Pub Date : 2024-07-24DOI: 10.17269/s41997-024-00914-5
Benedikt Fischer, Tessa Robinson
Cannabis control policies are increasingly being liberalized, including the legalization of non-medical cannabis use and supply in multiple settings, for example in Canada, with main policy objectives focusing on improved public health. An important while contested matter has been the appropriate design of legal cannabis supply structures and sources. These, in most Americas-based legalization settings, have included provisions for (limited) 'home cultivation'. Recent data suggest that about 8% of active consumers engage in cannabis home cultivation for their own supply, while approximately 14% are exposed to it in/around their home. Home cultivation commonly exceeds legal limits and/or occurs where not allowed, and is disproportionately associated with high-frequency and/or other risk patterns of cannabis use. In addition, home cultivation may facilitate exposure or diversion of cannabis to minors, as well as pose possible environmental exposure risks especially when occurring indoors. Given its placement in private spaces, related regulations are largely shielded from enforcement. Home cultivation, therefore, bears substantive potential to circumvent or work counter to public health‒oriented legalization policy objectives. Recent assessments of health outcomes from cannabis legalization show mixed-including multiple adverse-results, implying the need for regulatory revisions towards protecting public health outcomes. Especially in settings where extensive (e.g. commercial) retail systems were established to provide regulated, legal cannabis products to consumers, it is questionable whether home cultivation overall serves primary public health‒oriented objectives; relevant data should be expanded and used to review related provisions.
{"title":"Should cannabis self-cultivation be part of a public health‒oriented legalization policy framework?","authors":"Benedikt Fischer, Tessa Robinson","doi":"10.17269/s41997-024-00914-5","DOIUrl":"https://doi.org/10.17269/s41997-024-00914-5","url":null,"abstract":"<p><p>Cannabis control policies are increasingly being liberalized, including the legalization of non-medical cannabis use and supply in multiple settings, for example in Canada, with main policy objectives focusing on improved public health. An important while contested matter has been the appropriate design of legal cannabis supply structures and sources. These, in most Americas-based legalization settings, have included provisions for (limited) 'home cultivation'. Recent data suggest that about 8% of active consumers engage in cannabis home cultivation for their own supply, while approximately 14% are exposed to it in/around their home. Home cultivation commonly exceeds legal limits and/or occurs where not allowed, and is disproportionately associated with high-frequency and/or other risk patterns of cannabis use. In addition, home cultivation may facilitate exposure or diversion of cannabis to minors, as well as pose possible environmental exposure risks especially when occurring indoors. Given its placement in private spaces, related regulations are largely shielded from enforcement. Home cultivation, therefore, bears substantive potential to circumvent or work counter to public health‒oriented legalization policy objectives. Recent assessments of health outcomes from cannabis legalization show mixed-including multiple adverse-results, implying the need for regulatory revisions towards protecting public health outcomes. Especially in settings where extensive (e.g. commercial) retail systems were established to provide regulated, legal cannabis products to consumers, it is questionable whether home cultivation overall serves primary public health‒oriented objectives; relevant data should be expanded and used to review related provisions.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Setting: This paper describes an action research project with the Centre universitaire intégré de santé et de services sociaux - Capitale Nationale (CIUSSS-CN) who identified a need to assess vulnerability in their territories in order to ensure equitable distribution of the Integrated Perinatal and Early Childhood Services (SIPPE) program funds. The objective was to design and validate a multicriteria model to provide a more accurate portrait of vulnerability based on recent social realities.
Intervention: Our multidisciplinary research team of 7 members included experts in analytics, decision aiding, and community and public health. In collaboration with 6 CIUSSS-CN professionals, we co-constructed, during 9 workshops, a multicriteria model to aggregate the multiple dimensions of vulnerability. We used a value-focused thinking approach and applied the method MACBETH assisted by a geographic information system.
Outcomes: Criteria, scales, and weights were validated and led to a vulnerability score for each CIUSSS-CN territory. This score provides a more accurate portrait of territorial disparities based on data and the participants' experience. The model was implemented in a dynamic user-friendly tool and serves to support decision-makers in the resource allocation process. Knowledge transfer was conducted during and after the process.
