Health Reports最新文献

{"title":"Comparing Canada's OncoSim-Breast model with the United States' Cancer Intervention and Surveillance Modeling Network (CISNET) breast cancer models.","authors":"Oguzhan Alagoz, Claude Nadeau, Jean Hai Ein Yong, Rochelle Garner, Andrew Coldman, Amy Trentham-Dietz","doi":"10.25318/82-003-x202500600001-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202500600001-eng","url":null,"abstract":"<p><strong>Background: </strong>The OncoSim-Breast model, developed by the Canadian Partnership Against Cancer and Statistics Canada, represents breast cancer-related events in the Canadian female population. This study aimed to compare OncoSim-Breast with recent results from the United States' National Cancer Institute's Cancer Intervention and Surveillance Modeling Network (CISNET) breast cancer models. The primary focus was on the impact of extending breast cancer screening to women aged 40 to 49.</p><p><strong>Data and methods: </strong>The OncoSim-Breast model used Canadian demographics, competing mortality, and test performance, while the CISNET models used comparable United States data to analyze 10 different mammography screening scenarios. Lifetime outcomes were calculated for a cohort of 40-year-old women born in 1980, assuming perfect adherence to digital mammography screening. OncoSim-Breast's estimates were compared with the median and range of estimates from the five CISNET models. The primary outcomes were breast cancer deaths averted and life years gained per 1,000 40-year-old women.</p><p><strong>Results: </strong>OncoSim-Breast projected that starting screening at age 40 would lead to 1.7 breast cancer deaths averted and 53 life years gained per 1,000 women, compared with starting screening at age 50. CISNET models projected a median of 1.3 breast cancer deaths averted (range 0.8 to 3.2) and 43 life years gained (range 31 to 103) per 1,000 women for the same scenario. Secondary outcomes estimated by OncoSim-Breast and CISNET models were similarly consistent and comparable.</p><p><strong>Interpretation: </strong>This study demonstrates that OncoSim-Breast's estimates of the impact of starting breast cancer screening earlier align with those from CISNET models.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"36 6","pages":"3-14"},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327498","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":"Oral contraceptive use in Canada.","authors":"Michelle Rotermann","doi":"10.25318/82-003-x202500600002-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202500600002-eng","url":null,"abstract":"<p><strong>Background: </strong>Oral contraceptives (OCs) have been legally available in Canada since 1969. OCs remain the most common method of reversible contraception in Canada and are among the most commonly used medications by reproductive-aged women in Canada. The use of OCs offers protection against unplanned pregnancy, in addition to other non-contraceptive benefits. Detailed data about current and lifetime OC use in Canada are rarely available.</p><p><strong>Methods: </strong>Data from four cycles (from the 2007-to-2009 cycle to the 2018-to-2019 cycle) of Statistics Canada's Canadian Health Measures Survey were combined to estimate current OC use (past 30 days) by sociodemographic characteristics and other factors and formulations by estrogen dose and progestin type. Logistic regression was used to examine the association between current OC use and sociodemographic characteristics and other factors. Combined data from 2016-to-2017 and 2018-to-2019 were used to estimate lifetime OC use and use duration.</p><p><strong>Results: </strong>According to combined data from the 2007-to-2009 period to the 2018-to-2019 period, an average of 15.9% of non-pregnant women aged 15 to 49 had used OCs in the previous 30 days. Most (98.6%) used OCs containing estrogen and progestin, and 48.7% of them took lower-dose formulations with 10 to 25 micrograms of ethinylestradiol. Younger women aged 15 to 39 were more likely to have used OCs in the previous 30 days than those aged 40 to 49. Additionally, the adjusted odds of being an OC user were higher for women who had not had children, were non-racialized and non-Indigenous, and were currently sexually active. Another 53.9% of women aged 15 to 49 reported former use. A majority of both current (67.5%) and former (52.8%) OC users reported having used them for at least four years.</p><p><strong>Interpretation: </strong>Substantial proportions of reproductive-aged women in Canada are current or former OC users.