Higher Self-rated Health Research Articles

Examining the relationship between different physical activities and health and well-being in middle-aged and older men: an isotemporal substitution analysis

BackgroundWell-being declines during men’s middle years, and while physical activity (PA) can have a positive influence, the type of PA that provides the greatest benefit is not clear. This cross-sectional...

Self-assessment of health and care for health among employed men in Poland

Objectives. Self-assessment of health is one of the most important factors determining manifestations in care for health, expressed in health-promoting behaviours. The way a person takes care of their health affects not only their health but also their well-being, quality of life and work ability. This study aimed to present results regarding self-assessment of health and care for health and the relationship with work ability in a group of working men aged 20–65 years. Methods. The sample of 600 men were assessed using a survey. The work ability index was used to measure work ability. An original survey was developed, which included questions about self-assessment of health and taking care of health, motives for taking care of health, physical activity, healthy eating and smoking. Results. Most men rated their health well and declared that they took care of it. Low health scores were obtained among overweight men, men without physical activity, men with unhealthy nutrition and smokers. High self-rated health was associated with good work ability. Conclusions. There is a constant need to make men of all ages aware of the role of individual health care in maintaining good health and high work ability.

Mental health and BMI in children and adolescents during one year in obesity treatment

BackgroundMental health plays a major role in children and adolescents with obesity. The aim of this study was (1) to compare mental health in children with obesity with the background population and (2) to investigate if mental health changed during one year in an obesity treatment program.MethodsData on self-reported mental health was collected in 107 children and adolescents (mean age 13.2 years) with obesity at first visit in an obesity treatment program and at one year follow-up (n = 47). Mental health was assessed by eight questions from the Danish Health Behaviour in School-aged Children (HBSC) questionnaire: (1) self-rated health (2) life satisfaction (3) feeling low (4) body-image (5) loneliness (6) self-esteem (7) self-efficacy and (8) social competence. Data was compared to a reference population based on HBSC data. BMI-SDS was based on Danish reference values.ResultsChildren and adolescents with obesity had significantly higher odds of reporting negative body image and feeling low and lower odds of reporting high self-rated health and high self-esteem compared to a reference population. There was no difference between the groups regarding life-satisfaction, social competence, self-efficacy or feeling lonely. There were no significant changes in mental health from first visit to one-year follow-up.ConclusionOur findings highlight the mental health difficulties in children and adolescents with obesity, and the importance of addressing these issues in obesity treatment. The results also indicate that children with obesity have psychosocial resources that should be exploited in treatment protocols.

Relationship between parental acceptance of the COVID-19 vaccine and attitudes towards measles vaccination for children: A cross-sectional study

BackgroundThe COVID-19 pandemic has led to decreased measles vaccination rates globally, exacerbating vaccine hesitancy. This study examines the relationship between COVID-19 vaccine acceptance and childhood measles vaccination among parents in Hong Kong. MethodsA cross-sectional online survey was conducted in Hong Kong from March to September 2022. Parents were recruited via the Qualtrics panel, and a total of 588 parents were invited via email or social media account to participate in the survey. We used the adjusted Measles-containing Vaccine Hesitancy Scale for the assessment of parental vaccine hesitancy for children. A multiple linear regression analysis was conducted to examine the association between parental acceptance of the COVID-19 vaccine and their attitudes towards childhood measles vaccination. ResultsOf the 588 participants, parents who have been vaccinated against COVID-19 exhibited significantly less measles-containing vaccine hesitancy comparing to those unvaccinated (β = −2.96, 95% confidence interval [CI]: −5.10 to −0.83, p = 0.007). Mothers exhibited more hesitancy compared to fathers (β = 1.64, 95% CI: 0.60 to 2.68, p = 0.002). Parents with a higher self-rated health (β = −2.20, 95% CI: −3.21 to −1.20, p < 0.001), or who have received advice from health professionals to offer measles, influenza, or COVID-19 vaccines for kids (β = −2.41, 95% CI: −3.49 to −1.32, p < 0.001) had lower levels of hesitancy. ConclusionCOVID-19 vaccine status of parents was associated with reduced hesitancy towards measles vaccines for their children. Addressing vaccine hesitancy effectively requires targeted communication strategies, particularly focusing on those unvaccinated and leveraging the influence of healthcare professionals.

