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

{"title":"Factors associated with low self-compassion in young adults.","authors":"Erin K O'Loughlin, Maryam Marashi, Shannon Beer, Catherine M Sabiston, Amy E Nesbitt, Roxy H O'Rourke, Marie-Pierre Sylvestre, Jennifer L O'Loughlin","doi":"10.17269/s41997-024-00965-8","DOIUrl":"https://doi.org/10.17269/s41997-024-00965-8","url":null,"abstract":"<p><strong>Objective: </strong>Self-compassion comprises treating oneself non-judgementally with kindness and understanding during life challenges. Our aim was to identify, from among a diverse set of sociodemographic, lifestyle behavioural, psychological, family/peer social influence, and health indicators, factors associated with low self-compassion in a population-based sample of young adults.</p><p><strong>Methods: </strong>Data on 37 factors potentially associated with low self-compassion were drawn from cycle 23 of the ongoing 24-year Nicotine Dependence in Teens (NDIT) study for 682 participants (M_age 30.5, SD = 1.0, 41% male). Self-compassion data were drawn from cycle 25 (M_age 35.2, SD = 0.6). Crude and adjusted multivariable logistic regression models were fit separately for each factor studied.</p><p><strong>Results: </strong>Sixteen percent of participants reported low self-compassion. Factors associated with low self-compassion included female sex, poor sleep quality, higher frequency of overeating, trying to lose weight, higher depressive symptoms, low self-esteem, higher daily stress, body-related emotions, higher introjected regulation for physical activity, receiving negative comments about weight, poor self-rated health, and diagnosis of a mood or anxiety disorder.</p><p><strong>Conclusion: </strong>A complex array of factors may influence self-compassion, underscoring the need for better understanding of causality as well as the relationships across factors to determine which factors hold promise in terms of intervention.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734463","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":"Adolescent behavioural intentions: Secondary outcomes from a cluster randomized controlled trial of the Health4Life school-based lifestyle modification intervention.","authors":"Siobhan O'Dean, Scarlett Smout, Matthew Sunderland, Tim Slade, Lauren A Gardner, Cath Chapman, Louise Thornton, Bridie Osman, Emily Hunter, Lyra Egan, Maree Teesson, Nicola C Newton, Katrina E Champion","doi":"10.17269/s41997-024-00955-w","DOIUrl":"https://doi.org/10.17269/s41997-024-00955-w","url":null,"abstract":"<p><strong>Intervention: </strong>Health4Life: a school-based eHealth intervention targeting multiple health behaviour change (MHBC).</p><p><strong>Research question: </strong>Does Health4Life impact secondary outcomes of self-reported intentions regarding six lifestyle behaviours in adolescents (alcohol use, tobacco smoking, screentime, physical activity, discretionary beverage consumption, and sleep)?</p><p><strong>Methods: </strong>We implemented a cluster randomized controlled trial within secondary schools across three Australian states. Schools were randomly assigned (1:1) to receive either the Health4Life intervention, which consisted of a six-module, web-based program and accompanying smartphone app, or an active control (standard health education). Randomization was stratified by site and school gender composition (using Blockrand in R). All students aged 11-13 years who attended the participating schools and were fluent in English were eligible. Students completed self-report questionnaires at baseline, post-intervention, 12 months, and 24 months. Outcomes were intentions to try alcohol, try tobacco, reduce screentime, engage in physical activity on most or all days, swap discretionary beverages for water, and meet sleep guidelines. Mixed effects models estimated between-group differences in the outcomes over 24 months.</p><p><strong>Results: </strong>Immediately post-intervention, Health4Life significantly reduced intentions to try alcohol and tobacco and increased intentions for longer sleep and reduced screentime compared to control. Intervention effects on screentime intentions persisted at 12 months but not at 24 months. No lasting effects were observed on intentions for physical activity or discretionary beverage consumption.</p><p><strong>Conclusion: </strong>Health4Life shows promise in influencing adolescent intentions across various MHBC areas, especially immediately after intervention. However, further investigation is needed to sustain these intention changes beyond short term to facilitate behaviour change.