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

{"title":"Sex differences in the prevalence and cardiometabolic risk profiles of steatotic liver disease: A Canadian Longitudinal Study on Aging analysis.","authors":"Jessica Burnside, Felice Cinque, Giada Sebastiani, Alnoor Ramji, Keyur Patel, Mark Swain, Sahar Saeed","doi":"10.17269/s41997-025-01025-5","DOIUrl":"https://doi.org/10.17269/s41997-025-01025-5","url":null,"abstract":"<p><strong>Objective: </strong>Steatotic liver disease (SLD) is absent from global public health agendas. Our study is the first to comprehensively examine SLD prevalence in Canada, focusing on sex differences.</p><p><strong>Methods: </strong>We used data from the Canadian Longitudinal Study on Aging between 2012 and 2018. Steatosis was identified using the validated NAFLD Ridge Score. Using the most recent diagnostic criteria, we defined metabolic (dysfunction)-associated steatotic liver disease (MASLD), metabolic dysfunction-associated alcohol-associated liver disease (MetALD), and alcohol-associated liver disease (ALD) and estimated prevalences by sociodemographic factors. Survey-weighted adjusted prevalence ratios (aPR) for MASLD (sex-stratified) and MetALD were estimated using Poisson regression with robust standard errors.</p><p><strong>Results: </strong>A total of 24,888 people (51.4% female; median age 58 years) were included. The most common subtype of SLD was MASLD, 35% (95%CI, 34-36), followed by MetALD 2.6% (2.3-2.9), and ALD 0.8% (0.6-1.0). Overall, the prevalences for MASLD and MetALD were significantly higher among males at 46% (45-48) and 3.7% (3.2-4.2) compared to females at 24% (23-26) and 1.6% (1.2‒2.1), respectively. Lower household incomes were associated with higher MASLD prevalence in females (aPR, 2.9, 2.4-3.5) and males (aPR, 1.1, 1.0-1.3). Multimorbidity was high among the MASLD group; 31 unique MASLD phenotypes based on cardiometabolic characteristics were identified. Females with MASLD were also more likely to have more cardiometabolic conditions compared to males with MASLD.</p><p><strong>Conclusion: </strong>In this large Canadian cohort, we found significant sex differences in SLD burden and cardiometabolic features. Epidemiological assessments are necessary to improve preparedness for the significant projected increase in advanced liver disease.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037898","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 association between public health unit funding and vegetable and fruit intake in Ontario: A multilevel analysis of the 2013-2014 Canadian Community Health Survey.","authors":"Stephen Hunter, Derek Akateh, Naomi Schwartz, Brendan T Smith, Roman Pabayo","doi":"10.17269/s41997-025-01033-5","DOIUrl":"https://doi.org/10.17269/s41997-025-01033-5","url":null,"abstract":"<p><strong>Objective: </strong>Robust public health systems are vital for preventing disease and injury, improving well-being, and promoting health equity. The study objective was to estimate the association between public health funding and fruit and vegetable intake.</p><p><strong>Methods: </strong>Participants were residents aged 12 years and older living within 34 public health unit (PHU) regions in Ontario, Canada (n = 36,500). Secondary cross-sectional data from the population-representative 2013-2014 Canadian Community Health Survey (CCHS) were used. Vegetable and fruit intake was self reported in the CCHS along with individual covariates. PHU funding per capita and other area-level social characteristics were measured at the level of the public health region.</p><p><strong>Results: </strong>PHU funding per capita was not associated with vegetable and fruit intake overall (OR = 1.02, 95% CI 0.97, 1.07) or in gender-stratified analyses (males: OR = 1.06, 95% CI 0.99, 1.13; females: OR = 0.98, 95% CI 0.92, 1.05). Associations were not heterogenous across various sociodemographic indicators (age, gender, race, marital status, country of birth, education, income, urbanicity).</p><p><strong>Conclusion: </strong>PHU funding per capita was not associated with vegetable and fruit intake. More refined measures of PHU funding for vegetable and fruit intake may be beneficial for future research.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062637","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":"Polysubstance use and mental health among young adults.","authors":"Rajit Chopra, Marie-Pierre Sylvestre, Annie Pelekanakis, Isabelle Doré, Abdou Y Omorou, Jennifer O'Loughlin","doi":"10.17269/s41997-025-01035-3","DOIUrl":"https://doi.org/10.17269/s41997-025-01035-3","url":null,"abstract":"<p><strong>Objectives: </strong>To describe mental health indicators according to regular (i.e., weekly or daily) alcohol, cannabis, and/or nicotine use in a population-based sample of young adults.</p><p><strong>Methods: </strong>Data for 733 participants (mean age = 30.6 years) were drawn from cycle 23 of the ongoing Nicotine Dependence In Teens study, Montreal, Canada. The associations between (i) number of substances used and (ii) pattern of polysubstance use and each of depressive symptoms, anxiety symptoms, and positive mental health (PMH) were modeled using multivariable linear regression adjusting for age, sex, and education.