Canadian Adults Research Articles

Taking risk to heart: An evaluation of cardiometabolic risk and screening guideline adherence in outpatients with spinal cord injury.

To evaluate cardiometabolic disease (CMD) in outpatients with spinal cord injury/disease (SCI/D). The study aims were to (1) estimate the prevalence of CMD risk factors in a cohort of Canadian adults with SCI/D; (2) assess whether the frequency of CMD screening aligns with evidence-based guidelines; and (3) gain a preliminary understanding of the barriers to CMD screening and/or treatment within a rehabilitation program setting. Quality improvement initiative involving chart review extracting the presence of and frequency of screening for four CMD risk factors (obesity, hypertension, dyslipidemia, diabetes mellitus). Values were compared to evidence-based guidelines for CMD risk identification and management. Root cause analysis and focused interviews were conducted with clinic staff to identify barriers. Academic, tertiary rehabilitation hospital. Consecutive outpatients with SCI/D from October 2020 to December 2021 (n = 73). 43.8% of outpatients sampled had established CMD (≥3 risk factors) and 94.5% had at least one risk factor. Obesity was the most prevalent (82.2%), followed by dyslipidemia (71.7%), hypertension (46.5%), and diabetes mellitus (34.8%). Hypertension and obesity screening were completed at 14.3% and 10.4% of appointments. The frequency of dyslipidemia and diabetes mellitus screening could not be determined. Eighteen barriers to timely CMD screening and treatment intensification were identified. The prevalence of CMD risk factors in outpatients with SCI/D was high. While approximately two of every five outpatients had established CMD, adherence to screening guidelines was poor. These findings reinforce the need for strategies to improve screening and reduce preventable harm from CMD in this vulnerable population.

Adult influenza vaccination coverage before, during and after the COVID-19 pandemic in Canada

BackgroundVaccination prevents seasonal influenza and its complications, particularly among high-risk populations. The COVID-19 pandemic has been reported to impact healthcare behaviors and vaccination patterns. This study aims to assess influenza vaccination coverage and changes in vaccination settings among Canadian adults from the 2018–2019 to the 2023–2024 seasons.MethodWe conducted a retrospective analysis of data from multiple cycles of the Seasonal Influenza Vaccination Coverage Survey (SIVCS). Vaccination coverage was examined across different seasons, stratified by population groups. Odds ratios (ORs) were calculated to compare vaccination likelihoods across seasons, with 2018–2019 serving as the reference. Chi-square tests were applied to determine whether there were significant differences in the place of vaccination since the pre-pandemic season.ResultsWhen comparing vaccine uptake before, during and after the COVID-19 pandemic, we observed a temporary coverage decline in 2021–2022 season (OR = 0.882, 95% CI = 0.787–0.988) compared to the pre-pandemic season in 2018–2019. By the 2022–2023 and 2023–2024 seasons, vaccination coverage returned to pre-pandemic levels. Coverage among adults aged 18–64 without chronic medical condition consistently remained lower than in other groups. The places of vaccination shifted markedly, with pharmacies becoming the predominant site, increasing from 35.4% in 2018–2019 to 57.4% in 2023–2024, while doctor’s offices saw a decline from 32.7 to 15.2% over the same period.ConclusionOur findings highlight the transient effect of the pandemic on flu vaccine uptake in Canada. The increasing use of pharmacies for vaccinations underscores the importance of accessible and convenient vaccination sites. Future efforts should focus on maintaining and improving vaccination coverage through diverse and adaptable vaccination settings.

Temporal trends and characteristics of fall-related deaths, hospitalizations and emergency department visits among older adults in Canada.

Falls among older adults (aged 65 years and older) are a public health concern in Canada. Fall-related injuries can cause a reduction in quality of life among older adults, and death. They also entail substantial health care costs. It is essential to monitor fallrelated injuries and deaths among older adults to better understand temporal trends and characteristics and to evaluate fall prevention strategies. We used the most up-to-date data from the Canadian Vital Statistics-Death database, Discharge Abstract Database and National Ambulatory Care Reporting System to analyze the temporal trends of fallrelated mortality, hospitalizations and emergency department (ED) visits among older adults in Canada over more than a decade. Age and sex characteristics were also examined. In 2022, 7189 older adults died due to a fall in Canada (excluding Yukon). From 2010 to 2022, deaths due to falls generally increased in both number and rates. In fiscal year 2023/24, there were 81 599 fall-related hospitalizations in Canada (excluding Quebec) and 212 570 fall-related ED visits in Ontario and Alberta. From fiscal year 2010/11 to 2023/24, even though the overall trend of the rates of fall-related hospitalizations and ED visits did not increase, the numbers generally rose year by year except in 2020/21, the early stage of the COVID-19 pandemic. As for the age and sex characteristics, the rates for deaths, hospitalizations and ED visits rose with advancing age for both men and women. With the aging population, continuous monitoring of the trends is crucial for fall prevention.

