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

{"title":"Everyday racism experiences, healthcare access, and self-rated health: A study of Black men in Ontario, Canada.","authors":"Egbe B Etowa, Josephine P Wong, Roger Antabe, Francisca Omorodion, Josephine Etowa, Isaac Luginaah, Rade Zinaic, Carl James, Winston Husbands","doi":"10.17269/s41997-025-01048-y","DOIUrl":"10.17269/s41997-025-01048-y","url":null,"abstract":"<p><strong>Objectives: </strong>We explored the determinants and health-related outcomes of everyday racism (EDR) experienced by Black men in four Ontario cities in the context of HIV.</p><p><strong>Methods: </strong>Data were obtained from a CIHR-funded study that examined HIV vulnerability and resilience among Black men. The sample size was 866 (Ottawa [n = 210], Toronto [n = 343], London [n = 157], and Windsor [n = 156]). We applied the generalized linear model (GLM) to estimate the effects of EDR and other factors on (i) difficulty accessing healthcare and (ii) self-rated health. Next, using GLM, we determined the predictors of EDR. We measured difficulty accessing healthcare (difficulty accessing = 1, otherwise = 0) and self-rated health (good/very good/excellent = 1, otherwise = 0) as binary outcome variables. EDR was measured with the short version of the Everyday Discrimination Scale.</p><p><strong>Results: </strong>Of the Black men per city, 75‒85% experienced at least one of the five dimensions of EDR. EDR was associated with increased difficulty accessing health care, and fair to poor self-rated health (p < 0.05). EDR increased with residency in a smaller city (e.g. Windsor relative to Toronto), years of living in Canada, housing adequacy, traditional masculinity score, and individual resilience (p < 0.05). Collective resilience predicted reduced EDR.</p><p><strong>Conclusion: </strong>Racism experiences persist among Black men in Ontario and remain a key determinant of healthcare access and well-being among Black men. A multipronged approach, including ending anti-Black racism through transformation of organizational and governmental policies, promoting collective resilience within communities, and encouraging social reconstruction of the Black masculine ideologies, may be a practical approach to improving their health outcomes.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":"116 2","pages":"231-242"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048732","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":"Factorial invariance of the Everyday Discrimination Scale among African, Caribbean, Black, and other racialized women living with and without HIV in British Columbia, Canada.","authors":"Charity V Mudhikwa, João L Bastos, Notisha Massaquoi, Allison Carter, Patience Magagula, Elizabeth M King, Hélène C F Côté, Melanie C M Murray, Angela Kaida","doi":"10.17269/s41997-024-00966-7","DOIUrl":"10.17269/s41997-024-00966-7","url":null,"abstract":"<p><strong>Objectives: </strong>The Everyday Discrimination Scale (EDS) assesses the mistreatment racialized people experience daily. It is widely used in Canadian HIV research to measure racial discrimination among African, Caribbean, and/or Black (ACB), and other racialized women. However, no studies have examined whether the EDS provides valid estimates of racial discrimination that are objectively comparable across racial/ethnic groups or by HIV status in Canada. We aimed to address this gap.</p><p><strong>Methods: </strong>We analyzed EDS data from the British Columbia CARMA-CHIWOS Collaboration study of self-identifying women ≥ 16 years of age living with and without HIV. We conducted confirmatory factor analysis (CFA) by race/ethnicity (ACB; Indigenous; other racialized; white) and also by HIV status to assess validity and reliability of the EDS within these groups. Next, we ran multigroup-CFA (mCFA) to determine whether the EDS measures the same construct to the same extent across race/ethnicity- and HIV status-based groups.</p><p><strong>Results: </strong>Of 504 participants (202 with HIV), 62 were ACB, 152 Indigenous, 90 other racialized, and 200 white. CFA revealed adequate fit within race/ethnicity- and HIV status-based groups-all Cronbach's alpha > 0.9, factor loadings > 0.6, and acceptable fit indices, except for root mean square error of approximation. Residual correlations > 0.4 suggested redundancy between some item pairs. In the mCFA, the EDS was invariant across groups.</p><p><strong>Conclusion: </strong>The EDS provides racial discrimination estimates that are meaningfully comparable across race/ethnicity- and HIV status-based groups. Despite potential redundancy between item pairs that may warrant refinement, the EDS can be included in survey instruments that aim to examine and compare the prevalence and health impacts of racial discrimination among ACB and other racialized women in Canada.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"219-230"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774661","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":"HIV testing among heterosexual Black men in Toronto: What are the determinants?","authors":"Roger Antabe, Yujiro Sano, Egbe B Etowa, Joseph Bertrand Nguemo Djiometio, Mandana Vahabi, Kenneth Po-Lun Fung, Josephine Pui-Hing Wong, Winston Husbands","doi":"10.17269/s41997-024-00983-6","DOIUrl":"10.17269/s41997-024-00983-6","url":null,"abstract":"<p><strong>Objectives: </strong>African, Caribbean, and Black (ACB) men in Canada face a higher risk of HIV infection relative to other men. Despite this concern, these are nascent studies focused on the usage of HIV testing services among ACB men. To contribute to health policy in Canada, we seek to understand the prevalence and predictors of HIV testing among heterosexual ACB men living in Toronto.