Who uses connected health technologies after a cancer diagnosis? evidence from the US Health Information National Trends Survey.

As the number of people living with and beyond cancer increases, connected health technologies offer promise to enhance access to care and support, while reducing costs. However, uptake of connected health technologies may vary depending on sociodemographic and health-related variables. This study aimed to investigate demographic and health predictors of connected health technology use among people living with and beyond cancer. Cross-sectional data from the US Health Information National Trends Survey Version 5 Cycle 4 (H5c4) was used. Regression analysis was used to examine associations between sociodemographic factors and the use of connected health technologies. The sample was restricted to individuals who self-reported a cancer diagnosis or history of cancer. In this cycle, 626 respondents self-reported a cancer diagnosis, with 41.1% using connected health technologies (health and wellness apps and/or wearable devices). Most were female (58.9%) and white (82.5%); 43.4% had graduated college or higher education. One third (33.6%) had a household income of $75,000 or more. Respondents who were younger, have higher education, were living as married, had higher incomes, had higher self-rated health and had higher health-related self-efficacy were significantly more likely to use connected health technologies. There were no significant associations between gender, race, stratum, time since diagnosis, history of anxiety or depression, and use of connected health technologies among people living with and beyond cancer. Connected health technology use among people living with and beyond cancer is associated with sociodemographic factors. Future research should examine these demographic disparities as the use of connected health technologies in healthcare continues to gather momentum. The study underscores a disparity in connected heath technology usage among people living with and beyond cancer. There is a pressing need for research into adoption barriers and interventions to ensure equitable digital healthcare integration among this population, especially with the heightened adoption of technology post COVID-19 pandemic.

Disparities in positive mental health of sexual and gender minority adults in Canada.

The goal of this study was to examine potential disparities in positive mental health (PMH) among adults in Canada by sexual orientation and gender modality. Using 2019 Canadian Community Health Survey (CCHS) Annual Component data (N = 57 034), we compared mean life satisfaction and the prevalence of high self-rated mental health (SRMH), happiness and community belonging between heterosexual and sexual minority adults, and between cisgender and gender minority adults. We used 2019 CCHS Rapid Response on PMH data (N = 11 486) to compare the prevalence of high psychological well-being between heterosexual and sexual minority adults. Linear and logistic regression analyses examined the between-group differences in mean life satisfaction and the other PMH outcomes, respectively. Sexual minority (vs. heterosexual) adults reported lower mean life satisfaction (B = -0.7, 95% CI: -0.8, -0.5) and were less likely to report high SRMH (OR = 0.4, 95% CI: 0.3, 0.5), happiness (OR = 0.4, 95% CI: 0.3, 0.5), community belonging (OR = 0.6, 95% CI: 0.5, 0.7) and psychological well-being (OR = 0.4, 95% CI: 0.3, 0.6). Differences were not always significant for specific sexual minority groups in sexstratified analyses. Gender minority adults reported lower mean life satisfaction and were less likely to report high SRMH and happiness than cisgender adults. Future research could investigate how these PMH disparities arise, risk and protective factors in these populations, how other sociodemographic factors interact with sexual orientation and gender identity to influence PMH and changes in disparities over time.

Physical activity, physical fitness and self-rated health: cross-sectional and longitudinal associations in adolescents

ObjectivesTo evaluate the independent associations of physical activity and physical fitness with self-rated health in adolescents.MethodsData from a 2-year observational study (2013–2015) were used (n=256, 58% girls, 13.7±0.3 years at...

