Canadian Community Research Articles

Health Comparisons Between Truck Drivers and the General Population Using the Canadian Community Health Survey.

This study examined and compared risk factors and health conditions of truck drivers compared with the general Canadian population. This study used the Canadian Community Health Survey consisting of 991 male truck drivers and 29,958 male respondents of the general population. Compared with the general population, truck drivers were older, less educated, had lower incomes, worked more hours, and were more likely to be widowed/separated/divorced. In addition, truck drivers had significantly higher rates of cardiovascular disease and obesity and were more likely to be sedentary, smoke, drive when fatigued, and eat unhealthy compared with the general population. Multicomponent interventions are needed to address the poor lifestyle practices of truckers to reduce the high rates of morbidity.

PB1481 Evaluation of the Usage of an Electronic Venous Thromboembolism Assessment Tool for Ambulatory Oncology Patients at a Canadian Community Cancer Centre

PB1481 Evaluation of the Usage of an Electronic Venous Thromboembolism Assessment Tool for Ambulatory Oncology Patients at a Canadian Community Cancer Centre

Dental Insurance Coverage, Dentist Visiting, and Oral Health Status among Asian Immigrant Women of Childbearing Age in Canada: A Comparative Study.

This study examined the dental insurance coverage, dentist visits, self-perceived oral health status, and dental problems among Asian immigrant women of childbearing age in contrast to Canadian women of childbearing age and non-Asian immigrant women of childbearing age. Potential barriers to dental care services among Asian immigrant women were explored. This analysis utilized data from the combined Canadian Community Health Survey from 2011 to 2014. The analytical sample consisted of 5737 females whose age was between 20 and 39 years. Multivariable logistic regression models assessed immigrant status and other factors in relation to the indicators of dental health (i.e., dental visit, self-perceived oral health, acute teeth issue, and teeth removed due to decay). Amongst Asian women immigrants of childbearing age, there was a significantly lower frequency of dentist visits compared to non-immigrant counterparts (OR = 0.53; 95% CI: 0.37-0.76). The most commonly reported reason for not seeking dental care in the last three years was that the "respondent did not think it was necessary". Relative to Canadian born women of same age bracket, Asian women of childbearing age reported fewer acute teeth issues (OR = 0.67; 95% CI: 0.49-0.91) and had a greater risk of tooth extracted due to tooth decay (OR = 3.31; 95% CI: 1.64-6.68). Furthermore, for Asian women immigrants, their major barriers to dental care included low household income (≤$39,999 vs. $40,000-$79,999 OR = 0.26) and a lack of dental insurance (no vs. yes OR = 0.33). Asian immigrant women showed lower utilization of dental services than non-immigrant women. A perceived lack of necessity, lower household income, and dental insurance coverage were major barriers to professional dental usage for most Asian immigrants of childbearing age.

Fueling divisions: a multimodal analysis of Canadian petro-nationalism in the social media discourse of “oil sands strong”

ABSTRACT This research conducts a multimodal critical discourse analysis of social media posts by Oil Sands Strong (OSS), examining their role in advocating for resource extraction through the use of “petro-nationalism” discourse. The analysis uncovers three key aspects: First, the posts employ multimodal semiotic resources to create dichotomies and blend nationalist and xenophobic discourses with energy discourse. Second, they integrate diverse multimodal symbolic elements from various discursive frameworks to forge a collective identity for the local Canadian community. Lastly, the posts stigmatize foreign oil producers, new energy industries, and environmentalists, employing multimodal symbols to obfuscate the argument's focal point and generate a hybrid discourse. Through visual symbols, assertive text, and argumentation of topoi, the posts present an exaggerated and distorted image of petro-nationalism. The study concludes that these multimodal posts aim to reshape Canadian energy politics, promote biased sentiments, exploit cultural prejudices, and formulate petro-nationalism narratives for resource extraction advocacy.

