Health ReportsPub Date : 2024-10-16DOI: 10.25318/82-003-x202401000003-eng
Stacie Kerr, Leanne Findlay, Rubab Arim
{"title":"Child care for young children with disabilities.","authors":"Stacie Kerr, Leanne Findlay, Rubab Arim","doi":"10.25318/82-003-x202401000003-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202401000003-eng","url":null,"abstract":"<p><strong>Background: </strong>More than half (56%) of Canadian children aged 0 to 5 years are in non-parental child care, but data on child care attendance among children with disabilities is limited. This study examines child care participation among young children with disabilities in Canada, with a focus on different disability types.</p><p><strong>Data and methods: </strong>Analyses were conducted on 1,189 children aged 0 to 5 years identified with disabilities from Statistics Canada's 2023 Survey on Early Learning and Child Care Arrangements - Children with Long-term Conditions and Disabilities. Rates of child care participation, difficulties finding child care, difficulties within child care, and whether parents reported that their child had ever been denied a child care space because of their condition were examined. Logistic regression models tested for differences in the main child care arrangement and difficulty finding child care based on the child's disability while controlling for sociodemographic variables.</p><p><strong>Results: </strong>Among children aged 0 to 5 years with disabilities, 45% attended a daycare centre, preschool, centre de la petite enfance, or before or after school care as their main child care arrangement; 17% attended another type of child care, such as a family child care home or care by a relative; and 38% did not regularly attend non-parental child care. The parents of nearly half of children with disabilities reported difficulty finding a child care arrangement, particularly for children with emotional conditions. Close to 1 in 10 parents of children with disabilities who were using child care reported that their child had been denied a child care space because of their condition.</p><p><strong>Interpretation: </strong>These findings highlight the need for information to support inclusive policies, practices, and resources for children with disabilities within the Canada-wide early learning and child care system.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health ReportsPub Date : 2024-10-16DOI: 10.25318/82-003-x202401000002-eng
Jane Y Polsky
{"title":"Trends in household food insecurity from the Canadian Community Health Survey, 2017 to 2022.","authors":"Jane Y Polsky","doi":"10.25318/82-003-x202401000002-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202401000002-eng","url":null,"abstract":"<p><strong>Background: </strong>Income-related food insecurity is an important determinant of health. This study aimed to provide an update on the food security status of Canadian households using the most recent available data from a health-oriented national-level survey. This study also examined trends in food insecurity since 2017, and how these have tracked with changes in price inflation.</p><p><strong>Data and methods: </strong>Data on household food security status in the 10 Canadian provinces came from five annual cycles of the population-representative cross-sectional Canadian Community Health Survey (CCHS): 2017, 2018, 2020 (September to December), 2021, and 2022. The Household Food Security Survey Module was used to categorize household food security status during the previous 12 months as food secure or marginally, moderately, or severely insecure.</p><p><strong>Results: </strong>Before 2019, approximately 1 in 10 households had experienced some level of food insecurity in the previous 12 months (9.6% in 2017 and 11.6% in 2018). Household food insecurity prevalence was slightly lower and stable during the COVID-19 pandemic years (8.5% in fall 2020 and 9.1% in 2021) and increased to 15.6% in 2022. Levels of household food insecurity generally tracked with changes in consumer price inflation. Compared with 2021, there were notable increases in levels of moderate and severe food insecurity in 2022 among one-parent households with children, renters, and those reliant on government financial assistance.</p><p><strong>Interpretation: </strong>The prevalence of household food insecurity in the CCHS was relatively stable from 2017 to 2021, increased in 2022, and generally tracked with changes in price inflation. Monitoring levels of household food insecurity will continue to be important as price inflation eases but the cost of living remains high.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health ReportsPub Date : 2024-10-16DOI: 10.25318/82-003-x202401000001-eng
Tracey Bushnik, Heather Gilmour, Vincent Mak, Anne Mather
