2. Non-medical determinants of health

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2.1 Health behaviours

Smoking

Definition:
Population aged 12 and over who reported being a current smoker, daily or occasional. Occasional smokers include former daily smokers who now smoke occasionally. Does not take into account the number of cigarettes smoked.

Smoking is a risk factor for lung cancer, heart disease, stroke, chronic respiratory disease, and other conditions. According to the World Health Organization, smoking is an important and preventable cause of death.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Heavy drinking

Note(s): Starting in 2009, the denominator includes all the population aged 12 and over. This change applies to rates from all years in this table. In data released before 2009, the denominator included only the population who reported having had at least one drink in the past 12 months. Increasing the population in the denominator reduces the estimate rates. This change was implemented to produce more comparable rates over time and is more consistent with methods used in calculating other indicators.

A definition change was implemented in 2013 to conform with the World Health Organization (WHO) and Health Canada guidelines for Heavy Drinking. Heavy Drinking refers to males who reported having 5 or more drinks, or women who reported having 4 or more drinks, on one occasion, at least once a month in the past year.  While this indicator remains comparable for males to the 5 or more drinks indicator published in previous years, it is no longer comparable for females.

Definition:
Heavy Drinking refers to males who reported having 5 or more drinks, or women who reported having 4 or more drinks, on one occasion, at least once a month in the past year. This level of alcohol consumption can have serious health and social consequences, especially when combined with other behaviours such as driving while intoxicated.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Physical activity during leisure time

Definition:
Population aged 12 and over who reported a level of physical activity, based on their responses to questions about the frequency, nature and duration of their participation in leisure time physical activity.

Respondents are classified as active, moderately active or inactive based on an index of average daily physical activity over the past 3 months. For each leisure time physical activity engaged in by the respondent, an average daily energy expenditure is calculated by multiplying the number of times the activity was performed by the average duration of the activity by the energy cost (kilocalories per kilogram of body weight per hour) of the activity. The index is calculated as the sum of the average daily energy expenditures of all activities. Respondents are classified as follows: 3.0 kcal/kg/day or more = physically active; 1.5 to 2.9 kcal/kg/day = moderately active; less than 1.5 kcal per day = inactive.

The health benefits of physical activity include a reduced risk of cardiovascular disease, some types of cancer, osteoporosis, diabetes, obesity, high blood pressure, depression, stress and anxiety.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Breastfeeding practices

Note: As of June 2010, the method of calculation for the rate of exclusive breastfeeding in the Annual estimates has been modified to produce more comparable rates over time.

Definition:
The breastfeeding practices of women aged 15 to 55 who had a baby in the previous five years.

“Initiated breastfeeding” refers to women who breastfed or tried to breastfeed their last child even if only for a short time. “Exclusive breastfeeding” refers to an infant receiving only breast milk, without any additional liquid (even water) or solid food.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Fruit and vegetable consumption

Definition:
Population aged 12 and over, by the average number of times per day that they consume fruits and vegetables. Measure does not take into account the amount consumed.

Fruit and vegetables are an important source of vitamins, minerals and fibre. A diet rich in fruit and vegetables may reduce the risk of heart disease and some types of cancer.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Bicycle helmet use

Definition:
Population aged 12 and over who reported that they always wore a helmet when riding a bicycle in the last 12 months.

Source (s):
Statistics Canada, Canadian Community Health Survey.

2.2 Living and working conditions

High school graduates

Definition:
'High school diploma or equivalent' includes persons who have graduated from a secondary school or equivalent. It excludes persons with a postsecondary certificate, diploma or degree.

A measure of educational attainment and socio-economic status.

Source (s):
Statistics Canada, 2011 National Household Survey.

Post-secondary graduates

Definition:
Postsecondary certificate, diploma or degree' includes 'apprenticeship or trades certificates or diplomas,' 'college, CEGEP or other non-university certificates or diplomas' and university certificates, diplomas and degrees.

A measure of educational attainment and socio–economic status.

Source (s):
Statistics Canada, 2011 National Household Survey.