‘Good morning Metro shoppers!’ Food insecurity, COVID-19 and the emergence of roll-call neoliberalism

From April 2020 to December 2021, the Canadian federal government earmarked $330,000,000 through the Emergency Food Security Fund to address food insecurity during the COVID-19 global pandemic. These funds were disbursed through a handful of national and regional emergency food and food justice agencies to smaller front-line organizations for the purchase of emergency food provisions and personal protective equipment, and to hire additional workers. We theorize these dynamics within the broader processes of neoliberalization and argue that the Canadian federal government was conscripting food justice and community development organizations into its efforts to address dramatically increasing rates of food insecurity across the country through charity emergency food provisioning. Within Peck and Tickell’s stylized conceptions of the destructive (roll-back) and creative (roll-out) moments of the process of neoliberalization, we frame the crisis of COVID-19 as exposing a form of recalibration (roll-call) neoliberalism. We focus on this dynamic specifically within the context of household food insecurity in Canadian communities and argue that the federal government’s funding regime during the global pandemic effectively directed food justice organizations (and by extension, the populace in general) away from a more ambitious social change agenda towards the more acceptable strategy (in neoliberal terms) of emergency food provisioning services.

Income inequality and ‘hospitalisations of despair’ in Canada: a study on longitudinal, population-based data

BackgroundRates of drug overdoses, alcohol-related liver disease and suicide attempts represent a major public health burden in Canada. While the existing literature does highlight some evidence of association between income...

Is Sexual Aversion a Distinct Disorder or a Trans-Diagnostic Symptom across Sexual Dysfunctions? A Latent Class Analysis

Sexual aversion disorder (SAD) is a chronic condition that impacts sexual and psychological well-being. However, the relevance of SAD as a discrete disorder remains highly debated. This study aimed to clarify the status of SAD as either a distinct disorder or a trans-diagnostic symptom shared among sexual dysfunctions. This cross-sectional study used a latent class analysis approach among a Canadian community sample (n = 1,363) to identify how patterns of SAD symptoms (i.e., sexual fear, disgust, and avoidance) emerge across different spheres of sexual functioning (i.e., desire and arousal, erection or lubrication, genito-pelvic pain, and orgasm) and examine sociodemographic and psychosexual correlates of the identified classes. Examination of fit indices suggested four classes: Sexually functional, Impaired desire and responsiveness, Sexual aversion, and Comorbid sexual dysfunctions. Sexual aversion class members were more likely to be single, had experienced sexual assault in adulthood, and report lower levels of sexual satisfaction and psychological well-being, compared to Sexually functional class members. Results suggest that SAD is a distinct clinical syndrome, while its symptoms may co-occur with other sexual dysfunctions. To ensure that the needs of people with SAD are met with tailored treatment options, future nosography might consider reclassifying SAD as a specific disorder.

Chronic physical conditions and suicidal ideation: a population-level analysis of Canadian school-attending young adults

Background Students who identify with a chronic physical condition are a growing population and their conditions may be associated with poor mental well-being. Aim To compare suicidal ideation prevalence between Canadian school-attending young adults with and without a chronic physical condition. We hypothesized that students living with a chronic condition have a higher likelihood of experiencing suicidal ideation. Methods A cross-sectional study was conducted using a nationally representative sample of 2297 Canadian school-attending young adults (ages 15-29 years) from the 2012-13 Canadian Community Health Survey—Mental Health (CCHS-MH). Survey-weighted logistic regression and sensitivity analyses were performed to estimate the likelihood of experiencing suicidal ideation between students with and without a chronic physical condition. Results Approximately 14.3% (n = 329) students experienced suicidal ideation at some point. Students living with a physical chronic condition demonstrated 1.65 (95% CI: 1.14, 2.39) times higher odds of experiencing suicidal ideation, compared to students not living with a chronic physical condition. Conclusions Suicide prevention and health promotion are important considerations for campus health providers and administrators when planning services and accommodations for students living with chronic physical conditions.

