Expenditures In Canada Research Articles

Food and beverage advertising expenditures in Canada in 2016 and 2019 across media

BackgroundFood and beverage advertising has been identified as a powerful determinant of dietary intake and weight. Available evidence suggests that the preponderance of food and beverage advertising expenditures are devoted to the promotion of unhealthy products. The purpose of this study is to estimate food advertising expenditures in Canada in 2019 overall, by media and by food category, determine how much was spent on promoting healthier versus less healthy products and assess whether changes in these expenditures occurred between 2016 and 2019.MethodsEstimates of net advertising expenditures for 57 selected food categories promoted on television, radio, out-of-home media, print media and popular websites, were licensed from Numerator. The nutrient content of promoted products or brands were collected, and related expenditures were then categorized as “healthy” or “unhealthy” according to a Nutrient Profile Model (NPM) proposed by Health Canada. Expenditures were described using frequencies and relative frequencies and percent changes in expenditures between 2016 and 2019 were computed.ResultsAn estimated $628.6 million was spent on examined food and beverage advertising in Canada in 2019, with television accounting for 67.7%, followed by digital media (11.8%). In 2019, most spending (55.7%) was devoted to restaurants, followed by dairy and alternatives (11%), and $492.9 million (87.2% of classified spending) was spent advertising products and brands classified as “unhealthy”. Fruit and vegetables and water accounted for only 2.1 and 0.8% of expenditures, respectively, in 2019. In 2019 compared to 2016, advertising expenditures decreased by 14.1% across all media (excluding digital media), with the largest decreases noted for print media (− 63.0%) and television (− 14.6%). Overall, expenditures increased the most in relative terms for fruit and vegetables (+ 19.5%) and miscellaneous products (+ 5%), while decreasing the most for water (− 55.6%) and beverages (− 47.5%).ConclusionsDespite a slight drop in national food and beverage advertising spending between 2016 and 2019, examined expenditures remain high, and most products or brands being advertised are unhealthy. Expenditures across all media should continue to be monitored to assess Canada’s nutrition environment and track changes in food advertising over time.

Finances of the Nation: The Evolution of Health Expenditures in Canada, 1926-2019

In this article, Livio Di Matteo provides an overview of expenditures on health care in Canada over the long term. He examines changes in the size, relative importance, growth, and composition of health expenditures, with an additional focus on provincial-territorial government spending since the 1970s. Di Matteo links the evolution of health-care spending to factors affecting the demand for and supply of health services, including income, demographic changes, technological development, cost, policy, and public finances.

Finances of the Nation: The Economic Response of Governments in Canada to COVID-19 in the First Three Months of the Crisis

For almost 60 years, the Canadian Tax Foundation published an annual monograph, <i>Finances of the Nation</i>, and its predecessor, <i>The National Finances</i>. In a change of format, the 2014 <i>Canadian Tax Journal</i> introduced a new "Finances of the Nation" feature, which presents annual surveys of provincial and territorial budgets and topical articles on taxation and public expenditures in Canada. In this article, the authors recount how Canadian governments have responded to the COVID-19 crisis through the economic measures announced between March 11 and May 15, 2020. Their analysis shows that Canadian governments have acted quite rapidly and that, by expanding emergency measures, they have tried to help just about everyone. The authors set out the estimated costs of the various measures, followed by a brief comparison of Canada's response with the responses of other countries. The underlying data for the <i>Finances of the Nation</i> monographs and for the articles in this journal will be published online in the near future.

Association of Roux-en-Y Gastric Bypass With Postoperative Health Care Use and Expenditures in Canada