Unemployment rate

Definition:
The unemployment rate is the number of unemployed persons expressed as a percentage of the labour force. The unemployment rate for a particular group (age, sex, marital status or others) is the number of unemployed in that group expressed as a percentage of the labour force for that group.

The labour force consists of people who are currently employed and people who are unemployed but were available to work in the reference week and had looked for work in the past 4 weeks. Reference week refers to a one-week period (from Sunday to Saturday) that usually includes the 15th day of the month. The Labour Force Survey excludes residents of Indian Reserves, Yukon, Northwest Territories and Nunavut, inmates of institutions and full-time members of the Armed Forces. Labour Force Survey exclusions account for less than 2% of the population aged 15 and over.

The unemployment rate is a traditional measure of the economy. Unemployed people tend to experience more health problems.

Source (s):
Statistics Canada, Labour Force Survey (special tabulations).

Long-term unemployment rate

Definition:
The long term unemployed includes unemployed individuals who last worked in or before 2010.

The labour force consists of people who are currently employed and people who are unemployed but were available to work in the reference period and had looked for work in the past four weeks.

Unemployed people tend to experience more health problems. Long–term unemployment could extend ones' susceptibility to poor health.

Source (s):
Statistics Canada, 2011 National Household Survey.

Low income rate

Definition:
Income levels at which families or persons not in economic families spend 20 percentage points more than average of their before tax income on food, shelter and clothing.  The low income concept does not apply to the full population in private households. For the purposes of low income statistics, units in the Yukon Territory, Northwest Territories and Nunavut and on Indian reserves were excluded.

The term "economic family" refers to a group of two or more persons who live in the same dwelling and are related to each other by blood, marriage, common-law, adoption or a foster relationship. A widely used measure of socio-economic status. Higher income is associated with better health.

A widely used measure of socio-economic status. Higher income is associated with better health.

Source (s):
Statistics Canada, 2011 National Household Survey.

Children in low-income families

Definition:
Population of children aged 17 and under living in economic families who spend 20 percentage points more than average of their before tax income on food, shelter and clothing.   The low income concept does not apply to the full population in private households. For the purposes of low income statistics, units in the Yukon Territory, Northwest Territories and Nunavut and on Indian reserves were excluded.

The term "economic family" refers to a group of two or more persons who live in the same dwelling and are related to each other by blood, marriage, common-law, adoption or a foster relationship.

A widely used measure of children at risk.

Source (s):
Statistics Canada, 2011 National Household Survey.

Average personal income

Definition:
Average income of individuals refers to the weighted mean total income of individuals aged 15 years and over who reported income for 2010. Average income is calculated from unrounded data by dividing the aggregate income of a specified group of individuals (e.g., males aged 45 to 54 years) by the number of individuals with income in that group. Median and average of individuals will be calculated for those individuals who are at least aged 15 years and who have an income (positive or negative). Age - Refers to the age at last birthday before the reference date, that is, before May 10, 2011.

Higher income is associated with better health.

Source (s):
Statistics Canada, 2011 National Household Survey.

Median share of income

Definition:
The median income of a specified group of households is that amount which divides their income size distribution, ranked by size of income, into two halves. That is, the incomes of the first half of the households are below the median, while those of the second half are above the median. Median incomes of households are normally calculated for all units in the specified group, whether or not they reported income.

Source (s):
Statistics Canada, 2011 National Household Survey, special tabulations.

Government transfer income

Definition:
Refers to all cash benefits received from federal, provincial, territorial or municipal governments during 2010.

Source (s):
Statistics Canada, 2011 National Household Survey.

