University of Toronto Journal of Public Health最新文献

{"title":"Developing Resources for Staff and Adapting Programing During COVID-19 at Fred Victor","authors":"Claire Carnegie","doi":"10.33137/utjph.v2i2.36835","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36835","url":null,"abstract":"Fred Victor is an organization that supports those experiencing poverty and homelessness in Toronto. As a practicum student in the Health Promotions department at Fred Victor, I gained experience working on health promotion projects and was able to work directly with the community. Throughout the practicum, I worked on several projects to adapt Fred Victor’s services during COVID-19. First, I worked to develop a resilience toolkit for Fred Victor staff. COVID-19 has led to higher levels of stress. This prompted Fred Victor to develop tools to support their staff. I designed a toolkit that instructs managers on how to promote resilience in their supervision sessions and team meetings. This toolkit provided information on what resilience is, as well as practical actions that managers can take to promote resilience in staff. This project involved knowledge translation to convey the research on resilience to Fred Victor staff in an accessible way. Additionally, I worked to support the development of online peer support groups. Typically, Fred Victor runs weekly in-person peer support groups for community members. However, due to COVID-19, these groups had to move to an online format. I helped facilitate this transition by developing a guide for facilitating online group programming. This guide included information on the best platforms to run online programming, how to create a safety agreement, and best practices for facilitating the group. I then conducted outreach to community members to ask for their input on the format and content of the groups. These projects are important to public health as they work to meet the public health goal to improve quality of life by promoting and encouraging healthy behaviours. These projects played an important role in promoting the health of Fred Victor staff and clients during COVID-19 by providing them with support and tools to manage their mental health.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127005406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetics of skin intrinsic florescence","authors":"Jiamin Guo, Andrew Paterson, D. Roshandel","doi":"10.33137/utjph.v2i2.36843","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36843","url":null,"abstract":"Introduction & Objective: Cumulated advanced glycation end products (AGEs) in the bloodstream and tissues contribute to the pathogenesis of diabetes complications. The skin intrinsic fluorescence (SIF) is a non-invasive measurement of dermal AGEs level using spectrometer, and it can be used as a biomarker in AGEs-related diseases. Previously, specific epigenomic factor has been found to be associated with haemoglobin A1c (HbA1c). HbA1c is a type of glycated haemoglobin – the HbA1c test measures the average glycemic control over the period of 3 months. However, the effect of epigenetic factors on the level of AGEs in the skin remains unknown. We hypothesize that some cytosine-guanine dinucleotides (CpGs) are associated with SIF. An epigenome-wide associations study (EWAS) was performed to identify CpG sites associated with SIF in people with type 1 diabetes. \u0000Methods: 499 people with type 1 diabetes that have both methylation and SIF from the Diabetes Control Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study were included. We fit linear regression models for SIF with each CpG site one at a time. The epigenome-wide significance level (p=5e-8) was applied. Then the result is compared with the null hypothesis where CpGs are not associated with SIF to check the inflation. In order to check the assumptions of the multiple linear models at a single CpG, we use diagnostic plots. \u0000Results: We did not identify a specific CpG that is significantly associated with neither skin intrinsic fluorescence 1 (SIF1) nor skin intrinsic fluorescence 12 (SIF 12).The CpG site with strongest effect is cg06538183 ([SE] -2.73 [0.61], p = 8.72e-6) on SIF1 and cg12871967 ([SE] 2.52, 0.53, p = 2.71e-6) on SIF12. \u0000Conclusion: We did not find any specific CpG that was significantly associated with either SIF 1 or SIF12. In general, the result suggests that DNA methylation does not impact the accumulation of AGEs in skin cells. DNA methylation data has a unique pattern of distribution that drives the non-uniform distribution of the p-values. The group of 275,301 CpGs that have means above the median and standard deviations below the median has the expected uniform p-value distribution.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120894703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translations for Our Nations: Addressing the Indigenous Language Gap in COVID-19 Health Communication","authors":"Thilaxcy Yohathasan, Sterling Stutz","doi":"10.33137/utjph.v2i2.36897","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36897","url":null,"abstract":"Purpose: The availability of culturally safe and plain-language resources is necessary to reduce the spread of COVID-19 for Indigenous communities around the world. Translations For Our Nations is an initiative addressing these resource gaps, making available COVID-19 health resources in Indigenous languages on the web. The project began in April 2020 as a result of the Indigenous COVID-19 Health Partnership launched by Victor A. Lopez-Carmen, a Dakota and Yaqui medical student, Harvard Medical School) and co-founded by Sterling Stutz and Thilaxcy Yohathasan, (MPH-Indigenous Health at the University of Toronto), and Sukhmeet Singh Sachal (medical student, University of British Columbia). \u0000Methods: Translators from Indigenous communities around the world signed up to