Results of previous studies are mixed regarding the economic implications of a Roux-en-Y gastric bypass (RYGB). To assess the 5-year incremental health care use and expenditures after RYGB. This population-based cohort study conducted in Ontario, Canada, used a difference-in-differences approach to compare health care use and expenditures between patients who underwent a publicly funded RYGB from March 1, 2010, to March 31, 2013, and propensity score-matched control individuals who did not undergo a surgical bariatric procedure. The study period allowed for a minimum 60 months of follow-up because, at that time, the most recent date for which administrative data on health care and expenditures were available was March 31, 2018. Data sources included the Ontario Bariatric Registry linked to several Ontario health administrative databases and the Electronic Medical Record Administrative Data Linked Database. Health care use and expenditures data for 5 years before and 5 years after the index date (procedure date for RYGB group; random date for controls) were analyzed. Data analyses were performed March 12, 2019, to March 10, 2020. RYGB procedure. The primary outcome was total health care expenditures. The final propensity score-matched cohorts comprised 1587 individuals in the RYGB group (mean [SD] age, 47 [10.2] years) and 1587 controls (mean [SD] age, 47 [12.2] years); each group had 1228 women (77.4%) and a mean body mass index (calculated as weight in kilograms divided by height in meters squared) of 46. Mean total health care expenditures (2017 Canadian dollars) per patient in the RYGB group increased from CAD $15 594 (95% CI, CAD $14 743 to CAD $16 614) (US $12 008 [95% CI, US $11 353 to US $12 794]) in the 5 years before the procedure to CAD $30 389 (95% CI, CAD $28 789 to CAD $32 232) (US $23 401 [95% CI, US $22 169 to US $24 821]) over the 5 years after the procedure, a difference of CAD $14 795 (95% CI, CAD $13 172 to CAD $16 480) (US $11 393 [95% CI, US $10 143 to US $12 691]). For the control group, mean total health care expenditures per individual increased from CAD $16 109 (95% CI, CAD $14 727 to CAD $17 591) (US $12 405 [95% CI, US $11 341 to US $13 546]) 5 years before the index date to CAD $20 073 (95% CI, CAD $18 147 to CAD $22 169) (US $15 457 [95% CI, US $13 974 to US $17 071]) 5 years after the date, a difference of CAD $3964 (95% CI, CAD $2250 to CAD $5875) (US $3053 [95% CI, US $1733 to US $4524]). Overall, the difference-in-differences estimate of the net cost of RYGB was CAD $10 831 (95% CI, CAD $8252 to CAD $13 283) (US $8341 [95% CI, $6355 to $10 229]) over the 5-year period. This amount excluded the mean (SD) cost associated with the index date: CAD $6501 (CAD $1087) (US $5006 [US $837]) for the RYGB cohort and CAD $9 (CAD $72) (US $7 [US $55]) for the controls. The cost differential was primarily associated with increased hospitalizations in the first months immediately after RYGB. Expenditures leveled off in year 3 after the index date; differences in total expenditures between the RYGB and control cohorts were not statistically significantly different in years 4 and 5. Health care expenditures in the 3 years after publicly funded RYGB were higher in patients who underwent the procedure than in control individuals, but the costs were similar thereafter. This finding suggests the need to decrease hospital and emergency department readmissions after surgical bariatric procedures because such use is associated with increased spending.

Factors influencing interprofessional team collaboration when delivering care to community-dwelling seniors: A metasynthesis of Canadian interventions

ABSTRACT The rapid growth in the proportion of adults over the age of 65 translates into greater need of complex, highly specialized care. Hence, coupled with other factors, healthcare expenditures in Canada have grown exponentially, creating tension for a high-quality care while managing costs. Interventions with community-based interprofessional teams have been piloted across Canada as a means to provide efficient specialized care. These teams must, however, work collaboratively for a more comprehensive and patient-centered care. This metasynthesis aimed to identify common factors or characteristics found to be essential for a collaborative practice among members of an interdisciplinary team delivering coordinated care to community-dwelling seniors in both rural and urban centers in Canada. Six databases (Medline, CINAHL, Sage, JSTOR, ProQuest, Web of Science) were searched for qualitative peer‐reviewed articles on community-based interventions with interprofessional teams in Canada and published between 2005–2018. Six articles were included and appraised using the COREQ guidelines for quality, followed by a thematic analysis for common themes related to team collaboration. Overarching themes related to practices of interprofessional collaboration were trust and respect, communication, and shared vision. Sub-themes included trust in the relationship between health care professional, professional identity and role clarity, interprofessional communication, communication with the client or family, and common goals. Interprofessional teams work collaboratively when trust and respect, communication, and shared vision are valued and present. Agencies coordinating interprofessional teams for community-based care could be pivotal in ensuring an environment conducive to collaboration, such as learning and team building opportunities.