An individually adjusted approach for communicating epidemiological results on health and lifestyle to patients

If scientific research on modifiable risk factors was more accessible to the general population there is a potential to prevent disease and promote health. Mobile applications can automatically combine individual characteristics and statistical models of health to present scientific information as individually tailored visuals, and thus there is untapped potential in incorporating scientific research into apps aimed at promoting healthier lifestyles. As a proof-of-concept, we develop a statistical model of the relationship between Self-rated-health (SRH) and lifestyle-related factors, and a simple app for conveying its effects through a visualisation that sets the individual as the frame of reference. Using data from the 6th (n = 12 981, 53.4% women and 46.6% men) and 7th (n = 21 083, 52.5% women and 47.5% men) iteration of the Tromsø population survey, we fitted a mixed effects linear regression model that models mean SRH as a function of self-reported intensity and frequency of physical activity (PA), BMI, mental health symptoms (HSCL-10), smoking, support from friends, and HbA1c ≥ 6.5%. We adjusted for socioeconomic and demographic factors and comorbidity. We designed a simple proof-of-concept app to register relevant user information, and use the SRH-model to translate the present status of the user into suggestions for lifestyle changes along with predicted health effects. SRH was strongly related to modifiable health factors. The strongest modifiable predictors of SRH were mental health symptoms and PA. The mean adjusted difference in SRH between those with 10-HSCL index = 1.85 (threshold for mental distress) and HSCL-10 = 1 was 0.59 (CI 0.61–0.57). Vigorous physical activity (exercising to exhaustion ≥ 4 days/week relative to sedentary) was associated with an increase on the SRH scale of 0.64 (CI 0.56–0.73). Physical activity intensity and frequency interacted positively, with large PA-volume (frequency ⨯ intensity) being particularly predictive of high SRH. Incorporating statistical models of health into lifestyle apps have great potential for effectively communicating complex health research to a general audience. Such an approach could improve lifestyle apps by helping to make the recommendations more scientifically rigorous and personalised, and offer a more comprehensive overview of lifestyle factors and their importance.

Health care barriers and perceived mental health among adults in Canada during the COVID-19 pandemic: a population-based cross-sectional study.

The perceived mental health of individuals in Canada who faced health care barriers during the COVID-19 pandemic is underexplored. We analyzed data collected March to June 2021 from adults who reported needing health care services within the past 12 months in the Survey on Access to Health Care and Pharmaceuticals during the Pandemic. Unadjusted and adjusted logistic regression analyses examined the associations between health care barriers (appointment scheduling problems, delaying contacting health care) and high self-rated mental health and perceived worsening mental health compared to before the pandemic, overall and stratified by gender, age group, number of chronic health conditions and household income tertile. Individuals who experienced pandemic-related appointment changes or had appointments not yet scheduled were less likely to have high self-rated mental health (aOR = 0.81 and 0.64, respectively) and more likely to have perceived worsening mental health (aOR = 1.50 and 1.94, respectively) than those with no scheduling problems. Adults who delayed contacting health care for pandemic-related reasons (e.g. fear of infection) or other reasons were less likely to have high self-rated mental health (aOR = 0.52 and 0.45, respectively) and more likely to have perceived worsening mental health (aOR = 2.31 and 2.43, respectively) than those who did not delay. Delaying contacting health care for pandemic-related reasons was associated with less favourable perceived mental health in all subgroups, while the association between perceived mental health and pandemic-related appointment changes was significant in some groups. Health care barriers during the pandemic were associated with less favourable perceived mental health. These findings could inform health care resource allocation and public health messaging.

How does social integration work when older migrants obtain health services from community? Evidence from national database in China.

