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

{"title":"Community science for mosquito surveillance in Canada: a toolkit for program design and implementation.","authors":"Wendy Pons, Negar Elmieh, Atanu Sarkar, Angelo Armijos-Carrion, Tom Chapman, Amandeep Hans, Margaret Haworth-Brockman, Stefan Iwasawa, Victoria Ng, Jullia Santos, Jade Savage, Divya Zalawadia","doi":"10.17269/s41997-025-01134-1","DOIUrl":"10.17269/s41997-025-01134-1","url":null,"abstract":"<p><strong>Setting: </strong>Climate change in Canada has expanded suitable habitats for both native and invasive mosquitoes, heightening the need for more robust and adaptable surveillance systems. Traditional surveillance methods face significant logistical and geographical challenges, particularly in remote or underserved areas, emphasizing the importance of innovative strategies that complement existing approaches.</p><p><strong>Intervention: </strong>We developed a community-based mosquito surveillance toolkit, informed by a systematic review and validated by a multidisciplinary expert group. The toolkit includes a structured guide for developing a community science project, including how to design an effective mosquito surveillance program through data collection, volunteer engagement, and evaluation. It also features a quick reference guide and a 90-s animated video to facilitate understanding and engagement.</p><p><strong>Outcome: </strong>The toolkit was introduced at a national community meeting, with 69 participants bringing together public health professionals, educators, scientists, and community leaders from across Canada in February 2025. Participants expressed enthusiasm for using the toolkit to enhance local monitoring efforts, and discussions at the meeting helped identify key opportunities and challenges for adoption.</p><p><strong>Implications: </strong>Organizations and public health authorities now have a clear, evidence-based guide to designing, implementing, and evaluating community-driven initiatives. This toolkit not only helps ensure that volunteer participation is meaningful and effective, but it also enhances the capacity to respond to emerging challenges in vector control, laying the groundwork for sustainable, community-driven surveillance efforts.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"670-679"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589586","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":"Physical activity-based, wholistic, wellness interventions for Indigenous women in Canada: An environmental scan to identify programs and promising practices.","authors":"Sonja Wicklum, Tia Black, Loretta Tuttauk, Lynden Lindsay Crowshoe, Yunqi Jacob Ji, Kerry McBrien, Jessica Zhang, Carly Checholik, Ashley Amson, Patricia Doyle-Baker, Alicia Oliver, Levi Frehlich","doi":"10.17269/s41997-025-01091-9","DOIUrl":"10.17269/s41997-025-01091-9","url":null,"abstract":"<p><strong>Objectives: </strong>This environmental scan has two aims. The first is to identify wholistic, physical activity (PA)-based wellness interventions for Indigenous women in Canada through the completion of a scoping review of published and grey literature and key informant interviews. The second is to identify promising practices and potential barriers to intervention development and delivery.</p><p><strong>Methods: </strong>Components of the environmental scan included (1) the creation of a logic model in collaboration with a community-based Advisory Group, (2) a scoping review of wholistic PA-based wellness interventions between January 1990 and March 2022, (3) key informant interviews of individuals involved in PA-based wellness programming, and (4) thematic analysis of promising practices, enablers, and barriers found in both the articles and interviews.</p><p><strong>Synthesis: </strong>The scoping review identified 16 interventions. Through key informant interviews, 6 additional interventions were identified. Programs were largely community-based and culturally appropriate. Financial factors were the most common barrier. Walking as a form of PA was commonly employed and key informant interviews highlighted the importance of exploring on-the-land activities, group activities, and the incorporation of all elements of wholistic health (mental, physical, spiritual, and emotional). Only one study employed Indigenous research methods.</p><p><strong>Conclusion: </strong>There is limited published literature and a dearth of PA-based, wholistic health programs for Indigenous women in Canada. More programming and research are required to address the unique health needs of Indigenous women and mitigate the legacy impacts of colonization on health.