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677693","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":"Implementation of a paraprofessional role across the public health sector in Manitoba: Impacts on system capacity.","authors":"Shelley Marshall, Degol Tsegai, Mhairi Lintott, Trevor Carnelley, Santina Lee, Carol Kurbis","doi":"10.17269/s41997-024-00967-6","DOIUrl":"https://doi.org/10.17269/s41997-024-00967-6","url":null,"abstract":"<p><strong>Setting: </strong>Manitoba experiences sexually transmitted and blood-borne infection (STBBI) incidence rates above the national average and fundamental public health sector responses face human resource constraints.</p><p><strong>Intervention: </strong>Manitoba implemented a paraprofessional role, the Communicable Disease Technician (CD Tech), to complete low-complexity STBBI investigations and support STBBI testing, care engagement initiatives, provider reporting, harm reduction supply distribution, and community engagement. Secondary roles included tuberculosis directly observed treatment (DOT) and virtual DOT, and flu and COVID immunization support. Twenty CD Tech positions were allocated to regional public health teams along with additional Public Health Nurse (PHN) positions to support the role.</p><p><strong>Outcomes: </strong>Mixed methods were used to evaluate the impact on public health system capacity. Follow-up of chlamydia and gonorrhea case investigations increased from 35% to 98%. Volume of contacts followed by public health increased for chlamydia (114%), gonorrhea (33%), and HIV (68%). Health care provider reporting for cases of STBBI and treatment more than doubled (116%). No significant differences in case investigation data quality were found between CD Techs and PHNs. Qualitative interviews by public health staff (n = 24) found CD Techs highly flexible and competent team members who can fill gaps and expand capacity in direct client service, outreach, administration, data entry, or community/partner engagement.</p><p><strong>Implications: </strong>Mentorship, ongoing supervision, role clarity, training, and clear practice standards are required to optimize the role. There is potential to expand this innovation and build surge capacity in other areas of public health practice, and other public health jurisdictions.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677694","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":"Where public health meets public opinion: Understanding political support for fluoridation in Calgary, 2021.","authors":"Jack Lucas, R Michael McGregor, Simon Kiss, Andrea M L Perrella","doi":"10.17269/s41997-024-00960-z","DOIUrl":"10.17269/s41997-024-00960-z","url":null,"abstract":"<p><strong>Objectives: </strong>To understand variables associated with support for community water fluoridation among ordinary citizens during periods of heightened issue salience, with a particular focus on how support varies on the basis of demographic characteristics, attitudes toward public health science, and political variables such as ideology, populism, and issue salience.</p><p><strong>Methods: </strong>Statistical analysis of individual-level data from a large-scale survey of eligible voters in the City of Calgary, Alberta in 2021, collected at the time of a community water fluoridation plebiscite.</p><p><strong>Results: </strong>Survey data (N = 1130) reveal substantively important and statistically significant relationships with fluoridation support in each of our three analysis categories (demographics, public health expertise, and politics). Support for fluoridation tends to be higher among men, university-educated, higher-income; among those with trust in experts and knowledge of fluoride governance; and among those who consider the issue important and have low levels of populist attitudes. Two exceptions to findings in past studies are age and ideology: younger respondents were more likely than older respondents to support fluoridation in Calgary, as were those on the ideological left, as compared to the right.</p><p><strong>Conclusion: </strong>Incorporating studies of the correlates of public attitudes related to public health policies is important for understanding public health policy failure and success, especially in instances involving public consultation mechanisms, such as plebiscites.