participate in the project via a GoogleForm in April 2020. Over 100 Indigenous translators and community members in regions (South America, Asia, Africa, Europe, North America, and the Pacific) were provided the 5 English language source materials reviewed by physicians and Indigenous youth leaders. Translators submitted their translated documents via email and on September 1, 2020 the website Translations4OurNations.org was launched where the translated documents can be accessed and downloaded with more translations accepted on a rolling basis. \u0000Results: Translations for our Nations has published COVID-19 health resources in 40+ Indigenous languages from around the world. The website also includes photos and text submissions from community members speaking to the importance of culturally-specific COVID-19 health information disseminated directly to communities in local languages and dialects. \u0000Implications:  Indigenous Nations have the right to access vital health information in their mother tongue. This project is led by and designed for Indigenous youth and Indigenous community members to empower individuals and communities to make informed choices regarding their health and exposure risks, and decrease the risk of COVID-19 transmission in Indigenous communities around the world.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128997400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Impact of Alcohol Control Interventions on Suicide Mortality Rates","authors":"Xinyang Feng, Huan Jiang","doi":"10.33137/utjph.v2i2.36827","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36827","url":null,"abstract":"Introduction & Objective: Given that the impact of regulatory and public policy initiatives cannot usually be tested through traditional randomized controlled trial designs, well-selected, -designed, and -analyzed natural experiments are the method of choice when examining the effects of such enactments on a variety of outcomes. The classic methodology for such evaluations is interrupted time-series (ITS) analysis, which is considered as one of the quasi-experimental designs that use both pre- and post-policy data without randomization. This study tests the impact of alcohol control interventions implemented in different period of times on suicide mortality rates among people 25-74 years of age using ITS. \u0000Methods: We mainly use the generalized additive mixed model (GAMM) to capture trend and seasonality in suicide mortality rates while controlling for unemployment rates, financial crisis during 2007-2008, and legal alcohol consumption records. Given the notable differences in alcohol consumption and suicide mortality between males and females, all analyses are conducted gender-specifically. \u0000Results: The ITS shows that the intervention introduced in 2017 has a significant effect on reducing suicide mortality rates for males between 25 and 74. Following the implementation of the intervention, suicide mortality rates decreased by 23.8% (95% CI: 10.2% - 35.4%) on average. \u0000Conclusion: The alcohol control intervention that strictly increased the excise tax on alcohol products has been shown to have a strong impact on reducing suicide mortality rates among male adults 25-74 years of age. ITS analyses are one of the strongest evaluative designs and allow a more detailed assessment of the longitudinal impact of an intervention than may be possible with a randomized control trial.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125249684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on displaced populations and migrants around the world","authors":"Alifa Siddiqui","doi":"10.33137/utjph.v2i2.36896","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36896","url":null,"abstract":"My practicum placement was completed with the Dalla Lana School of Public Health Centre for Global Health. I have contributed to the work of a team of student and faculty members developing a review of the literature and environmental scan to explore the impact of the COVID-19 pandemic on migrant populations. I worked with colleagues to design and run a search strategy on the Medline (OVID) and Scopus bibliographic databases. The findings showed that crises including the COVID-19 pandemic act as magnifying lens and expose existing inequities within society as the impact of the pandemic is not equally felt by all population groups. Migrant populations are particularly impacted due to their intersectional identities that marginalize and disempower them and severely impact their health outcomes. Even though migration is the engine of the globalized economy and migrant workers make significant contribution to agricultural and economic prosperity, their precarious living conditions have worsened during the pandemic and they are being excluded from relief packages and income support. Furthermore, racism and xenophobia are fuelling hostility and prejudice towards migrants as governments are controlling the movement of migrants by closing their borders to asylum seekers and existing refugee camps are having outbreaks due to cramped and overcrowded living conditions and limited healthcare access. It is evident that migrant populations are very diverse groups that are facing unique challenges and thus, require distinct forms of protection particularly during this pandemic. The results of this work are currently being summarized in a manuscript that recognizes how determinants of health impact the health and well-being of migrants, the need to develop a road map for recovery using a health equity lens, and inform health policies. To eradicate COVID-19, it is imperative to leave no one behind including migrant populations and re-evaluate how inequities are addressed globally.