Implications: This multidisciplinary research has served to anchor public health funding in local realities, with an emphasis on equity and stakeholder engagement. Our mixed-method approach integrating qualitative and quantitative data is adaptable to other contexts. Our results can enhance intervention effectiveness and allow for a better response to the needs of the population targeted by the SIPPE program.
{"title":"A multicriteria vulnerability index for equitable resource allocation in public health funding.","authors":"Irène Abi-Zeid, Nicole Bouchard, Morgane Bousquet, Jérôme Cerutti, Sophie Dupéré, Julie Fortier, Roxane Lavoie, Isabelle Mauger, Catherine Raymond, Estelle Richard, Lynda Savard","doi":"10.17269/s41997-024-00903-8","DOIUrl":"https://doi.org/10.17269/s41997-024-00903-8","url":null,"abstract":"<p><strong>Setting: </strong>This paper describes an action research project with the Centre universitaire intégré de santé et de services sociaux - Capitale Nationale (CIUSSS-CN) who identified a need to assess vulnerability in their territories in order to ensure equitable distribution of the Integrated Perinatal and Early Childhood Services (SIPPE) program funds. The objective was to design and validate a multicriteria model to provide a more accurate portrait of vulnerability based on recent social realities.</p><p><strong>Intervention: </strong>Our multidisciplinary research team of 7 members included experts in analytics, decision aiding, and community and public health. In collaboration with 6 CIUSSS-CN professionals, we co-constructed, during 9 workshops, a multicriteria model to aggregate the multiple dimensions of vulnerability. We used a value-focused thinking approach and applied the method MACBETH assisted by a geographic information system.</p><p><strong>Outcomes: </strong>Criteria, scales, and weights were validated and led to a vulnerability score for each CIUSSS-CN territory. This score provides a more accurate portrait of territorial disparities based on data and the participants' experience. The model was implemented in a dynamic user-friendly tool and serves to support decision-makers in the resource allocation process. Knowledge transfer was conducted during and after the process.</p><p><strong>Implications: </strong>This multidisciplinary research has served to anchor public health funding in local realities, with an emphasis on equity and stakeholder engagement. Our mixed-method approach integrating qualitative and quantitative data is adaptable to other contexts. Our results can enhance intervention effectiveness and allow for a better response to the needs of the population targeted by the SIPPE program.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-22DOI: 10.17269/s41997-024-00911-8
Dorrie Rizzo, Marc Baltzan, Sanjeev Sirpal, James Dosman, Marta Kaminska, Frances Chung
Objectives: Obstructive sleep apnea (OSA) is a common chronic condition that is often undiagnosed or diagnosed after many years of symptoms and has an impact on quality of life and several health factors. We estimated the Canadian national prevalence of OSA using a validated questionnaire and physical measurements in participants in the Canadian Longitudinal Study on Aging (CLSA).
Methods: The method used individual risk estimation based upon the validated STOP-BANG scale developed for OSA. This stratified population sample spans Canada to provide regional estimates.
Results: In this sample of adults aged 45 to 85 years old, the overall prevalence in 2015 of combined moderate and severe OSA in the 51,337 participants was 28.1% (95% confidence intervals, 27.8‒28.4). The regional prevalence varied statistically between Atlantic Canada and Western Canada (p < 0.001), although clinically the variations were limited. The provincial prevalence for moderate and severe OSA ranged from 27.5% (New Brunswick and British Columbia) to 29.1% (Manitoba). Body mass index (BMI) was the dominant determinant of the variance between provinces (β = 0.33, p < 0.001). Only 1.2% of participants had a clinical diagnosis of OSA.
Conclusion: The great majority (92.9%) of the participants at high risk of OSA were unrecognized and had no clinical diagnosis of OSA.
