Canadian Journal of Public Health最新文献

{"title":"Preparing for the future of public health: ecological determinants of health and the call for an eco-social approach to public health education","authors":"M. Parkes, B. Poland, S. Allison, D. Cole, I. Culbert, M. Gislason, T. Hancock, C. Howard, A. Papadopoulos, Faiza Waheed","doi":"10.17269/s41997-019-00263-8","DOIUrl":"https://doi.org/10.17269/s41997-019-00263-8","url":null,"abstract":"As a collective organized to address the education implications of calls for public health engagement on the ecological determinants of health, we, the Ecological Determinants Group on Education (cpha.ca/EDGE), urge the health community to properly understand and address the importance of the ecological determinants of the public’s health, consistent with long-standing calls from many quarters—including Indigenous communities—and as part of an eco-social approach to public health education, research and practice. Educational approaches will determine how well we will be equipped to understand and respond to the rapid changes occurring for the living systems on which all life—including human life—depends. We revisit findings from the Canadian Public Health Association’s discussion paper on ‘ Global Change and Public Health: Addressing the Ecological Determinants of Health ’, and argue that an intentionally eco-social approach to education is needed to better support the health sector’s role in protecting and promoting health, preventing disease and injury, and reducing health inequities. We call for a proactive approach, ensuring that the ecological determinants of health become integral to public health education, practice, policy, and research, as a key part of wider societal shifts required to foster a healthy, just, and ecologically sustainable future. Notre collectif, appelé Ecological Determinants Group on Education (cpha.ca/EDGE), s’est structuré pour aborder les incidences pédagogiques des appels à la mobilisation de la santé publique autour des déterminants écologiques de la santé; nous exhortons les milieux de la santé à bien comprendre l’importance des déterminants écologiques de la santé publique et à en tenir compte, faisant ainsi écho aux appels de longue date de nombreux acteurs – dont les communautés autochtones – le tout dans le cadre d’une approche écosociale de la formation, de la recherche et de la pratique en santé publique. Les approches pédagogiques détermineront si nous serons en mesure de comprendre les changements rapides qui se produisent dans les systèmes vivants dont dépend toute vie – y compris la vie humaine – et d’y réagir. Nous revenons sur les constatations du document de travail de l’Association canadienne de santé publique intitulé Les changements globaux et la santé publique : Qu’en est-il des déterminants écologiques de la santé? , et nous faisons valoir qu’une approche intentionnellement écosociale de la formation est nécessaire pour mieux appuyer le rôle du secteur de la santé dans la protection et la promotion de la santé, la prévention des maladies et des blessures et la réduction des inégalités en santé. Nous réclamons une démarche en amont pour que les déterminants écologiques de la santé fassent partie intégrale de la formation, de la pratique, des politiques et de la recherche en santé publique, car ces déterminants seront un élément essentiel des grands mouvements sociétaux nécessaires pour favoriser ","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"7 1","pages":"60 - 64"},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89760092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial/ethnic variations in gestational weight gain: a population-based study in Ontario","authors":"Yanfang Guo, Q. Miao, Tianhua Huang, D. Fell, Alysha L. J. Harvey, S. Wen, M. Walker, L. Gaudet","doi":"10.17269/s41997-019-00250-z","DOIUrl":"https://doi.org/10.17269/s41997-019-00250-z","url":null,"abstract":"To explore inadequate and excessive gestational weight gain (GWG) among pregnant women of different racial/ethnic backgrounds in Ontario, Canada. A population-based retrospective cohort study was conducted among women who had prenatal screening and had a singleton birth in an Ontario hospital between April 2016 and March 2017. We estimated adjusted risk ratios (aRR) of racial/ethnic differences for inadequate or excessive GWG using multinomial logistic regression models. Interaction effects were examined to determine whether racial/ethnic difference in GWG varied by pre-pregnancy body mass index (BMI). Among 74,424 women, the prevalence of inadequate GWG in White, Asian, and Black women was 15.7%, 25.8%, and 25.0%, and excessive GWG was 62.8%, 45.5%, and 54.7%, respectively. There were significant interaction effects between race/ethnicity and