Finances of the Nation: Survey of Provincial and Territorial Budgets, 2019-20

For almost 60 years, the Canadian Tax Foundation published an annual monograph, <i>Finances of the Nation</i>, and its predecessor, <i>The National Finances</i>. In a change of format, the 2014 <i>Canadian Tax Journal</i> introduced a new "Finances of the Nation" feature, which presents annual surveys of provincial and territorial budgets and topical articles on taxation and public expenditures in Canada. This article surveys the 2019-20 provincial and territorial budgets.

Tax Expenditures to Limit the Growth of Carbon Emissions in Canada: Identification and Evaluation

Unlike the U.S., which relies heavily on tax expenditures as instruments of energy and climate change policy, Canada has introduced very few such tax expenditures, relying instead on voluntary initiatives, direct subsidies, and limited regulatory measures to limit carbon emissions. This paper identifies and evaluates the most prominent tax expenditures in Canada to limit the growth of carbon emissions. As background to this inquiry, Part II reviews Canadian experience with carbon emissions over the last two decades and the limited government response to this growing problem. Part III identifies the most prominent tax expenditures that Canadian governments have introduced in order limit the growth of carbon emissions. Part IV evaluates these tax expenditures as spending programs and tax measures, concluding that they are vulnerable to many of the traditional criticisms levied against tax expenditures. As a result, the paper concludes, if Canadian governments are to continue to utilize tax expenditures to help fight climate change, they should pay closer attention to the insights of tax expenditure analysis and design these policy instruments accordingly.

Forest fire management expenditures in Canada: 1970–2013

Fire plays a vital role in forest management in Canada and the cost of fire management varies significantly both spatially and temporally. We present the fixed (pre-suppression) and variable (suppression) expenditures incurred by Canadian forest and wildland fire management agencies over the period 1970–2013. We describe how the data was compiled, display it in a graphical format, present the results of our preliminary analysis of that data and discuss those results and the need to investigate both fire management productivity and the factors that influence it. The data is available in a public repository where it can be readily accessed by others who wish to explore it in further detail.

Care-Related Out-of-Pocket Expenditures in Canada

This research examined the prevalence and amount of care-related out-of-pocket expenditures of family caregivers and the factors that influence this spending. Secondary analysis of 2007 General Social Survey (Cycle 21) data yielded population estimates for Canadians age 45 years and older. Thirty-five percent of respondents—1.2 million Canadians—reported care-related out-of-pocket expenditures, which amounted to almost $12.6 million. Caregivers who were more likely to incur these costs reported higher levels of stress, were caring for a family member or friend with more complex health conditions, were providing more intense levels of care, and lived further away from the care receiver. We find that care-related out-of-pocket spending is common among Canadian caregivers, that it can be substantial, and that relatively few caregivers receive financial supports that can defray these costs.

The conditionality of the trade-off between government responsiveness and effectiveness: The impact of minority status and polls in the Canadian House of Commons

There is an extensive literature on the relative virtues of different electoral systems in producing more responsive and effective governments, but far less attention has been paid to role of dynamic factors. This article examines how government minority/majority status and popularity shape the trade-off between government responsiveness and effectiveness. We argue that minority governments face legislative constraints that incentivize them to be responsive to the public, but that this comes at the expense of legislative effectiveness. This trade-off between responsiveness and effectiveness is, however, conditioned by the government's standing in the polls. The more popular a minority government is in the polls, the less responsive and the more effective it becomes. These propositions are tested using original time-series data on public policy preferences, government popularity, legislative output and public expenditures in Canada from 1958 to 2009. Our findings demonstrate that minority governments are more responsive to the median voter but less legislatively effective than majority governments, and that these effects are moderated by the popularity of the government.

The financial burden of out of pocket prescription drug expenses in Canada.