目的:阻塞性睡眠呼吸暂停(OSA)是一种常见的慢性疾病,通常未得到诊断或出现症状多年后才得到诊断,对生活质量和多种健康因素都有影响。我们通过对加拿大老龄化纵向研究(CLSA)参与者进行有效问卷调查和身体测量,估算出加拿大全国的 OSA 患病率:方法:该方法根据针对 OSA 开发的 STOP-BANG 有效量表进行个人风险估计。该分层人口样本横跨加拿大,可提供地区估计值:在这一 45 至 85 岁的成人样本中,2015 年 51,337 名参与者中合并中度和重度 OSA 的总患病率为 28.1%(95% 置信区间,27.8-28.4)。据统计,加拿大大西洋地区和加拿大西部地区的患病率存在差异(p 结论):绝大多数(92.9%)OSA 高危参试者未被发现,也没有 OSA 的临床诊断。
{"title":"Prevalence and regional distribution of obstructive sleep apnea in Canada: Analysis from the Canadian Longitudinal Study on Aging.","authors":"Dorrie Rizzo, Marc Baltzan, Sanjeev Sirpal, James Dosman, Marta Kaminska, Frances Chung","doi":"10.17269/s41997-024-00911-8","DOIUrl":"https://doi.org/10.17269/s41997-024-00911-8","url":null,"abstract":"<p><strong>Objectives: </strong>Obstructive sleep apnea (OSA) is a common chronic condition that is often undiagnosed or diagnosed after many years of symptoms and has an impact on quality of life and several health factors. We estimated the Canadian national prevalence of OSA using a validated questionnaire and physical measurements in participants in the Canadian Longitudinal Study on Aging (CLSA).</p><p><strong>Methods: </strong>The method used individual risk estimation based upon the validated STOP-BANG scale developed for OSA. This stratified population sample spans Canada to provide regional estimates.</p><p><strong>Results: </strong>In this sample of adults aged 45 to 85 years old, the overall prevalence in 2015 of combined moderate and severe OSA in the 51,337 participants was 28.1% (95% confidence intervals, 27.8‒28.4). The regional prevalence varied statistically between Atlantic Canada and Western Canada (p < 0.001), although clinically the variations were limited. The provincial prevalence for moderate and severe OSA ranged from 27.5% (New Brunswick and British Columbia) to 29.1% (Manitoba). Body mass index (BMI) was the dominant determinant of the variance between provinces (β = 0.33, p < 0.001). Only 1.2% of participants had a clinical diagnosis of OSA.</p><p><strong>Conclusion: </strong>The great majority (92.9%) of the participants at high risk of OSA were unrecognized and had no clinical diagnosis of OSA.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.17269/s41997-024-00909-2
Ryan Yee, Cécile Raymond, Meredith Strong, Lori Seeton, Akash Kothari, Victor Lo, Emma-Cole McCubbin, Alexandra Kubica, Anna Subic, Anna Taddio, Mohammed Mall, Sheikh Noor Ul Amin, Monique Martin, Aaron M Orkin
Setting: Task sharing can fill health workforce gaps, improve access to care, and enhance health equity by redistributing health services to providers with less training. We report learnings from a demonstration project designed to assess whether lay student vaccinators can support community immunizations.
Intervention: Between July 2022 and February 2023, 27 undergraduate and graduate students were recruited from the University of Toronto Emergency First Responders organization and operated 11 immunization clinics under professional supervision. Medical directives, supported with online and in-person training, enabled lay providers to administer and document vaccinations when supervised by nurses, physicians, or pharmacists. Participants were invited to complete a voluntary online survey to comment on their experience.
Outcomes: Lay providers administered 293 influenza and COVID-19 vaccines without adverse events. A total of 141 participants (122 patients, 17 lay vaccinators, 1 nurse, and 1 physician) responded to our survey. More than 80% of patients strongly agreed to feeling safe and comfortable with lay providers administering vaccines under supervision, had no concerns with lay vaccinators, and would attend another lay vaccinator clinic. Content and thematic analysis of open-text responses revealed predominantly positive experiences, with themes about excellent vaccinators, organized and efficient clinics, and the importance of training, communication, and access to regulated professionals. The responding providers expressed comfort working in collaborative immunization teams.
Implications: Lay student providers can deliver vaccines safely under a medical directive while potentially improving patient experiences. Rather than redeploying scarce professionals, task sharing strategies could position trained lay vaccinators to support immunizations, improve access, and foster community engagement.