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"610-633"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460596","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":"Exploring factors associated with the physical, mental, and financial health of unpaid caregivers: An analysis of the Canadian National Caregiving Survey.","authors":"Hallie Benjamin, Fabio Robibaro, Donna Thomson, Grant Bruno, Yona Lunsky, James Janeiro, Liv Mendelsohn, Nathan M Stall, Eyal Cohen","doi":"10.17269/s41997-025-01133-2","DOIUrl":"10.17269/s41997-025-01133-2","url":null,"abstract":"<p><strong>Objectives: </strong>Unpaid caregiving can negatively impact well-being, but not all caregivers are affected equally. We explored factors associated with unpaid caregivers' health and financial outcomes.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of a panel survey from (n = 1977; 11% response rate) the Canadian Centre for Caregiving Excellence's \"National Caregiving Survey\" using logistic regression to assess the adjusted odds (aOR) of poor physical, mental, and financial health by caregiver, care recipient, and caregiving intensity characteristics.</p><p><strong>Results: </strong>Twenty percent of respondents reported poor physical health, 25% poor mental health, and 38% financial hardship. When adjusting for all other covariates, those who had a lower income or provided care to younger adult individuals (18-64 years) were more likely to report all three co-primary outcomes (aORs ranging from 1.68 to 1.80) and caregivers of sexual minorities were more likely to report poor physical and mental health (aOR 1.66, 95%CI 1.13-2.45, and 2.15, 95%CI 1.51-3.05, respectively). Compared with young adult caregivers (18-24 years), older caregivers (≥65 years) were less likely to report poor mental health (aOR 0.39, 95%CI 0.23-0.66), while middle-aged (45-64 years) and older (> 65 years) caregivers were more likely to report poor physical health (aORs 2.21, 95%CI 1.22-4.04, and 1.87, 95%CI 0.99-3.51, respectively). Those identifying as women were more likely to report poor mental health and those providing more intense care were more likely to experience financial hardship.</p><p><strong>Conclusion: </strong>Specific unpaid caregiver subgroups may be more at risk of poor physical, mental, and financial health and may be important targets for interventions aimed at improving these outcomes.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"691-702"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649752","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":"Rethinking the objectives of a pan-Canadian immunization information system.","authors":"Bryan Thomas, Colleen Flood, Kumanan Wilson","doi":"10.17269/s41997-025-01129-y","DOIUrl":"10.17269/s41997-025-01129-y","url":null,"abstract":"<p><p>Emerging from the pandemic and the largest mass vaccination campaign in history, governments at all levels are once again calling for the development of comprehensive vaccination registries. Yet these calls have persisted for decades at the federal level, and little progress has been made. At the heart of the challenge is the need to clarify the objectives of federal vaccine data collection and how these objectives dovetail with the federal government's constitutional role and jurisdiction in public health. We suggest that pan-Canadian immunization information collection initially focus on vaccine safety and effectiveness, as these would be most concordant with provincial/territorial aims and would fall under the federal government's jurisdiction. The federal spending power could be utilized to further support provincial/territorial systems to facilitate pan-Canadian data collection for coverage.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"606-609"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410761","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":"Identifying patients with obesity from health administrative data: Diagnostic accuracy of surgical billing claims.","authors":"Maria C Cusimano, Nancy N Baxter, Rahim Moineddin, Maria Chiu, Lena Nguyen, Suriya Aktar, Ning Liu, Andrea N Simpson, Christina Johnson, Sarah E Ferguson","doi":"10.17269/s41997-025-01114-5","DOIUrl":"10.17269/s41997-025-01114-5","url":null,"abstract":"<p><strong>Objectives: </strong>Obesity (body mass index, BMI ≥ 30 kg/m²) is a predictor of patient outcomes across surgical disciplines, but is not accurately captured by diagnostic codes in administrative databases. The objective of this study was to determine the validity of surgeon and anaesthetist billing claims indicating that their patients had concurrent class III obesity (BMI > 40) as compared to patients' self-reported BMI.