scholarly journals Multimorbidity disease clusters in Aboriginal and non-Aboriginal Caucasian populations in Canada

2014 ◽  
Vol 34 (4) ◽  
pp. 218-225 ◽  
Author(s):  
JP Kuwornu ◽  
LM Lix ◽  
S Shooshtari
Keyword(s):  
Chronic Diseases ◽  
Chronic Conditions ◽  
Latent Class ◽  
Canadian Community Health Survey ◽  
Disease Clusters ◽  
Prevalence Estimates ◽  
Community Health Survey ◽  
Caucasian Origin ◽  
Best Fit ◽  
Lca Results

Introduction Patterns of multimorbidity, the co-occurrence of two or more chronic diseases, may not be constant across populations. Our study objectives were to compare prevalence estimates of multimorbidity in the Aboriginal population in Canada and a matched non-Aboriginal Caucasian population and identify the chronic diseases that cluster in these groups. Methods We used data from the 2005 Canadian Community Health Survey (CCHS) to identify adult (≥ 18 years) respondents who self-identified as Aboriginal or non-Aboriginal Caucasian origin and reported having 2 or more of the 15 most prevalent chronic conditions measured in the CCHS. Aboriginal respondents who met these criteria were matched on sex and age to non-Aboriginal Caucasian respondents. Analyses were stratified by age (18–54 years and ≥ 55 years). Prevalence was estimated using survey weights. Latent class analysis (LCA) was used to identify disease clusters. Results A total of 1642 Aboriginal respondents were matched to the same number of non-Aboriginal Caucasian respondents. Overall, 38.9% (95% CI: 36.5%–41.3%) of Aboriginal respondents had two or more chronic conditions compared to 30.7% (95% CI: 28.9%–32.6%) of non-Aboriginal respondents. Comparisons of LCA results revealed that three or four clusters provided the best fit to the data. There were similarities in the diseases that tended to co-occur amongst older groups in both populations, but differences existed between the populations amongst the younger groups. Conclusion We found a small group of younger Aboriginal respondents who had complex co-occurring chronic diseases; these individuals may especially benefit from disease management programs.

scholarly journals Relationship Between Clusters of Chronic Conditions and Disability Trajectories

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 881-881
Author(s):  
Tara Klinedinst ◽  
Lauren Terhorst ◽  
Juleen Rodakowski
Keyword(s):  
Repeated Measures ◽  
Chronic Conditions ◽  
Latent Class ◽  
Functional Mobility ◽  
Multiple Chronic Conditions ◽  
Class Time ◽  
Time Interaction ◽  
Minimal Disease ◽  
Best Fit ◽  
Over Time

Abstract Recent evidence shows that more complex clusters of chronic conditions are associated with poorer health outcomes. Less clear is the extent to which these clusters are associated with different types of disability (basic and instrumental activities of daily living (ADL, IADL) and functional mobility (FM)) over time. This was a longitudinal analysis using the National Health and Aging Trends Study (NHATS) (n = 6,179). Using latent class analysis, we determined the optimal clusters of chronic conditions, then assigned each person to a best-fit class. Next, we used mixed-effects models with repeated measures to examine the effects of group (best-fit class), time (years from baseline), and the group by time interaction on each of the outcomes in separate models over 4 years. We identified 5 chronic condition clusters: “multisystem morbidity” (13.9% of the sample), “diabetes” (39.5%), “osteoporosis” (24.9%), “cardio/stroke/cancer” (4.5%), and “minimal disease” (17.3%). Group by time interaction was not significant for any outcome. For ADL outcome, only time was significant (F3,16249 = 224.72, p < .001). For IADL, both group (F4,5403 = 6.62, p < .001) and time (F3,22622 = 3.87, p = .009) were significant. For FM, both group (F4,5920 = 2.96, p = .02) and time were significant (F3,16381 = 213.41, p < .001). We did not find evidence that any cluster experienced greater increases in disability over time, but all clusters containing multiple chronic conditions had risk of IADL and FM disability. Increased screening for IADL and FM disability could identify early disability and prevent decline.