{"title":"Effectiveness, acceptability, and potential of lay student vaccinators to improve vaccine delivery.","authors":"Ryan Yee, Cécile Raymond, Meredith Strong, Lori Seeton, Akash Kothari, Victor Lo, Emma-Cole McCubbin, Alexandra Kubica, Anna Subic, Anna Taddio, Mohammed Mall, Sheikh Noor Ul Amin, Monique Martin, Aaron M Orkin","doi":"10.17269/s41997-024-00909-2","DOIUrl":"https://doi.org/10.17269/s41997-024-00909-2","url":null,"abstract":"<p><strong>Setting: </strong>Task sharing can fill health workforce gaps, improve access to care, and enhance health equity by redistributing health services to providers with less training. We report learnings from a demonstration project designed to assess whether lay student vaccinators can support community immunizations.</p><p><strong>Intervention: </strong>Between July 2022 and February 2023, 27 undergraduate and graduate students were recruited from the University of Toronto Emergency First Responders organization and operated 11 immunization clinics under professional supervision. Medical directives, supported with online and in-person training, enabled lay providers to administer and document vaccinations when supervised by nurses, physicians, or pharmacists. Participants were invited to complete a voluntary online survey to comment on their experience.</p><p><strong>Outcomes: </strong>Lay providers administered 293 influenza and COVID-19 vaccines without adverse events. A total of 141 participants (122 patients, 17 lay vaccinators, 1 nurse, and 1 physician) responded to our survey. More than 80% of patients strongly agreed to feeling safe and comfortable with lay providers administering vaccines under supervision, had no concerns with lay vaccinators, and would attend another lay vaccinator clinic. Content and thematic analysis of open-text responses revealed predominantly positive experiences, with themes about excellent vaccinators, organized and efficient clinics, and the importance of training, communication, and access to regulated professionals. The responding providers expressed comfort working in collaborative immunization teams.</p><p><strong>Implications: </strong>Lay student providers can deliver vaccines safely under a medical directive while potentially improving patient experiences. Rather than redeploying scarce professionals, task sharing strategies could position trained lay vaccinators to support immunizations, improve access, and foster community engagement.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-25DOI: 10.17269/s41997-024-00902-9
El Zahraa Majed, Ian Janssen, Lucie Lévesque
Objectives: The Canadian 24-Hour Movement Guidelines include recommendations for healthy levels of physical activity, sedentary behaviour, and sleep. Meeting these recommendations could help immigrants stay healthy. However, little is known about the movement behaviours of adult immigrants in Canada nor how these differ in relation to non-immigrants or time since immigration. The objectives were to estimate and compare the prevalence of meeting the 24-Hour Movement Guideline recommendations among adult non-immigrants, established immigrants, and recent immigrants in Canada across different sex groups.
Methods: Self-reported data from the 2017 and 2018 cycles of the Canadian Community Health Survey were used. Meeting the guideline recommendations was based on the following: accumulating ≥ 150 min/week of moderate-to-vigorous physical activity (MVPA), limiting screen time to ≤ 3 h/day, and getting 7-9 h/day of sleep for adults aged 18-64 or 7-8 h/day of sleep for adults aged 65 + . Logistic regression was used to compare guideline adherence according to immigration status while controlling for age, sex, income, marital status, and education.
Results: Among immigrants, 21.5% met all three guideline recommendations, 43.7% met 2 of 3 recommendations, and 28.5% met a single recommendation. The corresponding values for non-immigrants were 26.2%, 42.7%, and 24.6%. Compared to established immigrants, recent immigrants were more likely to meet all three recommendations (OR = 1.27; 95% CI (1.07, 1.50)) and to meet the sleep recommendation (OR = 1.29; 95% CI (1.07, 1.54)) after controlling for confounders.
Conclusion: Approximately 1 in 5 immigrants in Canada met all three recommendations of the 24-Hour Movement Guidelines. Movement behaviours vary according to immigrant status.