pre-pregnancy BMI for inadequate GWG (Wald p < 0.01) and excessive GWG (Wald p < 0.01). Compared with White women, Asian women had higher risk of inadequate GWG and lower risk of excessive GWG in all weight classes, and Black women had higher risk of inadequate GWG and lower risk of excessive GWG if their BMI was normal, overweight, or obese. Variations in unhealthy GWG by pre-pregnancy weight classes among Ontario White, Asian and Black women were observed. Individualized counseling regarding appropriate GWG is universally recommended. Additional consideration of racial/ethnic variations by maternal weight classes may help to promote healthy GWG in Canada.","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"52 1","pages":"657 - 667"},"PeriodicalIF":0.0,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81117869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmet health needs and discrimination by healthcare providers among an Indigenous population in Toronto, Canada","authors":"G. Kitching, M. Firestone, B. Schei, Sara H Wolfe, Cheryllee Bourgeois, P. O’Campo, M. Rotondi, R. Nisenbaum, R. Maddox, J. Smylie","doi":"10.17269/s41997-019-00242-z","DOIUrl":"https://doi.org/10.17269/s41997-019-00242-z","url":null,"abstract":"Objectives Inequalities between Indigenous and non-Indigenous peoples in Canada persist. Despite the growth of Indigenous populations in urban settings, information on their health is scarce. The objective of this study is to assess the association between experience of discrimination by healthcare providers and having unmet health needs within the Indigenous population of Toronto. Methods The Our Health Counts Toronto (OHCT) database was generated using respondent-driven sampling (RDS) to recruit 917 self-identified Indigenous adults within Toronto for a comprehensive health assessment survey. This cross-sectional study draws on information from 836 OHCT participants with responses to all study variables. Odds ratios and 95% confidence intervals were estimated to examine the relationship between lifetime experience of discrimination by a healthcare provider and having an unmet health need in the 12 months prior to the study. Stratified analysis was conducted to understand how information on access to primary care and socio-demographic factors influenced this relationship. Results The RDS-adjusted prevalence of discrimination by a healthcare provider was 28.5% (95% CI 20.4–36.5) and of unmet health needs was 27.3% (95% CI 19.1–35.5). Discrimination by a healthcare provider was positively associated with unmet health needs (OR 3.1, 95% CI 1.3–7.3). Conclusion This analysis provides new evidence linking discrimination in healthcare settings to disparities in healthcare access among urban Indigenous people, reinforcing existing recommendations regarding Indigenous cultural safety training for healthcare providers. Our study further demonstrates Our Health Counts methodologies, which employ robust community partnerships and RDS to address gaps in health information for urban Indigenous populations. Objectifs Des inégalités subsistent au Canada entre les peuples autochtones et non autochtones. Malgré la croissance des populations autochtones en milieu urbain, les informations sur leur santé sont rares. Nous avons voulu évaluer les associations entre les expériences de discrimination par des dispensateurs de soins de santé et la présence de besoins de santé non comblés au sein de la population autochtone de Toronto. Méthode Nous avons utilisé la base de données « Our Health Counts Toronto » (OHCT) pour recruter par échantillonnage en fonction des répondants (EFR) 917 adultes de Toronto s’identifiant comme étant Métis, Inuits ou membres des Premières Nations pour répondre à un questionnaire d’évaluation de santé exhaustif. Pour cette étude transversale, nous avons utilisé les données de 836 participants de l’OHCT ayant fourni des réponses à toutes les variables de l’étude. Nous avons estimé des rapports de cotes et des intervalles de confiance de 95 % pour examiner la relation entre l’expérience de discrimination par une dispensatrice ou un dispensateur de soins de santé au cours de la vie et la présence d’un besoin de santé non comblé au cours des 12 m","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"38 1","pages":"40 - 49"},"PeriodicalIF":0.0,"publicationDate":"2019-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86958099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-benefit analysis of a population-based education program on the wise use of antibiotics","authors":"A. Mamun, Bin Zhao, Mark McCabe, Kim Dreher, M. Otterstatter, N. Smith, E. Blondel-Hill, F. Marra, D. Patrick","doi":"10.17269/s41997-019-00245-w","DOIUrl":"https://doi.org/10.17269/s41997-019-00245-w","url":null,"abstract":"In 