{"title":"From BpTRU to OMRON: The impact of changing automated blood pressure measurement devices on adult population estimates of blood pressure and hypertension.","authors":"Tracey Bushnik, Heather Gilmour, Vincent Mak, Anne Mather","doi":"10.25318/82-003-x202401000001-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202401000001-eng","url":null,"abstract":"<p><strong>Background: </strong>In Cycle 7 (2022), the Canadian Health Measures Survey (CHMS) introduced the OMRON (OM) IntelliSense HEM-907XL blood pressure (BP) monitor after using the BpTRU (BT) BPM-300 BP monitor for six cycles. This study assessed differences between adult BP values measured by both devices and whether equations could be developed to compare BP measurements taken using the two devices.</p><p><strong>Data and methods: </strong>In Cycle 6 (2018 to 2019) of the CHMS, BP was measured using BT and OM devices. Between-device estimates of systolic BP (SBP), diastolic BP (DBP), and hypertension prevalence were compared for 1,072 adults aged 18 to 79 years. Sex, age, body mass index (BMI), and the use of antihypertensive medication were examined in linear regression models to predict SBP and DBP values measured with OM based on those measured with BT.</p><p><strong>Results: </strong>Average SBP measured with OM was 6 millimetres of mercury (mmHg) higher than average SBP measured with BT, and average DBP measured with OM was 2 mmHg lower than DBP measured with BT. Hypertension prevalence based on OM readings was 35.4%, compared with 34.0% based on BT readings. Between-device BP differences varied in magnitude by sex, age group, and BMI category. Average model-predicted estimates of BP were comparable to measured estimates, but predicted values were lower at higher levels of BP.</p><p><strong>Interpretation: </strong>Switching BP monitors will substantively affect population estimates of adult SBP and DBP but may have less impact on estimates of adult hypertension prevalence. The prediction equations proposed in this study can be applied to adult BP data from cycles 1 to 6 of the CHMS for comparison with BP measurements taken in Cycle 7, with some caveats. The impact of changing to the OM monitor in Cycle 7 should be acknowledged when reporting estimates of adult BP based on the CHMS.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health ReportsPub Date : 2024-09-18DOI: 10.25318/82-003-x202400900002-eng
Danielle Bader,Kristyn Frank
{"title":"Understanding experiences of non-physical maltreatment in childhood in Canada: What is the relationship with suicidal ideation and mental health disorders?","authors":"Danielle Bader,Kristyn Frank","doi":"10.25318/82-003-x202400900002-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202400900002-eng","url":null,"abstract":"BackgroundPhysical and sexual childhood abuse are associated with suicidal ideation and mental health disorders. However, less is known about non-physical types of maltreatment. This study examined associations between non-physical types of child maltreatment (e.g., emotional abuse, interpersonal aggression, exposure to physical intimate partner violence, emotional and physical neglect) and suicidal ideation, and mental health disorders.Data and methodsData from the 2018 Survey of Safety in Public and Private Spaces were used to estimate the proportion of individuals 15 years and older in Canada who experienced non-physical maltreatment during childhood. Multivariable regression analyses were used to examine associations between five types of non-physical child maltreatment and suicidal ideation, and mental health disorders.ResultsOverall, interpersonal aggression was the most common (45.7%), followed by emotional abuse (40.4%) and emotional neglect (20.0%). Individuals who experienced any type of non-physical maltreatment in childhood had a higher probability of lifetime suicidal ideation than those who never experienced the maltreatment examined. Mood disorder diagnoses were more likely among those who experienced emotional abuse, interpersonal aggression, and emotional neglect than among those who never experienced these types of maltreatment. Compared with those who never experienced the maltreatment examined, individuals who experienced emotional abuse, interpersonal aggression, emotional neglect, or physical neglect were more likely to be diagnosed with an anxiety disorder. Diagnoses of post-traumatic stress disorder were more likely among those who experienced emotional and physical neglect than among those who never experienced these types of maltreatment.InterpretationNon-physical child maltreatment is associated with suicidal ideation and mental health disorders. The findings highlight the importance of including non-physical types of child maltreatment on population-based surveys to differentiate associations with mental health outcomes to better align interventions and policies.","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health ReportsPub Date : 2024-09-18DOI: 10.25318/82-003-x202400900001-eng