Evaluating unmet need and access to a family physician in a universal health system: a national analysis using the Canadian Longitudinal Study of Aging

BackgroundThe Canadian health care system was founded on the principle of universal access to care. However, recent reports have ranked the country among the lowest performing high-income health systems in terms of access to care and health equity. This study investigates the determinants of access to care in older Canadian adults using a nationally representative survey. MethodsThis cross-sectional study used data from the Canadian Longitudinal Study of Aging (N = 41,135) to examine the determinants of two indicators of healthcare access: self-report of having a family physician and unmet need of care. Multivariable logistic regression models were used to evaluate the association between these indicators and sociodemographic determinants. ResultsApproximately 1 in 30 of the survey participants (aged ≥ 45 years at baseline) did not have a family physician, and 8% reported having unmet need for healthcare. The odds of having a family physician were higher for individuals who were older (≥ 55 years), female, had higher income (≥$100,000), poorer perceived mental health, or had ≥1 chronic condition. The odds of reporting unmet need were higher for individuals who were younger (45-54 years), female, non-white, had lower income (<$50,000), poorer perceived health status and had ≥2 chronic conditions. ConclusionsDespite progress over recent years, access to healthcare remains a challenge for older Canadians, particularly those who are socially disadvantaged. Tailored policy interventions are needed to reduce unmet need in the aging Canadian population.

Mental and Physical Wellbeing of Carer–Employees in Canada

Today, an increasing number of Canadian adults are providing unpaid care to their family members and friends while working full or part-time. We conducted a national survey of unpaid caregiving for older people in 2022 to learn who these people are, why they care, and to identify the social, economic, and health impacts of unpaid caregiving. Our findings show that many of these caregivers are also employees. While most research shows that women caregivers and carer-employees experience work-care tension that results in negative mental and physical health outcomes, our results are more mixed. This paper provides descriptive findings of carer-employee’s health and well-being, and compares them to previous research in Canada and abroad. I conclude with policy options for governments and employers to support the health and well-being of carer-employees.

Repeated use of hospital-based services and delayed hospital discharges in a population-based cohort of autistic adults in Canada.

We know that autistic people have more health problems and are more likely to go to the emergency department and get hospitalized than other people, but we know less about the problems they have once they get to the hospital. In this study, we looked at all autistic adults in Ontario and compared them to adults who were not autistic and to adults who had other kinds of developmental disabilities to see who came back to the emergency department in the month after an emergency department visit, who got re-hospitalized in the month after being sent home from hospital, and who stayed in the hospital longer than they needed to because there was no place appropriate for them to go to. We found that both autistic males and females were more likely to have these things happen to them than the same age- and sex-matched adults who did not have developmental disabilities. We also found that adults with other kinds of developmental disabilities had similar problems to autistic people. This makes us think that we need to work harder to improve health care for autistic adults and adults with other developmental disabilities when they come to hospital. We also need to make community services work better, and work more closely with hospital services, so that people only come to hospital when they need to and that they can go home when they are ready.

"Constantly justifying my existence": Lower-income, higher-weight Canadian adults' stigma coping mechanisms.

Individuals who are higher-weight and low-income may disproportionately experience weight and income stigmas in healthcare experiences compared to lower-weight, higher-income individuals. The ways that weight and income stigmas interact in healthcare should be better understood in order to provide better, less stigmatizing care to higher-weight, low-income patients. This study assesses how patients manage stigmatizing experiences in both healthcare and everyday experiences and how that impacts health seeking and stigma management behaviors through semi-structured interviews with 11 higher-weight (Body Mass Index ≥30), low-income adults (≥18 years of age) in an Atlantic Canadian province. Participants took part in two interviews that focused on healthcare experiences and both positive and negative places/spaces. The two face-to-face interviews for each participant (total 21 interviews) were audio-recorded and professionally transcribed verbatim. The transcripts were analyzed using thematic analysis to identify recurring concepts and patterns within the data. Two major themes emerged from the data, uptake of stigmatizing, neoliberal health messaging and coping with stigma. Coping with stigma included subthemes control over stigmatizing experiences and stoicism in the face of stigma. The findings suggest that individuals understand their health and wellness through a neoliberal lens and that they deploy strategies of control and stoicism to cope with the stigmas they face.