2005, the Do Bugs Need Drugs (DBND) program was imported to British Columbia (BC) from Alberta with the goal of reducing unnecessary antibiotic use in the community. The objective of this study was to estimate the impact of the program on antibiotic-associated costs and cost-benefit. We used data on antibiotic prescription and costs from BC PharmaNet for the period of 1996 to 2014. We conducted interrupted time series regression to formally interpret the impact of the DBND program. The average monthly prescription rate fell by 14.5%, from 54.3 to 46.4 per 1000 population between 2005 and 2014. The proportionate contribution of macrolide prescription decreased from 19.2% in 2005 to 13.2% in 2014 and for quinolones decreased from 13.1% in 2005 to 12% in 2014. The proportion of prescriptions for both penicillins and tetracyclines increased by > 35.5%. Before the program, the average monthly cost of antibiotics was increasing by CAD $8.12 per 1000 population (p < 0.001). After program introduction, average monthly cost decreased by CAD $18.19 per 1000 population (p < 0.001), creating an annual savings for BC in 2014 of CAD $83.6 million. In 2014, one Canadian dollar spent on the DBND program was associated with conservative savings of CAD $76.20. Significant cost savings have been observed in association with a community antimicrobial stewardship program focused on both public and prescribers. Such programs are an effective strategy in cost-benefit terms and should therefore be considered for universal adoption in Canadian healthcare systems.","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"26 1","pages":"732 - 740"},"PeriodicalIF":0.0,"publicationDate":"2019-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90461847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restrictive Measures in an Influenza Pandemic: A Qualitative Study of Public Perspectives","authors":"Maxwell J. Smith, C. Bensimon, Daniel F Perez, S. Sahni, Ross Upshur","doi":"10.1007/BF03404439","DOIUrl":"https://doi.org/10.1007/BF03404439","url":null,"abstract":"","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"32 1","pages":"e348 - e352"},"PeriodicalIF":0.0,"publicationDate":"2012-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85484333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development Assistance for Health: Donor Commitment as a Critical Success Factor","authors":"F. White","doi":"10.17269/CJPH.102.2722","DOIUrl":"https://doi.org/10.17269/CJPH.102.2722","url":null,"abstract":"In 1970, led by Canada, the world’s richest nations pledged 0.7% of their gross national income (GNI) to official development assistance (ODA). Although this pledge has been renewed several times, with the exception of only five countries, ODA allocations have lagged chronically behind this commitment. Put more bluntly, our rhetoric outpaces our actions. For example, spending only 0.3% GNI on development, Canada performs at about 40% of its pledge. The good news is that development assistance for health has improved over the past two decades, mostly due to private development assistance (PDA) and favourable shifts within bilateral and multilateral funding, but clearly more must be done to enhance this effort. Actions in support of the Millennium Development Goals and the Paris Declaration on Aid Effectiveness should make a difference, subject to monitoring and evaluation, and Canada’s Muskoka Initiative also is a step in the right direction. However, while success in meeting international development and global health goals depends on donor and recipient nations working as partners through such mechanisms, the relevance of the developed world as a force for global health will be measured in part by how well its governments keep their development commitments.RésuméEn 1970, sous l’égide du Canada, les pays les plus riches ont annoncé une contribution de 0,7 % de leur revenu national brut (RNB) à l’aide publique au développement (APD). Cette promesse a été renouvelée plusieurs fois. Pourtant, à l’exception de cinq pays seulement, les montants consentis à l’APD ont été en décalage chronique par rapport à cet engagement. Pour parler franc, nos discours creux ont pris le pas sur nos actions. Par exemple, en ne consacrant que 0,3 % de son RNB au développement, le Canada n’en est qu’à environ 40 % de sa contribution annoncée. La bonne nouvelle est que l’aide au développement en santé augmente depuis les 20 dernières années, surtout grâce à l’aide au développement privée et à des transferts favorables entre le financement bilatéral et multilatéral, mais il est clair qu’il faut en faire plus pour améliorer cet effort. Les actions à l’appui des objectifs du Millénaire pour le développement et de la Déclaration de Paris sur l’efficacité de l’aide devraient