</p><p><strong>Results: </strong>Median (IQR) scores for depressive symptoms (range 0-50), anxiety symptoms (range 0-21), and PMH (range 0-70) were 8.0 (7.0), 4.0 (6.0), and 43.0 (18.0), respectively. One third (37%) of participants did not report regular use of any substance; 42%, 16%, and 5% reported regular use of one, two, or three substances, respectively. There was no dose-response association between number of substances used and any mental health indicator. Relative to no substance use, regular use of two substances was associated with more frequent anxiety symptoms ( <math><mover><mi>β</mi> <mo>^</mo></mover> </math>  [95% CI] = 1.32 [0.34, 2.31]) and lower PMH (-3.64 [-6.34, -0.95]). Specifically, the cannabis-nicotine combination was associated with more frequent anxiety symptoms (2.58 [1.06, 4.10]) and lower PMH (-5.90 [-10.04, -1.76]). The alcohol-nicotine combination was associated with lower PMH (-3.70 [-7.30, -0.10]).</p><p><strong>Conclusion: </strong>Specific pairings of alcohol, nicotine, and cannabis may be important in their associations with mental health. Longitudinal studies in population-based samples of young adults are needed to replicate these findings before their implications for public health programming can be considered.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998845","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":"Naloxone awareness and acquisition: Findings from the 2021‒2022 Canadian Postsecondary Education Alcohol and Drug Use Survey.","authors":"Jacqueline Burt, Emilia Krzeminska","doi":"10.17269/s41997-025-01034-4","DOIUrl":"https://doi.org/10.17269/s41997-025-01034-4","url":null,"abstract":"<p><strong>Objectives: </strong>This cross-sectional study assessed naloxone awareness, acquisition rates, and reasons for acquisition among postsecondary students in Canada aged 17‒25 years.</p><p><strong>Methods: </strong>Using data from the 2021‒2022 Canadian Postsecondary Education Alcohol and Drug Use Survey, we conducted descriptive analyses of 31,643 students to characterize naloxone awareness, acquisition, and reasons for acquisition overall and by age, gender, race, international student status, and opioid pain reliever (OPR) use. Using multivariable logistic regression, we assessed the relationship between demographic variables and naloxone awareness and acquisition.</p><p><strong>Results: </strong>Among postsecondary students in Canada, only 47% had heard of naloxone, and only 5% had acquired it in the past year. Significant predictors of naloxone awareness and acquisition included gender, age, race, international student status, and OPR use. Older students, non-binary students, domestic students, and Indigenous students had higher odds of both naloxone awareness and acquisition. Students who had used OPRs in the past year were less likely to be aware of naloxone (AOR = 0.85, 95% CI: 0.80-0.91). However, among those who were aware, they were more likely to have acquired naloxone (AOR = 1.16, 95% CI: 1.01-1.34) than those who had not used OPRs. Among students who had acquired naloxone in the past year, 97% reported their main reason for obtaining it was for use in emergencies involving other people.</p><p><strong>Conclusion: </strong>Low naloxone awareness and acquisition among postsecondary students in Canada represent an important public health gap. Increasing naloxone awareness and acquisition may play an important role in enhancing safety on campuses and beyond.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052499","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":"Advocating for cash incentives instead of gift cards in public health research: Dollars over donuts.","authors":"Alexandra Kubica, Ben Evans-Durán, Daniel Z Buchman, Aaron M Orkin","doi":"10.17269/s41997-025-01039-z","DOIUrl":"https://doi.org/10.17269/s41997-025-01039-z","url":null,"abstract":"<p><p>Incentives for participation can help enable more equitable public health research practices, particularly when working with people from structurally disadvantaged populations, such as people who use drugs or people experiencing homelessness. Administrative and perceived ethical advantages have solidified gift card incentives in research, even though participants tend to prefer cash incentives for their time, knowledge, and contribution of lived experiences. The use of cash instead of gift cards may merit fresh attention. Drawing from research with marginalized groups, we summarize concerns with gift cards and argue that cash incentives align better with public health ethical principles. Gift cards, while convenient for researchers, can constrain participants' economic autonomy, foster mistrust, and magnify inequities and power imbalances between researchers and participants. Cash can help to affirm participants' autonomy, reduce stigma, demonstrate solidarity and trustworthiness, and directly benefit health. Public health researchers and ethics boards can enable cash incentive practices that centre participant welfare over researcher and institutional convenience. In so doing, they uphold more equitable and respectful relationships with study participants, advancing both public health research and ethical standards.