The roles of community are often overlooked when studying the older migrants' health issues, and more importantly, the mediating effect of social integration on the health of older migrants were rarely investigated empirically. This study developed comprehensive index to explore this relationship. With data from the 2017 China Migrants Dynamic Survey, the study first examined the potential linkage between community-based health services and the health of older migrants. Ordered logit regressions was carried to investigate whether the self-rated health of older migrants is related to health education and health records provided by community, then the Causal Stepwise Regression and bootstrap method was used to looked into the potential mediation effect. The findings showed that older migrants with more community-based health education had higher self-rated health (β = 0.038, SE = 0.009, p < 0.001). However, the community-based health records were not associated with older migrants' health. Moreover, higher levels of social integration were associated with community health education (β = 0.142, SE = 0.014, p < 0.001), and social integration was positively associated with older migrants' health (β = 0.039, SE = 0.002, p = 0.024), indicating the mediation role of social integration. The vital role of community-based health education in improving the health of older migrants was found, and social integration plays a mediating role.

Determinants of Self-Rated Health Disparities among Independent Community-Dwelling Older Adults: An Age-Stratified Analysis

In response to the distinctive healthcare requirements of independent, healthy, community-dwelling older adults in Japan and other developed countries with aging populations, the current study examined the differences in factors associated with self-rated health (SRH) between the following two age groups: young–old (65–74) and old–old (75 and above). Age-stratified analysis was used to provide a comprehensive understanding of the unique health challenges faced by these demographic segments and to inform the development of targeted interventions and health policies to improve their well-being. The results of a cross-sectional study of 846 older adults in Yokohama, Japan, who completed self-administered questionnaires, revealed that high SRH was consistently linked with the low prevalence of concurrent medical issues in both age groups (&lt;75 and ≥75) (β: −0.323, p &lt; 0.001 in the &lt;75 group; β: −0.232, p &lt; 0.001 in the ≥75 group) and increased subjective well-being (β: 0.357, p &lt; 0.001 in the &lt;75 group; β: 0.244, p &lt; 0.001 in the ≥75 group). Within the ≥75 age group, higher SRH was associated with more favorable economic status (β: 0.164, p &lt; 0.001) and increased engagement in social activities (β: 0.117, p = 0.008), even after adjusting for age, sex, and economic status. These findings may inform the development of targeted interventions and policies to enhance the well-being of this growing population in Japan and other developed countries.

The nexus of food and nutrition security in youth: linking a Canadian survey and administrative data

Abstract Background Food insecurity is impacted by social determinants of health and is a risk factor for poor nutrition. Simultaneously, nutrition insecurity remains a pervasive public health concern in wealthy countries, especially for children. This study describes characteristics of youth that may increase risk of food and nutrition insecurity. Methods A cross-sectional study of grade nine students took place in 37 schools in Manitoba, Canada. Students completed a web-based survey on food security, diet, and nutrition-related behaviours. When consenting, parents/guardians could provide their child's health number. This sub-sample (n = 943) was linked with social and health variables through a de-identified data repository and used for this study. Bivariate associations explored relationships between sociodemographic information, diet quality, eating behaviours, mental health, and food security. A multivariable logistic regression model determined adjusted odds ratios and 95% confidence limits for food security, and a general linear model for diet quality. Significance was set at p &amp;lt; 0.05 for all analyses. Results Twenty percent of participants were food insecure and 70% had sub-optimal diets. Food security was positively associated with living in a rural area, in higher income neighbourhoods and eating family dinner more frequently, while living in a northern area or in social housing, were negatively associated. Food security was not significantly related to diet quality; however, better nutrition was associated with being female, higher self-rated health, absence of a mental health diagnosis, and more frequent breakfast consumption, while receiving social assistance and living in a northern area were negatively associated with diet. Conclusions While results show a socioeconomic and geographic vulnerability to food insecurity, the diet quality of most adolescents was low. A multidimensional public health approach is needed to resolve these connected yet different issues. Key messages • Food insecurity and nutrition insecurity are public health concerns that require distinct but related interventions. • Scaling up income supports to resolve food insecurity is insufficient to improve dietary quality across adolescent populations.

Time to look at self-rated health: Do time attitudes scores explain variance in self-rated health beyond health indicators?