</p><p><strong>Methods: </strong>We performed a cross-sectional study of adult patients who had undergone major abdominopelvic, neck, and hip surgery in Ontario from 2011 to 2019, and had also reported their BMI on either the Canadian Community Health Survey or the Ontario Health Study. Physician billing claims for class III obesity were compared to self-reported BMI, and measures of diagnostic accuracy with 95% confidence intervals were calculated.</p><p><strong>Results: </strong>We identified 52,515 patients who had undergone surgery (80.6% abdominopelvic; 19.4% neck/hip) with median age 57 years and median BMI 26 (range 15-108); 2189 patients (4.2%) reported a BMI > 40. When self-reported BMI was collected within 1 year of surgery, billing claims submitted by either the surgeon, surgical assistant, or anaesthetist had sensitivity 82.9% (95% CI 79.1-86.7), specificity 95.5% (95.0-96.0), positive predictive value 52.9% (50.1-58.5), and negative predictive value 98.9% (98.7-99.2) for the identification of BMI > 40. Positive predictive value for the identification of BMI > 30 was 95.4% (93.7-97.0).</p><p><strong>Conclusion: </strong>Physician billing claims are specific and sensitive for the identification of patients with BMI > 40 undergoing surgery, enable accurate selection of a population with BMI > 30, and are valid for use in studies conducted with health administrative data.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"753-763"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758216","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":"Prenatal characteristics and factors contributing to congenital syphilis: A descriptive analysis of cases reported to the Canadian Paediatric Surveillance Program June 2021 through May 2023.","authors":"Genevieve Gravel, Joanna Merckx, Amandine Bemmo, Kelly Baekyung Choi, Jaskiran Sandhu, Joan Robinson, Ari Bitnun, Jason Brophy, Karen Leis, Laura Sauvé, Sam Wong, Melanie King, Jared Bullard, Carsten Krueger","doi":"10.17269/s41997-026-01152-7","DOIUrl":"10.17269/s41997-026-01152-7","url":null,"abstract":"<p><strong>Objectives: </strong>The incidence of congenital syphilis (CS) in Canada increased from 2.1 to 14.5 reported confirmed cases/100,000 live births from 2017 to 2023 (from 8 to 53 cases). We aimed to document prenatal characteristics and contributing factors to CS among mothers or birthing parents (M/BP) of infants with CS in Canada.</p><p><strong>Methods: </strong>Participants of the Canadian Paediatric Surveillance Program, which includes both paediatricians and paediatric subspecialists, were invited to report on CS cases meeting the study case definition between June 2021 and May 2023. A detailed questionnaire was completed by the reporting clinician. We used descriptive statistics in the assessment of prenatal risk factors among cases, including data on healthcare access, diagnosis, and treatment as well as on socio-demographic, socio-economic and socio-behavioural determinants.</p><p><strong>Results: </strong>During the 24-month study period, 245 live-born cases of CS were reported, including 81 (33.1%) confirmed and 164 (66.9%) probable cases from seven provinces and territories. Substance use in pregnancy was reported in 65% of cases. Only half of M/BP had at least 1 prenatal care visit during their pregnancy, while only one-quarter had ≥ 1 prenatal care visit in each trimester. In a quarter of cases, no syphilis screening was performed during pregnancy. Prenatal syphilis treatment was not initiated among 20% who screened positive.</p><p><strong>Conclusion: </strong>In this country-wide assessment, we identified substantial failures in the delivery of adequate prenatal care to M/BP of live-born infants diagnosed with CS. Public health action, such as community outreach to ensure prenatal care for all pregnant people, with specific attention to the prenatal healthcare needs and engagement in the care of those who use substances, is pressing.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"795-806"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488407","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":"Using Collective Impact for intersectoral action in rural Northern Ontario: Two case studies.","authors":"Amanda Mongeon, Erin Cowan, Walter Humeniuk, Shujian Liu, Leith Deacon","doi":"10.17269/s41997-025-01137-y","DOIUrl":"10.17269/s41997-025-01137-y","url":null,"abstract":"<p><strong>Setting: </strong>Timiskaming District in Northern Ontario has a population of 32,394 people across 24 municipalities, two unincorporated areas, and four First Nations. During the time of these case studies, public health services were provided by the Timiskaming Health Unit, one of 34 local public health agencies in Ontario.