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

{"title":"Reclaiming urban space for children: Examining the impact of School Streets on independent mobility and active transport.","authors":"Zeinab Aliyas, Carise Thompson, Fanny Bakkali, Patricia A Collins, Katherine L Frohlich","doi":"10.17269/s41997-025-01058-w","DOIUrl":"https://doi.org/10.17269/s41997-025-01058-w","url":null,"abstract":"<p><strong>Intervention: </strong>School Street initiatives are traffic-free zones around the entrances of primary schools designed to make it safer for children to come and go from school. Beyond increasing safety, these initiatives offer opportunities for children to increase their engagement in active school travel and to become more independently mobile.</p><p><strong>Research question: </strong>How does the implementation of a School Street intervention influence children's active travel and independent mobility on their way to school?</p><p><strong>Methods: </strong>A School Street intervention was implemented every Friday at a primary school in Montreal from September 2022 to June 2023. Bi-monthly direct observations were conducted to collect data on children's modes of travel and whether they travelled independently or with an adult before the start of classes.</p><p><strong>Results: </strong>Independent, active travel was more frequently observed on School Street days compared to non-School Street days. Additionally, a progressive increase in active transportation and independent mobility was observed throughout the school year, regardless of School Street designation.</p><p><strong>Conclusion: </strong>This study underscores the potential impact of School Street interventions on enhancing children's active school travel and independent mobility. Establishing safe zones near schools can positively influence children's commuting behaviours, fostering healthier and more autonomous travel habits.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259360","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 opioid agonist treatment (OAT) site operations and early signals of change in the first year of British Columbia's drug decriminalization policy: Insights from a provincial survey.","authors":"Cayley Russell, Justine Law, Kate Hodgson, Laura MacKinnon, Rita Shahin, Frank Crichlow, Sean Patenaude, Sameer Imtiaz, Jürgen Rehm, Farihah Ali","doi":"10.17269/s41997-025-01060-2","DOIUrl":"10.17269/s41997-025-01060-2","url":null,"abstract":"<p><strong>Objective: </strong>On January 31, 2023, the province of British Columbia (BC) introduced a 3-year drug decriminalization initiative, with a goal of increasing access, engagement, and retention in drug use treatment. There is limited information on the operational characteristics of opioid agonist treatment (OAT) sites in BC. These data are required to monitor the impacts of decriminalization on these outcomes. This study sought to characterize OAT service operations and examine any preliminary operational changes following decriminalization, from the perspectives of OAT site staff.</p><p><strong>Methods: </strong>Between March and April 2024, a cross-sectional, online self-report survey was distributed to OAT sites across BC, completed by site representatives. Questions focused on OAT service operations, including service capacity, treatment retention, and clientele demographics, as well as potential changes to service operations due to decriminalization. Data were analyzed descriptively.</p><p><strong>Results: </strong>A total of 28 OAT sites from across BC completed the survey. Findings suggest that decriminalization has had limited impacts on OAT site operations within the first year of the policy's implementation. However, several sites reported early signals of change related to client socio-demographics, including seeing more male and younger clients, as well as an increase in demand on their staff and resources.</p><p><strong>Conclusion: </strong>Despite minimal changes to OAT site operations within the first year of BC's decriminalization policy, findings suggest the need for increased staff training on decriminalization and continued investments into OAT to better support the anticipated demand on services if decriminalization is to successfully reach its goal of improving access to treatment.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250831","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 effect of take-home naloxone kits on opioid-related deaths in Alberta, Canada: An ecological analysis.","authors":"Eldon Spackman, Shainur Premji, Amy Woroniuk, Eddy Lang, Katrina Milaney, Kerry McBrien","doi":"10.17269/s41997-025-01056-y","DOIUrl":"https://doi.org/10.17269/s41997-025-01056-y","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the association between publicly provided take-home naloxone kits and opioid-related deaths.