Gabriella Christopher,Aviroop Biswas,Justin J Lang,Stephanie J Prince
{"title":"Occupational and sex differences in active commuting among Canadian workers from 2006 to 2016.","authors":"Gabriella Christopher,Aviroop Biswas,Justin J Lang,Stephanie J Prince","doi":"10.25318/82-003-x202400900001-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202400900001-eng","url":null,"abstract":"BackgroundActive commuting (AC) to and from work is associated with numerous health benefits, through increased physical activity. This study examined whether occupation types and part-time work, by sex, were associated with AC in a population-based sample of Canadian workers.Data and methodsCross-sectional public use microdata files from the 2006 (n=363,048), 2011 (n=370,672), and 2016 (n=362,310) Census of Population were examined. Multinomial logistic regression models were used to estimate the odds of cycling, walking, and using public transit, relative to using a private motorized vehicle, by occupation and sex. Time trends in mode share were also analyzed.ResultsIn 2016, commuting by private motorized vehicle and cycling were more common among males, while public transit and walking were more common among females. Occupations in art, culture, recreation, and sport were associated with the greatest odds of cycling (odds ratio [OR]=3.02, 99% confidence interval [CI]: 2.65 to 3.39), while those in trades, transportation, natural resources, and manufacturing had the lowest odds of cycling (OR=0.47, 99% CI: 0.44 to 0.51) and walking (OR=0.36, 99% CI: 0.33 to 0.38). Since 2006, relative declines of 1% and 8% in the proportion of workers commuting by driving and walking, respectively, were observed (absolute change of -1% each). Relative increases of 14% and 12% were observed for cycling and public transit, respectively (absolute changes of less than 1% and 1.5%, respectively).InterpretationThis study found that sex and occupation are important correlates of AC among Canadian workers. Further research aimed at understanding occupational barriers and facilitators may inform future AC interventions.","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health ReportsPub Date : 2024-08-21DOI: 10.25318/82-003-x202400800001-eng
Michael Wolfson, Derek Chapman, Jong Hyung Lee, Vid Bijelic, Steven Woolf
{"title":"Extent and socioeconomic correlates of small area variations in life expectancy in Canada and the United States.","authors":"Michael Wolfson, Derek Chapman, Jong Hyung Lee, Vid Bijelic, Steven Woolf","doi":"10.25318/82-003-x202400800001-eng","DOIUrl":"10.25318/82-003-x202400800001-eng","url":null,"abstract":"<p><strong>Background: </strong>An extensive literature documents substantial variations in life expectancy (LE) between countries and at various levels of subnational geography. These variations in LE are significantly correlated with socioeconomic covariates, though no analyses have been produced at the finest feasible census tract (CT) level of geographic disaggregation in Canada or designed to compare Canada with the United States.</p><p><strong>Data and methods: </strong>Abridged life tables for each CT where robust estimates were feasible were estimated comparably with U.S. data. Cross-tabulations and graphical visualizations are used to explore patterns of LE across Canada, for Canada's 15 largest cities, and for the 6 largest U.S. cities.</p><p><strong>Results: </strong>LE varies by as much as two decades across CTs in both countries' largest cities. There are notable differences in the strength of associations with socioeconomic status (SES) factors across Canada's largest cities, though these associations with income-poverty rates are noticeably weaker for Canada's largest cities than for the United States' largest cities.</p><p><strong>Interpretation: </strong>Small area geographic variations in LE signal major health inequalities. The association of CT-level LE with SES factors supports and extends similar findings across many studies. The variability in these associations within Canada and compared with those in the United States reinforces the importance for population health of better understanding differences in social structures and public policies not only at the national and provincial or state levels, but also within municipalities to better inform interventions to ameliorate health inequalities.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Household food insecurity among persons with disabilities in Canada: Findings from the 2021 Canadian Income Survey.","authors":"Shikha Gupta, Daphne Fernandes, Nicole Aitken, Lawson Greenberg","doi":"10.25318/82-003-x202400800002-eng","DOIUrl":"10.25318/82-003-x202400800002-eng","url":null,"abstract":"<p><strong>Background: </strong>Income-related food insecurity is an important determinant of health. Persons with disabilities are at a higher risk of experiencing household food insecurity (HFI) than those without disabilities. The main objectives of this study were to estimate the prevalence of HFI for persons with different types, numbers, and severity of disabilities, and to examine sociodemographic correlates of HFI among this group.