peser dans la balance, à condition de faire l’objet d’un suiviévaluation; l’Initiative de Muskoka du Canada est aussi un pas dans la bonne direction. Cependant, si l’atteinte des objectifs de développement international et de santé mondiale dépend de la collaboration entre pays donateurs et pays bénéficiaires à la faveur de tels mécanismes, la pertinence des pays développés comme une force pour la santé mondiale se mesurera en partie par la façon dont les gouvernements de ces pays tiendront leurs engagements en matière de développement.","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"54 1","pages":"421-423"},"PeriodicalIF":0.0,"publicationDate":"2011-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73401175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child Maltreatment in Canada: An Understudied Public Health Problem","authors":"T. Afifi","doi":"10.17269/CJPH.102.2778","DOIUrl":"https://doi.org/10.17269/CJPH.102.2778","url":null,"abstract":"Child maltreatment is a major public health problem associated with impairment in childhood, adolescence, and extending throughout the lifespan. Within Canada, high-quality child maltreatment studies have been conducted and are critical for informing prevention and intervention efforts. However, compared to other parts of the world (e.g., United States, United Kingdom, the Netherlands, and Mexico), the number of studies conducted in Canada is far fewer and the data used to study this important public health problem are less diverse. Importantly, to date, representative data on child maltreatment from the general population at the national level in Canada do not exist. This means that many questions regarding child maltreatment in Canada remain unanswered. To advance our understanding of child maltreatment in Canada and to make significant strides towards protecting Canadian children and families, research using Canadian data is essential. To begin to meet these important public health goals, we need to invest in collecting high-quality, nationally representative Canadian data on child maltreatment. Solutions for the barriers and challenges for the inclusion of child maltreatment data into nationally representative Canadian surveys are provided.RésuméLa maltraitance des enfants est un grave problème de santé publique associé à la déficience durant l’enfance, l’adolescence et le reste de la vie. On a mené au Canada des études de haute qualité sur la maltraitance des enfants, et ces études sont essentielles aux efforts de prévention et d’intervention. Cependant, comparativement à d’autres parties du monde (États-Unis, Royaume-Uni, Pays-Bas, Mexique), le nombre d’études menées au Canada est très inférieur, et les données utilisées pour étudier cet important problème de santé publique sont moins diversifiées. Surtout, jusqu’à maintenant, on n’a pas recueilli de données représentatives sur la maltraitance des enfants dans la population générale à l’échelle du Canada. Par conséquent, bien des questions sur la maltraitance des enfants au Canada restent sans réponse. Pour améliorer notre compréhension de ce phénomène et pour faire de réels progrès dans la protection des enfants et des familles au Canada, il est essentiel de faire de la recherche en utilisant des données canadiennes. Pour commencer à respecter ces importants objectifs de santé publique, nous devons investir dans la collecte de données représentatives canadiennes de haute qualité sur la maltraitance des enfants. Nous proposons des solutions pour surmonter les obstacles et les défis à l’inclusion de données sur la maltraitance des enfants dans les enquêtes représentatives canadiennes.","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"10 1","pages":"459-461"},"PeriodicalIF":0.0,"publicationDate":"2011-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78481078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Smokeless Tobacco Use Among Canadian Youth Between 2004 and 2008: Findings From the Youth Smoking Survey","authors":"R. Kennedy, S. Leatherdale, R. Burkhalter, R. Ahmed","doi":"10.17269/CJPH.102.2742","DOIUrl":"https://doi.org/10.17269/CJPH.102.2742","url":null,"abstract":"Objectives: The current study team sought to understand smokeless tobacco (SLT) usage trends among youth, using nationally representative data collected as part of the Canadian Youth Smoking Survey (YSS) between 2004 and 2008.Methods: Descriptive analyses of SLT ever use among respondents in grades 6 to 9 were examined according to year of data collection (2008, n=31,249; 2006, n=34,050; and 2004, n=23,362). Using the 2008 data from respondents in grades 6 to 12 (n=51,922), logistic regression models were used to examine characteristics associated with SLT ever use and current use.Results: Between 2004 and 2008, the