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A Canadian peer-reviewed journal of population health and health services research

Special 20th Anniversary Edition

As of October 2009, Health Reports will have been publishing landmark findings for 20 years. To celebrate the importance of our work to the health research and policy community, we are publishing a special issue looking retrospectively at studies published over the past two decades, and forward with new ground-breaking research on two themes: Chronic Disease Risk Factors which will be featured in October, and Social Determinants of Health in November.

Other notable articles will be published in December to round out our special edition. Each theme is introduced by a Guest Editor who reviews Health Reports' contribution to knowledge in that area to date and ties in two new studies chosen from the “Call for papers”. The new papers selected by each guest editor are being published in their entirety in this special issue.

December 2009

Mortality of Métis and Registered Indian adults: An 11-year follow-up study

by Michael Tjepkema, Russell Wilkins, Sacha Senécal, Éric Guimond and Christopher Penney

First Nations (North American Indians), Métis and Inuit are the three major Aboriginal groups in Canada. Research has consistently shown that First Nations have a much shorter life expectancy than that for Canada as a whole, and are at increased risk for causes of death that occur more frequently at younger ages, such as injuries and suicides. The pattern is similar for Inuit. However, mortality patterns among Métis are largely unknown.


A comparison of individual and area-based socio-economic data for monitoring social inequalities in health

by Robert Pampalon, Denis Hamel and Philippe Gamache

Indicators of health status and the health care system in Canada are available in publications such as the Federal Report on Comparable Health Indicators (2002, 2004 and 2006) and the annual online series, Health Indicators, which has been produced since 2002. These sources provide more than one hundred indicators, by sex, age group, province and health region, but only one indicator, health-adjusted life expectancy, is connected to a socio-economic measure—average neighbourhood income. Therefore, it is not surprising that participants in a recent conference recommended that health indicators take the concept of equity into account, specifi cally, that they incorporate socioeconomic status and place of residence (urban or rural).

Smokers’ use of acute care hospitals—A prospective study

by Kathryn Wilkins, Margot Shields and Michelle Rotermann

Hospital care for smoking-related illnesses constitutes an important part of the health care burden. However, because hospital administrative records contain only limited information, quantifying hospital use according to patients’ personal characteristics is challenging. For example, although smoking may have contributed to the illness for which a person is hospitalized, no information on smoking history is captured in the administrative discharge abstract.

November 2009

Guest editorial: Health inequalities research in Canada: From data liberation to research proliferation to . . . . ?

by James R. Dunn
CIHR-PHAC Chair in Applied Public Health;
Associate Professor, Department of Health, Aging and Society, McMaster University;
Scientist, Centre for Research on Inner City Health, St. Michael’s Hospital;
Fellow, Successful Societies Program, Canadian Institute for Advanced Research;
Deputy Editor, Journal of Epidemiology & Community Health

[Full text of Guest Editorial]
[Download PDF of Guest Editorial]

Income disparities in health-adjusted life expectancy for Canadian adults, 1991 to 2001

by Cameron N. McIntosh, Philippe Finès, Russell Wilkins and Michael C. Wolfson

The dramatic increase in life expectancy in Canada and other economically developed nations during the last century stands as testimony to the success of improvements in public health and advances in medical care. But despite these gains in longevity, inequalities in health outcomes across different subpopulations are still pervasive in Canada and other industrialized countries.

Social class, gender, and time use: Implications for the social determinants of body weight?

by Lindsay McLaren, Jenny Godley and Ian A.S. MacNairn

The social gradient in health refers to the consistent association between socio-economic position and health status, whereby higher socioeconomic position is associated with better health status across an array of health outcomes.The social gradient in body weight (body mass index (BMI), obesity) departs from this consistent pattern. Sex differences are apparent, with an inverse association (higher socio-economic positon— lower BMI) more prominent for women than men. Further differences by indicator of socio-economic position are evident; for example, recent Canadian data show a positive association with income for men (that is, higher income—higher likelihood of overweight/obesity) that is not observed in women, while an inverse association between education and overweight/obesity has been observed for both women and (less consistently) for men.

October 2009

Guest editorial: Canada in context: Challenging our epidemics of obesity and obesity-related chronic diseases

by Diane T. Finegood, PhD,
Department of Biomedical
Physiology and Kinesiology,
Simon Fraser University
Executive Director,
The CAPTURE Project

[Full text of Guest Editorial]
[Download PDF of Guest Editorial]

Diet composition and obesity among Canadian adults

by Kellie Langlois, Didier Garriguet and Leanne Findlay

The prevalence of obesity has been rising in Canada in recent decades. By 2004, 23.1% of adults were obese, nearly ten percentage points higher than in 1978 (13.8%). Dietary composition—the relative proportions of calories coming from fats, carbohydrates and protein, and intake of fibre— has been suspected of playing a role in obesity. However, few studies have examined the association between excess weight and the consumption of these nutrients, and the results are inconsistent. The unexpected and sometimes contradictory findings may be due to differences in sample size, time frames, and variations in how excess weight is measured. In addition, some of the studies could not account for key factors, including total energy intake and/or physical activity levels. Others were unable to adjust for under-reporting of calories consumed—a shortcoming of many nutrition studies.

Risk factors and chronic conditions among Aboriginal and non-Aboriginal populations

by Lisa M. Lix, Sharon Bruce, Joykrishna Sarkar and T. Kue Young

In Canada, the prevalence of behavioural risk factors and chronic conditions varies between Aboriginal and non-Aboriginal populations, with Aboriginal people generally having less favourable outcomes. For example, obesity and overweight are more common among Aboriginal people than among other groups. Also, the likelihood of having at least one chronic condition and specifi c conditions such as cardiovascular disease and diabetes is higher among Aboriginal people, even when differences in sociodemographic characteristics are taken into account.