</p><p><strong>Data and methods: </strong>Data from the 2021 Canadian Income Survey (CIS) were used. Disability status was assessed using the short version of the Disability Screening Questions module for one randomly selected household respondent. The Household Food Security Survey Module measured HFI as marginal, moderate, or severe. Weighted descriptive and multivariable analyses were conducted to estimate the prevalence of HFI and analyze the association between various socioeconomic factors and HFI among the study sample.</p><p><strong>Results: </strong>Among CIS participants with disabilities (30% of the total CIS sample: 31 million persons), 26% reported some level of HFI, including 8% with severe HFI. The prevalence of HFI was 13% among those without disabilities. The prevalence of HFI was highest among those with learning, memory, cognition, and seeing disabilities (each at 36%). Levels of HFI were higher for those with more severe disabilities and with a greater number of disabilities. For persons with disabilities, the odds of HFI were two times higher, compared with persons without disabilities (adjusted odds ratio [AOR]: 2.5 [95% confidence interval (CI): 2.2, 2.7]), after adjustment for a range of sociodemographic covariates. Persons with disabilities who were in the lowest income quintile (AOR: 4.0 [95% CI: 3.2, 4.9]) and aged 45 to 54 (AOR: 2.9 [95% CI: 2.1, 4.1]) had the highest odds of HFI, compared with other persons with disabilities living in wealthier households and those aged 65 and older, respectively. Other risk factors included being in a one-parent household, living in the Prairies, and living in a dwelling not owned by the household.</p><p><strong>Interpretation: </strong>HFI prevalence among CIS participants with disabilities was higher than for persons without disabilities, even after adjustment for well-documented sociodemographic risk factors. Consistent monitoring of HFI among persons with disabilities can help inform any ongoing or newly developed poverty reduction strategies for this population.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health ReportsPub Date : 2024-07-17DOI: 10.25318/82-003-x202400700002-eng
Jungwee Park
{"title":"Mental health among women and girls of diverse backgrounds in Canada before and during the COVID-19 pandemic: An intersectional analysis.","authors":"Jungwee Park","doi":"10.25318/82-003-x202400700002-eng","DOIUrl":"10.25318/82-003-x202400700002-eng","url":null,"abstract":"<p><strong>Background: </strong>Mental health disparity is associated with diverse characteristics, such as gender, socioeconomic status, Indigenous identity, immigrant status, race, disability, and sexual orientation. However, intersectional studies on women's mental health have been rare, particularly during the COVID-19 pandemic period.</p><p><strong>Methods: </strong>Using data from two cycles of the Canadian Community Health Survey (2019 annual data and data from September to December 2020), self-reported mental health outcomes before the COVID-19 pandemic (sample size was 64,880) and during the second wave of the pandemic in the fall of 2020 (sample size of 27,246) were analyzed.</p><p><strong>Results: </strong>After sociodemographic factors were controlled for, women and girls had higher odds of poorer self-perceived mental health and worsened mental health compared with before the COVID-19 pandemic than men and boys. Compared with 2019, the gender gap in negative self-perceived mental health increased during the pandemic. The number and type of intersections of specific socioeconomic characteristics also had an impact on mental health outcomes. During the pandemic, women and girls with the following characteristics were more likely to report low self-perceived mental health, compared with women and girls with no intersections: those with a disability (7.8 times); or who are lesbian, gay, or bisexual or have another sexual orientation than heterosexual (5.6); or who are Indigenous (3.6).</p><p><strong>Interpretation: </strong>The intersections of gender and other sociodemographic characteristics increased the odds of negative self-perceived mental health.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health ReportsPub Date : 2024-07-17DOI: 10.25318/82-003-x202400700001-eng
Hanbyoul Park, Christina Milani, Peter Tanuseputro, Colleen Webber