</p><p><strong>Methods: </strong>We used a sample of 325 self-identified heterosexual Black men in Toronto, Ontario, who participated in the weSpeak study, which examined HIV vulnerability among ACB men. Guided by Andersen's framework of health services utilization, we fitted negative log-log regression models to cross-sectional data of ACB men 16 years or older.</p><p><strong>Results: </strong>The findings indicate that (1) ACB men with secondary or lower levels of educational attainment (OR = 0.57, p < 0.1) were less likely to have ever been tested for HIV compared to their counterparts with a university education or higher, (2) foreign-born men were more likely to have ever been tested for HIV than their Canadian-born counterparts (OR = 3.14, p < 0.01), and (3) ACB men who report multiple sexual partners were more likely to have ever been tested for HIV compared to colleagues with one sexual partner (OR = 2.76, p < 0.01).</p><p><strong>Conclusion: </strong>Based on these findings, we recommend further research to understand the barriers to HIV testing among non-priority risk groups and the design of a more nuanced population-based approach to HIV testing that incorporates case management or various incentives.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":"209-218"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460918","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":"Reimagining Indigenous healthcare through a readiness to practice lens: A quantitative content analysis of the empirical literature.","authors":"Tyara Marchand, Adam Murry, Devin Proulx, K Alix Hayden, Lynden Crowshoe","doi":"10.17269/s41997-024-00989-0","DOIUrl":"https://doi.org/10.17269/s41997-024-00989-0","url":null,"abstract":"<p><strong>Objectives: </strong>The concept of \"readiness to practice\" has not been clearly delineated within an Indigenous health context. This systematic review occurred on a multi-database survey of published primary literature. The primary objective of this review was to determine what it takes for clinicians to be ready to practice with Indigenous populations.</p><p><strong>Methods: </strong>This review identified articles published in the last 20 years within Canada, the United States, New Zealand, and Australia. The databases that were searched included CINAHL, Medline (via Ovid), Embase (via Ovid), Scopus, and Web of Science, with an additional hand search of references from relevant articles. This search took place from January to May 2022, with subsequent analysis from May to September 2022.</p><p><strong>Results: </strong>Primary studies were coded using quantitative content analysis procedures and quantified codes were subjected to exploratory factor analyses. Four factors described a competent clinician across studies, including a relational disposition, decolonized practice, cultural immersion, and Indigenous professional support.</p><p><strong>Conclusion: </strong>This sphere of literature is relatively novel and there do not appear to be many individuals directly commenting on attributes needed to be prepared to work with Indigenous communities. There exist potential gaps in knowledge that could be addressed by conversations with Indigenous stakeholders and implementation of health education programs that focus on developing Indigenous-specific competencies.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755754","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 double burden of food and housing insecurity in Saskatchewan, Canada, understood in the context of a pandemic.","authors":"Suvadra Datta Gupta, Syed Jafar Raza Rizvi, James Dixon, Nazeem Muhajarine","doi":"10.17269/s41997-025-01014-8","DOIUrl":"https://doi.org/10.17269/s41997-025-01014-8","url":null,"abstract":"<p><strong>Objective: </strong>Using data from a population-based cross-sectional survey, we aim to measure the prevalence, risk factors, and impact of COVID-19 on household food insecurity, housing insecurity, and the double burden of experiencing both.</p><p><strong>Methods: </strong>Data were collected from July to November 2022. We used simple and multivariable logistic regression models to investigate the factors contributing to food insecurity, housing insecurity, and the double burden. Additionally, we computed the relative excess risk due to interaction (RERI) to determine whether any significant interactions contributed to the increased risk of experiencing the double burden.</p><p><strong>Results: </strong>Around 27% of our study participants were food insecure, 54% were housing insecure, and 22% were food and housing insecure (double burden). Respondents' gender, age, ethnicity, education, and income were associated with experiencing the double burden of food and housing insecurity. Additionally, this study found a significant statistical interaction between residence location and employment status, with both employed and unemployed individuals in urban areas facing higher odds of experiencing the double burden of food and housing insecurity compared to retired individuals in either urban or rural areas; the relative excess risk due to interaction analysis suggests that increasing employment opportunities may have a more substantial impact on reducing this burden in urban areas.</p><p><strong>Conclusion: </strong>Findings from this study provide important insights into addressing the issue of food and housing insecurity, especially through improving employment opportunities for vulnerable populations in Canada. Comprehensive systems-oriented intersectoral policies are much needed to improve households' experience of multiple need insecurities.