</p><p><strong>Methods: </strong>We analyzed 2732 opioid-related deaths and the distribution of 147,814 naloxone kits between January 2015 and June 2019 across five health zones in Alberta, Canada. We used a Poisson pseudo-maximum likelihood regression model with fixed effects to estimate the association between the number of kits in circulation and the number of monthly opioid-related deaths, controlling for population demographics, socio-economic indicators, other harm reduction strategies, police seizures of fentanyl and carfentanil, and an estimate of awareness.</p><p><strong>Results: </strong>Every 10,000 kits in circulation was associated with a 23.9% (95% confidence interval (CI), 12.6-33.7) reduction in opioid-related deaths. Marginal analysis suggests that if no kits had been distributed, Alberta would have had 3548 deaths (95% CI, 2264-4831), 816 more deaths than were recorded during this 4.5-year period. If during this time 200,000 kits were consistently in circulation, Alberta would have had an estimated 1587 deaths (95% CI, 705-2468), 1145 fewer deaths than recorded.</p><p><strong>Conclusion: </strong>This analysis provides evidence that the availability of naloxone kits is associated with a reduction in opioid-related deaths and suggests that a publicly funded program that allows the distribution of naloxone kits to all who request them reduces mortality.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210213","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":"Mortality among individuals living in permanent supportive housing: A retrospective cohort study.","authors":"Kaitlyn Ramsay, Hammad Shahid, Parvin Merchant, Ri Wang, Stephen W Hwang","doi":"10.17269/s41997-025-01045-1","DOIUrl":"https://doi.org/10.17269/s41997-025-01045-1","url":null,"abstract":"<p><strong>Objectives: </strong>Individuals experiencing homelessness have excess mortality as compared with the general population. This elevated risk of death may persist after individuals are housed, but there has been scant research on this topic. The objective of this study was to examine mortality among residents of a permanent supportive housing program serving people who were previously homeless.</p><p><strong>Methods: </strong>Deaths were identified among individuals who resided in a 145-unit supportive housing program in Toronto, Canada, between January 1, 2018, and December 31, 2022. Kaplan-Meier curves were used to examine survival.</p><p><strong>Results: </strong>Of 222 individuals who resided in the supportive housing program, 34 individuals died during the observation period, with 71% of deaths occurring in the housing unit and 21% in hospital. At least one third of deaths were caused by drug overdose. Mean age at death was 56.3 years. Crude mortality rate was 5.10 deaths per 100 person-years of observation. Survival at 5 years of follow-up was 78%, and individuals ≤ 40 years old did not have a survival advantage over those > 40 years old.</p><p><strong>Conclusion: </strong>Interventions are needed to support health and reduce preventable deaths among formerly homeless residents of permanent supportive housing.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188462","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: 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/s41997-025-01040-6","DOIUrl":"https://doi.org/10.17269/s41997-025-01040-6","url":null,"abstract":"","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175803","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":"Longitudinal effects of neighbourhoods' material and social deprivation on psychological distress of adults in Canada.","authors":"Vandad Sharifi, Gina Dimitropoulos, Anees Bahji, Jeanne V A Williams, Pardis Pedram, Andrew G M Bulloch, Scott B Patten","doi":"10.17269/s41997-025-01042-4","DOIUrl":"https://doi.org/10.17269/s41997-025-01042-4","url":null,"abstract":"<p><strong>Objectives: </strong>This nationwide longitudinal study investigates the impact of neighbourhood deprivation on psychological well-being of Canadian adults.</p><p><strong>Methods: </strong>Utilizing data from the Longitudinal and International Study of Adults (LISA) spanning 2016, 2018, and 2020, we included individuals aged 15 and above across Canada. The 2016 and 2020 samples comprised approximately 17,700 and 12,700 respondents, respectively. LISA data were paired to Neighbourhood Material and Social Deprivation data derived from Canada's 2016 Census. Psychological distress was assessed using the Kessler Scale (K-10), both dimensionally (score) and categorically (above the cut-point prevalence). Multi-level mixed-effects regressions were conducted, adjusting for individual-level variables.