{"title":"Meeting the 24-hour movement guidelines among adult immigrants in Canada.","authors":"El Zahraa Majed, Ian Janssen, Lucie Lévesque","doi":"10.17269/s41997-024-00902-9","DOIUrl":"https://doi.org/10.17269/s41997-024-00902-9","url":null,"abstract":"<p><strong>Objectives: </strong>The Canadian 24-Hour Movement Guidelines include recommendations for healthy levels of physical activity, sedentary behaviour, and sleep. Meeting these recommendations could help immigrants stay healthy. However, little is known about the movement behaviours of adult immigrants in Canada nor how these differ in relation to non-immigrants or time since immigration. The objectives were to estimate and compare the prevalence of meeting the 24-Hour Movement Guideline recommendations among adult non-immigrants, established immigrants, and recent immigrants in Canada across different sex groups.</p><p><strong>Methods: </strong>Self-reported data from the 2017 and 2018 cycles of the Canadian Community Health Survey were used. Meeting the guideline recommendations was based on the following: accumulating ≥ 150 min/week of moderate-to-vigorous physical activity (MVPA), limiting screen time to ≤ 3 h/day, and getting 7-9 h/day of sleep for adults aged 18-64 or 7-8 h/day of sleep for adults aged 65 + . Logistic regression was used to compare guideline adherence according to immigration status while controlling for age, sex, income, marital status, and education.</p><p><strong>Results: </strong>Among immigrants, 21.5% met all three guideline recommendations, 43.7% met 2 of 3 recommendations, and 28.5% met a single recommendation. The corresponding values for non-immigrants were 26.2%, 42.7%, and 24.6%. Compared to established immigrants, recent immigrants were more likely to meet all three recommendations (OR = 1.27; 95% CI (1.07, 1.50)) and to meet the sleep recommendation (OR = 1.29; 95% CI (1.07, 1.54)) after controlling for confounders.</p><p><strong>Conclusion: </strong>Approximately 1 in 5 immigrants in Canada met all three recommendations of the 24-Hour Movement Guidelines. Movement behaviours vary according to immigrant status.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.17269/s41997-024-00896-4
Ana Paula Belon, Jo Lin Chew, Naomi Schwartz, Kate E Storey, Brendan T Smith, Roman Pabayo
Objective: In 2018, Ontario Public Health Standards were updated to include the foundational Health Equity Standard to guide planning, implementation, and evaluation of public health programs and services. Public health units (PHUs), the regional public health bodies, are now required to address health equity through four requirements: (a) Assessing and Reporting; (b) Modifying and Orienting Public Health Interventions; (c) Engaging in Multi-sectoral Collaboration; and (d) Health Equity Analysis, Policy Development, and Advancing Healthy Public Policies.
Methods: This qualitative descriptive study explored how the 27 participating PHUs (out of 34) serving urban (N = 10), mixed urban-rural (N = 15), and rural (N = 9) populations addressed the Health Equity Standard. Using document analysis, we inductively and deductively coded the content of 68 PHU Annual Service Plan and Budget Submissions from a 3-year period (2018-2020) received from the 27 PHUs.
Results: Emergent categories were organized into the four requirements and one additional emergent theme: Organizational Implementation of Health Equity. The approaches of embedding health equity into PHUs' activities varied across groups. Urban PHUs presented more diverse strategies, including working with a larger number of organizations, and participating in academic research projects. We found more process standardization and greater discussion of capacity building in urban and mixed urban-rural PHUs. Rural PHUs strategically addressed the needs of their diverse populations through relationship building with Indigenous communities.
Conclusion: Findings suggest broad implementation of health equity approaches in public health independent of PHUs' geographic size and population dispersion, though strategies and key challenges differ across units.