scholarly journals Self-Reported Diagnoses of Schizophrenia and Psychotic Disorders May Be Valuable for Monitoring and Surveillance

2006 ◽  
Vol 51 (4) ◽  
pp. 256-259 ◽  
Author(s):  
Alison L Supina ◽  
Scott B Patten
Keyword(s):  
Health Survey ◽  
Psychotic Disorders ◽  
Well Being ◽  
Canadian Community Health Survey ◽  
Diagnostic Interview ◽  
Self Report ◽  
Prevalence Estimates ◽  
Community Health Survey ◽  
Monitoring And Surveillance ◽  
Health And Well Being

Objective: To examine whether a plausible estimate of the prevalence of schizophrenia can be obtained with a self-report item in a health survey. Methods: We estimated a self-reported prevalence of schizophrenia, using a grouped variable for all people who reported schizophrenia or any other psychotic disorder in the Canadian Community Health Survey: Mental Health and Well-Being ( n = 36 984). Estimates were stratified according to age, sex, and province of residence. Results: Of survey respondents, 411 (1.1%) reported having schizophrenia or other psychosis, as diagnosed by a health professional; the weighted and adjusted estimate was 0.9% (0.7% to 1.0%). There was no statistical evidence that the prevalence estimates of schizophrenia and other psychosis varied by age, sex, or province of residence. Conclusions: Additional studies incorporating a gold standard diagnostic interview should be carried out to determine the validity of the approach. However, responses to 2 self-report survey items provide what appears to be a plausible epidemiologic pattern.

scholarly journals Cross-Canada Forum – How we identify and count Aboriginal people—does it make a difference in estimating their disease burden?

2013 ◽  
Vol 33 (4) ◽  
pp. 277-280 ◽  
Author(s):  
WW Chan ◽  
C Ng ◽  
TK Young
Keyword(s):  
Chronic Diseases ◽  
Disease Burden ◽  
Aboriginal People ◽  
Economic Status ◽  
Canadian Community Health Survey ◽  
Health Conditions ◽  
Aboriginal Population ◽  
Socio Economic Status ◽  
Community Health Survey ◽  
The Individual

Introduction We examined the concordance between the Canadian Community Health Survey (CCHS) ''identity'' and ''ancestry'' questions used to estimate the size of the Aboriginal population in Canada and whether the different definitions affect the prevalence of selected chronic diseases. Methods Based on responses to the ''identity'' and ''ancestry'' questions in the CCHS combined 2009–2010 microdata file, Aboriginal participants were divided into 4 groups: identity only; ancestry only; either ancestry or identity; and both ancestry and identity. Prevalence of diabetes, arthritis and hypertension was estimated based on participants reporting that a health professional had told them that they have the condition(s). Results Of participants who identified themselves as Aboriginal, only 63% reported having an Aboriginal ancestor; of those who claimed Aboriginal ancestry, only 57% identified themselves as Aboriginal. The lack of concordance also differs according to whether the individual was First Nation, Métis or Inuit. The different method of estimating the Aboriginal population, however, does not significantly affect the prevalence of the three selected chronic diseases. Conclusion The lack of concordance requires further investigation by combining more cycles of CCHS to compare discrepancy across regions, genders and socio-economic status. Its impact on a broader list of health conditions should be examined.

scholarly journals Prevalence and patterns of chronic disease multimorbidity and associated determinants in Canada

2015 ◽  
Vol 35 (6) ◽  
pp. 87-94 ◽  
Author(s):  
K. C. Roberts ◽  
D. P. Rao ◽  
T. L. Bennett ◽  
L. Loukine ◽  
G. C. Jayaraman
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Social Deprivation ◽  
Age Groups ◽  
Canadian Community Health Survey ◽  
Income Quintile ◽  
Canadian Population ◽  
Community Health Survey ◽  
Care Costs

