Low concentrations of fine particle air pollution and mortality in the Canadian Community Health Survey cohort

Abstract Background Approximately 2.9 million deaths are attributed to ambient fine particle air pollution around the world each year (PM2.5). In general, cohort studies of mortality and outdoor PM2.5 concentrations have limited information on individuals exposed to low levels of PM2.5 as well as covariates such as smoking behaviours, alcohol consumption, and diet which may confound relationships with mortality. This study provides an updated and extended analysis of the Canadian Community Health Survey-Mortality cohort: a population-based cohort with detailed PM2.5 exposure data and information on a number of important individual-level behavioural risk factors. We also used this rich dataset to provide insight into the shape of the concentration-response curve for mortality at low levels of PM2.5. Methods Respondents to the Canadian Community Health Survey from 2000 to 2012 were linked by postal code history from 1981 to 2016 to high resolution PM2.5 exposure estimates, and mortality incidence to 2016. Cox proportional hazard models were used to estimate the relationship between non-accidental mortality and ambient PM2.5 concentrations (measured as a three-year average with a one-year lag) adjusted for socio-economic, behavioural, and time-varying contextual covariates. Results In total, 50,700 deaths from non-accidental causes occurred in the cohort over the follow-up period. Annual average ambient PM2.5 concentrations were low (i.e. 5.9 μg/m3, s.d. 2.0) and each 10 μg/m3 increase in exposure was associated with an increase in non-accidental mortality (HR = 1.11; 95% CI 1.04–1.18). Adjustment for behavioural covariates did not materially change this relationship. We estimated a supra-linear concentration-response curve extending to concentrations below 2 μg/m3 using a shape constrained health impact function. Mortality risks associated with exposure to PM2.5 were increased for males, those under age 65, and non-immigrants. Hazard ratios for PM2.5 and mortality were attenuated when gaseous pollutants were included in models. Conclusions Outdoor PM2.5 concentrations were associated with non-accidental mortality and adjusting for individual-level behavioural covariates did not materially change this relationship. The concentration-response curve was supra-linear with increased mortality risks extending to low outdoor PM2.5 concentrations.

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Multimorbidity in large Canadian urban centres: A multilevel analysis of pooled 2015–2018 cross-sectional cycles of the Canadian Community Health Survey

Journal of Multimorbidity and Comorbidity ◽

10.1177/26335565211058037 ◽

2021 ◽

Vol 11 ◽

pp. 263355652110580

Author(s):

Piotr Wilk ◽

Saverio Stranges ◽

Rino Bellocco ◽

Torsten Bohn ◽

Hanen Samouda ◽

...

Keyword(s):

Socioeconomic Factors ◽

Community Health ◽

Health Survey ◽

Canadian Community Health Survey ◽

Cross Sectional ◽

Logistic Regression Models ◽

Individual Level ◽

Community Health Survey ◽

Compositional Effects ◽

The Individual

Background There is limited knowledge on how the prevalence of multimorbidity varies within and across major Canadian urban centres. The objective of this study was to investigate the between-neighbourhood variation in the prevalence of multimorbidity in Canada’s large urban centres, controlling for compositional effects associated with individual-level demographic and socioeconomic factors. Methods Cross-sectional data from the 2015–2018 cycles of the Canadian Community Health Survey (CCHS) were pooled at the microdata level. Respondents (20 years and older) residing in one of the 35 census metropolitan areas (CMAs) were included ( N = 100,803). Census tracts (CTs) were used as a measure of neighbourhood. To assess the between-neighbourhood differences in multimorbidity prevalence, we fitted three sequential random intercept logistic regression models. Results During the 2015–2018 period, 8.1% of residents of large urban centres had multimorbidity. The results from the unadjusted model indicate that 13.4% of the total individual variance in multimorbidity could be attributed to the between-neighbourhood differences. After adjustment for overall characteristics of the CMAs in which these neighbourhoods are located, as well as for individual-level demographic and socioeconomic factors related to compositional effects, 11.0% of the individual variance in multimorbidity could still be attributed to the between-neighbourhood differences. Conclusion There is significant and substantial geographic variation in multimorbidity prevalence across neighbourhoods in Canada’s large urban centres. Residing in some neighbourhoods could be associated with increased odds of having multimorbidity, even after accounting for overall characteristics of the CMAs in which these neighbourhoods are located, as well as individual-level factors.