prevalence of youth in grades 6 to 9 reporting they have ever tried SLT significantly decreased by 30.8%. In 2008, male students were more likely than females to have tried SLT (OR 4.87, 95% CI 4.34–5.45) or to currently use SLT (OR 4.96, 95% CI 4.12–5.96). There are regional differences in prevalence of SLT use across Canada, with the highest rates in western provinces and the lowest in Quebec. Current smokers were also more likely to use SLT (OR 11.86, 95% CI 10.22–13.76) compared to non-smokers. Older students are more likely to report ever use or current use of SLT.Conclusion: The findings from this study demonstrate that in Canada, adolescent SLT use is primarily an issue with males and there are significant regional differences. Ongoing monitoring of SLT is encouraged considering the tobacco industry’s recent investments and product development and increased use in countries like the United States.RésuméObjectifs: Le groupe d’étude actuel de l’Enquête sur le tabagisme chez les jeunes (ETJ) a cherché à comprendre les tendances de l’usage du tabac sans fumée (TSF) chez les jeunes au moyen de données représentatives nationales recueillies dans le cadre de l’ETJ menée au Canada entre 2004 et 2008.Méthode: Des analyses descriptives de l’usage du TSF chez les répondants de la 6e à la 9e année ont été examinées selon l’année de collecte des données (2008, n=31 249; 2006, n=34 050; et 2004, n=23 362). À l’aide des données de 2008 obtenues auprès des répondants de la 6e à la 12e année (n=51 922), nous avons utilisé des modèles de régression logistique pour étudier les caractéristiques associées au fait d’avoir déjà utilisé du TSF et au fait d’en utiliser actuellement.Résultats: Entre 2004 et 2008, la prévalence de jeunes de la 6e à la 9e année ayant déjà essayé du TSF a présenté une baisse significative de 30,8%. En 2008, les garçons étaient plus susceptibles que les filles d’avoir essayé le TSF (RC=4,87, IC de 95% = 4,34–5,45) ou d’en utiliser actuellement (RC=4,96, IC de 95% = 4,12–5,96). Il y a des écarts régionaux dans la prévalence de l’usage du TSF au Canada, les taux les plus élevés étant observés dans les provinces de l’Ouest, et le taux le plus faible au Québec. Les fumeurs actuels étaient aussi plus susceptibles d’utiliser du TSF (RC=11,86, IC de 95 % = 10,22–13,76) que les non-fumeurs. Les élèves plus âgés étaient plus suscept","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"16 1","pages":"358-363"},"PeriodicalIF":0.0,"publicationDate":"2011-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78380139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk Indicators of Depressed Mood in On-Reserve First Nations Youth","authors":"M. Lemstra, M. Rogers, Adam Thompson, Lauren Redgate, Meghan Garner, R. Tempier, J. Moraros","doi":"10.17269/CJPH.102.2577","DOIUrl":"https://doi.org/10.17269/CJPH.102.2577","url":null,"abstract":"ObjectivesThe first objective was to determine the prevalence of depressive mood in First Nations youth in school grades 5 through 8 in seven onreserve communities. The second objective was to determine the unadjusted and adjusted risk indicators associated with depressed mood in these youth.MethodsStudents in grades 5 through 8 in the seven reserve communities of the Saskatoon Tribal Council were asked to complete a paper and pencil, comprehensive youth health survey in May 2010. An eight-stage consent protocol was followed prior to participation.ResultsOut of 271 students eligible to participate, 204 youth completed the survey for a response rate of 75.3%.Using the Center for Epidemiological Studies of Depression scale, 25% of the youth had moderate depressive symptoms. After cross-tabulation, 1 socioeconomic variable, 10 social variables, 3 social support variables, 1 self-esteem variable, 5 parental relationship variables and 3 bullying variables were associated with depressed mood.Logistic regression was used to determine four independent risk indicators associated with having depressed mood in First Nations youth, including: 1) not having worked through things that happened during childhood, 2) not having someone who shows love and affection, 3) having a lot of arguments with parents and 4) being physically bullied at least once per week.ConclusionsOur study found high rates of depressed mood in on-reserve First Nations youth. These youth are now at increased risk for problems later in life unless successful interventions can be implemented.RésuméObjectifsNotre premier objectif était de calculer la prévalence de l’humeur dépressive chez les jeunes des Premières nations fréquentant l’école (5e à 8e année) dans sept communautés de réserves. Notre second objectif était de déterminer les indicateurs de risque ajustés et non ajustés associés à l’humeur dépressive chez ces jeunes.MéthodeEn