Introduction Multimorbidity is increasingly recognized as a key issue in the prevention and management of chronic diseases. We examined the prevalence and correlates of chronic disease multimorbidity in the general adult Canadian population in relation to age and other key determinants. Methods We extracted data from the Canadian Community Health Survey 2011/12 on 105 416 Canadians adults. We analysed the data according to the number of multimorbidities (defined as 2+ or 3+ diseases from a list of 9) and examined the determinants of multimorbidity using regression analyses. Results Our findings show that 12.9% of Canadians report 2+ chronic diseases and 3.9% report 3+ chronic diseases. Those reporting 3 or more chronic diseases were more likely to be female, older, living in the lowest income quintile and to have not completed high school. In the overall population, social deprivation is associated with a 3.7 odds of multimorbidity, but when examined across age groups, the odds of multimorbidity were notably higher in middle age, 7.5 for those aged 35 to 49 years and 5.4 for those aged 50 to 64 years. Conclusion As the proportion of Canadians living with multiple chronic diseases increases, we need to assess chronic disease from a holistic perspective that captures multimorbidity and upstream factors, to facilitate broader and more context-appropriate associations with healthy living, quality of life, health care costs and mortality. Special consideration should be given to the role that social deprivation plays in the development of multimorbidity. Canadians living in the lowest socioeconomic group are not only more likely to develop multimorbidity, but the onset of multimorbidity is also likely to be significantly earlier.

scholarly journals Determinants of vitamin D supplement use in Canadians

2015 ◽  
Vol 20 (10) ◽  
pp. 1768-1774 ◽  
Author(s):  
Daniel McCormack ◽  
Xiaomei Mai ◽  
Yue Chen
Keyword(s):  
Vitamin D ◽  
Community Health ◽  
Health Survey ◽  
Chronic Conditions ◽  
Healthy Aging ◽  
Canadian Community Health Survey ◽  
Age Group ◽  
Supplement Use ◽  
Community Health Survey ◽  
Vitamin D Supplement

AbstractObjectiveTo determine the prevalence of vitamin D supplement use in Canadian adults and associations with demographic and socio-economic variables.DesignData from the Healthy Aging module of the Canadian Community Health Survey were used to investigate the prevalence of vitamin D supplement use in Canadians aged 45 years and over. The prevalence of supplement use stratified by various behavioural and demographic characteristics was calculated and adjusted models were used to find associations with those factors.SettingThe ten provinces of Canada.SubjectsCanadians aged 45 years and over who participated in the Healthy Aging module of the Canadian Community Health Survey from 2008–2009.ResultsThe highest observed prevalence for women was 48·0 % in the 65–69 years age group and the highest prevalence for men was 25·3 % in the 70–74 years age group. Women had higher odds of vitamin D supplement use than men in all age groups. Not using supplements was more common in smokers, those who did not engage in leisure-time physical activities and who were either overweight or obese. Vitamin D supplement use increased with household income and level of education, and decreased with self-perceived health. Supplement use was higher in those with chronic conditions.ConclusionsThe inverse association with self-perceived health could be partly explained by age, chronic conditions and increased use of health-care services. Associations with higher income and education suggest a strong socio-economic influence and that individuals may not have the expendable income to purchase vitamin D supplements or knowledge of their health benefits.

scholarly journals Initiation or cessation: what keeps the prevalence of smoking higher in Quebec than in the rest of Canada?

2021 ◽  
Vol 41 (10) ◽  
pp. 306-314
Author(s):  
Annie Pelekanakis ◽  
Jennifer L. O'Loughlin ◽  
Thierry Gagné ◽  
Cynthia Callard ◽  
Katherine L. Frohlich
Keyword(s):  
Cigarette Smoking ◽  
Smoking Prevalence ◽  
Smoking Initiation ◽  
Canadian Community Health Survey ◽  
Current Cigarette Smoking ◽  
Current Smoking ◽  
Prevalence Estimates ◽  
Community Health Survey ◽  
Current Cigarette ◽  
Canadian Provinces