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"36 6","pages":"15-26"},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327499","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":"Who is reaching out for help? Examining access to mental health and substance use health supports among girls and young women in Canada.","authors":"Kristyn Frank, Mila Kingsbury, Elizabeth Richards","doi":"10.25318/82-003-x202500500001-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202500500001-eng","url":null,"abstract":"<p><strong>Background: </strong>Girls and young women experience poorer mental health than boys and young men, although the reverse is true for substance use disorders. Few population-based studies examine girls' and young women's experiences accessing and receiving mental health and substance use (MHSU) health care support, particularly across sociodemographic groups.</p><p><strong>Data and methods: </strong>Data from the 2022 Mental Health and Access to Care Survey were used to estimate the proportions of girls and young women who met the criteria for at least one MHSU disorder and who accessed formal MHSU health supports. The types of supports accessed, reasons for not accessing services, and associations between sociodemographic characteristics and the likelihood of indicating that the supports they accessed were helpful were examined. Girls and women aged 15 to 29 were studied, with an analytical sample of 1,254.</p><p><strong>Results: </strong>Among girls and young women aged 15 to 29, 38.5% met the criteria for one or more MHSU disorders in 2022; of those, 54.6% had accessed formal MHSU health supports. Lesbian and bisexual girls and young women with an MHSU disorder were more likely to access formal supports and more likely to have found the supports helpful compared with their heterosexual peers. Racialized girls and young women were less likely than their non-racialized peers to report the care they received was helpful.</p><p><strong>Interpretation: </strong>Some sociodemographic differences in the experiences of girls and young women accessing and receiving formal care for MHSU disorders were observed. Results indicated a need to improve the accessibility of formal MHSU supports for this population.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"36 5","pages":"3-13"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132945","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":"Health and care-receiving profiles and unmet home care needs among community-dwelling Canadians aged 85 years and older.","authors":"Md Kamrul Islam, Heather Gilmour","doi":"10.25318/82-003-x202500500002-eng","DOIUrl":"10.25318/82-003-x202500500002-eng","url":null,"abstract":"<p><strong>Background: </strong>The population aged 85 and older is one of the fastest-growing age groups. Identifying distinct health status and care-receiving profiles can improve the understanding of the heterogeneity in this age group. Unmet home care needs are associated with negative health consequences and can challenge the ability of those 85 and older to age in the community.</p><p><strong>Data and methods: </strong>A representative sample of 4,083 community-dwelling Canadians aged 85 years and older from the 2019/2020 Canadian Health Survey on Seniors (CHSS) was used to identify health and care-receiving profiles applying latent class analysis. Multinomial logistic regression was used to examine factors associated with the profiles. Multivariable logistic regression was applied to evaluate the association between the profiles and unmet home care needs.</p><p><strong>Results: </strong>An estimated 201,000 Canadians aged 85 years and older (28.2%) were classified as \"healthiest-low care receiving\", 180,000 (25.3%) as \"moderately healthy-moderate care receiving,\" 194,000 (27.2%) as \"moderately unhealthy-low care receiving,\" and 137,000 (19.2%) as \"poor health-high care receiving.\" Increasing age and being an immigrant were associated with poorer health status and a higher likelihood of receiving care. An estimated 46,000 Canadians aged 85 years and older (6.5%) reported having unmet home care needs. Individuals with the profiles characterized by poorer health and a higher likelihood of receiving care were more likely to have unmet home care needs.</p><p><strong>Interpretation: </strong>The findings of this study highlight the importance of considering multiple health and care-receiving factors to better illuminate unmet home care needs among community-dwelling Canadians aged 85 years and older.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"36 5","pages":"14-27"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132864","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":"Understanding mortality differentials of Black adults in Canada.","authors":"Toyib Olaniyan, Tanya Christidis, Matthew Quick, Tafadzwa Machipisa, Tolulope Sajobi, Jude Kong, Kwame Mckenzie, Michael Tjepkema","doi":"10.25318/82-003-x202500400001-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202500400001-eng","url":null,"abstract":"<p><strong>Background: </strong>It is not clear whether the increased mortality pattern observed in a prior analysis of the Canadian Census Health and Environment Cohorts for HIV/AIDS, diabetes, prostate cancer, and uterine cancer among Black adults is reflected in incident hospitalization (a marker of severity) or the diagnosis of these diseases, nor is it clear whether disparities exist regarding early screening and survivability.