{"title":"Variability in public health programming and priorities to address health inequities across public health units in Ontario, Canada.","authors":"Ana Paula Belon, Jo Lin Chew, Naomi Schwartz, Kate E Storey, Brendan T Smith, Roman Pabayo","doi":"10.17269/s41997-024-00896-4","DOIUrl":"https://doi.org/10.17269/s41997-024-00896-4","url":null,"abstract":"<p><strong>Objective: </strong>In 2018, Ontario Public Health Standards were updated to include the foundational Health Equity Standard to guide planning, implementation, and evaluation of public health programs and services. Public health units (PHUs), the regional public health bodies, are now required to address health equity through four requirements: (a) Assessing and Reporting; (b) Modifying and Orienting Public Health Interventions; (c) Engaging in Multi-sectoral Collaboration; and (d) Health Equity Analysis, Policy Development, and Advancing Healthy Public Policies.</p><p><strong>Methods: </strong>This qualitative descriptive study explored how the 27 participating PHUs (out of 34) serving urban (N = 10), mixed urban-rural (N = 15), and rural (N = 9) populations addressed the Health Equity Standard. Using document analysis, we inductively and deductively coded the content of 68 PHU Annual Service Plan and Budget Submissions from a 3-year period (2018-2020) received from the 27 PHUs.</p><p><strong>Results: </strong>Emergent categories were organized into the four requirements and one additional emergent theme: Organizational Implementation of Health Equity. The approaches of embedding health equity into PHUs' activities varied across groups. Urban PHUs presented more diverse strategies, including working with a larger number of organizations, and participating in academic research projects. We found more process standardization and greater discussion of capacity building in urban and mixed urban-rural PHUs. Rural PHUs strategically addressed the needs of their diverse populations through relationship building with Indigenous communities.</p><p><strong>Conclusion: </strong>Findings suggest broad implementation of health equity approaches in public health independent of PHUs' geographic size and population dispersion, though strategies and key challenges differ across units.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-02-21DOI: 10.17269/s41997-024-00853-1
Ann C Lee, Leisha Toory, Megan E Harrison
Period poverty is the lack of access to menstrual products, sexual and reproductive health education, safe waste management, and adequate facilities. Despite its being a public health issue and a significant concern for numerous Canadians, there is a lack of peer-reviewed research on period poverty in Canada. Existing Canadian research has primarily been conducted by non-profit organizations/charities or industry leaders for menstrual products, resulting in incomplete data. More research is needed to explore the menstrual inequities in Canada and their impact on the well-being of Canadians. This is a critical step to ensure the menstrual needs of Canadians are appropriately addressed.
{"title":"Menstrual health inequities and \"period poverty\" in Canada.","authors":"Ann C Lee, Leisha Toory, Megan E Harrison","doi":"10.17269/s41997-024-00853-1","DOIUrl":"10.17269/s41997-024-00853-1","url":null,"abstract":"<p><p>Period poverty is the lack of access to menstrual products, sexual and reproductive health education, safe waste management, and adequate facilities. Despite its being a public health issue and a significant concern for numerous Canadians, there is a lack of peer-reviewed research on period poverty in Canada. Existing Canadian research has primarily been conducted by non-profit organizations/charities or industry leaders for menstrual products, resulting in incomplete data. More research is needed to explore the menstrual inequities in Canada and their impact on the well-being of Canadians. This is a critical step to ensure the menstrual needs of Canadians are appropriately addressed.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139914018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-02-21DOI: 10.17269/s41997-024-00854-0
Karen A Patte, Markus J Duncan, Angelica Amores, Emily Belita, Rita Kocsis, Negin A Riazi, Rachel Laxer, Scott T Leatherdale
Objective: To provide contemporary evidence of how dietary intake and eating behaviours vary by social positions among adolescents.
Methods: We used survey data collected during the 2020-2021 school year from 52,138 students attending 133 secondary schools in Alberta, British Columbia, Ontario, and Quebec, Canada. Multiple regression models tested whether self-reported indicators of dietary intake and eating behaviours differed by gender, race/ethnicity, and socioeconomic status (SES).
Results: Females were more likely than males to skip breakfast, restrict eating, and consume fruit, vegetables, and fast food on more days. Gender-diverse/"prefer not to say" students were more likely to restrict eating than males and the least likely to consume breakfast and drink water daily, and fruits and vegetables regularly. Black and Latin American students were more likely to restrict eating and consume purchased snacks and fast food, and less likely to drink water daily than white and Asian adolescents. Daily breakfast consumption was most likely among Latin American students. Black students were the least likely to report eating breakfast daily and fruits and vegetables regularly. Lower SES was associated with lower odds of eating breakfast and drinking water daily and regular fruit and vegetable consumption, and higher odds of restrictive eating and purchased snack consumption. Fast food consumption had a u-shaped association with SES.