Association between physical multimorbidity and suicidal ideation in young adults with obesity

BackgroundObesity is associated with multimorbidity and both, have an impact on physical and mental health. Previous studies suggested a possible relationship between obesity, multimorbidity and suicidal spectrum, but few studies focused on this association notably in young adults. The aim of the present study was to examine the co-occurring effect of multimorbidity and obesity on suicidal ideation. MethodsCross-sectional analysis of the Canadian Community Health Survey data was conducted. Data from a sample of young adults (18 to 30 years-old) with obesity, of the 2005 (n = 394) and 2015–2016 (n = 295) cycles were analyzed. Multimorbidity, suicidal ideation, and health behaviours were self-reported. ResultsThe prevalence of physical multimorbidity was 12 % in 2005 and 16 % in 2015–2016. Logistic regressions showed an association between multimorbidity and suicidal ideation (2005: OR 3.05, 95 % CI 1.56–5.98; 2015–2016: OR 2.85, 95 % CI 1.40–5.78). Among covariates, the significant association of sex (OR 1.89; 95 % CI 1.11–3.21) and educational status (OR 3.19; 95 % CI 1.47–6.94) in the 2005 cycle, were not replicated in the 2015–2016 cycle (sex: OR 1.01; 95 % CI 0.55–1.85; education: OR 0.97; 95 % CI 0.48–1.96). Finally, no consistent association between health behaviours and suicidal ideation was found. LimitationsData were self-reported, consequently, we cannot discard the possibility of a reporting bias. The study was cross-sectional so no directional conclusion or causality can be drawn. ConclusionMultimorbidity is associated with suicidal ideation among those with obesity. Attention should be given to chronic disease prevention in young people, as the development of suicidal ideation may also be prevented.

Training of Non-expert Users Using Remotely Delivered, Point-of-Care Tele-Ultrasound: A Proof-of-Concept Study in 2 Canadian Communities.

Many physicians, particularly those practicing in remote regions, lack training opportunities to develop point-of-care ultrasound (POCUS) skills. This pretest-posttest study quantified the skill improvement of learners after participating in a virtual training program that used real-time, remotely delivered point-of-care tele-ultrasound (tele-POCUS) for teaching and learner feedback provision. Ten physicians practicing in an urban tertiary (Kingston, Ontario, Canada, n = 6) or remote care center (Moose Factory, Ontario, Canada, n = 4) completed a 3-week educational program that consisted of e-learning module review, independent image acquisition practice, and expert-guided tele-POCUS consultations. Pretraining and posttraining assessments were performed to evaluate skill enhancement in image acquisition, image quality, and image interpretation for cardiac and lung/pleura POCUS using a 5-point Likert scale. A total of 76 tele-POCUS consultations were performed during the study period. Significant improvements in image quality were noted following remotely delivered mentorship and guidance (all P < 0.01). In cardiac POCUS, pretraining and posttraining comparisons noted significant improvements in image acquisition (means, 2.69-4.33; P < 0.02), quality (means, 2.40-4.03; P < 0.01), and interpretation (means, 2.50-4.40; P < 0.02). In lung/pleura POCUS, significant improvements in image acquisition (means, 3.00-4.43; P < 0.01), quality (means, 3.23-4.37; P < 0.01), and interpretation (means, 3.00-4.40; P < 0.01) were demonstrated. Introductory ultrasound can be taught to novice users using a virtual, live-streamed training format with tele-POCUS while demonstrating significant enhancement in imaging skills.

COLLABORATIVE LIVING LABORATORIES TO INFORM CANADIAN DESIGN GUIDANCE FOR COASTAL NATURE-BASED SOLUTIONS

Nature-based solutions (NbS) have been widely applied for managing coastal flood and erosion risk (Bridges et al. 2021). However, they are underutilized in Canada, owing to a variety of factors including, e.g.: (i) uncertainty surrounding the performance of different nature-based solutions across Canada’s diverse coastal climates, geographies, and land uses; and (ii) the lack of authoritative, regionally appropriate design guidance (Vouk et al. 2021). The Nature-based Infrastructure for Coastal Resilience and Risk Reduction project is bringing together a multi-disciplinary team of Canadian researchers, practitioners, and community leaders to develop an improved understanding of the performance of nature-based shore protection systems in diverse Canadian coastal environments. The project involves conducting synchronized and coordinated parallel research activities – laboratory experiments, field monitoring, and numerical modelling – centered on multiple pilot sites along Canada’s Pacific and Atlantic coasts.