</p><p><strong>Methods: </strong>To understand the paths that contribute to differential mortality patterns, standard Cox proportional hazard models were used to assess the incidence risk of diagnosis (uterine and prostate cancer) and incident hospitalization (HIV and diabetes) among 161,520 Black adults, compared with 6,866,070 White adults. Competing risk regression was used to evaluate the cumulative risk of death for the four disease outcomes since diagnosis or hospitalization. For the observed differential cancer mortality, mediation analysis was conducted to investigate the role of cancer diagnosis at follow-up (a proxy for delayed diagnosis that is not entirely indicative of late-stage cancer).</p><p><strong>Results: </strong>Across all examined outcomes, except for uterine cancer, Black adults had elevated incident diagnoses or hospitalizations compared with White adults. Notably, Black males demonstrated a risk of incident prostate cancer and hospitalizations from HIV and diabetes twice as high relative to White males. For Black females, the risk of incident HIV hospitalization was 12 times as high. However, Black females were 15% less likely to be diagnosed with uterine cancer, compared with White females. Cumulative mortality risk analysis showed significantly lower survivability (two times lower) among Black females diagnosed with uterine cancer, relative to White females. Delayed diagnosis mediated a marginally higher proportion of the total differential uterine cancer mortality among Black females (14.9%; 95% confidence interval [CI]: 10.5% to 23.1%), compared with White females (8.9%; 95% CI: 6.3% to 13.9%).</p><p><strong>Interpretation: </strong>This study unveils substantial parallels between heightened incidence risk and relative mortality for most of the four explored outcomes between Black and White adults in Canada. Notably, the study highlights a lower incident diagnosis of uterine cancer among Black females, despite a relatively higher uterine cancer mortality. Three in every 20 uterine cancer deaths were mediated through the time of uterine cancer diagnosis (relatively delayed in Black females), underscoring the need for targeted interventions and early detection strategies to address health disparities in this population.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"36 4","pages":"3-13"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056110","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":"Sense of control and positive mental health outcomes among adults in Canada during the COVID-19 pandemic.","authors":"Colin A Capaldi, Kinda Wassef, Melanie Varin, Eric Vallières, Karen C Roberts","doi":"10.25318/82-003-x202500400002-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202500400002-eng","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic in Canada, there was a decrease in population positive mental health (PMH); however, many individuals still reported high levels of PMH. One potential protective factor could be a sense of control, which involves perceptions of personal mastery and minimal perceived constraints. Limited Canadian research has been conducted on the link between sense of control and PMH during the pandemic.</p><p><strong>Data and methods: </strong>This study used cross-sectional data from the 2020 and 2021 Survey on COVID-19 and Mental Health, which included adults (18 years and older) living in the 3 territorial capitals and 10 provinces in Canada. Two facets of sense of control were measured with the Sense of Mastery Scale: personal mastery and perceived constraints. Three PMH outcomes were measured using single-item measures of self-rated mental health (SRMH), community belonging, and life satisfaction. Regression analyses were conducted to examine associations between the two sense of control facets and the three PMH outcomes.</p><p><strong>Results: </strong>Higher personal mastery was associated with higher average life satisfaction and a greater likelihood of high SRMH and strong community belonging. In contrast, greater perceived constraints were associated with lower average life satisfaction and a lower likelihood of high SRMH and strong community belonging. Sociodemographic differences on the facets were observed.