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The Daily

Wednesday, June 18, 2008

Statistics Canada today releases extensive new data on more than 20 health indicators from the Canadian Community Health Survey (CCHS), a comprehensive survey of more than 65,000 Canadians conducted between January 2007 and December 2007.

Data for all indicators are available at the national and provincial and territorial level, as well as for 118 health regions across Canada.

The CCHS collects a wide range of information about the health status of Canadians, factors determining their health status and their use of health care services.

This article focuses on three indicators: access to a regular medical doctor, smoking rates, and overweight and obesity. It also presents new information about where individuals who did not have a regular doctor sought health care services. Today's Daily also contains releases based on two articles in Health Reports using new CCHS data.

Most individuals who do not have a regular doctor use clinics

For the first time, the CCHS sheds light on where Canadians without a regular medical doctor go when they are sick or need advice about their health.

Note to readers

Statistics Canada is today releasing a set of 20 health indicators from Health Reports (82-003-XWE, free), based on Canadian Community Health Survey (CCHS) data collected from January to December 2007. Starting in 2007, the CCHS began collecting information every year from more than 65,000 individuals aged 12 or older in all provinces and territories. Previously, the CCHS collected information on over 130,000 individuals, but only every other year. As a result, starting this year, the survey data are being released on an annual basis.

This survey collects a wide range of information about the health status of Canadians, factors determining their health status and their use of health care services. Information was reported by the respondents themselves. As in previous cycles of the CCHS, residents of Indian reserves, health care institutions, some remote areas, and full-time members of the Canadian Forces were excluded.

Overweight and obesity rates were based on the body mass index (BMI), which was calculated by dividing self-reported weight in kilograms by self-reported height in meters squared.

For adults, a Body Mass Index of 25 to 29.99 indicates overweight and an increased risk of developing health problems; 30 or more indicates obesity and a high to extremely high risk of developing health problems.

In 2007, 15% of Canadians aged 12 or older, about 4.1 million people, reported that they did not have a regular medical doctor, either because they were unable to find one, or because they had not looked. This proportion was up 3 percentage points since the 1996/1997 National Population Health Survey (NPHS).

Of these individuals, 78%, or 3.3 million people, reported that they in fact had some place to go. Of these estimated 3.3 million people, 64% sought treatment in a walk-in or appointment clinic. Another 12% went to a hospital emergency room, while about 10% went to a community health centre. The remaining 14% chose to use other types of health care facilities or services such as hospital outpatient clinics, telephone health lines or doctor's offices.

The type of facility varied across the country. In Ontario and most of the western provinces, the choice was a clinic. In New Brunswick and Nova Scotia, nearly one-quarter of residents without a regular doctor sought help in a hospital emergency room.

The use of community health centres by those who did not have a regular medical doctor was significantly higher in Quebec and in Newfoundland and Labrador than in the rest of Canada. In the case of Quebec, this reflects the availability of such centres, known as CLSCs (Centre local de services communautaires).

The health service individuals used in the absence of a regular medical doctor varied by the size of their community. Nearly half of rural residents reported that they usually went to a clinic when they needed advice or treatment, compared with 7 in 10 urban residents.

Almost one-quarter of rural residents reported going to an emergency room, compared with 8% of urban residents.

Generally, men and women who needed medical treatment but did not have a regular doctor sought care in similar types of facilities. However, males aged 12 to 44 were more likely than females of the same age to go to an emergency room.

More men than women did not have a regular doctor

Almost one-fifth (19%) of men aged 12 or older did not have a regular doctor in 2007, nearly twice the proportion of 10% among women. As well, males were twice as likely as females to report that they had not looked for a regular doctor.

Respondents were considered not to have looked for a regular medical doctor if they reported "Have not tried to contact one" or "Other reasons." All other respondents without a regular medical doctor were considered to have been unable to find one. Their responses included various combinations of the following: "No medical doctors available in the area," "Medical doctors in the area are not taking new patients," and "Had a medical doctor who left or retired."

People rating their health as excellent or very good were the most likely not to have a regular doctor and not to have looked for one. This was especially true for individuals of both sexes aged 20 to 34.

Among adults, the likelihood of not having a regular medical doctor decreased with age. Only 5% of seniors aged 65 or older did not have a doctor, the lowest proportion of all age groups. Only 2% had not looked for one.

A small minority of Canadians (6%) who had heart disease, high blood pressure, diabetes or arthritis reported not having a doctor. This compared with 18% of those without any of these chronic conditions. This information is important because the involvement of appropriate primary health care in the management of these chronic conditions is important in reducing further progression of disease, as well as in reducing the overall burden on the health care system.