</p><p><strong>Results: </strong>At baseline, participants' mean age was 47.7 years (50.6% female), and higher social and material deprivation were associated with greater psychological distress. Longitudinally, psychological distress showed distinct temporal patterns based on the type of deprivation. Adjusted models revealed that residing in the most socially deprived neighbourhoods was linked to a greater increase in psychological distress scores over time as compared with the least socially deprived areas. Conversely, the highest degree of material deprivation showed a negative association with increasing distress, contrasting with the lowest material deprivation. A similar trend emerged regarding the prevalence of high psychological distress: in the most socially deprived neighbourhoods, there was an elevated prevalence over time, whereas the highest material deprivation was negatively associated with increasing prevalence.</p><p><strong>Conclusion: </strong>This study supports the link between mental health and neighbourhood social deprivation, but differs from previous research regarding material deprivation. While material support remains crucial for disadvantaged communities, public health interventions should also address social deprivation.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163691","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":"Income inequality and life expectancy in Canada: New evidence from province-level panel regression, 1996-2019.","authors":"Edgardo R Sepulveda, Lindsay McLaren","doi":"10.17269/s41997-025-01024-6","DOIUrl":"https://doi.org/10.17269/s41997-025-01024-6","url":null,"abstract":"<p><strong>Objectives: </strong>Previous research on the association between income inequality and population health measures has yielded mixed results. This reflects, in part, the level of income inequality and surrounding political economic context of the setting in question. Previous research in Canada has not consistently identified an association between income inequality and population health measures. Those studies, however, largely focused on time periods prior to the manifestations of neoliberal policy reforms, which led to high levels of income inequality characterized by rising income at the top of the distribution. Our objective was to investigate the population-level association between income inequality and life expectancy in Canada during the years 1996-2019, a period of high after-tax income inequality in Canada.</p><p><strong>Methods: </strong>We used ordinary least squares panel multivariate regression analysis of publicly available aggregate data on after-tax income inequality and life expectancy for the 10 Canadian provinces during the period 1996-2019. We used an inequality variable that is sensitive to the disproportionate growth in income at the top of the income distribution (share of income held by top 5%); we took into account the proportion of the First Nations, Métis, and Inuit populations across provinces and over time; and we separately analyzed female, male, and total populations.</p><p><strong>Results: </strong>We found a robust, negative and statistically significant association where higher population-level after-tax income inequality was associated with lower average life expectancy in Canada.</p><p><strong>Conclusion: </strong>Our findings speak to the far-reaching consequences of neoliberalism, and to the need for public policy that will reduce income inequality in the interest of the public's health.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121421","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":"Race, discrimination, and mental health adversity in Canada.","authors":"Newsha Mahinpey, Afia Amoako, David R Williams, Arjumand Siddiqi","doi":"10.17269/s41997-025-01021-9","DOIUrl":"https://doi.org/10.17269/s41997-025-01021-9","url":null,"abstract":"<p><strong>Objective: </strong>Canada is undergoing a crisis in mental health, and the federal government has established a strategy that is attentive to mental health among Black people. Our objective is to inform this work by understanding the relationships between race, discrimination, and mental health outcomes.</p><p><strong>Methods: </strong>We obtained a sample of 17,526 respondents from the Canadian Community Health Survey Rapid Response Module on Experiences of Discrimination, which asked about respondent race and other sociodemographic and socioeconomic characteristics, the validated Williams Everyday Discrimination Scale, and mental health outcomes (mood and anxiety disorders, substance use, and self-rated mental health). We ran descriptive statistics as well as crude, sociodemographic- and socioeconomic-adjusted logistic regressions to assess relationships in the overall sample between race and the Williams Discrimination Scale and between the Williams Discrimination Scale and mental health outcomes.