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123802411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Frontline Healthcare Worker's Stress and Recovery Off-Shift during the COVID-19 Pandemic","authors":"Hoora Emami","doi":"10.33137/utjph.v2i2.36841","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36841","url":null,"abstract":"I completed my practicum with 4YouandMe, a non-profit created to aid individuals who are interested in sharing health-related data using smartphones and other wearable devices so that they can better understand and navigate health conditions. The Stress and Recovery Study used the Oura ring and smartphones to track and understand the multidimensional components of stress and recovery off-shift in frontline healthcare workers during the current COVID-19 pandemic. My role in this study was actively working as a clinical research coordinator and digital participant engagement expert. This role consisted of calling participants and asking them about their overall study experience, details regarding their stress triggers, their home and work environments, and use of their Oura ring. I was responsible for maintaining contact with about 70 participants and creating contact logs after each phone call. The purpose of these phone calls is to provide support and encourage participant adherence to the study tasks. In addition to this primary role, I also completed an emerging COVID-19 hotspot map that was used in the recruitment process of the study. I outlined regions in the U.S that may become hotspots for COVID cases and may subsequently translate to a higher stressed group of healthcare workers in those areas. Additionally, I contributed to developing adherence tracking frameworks and other study materials used by team members. This study is contributing to the public health literature by using novel methodologies including digital approaches to understanding stress. Looking at digital stress responses and biometric data as signals to predict infection may inform other tools to aid in early detection.  Finally, the study aims to determine whether resiliency factors and some social determinants of health modify stress and recovery.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125371835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Methicillin-Resistant Staphylococcus aureus (MRSA) Bloodstream Infection Incidence Rates using Canadian Nosocomial Infection Surveillance Program (CNISP)","authors":"Jona Gjevori, K. Abdesselam","doi":"10.33137/utjph.v2i2.36999","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36999","url":null,"abstract":"Methicillin-Resistant Staphylococcus aureus (MRSA) is among the most prevalent nosocomial pathogens globally, causing significant morbidity, mortality, and healthcare costs. MRSA bloodstream infection (BSI) incidence rates in Canadian hospitals have significantly risen by almost 60% and have a mortality of over 20% upon Intensive Care Unit admission. MRSA is believed to be spread through healthcare workers; thus, high hand hygiene compliancy in addition to environmental cleaning are the cornerstone countermeasures to disrupting its transmission. The Public Health Agency of Canada (PHAC), in collaboration with the Canadian Nosocomial Infection Surveillance Program (CNISP), conducts national, sentinel surveillance on healthcare-associated infections like MRSA. As a Student Epidemiologist, I developed a research proposal detailing two study objectives: 1) develop a regression model to predict all incident MRSA BSI rates among acute-care hospitals in Canada using CNISP MRSA BSI incident cases from 2000 to 2019, and 2) create a compartmental (Susceptible-Infected-Recovered-Deceased) model to determine the impact of various Infection Prevention and Control (IPC) measures on the risk of healthcare-associated MRSA BSI transmission specifically. This study hopes to demonstrate that proper IPC compliance is associated with lower incident MRSA BSI rates with the goal being to produce a manuscript draft by 2021. MRSA poses a serious threat to patient safety globally and is becoming a growing national public health concern in Canada; determining which IPC strategy is most effective at disrupting MRSA transmission is essential to reducing incidence and mortality rates.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133766859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining prevalence of cancer risk factors across Ontario for the Ontario Cancer Profiles tool","authors":"Amy Chang, N. Schwartz, R. Truscott","doi":"10.33137/utjph.v2i2.36838","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36838","url":null,"abstract":"The Ontario Cancer Profiles is an interactive dashboard for the public containing population-level cancerstatistics created by Ontario Health (Cancer Care Ontario). The tool contains data on cancer burden, cancerscreening measures, and cancer risk factors by Local Health Integration Network (LHIN) and Public Health Unit (PHU). It can be used for health system planning, measuring health systems performance, monitoring the impact of interventions, and to help identify new areas of research. There were 9 new modifiable cancer risk factors proposed to be included in future updates of the dashboard. The proposed risk factors include: access to care, active transportation, binge drinking, alcohol abstinence, inadequate fruit consumption, inadequate vegetable consumption, sedentary behaviour, second-hand smoke exposure, and sun safety. My practicum consisted of two main objectives: to conduct a literature review on the association between the proposed risk factors and cancer and to determine the prevalence of exposure of the identified risk factors in Ontario using 2015 to 2017 CCHS data. I performed a literature review to examine current evidence linking each proposed risk factor with cancer risk to determine the inclusion or exclusion of the indicator in the analysis. An analysis was performed with the selected variables in CCHS. Each indicator was age-standardized, and both standardized and crude ratios of individuals engaging in selected indicator activities were calculated. The results were examined for reliability using the produced coefficient of variation values. The estimates for each risk indicators allowed for the identification of target population that may be at higher risk of developing cancer due to greater exposure to the risk factors. They also serve as useful predictors for areas of improvement in regions with a high prevalence, such as healthy living within the community, and a guide to implementing preventative measures, screening, or treatment plans that may have been lacking.