Canadian Journal of Public Health-Revue Canadienne De Sante Publique最新文献

{"title":"The Doctor of Public Health (DrPH) program at the University of Toronto: Early observations from Canada's first professional public health doctorate.","authors":"Theodore J Witek, Erica Di Ruggiero, Dionne Gesink","doi":"10.17269/s41997-025-01003-x","DOIUrl":"https://doi.org/10.17269/s41997-025-01003-x","url":null,"abstract":"<p><strong>Setting: </strong>The Dalla Lana School of Public Health (DLSPH) at the University of Toronto.</p><p><strong>Intervention: </strong>The DLSPH entered its inaugural cohort of Doctor of Public Health (DrPH) students in 2021. Development and launch of the program stemmed from the school's strategic plan to offer advanced public health training and was the first such university offering the DrPH in Canada. This paper reflects on the overarching launch experience of the program and its innovation in practice.</p><p><strong>Outcomes: </strong>Early interest in the program is strong and the entry requirement for at least 5 years of real-world experience drives the program's distinction in Canada. The inaugural cohort was instrumental in constructive criticism and harvestable suggestions via evaluations, reflections, and appreciative inquiry-a likely result of the lived professional experiences of students who enrolled in this program. A key feature is the hybrid nature of the program consisting of a series of in-person on-campus forums (\"burst weeks\") over the first half of the degree requirements. In addition to allowing in-person components of the core course, agenda components continually evolve to meet students' stated needs and competencies.</p><p><strong>Implications: </strong>The deliberate focus on the foundational competencies of leadership was fostered through classes on leadership of self as well as leadership and governance of organizations. Special lectures are curated to ensure that new and emerging concepts challenging society and today's public health leaders are addressed in an ongoing leadership series. The focus is not on developing new leaders but on catalyzing the leaders who constitute this professional cohort to higher levels of responsibility.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing health equity within the Canadian health system.","authors":"Abimbola K Saka, Mohamed Bella Jalloh, Ijeoma Ozurigbo, Notisha Massaquoi","doi":"10.17269/s41997-025-01010-y","DOIUrl":"https://doi.org/10.17269/s41997-025-01010-y","url":null,"abstract":"<p><p>Canada's universal healthcare system aspires to provide equitable care for all citizens, yet persistent health disparities among Indigenous, Black, and other racialized communities reveal significant gaps in service and outcomes. This commentary explores how race-based data collection could address these inequities by identifying at-risk populations, informing targeted interventions, and improving accountability within healthcare systems. The discussion includes an overview of existing challenges, such as mistrust stemming from historical research abuses, varied provincial approaches, and ethical complexities related to privacy and data sovereignty. Examples from within Canada highlight the effectiveness of standardized data collection policies, while international lessons-particularly from the United Kingdom's incentivized data reporting and the United States' mandated approaches-underscore the importance of consistent data-gathering and careful monitoring. The commentary emphasizes that community engagement and leadership are essential to the development of culturally safe practices, and that legal and ethical frameworks must safeguard data from commodification or other forms of misuse. By integrating race-based data collection into policy reforms, embracing Indigenous data governance principles, providing mandatory training for health providers, and establishing robust monitoring systems, Canada can advance meaningful strategies to reduce health disparities. This approach promotes a more equitable healthcare environment, ensuring the principle of universal coverage benefits all communities.