Suicidal ideation among Canadian adults during the third year of the COVID-19 pandemic compared to pre- and early pandemic periods

PurposeThis study examined the prevalence of suicidal ideation among adults in Canada during the third year of the COVID-19 pandemic comparing to the pre- and early pandemic periods, and assessed sociodemographic and pandemic-related factors. MethodsWe estimated prevalence of suicidal ideation from the Survey on COVID-19 and Mental Health (SCMH) conducted between February and May, 2023 (11,526 respondents, response rate 46.5 %), and compared with the prevalence in the 2019 Canadian Community Health Survey (57,034 respondents, response rate 54.9 %) and the 2021 SCMH (5,742 respondents, response rate 51.2 %). We used logistic regressions to assess the likelihood of reporting suicidal ideation. ResultsIn 2023, 3.8 % of adults reported suicidal ideation in the past 12 months, which was not significantly different from the 4.2 % in 2021, but higher than the 2.7 % in 2019. Adults aged 35-64 years and females 65 years or older had significantly higher prevalence in 2023 compared to 2019. Higher prevalence compared to the pre-pandemic baseline was also observed in other subpopulations, but none of them significantly differed from the prevalence in 2021. Adults who were aged 65 years or younger, White, Indigenous, born in Canada, with low income, without a spouse or child, LGBTQ2, with disability, or had experienced pandemic-related impacts had higher risk of suicidal ideation than their peers. ConclusionPrevalence of suicidal ideation remained elevated compared to the pre-pandemic baseline among most adults in Canada during the late pandemic period. Continued surveillance to evaluate middle and long-term impacts of the pandemic on mental health is needed.

Factors associated with the development, severity, and resolution of post COVID-19 condition in adults living in Canada, January 2020 to August 2022.

We aimed to characterize the burden of post COVID-19 condition (PCC) among adults in Canada and identify factors associated with its occurrence, severity, and resolution. We used self-report data from a population-based cross-sectional probability survey of adults in Canada conducted between April and August 2022. Incidence and prevalence of PCC were estimated using confirmed infections, as well as confirmed and suspected combined. Multivariable modeling using confirmed cases identified associated factors. As of August 2022, 17.2% (95% CI 15.7, 18.8) of adults with confirmed infections and 16.7% (95% CI 15.5, 18.0) of adults with confirmed or suspected infections experienced PCC, translating to 3.3% (95% CI 3.0, 3.6) and 4.4% (95% CI 4.1, 4.8) of all adults, respectively. Age less than 65years (aORs of 1.75 to 2.14), more pre-existing comorbidities (aORs of 1.75 to 3.57), and a more severe initial infection (aORs of 3.52 to 9.69) were all associated with higher odds of PCC, while male sex at birth (aOR = 0.54, 95% CI 0.41, 0.70), identifying as Black (aOR = 0.23, 95% CI 0.11, 0.51), and being infected after 2020 (aORs of 0.24 to 0.55) were associated with lower odds. Those residing in a rural area (aOR = 2.31, 95% CI 1.35, 3.93), or reporting a disability (aOR = 2.87, 95% CI 1.14, 7.25), pre-existing chronic lung condition (aOR = 5.47, 95% CI 1.85, 16.12) or back problem (aOR = 2.34, 95% CI 1.26, 4.36), or PCC headache (aOR = 2.47, 95% CI 1.60, 3.83) or weakness (aOR = 2.27, 95% CI 1.41, 3.68) had higher odds of greater limitations in daily activities, while males had lower odds (aOR = 0.54, 95% CI 0.34, 0.85). Two or more pre-existing chronic conditions (aHRs from 0.33 to 0.38), or PCC symptoms relating to the heart (aHR = 0.25, 95% CI 0.07, 0.90), brain fog (aHR = 0.44, 95% CI 0.23, 0.86), or stress/anxiety (aHR = 0.48, 95% CI 0.24, 0.96) were associated with a decreased rate of symptom resolution. Over the first two and a halfyears of the pandemic, a substantial proportion of infected adults in Canada reported PCC. Females and people with comorbidities were disproportionately impacted.