{"title":"The association between rurality, places of care and the location of death of long-term care home residents with dementia: A population-based study.","authors":"Hanbyoul Park, Christina Milani, Peter Tanuseputro, Colleen Webber","doi":"10.25318/82-003-x202400700001-eng","DOIUrl":"10.25318/82-003-x202400700001-eng","url":null,"abstract":"<p><strong>Background: </strong>Most individuals prefer to spend their final moments of life outside a hospital setting. This study compares the places of care and death of long-term care (LTC) home residents in Ontario in the last 90 days of life, according to LTC home rurality.</p><p><strong>Data and methods: </strong>This retrospective cohort study was conducted using health administrative data from ICES (formerly known as the Institute for Clinical Evaluative Sciences). The study population, which was identified through algorithms, included all Ontario LTC home residents with a dementia diagnosis who died between April 1, 2014, and March 31, 2019. The location of death was categorized as in an acute care hospital, an LTC home, a subacute care facility, or the community. Places of care included emergency department visits and hospitalizations in the last 90 days of life. Statistical tests were used to evaluate differences in location of death and places of care by rurality.</p><p><strong>Results: </strong>Of the 65,375 LTC home residents with dementia, 49,432 (75.6%) died in an LTC home. Residents of LTC homes in the most urban areas were less likely to die in an LTC home than those in more rural homes (adjusted relative risk: 0.84; 95% confidence interval: 0.83 to 0.85). A higher proportion of residents of the most urban LTC homes had at least one hospitalization in the last 90 days of life compared with rural residents (23.7% versus 9.9% palliative hospitalizations and 28.3% versus 15.9% non-palliative hospitalizations [p ⟨ 0.001]).</p><p><strong>Interpretation: </strong>Individuals with dementia residing in urban LTC homes are more likely to receive care in the hospital and to die outside a LTC home than their counterparts living in rural LTC homes. The findings of this work will inform efforts to improve end-of-life care for older adults with dementia living in LTC homes.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health ReportsPub Date : 2024-06-19DOI: 10.25318/82-003-x202400600001-eng
Matthew Quick
{"title":"The impacts of extreme heat events on non-accidental, cardiovascular, and respiratory mortality: An analysis of 12 Canadian cities from 2000 to 2020.","authors":"Matthew Quick","doi":"10.25318/82-003-x202400600001-eng","DOIUrl":"10.25318/82-003-x202400600001-eng","url":null,"abstract":"<p><strong>Background: </strong>Extreme heat has significant impacts on mortality. In Canada, past research has analyzed the degree to which non-accidental mortality increases during single extreme heat events; however, few studies have considered multiple causes of death and the impacts of extreme heat events on mortality over longer time periods.</p><p><strong>Data and methods: </strong>Daily death counts attributable to non-accidental, cardiovascular, and respiratory causes were retrieved for the 12 most populous cities in Canada from 2000 to 2020. Generalized additive models were applied to quantify daily mortality risks for people aged younger than 65 years and for those aged 65 years and older in each city and for each cause of death. Model results were used to calculate the change in mortality risks and the number of excess deaths attributable to extreme heat during extreme heat events.</p><p><strong>Results: </strong>Elevated mortality risks were observed during extreme heat events in most cities for non-accidental and respiratory causes. The impacts of extreme heat on non-accidental mortality were typically greater for people aged 65 and older than for those aged younger than 65. Significantly higher non-accidental mortality risks were observed during extreme heat events for people aged 65 and older in Montréal, the city of Québec, Surrey, and Toronto. For cardiovascular and respiratory causes, people aged 65 and older had significantly higher mortality risks during extreme heat events in Montréal, and both Montréal and Toronto, respectively. In the 12 cities, approximately 670 excess non-accidental deaths, 115 excess cardiovascular deaths, and 115 excess respiratory deaths were attributable to extreme heat events during the study period. Mortality risks during extreme heat events were generally higher in cities with larger proportions of renter households and fewer extreme heat events.</p><p><strong>Interpretation: </strong>This study estimates the longer-term impacts of extreme heat events on three mortality outcomes in a set of large Canadian cities. As climate change causes more frequent and intense extreme heat events, and as policy makers aim to reduce the health impacts of heat, it is important to understand how and where extreme heat affects health.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}