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Perinatal mental illness in Ontario (2007-2021): A population-based repeated cross-sectional surveillance study.","authors":"Simone N Vigod, Amreen Babujee, Anjie Huang, Kinwah Fung, Kelsey Vercammen, Jennifer Lye, Susie Dzakpasu, Wei Luo","doi":"10.17269/s41997-025-01030-8","DOIUrl":"https://doi.org/10.17269/s41997-025-01030-8","url":null,"abstract":"","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of the COVID-19 pandemic on the mental health of Black youth.","authors":"Khadija Brouillette, Olivia Aiello, Onaopeoluwapo Egbedeyi, Olga Loggale, Andre M N Renzaho, Aloysius Maduforo, Oluwabukola Salami","doi":"10.17269/s41997-025-01017-5","DOIUrl":"https://doi.org/10.17269/s41997-025-01017-5","url":null,"abstract":"<p><strong>Objectives: </strong>The COVID-19 pandemic had a disproportionate impact on members of Canada's Black community. Morbidity and mortality rates were higher among Blacks, and the mental health of Black youth was particularly affected by health policy measures undertaken during the pandemic, such as social distancing and isolation. Despite this understanding, a lack of awareness remains regarding how containment measures from COVID-19, such as school closures, physical distancing, and lockdowns, impacted the mental health of Black youth in Canada.</p><p><strong>Methods: </strong>We employed a qualitative description approach informed by Youth Participatory Action Research and guided by intersectionality theory as our methodological framework. Semi-structured interviews were used as the primary data generation method, enabling Black youths from across Canada to share their experiences of how the COVID-19 pandemic uniquely impacted their mental health. Thematic analysis was applied to analyze the data and identify key patterns and themes.</p><p><strong>Results: </strong>We recruited 48 Black youth, aged 16 to 30 years. Analysis revealed heightened stress, depression, and anxiety during the COVID-19 pandemic. These mental health challenges were linked to prolonged isolation, academic disruptions, financial insecurity, precarious employment, and fears of police brutality, all of which were exacerbated by the pandemic's disproportionate impact on Black communities.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic has had a profound impact on the mental health of Black youth in Canada. The results of this study highlight the urgent need for increased attention and investment in mental health initiatives specifically targeting Black youth across the country.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparities in HIV pre-exposure prophylaxis (PrEP) awareness and uptake among white, Black, and Indigenous men in Canada: Analysis of data from the I'm Ready national HIV self-testing study.","authors":"Wale Ajiboye, Wangari Tharao, Maureen Owino, Lena Soje, Jason M Lo Hog Tian, Amy Ly, Margaret Kisikaw Piyesis, Albert McLeod, Mathew Fleury, Kristin McBain, Notisha Massaquoi, Tegan Mosugu, Jaris Swidrovich, Darrell H S Tan, LaRon Nelson, Sean B Rourke","doi":"10.17269/s41997-025-01009-5","DOIUrl":"https://doi.org/10.17269/s41997-025-01009-5","url":null,"abstract":"<p><strong>Objectives: </strong>Black and Indigenous men in Canada continue to experience significant and disproportionate burden of new HIV infection. The purpose of this study was to understand racial differences in PrEP awareness and use, and PrEP cascade among white, Black, and Indigenous men in Canada with the intention to provide evidence for immediate action in our publicly funded health care system.</p><p><strong>Methods: </strong>We performed a secondary analysis (n = 4294) of cross-sectional data from the I'm Ready national HIV self-testing research program launched in June 2021 and running through December 2023. Binary logistic regression was used to assess racial differences in PrEP awareness and uptake. A proposed PrEP cascade was developed using the data on awareness, uptake, and retention in PrEP care.</p><p><strong>Results: </strong>Black participants (OR = 0.34, CI 0.29, 0.39), who are gbMSM (OR = 0.27, CI 0.21, 0.35), aged 18-45 (OR = 0.35, CI 0.30, 0.40), living in urban (OR = 0.41, CI 0.33, 0.51) or rural areas (OR = 0.33, CI 0.26, 0.44), and who are PrEP-eligible (OR = 0.34, CI 0.28, 0.40), were less likely to be aware of PrEP than white participants. Indigenous participants (OR = 0.57, CI 0.44, 0.75), aged 18-45 (OR = 0.57, CI 0.43, 0.75), living in rural communities (OR = 0.15, CI 0.25, 0.57), and who are PrEP-eligible (OR = 0.62, CI 0.46, 0.83), were less likely to be aware of PrEP than white participants. For PrEP uptake, Black participants (OR = 0.61, CI 0.46, 0.82), aged 18-45 (OR = 0.59, CI 0.44, 0.80), living in rural communities (OR = 0.44, CI 0.23, 0.84), and PrEP-eligible (OR = 0.62, CI 0.46, 0.85), were less likely to be on PrEP than white participants. Also, Indigenous men living in urban areas were more likely to be on PrEP than white participants (OR = 1.65, CI 1.01, 2.69).</p><p><strong>Conclusion: </strong>Community-based and public health interventions are immediately needed to increase PrEP awareness, access, and uptake for Black and Indigenous communities in Canada.