Abstract

Background

National health surveys linked to vital statistics and health care information provide a growing source of individual-level population health data. Pooling linked surveys across jurisdictions would create comprehensive datasets that are larger than most existing cohort studies, and that have a unique international and population perspective. This paper’s objectives are to examine the feasibility of pooling linked population health surveys from three countries, facilitate the examination of health behaviours, and present useful information to assist in the planning of international population health surveillance and research studies.

Methods

The design, methodologies and content of the Canadian Community Health Survey (2003 to 2008), the United States National Health Interview Survey (2000, 2005) and the Scottish Health Survey (SHeS) (2003, 2008 to 2010) were examined for comparability and consistency. The feasibility of creating common variables for measuring smoking, alcohol consumption, physical activity and diet was assessed. Sample size and estimated mortality events were collected.

Results

The surveys have comparable purposes, designs, sampling and administration methodologies, target populations, exclusions, and content. Similar health behaviour questions allow for comparable variables to be created across the surveys. However, the SHeS uses a more detailed risk factor evaluation for alcohol consumption and diet data. Therefore, comparisons of alcohol consumption and diet data between the SHeS and the other two surveys should be performed with caution. Pooling these linked surveys would create a dataset with over 350,000 participants, 28,424 deaths and over 2.4 million person-years of follow-up.

Conclusions

Pooling linked national population health surveys could improve population health research and surveillance. Innovative methodologies must be used to account for survey dissimilarities, and further discussion is needed on how to best access and analyze data across jurisdictions.

Keywords

population health, health surveillance, national health surveys

DOI: https://www.doi.org/10.25318/82-003-x202000700002-eng

Findings

In Canada and elsewhere, national population-based health surveys are increasingly being linked to vital statistics and health care data, bringing together large amounts of high-quality, nationally representative information about health risk factors with individual-level health outcomes. Health surveys in Canada and the United States alone have collected detailed sociodemographic and health behaviour information from over 1 million respondents since 1997, and have been linked to over 6 million person-years of mortality follow-up. Because national health surveys often have similar surveillance objectives and designs, pooling data from linked population health surveys could create a new resource for health surveillance and research, with an unparalleled international and population perspective. [Full article]

Authors

Stacey Fisher (stacey.fisher@uottawa.ca), Douglas G. Manuel (dmanuel@ohri.ca), Carol Bennett and Monica Taljaard are with the Ottawa Hospital Research Institute in Ottawa, Ontario. Stacey Fisher, Carol Bennett and Douglas G. Manuel are also with the ICES, as is Laura C. Rosella. Stacey Fisher, Monica Taljaard and Douglas G. Manuel are also with the School of Epidemiology and Public Health at the University of Ottawa, as is JianLi Wang. Douglas G. Manuel is also with Statistics Canada, as are Deirdre Hennessy and Claudia Sanmartin. Tony Robertson is with the Population and Public Health Research Group in the Faculty of Health Sciences and Sport at the University of Stirling in Scotland. Alastair Leyland is with the MRC/CSO Social and Public Health Sciences Unit at the University of Glasgow. Prabhat Jha and Christopher Tait are with the Dalla Lana School of Public Health at the University of Toronto. Prabhat Jha is also with St. Michael’s Hospital, as is Laura C. Rosella. John Frank is with the Scottish Collaboration for Public Health Research and Policy in Edinburgh, and the Usher Institute Centre for Population Health Sciences at the University of Edinburgh. JianLi Wang is also with The Royal’s Institute of Mental Health Research, the Department of Psychiatry at the University of Ottawa, and the Mathison Centre for Mental Health Research and Education at the University of Calgary. Douglas G. Manuel is also with the Department of Family Medicine at the University of Ottawa and the Bruyère Research Institute in Ottawa. Jack V. Tu (deceased May 20, 2018) was with ICES, the Sunnybrook Schulich Heart Centre, and the Institute of Health Policy, Management and Evaluation at the University of Toronto.

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