Health Reports最新文献

{"title":"Exploring the intersectionality of characteristics among those who experienced opioid overdoses: A cluster analysis.","authors":"Kenneth Chu,&nbsp;Gisèle Carrière,&nbsp;Rochelle Garner,&nbsp;Kevin Bosa,&nbsp;Deirdre Hennessy,&nbsp;Claudia Sanmartin","doi":"10.25318/82-003-x202300300001-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202300300001-eng","url":null,"abstract":"<p><strong>Background: </strong>As Canada continues to experience an opioid crisis, it is important to understand the intersection between the demographic, socioeconomic and service use characteristics of those experiencing opioid overdoses to better inform prevention and treatment programs.</p><p><strong>Data and methods: </strong>The Statistics Canada British Columbia Opioid Overdose Analytical File (BCOOAF) represents people's opioid overdoses between January 2014 and December 2016 (n = 13,318). The BCOOAF contains administrative health data from British Columbia linked to Statistics Canada data, including on health, employment, social assistance and police contacts. Cluster analysis was conducted using the k-prototypes algorithm.</p><p><strong>Results: </strong>The results revealed a six-cluster solution, composed of three groups (A, B and C), each with two distinct clusters (1 and 2). Individuals in Group A were predominantly male, used non-opioid prescription medications and had varying levels of employment. Individuals in Cluster A1 were employed, worked mostly in construction, had high incomes and had a high rate of fatal overdoses, while individuals in Cluster A2 were precariously employed and had varying levels of income. Individuals in Group B were predominantly female; were mostly taking prescription opioids, with about one quarter or less receiving opioid agonist treatment (OAT); mostly had precarious to no employment; and had low to no income. People in Cluster B1 were primarily middle-aged (45 to 65 years) and on social assistance, while people in Cluster B2 were older, more frequently used health services and had no social assistance income. Individuals in Group C were primarily younger males aged 24 to 44 years, with higher prevalence of having experienced multiple overdoses, were medium to high users of health care services, were mostly unemployed and were recipients of social assistance. Most had multiple contacts with police. Those in Cluster C1 predominantly had no documented use of prescription opioid medications, and all had no documented OAT, while all individuals in Cluster C2 were on OAT.</p><p><strong>Interpretation: </strong>The application of machine learning techniques to a multidimensional database enables an intersectional approach to study those experiencing opioid overdoses. The results revealed distinct patient profiles that can be used to better target interventions and treatment.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"34 3","pages":"3-14"},"PeriodicalIF":5.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9914368","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":"Daily accelerometer-measured physical activity patterns and associations with cardiometabolic health among Canadian working adults.","authors":"Aviroop Biswas,&nbsp;Cynthia Chen,&nbsp;Stephanie A Prince,&nbsp;Peter M Smith,&nbsp;Cameron A Mustard","doi":"10.25318/82-003-x202300300002-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202300300002-eng","url":null,"abstract":"<p><strong>Background: </strong>Previous studies examining the cardiometabolic risks associated with physical activity (PA) in workers have predominantly used self-reported measures. Little is known about workers' distinct daily PA patterns and whether these are linked with cardiometabolic risks. This study examined associations between patterns of workers' accelerometer-measured daily PA and four markers of cardiometabolic health.</p><p><strong>Data and methods: </strong>Working adults (N=8,229; 47% women; average age: 42 years; standard deviation = 0.3) were sampled from the Canadian Health Measures Survey (five cycles: 2007 to 2017). Accelerometer devices measured daily PA, and hierarchical cluster analysis identified distinct activity patterns. Multiple linear regression analyses examined associations between activity patterns and cardiometabolic risk markers (waist circumference, systolic and diastolic blood pressure, and non-high-density lipoprotein [HDL] cholesterol).</p><p><strong>Results: </strong>Workers were classified into six distinct activity patterns. On average, compared with workers classified in the \"lowest activity\" pattern, workers with the \"moderate consistent activity,\" \"fluctuating moderate activity,\" \"high daytime activity\" and \"highest activity\" patterns were associated with lower waist circumferences; workers with the \"fluctuating moderate activity\" and \"highest activity\" patterns were associated with lower systolic blood pressure; the \"moderate evening activity\" pattern was associated with lower diastolic blood pressure; and workers with the \"fluctuating moderate activity,\" \"high daytime activity\" and \"highest activity\" patterns were associated with lower non-HDL cholesterol. \"High daytime activity\" was associated with lower waist circumference in women, compared with men, and the \"moderate consistent activity\" and \"fluctuating moderate activity\" patterns were associated with lower diastolic blood pressure in younger workers (40 years or younger).