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the rollout of the Triple P system parenting program in Manitoba on rates of child maltreatment: Administrative data analyses and document review of policies and programs.","authors":"Divya Joshi, Marni Brownell, Elizabeth Decaire, Rob Santos, Isuru Dharmasena, Heather Prior, Okechukwu Ekuma, Charlene Attard, Tracie O Afifi, Andrea Gonzalez","doi":"10.17269/s41997-025-01005-9","DOIUrl":"https://doi.org/10.17269/s41997-025-01005-9","url":null,"abstract":"<p><strong>Intervention: </strong>Triple P is a multilevel parenting program aimed at promoting children's emotional, social, and behavioural competence and preventing behavioural problems through supporting parents in positive parenting.</p><p><strong>Research question: </strong>Examine the rollout of the Triple P system parenting program on child maltreatment rates in Manitoba, Canada, using administrative data analysis and document review of policies and programs.</p><p><strong>Methods: </strong>This population-based retrospective cohort study included 962,170 children aged 18 years or younger. Administrative healthcare and social services data from the Manitoba Population Research Data Repository were used to compare child maltreatment indicators before (1989-2004) and after (2005-2018) Triple P implementation.</p><p><strong>Results: </strong>Compared to before Triple P implementation, injury hospitalization rates were lower in the early (2005-2011) and later (2012-2018) periods of implementation. Maltreatment hospitalization and violent death rates were not statistically different in the early period, but they were lower in the later period of Triple P implementation. The interrupted time-series analysis showed that after Triple P intervention in 2005, injury hospitalization rates increased until 2012, followed by a gradual decline through 2018, compared to the expected trend without the intervention. Maltreatment hospitalization trends displayed a decline until 2012, followed by an increase, and then a gradual decline from 2014 to 2018 relative to the anticipated trend without the intervention. These trends varied by age, sex, income quintiles, and region.</p><p><strong>Conclusion: </strong>Triple P is one of several programs that may have contributed to reductions in child maltreatment rates observed in Manitoba since the implementation of the program.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focusing on sleep health for all, not just sleep disorders.","authors":"Jean-Philippe Chaput","doi":"10.17269/s41997-025-01008-6","DOIUrl":"https://doi.org/10.17269/s41997-025-01008-6","url":null,"abstract":"<p><p>Sleep is increasingly recognized as a critical pillar of overall health, yet public health efforts have traditionally focused on treating sleep disorders rather than promoting sleep health for all. This article argues that the time has come to shift the emphasis from a disorder-centric approach to one that prioritizes sleep health for everyone. Sleep health extends beyond the absence of disorders and involves achieving optimal sleep quality, duration, and consistency. Poor sleep is linked to numerous health problems, including cardiovascular disease, type 2 diabetes, mental health disorders, and impaired cognitive function. Focusing on sleep health can help prevent these conditions and reduce healthcare costs. Moreover, addressing sleep health disparities, particularly among lower-income populations, shift workers, and racial and ethnic minorities, is crucial for achieving health equity. This article outlines strategies such as public awareness campaigns, workplace policies, school-based interventions, and policy advocacy to promote sleep health. By fostering a sleep-healthy society, we can improve individual and public health outcomes, enhance productivity, and reduce the economic burden associated with poor sleep. Ultimately, a comprehensive approach to sleep health offers significant benefits that extend beyond the treatment of sleep disorders, promoting a healthier and more equitable society.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographical narcissism and Ontario's opioid crisis.","authors":"Emily Groot","doi":"10.17269/s41997-025-01019-3","DOIUrl":"https://doi.org/10.17269/s41997-025-01019-3","url":null,"abstract":"<p><p>Northern Ontario is the largest and least populated region of the Canadian province of Ontario. Like other rural, remote, and northern regions, Northern Ontario has been disproportionately impacted by the opioid crisis, with an opioid-related mortality rate more than twice that of the province as a whole. Social exclusion is a predictor of drug use, and the urban core-hinterland periphery socioeconomic relationship that undergirds Northern Ontario's economy results in social degradation and economic marginalization. Along with deindustrialization and increased employment precarity, lack of access to health services, and higher rates of work-related pain, the exclusion inherent to the core-hinterland relationship increases risk of opioid-related mortality. Although the inequities in both the determinants and outcomes of substance use in Northern Ontario are stark, research, policy, and intervention continue to focus on Southern Ontario.