Time attitudes refer to the way in which individuals feel about the past, present, and future and are associated with a range of health outcomes. In the present study, we examined the relationship between time attitudes and self-rated health, adjusted for a range of health indicators, sex, and a proxy for socio-economic status. Participants were school children (N = 3447; 58.8 % female) in the United Kingdom. Time attitudes scores were used to yield clusters, which were entered as factors in Multinomial Logistic Regression models, along with sex and free school meal entitlement (yes/no). Self-rated health was the dependent variable, and other health indicators were entered as covariates. Results showed that most health measures were significantly related to self-rated health. Higher self-rated health was also significantly associated with being male and having higher socio-economic status. Time attitudes clusters explained variance in self-rated health beyond that explained by health-related variables. The results add to a growing literature on a relationship between time attitudes and health outcomes. Based on existing work, it is suggested that interventions focused on time attitudes might be a viable way of promoting health behaviours. However, investigating this claim will require future longitudinal, behaviour change studies.

Health behaviours associated with healthy body composition among Aboriginal adolescents in Australia in the ‘Next Generation: Youth Well-being study’

This study described the distribution of healthy body composition among Aboriginal adolescents in Australia aged 10–24 years and examined associations with health behaviours and self-rated health. Data were cross-sectional from the ‘Next Generation: Youth Well-being study’ baseline (N = 1294). We used robust Poisson regression to quantify associations of self-reported health behaviours (physical activity, screen time, sleep, consumption of vegetables, fruit, soft drinks and fast food, and tobacco smoking and alcohol) and self-rated health to healthy body mass index (BMI) and waist/height ratio (WHtR). Overall, 48% of participants had healthy BMI and 64% healthy WHtR, with healthy body composition more common among younger adolescents. Higher physical activity was associated with healthy body composition (5–7 days last week vs none; adjusted prevalence ratio (aPR) healthy BMI 1.31 [95% CI 1.05–1.64], and healthy WHtR 1.30 [1.10–1.54]), as was recommended sleep duration (vs not; aPR healthy BMI 1.56 [1.19–2.05], and healthy WHtR 1.37 [1.13–1.67]). There was a trend for higher proportion of healthy body composition with more frequent fast food consumption. Healthy body composition was also associated with higher self-rated health (‘very good/excellent’ vs ‘poor/fair’; aPR healthy BMI 1.87 [1.45–2.42], and healthy WHtR 1.71 [1.40–2.10]). Culturally appropriate community health interventions with a focus on physical activity and sleep may hold promise for improving body composition among Aboriginal adolescents.

Racism hurts, can antiracism heal?: Positive mental health correlates of antiracist engagement.

Racism can hurt by negatively impacting mental health. For instance, large-scale events tied to racism like the May 2020 police-involved murder of George Floyd have been linked to poor mental health indicators (e.g. depression and anxiety). Notably, racism can spark antiracist engagement-support for addressing systemic racism. For example, Floyd's murder sparked unprecedented antiracist engagement, including heightened Black Lives Matter (BLM) support and protest participation. The present research explored the potential that antiracist engagement can heal: be positively associated with well-being. First, study 1 found that state-level BLM engagement (i.e. protest numbers, antiracism information-seeking on Google/YouTube) during an 8-week period following Floyd's death was associated with positive mental health indicators (i.e. lower depression and anxiety, higher self-rated health). It found these effects among racial/ethnic minorities (e.g. Black/African Americans, Hispanics, N = 161,359) and Whites (N = 516,002). Then, study 2 examined social media data (i.e. tweets) and emotional well-being. It used a measure of happiness indexed across 144,649,285,571 tweets from 2019 through 2021. It found a positive correlation between the volume of tweets with antiracist engagement content (e.g. referenced efforts to address systemic racism) and the happiness measure. Finally, study 3 examined antiracism protest data/information-seeking and a sample of BLM tweets (N = 100,321) posted between April and July 2020. Conceptually replicating studies 1-2, study 3 found that antiracist engagement was associated with greater positive emotion/sentiment (e.g. happiness) relative to negative emotion/sentiment (e.g. anxiety). Relevant to theory and policy, the observed results suggest that antiracist engagement can be associated with benefits for well-being across racial/ethnic groups.