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032653","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":"COVID-19 isolation and recovery sites evaluation: Lessons learned for systems innovation.","authors":"Michelle Firestone, Kimia Khoee, Gillian Kolla, Patricia O'Campo, Rosane Nisenbaum, D Linn Holness, Lisa Schlosser, Michaela Beder, Lorie Steer, Terry Pariseau, Ahmed M Bayoumi","doi":"10.17269/s41997-025-01031-7","DOIUrl":"https://doi.org/10.17269/s41997-025-01031-7","url":null,"abstract":"<p><strong>Objective: </strong>The City of Toronto opened COVID-19 Isolation and Recovery Sites (CIRS) in 2020 in response to the need for supported isolation spaces for people experiencing homelessness. As a team of academic researchers and community partners, we assessed how lessons from the CIRS can inform post-pandemic policies for people experiencing homelessness. We focused on identifying models and systems of care for understanding existing services and integration, identifying innovations, and imagining how care can be transformed to be more caring and just.</p><p><strong>Methods: </strong>We conducted 43 key informant interviews with clinicians, peer and harm reduction workers, executive leaders, operational leaders, and people who worked for funding or decision-making organizations. Data were coded and analyzed using deductive content analysis.</p><p><strong>Results: </strong>The CIRS presented a new service model that moved away from being overly medicalized towards having a community orientation, which involved greater integration of services for people experiencing homelessness, transparent decision-making, and open communication. Key to this approach were clinical case management, harm reduction services, strong support of peer workers, and adequate and consistent funding. Future models will need to address power imbalances and hierarchies through formal agreements and processes as well as establishing collaborative cultures.</p><p><strong>Conclusion: </strong>The CIRS offer an important opportunity to rethink services offered within shelter settings. Such change will require a strong vision, sufficient funding, political will, and accountability among all stakeholders. The COVID-19 pandemic offers decision makers an opportunity to consider system-level transformation by looking at largely successful elements of the crisis responses.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053279","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":"Two-Eyed Seeing and artificial intelligence: Enhancing healthcare delivery in Indigenous communities requires an ethical and culturally relevant public health framework.","authors":"Amal Khan, Veronica McKinney, Ivar Mendez","doi":"10.17269/s41997-025-01037-1","DOIUrl":"https://doi.org/10.17269/s41997-025-01037-1","url":null,"abstract":"<p><p>Artificial intelligence (AI) is poised to transform healthcare delivery; this may be particularly important to underserved rural, remote, and Indigenous communities. This commentary explores the potential of AI to enhance healthcare access and outcomes of these populations while emphasizing the need for culturally safe and ethical implementation. By integrating AI with Indigenous knowledge systems through the Two-Eyed Seeing approach, we propose a framework that ensures that AI-driven healthcare is equitable, culturally sensitive, and effective. This public health perspective highlights the importance of approaching AI advancements with a culturally appropriate and relevant lens.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048090","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":"Description and evaluation of a national humanitarian opioid poisoning education and naloxone distribution program.","authors":"Bruna Dos Santos, Alexandra Kubica, Anna Maria Subic, Nick Rondinelli, Ben Evans-Durán, Melina Hanna, Don Marentette, Joanna Muise, Kevin Paes, Meghan Riley, Samiya Bhuiya, Jeannene Crosby, Keely McBride, Joe Salter, Aaron M Orkin","doi":"10.17269/s41997-025-01027-3","DOIUrl":"https://doi.org/10.17269/s41997-025-01027-3","url":null,"abstract":"<p><strong>Setting: </strong>Canada's opioid poisoning crisis claimed 49,105 lives from January 2016 to June 2024. Opioid poisoning education and naloxone distribution programs can reduce fatalities, although access remains inconsistent across Canada. These programs have mostly been delivered in person through community, healthcare, and social service agencies.</p><p><strong>Intervention: </strong>The Canadian Red Cross implemented a national, free, bilingual, virtually accessible, opioid harm reduction program, leveraging its experience in first aid education and community relationships as a humanitarian organization. The Opioid Harm Reduction program launched three new courses and added opioid poisoning content to four existing courses. Courses were adapted continually based on the feedback of people with lived experience of drug use and program participants. The program was delivered from January 2021 to March 2024 and evaluated through quantitative and qualitative methods.</p><p><strong>Outcomes: </strong>The program delivered 1,386,995 trainings and successfully reached diverse groups, including those from Indigenous (5.3%) and rural (25.2%) communities, but had an underrepresentation of men (34.3%) and individuals working in the construction industry (4.8%). Participants' self-reported knowledge and confidence in responding to opioid poisoning increased across all courses (p < 0.001), particularly for learners without prior training. In total, 24,098 intranasal naloxone kits were distributed, 60.4% to Ontario, Manitoba, and British Columbia. Most participant feedback (82%) received was positive, highlighting the course's simplicity and focus on stigma.