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resident and staff experiences of structural barriers to a housing-based overdose prevention site in Vancouver, Canada: \"There is a double standard if you smoke\".","authors":"Benjamin D Scher, Benjamin W Chrisinger, David K Humphreys, Gillian W Shorter","doi":"10.17269/s41997-025-01007-7","DOIUrl":"https://doi.org/10.17269/s41997-025-01007-7","url":null,"abstract":"<p><strong>Objectives: </strong>Most overdoses in British Columbia (BC), Canada, occur within housing settings. In response, the provincial government is increasingly implementing housing-based overdose prevention sites (HOPS). Within the context of a contaminated drug supply, and changing consumption practices, there is little research examining the effectiveness of HOPS. The aim of this study was to explore qualitatively how residents and staff experience HOPS, focusing on how this intervention fits into the day-to-day operations of a low-barrier housing facility.</p><p><strong>Methods: </strong>This study was undertaken at a non-profit housing and emergency shelter facility, with a HOPS in Vancouver, BC. We employed rapid-ethnographic methods including six weeks of non-participant observation (> 200 h), three focus groups, 20 informal interviews with residents, and 10 semi-structured interviews with staff. Data were analyzed through an inductive thematic approach.</p><p><strong>Results: </strong>Our results suggest that this facility's HOPS is underutilized due to a variety of structural factors, the most prominent of these being the lack of inhalation services. This lack of service provision exacerbates overdose vulnerability and stigma. Continued drug consumption near the building and in non-monitored areas inside the building creates challenges for staff in identifying potential overdoses and exposes residents who do not consume drugs to drug use within the building.</p><p><strong>Conclusion: </strong>Housing provision which provides a safer consumption environment to include those who smoke drugs is urgently needed to support both individuals who smoke and those looking to transition from injecting to smoking.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolving HIV epidemic in Ontario, Canada: A retrospective analysis of new HIV diagnoses to identify subpopulations with persistent risk of HIV transmission.","authors":"Abigail Kroch, David Gogolishvili, Kristen O'Brien, Lauren Orser, Kevin Woodward, Wangari Tharao, Daniel Lazzam, Katherine Burress, Majorie Kabahenda, Mona Loutfy, Patrick O'Byrne","doi":"10.17269/s41997-025-00997-8","DOIUrl":"https://doi.org/10.17269/s41997-025-00997-8","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to characterize new HIV diagnoses in key Ontario cities, in order to understand current drivers of continued HIV transmission to inform HIV testing and prevention efforts.</p><p><strong>Methods: </strong>Chart reviews were carried out at four clinical sites in Ontario, Canada. The study population included individuals who were diagnosed with HIV in Ottawa, Hamilton, and Toronto between January 1, 2018, and December 31, 2020, and had no previous evidence of HIV documented.</p><p><strong>Results: </strong>The total number of persons in this analysis was 359, from Toronto (n = 201), Ottawa (n = 88), and Hamilton (n = 70). More than half of the diagnoses were among those who immigrated to Canada, and many were diagnosed (11%) during the year they arrived. Many participants experienced a late diagnosis (43.2%), and while 116 (32.3%) had HIV testing history in Ontario, 155 did not (43.2%). Many participants were men who have sex with men (MSM) and had a previously recorded diagnosis of gonorrhea or chlamydia (n = 27; 7.5%) or syphilis (n = 39; 10.9%). Among women and heterosexual men, a diagnosis of hepatitis C (n = 18; 5.0%) appeared to signal a risk of HIV diagnosis.</p><p><strong>Conclusion: </strong>These data show that HIV testing and prevention strategies should be targeted to (1) MSM with a history of syphilis, gonorrhea, or chlamydia; (2) heterosexual men and women with a history of hepatitis C; and (3) immigrants within the first 5 years of migration. To address the evolving epidemic, it will be necessary to employ targeted HIV screening and prevention measures.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}