Exposure to air pollutants and subclinical carotid atherosclerosis measured by magnetic resonance imaging: A cross-sectional analysis.

Long-term exposure to air pollution has been associated with higher risk of cardiovascular mortality. Less is known about the association of air pollution with initial development of cardiovascular disease. Herein, the association between low-level exposure to air pollutants and subclinical carotid atherosclerosis in adults without known clinical cardiovascular disease was investigated. Cross-sectional analysis within a prospective cohort study. The Canadian Alliance for Healthy Hearts and Minds Cohort Study; a pan-Canadian cohort of cohorts. Canadian adults (n = 6645) recruited between 2014-2018 from the provinces of British Columbia, Alberta, Ontario, Quebec, and Nova Scotia, were studied, for whom averages of exposures to nitrogen dioxide (NO2), ozone (O3), and fine particulate matter (PM2.5) were estimated for the years 2008-2012. Carotid vessel wall volume (CWV) measured by magnetic resonance imaging (MRI). In adjusted linear mixed models, PM2.5 was not consistently associated with CWV (per 5 μg/m3 PM2.5; adjusted estimate = -8.4 mm3; 95% Confidence Intervals (CI) -23.3 to 6.48; p = 0.27). A 5 ppb higher NO2 concentration was associated with 11.8 mm3 lower CWV (95% CI -16.2 to -7.31; p<0.0001). A 3 ppb increase in O3 was associated with 9.34 mm3 higher CWV (95% CI 4.75 to 13.92; p<0.0001). However, the coarse/insufficient O3 resolution (10 km) is a limitation. In a cohort of healthy Canadian adults there was no consistent association between PM2.5 or NO2 and increased CWV as a measure of subclinical atherosclerosis by MRI. The reasons for these inconsistent associations warrant further study.

Attitudes, Beliefs, and Self-Reported Rates of Influenza and COVID-19 Vaccinations in the Canadian 2023-2024 National Influenza and Respiratory Viruses Survey.

Background: We conducted a cross-sectional, online survey of adult Canadian residents to evaluate their attitudes and beliefs about vaccination against respiratory viruses, particularly influenza and coronavirus 2019 (COVID-19). Methodology: Survey participants aged ≥ 18 years were randomly recruited from the Léger Opinion (LEO) consumer panel. Results: Out of 3002 respondents, 76% reported being "up-to-date" on all of their recommended vaccinations, 86% reported understanding why the influenza vaccine was needed annually, 79% reported believing the influenza vaccine was safe, and 83% reported understanding that vaccines, in general, were important for health. However, only 49% reported receiving the influenza vaccine in the fall of 2023, and 46% received a COVID-19 vaccine (68% of those who received one received the other). More than half of the respondents (55%) reported that they found it difficult to keep track of which vaccines were recommended for them, while 74% indicated that they valued the opinion of their healthcare provider (HCP) when deciding whether to be vaccinated against influenza, and 73% said they would not hesitate to receive multiple vaccines at the same time if their HCP recommended it. Conclusions: These findings highlight the ongoing need for education and outreach in Canada.

Loneliness and cannabis use among older adults: findings from a Canada national survey during the COVID-19 pandemic

BackgroundCannabis use has been increasing among older adults in Canada, particularly during the COVID-19 pandemic. This study aims to examine the association between loneliness and cannabis use among older Canadians during the pandemic.MethodsQuantitative data analyses were performed based on 2,020 participants aged 55 years and older from the Canadian Perspectives Survey Series 6, 2021: Substance Use and Stigma During the Pandemic.ResultsThis study found that participants who used cannabis in the 30 days before the survey reported significantly higher loneliness scores than those who never used cannabis after adjusting social-demographic, social interaction, and pandemic-related factors. Participants who kept using cannabis during the pandemic also reported significantly higher loneliness scores than those who never used cannabis.ConclusionThe findings about the correlation between cannabis use and greater loneliness contribute to the discourse on potential health and wellbeing harms of cannabis use among older adults.