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755762","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":"Removing barriers to care: The importance of addressing nonfatal overdoses among women living with HIV in British Columbia, Canada.","authors":"Megan E Marziali, Katherine W Kooij, Silvia S Martins, Morgan M Philbin, Julio S G Montaner, Robert S Hogg","doi":"10.17269/s41997-025-01026-4","DOIUrl":"10.17269/s41997-025-01026-4","url":null,"abstract":"<p><p>The overdose and drug toxicity crisis continues to devastate communities across Canada. British Columbia has an overdose mortality rate nearly double the Canadian national average, emphasizing a dire need for proactive public health approaches. Within the general population, men experience higher overdose mortality rates in comparison to women; however, among people with HIV, the disparity is inverted such that women with HIV experience higher overdose mortality rates than men with HIV. Less is known concerning the epidemiology of nonfatal overdoses among people with HIV, and understanding gender disparities in nonfatal overdoses would allow public health practitioners and policymakers to focus evidence-informed interventions and clinical guidelines for people most in need. In this commentary, we propose that systemic and structural barriers function to hinder access to crucial services for women with HIV, thus placing them at a disproportionately high risk for nonfatal overdose. We argue that additional research is needed to understand how to completely address these barriers in order to create programmatic changes. Fatal overdoses are a failure of the healthcare system; intervening after the occurrence of a nonfatal overdose is crucial in order to prevent a subsequent fatal overdose.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755758","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":"Harm reduction, treatment, and prevention-essential pillars to Canada's response to the drug poisoning crisis.","authors":"Patricia Daly, Eileen de Villa, Mylène Drouin, Mark Lysyshyn, Jason Tockman","doi":"10.17269/s41997-025-01029-1","DOIUrl":"10.17269/s41997-025-01029-1","url":null,"abstract":"<p><p>Canada's toxic drug crisis continues to worsen in the country's urban centres, with the unregulated drug supply becoming more deadly and causing life-altering harms. The increasingly toxic mix of substances in the unregulated supply is the primary driver of drug poisoning deaths. We anticipate that the current toxicity of the supply will persist, and may worsen, until people are able to access alternatives to the poisoned supply. As the leaders responsible for public health in the country's largest urban centres, we understand that harm reduction and addiction treatment services are complementary medically necessary health services that enable people who use substances to survive and work toward their health and wellness goals. Harm reduction and treatment, along with prevention, are pillars of a serious response to the drug toxicity crisis. Neither should be prioritized to the exclusion of the other. In this commentary, we highlight the critical harm reduction measures that are being implemented to save lives and reduce the risks of substance use, and we point to some of the ways that these programs could be expanded to improve the health and well-being of people who use drugs and the capacity of the public health system to respond to the crisis.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755749","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 Doctor of Public Health (DrPH) program at the University of Toronto: Early observations from Canada's first professional public health doctorate.","authors":"Theodore J Witek, Erica Di Ruggiero, Dionne Gesink","doi":"10.17269/s41997-025-01003-x","DOIUrl":"https://doi.org/10.17269/s41997-025-01003-x","url":null,"abstract":"<p><strong>Setting: </strong>The Dalla Lana School of Public Health (DLSPH) at the University of Toronto.</p><p><strong>Intervention: </strong>The DLSPH entered its inaugural cohort of Doctor of Public Health (DrPH) students in 2021. Development and launch of the program stemmed from the school's strategic plan to offer advanced public health training and was the first such university offering the DrPH in Canada. This paper reflects on the overarching launch experience of the program and its innovation in practice.</p><p><strong>Outcomes: </strong>Early interest in the program is strong and the entry requirement for at least 5 years of real-world experience drives the program's distinction in Canada. The inaugural cohort was instrumental in constructive criticism and harvestable suggestions via evaluations, reflections, and appreciative inquiry-a likely result of the lived professional experiences of students who enrolled in this program. A key feature is the hybrid nature of the program consisting of a series of in-person on-campus forums (\"burst weeks\") over the first half of the degree requirements. In addition to allowing in-person components of the core course, agenda components continually evolve to meet students' stated needs and competencies.</p><p><strong>Implications: </strong>The deliberate focus on the foundational competencies of leadership was fostered through classes on leadership of self as well as leadership and governance of organizations. Special lectures are curated to ensure that new and emerging concepts challenging society and today's public health leaders are addressed in an ongoing leadership series. The focus is not on developing new leaders but on catalyzing the leaders who constitute this professional cohort to higher levels of responsibility.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

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