</p><p><strong>Intervention: </strong>To address local public health priorities in this rural region, the Timiskaming Health Unit implemented the Collective Impact framework, establishing governance structures for two initiatives: the Timiskaming Community Safety and Wellbeing Plan (CSWB) and Timiskaming Drug and Alcohol Strategy (TDAS). Acting as the backbone organization, the Health Unit facilitated a common agenda, shared progress measures, and coordinated mutually reinforcing activities.</p><p><strong>Outcomes: </strong>The 2023 CSWB Plan, co-funded by all 24 municipalities, established a steering committee and three working groups to address safety and well-being goals. TDAS, launched in 2022, engages over 20 organizations and community members through a steering committee and four working groups. Deliverables include public events, navigational resources, social marketing campaigns, capacity building, new health infrastructure, improved collaboration, and advocacy for healthy public policy.</p><p><strong>Implications: </strong>These initiatives demonstrate how local public health units can use the Collective Impact framework to address complex rural public health challenges. By integrating a continuous learning approach, implementation can integrate knowledge to foster collaboration that leads to community engagement and policy change. However, sustainable funding is critical for supporting collaborative governance and mitigating challenges like limited rural data availability.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"764-771"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851403","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":"The association between chronic back problems and poor sleep quality among Ontarian adults aged 60 years and older: A cross-sectional study analyzing the Canadian Community Health Survey 2015-2016.","authors":"Pegah Rahbar, Jessica J Wong, Dan Wang, Efrosini Papaconstantinou, Sheilah Hogg-Johnson, Pierre Côté","doi":"10.17269/s41997-025-01123-4","DOIUrl":"10.17269/s41997-025-01123-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Poor sleep quality's risk factors remain understudied in aging populations. Chronic back problems (CBP), a leading cause of disability, may contribute to poor sleep quality. Firstly, we determined the prevalence of poor sleep quality. Secondly, we investigated the association between chronic back problems and poor sleep quality, controlling for covariates. Lastly, we explored the interaction between sleep apnea and chronic back problems with respect to their association with poor sleep quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We analyzed data from Ontarians ≥ 60 years in the 2015-2016 Canadian Community Health Survey. We estimated the prevalence (95% confidence interval (CI)) of poor sleep quality. We investigated the association between CBP and poor sleep quality to compute prevalence ratios (PR) and 95% CI, controlling for covariates. We explored the interaction between CBP and sleep apnea in their association with poor sleep quality using four combined exposure categories.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 52% of participants reported sleeping &lt; 7 h or ≥ 9 h, 18% reported trouble going to/staying asleep, and 13% never/rarely felt refreshed. Controlling for covariates, CBP was associated with sleeping outside of recommended guidelines (PR = 1.19 (1.11-1.27)), trouble going to sleep or staying asleep (PR = 1.54 (1.32-1.79)), and rarely/never having refreshing sleep (PR = 1.45 (1.20-1.79)). No interaction was found between CBP and sleep apnea.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;We found that CBP is associated with poor sleep quality among Ontarians ≥ 60 years. Future studies should investigate CBP as a potential risk factor for poor sleep quality. Résumé Objectifs: Les facteurs de risque d'un sommeil de mauvaise qualité sont encore sous-étudiés dans les populations vieillissantes. Les problèmes de dos chroniques (PDC), l'une des principales causes d'invalidité, pourraient contribuer à la mauvaise qualité du sommeil. En premier lieu, nous avons déterminé la prévalence de la mauvaise qualité du sommeil. En deuxième lieu, nous avons étudié l'association entre les problèmes de dos chroniques et la mauvaise qualité du sommeil après avoir apporté des ajustements pour tenir compte des effets de covariables. Pour terminer, nous avons exploré l'interaction entre l'apnée du sommeil et les problèmes de dos chroniques du point de vue de leur association avec la mauvaise qualité du sommeil. Méthodes: Nous avons analysé les données d'Ontariennes et d'Ontariens de ≥ 60 ans ayant participé à l'Enquête sur la santé dans les collectivités canadiennes de 2015-2016. Nous avons estimé la prévalence (intervalle