Health

Description:

The National Health and Nutrition Examination Survey (NHANES) has been conducted by the National Center for Health Statistics for over forty years. The survey collects information on the health and nutritional status of the United States population using in-person interviews and standardized physical examinations conducted in mobile examination centers. During the course of these forty years, numerous lessons have been learned about the conduct of a survey using direct physical measures. Examples of these "lessons learned" are described and provide a guide for other organizations and countries as they plan similar surveys.

Description:

In Finland the first national health examination surveys were carried out in the 1960s. Comprehensive surveys of nationally representative population samples have been carried out in 1978 to 1980 (The Mini-Finland Health Survey) and in 2000 to 2001 (Health 2000). Surveys of cardiovascular risk factors, so called FinRisk surveys, have assessed their trends every five years. The health examination surveys are an important tool of health monitoring, and, linked with registers also a rich source of data for epidemiological research. The paper also gives examples on reports published from several of these studies.

Description:

Health services research generally relies on observational data to compare outcomes of patients receiving different therapies. Comparisons of patient groups in observational studies may be biased, in that outcomes differ due to both the effects of treatment and the effects of patient prognosis. In some cases, especially when data are collected on detailed clinical risk factors, these differences can be controlled for using statistical or epidemiological methods. In other cases, when unmeasured characteristics of the patient population affect both the decision to provide therapy and the outcome, these differences cannot be removed using standard techniques. Use of health administrative data requires particular cautions in undertaking observational studies since important clinical information does not exist. We discuss several statistical and epidemiological approaches to remove overt (measurable) and hidden (unmeasurable) bias in observational studies. These include regression model-based case-mix adjustment, propensity-based matching, redefining the exposure variable of interest, and the econometric technique of instrumental variable (IV) analysis. These methods are illustrated using examples from the medical literature including prediction of one-year mortality following heart attack; the return to health care spending in higher spending U.S. regions in terms of clinical and financial benefits; and the long-term survival benefits of invasive cardiac management of heart attack patients. It is possible to use health administrative data for observational studies provided careful attention is paid to addressing issues of reverse causation and unmeasured confounding.

Description:

Most major survey research organizations in the United States and Canada do not include wireless telephone numbers when conducting random-digit-dialed (RDD) household telephone surveys. In this paper, we offer the most up-to-date estimates available from the U.S. National Center for Health Statistics and Statistics Canada concerning the prevalence and demographic characteristics of the wireless-only population. We then present data from the U.S. National Health Interview Survey on the health and health care access of wireless-only adults, and we examine the potential for coverage bias when health research is conducted using RDD surveys that exclude wireless telephone numbers.

Description:

In an effort to increase response rates and decrease costs, many survey operations have begun to use several modes to collect relevant data. While the National Health Interview Survey (NHIS), a multipurpose household health survey conducted annually by the National Center for Health Statistics, Centers for Disease Control and Prevention, is primarily a face-to-face survey, interviewers also rely on the telephone to complete some interviews. This has raised questions about the quality of resulting data. To address these questions, data from the 2005 NHIS are used to analyze the impact of mode on eight key health indicators.

Description:

Many population surveys collecting food consumption data use 24 hour recall methodology to capture detailed one day intakes. In order to estimate longer term intakes of foods and nutrients from these data, methods have been developed that required a repeat recall to be collected from at least a subset of responders in order to estimate day to day variability. During the Canadian Community Health Survey Cycle 2.2 Nutrition Focus Survey, most first interviews were collected in person and most repeat interviews were conducted by telephone. This paper looks at the impact of the mode of interview on the reported foods and nutrients on both the first day and the repeat day and on the estimation of intra individual variability between the first and the second interviews.

Description:

Statistics Canada's Canadian Community Health Survey uses two sample frames and two data collection methods. In cycle 2.1, a change was made in sample allocation between the two frames. A study of the collection method effect by Statistics Canada revealed comparability problems between cycles 1.1 and 2.1. In contrast, the Institut de la statistique du Québec took a comprehensive look at the changes, and classified 178 variables as "comparable" or 'non-comparable". It made recommendations to Quebec users concerning chronological and interregional comparisons.