Pharmaceutical expenditures account for approximately 15.9% of total health expenditures in Canada. Unlike hospital and physician services, in which costs are universally covered, most pharmacological therapy does not fall under the umbrella of 'medically necessary' services set out by the Canada Health Act, and therefore is funded through a mix of public and private plans. Little is known about the actual financial burden experienced by Canadians from out-of-pocket drug expenditures (OOPDE). This paper examines the burden of OOPDE in Canada. 1.1% of Canadian households exceed our catastrophic threshold (9%) of the drug budget share. Additionally, 2.6 and 8.2% of households exceed lower thresholds of 6 and 3% respectively. We find an inverse relationship between household income and the burden of OPPDE. Low-income households have the highest likelihood of being in the 'catastrophic' drug expenditure category. This finding suggests that a vulnerable population of 'working poor' are likely to be experiencing disproportionate financial burden because they are not eligible for public assistance programs. Seniors experience the highest burden of OPPDE when compared to other age groups. We also find that there is significant interprovincial variation in the burden of OOPDE, which partly reflects different provincial government drug coverage policies.

Assessing the Impact of Some Health Care Cost Drivers in Canada During the Last Decade

Public spending on health in Canada has reach $121 billion in 2008; an average annual increase of 7.4% compared to the 1998 level. For the same period, total government revenue has grown at an average annual rate of 5.2%. This fact has led some stakeholders to conclude that health spending is unsustainable. It has also kindled interest of policy makers in understanding current cost drivers of health expenditures in Canada, namely within the context of the imminent end of the 2004 Health Ministers Accord and future discussions regarding renewal of Federal/Provincial/Territorial (F/P/T) funding of health care. The objective of this study is to better understand the impact of some health care cost drivers over the last ten years in Canada. These key questions are addressed: To what extent did aging and other factors such as technology drive health care costs over the last ten years? How did growth in public sector health spending compare to growth in other government programs? Using data from Public Accounts and the National Health Expenditures (NHEX) database, we found that, even in a decade where the health sector has benefited from substantial funding, it did not prevent growth from happening in most of the other sectors, such as transport and education. Aging accounted for less than 1.0% of the growth in public sector health spending. Other factors that impact health spending growth include: fiscal position, health-specific inflation and technological change, with the latter being possibly one of the most important components.

Price Elasticities of Charitable Giving across Donation Sectors in Canada: Is the Tax Incentive Effective?

The effectiveness of tax incentives on charitable donation expenditures in Canada is explored, and the analysis is extended to compare the effectiveness across different donation sectors. Price elasticities are estimated with data from the 2007 Canada Survey of Giving, Volunteering and Participating. Results suggest that specific charitable sectors are affected differently by Canada’s tax credit system. The findings have implications for public policy.

Feasibility of Reporting Health Expenditures in Canada from a Financing Source Perspective, 2006

This discussion document estimates the contribution of the public sector, business and households in the financing of total health expenditures in Canada in 2006. It suggests a detailed methodological framework to come up with such an estimate. Total health expenditures without taking into account tax expenditures were separately estimated for households and corporations, which is the main contribution of the document. Even though tax expenditures are not included in the estimate, they are discussed in terms of scope, potential data sources, methodology and challenges. In spite of the difficulty to come up with a reasonable estimate of these tax expenditures, they will continue to be part of the discussion in the financing of the Canadian health care system.