Suicidal ideation and mental illnesses during the COVID-19 pandemic in Canada

Abstract Background The presence of a mental illness is a known risk factor for suicide mortality and other suicide-related behaviours, including suicidal ideation. We examined prevalence of mental illnesses among adults with and without suicidal ideation in Canada during the pandemic. Data and methods We used pooled data from the 2020, 2021, &amp; 2023 Survey on COVID-19 and Mental Health to estimate the prevalence of moderate to severe symptoms of generalized anxiety disorder, major depressive disorder, and posttraumatic stress disorder among adults who reported suicidal ideation, compared to those who did not report suicidal ideation. We also conducted the analyses across sociodemographic factors and COVID-19 pandemic-related experiences. Results Among adults in Canada who reported suicidal ideation, 83.0% also screened positive for at least one of the three mental illnesses. The prevalence of mental illnesses did not differ significantly across sociodemographic factors or pandemic-related experiences. In contrast, the prevalence of at least one mental illness among adults without suicidal ideation was much lower (21.2%), and this prevalence differed by sociodemographic factors and pandemic-related experiences. Interpretation During the COVID-19 pandemic, most adults in Canada with suicidal ideation had moderate to severe symptoms of mental illness.

Fear of Crime and Anti-Refugee Sentiments: Evidence from Canada

Many states have witnessed growing xenophobia and hostility towards refugees alongside the framing of refugees as a serious security or criminal threat in public discourse. Making use of an original cross-national survey of adults in Canada, this article explores the link between fear of crime and negative views of refugees. Its results reveal that even after controlling for alternative explanations, people with more fear of crime are significantly more likely to express anti-refugee sentiments. These results have implications for understanding ongoing challenges in maintaining domestic support for refugee protection and the importance of dispelling myths that refugees are sources of criminality.

"I Needed to be That Voice": A Multi-Party Study of the Healthcare and Social Service Experiences and Needs of Transgender and Gender-diverse Older Adults in Canada.

The social contexts of transgender and gender-diverse (TGD) older adults remain under-examined. In this qualitative study, which involved six virtual focus groups with a total of 21 participants inclusive of TGD adults ages 50+, service providers, and community advocates, we sought to examine the healthcare and social service experiences and needs of TGD older adults in Canada. Drawing theoretically on critical gerontology and intersectionality, and methodologically on interpretive description, we examined the perspectives of different participant groups to develop insight into TGD older adults' issues and priorities in the context of their engagements with systems of care. Our findings revealed the role of histories of marginalization, precarity, contemporary sources of intersectional oppression, and resistance in shaping the experiences of this population, while also highlighting community-driven ground-up activities to address evolving needs. Drawing on this conceptualization, we explored the implications of our research for ongoing inquiry, policy, and practice.

Social determinants of unmet need for primary care: a systematic review

BackgroundDespite primary care being largely free at the point of delivery, many Canadians experience challenges in accessing the services they need. A systematic review was conducted to summarize the evidence on the level of unmet need for primary care in Canada and its social determinants.MethodsMEDLINE, Embase, Cochrane, and Web of Science databases were screened from inception to December 2023 using relevant search terms for primary care and unmet healthcare needs. Quantitative observational studies in the English language that included Canadian adults aged 18 years and older and focused on unmet needs for primary care were included. The risk of bias in the studies was assessed using either the Joanna Briggs Institute (JBI) critical appraisal checklist or the Newcastle–Ottawa Scale. The included studies were synthesized narratively.ResultsForty-six studies met the inclusion criteria for this review. Of the included studies, 96% were cross-sectional in design and 91% had low risk of bias. The prevalence of unmet need, mostly self-reported, varied between 6.6% and 25.2% in national studies. Social determinants of unmet needs were heterogeneous across studies. Findings suggest that unmet need for primary care is related to having low income, mental health diagnoses, and chronic conditions, and negatively associated with older age, having better-perceived health, and having a family physician.ConclusionsUniversal access to primary care is the founding principle of the Canadian healthcare system. However, we found evidence suggesting that the extent to which primary care needs are met is influenced by social determinants of health. Further research is needed to improve our understanding of the mechanisms of unmet primary care needs in Canada.Systematic review registrationPROSPERO CRD42021285074.