</p><p><strong>Interpretation: </strong>Workers with high daily PA levels tended to have the most optimal cardiometabolic health. Some evidence suggested that there are benefits to moderate levels of PA, particularly for lowering waist circumference and non-HDL cholesterol. Findings may assist in identifying workers for PA initiatives to promote cardiometabolic health benefits.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"34 3","pages":"15-29"},"PeriodicalIF":5.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9914367","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 Utilities Index Mark 3 scores for children and youth: Population norms for Canada based on cycles 5 (2016 and 2017) and 6 (2018 and 2019) of the Canadian Health Measures Survey.","authors":"Mariana Molina,&nbsp;Brittany Humphries,&nbsp;Jason R Guertin,&nbsp;David Feeny,&nbsp;Jean-Eric Tarride","doi":"10.25318/82-003-x202300200003-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202300200003-eng","url":null,"abstract":"<p><strong>Background: </strong>Utility scores are an important tool for evaluating health-related quality of life. Utility score norms have been published for Canadian adults, but no nationally representative utility score norms are available for children and youth.</p><p><strong>Data and methods: </strong>Health Utilities Index Mark 3 (HUI3) data from two recent cycles of the Canadian Health Measures Survey (i.e., 2016 and 2017, and 2018 and 2019) were used to provide utility score norms for children aged 6 to 11 years and adolescents aged 12 to 17 years. Children younger than 14 years answered the HUI3 under the supervision of an adult, while older children answered without supervision. Utility scores were reported as a weighted average (95% confidence intervals [CIs]) and median values (interquartile range). Utility scores were stratified by sociodemographic and medical characteristics of the child or adolescent. Regression analyses were used to identify predictors of utility scores. All results were weighted using sampling weights provided by Statistics Canada.</p><p><strong>Results: </strong>Among the 2,297,136 children aged 6 to 11 years and the 2,329,185 adolescents aged 12 to 17 years in the weighted sample, the average utility scores were 0.95 (95% CI: 0.94 to 0.95) and 0.89 (95% CI: 0.87 to 0.90), respectively. Approximately 60% of the children and 34% of the adolescents had a utility score of 1.00. Analyses identified several factors associated with utility scores (e.g., age, chronic condition and income levels), although differences were observed between children and adolescents.</p><p><strong>Interpretation: </strong>This study provides utility score estimates based on a nationally representative sample of Canadian children and youth. Further research examining the determinants of utility scores of children and adolescents is warranted.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"34 2","pages":"29-39"},"PeriodicalIF":5.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913861","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":"Online digital media use and adolescent mental health.","authors":"Stacie Kerr,&nbsp;Mila Kingsbury","doi":"10.25318/82-003-x202300200002-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202300200002-eng","url":null,"abstract":"<p><strong>Background: </strong>Online digital media are a central part of adolescents' lives, providing opportunities for social connection. However, some research has suggested that online digital media use may be negatively associated with mental health. Little population-based research has examined associations between various types of online digital media use and adolescent mental health.</p><p><strong>Data and methods: </strong>Data from 13,600 adolescents aged 12 to 17 were drawn from the 2019 Canadian Health Survey on Children and Youth. Adolescents reported on how frequently they used social media, video or instant messaging, and online gaming, as well as their general mental health, eating disorder symptoms and, for those aged 15 to 17, suicidal ideation and attempt. Logistic regression was used to estimate the odds of each outcome from the frequency of each type of digital media use, stratified by sex.</p><p><strong>Results: </strong>Associations were noted between the frequency of social media and video and instant messaging use, and general mental health, eating disorder symptoms, and suicidal ideation and attempt. After cybervictimization and sleep adequacy were accounted for, associations with eating disorder symptoms remained significant for girls and boys. Never participating in online gaming was associated with lower odds of lower general mental health and suicidal ideation among girls, but not boys.