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Gambling and Problem Gambling in Canada in 2018: Prevalence and Changes Since 2002: Le Jeu et le Jeu Problématique au Canada en 2018 : Prévalence et Changements Depuis 2002

The Canadian Journal of Psychiatry ◽

10.1177/0706743720980080 ◽

2020 ◽

pp. 070674372098008

Author(s):

Robert J. Williams ◽

Carrie A. Leonard ◽

Yale D. Belanger ◽

Darren R. Christensen ◽

Nady el-Guebaly ◽

...

Keyword(s):

Problem Gambling ◽

Community Health ◽

Health Survey ◽

Canadian Community Health Survey ◽

Problem Gamblers ◽

Type Of Gambling ◽

Community Health Survey ◽

Electronic Gambling ◽

Time Periods ◽

Electronic Gambling Machine

Objective: The purpose of this study was to provide an updated profile of gambling and problem gambling in Canada and to examine how the rates and pattern of participation compare to 2002. Method: An assessment of gambling and problem gambling was included in the 2018 Canadian Community Health Survey and administered to 24,982 individuals aged 15 and older. The present analyses selected for adults (18+). Results: A total of 66.2% of people reported engaging in some type of gambling in 2018, primarily lottery and/or raffle tickets, the only type in which the majority of Canadians participate. There are some significant interprovincial differences, with perhaps the most important one being the higher rate of electronic gambling machine (EGM) participation in Manitoba and Saskatchewan. The overall pattern of gambling in 2018 is very similar to 2002, although participation is generally much lower in 2018, particularly for EGMs and bingo. Only 0.6% of the population were identified as problem gamblers in 2018, with an additional 2.7% being at-risk gamblers. There is no significant interprovincial variation in problem gambling rates. The interprovincial pattern of problem gambling in 2018 is also very similar to what was found in 2002 with the main difference being a 45% decrease in the overall prevalence of problem gambling. Conclusions: Gambling and problem gambling have both decreased in Canada from 2002 to 2018 although the provincial patterns are quite similar between the 2 time periods. Several mechanisms have likely collectively contributed to these declines. Decreases have also been reported in several other Western countries in recent years and have occurred despite the expansion of legal gambling opportunities, suggesting a degree of inoculation or adaptation in the population.

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Determinants of food insecurity among elderly people: findings from the Canadian Community Health Survey

Ageing and Society ◽

10.1017/s0144686x20002081 ◽

2021 ◽

pp. 1-15

Author(s):

Moses Mosonsieyiri Kansanga ◽

Yujiro Sano ◽

Isaac Bayor ◽

Joseph Asumah Braimah ◽

Abraham Marshall Nunbogu ◽

...

Keyword(s):

Food Security ◽

Food Insecurity ◽

Community Health ◽

Elderly People ◽

Health Survey ◽

Policy Issue ◽

Integrated Approach ◽

Canadian Community Health Survey ◽

Health Concern ◽

Community Health Survey

Abstract Food insecurity among elderly people is a major public health concern due to its association with several health conditions. Despite growing research and implementation of diverse income-based policy measures, food insecurity among elderly people remains a major policy issue in Canada. Additional research could inform food policy beyond strategies that target improving the financial resources of elderly people. Drawing data from the Canadian Community Health Survey (N = 24,930), we explored the correlates of food insecurity among older adults using negative log-log logistic regression techniques. Our findings show that certain categories of elderly people are more prone to food insecurity. These segments include seniors who are visible minorities (OR = 1.29, p < 0.01), live alone (OR = 1.13, p < 0.05), have a very weak sense of community belonging (OR = 1.40, p < 0.001), in poor physical health (OR = 1.20, p < 0.01), and those in lower age and income categories. These findings corroborate previous studies that demonstrate that food insecurity among elderly people is a complex phenomenon influenced by diverse socio-economic factors. In Canada, food security policies targeted at elderly people have largely prioritised poverty alleviation through income support programmes. While these programmes can improve the purchasing power of elderly people, they may not be sufficient in ensuring food security. There is a need to embrace and further investigate an integrated approach that pays attention to other contextual socio-economic dynamics.

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