Description:

This paper describes the sample design used to satisfy the objectives and logistics of the Canadian Health Measures Survey. Among the challenges in developing the design were the need to select respondents close to clinics, the difficulty of achieving the desired sample size for young people, and subsampling for measures associated with exposure to environmental contaminants. The sample design contains solutions to those challenges: the establishment of collection sites, the use of more than one sample frame, and a respondent selection strategy.

Description:

The National Health and Nutrition Examination Surveys (NHANES) is one of a series of health-related programs sponsored by the United States National Center for Health Statistics. A unique feature of NHANES is the administration of a complete medical examination for each respondent in the sample. To standardize administration, these examinations are carried out in mobile examination centers (MECs). The examination includes physical measurements, tests such as eye and dental examinations, and the collection of blood and urine specimens for laboratory testing. NHANES is an ongoing annual health survey of the noninstitutionalized civilian population of the United States. The major analytic goals of NHANES include estimating the number and percentage of persons in the U.S. population and in designated subgroups with selected diseases and risk factors. The sample design for NHANES needs to create a balance between the requirements for efficient annual and multiyear samples and the flexibility that allows changes in key design parameters to make the survey more responsive to the needs of the research and health policy communities. This paper discusses the challenges involved in designing and implementing a sample selection process that satisfies the goals of NHANES.

Description:

In the last two decades, considerable international effort has been put into the development of summary measures of population health that integrate information of mortality and non-fatal health outcomes and international policy interest in such indicators is increasing. There are two main classes of summary measures of population health: health gaps and health expectancies. The Disability-Adjusted Life Year (DALY) is the best known health gap measure and quantifies the gap between a population's actual health and a normative health goal, defined in terms of a global standard life table specifying the healthy years of life lost due to a death at any given age.

This paper gives an overview of the Global Burden of Disease (GBD) conceptual framework, the relationship of the DALY to other measures of population health, and the GBD analytical approach, with particular attention to issues in (1) dealing with biased and missing data, (2) dealing with uncertainty and (3) specific technical issues in ensuring cross-population comparability. The latter include dealing with variations in quality and completeness of cause of death information, explicit use of a comprehensive framework and internal consistency checks for improving comparability of estimates of incidence, prevalence and mortality for causes, the assessment of disability weights, and techniques for improving the comparability of the assessment of the disease burden attributable to risk factors.

Description: The public use microdata file (PUMF) from the Canadian Health Survey on Seniors (CHSS) provides data at the provincial level. Over the two-year period, data were collected from approximately 42,000 respondents aged 65 or older, residing in households in all provinces.

The file includes information on a wide range of topics, including oral health, care receiving, community service use, access to health care services, vaccines, smoking, alcohol consumption, general health, chronic health conditions and provides information on the socio-demographic characteristics of the population.

Note: The Canadian Health Survey on Seniors (CHSS) is a supplement to the Canadian Community Health Survey (CCHS) - Annual component.

Description: This dashboard allows users to examine data on barriers to accessibility experienced by persons with disabilities. These are barriers encountered in different aspects of daily living including those found in public spaces; communicating in different situations; using the Internet and barriers related to behaviours, misconceptions or assumptions by others. The data can be organized by province, gender and other characteristics such as age group. This dashboard is based on the 2022 Canadian Survey on Disability.

Description: Differences in the number and proportions of persons with disabilities who experienced one or more barriers to accessibility, by the type of disability, age group and gender, Canada.

Description: Differences in the number and proportions of persons with disabilities who experienced one or more barriers to accessibility, by the severity of the disability, age group and gender, Canada.

Description: Differences in the number and proportions of persons with disabilities who experienced a barrier to accessibility, Canada, provinces and territories.