Comparison of attempts and plans to quit tobacco products among single, dual, and triple users.

Tobacco users are categorized as single, dual, and triple users based on the number of tobacco products (cigarettes, e-cigarettes, and heated tobacco products) used. This study addressed a literature gap by examining how adult Korean tobacco users' quit attempts/plans differed based on the user type, and the associated psychosocial and subjective health-related factors. We used a questionnaire to examine participants' self-reported health, stress, health concerns, health behavior, tobacco addiction, intentions/plans to quit, and demographic characteristics. Data were analyzed using chi-squared tests, one-way analysis of variance, and multiple linear regression. Of the 1288 tobacco users, 55.4%, 28.3%, and 16.4% were single, dual, and triple users, respectively. Self-rated health and stress were lowest among single users and highest among triple users. Most user types had intentions/plans to quit, especially triple users. Quit attempts and plans increased with increasing health behaviors and time elapsed before first tobacco use in the morning, but decreased with higher stress and self-rated addiction. Intentions/plans to quit tobacco use varied based on the type of tobacco user. Multiple users had higher self-rated health, plans to quit, and self-reported addiction; they considered themselves healthy or engaged in healthy behaviors to offset problems from tobacco use and used multiple tobacco products to quit smoking. Highly stressed users had fewer plans to quit and used tobacco for stress relief. Thus, the provision of accurate information about tobacco products and stress management is important to promote successful quitting.

Improving Women’s Happiness and Self-Rated Health and Social Capital in Rural Cambodia

Achieving a state of happiness and good health is undoubtedly important for people&amp;rsquo;s mental health. It is a challenging feat in any country, but more so in developing countries. However, scant research exists on the happiness and self-rated health of people in developing countries. To examine the impact of social capital on women&amp;rsquo;s happiness and self-rated health in rural Cambodia, this study applies ordinal logit regression on the interview data of 283 women living in Siem Reap. The following factors positively impacted the happiness of the women: high household income, lending of money to others, high level of trust toward family, social participation, and having high self-rated health. The following factors were associated with higher self-rated health, similarly as with happiness: high level of trust toward family, lending of money to others, social participation, and higher number of surviving children. However, self-rated health decreased when the women were of advanced age, had given birth to many children, or had received poverty identification. The novelty of this study is that it provides a valuable insight into the impact of social capital on the happiness and self-rated health of women in rural Cambodian villages.

Associations for Sense of Purpose with Smoking and Health Outcomes Among Adults with Diabetes

BackgroundHealth complications from diabetes place major strain on individuals, financially and emotionally. The onset and severity of these complications are largely driven by patients’ behaviors, making psychosocial factors that influence behaviors key targets for interventions. One promising factor is sense of purpose or the degree to which a person believes their life has direction.MethodThe current study investigated whether sense of purpose predicts self-rated health, cardiovascular disease, and smoking status among adults with diabetes concurrently and prospectively. Moreover, it tested whether these associations held across multiple samples and cultures. Coordinated analysis using 12 datasets cross-sectionally and eight longitudinally (total N = 7277) estimated the degree to which sense of purpose is associated with subjective health, smoking status, and cardiovascular disease among adults with diabetes. Coordinated analysis allows for greater generalizability of results across cultures, time periods, and measurement instruments. Datasets were included if they concurrently included a measure of sense of purpose and diabetes status and at least one health measure: self-rated health, current smoking status, or heart condition status.ResultsSense of purpose was associated with higher self-rated health, smoking status, and cardiovascular disease cross-sectionally and self-rated health prospectively. Purpose was unassociated with changes in health over time.ConclusionThese results highlight the relationship of a key individual difference, sense of purpose, to the behaviors and outcomes of adults with diabetes. While more research is needed to determine the boundaries of this relationship, it seems sense of purpose may be considered in the future as a potential target for intervention.