</p><p><strong>Interpretation: </strong>Different types of online digital media use are differentially associated with mental health outcomes, and associations differ between sexes. The associations between social media and video or instant messaging, and mental ill health may be partially explained by the experience of cybervictimization and sleep adequacy. More research on online gaming, particularly among girls, is needed to clarify associations with mental health.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"34 2","pages":"17-28"},"PeriodicalIF":5.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913859","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":"Mortality inequalities of Black adults in Canada.","authors":"Michael Tjepkema,&nbsp;Tanya Christidis,&nbsp;Toyib Olaniyan,&nbsp;Jeremiah Hwee","doi":"10.25318/82-003-x202300200001-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202300200001-eng","url":null,"abstract":"<p><strong>Background: </strong>Mortality rates in Canada have been shown to vary by population group (e.g., Indigenous peoples, immigrants) and social economic status (e.g., income levels). Mortality patterns for some groups, including Black individuals, are not as well known. The objective of this study was to assess cause-specific mortality for Black adults living in Canada.</p><p><strong>Methods: </strong>Mortality inequalities between Black and White cohort members were estimated by sex using Cox proportional hazard models, based on data from the 2001, 2006 and 2011 Canadian Census Health and Environment Cohorts (CanCHECs). The CanCHEC cycles were combined and followed for mortality between Census Day and December 31, 2016 or 2019, resulting in a follow-up period of 15.6, 13.6 or 8.6 years, depending on the CanCHEC cycle.</p><p><strong>Results: </strong>Ischemic heart disease mortality was the leading cause of death among adult Black males (12.9%) and females (9.8%), as it is for adult White males (16.4%) and females (12.4%). Despite reduced risk of all-cause mortality among Black males and females, compared with White cohort members, there was notable increased risk for some cause-specific mortality. For instance, in the age-adjusted model, among the 25 causes of death examined, Black males had an increased risk of dying from four causes (HIV/AIDS, prostate cancer, diabetes mellitus and cerebrovascular disease), compared with White males. Similarly, Black females were at an increased risk for 6 causes of death (HIV/AIDS, stomach cancer, corpus uteri cancer, lymphomas and multiple myeloma, diabetes mellitus, and endocrine disorders) out of the 27 causes of death examined. These relative increased risks persisted for most causes of death after adjustment for differences in important social determinants of health.</p><p><strong>Interpretation: </strong>Results showed substantial variability in the risk of dying by cause of death between Black and White cohort members. An important step in reducing health inequities is the routine identification and surveillance of different health outcomes by population groups. This study helps fill that information gap.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"34 2","pages":"3-16"},"PeriodicalIF":5.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913857","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":"Five-year cancer survival by stage at diagnosis in Canada.","authors":"Larry F Ellison,&nbsp;Nathalie Saint-Jacques","doi":"10.25318/82-003-x202300100001-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202300100001-eng","url":null,"abstract":"<p><strong>Background: </strong>Cancer survival estimates provide insights into the effectiveness of early detection and treatment. The stage of cancer at diagnosis is an important determinant of survival, reflecting the extent and spread at the time of disease detection. This work provides stage-specific, five-year survival results not previously available for Canada.</p><p><strong>Data and methods: </strong>Data reflect the population-based Canadian Cancer Registry death-linked analytic file covering the period from 2010 to 2017. The stage at diagnosis was determined by the Collaborative Stage Data Collection System. Five-year net survival (NS) estimates for Canada excluding Quebec were derived using the Pohar Perme estimator for the five most commonly diagnosed cancers.</p><p><strong>Results: </strong>Except for prostate cancer, NS decreased monotonically with increased stage at diagnosis. For example, female breast cancer NS estimates were 100% (stage I), 92% (stage II), 74% (stage III) and 23% (stage IV). Apart from lung cancer, stage I NS exceeded 90% for all cancers studied. The largest sex-specific difference in NS was for lung cancer stage I (female 66%; male 56%). Stage-specific NS generally decreased with age, particularly for early-stage lung cancer. Between the 2010-to-2012 and 2015-to-2017 periods, NS improved among stage IV prostate, female breast and lung cancer cases, as well as for stage I and III lung cancer cases; however, it did not improve at any stage for colon or rectal cancer cases.</p><p><strong>Interpretation: </strong>The work highlights the importance of detecting cancer early, when treatment is most effective. It demonstrates some progress in stage-specific survival among top cancers in Canada and offers data to inform health policy, including screening, and clinical decisions regarding cancer treatment.