Feasibility Of A “Walk With A Future Doc” Program In A Rural Canadian Community

Feasibility Of A “Walk With A Future Doc” Program In A Rural Canadian Community

The Impacts of Selling Alcohol in Grocery Stores in Ontario, Canada: A Before-After Study.

From 2015 to 2019, the Government of Ontario expanded privatized sales of alcohol, licensing 450 grocery stores to sell beer, cider, and wine. The impacts of a nearby grocery store gaining an alcohol license on adults' alcohol use in Ontario are examined, including whether impacts differed by gender. Data from 2015-2019 Canadian Community Health Survey participants in Ontario (age ≥ 20 years), living within 1,000 m and 1,500 m of grocery stores that gained a license to sell alcohol and propensity-matched controls were included (1,000 m n = 14,052, 1,500 m n = 30,486). Alcohol use outcomes included past-7-day number of standard drinks consumed, near-daily drinking (≥4 days/week), and heavy drinking (5+ drinks in men/4+ in women, at least once/month). Gender-specific difference-in-differences (DiD) analyses compared changes in alcohol use before and after intervention in intervention and control populations. Decreases in past-7-day drinks, near-daily drinking, and heavy drinking were observed after intervention in both intervention and control populations. At the 1,000 m level, adjusted DiD analyses showed past-7-day drinking in women (risk ratio = 1.21, 95% CI [0.88, 1.60]) and heavy drinking in men (odds ratio = 1.38, 95% CI [0.92, 2.08]) had effect sizes above 1, a relative increase over controls, although confidence intervals crossed 1. Findings did not indicate significant differences in alcohol use in intervention relative to controls for other alcohol use measures and at 1,500 m. Findings suggest no association between a partial alcohol deregulation initiative in Ontario and alcohol use from 2015 to 2019. It is important to monitor the impacts on alcohol use over time as further alcohol deregulation plans in Ontario and other jurisdictions are considered.

A One Health Approach Addressing Dog Overpopulation in Northern Canadian Communities

Dog overpopulation in northern Canadian communities is a major health concern affecting humans, non-human animals, and the environment. Issues include aggression between dogs, contamination of soil and water systems, and a heightened risk of injury or zoonotic disease spread (Boissonneault &amp; Epp, 2018; Brook et al., 2010). These One Health concerns are worsened by barriers in northern Canadian communities including isolation from veterinary or medical services, high cost, and potential judgement over the treatment of companion animals (CBC News, 2018). Several grassroots organizations across Canada have developed initiatives to address aspects of the dog overpopulation problem. Despite these efforts, there are very few sustainable, long-term interventions targeting isolated northern Canadian communities such as Inuvik, Northwest Territories. The proposed initiative therefore aims to fill this gap, reducing the dog overpopulation problem over time by partnering with organizations to provide free-roaming or stray dogs with a chemical contraceptive. It also aims to raise awareness across Canada and draw in donations to fund these procedures using the “Sponsor-A-Dog” approach. This may reduce the effects of dog overpopulation on humans, non-human animals, and the environment, with potential for expansion to other northern communities or canine-related health concerns.

Disparities in primary and emergency health care among "off-reserve" Indigenous females compared with non-Indigenous females aged 15-55 years in Canada.

Access to primary care protects the reproductive and non-reproductive health of females. We aimed to quantify health care disparities among "off-reserve" First Nations, Métis and Inuit females, compared with non-Indigenous females of reproductive age. We used population-based data from cross-sectional cycles of the Canadian Community Health Survey (2015-2020), including 4 months during the COVID-19 pandemic. We included all females aged 15-55 years. We measured health care access, use and unmet needs, and quantified disparities through weighted and age-standardized absolute prevalence differences compared with non-Indigenous females. We included 2902 First Nations, 2345 Métis, 742 Inuit and 74 760 non-Indigenous females of reproductive age, weighted to represent 9.7 million people. Compared with non-Indigenous females, Indigenous females reported poorer health and higher morbidity, yet 4.2% (95% confidence interval [CI] 1.8% to 6.6%) fewer First Nations females and 40.7% (95% CI 34.3% to 47.1%) fewer Inuit females had access to a regular health care provider. Indigenous females waited longer for primary care, more used hospital services for nonurgent care, and fewer had consultations with dental professionals. Accordingly, 3.2% (95% CI 0.3% to 6.1%) more First Nations females and 4.0% (95% CI 0.7% to 7.3%) more Métis females reported unmet needs, especially for mental health (data for Inuit females not reported owing to high variability). During reproductive age, Indigenous females in Canada face many disparities in health care access, use and unmet needs. Solutions aimed at increasing access to primary care are urgently needed to advance health care reconciliation.