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669514","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":"Nats'eji (healing): Examining patient and provider experiences with hospital-based Indigenous wellness services in Northwest Territories, Canada.","authors":"Sophie Isabelle Grace Roher, Paul Andrew, Susan Chatwood, Kimberly Fairman, Tracey Galloway, Angela Mashford-Pringle, Jennifer L Gibson","doi":"10.17269/s41997-024-00959-6","DOIUrl":"https://doi.org/10.17269/s41997-024-00959-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine how Indigenous patients and biomedical healthcare providers understand and experience the Indigenous wellness services at a hospital in the Northwest Territories.</p><p><strong>Methods: </strong>The qualitative study (May 2018-June 2022) was overseen by a regional Indigenous Community Advisory Committee. Guided by Two-Eyed Seeing and post-colonial theory, the study employed a community-engaged research design, and included two strategies for data generation: (1) interviews with Indigenous Elders, patient advocates, biomedical healthcare providers, policy makers, and hospital administrators (n = 41), and (2) iterative sharing circles with Indigenous Elders (n = 4). Data from the interviews and first sharing circle were transcribed, thematically analyzed, and presented to the sharing circle Elders for validation.</p><p><strong>Results: </strong>The study revealed three overarching and related themes: (1) Elders and patient advocates emphasized that while the Indigenous wellness services at the hospital play a pivotal role connecting patients with cultural supports, the hospital was still not effectively bringing Indigenous healing practices into hospital care; (2) participants identified that structural factors (i.e., policy and governance decisions) shaped patients' experiences with the wellness services; and (3) participants underscored that deeply rooted forces (i.e., racism, colonialism, and biomedical dominance) inhibit the integration of Indigenous healing practices.</p><p><strong>Conclusion: </strong>The findings extend understandings of hospital-based Indigenous wellness services by surfacing relationships between deeply rooted forces, organizational structures, and Indigenous patients' experiences. Altogether, they suggest that to advance care for Indigenous patients and improve the integration of Indigenous healing practices, a system-wide transformation is necessary, which includes Indigenous governance at the hospital and a recognition of the value of Indigenous healing practices.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632378","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":"Factors associated with the development, severity, and resolution of post COVID-19 condition in adults living in Canada, January 2020 to August 2022.","authors":"Dianne Zakaria, Alain Demers, Nicholas Cheta, Samina Aziz, Peri Abdullah","doi":"10.17269/s41997-024-00958-7","DOIUrl":"https://doi.org/10.17269/s41997-024-00958-7","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to characterize the burden of post COVID-19 condition (PCC) among adults in Canada and identify factors associated with its occurrence, severity, and resolution.</p><p><strong>Methods: </strong>We used self-report data from a population-based cross-sectional probability survey of adults in Canada conducted between April and August 2022. Incidence and prevalence of PCC were estimated using confirmed infections, as well as confirmed and suspected combined. Multivariable modeling using confirmed cases identified associated factors.</p><p><strong>Results: </strong>As of August 2022, 17.2% (95% CI 15.7, 18.8) of adults with confirmed infections and 16.7% (95% CI 15.5, 18.0) of adults with confirmed or suspected infections experienced PCC, translating to 3.3% (95% CI 3.0, 3.6) and 4.4% (95% CI 4.1, 4.8) of all adults, respectively. Age less than 65 years (aORs of 1.75 to 2.14), more pre-existing comorbidities (aORs of 1.75 to 3.57), and a more severe initial infection (aORs of 3.52 to 9.69) were all associated with higher odds of PCC, while male sex at birth (aOR = 0.54, 95% CI 0.41, 0.70), identifying as Black (aOR = 0.23, 95% CI 0.11, 0.51), and being infected after 2020 (aORs of 0.24 to 0.55) were associated with lower odds. Those residing in a rural area (aOR = 2.31, 95% CI 1.35, 3.93), or reporting a disability (aOR = 2.87, 95% CI 1.14, 7.25), pre-existing chronic lung condition (aOR = 5.47, 95% CI 1.85, 16.12) or back problem (aOR = 2.34, 95% CI 1.26, 4.36), or PCC headache (aOR = 2.47, 95% CI 1.60, 3.83) or weakness (aOR = 2.27, 95% CI 1.41, 3.68) had higher odds of greater limitations in daily activities, while males had lower odds (aOR = 0.54, 95% CI 0.34, 0.85). Two or more pre-existing chronic conditions (aHRs from 0.33 to 0.38), or PCC symptoms relating to the heart (aHR = 0.25, 95% CI 0.07, 0.90), brain fog (aHR = 0.44, 95% CI 0.23, 0.86), or stress/anxiety (aHR = 0.48, 95% CI 0.24, 0.96) were associated with a decreased rate of symptom resolution.