Conclusion: Results emphasize gender, racial/ethnic, and socioeconomic inequities in the diets and eating behaviours of adolescents. There is a critical need to address the structural factors contributing to inequities and prevent the consequences of dietary disparities.
目的提供当代证据,说明不同社会地位的青少年的饮食摄入量和饮食行为有何不同:我们使用了 2020-2021 学年收集的调查数据,这些数据来自加拿大艾伯塔省、不列颠哥伦比亚省、安大略省和魁北克省 133 所中学的 52138 名学生。多元回归模型检验了自我报告的饮食摄入指标和饮食行为是否因性别、种族/族裔和社会经济地位(SES)而有所不同:结果:与男性相比,女性更有可能不吃早餐、限制饮食以及在更多的日子里食用水果、蔬菜和快餐。性别不同/"不愿透露 "的学生比男生更有可能限制饮食,也最不可能每天吃早餐和喝水,以及经常吃水果和蔬菜。与白人和亚裔青少年相比,黑人和拉美裔学生更倾向于限制饮食和食用购买的零食和快餐,每天喝水的可能性较低。拉丁美洲学生最有可能每天吃早餐。黑人学生最不可能每天吃早餐,也不可能经常吃水果和蔬菜。较低的社会经济地位与每天吃早餐和喝水以及经常吃水果和蔬菜的几率较低有关,而与限制性饮食和购买零食的几率较高有关。快餐消费与社会经济地位呈 U 型关系:结论:研究结果表明,在青少年的饮食和饮食行为中存在着性别、种族/民族和社会经济方面的不平等。我们亟需解决导致不平等的结构性因素,并防止饮食差异造成的后果。
{"title":"Inequities in dietary intake and eating behaviours among adolescents in Canada.","authors":"Karen A Patte, Markus J Duncan, Angelica Amores, Emily Belita, Rita Kocsis, Negin A Riazi, Rachel Laxer, Scott T Leatherdale","doi":"10.17269/s41997-024-00854-0","DOIUrl":"10.17269/s41997-024-00854-0","url":null,"abstract":"<p><strong>Objective: </strong>To provide contemporary evidence of how dietary intake and eating behaviours vary by social positions among adolescents.</p><p><strong>Methods: </strong>We used survey data collected during the 2020-2021 school year from 52,138 students attending 133 secondary schools in Alberta, British Columbia, Ontario, and Quebec, Canada. Multiple regression models tested whether self-reported indicators of dietary intake and eating behaviours differed by gender, race/ethnicity, and socioeconomic status (SES).</p><p><strong>Results: </strong>Females were more likely than males to skip breakfast, restrict eating, and consume fruit, vegetables, and fast food on more days. Gender-diverse/\"prefer not to say\" students were more likely to restrict eating than males and the least likely to consume breakfast and drink water daily, and fruits and vegetables regularly. Black and Latin American students were more likely to restrict eating and consume purchased snacks and fast food, and less likely to drink water daily than white and Asian adolescents. Daily breakfast consumption was most likely among Latin American students. Black students were the least likely to report eating breakfast daily and fruits and vegetables regularly. Lower SES was associated with lower odds of eating breakfast and drinking water daily and regular fruit and vegetable consumption, and higher odds of restrictive eating and purchased snack consumption. Fast food consumption had a u-shaped association with SES.</p><p><strong>Conclusion: </strong>Results emphasize gender, racial/ethnic, and socioeconomic inequities in the diets and eating behaviours of adolescents. There is a critical need to address the structural factors contributing to inequities and prevent the consequences of dietary disparities.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11133286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139914017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-03-25DOI: 10.17269/s41997-024-00869-7
Micheline Beaudry, Ray Bustinza, Isabelle Michaud-Létourneau
The method of infant feeding has consequences for the production of greenhouse gases (GHG) as well as for the risks to infants posed by climate change. Breastfeeding can reduce the carbon footprint associated with the use of commercial infant formula by nearly 50% while reducing its water footprint and waste. It is also an excellent way of coping with emergencies associated with climate change, such as water shortages, since breastfed children are better protected than those fed with formula. To ensure that the protection offered by breastfeeding can be realized, we present elements that can help decision-makers seize a promising opportunity: improve infant feeding support for women and families.