Housing affordability

Definition:
Percentage of an owner household's average total monthly income which is spent on shelter-related expenses. Those expenses include the mortgage payment, property taxes and condominium fees and the costs of electricity, heat, municipal services, etc. The percentage is calculated by dividing the total shelter-related expenses by the household's total monthly income and multiplying the result by 100. Includes owner households in non-farm, non-reserve private dwellings with household total income greater than zero in 2010 (i.e., excludes negative or zero household total income). The relatively high shelter costs to household income ratios for some households may have resulted from the difference in the reference period for shelter costs and household total income data. The reference period for shelter cost data is 2011, while household total income is reported for the year 2010. As well, for some households, the 2010 household total income may represent income for only part of a year. Household total income - The total income of a household is the sum of the total incomes of all members of that household. Total income refers to the total of income from all sources, including employment income, income from government programs, pension income, investment income and any other money income, before income taxes and deductions, during the calendar year 2010.

As a general rule, households are considered to have affordability problems if more than 30% of household income is spent on housing costs. At that level of spending, it is likely that inadequate funds will be available for other necessities such as food, clothing, and transportation. Housing affordability problems affect renters more than owners.

Source (s):
Statistics Canada, 2011 National Household Survey.

Crime Incidents

Definition:
The number and rate (per 100,000 population) of total Criminal Code offences, violent crimes, property crimes, and other crimes.

Source (s):
Statistics Canada, Canadian Centre for Justice Statistics, Uniform Crime Reporting Survey.

Adults and Youth Charged

Definition:
The number and rate (per 100,000 population) of youths, aged 12 to 17 years, or adults, aged 18 and over, charged with Criminal Code offences by type of offence.

Source (s):
Statistics Canada, Canadian Centre for Justice Statistics, Uniform Crime Reporting Survey.

Household food insecurity

Definition:
Food security is commonly understood to exist in a household when all people, at all times, have access to sufficient safe and nutritious food for an active and healthy life. Conversely, food insecurity occurs when food quality and/or quantity are compromised, typically associated with limited financial resources.

Recognized as an important public health issue in Canada, household food insecurity has been associated with a range of poor physical, mental health outcomes, for example, self-assessed poor/fair health, multiple chronic conditions, obesity, distress, and depression.

Source (s):
Statistics Canada, Canadian Community Health Survey.

2.3 Personal resources

Sense of community belonging

Definition:
Population aged 12 and over who reported a sense of belonging to their local community as being very strong or somewhat strong.

Research shows a high correlation of sense of community belonging with physical and mental health.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Life satisfaction

Definition:
Population aged 12 and over who reported being satisfied or very satisfied with their life in general.

Source (s):
Statistics Canada, Canadian Community Health Survey.

2.4 Environmental factors

Exposure to second-hand smoke at home

Definition:
Non-smoking population aged 12 and over who reported that at least one person smoked inside their home every day or almost every day.

Smoking includes cigarettes, cigars and pipes.

‘Passive smoking,’ or exposure to second-hand smoke, has negative respiratory health effects. Two of the most common associated diseases are lung cancer in adults and asthma among children.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Exposure to second-hand smoke in vehicles and public places

Definition:
Non-smoking population aged 12 and over who reported being exposed to second-hand smoke in private vehicles and/or public places everyday or almost every day during the past month.

Smoking includes cigarettes, cigars and pipes.

‘Passive smoking,’ or exposure to second-hand smoke, has negative respiratory health effects. Two of the most common associated diseases are lung cancer in adults and asthma among children.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Lead concentration

Definition:
Concentration of lead in the blood of the population aged 3 to 79.

Lead is a heavy metal (and known toxicant) that occurs naturally in the environment.

Source (s):
Statistics Canada, Canadian Health Measures Survey.

Bisphenol A concentration

Definition:
Concentration of bisphenol A in the urine of the population aged 3 to 79.

Bisphenol A (BPA) is an industrial chemical used primarily in the production of polycarbonate plastic (such as food containers and water bottles) and epoxy resins (commonly used in protective linings for canned food, coatings on metal lids of glass bottles/jars, and dental sealants).

Source (s):
Statistics Canada, Canadian Health Measures Survey.

Mercury concentration

Definition:
Concentration of mercury in the blood of the population aged 3 to 79.

Mercury is a heavy metal that occurs naturally in the environment and exists in three forms: elemental, inorganic and organic.

Source (s):
Statistics Canada, Canadian Health Measures Survey.

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