</p><p><strong>Interpretation: </strong>Adults in Canada with a higher sense of control during the pandemic tended to have better PMH than those who felt like they had less control. Further research on mental health promotion efforts involving sense of control is needed.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"36 4","pages":"14-26"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043634","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":"Trends and inequalities in multimorbidity from 2001/2002 to 2019/2020: A population-based study in British Columbia.","authors":"Jennifer K Ferris, Amy Prangnell, Brandon Wagar, Alex Choi, Jonathan Simkin, Ryan R Woods, Hind Sbihi, Kari Harder, Kate Smolina","doi":"10.25318/82-003-x202500300001-eng","DOIUrl":"10.25318/82-003-x202500300001-eng","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity is a significant challenge for health care systems worldwide. There are limited data, particularly in a Canadian context, on multimorbidity prevalence and incidence, and how these differ by multimorbidity complexity, sex, age, and neighbourhood income quintile.</p><p><strong>Methods: </strong>This study included administrative data from residents of British Columbia, Canada, from 2001/2002 to 2019/2020. This study analyzed trends in the prevalence and incidence of multimorbidity (two or more conditions) and complex multimorbidity (five or more conditions) by sex, age, and neighbourhood income quintile. This study also identified the most prevalent disease combinations.</p><p><strong>Results: </strong>More than 25% of adults and 60% of seniors met criteria for multimorbidity in 2019/2020. From 2001/2002 to 2019/2020, age-standardized multimorbidity prevalence increased annually by an average of 1.5% in females and 2.9% in males, and incidence decreased by 3.3% in females and 1.1% in males. Complex multimorbidity prevalence increased annually by an average of 4.8% in females and 5.7% in males, and incidence increased by 1.1% in females and 2.2% in males. Younger age groups had higher average annual increases in multimorbidity prevalence and incidence. Multimorbidity risk was higher in lower income quintiles, relative to higher income quintiles, and these disparities were larger for complex, relative to standard, multimorbidity. Highly prevalent single diseases tended to form the most prevalent disease combinations, and the most prevalent disease combinations varied by income quintile.</p><p><strong>Interpretation: </strong>These findings suggest that the burden and complexity of multimorbidity continue to rise in British Columbia. Population trends in multimorbidity have important implications for projecting future disease burden and health care planning.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"36 3","pages":"3-16"},"PeriodicalIF":2.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693948","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":"Avoidable hospitalizations among racialized groups in Canada: Results from the 2016 Canadian Census Health and Environment Cohort.","authors":"Anita Brobbey, Vijata Sharma, Maegan Mazereeuw","doi":"10.25318/82-003-x202500300002-eng","DOIUrl":"10.25318/82-003-x202500300002-eng","url":null,"abstract":"<p><strong>Background: </strong>Ambulatory care sensitive conditions (ACSCs) are illnesses that can be effectively treated and managed in primary care settings. Hospitalizations for ACSCs are therefore considered avoidable and may indicate poor access to quality primary care. This study examined trends in avoidable hospitalizations in Canada among racialized groups.</p><p><strong>Data and methods: </strong>The 2016 Canadian Census Health and Environment Cohort was used to estimate annual age-standardized hospitalization rates (ASHRs) for ACSCs among people aged 10 to 74 from 2016/2017 to 2021/2022. ASHRs were disaggregated by sex and racialized group. Rate ratios (RRs) and 95% confidence intervals (CIs) were calculated to assess relative inequality. Logistic regression models were run, adjusting for age, sex, immigrant status, household income, and education.</p><p><strong>Results: </strong>Across all study years, the odds of avoidable hospitalizations were significantly higher among males, Black people, and non-immigrants, and significantly lower among Chinese people and people in the category \"other racialized groups not included elsewhere.\" In 2020/2021, during the COVID-19 pandemic, RRs for Black females compared with non-racialized females decreased (2019/2020: RR=1.12, 95% CI=1.07 to 1.61; 2020/2021: RR=0.99, 95% CI=0.94 to 1.04), while they significantly increased for Black males compared with non-racialized males (2019/2020: RR=1.30, 95% CI=1.25 to 1.35; 2020/2021: RR=1.63, 95% CI=1.41 to 1.88).