Prevalence of dementia, heart disease and stroke in community-dwelling adults in Canada, 2016–2021: opportunities for joint prevention

IntroductionThis aim of this study is to provide updated estimates on the prevalence of dementia, heart disease, and stroke in Canadian communities. Targeting all three conditions together, at the community level, may be key to disease prevention and health aging in the Canadian population.MethodsUsing nationwide health survey data, we calculated the age-standardized prevalence of self-reported dementia, heart disease and stroke in adults aged 18 years and over residing in Canadian communities from 2016 to 2021. Poisson regression models were used to detect statistically significant changes in the prevalence of all three conditions from 2016 to 2021.ResultsLess than 1% (~ 175,000 individuals) of adults residing in Canadian communities reported dementia, 5% (~ 1.5 million individuals) reported heart disease, and more than 1% (~ 370,000 individuals) reported stroke annually from 2016 to 2021. Overall, the age-standardized prevalence for stroke decreased minimally from 2016 to 2021 (p = 0.0004). Although the age-standardized prevalence of heart disease and dementia decreased from 2016 to 2018, subsequent increases in prevalence from 2018 to 2021 led to a lack of overall statistically significant changes from 2016 to 2021 (p = 0.10 for heart disease and p = 0.37 for dementia).ConclusionRecent increases in the prevalence of dementia, heart disease and stroke in Canadian communities threaten to reverse any gains in vascular disease prevention over the past six years. Findings reveal the urgent need for intensified prevention efforts that are community-based with a focus on joint reduction in the shared risk factors contributing to all three diseases.

Race, immigrant status, and inequality in physical activity: An intersectional and life course approach.

Physical activity improves health and well-being, but not everyone can be equally active. Previous research has suggested that racial minorities are less active than their white counterparts and immigrants are less active than their native-born counterparts. In this article, we adopt an intersectional and life course approach to consider how race and immigrant status may intersect to affect physical activity across the life span. This new approach also allows us to test the long-standing habitual versus structural debate in physical activity. Analysing data from two recent cycles of the Canadian Community Health Survey (CCHS, 2015-2016 & 2017-2018), we find that physical activity is only lower among immigrants who are also racial minorities and that the gap is most significant during adulthood, but rather insignificant during adolescence and late life. The findings that inequality in physical activity is more apparent among the most disadvantaged racialised immigrants and among working-age adults when structural influences are greater suggest that inequality in physical activity is rooted in structural inequalities, rather than habitual differences. Finally, we demonstrate that the widely observed 'healthy (racialised) immigrant effect' can be underestimated if inequality in physical activity is not considered.

The association between household food insecurity and healthcare costs among Canadian children.

To examine the relationship between household food insecurity and healthcare costs in children living in Ontario, Canada. We conducted a cross-sectional, population-based study using four cycles of the Canadian Community Health Survey (2007-2008, 2009-2010, 2011-2012, 2013-2014) linked with administrative health databases (ICES). We included Ontario children aged 1-17years with a measure of household food insecurity (Household Food Security Survey Module) over the previous 12months. Our primary outcome was the direct public-payer healthcare costs per child over the same time period (in Canadian dollars, standardized to year 2020). We used gamma-log-transformed generalized estimating equations accounting for the clustering of children to examine this relationship, and adjusted models for important sociodemographic covariates. As a secondary outcome, we examined healthcare usage of specific services and associated costs (e.g. visits to hospitals, surgeries). We found that adjusted healthcare costs were higher in children from food-insecure than from food-secure households ($676.79 [95% CI: $535.26, $855.74] vs. $563.98 [$457.00, $695.99], p = 0.047). Compared with children living in food-secure households, those in insecure households more often accessed hospitals, emergency departments, day surgeries, and home care, and used prescription medications. Children from food-secure households had higher usage of non-physician healthcare (e.g. optometry) and family physician rostering services. Even after adjusting for measurable social determinants of health, household food insecurity was associated with higher public-payer health services costs and utilization among children and youth. Efforts to mitigate food insecurity could lessen child healthcare needs, as well as associated costs to our healthcare systems.