</p><p><strong>Results: </strong>Compared to white people, Black people had two to three times the odds of experiencing frequent discrimination, while Asian people were not statistically different from white people. Frequent experiences of everyday discrimination in the sample were associated with between 40% and two times the odds of experiencing adverse mental health outcomes, though white people had the highest prevalences of adverse mental health outcomes in the sample.</p><p><strong>Conclusion: </strong>In Canada, experiences of discrimination can produce adverse mental health outcomes, and Black people in particular experience high degrees of discrimination compared to all other racial groups. National health surveys should contain larger and more representative samples of non-white individuals, which allow for more complex analyses.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121507","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":"Lessons from an evaluation of an urban Indigenous food sharing initiative in Southwestern Ontario: \"I feel like I'm nourishing my spirit\".","authors":"Laura Peach, Kaitlyn Patterson, Dave Skene, Sarina Perchak, Kelly Skinner, Hannah Neufeld","doi":"10.17269/s41997-025-01044-2","DOIUrl":"https://doi.org/10.17269/s41997-025-01044-2","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to examine an urban Indigenous food sharing initiative through an evaluation attending to the Food Share Initiative's implementation and early outcomes.</p><p><strong>Methods: </strong>This project used a community-based participatory research methodology to guide an evaluation of process and initial outcomes. Storytelling methods including interviews and a sharing circle, which took place in July and August 2021, were used to create a relational context for the research team and project participants, which honour Indigenous research methodologies.</p><p><strong>Results: </strong>A total of 14 self-identifying Indigenous people participated in this evaluation. Initiative staff and Food Share recipients identified community relationships as a shared initiative experience that contributed to the wholistic health effects experienced by recipients. All participants recognized capacity limitations of both Food Share recipients and operational staff were important constraints to the initiative's process and implementation. Participant recommendations to improve the Food Share included enhanced outreach to involve other Indigenous community members as well as infrastructure like long-term funding and a central location to strengthen the initiative's operational capacity.</p><p><strong>Conclusion: </strong>As an important community food support, the Food Share's relational care approach fosters a meaningful and wholistic sense of nourishment for Indigenous community members in the Waterloo-Wellington Region.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103131","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":"Evaluation of the post-landing surveillance process for people migrating to British Columbia: A retrospective cohort study.","authors":"Audrey Mitchell, Raman Ubhi, Negar Mousavi, Marie Yan, Elisabeth Hansen, Victoria J Cook, James C Johnston","doi":"10.17269/s41997-025-01050-4","DOIUrl":"https://doi.org/10.17269/s41997-025-01050-4","url":null,"abstract":"<p><strong>Objectives: </strong>People migrating to Canada are disproportionately impacted by tuberculosis (TB) disease. Prior to arrival, Immigration, Refugees and Citizenship Canada (IRCC) require an immigration medical exam (IME) intended to detect TB disease in all permanent and select temporary residents. People deemed high risk for TB are then referred for post-landing surveillance. This process has not substantially changed in four decades, prompting our review.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of people referred for post-landing surveillance in British Columbia (BC) from Aug 1, 2020, to May 31, 2022. Through chart review, clinical and demographic data were recorded from the IME and provincial TB registry. Participants were followed for 2 years to assess for TB disease and to record their clinical outcomes.</p><p><strong>Results: </strong>Of 1700 participants, 19 (1.1%, 95% CI 0.7, 1.7) were diagnosed with TB disease after arriving in Canada; 580 (34.1%) had prior TB treatment noted on their IME, with a median time from treatment to arrival of 9 years (IQR 4-18 years). The post-landing process took a median of 211 days (IQR 160-282 days) to complete workup. Some participants (611; 35.9%) received either an interferon gamma release assay or tuberculin skin test with 127 (35.5%) and 166 (65.6%) positive results, respectively.</p><p><strong>Conclusion: </strong>The post-landing surveillance process in BC is slow and resource-intensive for both migrants and the healthcare system, with uncertain impact on outcomes. These findings highlight existing inefficiencies in the process and the need to identify people who are at highest risk.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086781","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}