mai 2010, nous avons demandé aux élèves de la 5e à la 8e année des sept communautés de réserves du conseil tribal de Saskatoon de remplir sur papier un questionnaire exhaustif sur la santé des jeunes. Un protocole de consentement en huit étapes a été suivi avant de les laisser participer.RésultatsSur les 271 élèves admissibles, 204 ont rempli le questionnaire, soit un taux de réponse de 75,3 %.Selon l’échelle de dépression du Center for Epidemiological Studies, 25 % des jeunes éprouvaient des symptômes dépressifs modérés. Après tabulation en croix, 1 variable socioéconomique, 10 variables sociales, 3 variables du soutien social, 1 variable de l’estime de soi, 5 variables des relations parentales et 3 variables de l’intimidation étaient associées à l’humeur dépressive.Par régression logistique, nous avons repéré quatre indicateurs de risque indépendamment associés à l’humeur dépressive chez les jeunes des Premières nations: 1) ne pas avoir résolu des traumatismes survenus durant l’enfance, 2) n’avoir personne qui leur montre de l’amour et de l’affection, 3) avoi","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"15 1","pages":"258-263"},"PeriodicalIF":0.0,"publicationDate":"2011-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78402909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refugees and Health Care – The Need for Data: Understanding the Health of Government-assisted Refugees in Canada Through a Prospective Longitudinal Cohort","authors":"Patricia Gabriel, Cecily Morgan-Jonker, Charlene Phung, R. Barrios, J. Kaczorowski","doi":"10.17269/CJPH.102.2425","DOIUrl":"https://doi.org/10.17269/CJPH.102.2425","url":null,"abstract":"Canada is a country with large populations of immigrants and refugees. These populations face unique health challenges and barriers to accessing health care services. Amendments to the Canadian Immigration and Refugee Protection Act in 2002 have resulted in an increase in refugees with complex medical needs. However, little is known about the health of refugees on arrival and their subsequent health care trajectories.There is an urgent need for an improved understanding of refugee demographics and health status on arrival, changes in health status over time, utilization of health services, and characteristics associated with optimal health outcomes. This knowledge gap could be addressed through the creation of a longitudinal cohort study of government-assisted refugees (GARs) in British Columbia (BC). The provision of services for GARs in BC lends itself readily to the creation of a prospective GAR cohort. This, combined with access to highly reliable, valid and comprehensive administrative databases available through Population Data BC, would allow for longitudinal follow-up, and ensure low attrition rates.Establishment of such a cohort would improve knowledge of refugee health and could guide health service providers and policy-makers in providing optimal services to GARs.RésuméLe Canada est un pays ayant de grandes populations d’immigrants et de réfugiés. Ces populations sont confrontées à des problèmes et à des obstacles particuliers pour accéder aux services de santé. À la suite des modifications apportées en 2002 à la Loi sur l’immigration et la protection des réfugiés du Canada, il y a eu une augmentation des réfugiés ayant des besoins médicaux complexes. Toutefois, on en sait peu sur la santé des réfugiés à leur arrivée et sur leurs trajectoires subséquentes dans le système des soins de santé.Il y a un urgent besoin d’améliorer nos connaissances du profil démographique et de l’état de santé des réfugiés à leur arrivée, de l’évolution de leur état de santé au fil du temps, de leur utilisation des services de santé et des caractéristiques associées aux résultats sanitaires optimaux. Ces lacunes pourraient être comblées par la création d’une étude longitudinale de cohorte pour les réfugiés parrainés par le gouvernement (RPG) en Colombie-Britannique (C.-B.). La prestation de services aux RPG dans cette province se prête bien à la création d’une cohorte prospective de RPG. Si en plus on avait accès aux bases de données administratives de Population Data BC–qui sont extrêmement fiables, valides et complètes–cette initiative permettrait d’effectuer un suivi longitudinal et garantirait de faibles taux d’attrition.L’établissement d’une telle cohorte améliorerait l’état des connaissances sur la santé des réfugiés et pourrait aider les dispensateurs de services de santé et les responsables des politiques à optimaliser les services offerts aux RPG.","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"18 1","pages":"269-272"},"PeriodicalIF":0.0,"publicationDate":"2011-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80871503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}