de confiance [IC] de 95%) de la mauvaise qualité du sommeil. Nous avons étudié l'association entre les PDC et la mauvaise qualité du sommeil pour calculer des ratios de prévalence (RP) et des IC de 95%, après avoir apporté des ajustements pour tenir compte des effets de covariables. Nous avons exploré l'interaction entre l","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"658-669"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589670","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":"Gender and self-rated mental health: an integrative approach.","authors":"Chloe Sher, Ingrid G Pechenkov, Cary Wu","doi":"10.17269/s41997-025-01141-2","DOIUrl":"10.17269/s41997-025-01141-2","url":null,"abstract":"<p><strong>Objective: </strong>Men often self-rate their mental health better than women and other gender groups. To better assess how gender is related to self-rated health, this study goes beyond the binary approach and explores how variations in self-rated mental health across multiple fixed gender categories are associated with variations along the continuous masculinity and femininity scales.</p><p><strong>Methods: </strong>Data came from a large sample of Canadian adults (n = 11,712) collected from August 17 to September 19, 2021. Gender identity is measured using both fixed categories (i.e., men, women, and TNO-trans, non-binary, or other genders) as well as self-ratings of masculinity and femininity on a scale from 0 to 100. Self-rated mental health includes four categories: poor, fair, good, and excellent. Logistic regression models were used in estimations.</p><p><strong>Results: </strong>Men reported better self-rated mental health than women and individuals who identify as trans, non-binary, or other genders. These gender gaps become non-significant once femininity and masculinity scales are taken into account. Overall, both femininity and masculinity are positively and non-linearly associated with self-rated mental health, and the positive associations get stronger at higher levels of femininity and masculinity. When separated by fixed gender categories, the accelerating positive effect of masculinity on self-rated mental health is present among both men and women, but not among TNO individuals. In contrast, the accelerating positive effect of femininity is observed only among men.</p><p><strong>Conclusion: </strong>The gender gaps in self-rated mental health are primarily driven by the differing relationships between mental health and masculinity and femininity across gender categories. Improvement in measuring gender identity can provide valuable insights into how gender is a critical determinant of mental health and mental health disparities. It can also help identify those most affected and enable more targeted prevention and treatment services.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"741-752"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745743","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":"Distance as a determinant: A spatial analysis of crisis and second-stage housing for survivors of domestic violence in Ontario.","authors":"Madeleine D Sheppard-Perkins, Tomoko McGaughey, Francine E Darroch","doi":"10.17269/s41997-026-01234-6","DOIUrl":"https://doi.org/10.17269/s41997-026-01234-6","url":null,"abstract":"<p><p>This study presents the first province-wide spatial analysis of shelter accessibility for survivors of domestic violence in Ontario, Canada. Using travel time calculations from dissemination area (DA) centroids to the nearest crisis and second-stage shelters, we quantify geographic disparities in access across urban, suburban, rural, and remote communities. Shelter data were compiled from ShelterSafe and public databases, and rurality was classified using Statistics Canada's Index of Remoteness. Results reveal stark gradients in accessibility: average travel time to second-stage housing in remote areas exceeds 247 min, compared to 26.6 min in urban centres. Crisis shelters, while more numerous per capita, remain significantly less accessible in rural regions. Regression models indicate that shelter type, remoteness, and service features (i.e., pet accommodation, childcare, accessibility) predict travel time, with second-stage shelters and those offering more service options often situated farther away. These findings underscore how structural and spatial inequities shape survivors' ability to seek safety and support. Policy recommendations include revising housing eligibility timelines, investing in rural second-stage infrastructure, and using geospatial tools to identify service deserts.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581063","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}