17 represented 30.5% (95% CI: 26.6% to 34.4%) of users. The highest laser device use or exposure was among those with a university education (13.8%; 95% CI: 11.8% to 15.8%), and a significant trend was found over income categories (p < 0.0001). The highest prevalence of exposure or use involved laser pointers (69.4%; 95% CI: 65.4% to 73.4%), followed by laser toys (38.5%; 95% CI: 34.6% to 42.5%), laser torches (8.2%; 95% CI: 6.1% to 10.4%) and-lastly-search-and-rescue lasers (0.8%E; 95% CI: 0.3% to 1.2%). Overall, 0.7%E (95% CI: 0.2% to 1.2%) of Canadians reported discomfort or injury in the past 12 months. One-quarter (27.9%; 95% CI: 23.8% to 31.9%) of users had a laser beam intentionally directed toward their eyes or skin. Most users did not buy the device (56.3%; 95% CI: 52.1% to 60.5%), while 40.5% (95% CI: 36.2% to 44.7%) purchased it at a Canadian retail store or online (3.8%E; 95% CI: 2.6% to 5.0%).

Discussion: The prevalence of handheld laser device use and beam exposure was 12.4% (95% CI: 11.4% to 13.4%), representing approximately 3.9 million Canadians. While the number of reported injuries was low, ongoing surveillance helps assess the effectiveness of current risk management approaches for laser products.