</p><p><strong>Interpretation: </strong>This study reveals inequalities in avoidable hospitalizations in Canada, pronounced for the Black population compared with the non-racialized population, especially during the pandemic (2020/2021 and 2021/2022). Future studies examining the factors driving these inequalities (e.g., access to primary care, most prevalent conditions, geography) may inform targeted interventions.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"36 3","pages":"17-28"},"PeriodicalIF":2.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693712","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":"The health consequences of obesity history and weight fluctuations in adulthood.","authors":"Rachel C Colley, Tracey Bushnik, Joel Barnes","doi":"10.25318/82-003-x202500200002-eng","DOIUrl":"10.25318/82-003-x202500200002-eng","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of Canadians living with obesity has increased over the past four decades. Disease and mortality risk increase as the number of years lived with obesity increases.</p><p><strong>Methods: </strong>This study used self-reported weight history and health data collected from 2007 to 2011 via the Canadian Health Measures Survey (n = 5,761) to examine whether increased exposure to obesity during adulthood increases the odds of having poor health outcomes.</p><p><strong>Results: </strong>The percentage of respondents with an obesity-related chronic condition was lower among those who did not have obesity at the time of survey or report having obesity in the past (50.6%) compared with those who did not have obesity at the time of the survey but did in the past (65.9%) or who had obesity at the time of the survey and in the past (71.1%). Relative to never having obesity, having obesity in the past but not at present or having obesity in the past and at present were associated with increased odds of having a range of chronic conditions. The highest odds were observed for type 2 diabetes (odd ratio (OR) = 3.26, 95% confidence interval (CI): 2.40 to 4.43 and OR = 5.36, 95% CI: 3.88 to 7.41), hypertension (OR = 2.41, 95% CI: 1.69 to 3.44 and OR = 3.76, 95% CI: 2.84 to 4.97), and poor or fair self-rated general health (OR = 2.04, 95% CI: 1.51 to 2.76 and OR = 2.68, 95% CI: 2.11 to 3.40).</p><p><strong>Interpretation: </strong>Having had obesity in the past, regardless of current obesity status, was associated with increased odds of poor health outcomes. Obesity history information should be considered when estimating the population burden of obesity.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"36 2","pages":"15-28"},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505485","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":"Changes in life expectancy at birth during the COVID-19 pandemic and contributions by cause of death in British Columbia, Canada.","authors":"Xibiao Ye, Ioana Sevcenco, Richard Mercer, Henry Ngo, Alyssa Parker, Viet Dao, Reiko Okamoto, Bonnie Henry","doi":"10.25318/82-003-x202500200001-eng","DOIUrl":"10.25318/82-003-x202500200001-eng","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown that excess all-cause mortality during the COVID-19 pandemic caused declines of life expectancy at birth (LE₀) in most countries around the world, after decades of improvement prior to the pandemic. However, those studies rarely examined the contributions from specific causes of death other than COVID-19.</p><p><strong>Methods: </strong>This study used the Chiang method to estimate LE₀ for each year in British Columbia from 2000 to 2022 and the changes from 2019 to 2020, 2021, and 2022. Each death case was classified into 1 of 23 categories, including COVID-19, unregulated drug toxicity, cardiovascular diseases, and injuries, according to the International Classification of Diseases, 10th Revision (ICD-10). The changes in LE₀ were decomposed into age and causes of death using the Arriaga method.</p><p><strong>Results: </strong>Compared with 2019, male LE₀ decreased by 1.16 years in 2020, 1.81 years in 2021, and 1.62 years in 2022; female LE₀ did not change in 2020, but decreased by 0.65 years in 2021, and by 0.56 years in 2022. COVID-19 and unregulated drug toxicity were the top two causes of deaths contributing to the LE₀ declines in males and females, with COVID-19 being the number one contributor in females and unregulated drug toxicity deaths as the number one contributor in males.</p><p><strong>Interpretation: </strong>The COVID-19 pandemic impacted population health not only through its direct effects but also through indirect impacts on other health outcomes, including the unregulated drug toxicity crisis, the combination of which were driving factors in the decline in life expectancy at birth.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"36 2","pages":"3-14"},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505484","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}