</p><p><strong>Conclusion: </strong>Over the first two and a half years of the pandemic, a substantial proportion of infected adults in Canada reported PCC. Females and people with comorbidities were disproportionately impacted.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562570","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":"Our health counts: In our voices.","authors":"Cheryllee Bourgeois, Michael Hardy, Constance McKnight, Marcie Snyder, Maggie Yakorennio Powless-Lynes, Janet Smylie","doi":"10.17269/s41997-024-00939-w","DOIUrl":"10.17269/s41997-024-00939-w","url":null,"abstract":"","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"181-186"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Our Health Counts: Examining associations between colonialism and ever being incarcerated among First Nations, Inuit, and Métis people in London, Thunder Bay, and Toronto, Canada.","authors":"Nicole M Muir, Michael Rotondi, Raman Brar, Nooshin Khobzi Rotondi, Cheryllee Bourgeois, Brian Dokis, Michael Hardy, Raglan Maddox, Janet Smylie","doi":"10.17269/s41997-023-00838-6","DOIUrl":"10.17269/s41997-023-00838-6","url":null,"abstract":"<p><strong>Objectives: </strong>Indigenous peoples have a disproportionately high prevalence of incarceration in the Canadian justice system. However, there is limited Indigenous-driven research examining colonialism and the justice system, specifically associations between racism, externally imposed family disruptions, and history of ever being incarcerated. Therefore, this study examined the association between the proportion of previous incarceration and family disruption, experiences of racism, and victimization for Indigenous adults in London, Thunder Bay, and Toronto, Ontario, Canada. The three communities expressed that they did not want comparison between the communities; rather, they wanted analysis of their community to understand where more supports were needed.</p><p><strong>Methods: </strong>Indigenous community partners used respondent-driven sampling (RDS) to collect data from First Nations, Inuit, and Métis (FNIM) peoples in London, Thunder Bay, and Toronto. Prevalence estimates, 95% confidence intervals, and relative risk were reported using unweighted Poisson models and RDS-adjusted proportions.</p><p><strong>Results: </strong>Proportions of ever being incarcerated ranged from 43.0% in London to 54.0% in Toronto and 72.0% in Thunder Bay. In all three cities, history of child protection involvement and experiencing racism was associated with an approximate 25.0% increase in risk for previous incarceration. In Toronto and London, victimization was associated with increased risk for incarceration.</p><p><strong>Conclusion: </strong>This research highlights disproportionately high prevalence of ever being incarcerated among FNIM living in three Ontario cities. Experiencing racism, family disruption, and victimization are associated with incarceration. Decreasing the rates of family disruption, experiences of racism, and victimization should inform future policy and services to reduce the disproportionately high prevalence of incarceration for FNIM people living in urban settings.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"239-252"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11582257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Our Health Counts Toronto: Commercial tobacco use among Indigenous peoples in Toronto.","authors":"Raglan Maddox, Kristen O'Brien, Chloé G Xavier, Sara Wolfe, Cheryllee Bourgeois, Janet Smylie","doi":"10.17269/s41997-024-00975-6","DOIUrl":"10.17269/s41997-024-00975-6","url":null,"abstract":"<p><strong>Objective: </strong>Fueled by the commercial tobacco industry, commercial tobacco use continues to be the leading preventable cause of premature death in Canada, with opportunities to improve health outcomes. The objective of this research was to work with Indigenous partners to generate Indigenous population prevalence estimates of commercial tobacco use in Toronto, and examine the association between smoking and sociodemographic, cultural, resiliency, and social variables.</p><p><strong>Methods: </strong>Respondent-driven sampling (RDS) was used to generate prevalence estimates of commercial tobacco use and potentially associated sociodemographic, cultural, resiliency, and social connection variables for Indigenous adults living in Toronto. Statistical analysis examined associations between smoking and variables theorized to be predictors of tobacco use.