Having a doctor also appears to be linked to socio-economic status. Individuals living in the households with the lowest incomes were less likely than those in higher-income households to have a regular doctor. Individuals in low-income households were also more likely not to have looked for a doctor.

Immigrants, that is, those who have been in Canada for no more than five years, were considerably less likely to have a regular medical doctor than were Canadian-born persons or immigrants who arrived more than five years ago. Also, aboriginal people were less likely than non-Aboriginal people to have a regular doctor.

Nationally, 1 in 15 people could not find a doctor

Just under 1.7 million Canadians (6% of the population aged 12 or older) reported that they could not find a regular doctor in 2007.

Among people under the age of 65, males in every age group were more likely than females to have difficulty finding a doctor. Among seniors 65 and older, just 3% of both sexes had been unsuccessful in finding a doctor.

Provincially, 10% of the population in Prince Edward Island and Quebec said they could not find a doctor, significantly higher than the national average of 6%.

Smoking: Rates stable among young people aged 12 to 19 

Nationally, over one-fifth (22%) of the population aged 12 or older smoked either daily or occasionally in 2007, the same rate as in 2005.

After several years of declines, rates of smoking among youth aged 12 to 19 did not change during the two year period. About 400,000 Canadians in this age group, 12% of the total, reported that they smoked daily or occasionally.

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Rates remained highest among adults aged 20 to 44, 28% of whom smoked either daily or occasionally. One-third of men in this age group smoked, as did one-quarter of women.

Smoking rates were similar for both sexes under the age of 20. However, in each successive age group, a higher percentage of men than women smoked.

About one-quarter of adults smoked in Newfoundland and Labrador, Nova Scotia, Quebec and Saskatchewan, all significantly above the national average. Smoking rates were below the national average in Ontario (21%) and British Columbia (18%).

Obesity: Rates of self-reported obesity highest among middle-aged

According to the 2007 CCHS, 4 million people aged 18 or older, 16% of the total, reported data on weight and height that put them in the obese category. Another 8 million, or 32%, were overweight.

The percentage of Canadians who are overweight or obese rose dramatically between 1985 and 1994/1995 but appears to have stabilized more recently.

Between 2005 and 2007, rates of both overweight and obesity generally changed little. During that period, there was a slight increase in the proportion of women aged 18 to 24 who were obese, and a decrease in the proportion of senior men who were overweight.

Self-reported obesity rates were generally highest among individuals aged 45 to 64. One-fifth (20%) of men in this age group were obese, as were 18% of women. The proportion who were overweight also tended to peak in middle-age.

Rates of overweight and obesity were lowest among those aged 18 to 24 both for men and women. However, men aged 25 to 44 were considerably more likely than their female counterparts to be obese.

Among the provinces, rates of obesity were highest in Saskatchewan, Alberta and Atlantic Canada, ranging from 18% in Alberta to a high of 22% in Newfoundland and Labrador. The lowest rates were in British Columbia where only 11% of adults were obese.

Being overweight is a risk factor for chronic conditions such as type 2 diabetes and heart disease. Not surprisingly, individuals who were overweight or obese were more likely to have these conditions than were individuals whose Body Mass Index was in the normal range. Similarly, overweight and obese adults were less likely to rate their health as excellent or very good than were adults not carrying excess weight.

A separate study released today in Health Reports (82-003-XWE, free) found strong evidence of a positive association between sedentary activities and obesity among both sexes.

Because of the tendency of respondents to over-report their height and under-report their weight, it is likely that these figures from the CCHS underestimate the actual prevalence of obesity and overweight.

Definitions, data sources and methods: survey number 3226.

Two products featuring results of CCHS 2007 are released today from the Publications module of our Web site. The latest electronic issue of Health Indicators, 2008, no. 1 (82-221-XIE, free), provides a set of more than 20 health indicators for Canada, the provinces and territories, and the health regions. Indicator updates from other sources, such as the 2006 Census, are also available.

In addition, the two articles in today's Health Reports online release, are based on CCHS 2007 data. "Screen time among Canadian adults: A profile," and "Sedentary behaviour and obesity" are now available (82-003-XWE) from the Publications module of our website.

The complete version of the latest issue of Health Reports, Vol. 19, no. 2 (82-003-XWE, free) is now available from the Publications module or our website. A printed version (82-003-XPE, $24/$68) is also available.

For more information about the Canadian Community Health Survey, 2007, or to enquire about the concepts, methods or data quality of this release, contact Client Services (613-951-1746;, Health Statistics Division.

For more information, contact Media Relations (613-951-4636), Communications and Library Services Division.

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