Self-rated health, interviewer-rated health, and objective health, their changes and trajectories over time, and the risk of mortality in Chinese adults.

Self-rated health (SRH), interviewer-rated health (IRH), and objective health reflect the overall health status from different aspects. This study aimed to investigate the associations of SRH, IRH, and objective health with mortality among Chinese older adults. This study used data from the 2008 (baseline), 2011, 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. SRH and IRH were evaluated by questionnaire. Objective health was evaluated by the Chinese multimorbidity-weighted index (CMWI), which incorporated 14 diagnosed chronic diseases. SRH, IRH, and CMWI were assessed as: (1) baseline levels; (2) longitudinal changes by subtracting the values obtained in 2008 from the corresponding values in 2014; (3) trajectories by Group-Based Trajectory Modeling, respectively. The Cox proportional hazards model was used to explore the associations of baseline SRH, IRH, and CMWI, their changes, and trajectories with mortality. A total of 13,800 participants were included at baseline (2008). The baseline SRH ([hazard ratio] 0.93, [95% confidence interval] 0.91-0.96), IRH (0.84, 0.81-0.87), and CMWI (0.99, 0.98-1.00) in 2008 were significantly associated with 10-year mortality (2008 to 2018). Among 3,610 participants, the changes of SRH (0.93, 0.87-0.98), IRH (0.77, 0.71-0.83), and CMWI (0.97, 0.95-0.99) from 2008 to 2014 were significantly associated with 4-year mortality (2014-2018). The trajectories were divided into "high SRH/IRH/CMWI" and "low and declining SRH/IRH/CMWI." Compared with "low and declining SRH/IRH/CMWI," "high SRH" (0.58, 0.48-0.70), "high IRH" (0.66, 0.55-0.80), and "high CMWI" (0.74, 0.61-0.89) from 2008 to 2014 were significantly associated with 4-year mortality (2014-2018). Baseline SRH, IRH, and CMWI, their changes and trajectories are all associated with mortality in Chinese older adults. It is possibly necessary to promote the use of cost-effective indicators in primary medical institutions to improve the health management of the older adults.

Associations of sleep duration and sleep quality with indicators of mental health among youth and adults: findings from the 2015 Canadian Community Health Survey.

A growing number of Canadian studies have examined the link between sleep and mental health. This research builds upon that work by investigating associations of sleep duration and quality with positive mental health (PMH) and mental illness and suicidal ideation (MI/SI) outcomes among youth and adults from threeCanadian provinces (i.e. Ontario, Manitoba and Saskatchewan). Using cross-sectional data from respondents 12 years and older (n = 18 683) who were asked questions on their sleep in the 2015 Canadian Community Health Survey - Annual Component, we conducted unadjusted and adjusted logistic regressionswith self-reported measures of sleep duration and sleep quality as independent variables and a range of PMH (e.g. high self-rated mental health) and MI/SI indicators (e.g. mood disorder diagnosis) as dependent variables. Analyses were conducted of allcomplete cases and also stratified by sex and age group. Good sleep quality was associated with higher odds of PMH indicators (adjusted odds ratio [aOR]: 1.52-4.24) and lower odds of MI/SI indicators (aOR: 0.23- 0.47); associations remained significant when analyses were stratified. Meeting sleep duration recommendations was positively associated with PMH indicators (aOR: 1.27- 1.56) and negatively associated with MI/SI indicators (aOR: 0.41-0.80), but some associations did not remain significant when stratified. This study provides support for associations between sleep duration and quality and indicators of PMH and MI/SI. Findings can inform future research and surveillance efforts that monitor sleep behaviours and indicators of PMH and MI/SI.