</p><p><strong>Results: </strong>The findings indicated that 36.3% (95%CI 28.2-44.5) of the Indigenous population in Toronto do not smoke, and 63.6% (95%CI 55.5-71.7) reported smoking. Univariate analysis of demographic, social, and cultural variables found age and employment to be statistically significantly different between adults who smoked and adults who did not smoke. Indigenous adults who were above the before-tax low-income cut-off (LICO) were more likely to smoke compared to those who were below the before-tax LICO. Indigenous adults who completed high school were more likely to smoke compared to those who did not complete high school, similarly to those who were unemployed compared to those who were employed. However, those who were not in the labour force (student or retired) were less likely to smoke compared to those who were employed. These effects remained after adjustment for age, gender, and LICO. Indigenous adults with stable housing were 20% less likely to smoke compared to those experiencing homelessness. Adults who had at least one close friend or family member to confide in were more likely to smoke compared to those who did not have any close friends or family members. Indigenous adults were more likely to smoke if they participated in Indigenous ceremony compared to those who did not participate.</p><p><strong>Conclusion: </strong>The Indigenous population in Toronto continues to experience smoking prevalence nearly four times greater than that in the general population. This highlights the need for accurate population data to inform programs and policies and address the social determinants of health.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"273-287"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11582226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking population undercounts, health inequities, and health service access barriers across Indigenous populations in urban Ontario.","authors":"Marcie Snyder, Stephanie McConkey, Raman Brar, Judy Anilniliak, Cheryllee Bourgeois, Brian Dokis, Michael Hardy, Serena Joseph, Amanda Kilabuk, Jo-Ann Mattina, Constance McKnight, Janet Smylie","doi":"10.17269/s41997-024-00957-8","DOIUrl":"10.17269/s41997-024-00957-8","url":null,"abstract":"<p><strong>Objectives: </strong>Our Health Counts (OHC) methods are designed to address gaps in urban-based Indigenous health information. In partnership with local Indigenous health service providers, we have successfully implemented OHC in six Ontario cities. The aim of this study is to summarize findings regarding Indigenous population undercount, health inequities, and health service access barriers across study sites.</p><p><strong>Methods: </strong>We estimated Indigenous population size using OHC census participation survey responses and a multiplier approach. Health inequities between Indigenous populations and overall populations in each city were examined using respondent-driven sampling (RDS), adjusted OHC survey results, and existing public data. Measures included health status outcomes; determinants of health; barriers to health service access, including discrimination by health service providers; and unmet health needs.</p><p><strong>Results: </strong>Indigenous social networks were strong and extensive, and the urban populations demonstrate resilience and cultural continuity across multiple measures. Self-reported rates of census participation for Indigenous populations were markedly lower than those for the general population in each city, and OHC Indigenous population size estimates were consistently 2‒4 times higher than reported in the census. Indigenous to general population health inequities cut across measures of chronic disease, determinants of health, and unmet health needs. Indigenous populations experienced multiple barriers to health services access, including racial discrimination by health service providers.</p><p><strong>Conclusion: </strong>The Canadian census appears to markedly underestimate Indigenous population size in urban areas. Indigenous health inequities and service access barriers are striking and cross-cutting. Timely adaptation of health policies, services, and funding allocations in response to these findings is recommended.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"209-226"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11582239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}