Introduction We compared smoking initiation and cessation in Quebec versus the rest of Canada as possible underpinnings of the continued higher cigarette smoking prevalence in Quebec. Methods Data were drawn from the Canadian Community Health Survey (CCHS). We compared average and sex-stratified prevalence estimates of (1) current cigarette smoking in persons aged 15 years and older; (2) past-year initiation of cigarette smoking in those aged 12 to 17 and 18 to 24 years; and (3) past-year cessation in adults aged 25 years and older in Quebec versus the other nine Canadian provinces in each two-year CCHS cycle from 2007/08 to 2017/18. Results The prevalence of current smoking decreased from 25% to 18% among adults aged 15 years and older in Quebec from 2007/08 to 2017/18, and from 22% to 16% in the rest of Canada. Initiation among those aged 12 to 17 years decreased from 9% to 5% in Quebec, and from 7% to 3% in the rest of Canada. Neither initiation among people aged 18 to 24 (at 6% and 7%, respectively) nor cessation among adults aged 25 and older (approximately 8%) changed over time in Quebec or in the rest of Canada. In each two-year CCHS cycle, past-year initiation among those 12 to 17 years of age was consistently higher in Quebec than in the rest of Canada, but there were no substantial or sustained differences in initiation among people aged 18 to 24 or in past-year cessation. Findings were similar when stratified by sex. Conclusion Higher levels of smoking initiation among youth aged 12 to 17 years could be a proximal underpinning of the continuing higher prevalence of smoking in Quebec versus the rest of Canada.

scholarly journals Using Correction Equations Based on Measured Height and Weight Weakens Associations between Obesity Based on Self-Reports and Chronic Diseases

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Cynthia L. Murray ◽  
Gordon W. Walsh ◽  
Sarah Connor Gorber
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Canadian Community Health Survey ◽  
Obesity Prevalence ◽  
Obese Adults ◽  
Logistic Regression Models ◽  
Community Health Survey ◽  
Reported Data ◽  
Correction Equations ◽  
Overweight Or Obesity

Objective. Researchers have established a preponderance of height overestimation among men and weight underestimation among women in self-reported anthropometric data, which skews obesity prevalence data and obscures obesity-chronic disease relationships. The objective of this study was to reevaluate associations between obesity and chronic diseases using body mass index (BMI) correction equations derived from measured data. Methods. Measured height and weight (MHW) data were collected on a subsample of the 17,126 Atlantic Canadians who participated in the 2007-2008 Canadian Community Health Survey (CCHS). To obtain corrected BMI estimates for the 17,126 adults, correction equations were developed in the MHW subsample and multiple regression procedures were used to model BMI. To test obesity-chronic disease relationships, logistic regression models were utilized. Results. The correction procedure eliminated statistically significant relations (P<0.05) between obesity and chronic bronchitis and obesity and stroke. Also, correction attenuated many relationships between adiposity and chronic disease. For example, among obese adults, there was a 13%, 12%, and 7% reduction in the adjusted odds ratios for asthma, urinary incontinence, and cardiovascular disease, respectively. Conclusion. Further research is needed to fully understand how the usage of self-reported data alters our understanding of the relationships between overweight or obesity and chronic diseases.

scholarly journals Using national surveys for mental health surveillance of individuals with intellectual disabilities in Canada

2012 ◽  
Vol 32 (4) ◽  
pp. 194-199
Author(s):  
I.A. Bielska ◽  
H. Ouellette-Kuntz ◽  
D. Hunter
Keyword(s):  
Intellectual Disabilities ◽  
Dual Diagnosis ◽  
Secondary Analysis ◽  
Canadian Community Health Survey ◽  
Population Based ◽  
National Surveys ◽  
Prevalence Estimates ◽  
Community Health Survey ◽  
Adults With Intellectual Disabilities ◽  
Individuals With Intellectual Disabilities

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.

scholarly journals OP0074 MULTIMORBIDITY CLUSTERS, DETERMINANTS AND TRAJECTORIES IN OSTEOARTHRITIS IN THE UK: FINDINGS FROM THE CLINICAL PRACTICE RESEARCH DATALINK

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 49.1-50
Author(s):  
S. Swain ◽  
C. Coupland ◽  
V. Strauss ◽  
C. Mallen ◽  
C. F. Kuo ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Index Date ◽  
Latent Class ◽  
Rapid Onset ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Research Support ◽  
Gradual Onset ◽  
The Uk ◽  
Slow Onset