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"34 1","pages":"3-15"},"PeriodicalIF":5.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9558318","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 to acute-care hospitalizations among Indigenous children and youth: Results from the 2006 and 2011 Canadian Census Health and Environment Cohorts.","authors":"Gisèle Carrière, Evelyne Bougie","doi":"10.25318/82-003-x202300100002-eng","DOIUrl":"10.25318/82-003-x202300100002-eng","url":null,"abstract":"<p><strong>Background: </strong>This study described the differences in the hospitalization rates of First Nations children and youth living on and off reserve, Inuit children and youth living in Inuit Nunangat (excluding Nunavik), and Métis children and youth, relative to non-Indigenous children and youth and examined rate changes across 2006 and 2011.</p><p><strong>Data and methods: </strong>The 2006 and the 2011 Canadian Census Health and Environment Cohorts provided five years of hospital records that Statistics Canada linked to peoples' self-reported Indigenous identity as recorded on the census. Causes of hospitalizations were based on the most responsible diagnosis coded according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada, aggregated by chapter code. Age-standardized hospitalization rates (ASHRs) were calculated per 100,000 population. Rate ratios (RRs) were reported for each Indigenous group relative to non-Indigenous children and youth.</p><p><strong>Results: </strong>For the 2006 and the 2011 cohorts, ASHRs were generally higher among Indigenous children and youth than among non-Indigenous children and youth. For some health conditions, hospitalization patterns also varied across the two time periods within the given Indigenous groups. Among children, leading elevated RRs occurred for diseases of the respiratory system, the digestive system and injuries. Elevated mental health-related RRs were observed among all Indigenous groups for both cohort years of youth. Significant increases in mental health-related ASHRs were observed in 2011 compared with 2006 among all youth groups, except for Inuit youth living in Inuit Nunangat, possibly due in part to data limitations. Among Indigenous youth, elevated RRs were observed for pregnancy, childbirth and the puerperium, and for injuries. For all youth (except Inuit), childbirth-related ASHRs decreased in 2011 compared with 2006.</p><p><strong>Interpretation: </strong>Findings align with previously observed hospitalization disparities between Indigenous and non-Indigenous children and youth. These data enabled the tracking of changes over time to partly address national information gaps about population health outcomes for children and youth, namely hospitalization.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"34 1","pages":"16-31"},"PeriodicalIF":2.7,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9558316","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":"Sociodemographic Disparities in COVID-19 Vaccine Uptake and Vaccination Intent in Canada.","authors":"Mireille Guay,&nbsp;Aubrey Maquiling,&nbsp;Ruoke Chen,&nbsp;Valérie Lavergne,&nbsp;Donalyne-Joy Baysac,&nbsp;Jackie Kokaua,&nbsp;Catherine Dufour,&nbsp;Eve Dubé,&nbsp;Shannon E MacDonald,&nbsp;Nicolas L Gilbert","doi":"10.25318/82-003-x202201200004-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202201200004-eng","url":null,"abstract":"<p><strong>Introduction: </strong>This study's objective was to examine sociodemographic disparities in COVID-19 vaccine uptake and vaccination intent in the Canadian provinces by identifying factors associated with vaccine uptake in seniors prioritized for vaccination at the time of the survey and vaccination intent in all adults.</p><p><strong>Data and methods: </strong>A cross-sectional survey of Canadian adults was conducted in all provinces from mid-April to mid-May 2021. In addition to sociodemographic characteristics, respondents (n=10,678) provided information on their COVID-19 vaccination status or their intent to get vaccinated. Logistic regression models were fitted using sociodemographic factors as explanatory variables and vaccination status (unvaccinated vs at least one dose) or vaccination intent (unlikely versus likely or already vaccinated) as outcomes. To account for vaccine prioritization groups, multiple regression models were adjusted for province of residence, age, Indigenous identity and health care worker status.</p><p><strong>Results: </strong>Seniors with a lower household income (less than $60,000) and those living in smaller communities (fewer than 100,000 inhabitants) had higher odds of being unvaccinated. Among Canadian adults, the odds of being unlikely to get vaccinated were higher for males (adjusted odds ratio [AOR] 1.3), individuals younger than 60 (AOR between 3.3 and 5.1), non-health care workers (AOR 3.3), those with less than a high school education (AOR 3.4) or a household income of less than $30,000 (AOR 2.7) and individuals who do not identify as South Asian, Chinese, Black, Filipino, Arab, Latin American, Southeast Asian, West Asian, Korean or Japanese (AOR 1.7).