Description:

Distribution of market, total and after-tax income by disability status for persons aged 16 years and over and persons aged 25 to 54, Canada and regions, annual.

Description:

Income of individuals by disability status, age group, sex and income source, Canada, annual.

Description:

Distribution of employment income of individuals by disability status, sex and work activity, Canada, annual.

Description:

Poverty and low-income statistics by disability status, age group, sex and economic family type, Canada, annual.

Description: Number and percentage of persons by household food security status and economic family type, Canada and provinces.

Description: Over the last several years, recreational screen time has been increasing. During the COVID-19 pandemic, recreational screen time rose among Canadian youth and adults, and those who increased screen time had poorer self-reported mental health. Using data from the 2017, 2018, and 2021 Canadian Community Health Survey, the objective of this study was to compare recreational screen time behaviours before (2018) and during (2021) the pandemic, looking at patterns by sociodemographic subgroups of the Canadian population.

Description: The availability of measures to operationalize allostatic load—the cumulative toll on the body of responding to stressor demands—in population health surveys may differ across years or surveys, hampering analyses on the entire sampled population. In this study, the impacts of variable selection and calculation method were evaluated to generate an allostatic load index applicable across all cycles of the Canadian Health Measures Survey (CHMS). CHMS data were used to compare individual and population-level changes in scores for allostatic load indexes in which other commonly used measures were substituted for waist-to-hip ratio. Associations between the various constructs and indicators of socioeconomic position were then assessed to evaluate whether relationships were maintained across indexes.

Description: This infographic examines the early child care experiences of children with long-term conditions or disabilities using data from the 2023 Survey on Early Learning and Child Care arrangements – Children with Long-term Conditions and Disabilities (SELCCA – CLCD). It explores the types of extra support needed while in child care, the common difficulties they experienced as well as the impacts on the parent or guardian having difficulty finding a child care arrangement.

Description: Using data from the 2023 Survey on Early Learning and Child Care arrangements – Children with Long-term Conditions and Disabilities (SELCCA – CLCD), this American Sign Language video examines the early child care experiences of children with long-term conditions or disabilities.

Description: Oral health is a crucial component of overall health, influencing both physical and mental well-being. Yet, despite the important role that access to and use of oral health care services play in maintaining optimal oral health, substantial disparities remain in access to oral health care services across population groups in Canada. Using data from the 2022 Canadian Community Health Survey, this study examines the association of dental insurance with oral health care access and use in Canada while accounting for income and sociodemographic factors. It contributes to a baseline of oral health care disparities before the implementation of the Canadian Dental Care Plan.

Description: Children’s oral health can affect functional capacities, psychological well-being, and social integration. Additionally, health behaviours established in childhood extend into adulthood and can influence oral health outcomes later in life. Using data from the 2019 Canadian Health Survey on Children and Youth, this study investigates the association between dental insurance, income, and dental care access for Canadian children and youth aged 1 to 17 years. It contributes to a baseline understanding of oral health care use before the implementation of the Canadian Dental Care Plan.

Description: This infographic provides estimates on health care workers' stress, alcohol consumption and positive health behaviours during the COVID-19 pandemic. Estimates are provided across three primary health care worker groups: nurses, physicians, and Personal Support Workers/Care Aides (PSWs/CAs).

Description: This infographic investigates sandwich caregiving in Canada in 2022, defined as providing care in the past 12 months to both children under 15 years old and care-dependent adults and youth over 15 years old with a long-term condition or disability. The infographic explores the prevalence of sandwich caregiving, the types of relationships involved, and the impacts of this type of caregiving.

Description: Release published in The Daily – Statistics Canada’s official release bulletin

Description: Using data from the 2022 Canadian Social Survey Wave 6 (Well-being and caregiving), this study explores unpaid caregiving in the past 12 months for care-dependent groups (children under 15 years old or adults and youth over 15 years old with a long-term condition or disability). This paper explores: Who are the unpaid caregivers, including "sandwich" caregivers? How much unpaid care is provided and to whom? What are the impacts of this unpaid caregiving on well-being, especially the gendered differences?

