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Health behaviours are influenced by the social, cultural and physical environments in which we live and work. They are shaped by individual choices and external constraints. Positive behaviours help promote health and prevent disease, while the opposite is true for risk behaviours. By monitoring health behaviours over time it is possible to anticipate threats to population health, identify sectors of the population most in need of public health intervention, and evaluate the effectiveness of public health policies.
To capture patterns of behaviour in Canada, four indicators are presented: two health risk behaviours, and two associated with disease prevention. The first looks at smokers, identifying the proportion of the population who smoke either daily or occasionally. Despite the known dangers of tobacco, millions of Canadians continue to smoke. They have a higher risk of developing lung cancer, high blood pressure, heart disease, and other life-threatening conditions.
The second health behaviour indicator is heavy drinking, what is sometimes called "binge drinking." In the short term, excessive drinking can lead to poisoning and death and has been associated with other health risk behaviours such as unprotected sex and driving under the influence, particularly among young people1,2. The consequences—unwanted pregnancies, sexually transmitted diseases, motor vehicle collisions—have implications for the health of individuals, their families and the community as a whole. Over the long term, repeated, excessive alcohol consumption may lead to cirrhosis of the liver.
While some behaviours jeopardize health, physical activity and fruit and vegetable consumption promote health and help ward off chronic conditions. The first of these positive health indicators monitors the percentage of Canadians who are either active or moderately active during their leisure time. Exercise helps reduce overweight and obesity and over the life–course, contributes to cardiovascular and musculoskeletal fitness.
The percentage of Canadians who eat fruit and vegetables five or more times daily is another positive indicator of population health. As part of a balanced diet, adequate consumption of fruit and vegetables helps prevent overweight and obesity, diabetes and other chronic conditions.
Several patterns in the selected health behaviours have emerged among Canadians. The first is differences between males and females. Males are more likely than females to smoke and to drink heavily, and less likely to eat enough fruit and vegetables. However, males are more likely to be active during their leisure time.
As would be expected, Canadians of different ages behave differently. Perhaps most striking is the difference in smoking and heavy drinking among 18- to 24-year-olds compared with those aged 12 to 17. Young adults, particularly men, are most likely to engage in health risk behaviours. Seniors, on the other hand, measure up well compared to Canadians overall for fruit and vegetable consumption, and low levels of smoking and heavy drinking.
Over time, the health behaviours of Canadians have changed. The percentage of smokers is declining, while fruit and vegetable consumption appears to be on the rise. Change is less obvious for physical activity and heavy drinking.
Health behaviours are early indicators of population health. Because of the time lag that often occurs between certain behaviours and the development of disease, these indicators may foreshadow the future burdens and benefits of health-risk and health-promoting behaviours. Health behaviours do not occur in isolation—they are influenced and constrained by social and cultural norms. It is important that they be monitored over time to help Canadians reach and maintain optimal levels of health.
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1. Lavikainen HM, Lintonen T, Kosunen E. Sexual behavior and drinking among teenagers: a population-based study in Finland. Health Promotion International 2009;doi:10.1093/heapro/dap007.
2. Miller JW, Naimi TS, Brewer RD, et al. Binge Drinking and Associated Health Risk Behaviors Among High School Students. Pediatrics 2007;119(1)1:76-85.