Perspectives on Intervening on Physical Inactivity and Diet

The global epidemic of obesity is staggering in its scope. The World Health Organization (2011) reports that nearly 1.5 billion adults aged 20 years and older and 43 million children younger than 5 years are overweight. The health, societal, and economic impact of obesity on current and future generations is daunting. Obesity is associated with an increased prevalence of serious chronic diseases and con-ditions, including cardiovascular diseases, diabetes mellitus, cancer, musculoskeletal conditions, mental health disorders, and physical function limitations and disability (Abdullah et al., 2011; Alley & Chang, 2007; Deaton et al., 2011; Martin, Freedman, Schoeni, & Andreski, 2010; Wang, McPherson, Marsh, Gortmaker, & Brown, 2011).Obesity among participants 30 to 49 years old in the Framingham Study was associated with a doubling of proba-bility of having a physical function limitation in older age (Peeters, Bonneux, Nusselder, De Laet, & Barendregt, 2004). Available data on direct health care costs estimate that obesity accounts for 74 billion dollars of all health care expenditures in the United States and 33 billion euros in the European Union and 25% of all health expenditures in Canada (Allender, Foster, Scarborough, & Rayner, 2007; Anis et al., 2010; Trasande & Elbel, 2012). An additional 5.5 billion British sterling pounds in health care expenditures associated with obesity are projected by 2050 in the United Kingdom (Trasande & Elbel, 2012; Wang et al., 2011).Physical inactivity and poor dietary habits are the primary contributors to overweight and obesity. Individually, physi-cal inactivity and poor dietary habits increase the risks of developing many chronic diseases and conditions—and these risks are compounded in the presence of obesity (U.S. Department of Health and Human Services, 2008; World Health Organization, 2011, 2012). Physical inactivity and unhealthy dietary habits are highly prevalent in developed and—increasingly so—in developing countries throughout the world (World Health Organization, 2008, 2011).The body of scientific literature about physical activity and diet has grown exponentially over the past decade, demon -strated by the sheer volume of published articles in this and other journals. However, the effectiveness of long-term interventions to promote physical activity has been equivo-cal, but shorter term interventions have shown some success in improving physical activity (Garber et al., 2011). Obesity prevention and treatment programs have been effective in children (Oude Luttikhuis et al., 2009; Waters et al., 2011) but somewhat less so in adults (Appel et al., 2011; Wing & Phelan, 2005). Thus, there remains much to learn about these complex behaviors and how to effectively intervene in diverse settings and populations.This issue of

Comment

Previous articleNext article FreeCommentFrancesco GiavazziFrancesco GiavazziBocconi University, MIT, and NBER Search for more articles by this author PDFPDF PLUSFull Text Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinked InRedditEmailQR Code SectionsMoreTable 1 (from Favero, Giavazzi, and Perego 2012) illustrates the extent to which fiscal policy reacts to fluctuations in the (lagged) debt/GDP ratio. The table reports the estimated coefficients on the debt/GDP ratio in the fiscal reaction function of eight OECD countries (the data are annual and extend from 1978 to 2009). Debt stabilization plays a role in all countries, as the difference between the feedback coefficients on taxes and government spending implies a positive feedback of the primary surplus to the debt to GDP ratio, with Japan as the only exception. The style of stabilization is, however, heterogenous across countries: lagged debt impacts more significantly (with a negative sign) on expenditures in Canada, the United Kingdom, and in the United States, while it has instead a borderline significant (positive) coefficient on taxes in France. Italian fiscal policy reacts to fluctuations in the debt/GDP ratio by adjusting both taxes and spending.Table 1 . Coefficients of bt–1 ExpendituresRevenuesCountries gtτtBelgium –.038.030 (–.27)(.35)Canada –.149–.072 (–2.25)(.27)France .036.144 (.57)(1.56)Italy –.110.218 (–2.12)(3.18)Japan .015.180 (.10)(1.52)Sweden –.072581.045513 (–.64)(.38)United Kingdom .183.086 (2.02)(.47)United States –.292.47 (–2.23)1(1.62) 1 Source. Favero et al. (2011).Notes. t-stats in parentheses. Yearly data: 1978–2009.View Table ImageThe authors assume that “the costs of changing the tax rates and their enforcement are high relative to the lower political costs of changing the public debt/GDP and the fiscal deficit/GDP. The tax base depends on structural factors that are harder to modify in the short run than adjusting government expenditure.” They thus contend that “the tax revenue as a share of the GDP provides a more efficient way of normalizing macro public finance data [because] the public debt/GDP normalized by the de facto tax base measures the average tax years that it would take to ‘buy’ the outstanding public debt, and provides a stock measure of public debt overhang.” The results in table 1 show that some countries—Italy, and to some extent France, in our sample—do instead adjust taxes. Others use changes in government spending, a variable that the authors implicitly assume to remain constant.Thus, while the authors address a very interesting issue—the sources of heterogeneity in fiscal policy—by concentrating on one variable, their definition of fiscal space, they overlook a number of other factors that determine a government’s reaction to exogenous shocks and to their effect on the debt/GDP ratio. The extent to which a government will use fiscal policy to cushion the effects of a shock, thus letting the debt ratio rise, depends in the end on the credibility of its commitment to satisfy the intertemporal budget constraint(DY)t=∑i=0∞(Tt−1Yt−1−Gt−1Yt−1)i(1+r1+g)i.This does depend on the ability to adjust tax rates, but also spending, and most importantly, depends on the distance of the cost of debt service from the economy’s growth rate. NotesFor acknowledgments, sources of research support, and disclosure of the author’s material financial relationships, if any, please see http://www.nber.org/chapters/c12500.ack.ReferenceGiavazzi, Francesco, Carlo A. Favero, and Jacopo Perego. 2012. “Country Heterogeneity and the International Evidence on the Effects of Fiscal Policy.” IMF Economic Review, forthcoming.First citation in articleGoogle Scholar Previous articleNext article DetailsFiguresReferencesCited by Volume 8, Number 12012 Article DOIhttps://doi.org/10.1086/663665 Views: 103Total views on this site © 2012 by the National Bureau of Economic ResearchPDF download Crossref reports no articles citing this article.