{"title":"Alimentation infantile et changements climatiques : une opportunité prometteuse.","authors":"Micheline Beaudry, Ray Bustinza, Isabelle Michaud-Létourneau","doi":"10.17269/s41997-024-00869-7","DOIUrl":"10.17269/s41997-024-00869-7","url":null,"abstract":"<p><p>The method of infant feeding has consequences for the production of greenhouse gases (GHG) as well as for the risks to infants posed by climate change. Breastfeeding can reduce the carbon footprint associated with the use of commercial infant formula by nearly 50% while reducing its water footprint and waste. It is also an excellent way of coping with emergencies associated with climate change, such as water shortages, since breastfed children are better protected than those fed with formula. To ensure that the protection offered by breastfeeding can be realized, we present elements that can help decision-makers seize a promising opportunity: improve infant feeding support for women and families.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-04-11DOI: 10.17269/s41997-024-00874-w
Carolyn Côté-Lussier, Paul Rodrigues
Canada has been a pioneer in adopting a harm reduction approach to address risks associated with drug use for people who inject drugs. Today, Canada is home to 39 supervised injection sites spread throughout the country. The scientific literature demonstrates, unequivocally, that these sites have numerous health benefits for people who inject drugs, namely by decreasing risks of blood-borne diseases, overdose, and mortality. Yet, a lack of clear guidelines on optimal locations for the implementation of such sites and NIMBYISM ("Not In My Back Yard") have been stumbling blocks for planned and operating sites. Various Canadian governments have introduced their own policies to overcome the lack of national public health guidelines on community planning. Namely, policies aim to limit the exposure to sites and drug use for vulnerable populations, such as children. However, there is a veritable lack of research on the public health impacts of supervised injection sites for local communities, who tend to be disadvantaged. The existing literature fails to address the broader and differential impacts of such sites for local vulnerable and disadvantaged populations, including use of active transportation, psychological distress, perceived safety, and social cohesion. Moreover, existing research, largely focusing on assessing pre-implementation social acceptability and post-implementation impacts on crime, faces important methodological limitations. The following commentary reviews the existing literature and makes recommendations for future public health research on the impacts of supervised injection sites.
{"title":"The public health impacts of supervised injection sites in Canada: Moving beyond social acceptability and impacts on crime.","authors":"Carolyn Côté-Lussier, Paul Rodrigues","doi":"10.17269/s41997-024-00874-w","DOIUrl":"10.17269/s41997-024-00874-w","url":null,"abstract":"<p><p>Canada has been a pioneer in adopting a harm reduction approach to address risks associated with drug use for people who inject drugs. Today, Canada is home to 39 supervised injection sites spread throughout the country. The scientific literature demonstrates, unequivocally, that these sites have numerous health benefits for people who inject drugs, namely by decreasing risks of blood-borne diseases, overdose, and mortality. Yet, a lack of clear guidelines on optimal locations for the implementation of such sites and NIMBYISM (\"Not In My Back Yard\") have been stumbling blocks for planned and operating sites. Various Canadian governments have introduced their own policies to overcome the lack of national public health guidelines on community planning. Namely, policies aim to limit the exposure to sites and drug use for vulnerable populations, such as children. However, there is a veritable lack of research on the public health impacts of supervised injection sites for local communities, who tend to be disadvantaged. The existing literature fails to address the broader and differential impacts of such sites for local vulnerable and disadvantaged populations, including use of active transportation, psychological distress, perceived safety, and social cohesion. Moreover, existing research, largely focusing on assessing pre-implementation social acceptability and post-implementation impacts on crime, faces important methodological limitations. The following commentary reviews the existing literature and makes recommendations for future public health research on the impacts of supervised injection sites.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}