4. Indicators based on Statistics Canada surveys

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4.1 National Population Health Survey

The National Population Health Survey (NPHS), which began in 1994/1995, collects information about the health of the Canadian population every two years. It covers household and institutional residents in all provinces and territories, except persons living on Indian reserves, Canadian Forces bases, and in some remote areas. The NPHS has both a longitudinal and a cross-sectional component. Respondents who are part of the longitudinal component will be followed for up to 20 years.

The Health Indicators data are based on both the longitudinal and cross–sectional components for household residents (institutional excluded) living in the provinces (territories excluded). Data are available for the first three cycles (1994/1995, 1996/1997 and 1998/1999).

The 1994/1995 and 1996/1997 cross-sectional samples are made up of longitudinal respondents and their household members and individuals who were selected as part of supplemental samples, or "buy–ins", in some provinces. The 1998/1999 cross–sectional sample is made up mostly of longitudinal respondents and their cohabitants. No buy–ins were added to 1998/1999 data. However, to keep the sample representative, infants born in 1995 and thereafter and immigrants who entered Canada since the beginning of 1995 were randomly selected and added to the NPHS sample.

The 1994/1995 provincial, non–institutional cross–sectional sample consisted of 27,263 households, of which 88.7% agreed to participate in the survey. After application of a screening rule to maintain the representativeness of the sample, 20,725 households remained in scope. In 18,342 of these households, the selected person was aged 12 or older. Their response rate to the in–depth health questions was 96.1% or 17,626 respondents. In 1996/1997, the overall response rate at the household level was 82.6%. The response rate for the randomly selected individuals aged 2 or older in these households was 95.6%. A total of 81,804 respondents answered the in depth health questions in 1996/1997. In 1998/1999, the overall response rate was 88.2% at the household level. The response rate for the randomly selected respondents 0 or older in these households was 98.5%. A total of 17,244 respondents answered the in depth health questions in 1998/1999.

The 1994/1995 provincial, non–institutional longitudinal sample consisted of 17,276 respondents. A response rate of 93.6% was achieved in 1996/1997, and a response rate of 88.9% was achieved in 1998/1999.

4.2 National Population Health Survey – North Component

Statistics Canada conducted the north component of the NPHS in conjunction with the statistical bureaus in Yukon and Northwest Territories. Data were obtained through a separate survey due to the special challenges of survey taking in Canada’s North.

The target population of the Yukon/Northwest Territories integrated NPHS/National Longitudinal Survey of Children and Youth survey included household residents living in private occupied dwellings located in the two territories, with the exclusion of populations on Indian Reserves, Canadian Forces Bases and in institutions. Moreover, persons living in unorganized areas in the Yukon (13% of the population) and persons living in unorganized areas, very small or extreme northern communities of the NWT (4.9% of the population) were also excluded from the target population.

Most of the core content from the 1994/1995 NPHS main survey is included in the northern survey; however, special "focus content" on stress was excluded. In each selected household in the North, demographic information was collected from all household members, then one person, aged 12 years and over, was randomly selected for a more in–depth interview. The questionnaire included components on health status, use of health services, risk factors and demographic and socio–economic status. Some content changes were made in the 1996/1997 NPHS North survey.

Collection operations ran from November 1994 to March 1995 (and again from November 1996 to March 1997). Computer–assisted personal interviewing (CAPI), used for the NPHS in the provinces, was not available in the territories at the time of the survey. A paper and pencil questionnaire designed to replicate the CAPI application was used instead. Telephone interviews were conducted where available, otherwise personal interviews were done.

The selected person response rate for the NPHS 1994/1995 was 94.2% at the North level (2,020 respondents). For the Yukon this rate was 94.8%, while the rate for the NWT was 93.1%. The cross–sectional response rate at the North level (both territories) for the NPHS 1996/1997 was 86.2% (1,499 respondents). For the Yukon, this rate was 83.9% while the rate for the NWT was 89.8%.

Data quality note on Heavy Drinking in the 1994/1995 NPHS-North:

Due to a high proportion (42.8%) of refusals/non-stated responses to the question on frequency of heavy drinking in the 1994/1995 NPHS –North, these data were deemed unreleasable/unreliable. Heavy drinking has been defined as the number of times current drinkers drank 5 or more alcoholic beverages on one occasion.

For more information, go to the NPHS - Household component or NPHS - North component.

4.3 Canadian Community Health Survey

For detailed information on this survey, including methodology, go to Canadian Community Health Survey (CCHS).

Different period estimates available

Since 2007, data for the Canadian Community Health Survey (CCHS) are collected yearly instead of every two years. While a sample of approximately 130,000 respondents has been interviewed during the reference periods of 2003 and 2005, it has been changed to 65,000 respondents each year starting in 2007. Two indicator profiles based on CCHS core content are available, featuring the same variables, geography and age breakdowns, but different reference periods. The CANSIM table 105-0501 includes data from 2008, 2007, 2005 and 2003. These estimates present the most up-to-date population health characteristics and will be updated yearly. The CANSIM table 105-0502 includes estimates from 2007/2008 combined, 2005 and 2003. The two-year combined data are less current than annual estimates, but have higher precision (less variability). Users should refer to the CANSIM annual data table 105-0501 as the primary source for most current estimates from the survey. However, where data quality flags indicate suppression (F) or higher variability (E), the CANSIM two-year data table 105-0502 should be used.

“Not stated” category
Rates calculated from Canadian Community Health Survey (CCHS) data for Health Indicators no longer include the ‘not stated’ categories in the denominator. ‘Not stated’ refers to non-response which covers the ‘Refusal’, ‘Don’t Know’, and ‘Not Stated’ response categories. This approach ensures a coherent method across all reported CCHS indicators, as well as with rates published in Statistics Canada's publication Health Reports, which generally exclude the ‘not stated’ responses from the denominator.

Regular medical doctor indicator
In 2005 and 2003, the indicator in French only included “médecin de famille”. Starting in 2007, this concept was widened to “médecin régulier”, which includes “médecin de famille”.

4.5 Bootstrap resampling method

To ensure high data quality for estimates from the NPHS, the CCHS and NLSCY , a weighted bootstrap resampling procedure (and for the NPHS–North, a modified bootstrap procedure) was used to calculate coefficients of variation (CVs) for totals and rates. If the CV was greater than 33.3% or the sample size was less than 10, the data were suppressed and an "F" symbol appears in the data cell. If the CV is greater than 16.5% and no greater than 33.3%, the data should be interpreted with caution and an "E" symbol appears in the same cell as the data. Data with CVs of 16.5% or less are presented without restrictions.

Sampling theory dictates that sample survey results of exactly 100% or 0% must have a coefficient of variation of exactly 0. In reality it is possible that in rare circumstances the true estimate may be lower than 100% or conversely greater than 0% and results should be interpreted as such.