Psychological well-being and its associations with sociodemographic characteristics, physical health, substance use and other mental health outcomes among adults in Canada

Introduction Psychological well-being (PWB) is an important component of positive mental health (PMH) and an asset for population health. This study examined correlates of PWB among community-dwelling adults (18+ years) in the 10 Canadian provinces. Methods Using data from the 2019 Canadian Community Health Survey Rapid Response on PMH, we conducted linear regression analyses with sociodemographic, mental health, physical health and substance use variables as predictors of PWB. PWB was measured using six questions from the Mental Health Continuum—Short Form, which asked about feelings of self-acceptance, personal growth, environmental mastery, autonomy, positive relations and purpose in life during the past month. Results In unadjusted and adjusted analyses, older age, being married or in a commonlaw relationship and having a BMI in the overweight category (25.00–29.99) were associated with higher PWB, while reporting a mood disorder, anxiety disorder, high perceived life stress, engaging in heavy episodic drinking and frequent cannabis use were associated with lower PWB. Sex, having children living at home, immigrant status, racialized group membership, educational attainment, household income tertile, having a BMI in the obese category (≥30.00), major chronic disease and smoking status were not significantly associated with PWB. Conclusion This research identifies sociodemographic, mental health, physical health and substance use factors associated with PWB among adults in Canada. These findings highlight groups and characteristics that could be the focus of future research to promote PMH.

Handgrip Strength Asymmetry Is Associated With Health-Related Quality Of Life Among Canadian Adults

Handgrip Strength Asymmetry Is Associated With Health-Related Quality Of Life Among Canadian Adults

Perceived control moderates the internalized stigma model of seeking mental health services in distressed older adults.

Older adults are especially unlikely to seek mental health services, and internalized stigma is a key reason why. However, little research has investigated which older adults are particularly likely to have stigma influence help-seeking. To address this, we tested whether perceived control (PC) moderates an internalized stigma model in which public stigma is internalized as self-stigma, which negatively predicts help-seeking attitudes and help-seeking intentions. We employed moderated mediation analysis of cross-sectional, secondary data from 348 psychologically distressed Canadian adults aged 65 years and older. Participants completed an online survey that included measures of public stigma of help-seeking, self-stigma of help-seeking, help-seeking attitudes, conditional help-seeking intentions, psychological distress, and PC. PC emerged as a moderator of the internalized stigma model. Those lower in PC were more likely to have public stigma negatively predict help-seeking intentions through the serial mediation of (a) self-stigma and (b) help-seeking attitudes. Further, those lower in PC were more likely to have public stigma internalized as self-stigma and more likely to have negative help-seeking attitudes predict lower help-seeking intentions. Finally, those lower in PC also had lower help-seeking intentions in the face of low levels of self-stigma. These results contribute to a nuanced understanding of which older adults are unlikely to seek help. Identifying PC as a moderator of the internalized stigma model suggests that interventions that enhance PC should protect against public stigma's internalization and improve help-seeking behaviors for older adults who need such help. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence of insomnia and use of sleep aids among adults in Canada

ObjectivesTo estimate the prevalence of insomnia and the use of sleep aids among Canadian adults. MethodsData were derived from a phone interview conducted (April to October 2023) with a stratified, population-based sample of 4037 adults (57.6 % females; mean age 50.6 ± 18.4; range 18–102 years old) living in Canada. Post-stratified survey weights were included in the analysis to ensure the representativity of the adult Canadian population. ResultsThe prevalence estimate of insomnia disorder was 16.3 % (95 % CI 15.1–17.6), with higher rates in females (risk ratio [RR] 1.24, 95 % CI 1.06–1.45), Indigenous peoples (RR 1.77, 95 % CI 1.27–2.47), and individuals with poorer mental or physical health. Overall, 14.7 % of respondents reported having used prescribed sleep medications in the previous 12 months, 28.7 % used natural products or over-the-counter (OTC) sleep aids, 15.6 % used cannabis-derived products and 9.7 % used alcohol for sleep in the last 12 months. Higher proportions of females used prescribed medication (RR 1.79, 95 % CI 1.31–2.43) and natural products or OTC medication (RR 1.41, 95 % CI 1.16–1.71), while more males used cannabis (RR 1.33, 95 % CI 1.03–1.72) and alcohol (RR 1.67, 95 % CI 1.16–2.33) for sleep. Higher proportions of older adults (≥65 years) were taking prescribed medications, while more young adults (18–35 years) used natural products or OTC medications, cannabis, and alcohol as sleep aids. ConclusionsInsomnia is a highly prevalent condition in Canada and there is widespread and increasing use of various medications and substances to cope with this health issue. These findings highlight the need for public health interventions to promote healthy sleep and for wider dissemination of evidence-based treatments for insomnia, such as cognitive behavioral therapy which is the first-line treatment for insomnia in practice guidelines, to reduce sleep health disparities.