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125549068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current diesel engine exhaust exposure in the Ontario construction industry","authors":"Stephanie Ziembicki, T. Kirkham, P. Demers, Cheryl E Peters, Melanie Gorman-Ng, H. Davies, T. Tenkate, S. Kalengé, Nicola Blagrove-Hall, Kate Jardine, V. Arrandale","doi":"10.33137/utjph.v2i2.37006","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.37006","url":null,"abstract":"Introduction: Diesel engine exhaust (DEE) is a known carcinogen and a common occupational exposure in Canada, particularly within construction. The use of diesel-powered equipment in the construction industry is widespread, but little is known about DEE exposures and occupational disease in this work setting. The objective of this study was to characterize and identify key determinants of DEE exposure at construction sites in Ontario. \u0000Methods: Diesel particulate matter (DPM) measurements were taken from workers employed on seven infrastructure construction worksites in Ontario. Full-shift personal air samples were collected from workers using a constant-flow pump and SKC aluminum cyclone with 37-mm quartz fibre filters in an open-faced cassette. Samples were analyzed for elemental carbon (EC), a surrogate of DEE exposure, following NIOSH method 5040. Exposures were compared to recommended health-based limits, including the Dutch Expert Committee on Occupational Safety (DECOS) limit (1.03µg/m3 respirable EC) and the Finnish Institute of Occupational Health (FIOH) recommendation (5µg/m3 respirable EC). A determinants of exposure model was constructed. \u0000Results: In total, 126 DPM samples were collected, ranging from <0.47-52.58µg/m3 with a geometric mean (GM) of 4.23µg/m3 (geometric standard deviation (GSD)=3.05). Overall, 44.8% of samples exceeded the FIOH limit, mostly within underground worksites (93.5%), and 88.8% exceeded the DECOS limit. Underground workers (GM=13.20µg/m3, GSD=1.83) had exposures approximately 4-times higher than below grade workers (GM=3.56µg/m3, GSD=1.94) and 9-times higher than aboveground workers (GM=1.49µg/m3, GSD=1.75). Work grade, enclosed cabs, and seasonality were identified as the major determinants of exposure. \u0000Conclusions: This study provides a better understanding of current DPM exposure in Canadian construction. Most exposures were above recommended health-based limits, signifying a need to further reduce DPM levels in construction. These results can inform a hazard reduction strategy including a new occupational exposure limit and targeted intervention/control measures to reduce DPM exposure and the burden of occupational cancer.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115782249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Back Pain on Health Care Utilization and Costs","authors":"Jessica J. Wong, P. Côté, A. Tricco, T. Watson, L. Rosella","doi":"10.33137/utjph.v2i2.37005","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.37005","url":null,"abstract":"Introduction: We assessed the effect of self-reported back pain on health care utilization and costs in a population-based sample of Ontario adults. \u0000Methods: We conducted a population-based matched cohort study of Ontarian respondents aged ≥18 years of Canadian Community Health Survey (CCHS) from 2003-2012. CCHS data were individually linked to health administrative data to measure health care utilization and costs up to 2018. We propensity-score matched (hard-matched on sex) adults with self-reported back pain to those without back pain, accounting for sociodemographic, health-related, and behavioural factors. We evaluated back pain-specific and all-cause health care utilization and costs from healthcare payer perspective adjusted to 2018 Canadian dollars. Poisson and linear (log-transformed) models were used to assess healthcare utilization rates and costs.  \u0000Results: After propensity-score matching, we identified 36,806 pairs (21,054 for women, 15,752 for men) of CCHS respondents with and without back pain (mean age 51 years; SD=18). Compared to propensity-score matched adults without back pain, adults with back pain had two times the rate of back pain-specific visits (women: rate ratio [RR] 2.06, 95% CI 1.88-2.25; men: RR 2.32, 95% CI 2.04-2.64), 1.1 times the rate of all-cause physician visits (women: RR 1.12, 95% CI 1.09-1.16; men: RR 1.10, 95% CI 1.05-1.14), and 1.2 times the costs (women: 1.21, 95% CI 1.16-1.27; men: 1.16, 95% CI 1.09-1.23). Incremental annual per-person costs were higher in adults with back pain versus those without (women: $395, 95% CI $281-$509; men: $196, 95% CI $94-$300), corresponding to $532 million for women and $227 million CAD for men annually in Ontario. \u0000Conclusions: Adults with back pain had considerably higher health care utilization and costs compared to adults without back pain. These findings provide the most recent, comprehensive, and high-quality estimates of the health system burden of back pain to inform healthcare policy and decision-making. New strategies to reduce the substantial burden of back pain are warranted.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126913459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}