Schizophrenia in a worldwide perspective: explaining similarities and differences

Schizophrenia in a worldwide perspective: explaining similarities and differences

Obesity and overweight in Canada: an updated cost‐of‐illness study

This study is to update the estimates of the economic burden of illness because of overweight and obesity in Canada by incorporating the increase in prevalence of overweight and obesity, findings of new related comorbidities and rise in the national healthcare expenditure. The burden was estimated from a societal perspective using the prevalence-based cost-of-illness methodology. Results from a literature review of the risks of 18 related comorbidities were combined with prevalence of overweight and obesity in Canada to estimate the extent to which each comorbidity is attributable to overweight and obesity. The direct costs were extracted from the National Health Expenditure Database and allocated to each comorbidity using weights principally from the Economic Burden of Illness in Canada. The study showed that the total direct costs attributable to overweight and obesity in Canada were $6.0 billion in 2006, with 66% attributable to obesity. This corresponds to 4.1% of the total health expenditures in Canada in 2006. The inclusion of newly identified comorbidities increased the direct cost estimates of obesity by 25%, while the rise in national healthcare expenditure accounted for a 19% increase. Policies to reduce being overweight and obese could potentially save the Canadian healthcare system millions of dollars.

Agricultural Trade among NAFTA Countries: A Case Study of U.S. Meat Exports

The U.S. NAFTA partners are important markets for U.S. meat exports. A source-differentiated almost ideal demand system is used in this study to estimate meat demand in Canada and Mexico. Empirical results suggest that while a U.S. price increase in the Canadian market is expected to increase U.S. sales revenues; it would decrease sales revenues in the Mexican market. Furthermore, an increase in meat expenditures in Canada and Mexico is expected to increase the demand for U.S. meats, while the bovine spongiform encephalopathy outbreaks have had a negative effect on U.S. and Canadian beef market shares. Finally, a decomposition of the causes of changes in demand for U.S. meats over time is performed.

Bailing out expectations and public health expenditure

We use a “natural experiment”, the fiscal adjustment of Italy in the 1990s to meet the Maastricht criteria, to test a simple model of soft budget constraint that closely resembles the intergovernmental relationships in the Italian public health care sector. We show that the link between the ex-ante financing by the Central government and the health expenditure by regions was stronger when regional expectations of future bailing outs were presumably lower. Confirming previous research, we also prove that more fiscally autonomous regions were more financially responsible and that a political “alignment” effect was present, with “friendly” regional governments controlling more expenditure than unfriendly ones. Our results suggest that, at least in Italy, bailing out expectations by regions may be the missing variable emphasised by [Culyer A.J., 1988. Health care expenditures in Canada: Myth and reality. Canadian Tax Papers, 82] for empirical models explaining health expenditure. Our results also raise some worries about the outcome of the current decentralization process in Europe.