Background:Multimorbidity (≥2 chronic conditions) escalates the risk of adverse health outcomes. However, its burden in people with osteoarthritis (OA) remains largely unknown.Objectives:To identify the clusters of patients with multimorbidity and associated factors in OA and non-OA populations and to estimate the risk of developing multimorbidity clusters after the index date (after diagnosis).Methods:The study used the Clinical Practice Research Datalink – a primary care database from the UK. Firstly, age, sex and practice matched OA and non-OA people aged 20+ were identified to explore patterns and associations of clusters of multimorbidity within each group. Non-OA controls were assigned with same index date as that of matched OA cases. Secondly, multimorbidity trajectories for 20 years after the index date were examined in people without any comorbidities at baseline in both OA and non-OA groups. Latent class analysis was used to identify clusters and latent class growth modelling was used for cluster trajectories. The associations between clusters and age, sex, body mass index (BMI), alcohol use, smoking habits at baseline were quantified through multinomial logistic regression.Results:In total, 47 long-term conditions were studied in 443,822 people (OA- 221922; non-OA- 221900), with a mean age of 62 years (standard deviation ± 13 years), and 58% being women. The prevalence of multimorbidity was 76.6% and 68.9% in the OA and non-OA groups, respectively. In the OA group five clusters were identified including relatively healthy (18%), ‘cardiovascular (CVD) and musculoskeletal (MSK)’ (12.3%), metabolic syndrome (28.2%), ‘pain and psychological (9.1%), and ‘musculoskeletal’ (32.4%). The non-OA group had similar patterns except that the ‘pain+ psychological’ cluster was replaced by ‘thyroid and psychological’. (Figure 1) Among people with OA, ‘CVD+MSK’ and metabolic syndrome clusters were strongly associated with obesity with a relative risk ratio (RRR) of 2.04 (95% CI 1.95-2.13) and 2.10 (95% CI 2.03-2.17), respectively. Women had four times higher risk of being in the ‘pain+ psychological’ cluster than men when compared to the gender ratio in the healthy cluster, (RRR 4.28; 95% CI 4.09-4.48). In the non-OA group, obesity was significantly associated with all the clusters.Figure 1: Posterior probability distribution of chronic conditions across the clusters in Osteoarthritis (OA, n=221922) and Non-Osteoarthritis (Non-OA, n=221900) group. COPD- Chronic Obstructive Pulmonary Disease; CVD- Cardiovascular; MSK- MusculoskeletalOA (n=24139) and non-OA (n=24144) groups had five and four multimorbidity trajectory clusters, respectively. Among the OA population, 2.7% had rapid onset of multimorbidity, 9.5% had gradual onset and 11.6% had slow onset, whereas among the non-OA population, there was no rapid onset cluster, 4.6% had gradual onset and 14.3% had slow onset of multimorbidity. (Figure 2)Figure 2: Clusters of multimorbidity trajectories after index date in OA (n=24139) and Non-OA (n=24144)Conclusion:Distinct identified groups in OA and non-OA suggests further research for possible biological linkage within each cluster. The rapid onset of multimorbidity in OA should be considered for chronic disease management.Supported by:Acknowledgments:We would like to thank the University of Nottingham, UK, Beijing Joint Care Foundation, China and Foundation for Research in Rheumatology (FOREUM) for supporting the study.Disclosure of Interests:Subhashisa Swain: None declared, Carol Coupland: None declared, Victoria Strauss: None declared, Christian Mallen Grant/research support from: My department has received financial grants from BMS for a cardiology trial., Chang-Fu Kuo: None declared, Aliya Sarmanova: None declared, Michael Doherty Grant/research support from: AstraZeneca funded the Nottingham Sons of Gout study, Consultant of: Advisory borads on gout for Grunenthal and Mallinckrodt, Weiya Zhang Consultant of: Grunenthal for advice on gout management, Speakers bureau: Bioiberica as an invited speaker for EULAR 2016 satellite symposium

scholarly journals 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

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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