Protecting traditional cultural food practices: Trends in diet quality and intake of ultra-processed foods by Indigenous status and race/ethnicity among a nationally representative sample of adults in Canada

BackgroundThe traditional cultural food practices of Indigenous people and adults from racial/ethnic minority groups may be eroded in the current food system where nutrient-poor and ultra-processed foods (UPF) are the most affordable and normative options, and where experiences of racism may promote unhealthy dietary patterns. We quantified absolute and relative gaps in diet quality and UPF intake of a nationally representative sample of adults in Canada by Indigenous status and race/ethnicity, and trends between 2004 and 2015. MethodsAdults (≥18 years) in the Canadian Community Health Survey-Nutrition self-reported Indigenous status and race/ethnicity and completed a 24-h dietary recall in 2004 (n = 20,880) or 2015 (n = 13,970) to calculate Healthy Eating Index-2015 (HEI-2015) scores from 0 to 100 and proportion of energy from UPF. Absolute and relative dietary gaps were quantified for Indigenous people and six racial/ethnic minority groups relative to White adults and trends between 2004 and 2015. ResultsAdults from all six racial/ethnic minority groups had higher mean HEI-2015 scores (58.7–61.9) than White (56.3) and Indigenous adults (51.9), and lower mean UPF intake (31.0%–41.0%) than White (45.9%) and Indigenous adults (51.9%) in 2015. As a result, absolute gaps in diet quality were positive and gaps in UPF intake were negative among racial/ethnic minority groups—indicating more favourable intakes—while the reverse was found among Indigenous adults. Relative dietary gaps were small. Absolute and relative dietary gaps remained largely stable. ConclusionsAdults from six racial/ethnic minority groups had higher diet quality and lower UPF intake, whereas Indigenous adults had poorer diet quality and higher UPF intake compared to White adults between 2004 and 2015. Absolute and relative dietary gaps remained largely stable. Findings suggest racial/ethnic minority groups may have retained some healthful aspects of their traditional cultural food practices while highlighting persistent dietary inequities that affect Canada's Indigenous people.

Modelling population-level and targeted interventions of weight loss on chronic disease prevention in the Canadian population

Obesity is a known risk factor for major chronic diseases. Prevention of chronic disease is a top global priority. The study aimed to model scenarios of population-level and targeted weight loss interventions on 10-year projected risk of chronic disease in Canada using a population-level risk prediction algorithm. The validated Chronic Disease Population Risk Tool (CDPoRT) forecasts 10-year risk of chronic disease in the adult population. We applied CDPoRT to the 2013/14 Canadian Community Health Survey to generate prospective chronic disease estimates for adults 20 years and older in Canada (n = 83,220). CDPoRT was used to model the following scenarios: British Columbia's (BC) and Quebec's (QC) provincial population-level weight reduction targets, a population-level intervention that could achieve weight loss, targeted weight loss interventions for overweight and obese groups, and the combination of a population-level and targeted weight loss intervention. We estimated chronic disease risk reductions and number of cases prevented in each scenario compared with the baseline. At baseline, we predicted an 18.4% risk and 4,151,929 new cases of chronic disease in Canada over the 10-year period. Provincial weight loss targets applied to the Canadian population estimated chronic disease reductions of 0.6% (BC) and 0.1% (QC). The population-level intervention estimated a greater reduction in risk (0.2%), compared to the targeted interventions (0.1%). The combined approach estimated a 0.3% reduction in chronic disease risk. Our modelling predicted that population-level approaches that achieve weight loss in combination with targeted weight loss interventions can substantially decrease the chronic disease burden in Canada.