Description:

The User Guide to Record Linkage Feedback Reports C1 and C2 is intended for the users of the reports. The reports were developed to facilitate the exchange of information and decisions between the Canadian Cancer Registry and the Provincial and Territorial Cancer Registries.

Description:

The User Guide to Record Linkage Feedback Reports C1 and C2 is intended for the users of the reports. The reports were developed to facilitate the exchange of information and decisions between the Canadian Cancer Registry and the Provincial and Territorial Cancer Registries.

Description:

The user guide to Death Clearance Feedback Reports is intended for users of the feedback reports. The feedback reports were developed to facilitate the exchange of information and decisions between the Canadian Cancer Registry and the Provincial and Territorial Cancer Registries.

Description:

The Record Linkage Overview describes the process used in annual internal record linkage of the Canadian Cancer Registry. The steps include: preparation; pre-processing; record linkage; post-processing; analysis and resolution; resolution entry; and, resolution processing.

Description:

The Death Clearance Overview document describes the Death Clearance module of the Canadian Cancer Registry, its structure, its function and its role in the operation of the national cancer registry. Inputs and outputs are listed and briefly described, as well as the different steps constituting the Death Clearance process.

Description:

The Guidelines for Abstracting and Determining Death Certificate Only Cases are intended for use by all provincial and territorial cancer registries during their Death Clearance Process. The guidelines should be used when performing a comparison between the Death Certificate Notification and the cancer registry database.

Description:

This document examines the functional limitations, physical, emotional and social, related to the musculoskeletal conditions having the largest impact on the health of Canadians. These functional limitations are described and classified using the Classification and Measurement System of Functional Health (CLAMES).

These descriptions and classifications are the first step in a new approach to measuring the health of Canadians that examines what factors are adversely affecting population health and how to address them. This document also provides health professionals, advocacy groups, and individual Canadians with an overview of how living with certain musculoskeletal conditions affects day-to-day functioning.

Description:

This report describes the design, methodology, and results of the first study undertaken by Statistics Canada to measure the impact on Canadian cause of death trends of a new revision of the World Health Organization's International Classification of Diseases (ICD).

Using 1999 Canadian mortality data, Statistics Canada carried out a comparability, or "bridge-coding", study by dual-coding deaths to both the Ninth and Tenth Revisions of the International Classification of Diseases (ICD-9 and ICD-10). The preliminary results of this exercise were used to generate comparability ratios; these ratios measure the net effect of the new revision, with ratios above 1.00 indicating a net increase in deaths classified to a cause of death, and ratios below 1.00 indicating a net decrease.

The comparability ratios derived from dual-coding medical certificates of cause of death presented in this report estimate the size and direction of the disruption to cause of death trends due to the implementation of ICD-10. Researchers and analysts using Canadian mortality data should use these summary measures to calculate comparability-modified death counts and mortality rates to bridge the gap between ICD-9 and ICD-10.

Description:

This document examines the functional limitations-physical, emotional and social-related to the most common types of diabetes and the conditions that result from the disease. These functional limitations are described and classified using the Classification and Measurement System of Functional Health (CLAMES).

These descriptions and classifications are the first step in a new approach to measuring the health of Canadians that examines what factors are adversely affecting population health and how to address them. This document also provides health professionals, advocacy groups, and individual Canadians with an overview of how living with diabetes affects day-to-day functioning.

Description:

This document examines the functional limitations - physical, emotional and social -experienced by patients at the time of diagnosis of cancer and as they undergo various treatments, remission, and palliative and terminal care. These functional limitations are described and classified using the Classification and Measurement System of Functional Health (CLAMES).

These descriptions and classifications are the first step in a new approach to measuring the health of Canadians that examines what factors are adversely affecting population health and how to address them. This document also provides health professionals, advocacy groups, and individual Canadians with an overview of how living with cancer affects day-to-day functioning.