Chronic Diseases and Injuries in Canada最新文献

Introduction: Guidelines for recommended physical activity (PA) levels have been developed by the Canadian Society for Exercise Physiology (CSEP) and the U.S. Department of Health and Human Services (USDHHS) for health benefits and by the American Cancer Society (ACS) and the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) for cancer prevention benefits.

Methods: We examined if these guidelines were met using a sample of 14 294 Albertan participants of the Tomorrow Project, aged 35 to 64 years, enrolled from 2001 to 2005. We used logistic regression to examine correlates of leisure PA behaviour.

Results: An estimated 55%, 42%, 26% and 23% of participants met CSEP, ACS, USDHHS, and WCRF/AICR guidelines, respectively. Women were less likely than men to meet ACS (Odds Ratio [OR] = 0.72, 95% confidence interval [CI]: 0.55-0.93), USDHHS (OR = 0.67, 95% CI: 0.50-0.89) and WCRF/AICR (OR = 0.63, 95% CI: 0.47-0.85) guidelines, and being obese was correlated with not meeting USDHHS (OR = 0.45, 95% CI: 0.32-0.65) and WCRF/AICR guidelines (OR = 0.79, 95% CI: 0.63-0.98).

Conclusion: Albertans, particularly women and obese individuals, are not sufficiently active for cancer prevention benefits.

Objectives: We conducted a study to investigate the prevalence of human papillomavirus (HPV) infections in an opportunistic sample of women in Manitoba, Canada. We inquired about risk factors associated with HPV infections and linked the HPV typing results with the cervical cancer screening history of the participants.

Methods: The study population included 592 women attending Papanicolaou (Pap) test clinics. After signing a consent form, participants were given a self-administered questionnaire on risk factors and received a conventional Pap test. Residual cells from the Pap tests were collected and sent for HPV typing.

Results: The mean age of the population was 43 years. A total of 115 participants (19.4%) had an HPV infection, 89 of whom had a normal Pap test. Of those who were HPV-positive, 61 (10.3%) had high-risk (Group 1) HPV. HPV-16 was the most prevalent type (15/115: 13.0% of infections). The most consistent risk factors for HPV infection were young age, Aboriginal ethnicity, higher lifetime number of sexual partners and higher number of sexual partners in the previous year.

Conclusion: The prevalence of HPV types in Manitoba is consistent with the distributions reported in other jurisdictions. These data provide baseline information on type-specific HPV prevalence in an unvaccinated population and can be useful in evaluating the effectiveness of the HPV immunization program. An added benefit is in the validation of a proof of concept which links a population-based Pap registry to laboratory test results and a risk behaviour survey to assess early and late outcomes of HPV infection. This methodology could be applied to other jurisdictions across Canada where such capacities exist.

Introduction: To understand the lack of a gradient in mortality by neighbourhood income in a previous study, we used individual-level data from the 1991-2001 Canadian census mortality follow-up study to examine income-related disparities in life expectancy and probability of survival to age 75 years in the City of Toronto and Region of Peel.

Methods: We calculated period life tables for each sex and income adequacy quintile, overall and separately for immigrants and non-immigrants.

Results: For all cohort members of both sexes, including both immigrants and non-immigrants, there was a clear gradient across the income quintiles, with higher life expectancy in each successively richer quintile. However, the disparities by income were much greater when the analysis was restricted to non-immigrants. The lesser gradient for immigrants appeared to reflect the higher proportion of recent immigrants in the lower income quintiles.

Conclusion: These findings highlight the importance of using individual-level ascertainment of income whenever possible, and of including immigrant status and period of immigration in assessments of health outcomes, especially for areas with a high proportion of immigrants.

Introduction: Individuals with intellectual disabilities have a higher prevalence of health problems, including psychiatric and behavioural conditions, than the general population. However, there is little population-based information in Canada about individuals with a dual diagnosis of psychiatric disorder and intellectual impairment. The aim of this study was to determine whether the 2005 Canadian Community Health Survey (CCHS) and the 2006 Participation and Activity Limitation Survey (PALS) could be used to estimate the prevalence of dual diagnosis in Canada.

Methods: We undertook a secondary analysis of two population-based surveys to determine if these could be used to estimate the prevalence of psychiatric or behavioural conditions among adults with intellectual disabilities in Canada.

Results: The surveys reflect prevalence estimates of intellectual disabilities (CCHS: 0.2% and PALS: 0.5%) that are considerably lower than those published in the literature. While it was possible to calculate the proportion of individuals with a dual diagnosis (CCHS: 30.6% and PALS: 44.3%), the surveys were of limited use for detailed analyses. The estimates of prevalence derived from the surveys, especially from the CCHS, were of unacceptable quality due to high sampling variability and selection bias.

Conclusion: The estimates should be interpreted with caution due to concerns regarding the representativeness of the sample with intellectual disabilities in the national surveys.

Objective: To compare cardiovascular disease mortality patterns between First Nations people and non-Aboriginal adults by sex and by income adequacy quintile and level of educational attainment.

Methods: A 15% sample of 1991 Canadian census respondents aged 25 years or older was previously linked to 11 years of mortality data. In this study, First Nations people were defined by North American Indian ethnic origin (ancestry), registration under the Indian Act, and/or membership in an Indian band or First Nation. The cohort included 62 400 First Nations people and 2 624 300 non-Aboriginal people.

Results: Compared to non-Aboriginal cohort members, the age-standardized cardiovascular disease mortality rate was 30% higher for First Nations men and 76% higher for First Nations women. This represented an excess of 58 deaths and 71 deaths per 100 000 person-years at risk, for First Nations men and women, respectively. Within each income adequacy quintile (adjusted for family size and region of residence) and level of educational attainment, the risk of dying from cardiovascular disease was higher for First Nations people compared to their non-Aboriginal counterparts.

Conclusion: First Nations people had higher rates of death from cardiovascular disease than non-Aboriginal Canadians within each income quintile and level of education. Income and education accounted for 67% and 25% of the excess mortality of First Nations men and women respectively.