</p><p><strong>Interpretation: </strong>COVID-19 vaccine uptake (80%) and vaccination intent (95%) were high among Canadians; however, relative disparities were observed among specific groups. Continued efforts targeted toward these groups are essential in reducing potential inequity in access or service provision.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"33 12","pages":"37-54"},"PeriodicalIF":5.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10616823","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":"Sociodemographic and endogenous factors associated with access to eye care in Canada, 2016 to 2019.","authors":"Philippe Finès","doi":"10.25318/82-003-x202201200003-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202201200003-eng","url":null,"abstract":"<p><strong>Introduction: </strong>Eye care is important, but it is not always promoted as much as other aspects of health. A visit to an eye care professional is made when need, stimulus, access and availability exist.</p><p><strong>Data and methods: </strong>Data from cycles 5 and 6 (2016 to 2019) of the Canadian Health Measures Survey were used. Analyzed variables were related to sociodemographic characteristics, general health, behaviour and eye health. Estimates were obtained using survey weights, and 95% confidence intervals were obtained with bootstrap weights.</p><p><strong>Results: </strong>From 2016 to 2019, 75% of people diagnosed with diabetes visited an eye care professional during the previous year. For people not diagnosed with diabetes, the rate varied, at 57% for those aged 6 to 18 years, 40% for those aged 19 to 64, and 63% for those aged 65 to 79. For those aged 6 to 64, wearing glasses and having access to a family doctor were the main factors associated with a visit to an eye care professional in the previous year. For those aged 65 to 79, cataracts, sex, marital status and self-perceived quality of life were the most significant factors.</p><p><strong>Interpretation: </strong>Although wearing glasses or having eye diseases was associated with a visit to an eye care professional, this study revealed additional emerging associated factors: access to a family doctor for people aged 6 to 64, and an excellent or very good self-perceived quality of life for those aged 65 to 79.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"33 12","pages":"24-36"},"PeriodicalIF":5.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10616821","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 role of neighbourhood environments in hospitalization risk for diabetes and related conditions: A population-based cohort analysis by remoteness and deprivation indices.","authors":"Neeru Gupta,&nbsp;Dan Lawson Crouse,&nbsp;Pablo Miah,&nbsp;Tim Takaro","doi":"10.25318/82-003-x202201200001-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202201200001-eng","url":null,"abstract":"<p><strong>Background: </strong>Most socio-epidemiological studies on diabetes incidence, prevalence, or hospitalization focus on individual-level risk factors. This population-based cohort study sought to advance understanding on the associations of contextual characteristics and risk of diabetes-related avoidable hospitalization (DRAH) among at-risk Canadians.</p><p><strong>Data and methods: </strong>A national cohort was compiled from the 2013/2014 Canadian Community Health Survey, representing 5.1 million adults aged 35 years and older, reporting having been diagnosed with diabetes, hypertension, or heart disease. Their information was linked longitudinally to hospitalization data from the 2013/14 to 2017/18 Discharge Abstract Database as well as to measures of geographic variability from the Material and Social Deprivation Index and the Index of Remoteness. Cox regression models were used to examine associations between the contextual indices and first occurrence of a DRAH.</p><p><strong>Results: </strong>Residents in the most rural and remote communities were 50% more likely (hazard ratio (HR): 1.51, 95% confidence interval (95% CI): 1.26 to 1.80) to experience a DRAH than those in the most urbanized and accessible communities, and residents in the most socially deprived areas were significantly more likely (HR: 1.44, 95% CI: 1.26 to 1.65) to be hospitalized than those in the most socially privileged areas, controlling for individuals' sociodemographic characteristics and health behaviours. Neighbourhood material deprivation did not exercise a statistically significant influence on hospitalization risk after adjusting for the other residential characteristics.</p><p><strong>Interpretation: </strong>There is a clear and significant gradient in diabetes-related hospitalization risk among Canadians with an underlying cardiometabolic condition by degree of residential remoteness and of neighbourhood social deprivation, independently of individual characteristics and despite Canada's universal healthcare system.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"33 12","pages":"3-13"},"PeriodicalIF":5.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10616822","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}