</p><p><strong>Implications: </strong>The Canadian Red Cross Opioid Harm Reduction program advanced harm reduction, increased awareness of opioid poisonings, and situated the response to the opioid poisoning crisis as a community health effort.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057377","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":"Nuts'a'maat shqwaluwun - Knitting ways of life with Indigenous research principles to examine preterm birth in Quw'utsun.","authors":"Tˈultunaat Lydia Seymour, Doreen Peter, Eugenia Tinoco, Maia Thomas, Lynsey Johnny, Brenda Yuen, Liz Spry, Fairlie Mendoza, Marnie Elliott, Barbara Webster, Shannon Waters, Diane Sawchuck, Ashley Simpson, Jennifer Leason, Patricia A Janssen, Jennifer B Murray","doi":"10.17269/s41997-025-01028-2","DOIUrl":"https://doi.org/10.17269/s41997-025-01028-2","url":null,"abstract":"<p><strong>Setting: </strong>The Quw'utsun Preterm Birth Study used a community-led and participatory action research methodology to investigate preterm birth in Quw'utsun, a First Nations community in Cowichan Valley, British Columbia (BC). Quw'utsun people and staff from the community's Ts'ewulhtun Health Centre partnered with the BC First Nations Health Authority, Island Health (regional health authority), and the University of British Columbia to develop Nuts'a'maat shqwaluwun (one heart, one mind), a framework for conducting research activities.</p><p><strong>Intervention: </strong>Guided by Elders, Nuts'a'maat shqwaluwun incorporated Quw'utsun standards for research ethics by knitting together snuw'uy'ulh (ways of life), such as Stsi'elh stuhw tu Sul-hween (honour the Elders), with federal policy for ethical conduct of research involving Indigenous people. Situating the study at Cowichan Tribes strengthened the community's authority to lead.</p><p><strong>Outcome: </strong>The framework, Nuts'a'maat shqwaluwun, fostered a research environment where we could Ti'tul'atul' tst (learn from one another). We learned to bring our knowledges together to conduct the study in ways that respected snuw'uy'ulh. This research was meaningful to Quw'utsun people because snuw'uy'ulh were respected. Our partnerships resulted in the first-ever report of preterm birth rates and risk factors among Quw'utsun people. Knowledge translation activities enhanced community access to results.</p><p><strong>Implications: </strong>Indigenous Peoples have an inherent and legislated right to self-determination, including the right to lead research involving them. Several principles within Nuts'a'maat shqwaluwun enabled Quw'utsun people to lead this research: (1) trusting relationships; (2) respecting community-specific ways of life; (3) community ownership and access to data; and (4) training opportunities to lead research.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026161","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":"Are we out of the woods yet? Youth-developed recommendations on recovery from the COVID-19 pandemic: A national Delphi study.","authors":"Meaghen Quinlan-Davidson, Kristin Cleverley, Skye Barbic, Darren Courtney, Gina Dimitropoulos, Lisa D Hawke, Nadia Nandlall, Clement Ma, Matthew Prebeg, J L Henderson","doi":"10.17269/s41997-025-01020-w","DOIUrl":"https://doi.org/10.17269/s41997-025-01020-w","url":null,"abstract":"<p><strong>Objectives: </strong>To generate concrete, youth-derived recommendations to support Canada's post-pandemic recovery from COVID-19 to support youth mental health and substance use (MHSU), economic, and educational recovery.</p><p><strong>Methods: </strong>Using a virtual, modified Delphi, participants rated recommendation items over three rounds, with the option to create their own recommendation items. A priori consensus was defined as ≥ 70% of the entire group, or subgroups of youth (e.g., age, race/ethnicity, gender and sexual identities), rating items at a 6 or 7 (on a 7-point Likert scale). Items were dropped in subsequent rounds if they did not achieve consensus. Qualitative responses were analyzed using content analysis for Round 1.</p><p><strong>Results: </strong>A total of 40 youths participated in Round 1, with good retention (97.5%) in subsequent rounds. Youths achieved consensus on eight recommendations to support post-pandemic recovery. Youths endorsed post-pandemic strategies that prioritize the implementation of effective, accessible, and low-cost MHSU services in schools, workplaces, and communities; the integration of MHSU education into school lessons; increased awareness about MHSU services in schools and workplaces; and the prioritization of health and well-being in schools and workplaces.</p><p><strong>Conclusion: </strong>Findings indicate the need for stronger partnerships between schools, community-based MHSU services, and hospitals, and job opportunities that pay a living wage.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055504","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}